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Expression of duodenase-like protein in epitheliocytes of Brunner's glands in human duodenal mucosa.  


A duodenase, a protease structurally related to human cathepsin G, was found earlier in bovine duodenal mucosa. It was demonstrated that under the influence of duodenase an enteropeptidase zymogen is activated in vitro showing the possible participation of duodenase in the cascade of activation of digestive enzymes. To identify a duodenase functional analog in human duodenum, an immunofluorescence study of duodenal mucosa was conducted by confocal microscopy using antibodies to human cathepsin G and to bovine duodenase. The previously unknown place of synthesis and secretion of cathepsin G - Paneth cells located at the bottom of Lieberkuhn crypts - was revealed. Binding of cathepsin G-specific antibodies in a rough endoplasmic reticulum zone and in the cryptal duct was observed. Duodenase-specific immunofluorescence but not that of cathepsin G was found in the epitheliocytes and secretory ducts of Brunner's glands, which are characteristic sites of duodenase biosynthesis in cattle. Binding of CD14-specific antibodies in the Brunner's glands, where the antibodies co-localized with the antibodies to duodenase, was also demonstrated. These data indicate the presence of a protein immunologically similar to duodenase in the human duodenal mucosa. Our study demonstrated the absence of its co-localization with cathepsin G in Brunner's glands. PMID:24228885

Zamolodchikova, T S; Scherbakov, I T; Khrennikov, B N; Svirshchevskaya, E V



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

SciTech Connect

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.

Fluge, G.; Aksnes, L.



Effect of the hexapeptide dalargin on ornithine decarboxylase activity in the duodenal mucosa of rats with experimental duodenal ulcer  

SciTech Connect

The authors study the effect of dalargin on ornithine decarboxylase in homogenates of the duodenal ulcer from rats with experimental duodenal ulcer induced by cysteamine. Activity of the enzyme was expressed in pmoles /sup 14/CO/sub 2//mg protein/h. Protein was determined by Lowry's method. The findings indicate that stimulation of ornithine decarboxylase and the antiulcerative effect of dalargin may be due to direct interaction of the peptide with cells of the intestinal mucosa and with enterocytes.

Yarygin, K.N.; Shitin, A.G.; Polonskii, V.M.; Vinogradov, V.A.



Dopamine receptors in human gastrointestinal mucosa  

SciTech Connect

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.

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



Ethanol-induced alterations of matrix network in the duodenal mucosa of chronic alcohol abusers  

Microsoft Academic Search

Excessive consumption of alcoholic beverages may be associated with gastrointestinal symptoms, including dyspepsia and diarrhoea.\\u000a It is not clear whether or not chronic alcohol ingestion damages the mucosa of the small intestine. We investigated the effect\\u000a of chronic alcohol abuse on the duodenal mucosa, and particularly on its extracellular matrix (ECM) network. Duoenal biopsy\\u000a specimens were obtained during upper gastrointestinal

A. Casini; Andrea Galli; Antonio Calabro’; S. Di Lollo; Barbara Orsini; L. Arganini; Anne M. Jezequel; Calogero Surrenti



Optical Markers in Duodenal Mucosa Predict the Presence of Pancreatic Cancer  

E-print Network

Optical Markers in Duodenal Mucosa Predict the Presence of Pancreatic Cancer Yang Liu,1 Randall E Shah,2 Curtis Hall,2 and Vadim Backman1 Abstract Purpose: Pancreatic cancer remains one of the most architecture of the epithe- lium.We propose a novel approach to predict pancreatic cancer through

Ottino, Julio M.


CD4+ T Cell Cytokine Gene and Protein Expression in Duodenal Mucosa of Dogs with Inflammatory Bowel Disease  

PubMed Central

ABSTRACT 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

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



Cellular bicarbonate protects rat duodenal mucosa from acid-induced injury  

PubMed Central

Secretion of bicarbonate from epithelial cells is considered to be the primary mechanism by which the duodenal mucosa is protected from acid-related injury. Against this view is the finding that patients with cystic fibrosis, who have impaired duodenal bicarbonate secretion, are paradoxically protected from developing duodenal ulcers. Therefore, we hypothesized that epithelial cell intracellular pH regulation, rather than secreted extracellular bicarbonate, was the principal means by which duodenal epithelial cells are protected from acidification and injury. Using a novel in vivo microscopic method, we have measured bicarbonate secretion and epithelial cell intracellular pH (pHi), and we have followed cell injury in the presence of the anion transport inhibitor DIDS and the Cl– channel inhibitor, 5-nitro-2-(3-phenylpropylamino) benzoic acid (NPPB). DIDS and NPPB abolished the increase of duodenal bicarbonate secretion following luminal acid perfusion. DIDS decreased basal pHi, whereas NPPB increased pHi; DIDS further decreased pHi during acid challenge and abolished the pHi overshoot over baseline observed after acid challenge, whereas NPPB attenuated the fall of pHi and exaggerated the overshoot. Finally, acid-induced epithelial injury was enhanced by DIDS and decreased by NPPB. The results support the role of intracellular bicarbonate in the protection of duodenal epithelial cells from luminal gastric acid. PMID:11748264

Akiba, Yasutada; Furukawa, Osamu; Guth, Paul H.; Engel, Eli; Nastaskin, Igor; Sassani, Pejvak; Dukkipatis, Ramanath; Pushkin, Alexander; Kurtz, Ira; Kaunitz, Jonathan D.



Changes in gastric mucosa after vagotomy and gastrojejunostomy for duodenal ulcer.  

PubMed Central

Gastric mucosa was studied histologically in 141 patients. Eighty two had undergone vagotomy and gastrojejunostomy between 15 and 25 years previously for duodenal ulcer, and 59 control patients had a long history (minimum 15 years) of duodenal ulcer treated medically. No carcinoma was found in either group. Two patients with severe dysplasia and 13 patients with moderate dysplasia were found in the study group, compared with none in the control group (p less than 0.01). Intestinal metaplasia was seen in 44 (53%) of the study group and 16 (27%) of the control group (p less than 0.01). Atrophy and gastritis were more severe (p less than 0.01 for atrophy; p = 0.05 for gastritis) in the study group. Gastric mucosal changes were more severe after surgical treatment for duodenal ulcer than after medical treatment, and possibly a high incidence of gastric carcinoma may occur 25 years after vagotomy and gastrojejunostomy. PMID:6416435

Watt, P C; Sloan, J M; Kennedy, T L



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

PubMed Central

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

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



Increased tissue concentrations of 5-hydroxytryptamine in the duodenal mucosa of patients with coeliac disease.  

PubMed Central

Tissue concentrations of 5-HT have been measured in the duodenal mucosa of adults and children with coeliac disease and were found to be significantly higher than those from a control group. This finding may be associated with hyperactivity or hyperplasia of enterochromaffin (EC) cells in the duodenum of patients with coeliac disease and could also be directly related to described abnormalities of 5-HT metabolism in this disease. PMID:590848

Challacombe, D N; Dawkins, P D; Baker, P



Estrogen Regulation of Duodenal Bicarbonate Secretion and Sex-Specific Protection of Human Duodenum  

PubMed Central

BACKGROUND & AIMS The reason that women have a lower prevalence of duodenal ulcer is not clear. We investigated whether estrogen regulates human duodenal bicarbonate secretion (DBS) and whether this process accounts for sex differences in the prevalence of duodenal ulcer. METHODS We performed an epidemiological study to correlate duodenal ulcer prevalence with sex and age. Proximal DBS was measured from healthy subjects. Estrogen receptor expression was examined in human duodenal mucosa by immunoblot and immunohistochemical analyses. RESULTS Among women, the prevalence of duodenal ulcer was significantly lower than among men. The reduced prevalence was greatest among premenopausal women (20–49 years), who were 3.91–5.09-fold less likely to develop duodenal ulcers than age-matched men; the difference was reduced to ?1.32-fold among subjects 60 years or older. Premenopausal (20–29 years), but not post-menopausal (60–69 years) women, had significantly higher basal and acid-stimulated DBS than the age-matched men. Basal and acid-stimulated DBS in premenopausal women (20–29 years) were significantly higher than in post-menopausal women (60–69 years), whereas there were no significant differences in basal or acid-stimulated DBS between men that were 20–29 years old or 60–69 years old. Serum levels of estradiol changed in parallel with basal and acid-stimulated DBS during the physiological menstrual cycle in premenopausal women. 17?-estradiol-stimulated DBS was independent of age or sex. Estrogen receptors- and - were detected on plasma membrane and in cytosol of human duodenal epithelial cells. CONCLUSIONS Estrogen regulates human DBS, which could reduce the risk for duodenal ulcer in women and contribute to sex differences in prevalence of duodenal ulcer. PMID:21699784

Tuo, Biguang; Wen, Guorong; Wei, Jinqi; Liu, Xuemei; Wang, Xue; Zhang, Yalin; Wu, Huichao; Dong, Xiao; Chow, Jimmy Y.C.; Vallon, Volker; Dong, Hui



Neuroregulation of Human Nasal Mucosa  

PubMed Central

Multiple subsets of nociceptive, parasympathetic, and sympathetic nerves innervate human nasal mucosa. These play carefully coordinated roles in regulating glandular, vascular, and other processes. These functions are vital for cleaning and humidifying ambient air before it is inhaled into the lungs. The recent identification of distinct classes of nociceptive nerves with unique patterns of transient receptor potential sensory receptor ion channel proteins may account for the polymodal, chemo- and mechanicosensitivity of many trigeminal neurons. Modulation of these families of proteins, excitatory and inhibitory autoreceptors, and combinations of neurotransmitters introduces a new level of complexity and subtlety to nasal innervation. These findings may provide a rational basis for responses to air-temperature changes, culinary and botanical odorants (“aromatherapy”), and inhaled irritants in conditions as diverse as allergic and nonallergic rhinitis, occupational rhinitis, hyposmia, and multiple chemical sensitivity. PMID:19686200

Baraniuk, James N.; Merck, Samantha J.



Membrane mechanisms for electrogenic Na(+)-independent L-alanine transport in the lizard duodenal mucosa.  


The active Na(+)-independent transport of L-alanine across the duodenal mucosa of the lizard Gallotia galloti was studied in Ussing-type chambers using a computer-controlled voltage clamp. Addition of L-alanine to the Na(+)-free bathing solutions resulted in a significant L-alanine absorption (J(net)) that was paralleled by an increase in transepithelial short-circuit current (I(sc)) and potential difference (PD) without apparent changes in the tissue conductance. The concentration dependence of J(net), PD, and I(sc) displayed Michaelis-Menten kinetics. L-alanine-induced electrical changes were completely inhibited by external alkaline pH or by the H(+)-ionophore carbonyl cyanide m-chlorophenyl-hydrazone in the bathing solution. The alanine-induced electrogenicity was dependent on the presence of extracellular K(+) and could be blocked by serosal Ba(2+) or mucosal orthovanadate. These results suggest the existence of an H(+)-coupled L-alanine cotransport at the apical membrane of enterocytes. The favorable H(+) driving force is likely to be maintained by an apical vanadate-sensitive H(+)-K(+)-ATPase, allowing the extrusion of H(+) in an exchange with K(+). Potassium exit through a basolateral barium-sensitive conductance provides the key step for the electrogenicity of L-alanine absorption. PMID:10956250

Díaz, M; Medina, V; Gómez, T; Lorenzo, A



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

NASA Astrophysics Data System (ADS)

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.

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.



Gastric and duodenal mucosa in 'healthy' individuals. An endoscopic and histopathological study of 50 volunteers  

Microsoft Academic Search

The results of histological and immunohistochemical examination of gastric and duodenal biopsy specimens from 50 volunteers without a clinical history of gastrointestinal disease are reported. Multiple specimens of tissue from standard sites in the stomach and duodenum were carefully orientated, and serially sectioned for examination by light microscopy and for immunohistochemical characterisation of plasma cells within the lamina propria. The

J Kreuning; F T Bosman; G Kuiper; A M Wal; J Lindeman



Duodenal osmolality drives gallbladder emptying in humans  

Microsoft Academic Search

The effect of duodenal osmoreceptor stimulation on gallbladder motility was evaluated in 18 normal subjects during intraduodenal infusion of 280, 560 and 840 mosmlliters NaCl solutions. Gallbladder emptying was found to be dose-dependent between 560 and 840 mosm\\/liter (P,indicating that cholinergic and endorphinergic pathways may be involved in regulating this reflex. Since proglumide, a cholecystokinin (CCK) antagonist, did not affect

Stefano Fiorucci; Rachele Bosso; Antonio Morelli



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

SciTech Connect

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.

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



Cholesterol esterase activity of human intestinal mucosa  

SciTech Connect

It has been suggested that cholesterol absorption in humans is dependent on bile acid pool composition and that expansion of the cholic acid pool size is followed by an increase of the absorption values. Similar observations were reported in rats. In the present study, therefore, the authors investigated some general properties of human intestinal cholesterol esterase, with particular emphasis on the effect of bile acids on this enzymatic activity. Twenty-nine segments of small intestine were taken during operations; the enzymatic activity was studied by using mucosal homogenate as a source of enzyme and oleic acid, cholesterol, and UC-labeled cholesterol as substrates. The time-activity relationship was linear within the first two hours; optimal pH for esterification ranged between 5 and 6.2. There was little difference between the esterifying activity of the jejunal and ileal mucosa. Esterification of cholesterol was observed with all the investigated fatty acids but was maximal with oleic acid. Bile acids did not affect cholesterol esterase activity when present in the incubation mixture at 0.1 and 1.0 mM; the enzymatic activity, however, was significantly inhibited when bile acids were added at 20 mM. In conclusion, this study has shown that the human intestinal mucosa possesses a cholesterol esterase activity; at variance with the rat, however, the human enzyme does not seem to be stimulated by trihydroxy bile acids.

Ponz de Leon, M.; Carubbi, F.; Di Donato, P.; Carulli, N.



Irritative properties of two clinical potassium chloride formulations on duodenal mucosa of the cat and esophageal mucosa of the opossum.  


The local gastrointestinal irritating properties of microencapsulated KCl (M-E), a new and unique form of KCl (8 meq potassium per capsule), were compared with a wax-matrix (W-M) KCl formulation (8 meq potassium per tablet). Normal saline in 0-size gelatin capsules was used as the control substance. The comparisons were made in two animal models that simulate the condition of partial obstruction of the gastrointestinal tract in humans. These models are the duodenum of the cat and the esophagus of the opossum, each with a surgically created partial obstruction. The tissues were exposed to two capsules or tablets of KCl or saline for 4 hr, and the extent of tissue injury assessed by using a rating scale. The irritation caused by M-E was significantly (P less than 0.05) less than that caused by W-M in both the cat and the opossum, and it was not significantly (P greater than 0.05) different from the injury caused by saline in either model. The relative lack of irritation by M-E is probably explained by the fact that there was a significantly (P less than 0.05) greater dispersion of KCl from the M-E capsule than from the W-M tablet. PMID:6723482

Alphin, R S; O'Dell, S W; Sancilio, L F; Ward, J W



Human vaginal mucosa as a model of buccal mucosa for in vitro permeability studies: an overview.  


The buccal cavity is attractive for noninvasive, controlled transmucosal delivery of both local and systemic therapeutically active compounds. Administering drugs via this route is advantageous due to the rich vasculature of the oral mucosa, and the absence of gastrointestinal and "first-pass" hepatic degradation. Moreover, the barrier properties of the oral mucosa against noxious substances and its role in disease require further investigation. However, the scarcity of sizeable specimens of human oral mucosa for in vitro experimental studies has hampered research on this tissue. For this reason we developed a model in which human vaginal mucosa is used as a substitute for buccal mucosa. In this article the quality and predictive value of the human vaginal/buccal in vitro model with respect to a number of drugs and other chemical compounds differing widely in molecular size and lipophilicity, including water, arecoline, arecaidine, benzo[a]pyrene, 17beta-estradiol, sumatriptan, vasopressin and dextrans, are reviewed. In addition some applications of the model for investigating the effect of areca nut extract on epithelial barrier properties, temperature effects on water and 17beta-estradiol flux rates, and cyclosporin diffusion through mucosal membranes are described. The permeability characteristics of vaginal mucosa, as a model of buccal mucosa, are compared with those of other human tissue, including mucosae from the small intestine and colon. PMID:16305378

van der Bijl, Pieter; van Eyk, Armorel D



Human dirofilariasis of the buccal mucosa: a case report  

Microsoft Academic Search

Human dirofilariasis is a helminthic zoonosis that is common in some parts of the world. A sporadic case of dirofilariasis affecting the buccal mucosa has been reported in a non-endemic area of southern China. Clinical findings, diagnosis, pathogenesis and management are discussed. This is the fourth case of human dirofilariasis involving the oral mucosa reported in world literature.

E. W. H To; W. M Tsang; K. F Chan



Transitional mucosa in human colorectal lesions  

Microsoft Academic Search

Mucosa adjacent to colorectal disease was studied mucinhistochemically. Selected specimens were also studied immunohistochemically for carcinoembryonic antigen (CEA). Transitional mucosa, which showed elongation of crypts and marked sialomucin secretion, accompanied by a marked reduction in the normal sulfomucin content, was evident in 96 of 100 carcinomas (96 percent), 18 of 36 adenomas (50 percent), and 10 of 30 metaplastic polyps

Masaki Mori; Reishi Shimono; Yosuke Adachi; Hiroyuki Matsuda; Hiroyuki Kuwano; Keizo Sugimachi; Masahito Ikeda; Motonori Saku



Comparative permeability of human vaginal and buccal mucosa to water.  


There is currently a resurgence of interest in the oral mucosa as a route for drug delivery. The relative scarcity of human oral mucosa for in vitro permeability studies, and the fact that vaginal mucosa is histologically similar and more abundant than the former, caused us to compare these 2 tissues with respect to their barrier properties to water. Specimens of fresh, clinically-healthy human vaginal and buccal mucosa from non-smokers were taken from excised tissue obtained during vaginal hysterectomies and various oral surgical procedures. Biopsies from each specimen were mounted in flow-through diffusion cells and their permeability to tritiated water determined using a continuous flow-through perfusion system. Specimens were examined histologically before and after permeability experiments and similarities between vaginal and buccal tissues verified. No statistically significant differences between mean steady state flux values (10-16 h) for vaginal and buccal mucosa, respectively, were found. Human vaginal mucosa is therefore as permeable as buccal mucosa to water, and these results warrant further investigation with other compounds to establish whether vaginal mucosa may be a useful model for buccal mucosa for drug permeability studies. PMID:9469607

van der Bijl, P; Thompson, I O; Squier, C A



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

PubMed Central

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

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



[Effects of histamine H2-receptor blockers and dalargin on reparative processes gastroduodenal mucosa in patients with duodenal ulcer].  


The effect of synthetic opiate peptide dalargin, histamine H2-receptors blockers (cimetidin, famotidin) and combination of dalargin with famotidin on proliferative activity of gastroduodenal mucosal epithelium has been studied autoradiographically (3H-thymidine) in 75 patients with duodenal ulcer. Compared to spasmolytics and antacids, the studied drugs (dalargin, cimetidin and famotidin) significantly increased the number of DNA-synthetizing cells in the epithelium of fundal stomach, duodenal cap and ulcer borders. Maximal effect was noticed in combined use of dalargin and famotidin. A correlation existed between clinical and stimulating reparative effect of the drugs. PMID:9121092

Alekseenko, S A; Timoshin, S S



Characterizing lamina propria of human gastric mucosa by multiphoton microscopy  

NASA Astrophysics Data System (ADS)

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 ?ex = 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.

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



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

PubMed Central

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

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



Characterization of duodenal expression and localization of fatty acid-sensing receptors in humans: relationships with body mass index.  


Fatty acids (FAs) stimulate the secretion of gastrointestinal hormones, including cholecystokinin (CCK) and glucagon like peptide-1 (GLP-1), which suppress energy intake. In obesity, gastrointestinal responses to FAs are attenuated. Recent studies have identified a key role for the FA-sensing receptors cluster of differentiation (CD)36, G protein-coupled receptor (GPR)40, GPR120, and GPR119 in mediating gastrointestinal hormone secretion. This study aimed to determine the expression and localization of these receptors in the duodenum of humans and to examine relationships with obesity. Duodenal mucosal biopsies were collected from nine lean [body mass index (BMI): 22 ± 1 kg/m(2)], six overweight (BMI: 28 ± 1 kg/m(2)), and seven obese (BMI: 49 ± 5 kg/m(2)) participants. Absolute levels of receptor transcripts were quantified using RT-PCR, while immunohistochemistry was used for localization. Transcripts were expressed in the duodenum of lean, overweight, and obese individuals with abundance of CD36>GPR40>GPR120>GPR119. Expression levels of GPR120 (r = 0.46, P = 0.03) and CD36 (r = 0.69, P = 0.0004) were directly correlated with BMI. There was an inverse correlation between expression of GPR119 with BMI (r(2) = 0.26, P = 0.016). Immunolabeling studies localized CD36 to the brush border membrane of the duodenal mucosa and GPR40, GPR120, and GPR119 to enteroendocrine cells. The number of cells immunolabeled with CCK (r = -0.54, P = 0.03) and GLP-1 (r = -0.49, P = 0.045) was inversely correlated with BMI, such that duodenal CCK and GLP-1 cell density decreased with increasing BMI. In conclusion, CD36, GPR40, GPR120, and GPR119 are expressed in the human duodenum. Transcript levels of duodenal FA receptors and enteroendocrine cell density are altered with increasing BMI, suggesting that these changes may underlie decreased gastrointestinal hormone responses to fat and impaired energy intake regulation in obesity. PMID:25258406

Little, Tanya J; Isaacs, Nicole J; Young, Richard L; Ott, Raffael; Nguyen, Nam Q; Rayner, Christopher K; Horowitz, Michael; Feinle-Bisset, Christine



Epithelial cell proliferation in human fundic and antral mucosae. Influence of superselective vagotomy and relationship with gastritis  

SciTech Connect

Epithelial cell proliferation in the fundic and antral mucosae was studied in 19 duodenal ulcer patients, 11 patients having undergone fundic superselective vagotomy for duodenal ulcer, and 10 controls. This was achieved through in vitro incorporation of tritiated thymidine in mucosal biopsies and radioautography. Except for increased fundic mucosal height, duodenal ulcer patients did not differ from controls for all parameters studied. In vagotomized patients, as compared to the other two groups, the labeling index was significantly enhanced in the innervated antral mucosa where atrophic gastritis developed, but there was no change in the labeling index and no worsening of mucosal inflammation in the denervated fundic mucosa. The only abnormality in the latter was a striking expansion, towards the surface, of the proliferative area within the fundic pit. The labeling indices and the degree of gastritis in gastric mucosae are significantly correlated in control and duodenal ulcer patients. If findings in antral mucosa, after superselective vagotomy, seemed related to gastritis lesions, those in fundic mucosa were not and may indicate an alteration due to the vagotomy per se.

Gutierrez, O.; Lehy, T.; Rene, E.; Gres, L.; Bonfils, S.



Effects of glucagon-like peptide-1(7-36)amide on antro-pyloro-duodenal motility in the interdigestive state and with duodenal lipid perfusion in humans  

PubMed Central

BACKGROUND—Glucagon-like peptide-1(7-36)amide (GLP-1) is a gut hormone released postprandially. Synthetic GLP-1 strongly inhibits gastric emptying in healthy subjects and in patients with diabetes mellitus.?AIMS—To investigate the effects of GLP-1 on antro-pyloro-duodenal motility in humans.?METHODS—Eleven healthy male volunteers were studied on two separate days. On the interdigestive study day, a basal period was followed by a 60 minute period of saline infusion and two further 60 minute periods of intravenous infusion of GLP-1 0.4 and 1.2 pmol/kg/min to achieve postprandial and supraphysiological plasma levels, respectively. On the postprandial study day, the same infusions were coadministered with intraduodenal lipid perfusion at 2.5 ml/min (2.5 kcal/min) followed by another 60 minutes of recording after cessation of GLP-1. Antro-pyloro-duodenal motility was measured by perfusion manometry.?RESULTS—GLP-1 significantly inhibited the number and amplitudes of antral and duodenal contractions in the interdigestive state and after administration of duodenal lipid. It abolished interdigestive antral wave propagation. In the interdigestive state, GLP-1 dose dependently increased pyloric tone and significantly stimulated isolated pyloric pressure waves (IPPW). Pyloric tone increased with duodenal lipid, and this was further enhanced by GLP-1. GLP-1 transiently restored the initial IPPW response to duodenal lipid which had declined with lipid perfusion. Plasma levels of pancreatic polypeptide were dose dependently diminished by GLP-1 with and without duodenal lipid.?CONCLUSIONS—GLP-1 inhibited antro-duodenal contractility and stimulated the tonic and phasic motility of the pylorus. These effects probably mediate delayed gastric emptying. Inhibition of efferent vagal activity may be an important mechanism. As postprandial plasma levels of GLP-1 are sufficient to appreciably affect motility, we believe that endogenous GLP-1 is a physiological regulator of motor activity in the antro-pyloro-duodenal region.???Keywords: GLP-1; gastrointestinal motility; pylorus; pancreatic polypeptide PMID:10764704

Schirra, J; Houck, P; Wank, U; Arnold, R; Goke, B; Katschinski, M



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

SciTech Connect

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 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.

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



Permeation of 17beta-estradiol through human vaginal and buccal mucosa.  


Because of the relative scarcity of fresh human oral mucosa specimens for permeability studies, we investigated the use of human vaginal mucosa as a model of the former. In a previous study we demonstrated the comparable diffusion rate of water across human vaginal and buccal mucosa and proposed the use of the former as a suitable model of the latter for in vitro drug permeability studies. To further evaluate the human vaginal/buccal mucosa model, we decided to compare these two tissues with respect to their permeability to 17beta-estradiol. Clinically healthy human vaginal and buccal mucosa specimens were obtained during vaginal hysterectomies and different oral surgical procedures. The permeability of each tissue specimen to 17beta-estradiol was determined through the use of a continuous flow-through diffusion system. Specimens were examined histologically before and after experiments. Mean flux values for 17beta-estradiol across human buccal mucosa tended to be slightly higher than those observed for vaginal tissue, but no statistically significant differences could be demonstrated. The results from this study further support our hypothesis that human vaginal mucosa may be a suitable model of human buccal mucosa for in vitro drug permeability studies. PMID:9574947

van der Bijl, P; van Eyk, A D; Thompson, I O



Duodenal atresia  


... 20-30% of infants with duodenal atresia have Down syndrome. Duodenal atresia is often associated with other birth ... abnormality. Associated problems (such as those related to Down syndrome) must be treated as appropriate.


Intraoral Grafting of Tissue-Engineered Human Oral Mucosa  

PubMed Central

Purpose The primary objective of this study was to evaluate the safety of a tissue-engineered human ex vivo–produced oral mucosa equivalent (EVPOME) in intraoral grafting procedures. The secondary objective was to assess the efficacy of the grafted EVPOME in producing a keratinized mucosal surface epithelium. Materials and Methods Five patients who met the inclusion criteria of having one mucogingival defect or a lack of keratinized gingiva on a nonmolar tooth, along with radiographic evidence of sufficient interdental bone height, were recruited as subjects to increase the width of keratinized gingiva at the defect site. A punch biopsy specimen of the hard palate was taken to acquire oral keratinocytes, which were expanded, seeded, and cultured on an acellular dermal matrix for fabrication of an EVPOME. EVPOME grafts were applied directly over an intact periosteal bed and secured in place. At baseline (biopsy specimen retrieval) and at 7, 14, 30, 90, and 180 days postsurgery, Plaque Index and Gingival Index were recorded for each subject. In addition, probing depths, keratinized gingival width, and keratinized gingival thickness were recorded at baseline, 30, 90, and 180 days. Results No complications or adverse reactions to EVPOME were observed in any subjects during the study. The mean gain in keratinized gingival width was 3 mm (range, 3 to 4 mm). The mean gain in keratinized gingival thickness was 1 mm (range, 1 to 2 mm). No significant changes in probing depths were observed. Conclusion Based on these findings, it can be concluded that EVPOME is safe for intraoral use and has the ability to augment keratinized tissue around teeth. Future clinical trials are needed to further explore this potential. PMID:24066347

Izumi, Kenji; Neiva, Rodrigo F.; Feinberg, Stephen E.




Microsoft Academic Search

Merkel cells identical to those described in the skin were found in the gingival mucosa and in the vermilion border of the lip. They were often clustered in rete ridges but also found individually in the basal layer. Unmyelinated axons (neurites) of presumably a sensory afferent nerve surrounded the basal half of these cells within the epithelium. Occasional desmosomes connected

Ken Hashimoto



Laser capture microdissection and metagenomic analysis of intact mucosa-associated microbial communities of human colon  

Microsoft Academic Search

Metagenomic analysis of colonic mucosa-associated microbes has been complicated by technical challenges that disrupt or alter\\u000a community structure and function. In the present study, we determined the feasibility of laser capture microdissection (LCM)\\u000a of intact regional human colonic mucosa-associated microbes followed by phi29 multiple displacement amplification (MDA) and\\u000a massively parallel sequencing for metagenomic analysis. Samples were obtained from the healthy

Yunwei Wang; Dionysios A. Antonopoulos; Xiaorong Zhu; Laura Harrell; Ira Hanan; John C. Alverdy; Folker Meyer; Mark W. Musch; Vincent B. Young; Eugene B. Chang



The color of human gingiva and mucosa: visual measurement and description of distribution  

Microsoft Academic Search

No soft tissue shade guide is available for matching the color of denture resins to human intraoral soft tissues. To determine\\u000a the color of both the gingiva and the alveolar mucosa, intraoral soft tissue colors of 150 men and women were assessed under\\u000a standardized lighting conditions. Colors of the papilla, attached gingiva, and alveolar mucosa in the central incisor region

Guido Heydecke; Stefan Schnitzer; Jens C. Türp



Nasal challenge with diesel exhaust particles can induce sensitization to a neoallergen in the human mucosa  

Microsoft Academic Search

Background: Diesel exhaust particles (DEPs) increase in vivo IgE and cytokine production at the human upper respiratory mucosa, exacerbating allergic inflammation. Objective: We examined the ability of DEP exposure to lead to primary sensitization of humans by driving a de novo mucosal IgE response to a neoantigen, keyhole limpet hemocyanin (KLH). Methods: Ten atopic subjects were given an initial nasal

David Diaz-Sanchez; Marisol Penichet Garcia; Margaret Wang; Minna Jyrala; Andrew Saxon



Effect of vasoactive intestinal peptide on cyclic adenosine monophosphate production in enterocytes isolated from human duodenal biopsy specimens.  

PubMed Central

A modification of a cell isolation technique used in animal studies was developed to remove enterocytes from duodenal biopsy specimens. Citrate-ethylenediaminetetra-acetic acid treatment removed enterocytes from any underlying lamina propria and produced single cells and strips of cells. A mean (SEM) of 4.39 (2.06) x 10(6) cells was obtained from nine duodenal biopsy specimens. Enterocyte recovery was estimated enzymatically using alkaline phosphatase activity and was found to be 61%. Cytological assessment of the cells with CAM 5.2 showed that 98% of the cells isolated were enterocytes with an intact brush border. The cells responded well to vasoactive intestinal peptide stimulation in the absence of an exogenously added adenosine triphosphate regenerating system. The addition of vasoactive intestinal peptide to duodenal enterocytes produced a biphasic dose dependent increase in cyclic adenosine monophosphate production. Stimulation of these cells with 10(-13)M vasoactive intestinal peptide resulted in a 50% stimulation over basal value while 10(-6)M vasoactive intestinal peptide led to a fivefold increase in cyclic adenosine monophosphate production. We conclude that duodenal biopsy specimens are a good source of human intestinal cells for the study of enterocyte physiology. The cells were viable and highly responsive to vasoactive intestinal peptide. Images Figure 1 Figure 2 PMID:2176169

Smith, J A; Griffin, M; Mireylees, S E; Long, R G




PubMed Central

SUMMARY Nasal mucosa is innervated by multiple subsets of nociceptive, parasympathetic and sympathetic nerves. These play carefully coordinated roles in regulating glandular, vascular and other processes. These functions are vital for cleaning and humidifying ambient air before it is inhaled into the lungs. The recent recognition of distinct classes of nociceptive nerves with unique patterns of sensory receptors that include seven transmembrane G-protein coupled receptors, new families of transient receptor potential and voltage and calcium gated ion channels, and combinations of neurotransmitters that can be modulated during inflammation by neurotrophic factors has revolutionized our understanding of the complexity and subtlety of nasal innervation. These findings may provide a rational basis for responses to air temperature changes, culinary and botanical odorants (“aromatherapy”), and inhaled irritants in conditions as diverse as idiopathic nonallergic rhinitis, occupational rhinitis, hyposmia, and multiple chemical sensitivity. PMID:19623876

Baraniuk, James N.; Merck, Samantha J.



Sample taking problems in measuring actual histamine levels of human gastroduodenal mucosa: specific and general relevance in clinical trials on peptic ulcer pathogenesis and selective proximal vagotomy.  

PubMed Central

Changes in histamine storage in the oxyntic mucosa of duodenal ulcer patients and their reversal by vagotomy and the histamine H2-antagonist cimetidine supported the hypothesis that histamine could be a causal factor in peptic ulcer pathogenesis. The specificity of these findings was impaired by problems in biopsy taking, however, and in the preparative steps before measuring the actual histamine contents in all parts of the gastric mucosa and in the duodenum. A prospective trial was carried out in 190 patients to identify these sources of bias and to overcome them by appropriate study designs. Usually a direct correlation was found between weight of biopsy and mucosal histamine content. This problem was solved by selecting a biopsy forceps producing smaller variations in sample size, by limiting the time of cold ischaemia to four to five minutes only and by taking three biopsy specimens for each single histamine value. The actual histamine content of mucosal biopsies remained constant for about four to five minutes only. The 'disappearance' rate was faster in control subjects than in duodenal ulcer patients. Hence by variation of the cold ischaemia time any artefacts of differences between mucosal histamine levels in controls and duodenal ulcer patients could be produced. Using the optimised sample taking procedure mucosal histamine contents of several gastric regions and the duodenal bulb were measured in 24 patients with duodenal ulcer, after selective proximal vagotomy without drainage and in control subjects without any stomach disease (randomised controlled trial). The histamine content was lower in all parts of the upper gastrointestinal tract in duodenal ulcer patients than in controls and was raised again in all regions after selective proximal vagotomy. As the most likely hypothesis it is suggested that vagal reflexes with afferent fibres coming from the oxyntic mucosa stimulate histamine release in duodenal ulcer patients by efferent peptidergic neurones to all parts of the stomach and the duodenum where the ulcer lesion is situated. PMID:3905529

Thon, K P; Lorenz, W; Ohmann, C; Weber, D; Rohde, H; Roher, H D



In vitro adherence of type 1-fimbriated uropathogenic Escherichia coli to human ureteral mucosa.  

PubMed Central

Type 1-fimbriated Escherichia coli isolated from patients with urinary tract infections adhered in vitro to the epithelial cell surface of an excised human ureter. The bacteria also adhered to a mucous coating and to Formalin-fixed human ureteral mucosa. D-Mannose strongly inhibited such adherence. The bacteria in their nonfimbriated phase lacked the ability to adhere. We concluded that type 1 fimbriae play a role, at least in part, in upper urinary tract infections in humans. Images PMID:2568346

Fujita, K; Yamamoto, T; Yokota, T; Kitagawa, R



Transforming Gene from Human Stomach Cancers and a Noncancerous Portion of Stomach Mucosa  

Microsoft Academic Search

DNAs from 21 human stomach cancers, 16 metastatic stomach cancers to lymph nodes, and 21 apparently noncancerous specimens of stomach mucosae from a total of 26 patients with stomach cancer were tested for their ability to induce neoplastic transformation of NIH 3T3 cells on transfection by the calcium phosphate precipitation technique. Three samples of DNA were shown to have transforming

Hiromi Sakamoto; Midori Mori; Masanori Taira; Teruhiko Yoshida; Saeko Matsukawa; Kenji Shimizu; Mutsuo Sekiguchi; Masaaki Terada; Takashi Sugimura



Diffusion Studies of Nanometer Polymersomes Across Tissue Engineered Human Oral Mucosa  

Microsoft Academic Search

Purpose  To measure the diffusion of nanometer polymersomes through tissue engineered human oral mucosa.\\u000a \\u000a \\u000a \\u000a Methods  \\u000a In vitro models of full thickness tissue engineered oral mucosa (TEOM) were used to assess the penetration properties of two chemically\\u000a different polymersomes comprising two of block copolymers, PMPC-PDPA and PEO-PDPA. These copolymers self-assemble into membrane-enclosed\\u000a vesicular structures. Polymersomes were conjugated with fluorescent rhodamine in order

Vanessa Hearnden; Hannah Lomas; Sheila MacNeil; Martin Thornhill; Craig Murdoch; Andrew Lewis; Jeppe Madsen; Adam Blanazs; Steve Armes; Giuseppe Battaglia



Microvascular corrosion casting of normal tissue, transitional mucosa and adenocarcinoma in the human colon.  


The microcirculatory architecture of normal tissue, transitional mucosa and adenocarcinoma of the human colon was investigated with microvascular corrosion casting (MVCC) combined with scanning electron microscopy (SEM). The study showed that the capillaries within the normal mucosa were arranged in a regular hexagonal pattern around the mucosal glands and that the microvessels of transitional mucosa mostly had lost the typical hexagonal pattern and become slightly wider in diameter. The microvessels in the tumor periphery were increased in number and disorganized, and presented large variation in morphology with claw-like formations, widened sinuses, diverticula and appendixoid patterns. Microvessels were lacking in the central areas of tumors. These morphological alterations may serve as additional indicators of tumor development. PMID:1586502

Sun, X F; Zhang, H; Wu, X C; Han, Y M; Hou, G Q; Xian, M S



Oxidative-stress-related proteome changes in Helicobacter pylori-infected human gastric mucosa.  

PubMed Central

Helicobacter pylori infection leads to gastroduodenal inflammation, peptic ulceration and gastric carcinoma. Proteomic analysis of the human gastric mucosa from the patients with erosive gastritis, peptic ulcer or gastric cancer, which were either infected or not with H. pylori, was used to determine the differentially expressed proteins by H. pylori in the human gastric mucosa in order to investigate the pathogenic mechanism of H. pylori -induced gastric diseases. Prior to the experiment, the expression of the main 18 proteins were identified in the gastric mucosa and used for a proteome map of the human gastric mucosa. Using two-dimensional electrophoresis of the protein isolated from the H. pylori -infected tissues, Coomassie Brilliant Blue staining and computerized analysis of the stained gel, the expression of eight proteins were altered in the H. pylori -infected tissues compared with the non-infected tissues. MS analysis (matrix-assisted laser desorption/ionization-time of flight MS) of the tryptic fragment and a data search allowed the the identification of the four increased proteins (78 kDa glucose-regulated protein precursor, endoplasmin precursor, aldehyde dehydrogenase 2 and L-lactate dehydrogenase B chain) and the four decreased proteins (intracellular chloride channel protein 1, glutathione S-transferase, heat-shock protein 60 and cytokeratin 8) caused by H. pylori infection in the gastric mucosa. These proteins are related to cell proliferation, carcinogenesis, cytoskeletal function and cellular defence mechanism. The common feature is that these proteins are related to oxidative-stress-mediated cell damage. In conclusion, the established gastric mucosal proteome map might be useful for detecting the disease-related protein changes. The H. pylori -induced alterations in protein expression demonstrate the involvement of oxidative stress in the pathogenesis of H. pylori -induced gastric diseases, including inflammation, ulceration and carcinogenesis. PMID:14711373

Baek, Hye Yeon; Lim, Joo Weon; Kim, Hyeyoung; Kim, Jung Mogg; Kim, Joo Sung; Jung, Hyun Chae; Kim, Kyung Hwan



Characterisation of human dental stem cells and buccal mucosa fibroblasts  

Microsoft Academic Search

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),

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



An engineered 3D human airway mucosa model based on an SIS scaffold.  


To investigate interrelations of human obligate airway pathogens, such as Bordetella pertussis, and their hosts test systems with high in vitro/in vivo correlation are of urgent need. Using a tissue engineering approach, we generated a 3D test system of the airway mucosa with human tracheobronchial epithelial cells (hTEC) and fibroblasts seeded on a clinically implemented biological scaffold. To investigate if hTEC display tumour-specific characteristics we analysed Raman spectra of hTEC and the adenocarcinoma cell line Calu-3. To establish optimal conditions for infection studies, we treated human native airway mucosa segments with B. pertussis. Samples were processed for morphologic analysis. Whereas our test system consisting of differentiated epithelial cells and migrating fibroblasts shows high in vitro/in vivo correlation, hTEC seeded on the scaffold as monocultures did not resemble the in vivo situation. Differences in Raman spectra of hTEC and Calu-3 were identified in distinct wave number ranges between 720 and 1662 cm(-1) indicating that hTEC do not display tumour-specific characteristics. Infection of native tissue with B. pertussis led to cytoplasmic vacuoles, damaged mitochondria and destroyed epithelial cells. Our test system is suitable for infection studies with human obligate airway pathogens by mimicking the physiological microenvironment of the human airway mucosa. PMID:24912816

Steinke, Maria; Gross, Roy; Walles, Heike; Gangnus, Rainer; Schütze, Karin; Walles, Thorsten



Characteristics of adherence of enteroaggregative Escherichia coli to human and animal mucosa.  

PubMed Central

An Escherichia coli strain (serotype O127a:H2) that had been isolated from a child with diarrhea in Thailand and that was negative for the virulence factors of the four categories of diarrheagenic E. coli (enterotoxigenic, enteropathogenic, enteroinvasive, and enterohemorrhagic) and that showed an aggregative pattern of adherence to HeLa cells was investigated for adherence to native or Formalin-fixed human and animal mucosa. The hemagglutinating activity and adherence ability of the bacteria were resistant to D-mannose and were strictly regulated by environmental conditions. Genetic data supported the close relation between the hemagglutinating activity and adherence ability. In accordance with the adherence pattern on tissue-cultured cells, the bacteria adhered to human and animal mucosa, as evidenced by a direct gold-labeling analysis. In human intestines, Formalin-fixed mucous coatings, epithelial cells of colonic mucosa, epithelial cells of ileal single lymphoid follicles and Peyer's patches, and the absorptive cells of jejunal or ileal villi provided adherence targets. Adherence to M cells in the Peyer's patch-associated epithelium was also confirmed. The adherence levels to native jejunal or ileal human villi were low, as was the case with the corresponding Formalin-fixed villi. In human urinary tract, the superficial epithelial cells of both native and Formalin-fixed ureter provided striking adherence targets. In animal (porcine and rabbit) small intestines, the bacteria adhered to the native villi to a lesser extent than to the Formalin-fixed villi. The adherence levels were compared with those of enterotoxigenic E. coli with colonization factor antigen (CFA)/I pili or CFA/II pili. The data suggested unique mucosa adherence characteristics of the enteroaggregative E. coli strain. The possibility of the adherence ability as a virulence factor was discussed. Images PMID:1680107

Yamamoto, T; Endo, S; Yokota, T; Echeverria, P



Glycoconjugate distribution in the human fundic mucosa revealed by lectin- and glycoprotein-gold cytochemistry  

Microsoft Academic Search

The glycoconjugates of the human fundic mucosa were characterized at the ultrastructural level by means of direct (Helix pomatia agglutinin-gold complex) and indirect lectin techniques (Concanavalin A and horseradish peroxidase-gold complex; wheat germ agglutinin and ovomucoid-gold complex). Surface mucous cells and mucous neck cells secreted O-glycoproteins with N-acetylgalactosamine and N-acetylglucosamine residues at the non reducing terminus of the saccharidic chain.

J. F. Madrid; J. Ballesta; M. T. Castells; F. Hernández



Profiling of Olfactory Receptor Gene Expression in Whole Human Olfactory Mucosa  

PubMed Central

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

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



Binding and Transfer of Human Immunodeficiency Virus by DC-SIGN+ Cells in Human Rectal Mucosa  

PubMed Central

The role of DC-SIGN on human rectal mucosal dendritic cells is unknown. Using highly purified human rectal mucosal DC-SIGN+ cells and an ultrasensitive real-time reverse transcription-PCR assay to quantify virus binding, we found that HLA-DR+/DC-SIGN+ cells can bind and transfer more virus than the HLA-DR+/DC-SIGN? cells. Greater than 90% of the virus bound to total mucosal mononuclear cells (MMCs) was accounted for by the DC-SIGN+ cells, which comprise only 1 to 5% of total MMCs. Significantly, anti-DC-SIGN antibodies blocked 90% of the virus binding when more-physiologic amounts of virus inoculum were used. DC-SIGN expression in the rectal mucosa was significantly correlated with the interleukin-10 (IL-10)/IL-12 ratio (r = 0.58, P < 0.002; n = 26) among human immunodeficiency virus (HIV)-positive patients. Ex vivo and in vitro data implicate the role of IL-10 in upregulating DC-SIGN expression and downregulating expression of the costimulatory molecules CD80/CD86. Dendritic cells derived from monocytes (MDDCs) in the presence of IL-10 render the MDDCs less responsive to maturation stimuli, such as lipopolysaccharide and tumor necrosis factor alpha, and migration to the CCR7 ligand macrophage inflammatory protein 3?. Thus, an increased IL-10 environment could render DC-SIGN+ cells less immunostimulatory and migratory, thereby dampening an effective immune response. DC-SIGN and the IL-10/IL-12 axis may play significant roles in the mucosal transmission and pathogenesis of HIV type 1. PMID:15827191

Gurney, Kevin B.; Elliott, Julie; Nassanian, Hoorig; Song, Carol; Soilleux, Elizabeth; McGowan, Ian; Anton, Peter A.; Lee, Benhur



Portal hypertensive duodenal polyp: A case report  

PubMed Central

Abnormalities of gastric mucosa in patients with portal hypertension are well documented. Manifestations of portal hypertension in small bowel and colon are less common. Colonic polypoid lesions microscopically consisting of a normal mucosa, with dilatation of submucosal vessels, have been described. We here report the first case of portal hypertensive duodenal polyp, responsible for gastro-intestinal bleeding. Endoscopic treatment turned out to be successful. PMID:17457981

Zeitoun, Jean-David; Chryssostalis, Ariane; Terris, Benoit; Prat, Frederic; Gaudric, Marianne; Chaussade, Stanislas



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

SciTech Connect

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.

Lee, Kang Kyoo [Department of Radiation Oncology, University of Wonkwang School of Medicine, Iksan (Korea, Republic of); Jo, Hyang Jeong [Department of Pathology, University of Wonkwang School of Medicine, Iksan (Korea, Republic of); Hong, Joon Pio [Department of Plastic and Reconstructive Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Lee, Sang-wook [Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)], E-mail:; Sohn, Jung Sook [Vestibulocochlear Research Center, University of Wonkwang School of Medicine, Iksan (Korea, Republic of); Moon, Soo Young [Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Yang, Sei Hoon; Shim, Hyeok [Department of Internal Medicine, University of Wonkwang School of Medicine, Iksan (Korea, Republic of); Lee, Sang Ho [Department of Radiology, Iksan General Hospital, Iksan (Korea, Republic of); Ryu, Seung-Hee [Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Moon, Sun Rock [Department of Radiation Oncology, University of Wonkwang School of Medicine, Iksan (Korea, Republic of)



Imaging diagnosis--duodenal diverticulum in a dog.  


A young female Boxer had a history of chronic soft stool. Survey abdominal radiographs were unremarkable. A duodenal diverticulum was identified in abdominal ultrasound and barium upper-gastrointestinal contrast examinations. Before surgery a 99mTc-pertechnetate study was performed to evaluate for ectopic gastric mucosa in the duodenal diverticulum. Focal abnormal increased radioactivity was identified in the right caudal abdominal quadrant. The diverticulum was excised. Upon histopathologic examination of the duodenal diverticulum, ectopic gastric mucosa was not identified but ectopic pancreatic tissue was found. Mild eosinophilic inflammation within the diverticulum was suspected to be the cause of the mild 99mTc uptake seen in this dog. PMID:20166396

Polf, Holly; Poteet, Brian



Duodenal adenocarcinoma: why the extreme rarity of duodenal bulb primary tumors?  


Adenocarcinoma of the small bowel accounts for only one per cent of all gastrointestinal malignancies. Duodenal adenocarcinoma accounts for half of all small bowel adenocarcinomas. The duodenum is divided into four segments: D1 (proximal horizontal 5 cm beginning with the 3-cm duodenal bulb), D2 (descending), D3 (distal horizontal), and D4 (ascending). The most common location of duodenal adenocarcinomas is the ampullary region of D2. Based on observational experience, our hypothesis was that primary adenocarcinomas arising from the mucosa of the duodenal bulb are extremely rare or possibly nonexistent. Our institutional cancer registry provided a list of patients for the years 1990 through 2012 who had small bowel cancers. Only those patients with primary adenocarcinomas of the duodenal mucosa were reviewed. Ampullary cancers arising from bile duct mucosa were specifically excluded. Medical records were abstracted to obtain patient age, sex, race, anatomic location of the tumor, disease stage (as per American Joint Committee on Cancer 7th edition staging guidelines), operation performed, and current vital status. A total of 30 patients with primary duodenal adenocarcinomas were identified. The mean age was 58 years and 17 (57%) patients were male. The tumor locations were: D2 in 26 (87%), D3 in two (7%), and D4 in two (7%). No tumors arose from D1. The patients presented with the following stages of disease: Stage 0is in three (10%), Stage I in three (10%), Stage II in five (17%), Stage III in 15 (50%), and Stage IV in four (13%). These findings combined with a diligent review of 724 reported cases in the English language literature yielded only five clearly defined cases of adenocarcinoma arising from the mucosa of the duodenal bulb. Although a 1991 published multicenter tumor registry series of 128 localized duodenal adenocarcinomas reported 29 D1 tumors, no anatomic distinction was made between duodenal bulb and more distal D1 tumors. Earlier reports used nonanatomic divisions of the duodenum or a simple breakdown into supra-ampullary, periampullary, and infra-ampullary portions. These data beg the question as to why primary duodenal bulb adenocarcinomas are so exceedingly rare. The obvious implication is that the duodenal bulb mucosa may be physiologically, immunologically, or otherwise uniquely privileged to virtually escape oncogenic transformation. The scientific challenge and opportunity is to explore and understand the important phenomena responsible for this finding. PMID:25264638

Goldner, Bryan; Stabile, Bruce E



Molecular cross-talk between Helicobacter pylori and human gastric mucosa  

PubMed Central

Helicobacter pylori (H. pylori) has co-evolved with humans to be transmitted from person to person and to colonize the stomach persistently. A well-choreographed equilibrium between the bacterial effectors and host responses permits microbial persistence and health of the host, but confers a risk for serious diseases including gastric cancer. During its long coexistence with humans, H. pylori has developed complex strategies to limit the degree and extent of gastric mucosal damage and inflammation, as well as immune effector activity. The present editorial thus aims to introduce and comment on major advances in the rapidly developing area of H. pylori/human gastric mucosa interaction (and its pathological sequelae), which is the result of millennia of co-evolution of, and thus of reciprocal knowledge between, the pathogen and its human host. PMID:21472096

Ricci, Vittorio; Romano, Marco; Boquet, Patrice



Duodenal somatostatinoma  

Microsoft Academic Search

Aim -Background  Somatostatinomas is a very rare neuroendocrine tumour of the gastrointestinal tract, first described in the pancreas in 1977\\u000a and in the duodenum in 1979. We present the case a 67-year-old woman with duodenal somatostatinoma that was resected with\\u000a a pancreaduodenectomy procedure and also provide a brief review of the literature.\\u000a \\u000a \\u000a \\u000a \\u000a Method  Databases from Pubmed and Medline were searched using a

Ch. Kontovounisios; M. Korontzi; C. Zaharioudakis; V. Armoutides; Ch. Karaliotas; S. Lanitis; G. Sgourakis



Downregulation of duodenal SLC transporters and activation of proinflammatory signaling constitute the early response to high altitude in humans.  


Solute carrier (SLC) transporters mediate the uptake of biologically active compounds in the intestine. Reduced oxygenation (hypoxia) is an important factor influencing intestinal homeostasis. The aim of this study was to investigate the pathophysiological consequences of hypoxia on the expression and function of SLCs in human intestine. Hypoxia was induced in human intestinal epithelial cells (IECs) in vitro (0.2; 1% O2 or CoCl2). For human in vivo studies, duodenal biopsies and serum samples were obtained from individuals (n = 16) acutely exposed to 4,554 meters above sea levels. Expression of relevant targets was analyzed by quantitative PCR, Western blotting, or immunofluorescence. Serum levels of inflammatory mediators and nucleosides were determined by ELISA and LC/MS-MS, respectively. In the duodenum of volunteers exposed to high altitude we observed decreased mRNA levels of apical sodium-dependent bile acid transporter (ASBT), concentrative nucleoside transporters 1/2 (CNT1/2), organic anion transporting polypeptide 2B1 (OATP2B1), organic cation transporter 2 (OCTN2), peptide transporter 1 (PEPT1), serotonin transporter (SERT), and higher levels of IFN-?, IL-6, and IL-17A. Serum levels of IL-10, IFN-?, matrix metalloproteinase-2 (MMP-2), and serotonin were elevated, whereas the levels of uridine decreased upon exposure to hypoxia. Hypoxic IECs showed reduced levels of equilibrative nucleoside transporter 2 (ENT2), OCTN2, and SERT mRNAs in vitro, which was confirmed on the protein level and was accompanied by activation of ERK1/2, increase of hypoxia-inducible factor (HIF) proteins, and production of IL-8 mRNA. Costimulation with IFN-? and IL-6 during hypoxia further decreased the expression of SERT, ENT2, and CNT2 in vitro. Reduced oxygen supply affects the expression pattern of duodenal SLCs that is accompanied by changes in serum levels of proinflammatory cytokines and biologically active compounds demonstrating that intestinal transport is affected during systemic exposure to hypoxia in humans. PMID:24970780

Wojtal, Kacper A; Cee, Alexandra; Lang, Silvia; Götze, Oliver; Frühauf, Heiko; Geier, Andreas; Pastor-Anglada, Marçal; Torres-Torronteras, Javier; Martí, Ramon; Fried, Michael; Lutz, Thomas A; Maggiorini, Marco; Gassmann, Max; Rogler, Gerhard; Vavricka, Stephan R



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

Microsoft Academic Search

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

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



Expression of growth factors in fetal human olfactory mucosa during development.  


The olfactory epithelium is one of the unique sites in the mammalian nervous system at which there is continual neurogenesis. Constant turnover of primary sensory neurons in the periphery results in remodeling of neuronal circuits and synapses in the olfactory bulb throughout life. Most of the specific mechanisms and factors that control this process are still unknown. Recent studies suggest that growth factors and their receptors may play a significant role in the development and continuous regeneration of olfactory neurons. In this study, standard immunohistochemical methods were used to detect the presence of epidermal growth factor-receptor, transforming growth factor-alpha and nerve growth factor-beta in the human olfactory epithelium of different developmental stages (7 to 30 weeks) in formalin-fixed tissue specimens. Immunoreactivity to epidermal growth factor-receptor was seen in basal cells, supporting cells, neurons, apical cytoplasmic region of olfactory epithelium, lamina propria and gland's cell cytoplasm. Similarly transforming growth factor-alpha immunoreactivity was recognized in basal cells, supporting cells, apical cytoplasmic region of olfactory epithelium, lamina propria and gland's cell cytoplasm but not in neurons. Nerve growth factor-beta detection was restricted on olfactory nerve cells, dentritic knob and basal cell layer. So, this study confirms the development of human olfactory mucosa and shows epidermal growth factor-receptor, transforming growth factor-alpha and nerve growth factor-beta proteins are reliable markers for developing olfactory epithelium. PMID:12739843

Elmas, C; Erdo?an, D; Ozo?ul, C



Acid-induced release of platelet-activating factor by human esophageal mucosa induces inflammatory mediators in circular smooth muscle.  


In a human in vitro model of esophagitis, we investigated the genesis of esophagitis-associated dysmotility by examining HCl-induced production of inflammatory mediators in the mucosa and investigating their effect on esophageal circular muscle. Muscularis propria was removed from organ donors' esophagi, leaving the mucosal tube intact. The tube was tied at both ends, forming a sac, and filled with HCl at pH 4. After 3 h of incubation, the supernatant surrounding the sac was analyzed or applied to circular muscle strips. HCl alone did not affect circular muscle contraction in response to electrical field stimulation (EFS), but supernatant of HCl-treated mucosa abolished contraction. The inhibition was reversed by the platelet-activating factor (PAF) antagonist CV3988 [(+/-)-3-(N-octadecylcarbamoyl)-2-methoxy) propyl-(2-thiazolioethyl) phosphate], whereas the PAF analog 2-O-methyl platelet-activating factor C-16 (PAF-16) inhibited EFS-induced contraction and acetylcholine (ACh) release in circular muscle strips. The hydrogen peroxide scavenger catalase reversed the inhibition in contraction, to the same extent as CV3988. We therefore measured PAF and hydrogen peroxide (H(2)O(2)) in mucosa, mucosa supernatant, and circular muscle. HCl increased PAF and interleukin (IL)-1beta (but not IL-6, prostaglandin E(2), or H(2)O(2)) in mucosa, and only PAF was released into the supernatant, presumably to affect circular muscle. In circular muscle, exogenous PAF induced sequential formation of IL-6, H(2)O(2), IL-1beta, and PAF. Release of PAF by the mucosa inhibits ACh release from circular muscle layer neurons and initiates sequential formation of inflammatory mediators in muscle, resulting in production of PAF by the muscle itself, possibly initiating in a self-sustaining cycle. PMID:16807360

Cheng, Ling; Cao, Weibiao; Behar, Jose; Fiocchi, Claudio; Biancani, Piero; Harnett, Karen M



Mucosa-associated bacteria in the human gastrointestinal tract are uniformly distributed along the colon and differ from the community recovered from feces  

Microsoft Academic Search

The human gastrointestinal (GI) tract harbors a complex community of bacterial cells in the mucosa, lumen, and feces. Since most attention has been focused on bacteria present in feces, knowledge about the mucosa-associated bacterial communities in different parts of the colon is limited. In this study, the bacterial communities in feces and biopsy samples from the ascending, transverse, and descending

Erwin G. Zoetendal; Atte von Wright; Terttu Vilpponen-Salmela; B. Amor; Antoon D. L. Akkermans; Vos de W. M



Early HIV-1 Target Cells in Human Vaginal and Ectocervical Mucosa  

PubMed Central

After translocation through the pleuristratified epithelium of the lower female genital tract, HIV-1 encounters potential target mononuclear cells in the lamina propria of the vagina and ectocervix. Here we show that each major type of genital mononuclear cell, including dendritic cells (DCs), macrophages and lymphocytes, are susceptible to HIV-1 in vitro. Among suspensions of vaginal and ectocervical mononuclear cells, DCs were the first cells to take up virus, containing GFP-tagged virions as early as 15 minutes after exposure. At 2 hr after exposure, DCs still contained the largest proportion of infected cells compared to lamina propria macrophages and lymphocytes from the same mucosal compartment. By 4 days, however, lymphocytes from both vaginal and ectocervical mucosa supported the highest level of HIV-1 replication. Genital macrophages from the same mucosal tissues also were permissive to HIV-1, in sharp contrast to intestinal macrophages, which we previously have shown do not support HIV-1 replication. Thus, among human vaginal and ectocervical mononuclear target cells, DCs are the first to take up HIV-1 and T cells support the most robust viral replication. Further characterization of the parameters of HIV-1 infection in genital mononuclear cells will enlarge our understanding of HIV-1 infection in the female genital tract. PMID:21118402

Shen, Ruizhong; Richter, Holly E.; Smith, Phillip D.



DNA damage in human colonic mucosa cells evoked by nickel and protective action of quercetin – Involvement of free radicals?  

Microsoft Academic Search

Nickel is a toxic and carcinogenic environmental and occupational pollutant and quercetin is a dietary flavonoid that is reported\\u000a to modulate effects of many mutagens and carcinogens. We investigated the ability of nickel chloride to induce DNA damage\\u000a in human colonic mucosa cells in the presence of quercetin, using the alkaline comet assay. Nickel chloride (5–250 ?mol\\/L)\\u000a evoked dose-dependent DNA

J. Blasiak; M. Arabski; T. Perty?ski; E. Malecka-Panas; K. Wo?niak; J. Drzewoski



High and Low Inhibitor Soybean Meals Affect Human Duodenal Proteinase Activity Differently: In Vivo Comparison with Bovine Serum Albumin  

Microsoft Academic Search

The objective of this study was to investi gate the effects of high and low inhibitor soybean meals on the duodenal enzyme activities and on the possible regulatory role of gastrointestinal hormones in the pan creatic response. After an overnight fast, 11 healthy vol unteers received an intraduodenal infusion of saline for 60 min. This was followed by infusion of



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

SciTech Connect

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 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.

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



Disease-Dependent Adhesion of Lactic Acid Bacteria to the Human Intestinal Mucosa  

Microsoft Academic Search

Their adhesion to the intestinal mucosa is considered one of the main reasons for the beneficial health effects of specific lactic acid bacteria (LAB). However, the influence of disease on the mucosal adhesion is largely unknown. Adhesion of selected LAB to resected colonic tissue and mucus was determined in patients with three major intestinal diseases (i.e., diverticulitis, rectal carcinoma, and

Arthur C. Ouwehand; Seppo Salminen; Peter J. Roberts; Jari Ovaska; Eeva Salminen



Extracellular Matrix-associated Cytokines Regulate CD4+ Effector T-cell Responses in Human Intestinal Mucosa  

PubMed Central

Extracellular matrix (stroma) regulation of mucosal T-cell function is incompletely understood. Here we uncovered a role for intestinal stromal products in the innate regulation of effector T-cells. Stroma-conditioned media (S-CM) derived from normal human intestinal stroma (TGF-?hi/IL-6lo/IL-1?lo) significantly down-regulated T-cell proliferation and IFN-? production compared to S-CM derived from inflamed Crohn’s mucosa (TGF-?hi/IL-6hi/IL-1?hi). Antibody neutralization studies showed that TGF-? in normal S-CM inhibited T-cell proliferation and IFN-? production, whereas IL-6 plus IL-1? in Crohn’s S-CM promoted T-cell proliferation, and the IL-1? alone promoted IFN-? and IL-17 release. Importantly, normal S-CM inhibited T-bet expression, whereas Crohn’s S-CM activated STAT3, suggesting that discordant T-cell responses are regulated at the transcription factor and signaling levels. These findings implicate stromal TGF-? in the down-regulation of T-cell responses in normal intestinal mucosa but stromal IL-6 and IL-1? in the promotion of Th1 and Th17 responses in inflamed Crohn’s mucosa, suggesting innate regulatory function for the intestinal extracellular matrix. PMID:21228771

Huff, Kayci R.; Akhtar, Lisa Nowoslawski; Fox, Anna L.; Cannon, Jamie A.; Smith, Phillip D.; Smythies, Lesley E.



Parallel Human Immunodeficiency Virus Type 1-Specific CD8+ T-Lymphocyte Responses in Blood and Mucosa during Chronic Infection  

PubMed Central

Gut-associated lymphoid tissue is the major reservoir of lymphocytes and human immunodeficiency virus type 1 (HIV-1) replication in vivo, yet little is known about HIV-1-specific CD8+ T-lymphocyte (CTL) responses in this compartment. Here we assessed the breadth and magnitude of HIV-1-specific CTL in the peripheral blood and sigmoid colon mucosa of infected subjects not on antiretroviral therapy by enzyme-linked immunospot analysis with 53 peptide pools spanning all viral proteins. Comparisons of blood and mucosal CTL revealed that the magnitude of pool-specific responses is correlated within each individual (mean r2 = 0.82 ± 0.04) and across all individuals (r2 = 0.75; P < 0.001). Overall, 85.1% of screened peptide pools yielded concordant negative or positive results between compartments. CTL targeting was also closely related between blood and mucosa, with Nef being the most highly targeted (mean of 2.4 spot-forming cells [SFC[/106 CD8+ T lymphocytes/amino acid [SFC/CD8/aa]), followed by Gag (1.5 SFC/CD8/aa). Finally, comparisons of peptide pool responses seen in both blood and mucosa (concordant positives) versus those seen only in one but not the other (discordant positives) showed that most discordant results were likely an artifact of responses being near the limit of detection. Overall, these results indicate that HIV-1-specific CTL responses in the blood mirror those seen in the mucosal compartment in natural chronic infection. For protective or immunotherapeutic vaccination, it will be important to determine whether immunity is elicited in the mucosa, which is a key site of initial infection and subsequent HIV-1 replication in vivo. PMID:15767429

Ibarrondo, F. Javier; Anton, Peter A.; Fuerst, Marie; Ng, Hwee L.; Wong, Johnson T.; Matud, Jose; Elliott, Julie; Shih, Roger; Hausner, Mary Ann; Price, Charles; Hultin, Lance E.; Hultin, Patricia M.; Jamieson, Beth D.; Yang, Otto O.



Bleeding from duodenal lymphangiectasia.  

PubMed Central

An 8 year old girl with recurrent upper gastrointestinal bleeding was found to have localised duodenal lymphangiectasia by fibreoptic endoscopy. She did not show physical signs or laboratory evidence of significant enteric protein loss. A low fat diet seemed to prevent further bleeding. Duodenal lymphangiectasia may be associated with gastrointestinal bleeding in children. Images p153-a PMID:1994845

Perisic, V N; Kokai, G



A Comparative Study of Clinicopathological Features between Chronic Cholecystitis Patients with and without Helicobacter pylori Infection in Gallbladder Mucosa  

PubMed Central

Background Helicobacter pylori has been isolated from 10%–20% of human chronic cholecystitis specimens but the characteristics of “Helicobacter pylori positive cholecystitis” remains unclear. This study aims to compare the clinicopathological features between chronic cholecystitis patients with and without Helicobacter pylori infection in gallbladder mucosa. Methods Three hundred and twenty-six chronic cholecystitis patients were divided into two groups according to whether Helicobacter pylori could be detected by culture, staining or PCR for Helicobacter 16s rRNA gene in gallbladder mucosa. Positive samples were sequenced for Helicobacter pylori-specific identification. Clinical parameters as well as pathological characteristics including some premalignant lesions and the expression levels of iNOS and ROS in gallbladder were compared between the two groups. Results Helicobacter pylori infection in gallbladder mucosa was detected in 20.55% of cholecystitis patients. These patients had a higher prevalence of acid regurgitation symptoms (p?=?0.001), more histories of chronic gastritis (p?=?0.005), gastric ulcer (p?=?0.042), duodenal ulcer (p?=?0.026) and higher presence of Helicobacter pylori in the stomach as compared to patients without Helicobacter pylori infection in the gallbladder mucosa. Helicobacter pylori 16s rRNA in gallbladder and gastric-duodenal mucosa from the same individual patient had identical sequences. Also, higher incidences of adenomyomatosis (p?=?0.012), metaplasia (p?=?0.022) and higher enhanced expressions of iNOS and ROS were detected in Helicobacter pylori infected gallbladder mucosa (p<0.05). Conclusions Helicobacter pylori infection in gallbladder mucosa is strongly associated with Helicobacter pylori existed in stomach. Helicobacter pylori is also correlated with gallbladder premalignant lesions including metaplasia and adenomyomatosis. The potential mechanism might be related with higher ROS/RNS production but needs further investigation. PMID:23936177

Wang, Jian-dong; Zhang, Yong; Gong, Wei; Quan, Zhi-wei



The histopathology of human gastric mucosa inhabited by Helicobacter heilmannii-like (Gastrospirillum hominis) organisms, including the first culturable case.  


The aim was to determine the prevalence of Helicobacter heilmannii-like organisms in human gastric biopsies and the associated histology compared with that of Helicobacter pylori-bearing gastric biopsies. Furthermore, the feasibility of culturing H. heilmannii was examined. A consecutive series of 727 gastric biopsies from 650 patients were prospectively scrutinized for H. heilmannii. Their distribution pattern was recorded as well as the affiliated morphology of the gastric mucosa. Additional biopsies from some of the patients were examined microbiologically. Four cases (0.6%)(95% confidence intervals: 0.01-1.2%) of the examined material harboured H. heilmannii. The bacterial burden was graded as sparse in three cases, moderate in one case. The distribution pattern was patchy; thus, in no case did all biopsies from one endoscopy comprise H. heilmannii. Adhesion to epithelial cells was infrequent. A mild gastritis, active in three cases, characterized all biopsies. Lymphoid aggregates occurred in biopsies from three patients. Micropapillary tufting of the epithelial layer and intestinal metaplasia were not apparent. Culture studies proved successful in the one of the four cases assayed. In conclusion the morphology of H. heilmannii-bearing mucosa deviates from that of H. pylori-associated mucosa by the absence of epithelial damage in the former. This observation can in part be explained by the predominant location of H. heilmannii at a distance from the epithelium in contrast to the conspicuous H. pylori adhesion to epithelial cells, coupled with a usually low bacterial burden and patchy occurrence of H. heilmannii as opposed to the generally more heavy infestation with H. pylori. PMID:9368589

Holck, S; Ingeholm, P; Blom, J; Nørgaard, A; Elsborg, L; Adamsen, S; Andersen, L P



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

SciTech Connect

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.

Sagar, S.M.; Thomas, R.J.; Loverock, L.T.; Spittle, M.F. (Meyerstein Institute of Radiotherapy, Middlesex Hospital, London (England))



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


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

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



Medium-term culture of normal human oral mucosa: a novel three-dimensional model to study the effectiveness of drugs administration.  


Tissue-engineered oral mucosal equivalents have been developed for in vitro studies for a few years now. However, the usefulness of currently available models is still limited by many factors, mainly the lack of a physiological extracellular matrix (ECM) and the use of cell populations that do not reflect the properly differentiated cytotypes of the mucosa of the oral cavity. For this reason, we have developed a novel three-dimensional culture model reflecting the normal architecture of the human oral mucosa, with the main aim of creating a better in vitro model where to test cellular responses to drugs administration. This novel 3D cell culture model (3D outgrowth) was set up using an artificial extracellular matrix (Matrigel™ ), allowing the interactions required for proper differentiation of the various citotypes which form the mucosal layer. Biopsies of human oral mucosa, in fragments of about 0.5 mm3, were placed onto 6.5mm Transwells, covered with Matrigel™ and grown in a specific culture medium. A gradual formation of an architectural structure similar to that of the in vivo oral mucosa was observed. Transmission electron and confocal microscopy were employed to characterize the newly developed model: the cell components (keratinocytes and fibroblasts) differentiated properly within the outgrowth and reconstituted, in vitro, the physiological structure of the human oral mucosa, including a stratified non-keratinized squamous layer composed of four different layers, a proper basal membrane and a lamina propria where fibroblasts produce ECM. Moreover, keratinocytes expressed CK5, CK13, CK19 and E-cadherin, whereas fibroblasts expressed collagen type I and IV, laminin and fibronectin. 3D outgrowths could be considered a valid alternative to animal models, and provide useful information for researchers interested in studying the responses of the human oral mucosa to locally delivered drugs or other exogenous treatments. PMID:22632390

Bucchieri, Fabio; Fucarino, Alberto; Marino Gammazza, Antonella; Pitruzzella, Alessandro; Marciano, Vito; Paderni, Carlo; De Caro, Viviana; Siragusa, Maria Gabriella; Lo Muzio, Lorenzo; Holgate, Stephen T; Davies, Donna E; Farina, Felicia; Zummo, Giovanni; Kudo, Yasusei; Giannola, Italo Libero; Campisi, Giuseppina



Raman fiberoptic probe for monitoring human tissue engineered oral mucosa constructs  

NASA Astrophysics Data System (ADS)

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.

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



Early or pre-coeliac mucosa: development of gluten enteropathy  

Microsoft Academic Search

Duodenal mucosa showed normal morphology, interepithelial lymphocytes, alkaline phosphatase, and sucrase in a girl with growth retardation and iron deficiency, but normal absorption of lactose and xylose after two years of abnormal stools. Mucosal lactase was low. Fourteen months later mucosal damage consistent with coeliac disease was evident, and gluten intolerance was subsequently confirmed by gluten challenge. It is probable

B Egan-Mitchell; P F Fottrell; B McNicholl



Human ethmoid sinus mucosa: a promising novel tissue source of mesenchymal progenitor cells  

PubMed Central

Introduction The identification of new progenitor cell sources is important for cell-based tissue engineering strategies, understanding regional tissue regeneration, and modulating local microenvironments and immune response. However, there are no reports that describe the identification and isolation of mesenchymal progenitor cells (MPCs) from paranasal sinus mucosa, and compare the properties of MPCs between tissue sources within the sinonasal cavity. We report here the identification of MPCs in the maxillary sinus (MS) and ethmoid sinus (ES). Furthermore, we contrast these MPCs in the same individuals with MPCs from two additional head and neck tissue sources of the inferior turbinate (IT) and tonsil (T). Methods These four MPC sources were exhaustively compared for morphology, colony-forming potential, proliferation capability, immunophenotype, multilineage differentiation potential, and ability to produce soluble factors. Results MS-, ES, IT-, and T-MPCs showed similar morphologies and surface phenotypes, as well as adipogenic, osteogenic, and chondrogenic differentiation capacity by immunohistochemistry and qRT-PCR for defined lineage-specific genes. However, we noted that the colony-forming potential and proliferation capability of ES-MPCs were distinctly higher than other MPCs. All MPCs constitutively, or upon stimulation, secrete large amounts of IL-6, IL-8, IL-10, IFN-?, and TGF-?. After stimulation with TNF-? and IFN-?, ES-MPCs notably demonstrated significantly higher secretion of IL-6 and IL-10 than other MPCs. Conclusions ES-MPCs may be a uniquely promising source of MPCs due to their high proliferation ability and superior capacity toward secretion of immunomodulatory cytokines. PMID:24460892



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)

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.

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



Expression of nerve growth factor receptor immunoreactivity on follicular dendritic cells from human mucosa associated lymphoid tissues.  

PubMed Central

Nerve growth factor (NGF) was originally considered as a trophic factor for peripheral sympathetic and sensory neurones; however, recent reports indicate that NGF may induce proliferation of immune and haematopoietic cells. Histochemical studies conducted in human spleen and lymph nodes have suggested the presence of NGF receptor (NGF-R) immunoreactive elements in secondary follicles; however the nature of the cells bearing the NGF-R in lymphoid tissue has not been determined. In this paper we report the results of an immunohistochemical study conducted on mucosa associated lymphoid tissue. Using a specific monoclonal antibody to human NGF-R (mAb 20.4) we observed an NGF-R-immunoreactive population in all secondary lymphoid follicles examined. Double immunostaining revealed that this population was composed of follicular dendritic cells (FDC); lymphoid cells within the germinal centres did not appear to be 20.4 immunoreactive. Cell suspensions from tonsillar follicles also contained NGF-R immunopositive dendritic cells which were enriched by a 20.4 labelled magnetic bead procedure, revealing cells with the morphological characteristics of FDC. Mononuclear cells from human peripheral blood did not contain any NGF-R-immunoreactive elements using our techniques. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:1326478

Pezzati, P; Stanisz, A M; Marshall, J S; Bienenstock, J; Stead, R H



Recombinant human interleukin 10 suppresses gliadin dependent T cell activation in ex vivo cultured coeliac intestinal mucosa  

PubMed Central

Background: Enteropathy in coeliac disease (CD) is sustained by a gliadin specific Th1 response. Interleukin (IL)-10 can downregulate Th1 immune responses. Aim: We investigated the ability of recombinant human (rh) IL-10 to suppress gliadin induced Th1 response. Patients and methods: IL-10 RNA transcripts were analysed by competitive reverse transcription-polymerase chain reaction in duodenal biopsies from untreated and treated CD patients, non-coeliac enteropathies (NCE), and controls. CD biopsies were cultured with a peptic-tryptic digest of gliadin with or without rhIL-10. The proportion of CD80+ and CD25+ cells in the lamina propria, epithelial expression of Fas, intraepithelial infiltration of CD3+ cells, as well as cytokine synthesis (interferon ? (IFN-?) and IL-2) were measured. Short term T cell lines (TCLs) obtained from treated CD biopsies cultured with gliadin with or without rhIL-10 were analysed by ELISPOT for gliadin specific production of IFN-?. Results: In untreated CD and NCE, IL-10 RNA transcripts were significantly upregulated. In ex vivo organ cultures, rhIL-10 downregulated gliadin induced cytokine synthesis, inhibited intraepithelial migration of CD3+ cells, and reduced the proportion of lamina propria CD25+ and CD80+ cells whereas it did not interfere with epithelial Fas expression. In short term TCLs, rhIL-10 abrogated the IFN-? response to gliadin. Conclusions: rhIL-10 suppresses gliadin specific T cell activation. It may interfere with the antigen presenting capacity of lamina propria mononuclear cells as it reduces the expression of CD80. Interestingly, rhIL-10 also induces a long term hyporesponsiveness of gliadin specific mucosal T cells. These results offer new perspectives for therapeutic strategies in coeliac patients based on immune modulation by IL-10. PMID:15591503

Salvati, V M; Mazzarella, G; Gianfrani, C; Levings, M K; Stefanile, R; De Giulio, B; Iaquinto, G; Giardullo, N; Auricchio, S; Roncarolo, M G; Troncone, R



Duodenal Malignant Somatostatinoma  

PubMed Central

The authors report a case of hormonally silent duodenal somatostatinoma. The main clinical features, the natural history and the currently available therapies of these rare neoplasms are described on the basis of this case and of the scientific literature. Although the antiblastic therapies are still debated, the patient showed a surprising outcome following chemotherapy. PMID:18612476

Ferrante, A. M. R.; Frontera, D.; Doglietto, G. B.; de Santis, G.; Viola, G.; Crucitti, F.



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

PubMed Central

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 (h?Ds) are antimicrobial peptides, h?D1 being constitutively expressed in the human stomach. We hypothesized that H.?pylori may persist, in part, by downregulating gastric h?D1 expression. We measured h?D1 and h?D2 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 h?D1 and higher h?D2 mRNA and protein concentrations were present in gastric biopsies from infected patients. Those patients with higher-level bacterial colonization and inflammation had significantly lower h?D1 expression, but there were no differences in h?D2. H.?pylori infection of human gastric epithelial cell lines also downregulated h?D1. 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-?B signalling to modulate h?D1 expression. These data indicate that H.?pylori downregulates h?D1 expression via NF-?B signalling, and suggest that this may promote bacterial survival and persistence in the gastric niche. PMID:23870035

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



Antibody to parietal cells in patients with duodenal ulcer, and relationship to pernicious anaemia.  


Of 160 patients with pernicious anaemia, none had current duodenal ulceration, whereas in a random population of similar age and sex distribution some 5% would be expected to have a duodenal ulcer. Parietal-cell antibody was detected in serum from 8 of 169 men (4-7%) and from 2 to 31 women (6-4%) with duodenal ulceration. None of the 200 duodenal ulcer patients had antibody to intrinsic factor. The prevalence of these antibodies in duodenal ulcer patients was not significantly different from that in control subjects of similar age and sex distribution. The decreased prevalance of duodenal ulcer in pernicious anaemia patients implies that pernicious anaemia must be less prevalent in duodenal ulcer patients than in a random population; but it appears that this cannot be attributed to an absence of gastric autoimmunity in patients with duodenal ulcer. To resolve this disrepancy, we suggest that pernicious anaemia is determined not only by autoimmune reactions, but also by independent genetic and environmental factors which influence the state of the gastric mucosa. PMID:1018665

Ungar, B; Francis, C M; Cowling, D C



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

PubMed Central

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?=?1.49×10–19). 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

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



Inactivation of rhodanese from human gastric mucosa and stomach adenocarcinoma by 2,4, 6-trinitrobenzenesulphonate and by 4,4'-diisothiocyanatostilbene-2,2'-disulphonate.  


Rhodanese (thiosulphate sulphurtransferase, EC was partially purified from normal human gastric mucosa and from gastric adenocarcinoma by DEAE-cellulose column chromatography. Rhodanese inactivation by 2, 4, 6-trinitrobenzenesulphonate and by 4,4'-diisothiocynatostilbene-2-2'-disulphonate was studied by an analysis of the time-dependence of rhodanese activity loss. Rhodanese inactivation by 2, 4, 6-trinitrobenzenesulphonate was, under all conditions tested, found to be first-order with regard to enzyme residual activity. In contrast to this, rhodanese inactivation by 4, 4'-diisothiocyanatostilbene-2, 2'-disulphonate was found to be biphasic, when log residual enzyme activity was plotted vs reaction time. The first-order rate constant, k, for rhodanese inactivation by 2, 4, 6-trinitrobenzenesulphonate was, at all pH values tested, higher with the gastric adenocarcinoma enzyme than with the normal mucosa enzyme: at pH 8.00, k is 27.0 per hour, for the normal mucosa enzyme, while for the adenocarcinoma enzyme k is 69.0 per hour. In contrast to this, no difference in the inactivation profile of the normal mucosa enzyme and the gastric adenocarcinoma enzyme was to be observed with 4,4'-diisothiocyanatostilbene-2,2'-disulphonate. PMID:2817794

Malliopoulou, V A; Rakitzis, E T; Malliopoulou, T B



High molecular weight polysaccharides from black currant seeds inhibit adhesion of Helicobacter pylori to human gastric mucosa.  


Several crude and purified polysaccharides from black currant seeds (Ribes nigrum L.) have been isolated, analysed and examined on their effects against Helicobacter pylori in in situ adhesion studies on sections of human gastric mucosa. After pre-treatment of Helicobacter pylori with 0.01 to 0.1 % solutions of the isolated raw polysaccharide (RPS), the epithelial binding of the bacteria was considerably reduced in a concentration-dependent manner, as compared with a non-treated control suspension. Preincubation of the mucosal sections with 0.1 % solutions did not result in a reduced binding of non-treated bacteria. An anion-exchange fraction of RPS eluted with 0.1 M phosphate buffer exhibited a comparable, concentration-dependent reduction of adhesion, whereas the water-eluted fraction was ineffective at the respective concentrations. Both subfractions consisted of similar 1,3-linked galactans, decorated with side chains possessing 1,4-galacturonic acid, galactose and arabinose residues. Molecular weight profiling by GPC revealed that the antiadhesive activity of the buffer eluate correlated with high molecular weight components ranging from about 1000 Da to 340 kDa, whereas the ones of the inactive water eluate had molecular weights of about 100 and 25 kDa, respectively. None of the active fractions revealed inhibitory effects on bacterial growth in vitro. We conclude that acidic, high molecular weight galactans are responsible for the antiadhesive qualities of black currant seed extracts and that these polymers are able to block Helicobacter surface receptors, thus inhibiting their interaction with specific binding factors located on human gastric epithelia. PMID:15254855

Lengsfeld, C; Deters, A; Faller, G; Hensel, A



Immunolocalization of antimicrobial and cytoskeletal components in the serous glands of human sinonasal mucosa.  


Secretory cells in the seromucous glands of paranasal sinuses secrete antibacterial proteins for innate immune mucosal integrity. We studied the localization of antimicrobial and cytoskeletal components of the human seromucous glands and respiratory epithelium of the maxillary sinus and the ethmoidal cells by immunohistochemical methods. The presence of a variety of defense proteins such as lysozyme, lactoferrin, cathelicidin, and defensin-1, -2, -3 point to a crucial role in the immune defense for the respiratory tract. Cytoskeletal proteins such as actin, myosin 2, cytokeratin 7 and 19, ?- and ?-tubulin, investigated for the first time in glands of paranasal sinuses, showed a stronger expression at the apical and lateral cell membrane. The localization of the cytoskeletal proteins might point to their participation in exocrine secretory processes and stabilizing effects. PMID:24737387

Stoeckelhuber, Mechthild; Olzowy, Bernhard; Ihler, Friedrich; Matthias, Christoph; Scherer, Elias Q; Babaryka, Gregor; Loeffelbein, Denys J; Rohleder, Nils H; Nieberler, Markus; Kesting, Marco R



Measurement of in vivo proliferation in human colorectal mucosa using bromodeoxyuridine.  

PubMed Central

In vivo bromodeoxyuridine (BrdUrd) labelling of the human large bowel was performed and a detailed histochemical localisation of label in sections of crypts was undertaken using a monoclonal antibody to BrdUrd containing DNA. Flow cytometric studies on extracted nuclei were also performed (data presented elsewhere). The average crypt in the human large bowel (excluding the rectum) was 82 cells in height and 41 cells in circumference, with a total of about 2000 cells (assuming a topographical correction factor of 0.6). Ten per cent of the cells were replicating their DNA--that is, were in the S phase of the cell cycle--and 0.4% were in mitosis. The median position for the labelling index versus cell position frequency plot is at the 20th cell position--at a quarter of the crypt height. The lower and upper limits of the cell proliferation are given by the 5th and 95th percentiles at cell positions 4 and 43 respectively. The peak labelling index is about 30% and it occurs at cell position 15. The labelling index at the crypt base, the probable stem cell zone, is about 14%, suggesting that these cells have a longer cell cycle. Taking a value of 8.6 hours for the duration of the S phase (deduced from the flow cytometric data) and assuming a growth fraction of 1.0 for the mid-crypt, these data provide an estimate of about 30 hours for the cell cycle time. The rectal crypts are about the same size but contain about 30% fewer S phase cells. The data also yielded a per cent BrdUrd labelled mitosis curve. Images Figure 1 PMID:1740282

Potten, C S; Kellett, M; Roberts, S A; Rew, D A; Wilson, G D



Acute duodenal ulcer.  

PubMed Central

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

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



Depicting the inner and outer nose: the representation of the nose and the nasal mucosa on the human primary somatosensory cortex (SI).  


The nose is important not only for breathing, filtering air, and perceiving olfactory stimuli. Although the face and hands have been mapped, the representation of the internal and external surface of the nose on the primary somatosensory cortex (SI) is still poorly understood. To fill this gap functional magnetic resonance imaging (fMRI) was used to localize the nose and the nasal mucosa in the Brodman areas (BAs) 3b, 1, and 2 of the human postcentral gyrus (PG). Tactile stimulation during fMRI was applied via a customized pneumatically driven device to six stimulation sites: the alar wing of the nose, the lateral nasal mucosa, and the hand (serving as a reference area) on the left and right side of the body. Individual representations could be discriminated for the left and right hand, for the left nasal mucosa and left alar wing of the nose in BA 3b and BA 1 by comparing mean activation maxima and Euclidean distances. Right-sided nasal conditions and conditions in BA 2 could further be separated by different Euclidean distances. Regarding the alar wing of the nose, the results concurred with the classic sensory homunculus proposed by Penfield and colleagues. The nasal mucosa was not only determined an individual and bilateral representation, its position on the somatosensory cortex is also situated closer to the caudal end of the PG compared to that of the alar wing of the nose and the hand. As SI is commonly activated during the perception of odors, these findings underscore the importance of the knowledge of the representation of the nasal mucosa on the primary somatosensory cortex, especially for interpretation of results of functional imaging studies about the sense of smell. PMID:24659451

Gastl, Mareike; Brünner, Yvonne F; Wiesmann, Martin; Freiherr, Jessica



Proinflammatory V?2+ T cells populate the human intestinal mucosa and enhance IFN-? production by colonic ?? T cells.  


In nonhuman primates, V?9V?2(+) (V?2)T cells proliferate and accumulate in mucosal tissues following microbial activation. Human V?2T cells produce proinflammatory cytokines in response to bacterial species that colonize the gut, but the role played by V?2T cells in intestinal immunity is unknown. We hypothesized that circulating V?2T cells can populate the human intestine and contribute to mucosal inflammation. Cell suspensions prepared from peripheral blood and intestinal biopsies were stimulated with microbial phosphoantigen (1-hydroxy-2-methyl-2-buten-4-yl 4-diphosphate [HDMAPP]) and analyzed by flow cytometry to determine V?2T cell phenotype, cytokine production, and proliferative potential. Circulating V?2T cells expressed gut-homing integrin ?4?7 (>70%), which was coexpressed with skin-associated cutaneous leukocyte Ag by up to 15% of the total population. However, V?2T cell activation with HDMAPP and exposure to retinoic acid (signaling via retinoic acid receptor ?) increased ?4?7 expression and enhanced binding to mucosal addressin cell adhesion molecule-1 in vitro while simultaneously suppressing cutaneous leukocyte Ag, thereby generating a committed gut-tropic phenotype. Confocal microscopy and flow cytometry identified frequent V?2T cells that migrated out of human intestinal biopsies and comprised both CD103(+) and CD103(-) subsets that produced TNF-? and IFN-? upon phosphoantigen exposure, with more frequent cytokine-producing cells in the CD103(-) population. Activated intestinal V?2T cells expressed CD70 and HLA-DR but were unable to drive the proliferation of allogeneic naive CD4(+) T cells. Instead, phosphoantigen-activated CD103(-) V?2T cells increased T-bet expression and enhanced IFN-? production by autologous colonic ?? T cells via an IFN-?-dependent mechanism. These data demonstrate that circulating V?2T cells display enhanced gut-homing potential upon microbial activation and populate the human intestinal mucosa, generating functionally distinct CD103(+) and CD103(-) subsets that can promote inflammation by colonic ?? T cells. PMID:23904167

McCarthy, Neil E; Bashir, Zora; Vossenkämper, Anna; Hedin, Charlotte R; Giles, Edward M; Bhattacharjee, Shaumick; Brown, Sabrina G; Sanders, Theodore J; Whelan, Kevin; MacDonald, Thomas T; Lindsay, James O; Stagg, Andrew J



Intraluminal duodenal diverticulum in the adult.  

PubMed Central

Four patients with intraluminal diverticulum of the duodenum are presented and compared with those reported previously. This lesion is a rare congenital disorder that usually becomes symptomatic in adult life. It is located in the second portion of the duodenum within the lumen, extending distally. It has the appearance of a "thumb of a glove" and it is lined by mucosa on both surfaces. It develops betweeen the fourth and eighth week of the embryo's life, but it increases in size during adult life. It usually presents with typical or atypical symptoms of peptic ulcer disease, but sometimes manifestations such as gastrointestinal bleeding, duodenal obstructions or pancreatitis may predominate and may be severe and life-threatening. The diagnosis is best made with hypotonic duodenography, which demonstrates the lesion as a barium coated pouch within the air filled duodenal lumen. The treatment of choice is duodenotomy and excision of the lesion. Proper identification of the papilla of the ampulla of Vater is important since this structure is often adjacent to the diverticulum. No recurrences have been noted in the three patients operated upon. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 5. PMID:402122

Economides, N G; McBurney, R P; Hamilton, F H



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

SciTech Connect

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.

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



Hydroxyl radical formation in human gastric juice.  


The hydroxyl radical is the most potent free radical derived from oxygen, and has been implicated in damage caused to the gastroduodenal mucosa. The ability of human gastric juice to generate hydroxyl radicals has been investigated in 54 adults with endoscopically normal gastroduodenal mucosa and in 39 patients with chronic duodenal ulcer. Hydroxyl radical production was measured by the formation of formaldehyde from dimethylsulfoxide. Unlike other body fluids, this reaction could proceed without the extraneous addition of catalysts such as hydrogen peroxide (H2O2), ascorbate and iron. Measurement of H2O2, iron and ascorbate showed that these catalysts are already present in the gastric juice. There was no significant difference in the concentration of these components in gastric juice between normal subjects and patients with duodenal ulcer, except that H2O2 levels were slightly higher in duodenal ulcer patients. Although generation of free radicals has been investigated in other body fluids, this is the first reported case regarding the production of these active species in normal human gastric juice. Since hydroxyl production is not significantly enhanced in duodenal ulcer, we suggest that attention may be turned to mucosal antioxidant defences in this disease. PMID:1327262

Nalini, S; Ramakrishna, B S; Mohanty, A; Balasubramanian, K A



Acrolein- and 4-Aminobiphenyl-DNA adducts in human bladder mucosa and tumor tissue and their mutagenicity in human urothelial cells  

PubMed Central

Tobacco smoke (TS) is a major cause of human bladder cancer (BC). Two components in TS, 4-aminobiphenyl (4-ABP) and acrolein, which also are environmental contaminants, can cause bladder tumor in rat models. Their role in TS related BC has not been forthcoming. To establish the relationship between acrolein and 4-ABP exposure and BC, we analyzed acrolein-deoxyguanosine (dG) and 4-ABP-DNA adducts in normal human urothelial mucosa (NHUM) and bladder tumor tissues (BTT), and measured their mutagenicity in human urothelial cells. We found that the acrolein-dG levels in NHUM and BTT are 10-30 fold higher than 4-ABP-DNA adduct levels and that the acrolein-dG levels in BTT are 2 fold higher than in NHUM. Both acrolein-dG and 4-ABP-DNA adducts are mutagenic; however, the former are 5 fold more mutagenic than the latter. These two types of DNA adducts induce different mutational signatures and spectra. We found that acrolein inhibits nucleotide excision and base excision repair and induces repair protein degradation in urothelial cells. Since acrolein is abundant in TS, inhaled acrolein is excreted into urine and accumulates in the bladder and because acrolein inhibits DNA repair and acrolein-dG DNA adducts are mutagenic, we propose that acrolein is a major bladder carcinogen in TS. PMID:24939871

Weng, Mao-wen; Hu, Yu; Chen, Wei-sheng; Chou, David; Liu, Yan; Donin, Nicholas; Huang, William C.; Lepor, Herbert; Wu, Xue-Ru; Wang, Hailin; Beland, Frederick A.; Tang, Moon-shong



Acrolein- and 4-Aminobiphenyl-DNA adducts in human bladder mucosa and tumor tissue and their mutagenicity in human urothelial cells.  


Tobacco smoke (TS) is a major cause of human bladder cancer (BC). Two components in TS, 4-aminobiphenyl (4-ABP) and acrolein, which also are environmental contaminants, can cause bladder tumor in rat models. Their role in TS related BC has not been forthcoming. To establish the relationship between acrolein and 4-ABP exposure and BC, we analyzed acrolein-deoxyguanosine (dG) and 4-ABP-DNA adducts in normal human urothelial mucosa (NHUM) and bladder tumor tissues (BTT), and measured their mutagenicity in human urothelial cells. We found that the acrolein-dG levels in NHUM and BTT are 10-30 fold higher than 4-ABP-DNA adduct levels and that the acrolein-dG levels in BTT are 2 fold higher than in NHUM. Both acrolein-dG and 4-ABP-DNA adducts are mutagenic; however, the former are 5 fold more mutagenic than the latter. These two types of DNA adducts induce different mutational signatures and spectra. We found that acrolein inhibits nucleotide excision and base excision repair and induces repair protein degradation in urothelial cells. Since acrolein is abundant in TS, inhaled acrolein is excreted into urine and accumulates in the bladder and because acrolein inhibits DNA repair and acrolein-dG DNA adducts are mutagenic, we propose that acrolein is a major bladder carcinogen in TS. PMID:24939871

Lee, Hyun-Wook; Wang, Hsiang-Tsui; Weng, Mao-wen; Hu, Yu; Chen, Wei-sheng; Chou, David; Liu, Yan; Donin, Nicholas; Huang, William C; Lepor, Herbert; Wu, Xue-Ru; Wang, Hailin; Beland, Frederick A; Tang, Moon-shong



Gastro-duodenal Crohn's disease  

PubMed Central

Gastro-duodenal Crohn's disease is rare. Thirty-one previously reported cases are briefly reviewed; histological confirmation of the diagnosis was not always possible. Details are given of a patient with pyloro-duodenal involvement accompanied by terminal ileitis and appendicitis where surgical specimens were available for study. The differential diagnosis is considered from the clinical and pathological aspects. Images PMID:14100012

Pryse-Davies, J.



Laparoscopic Duodenal Switch  

Microsoft Academic Search

Laparoscopic biliopancreatic diversion with duodenal switch (BPD-DS) is one of the most effective weight loss procedures currently\\u000a available. Both short- and long-term weight loss exceed that of any other bariatric operation. BPD-DS involves a 150- to 200-cc\\u000a sleeve or vertical gastrectomy, a duodenoileal anastomosis, and a long Roux-en-Y with a 150-cm alimentary limb and a 100-cm\\u000a common channel (Fig. 14.1).

Manish Parikh; Michel Gagner; Alfons Pomp


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

SciTech Connect

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.

Szabo, S.; Cho, C.H.



Composition and physicochemical properties of fasted-state human duodenal and jejunal fluid: a critical evaluation of the available data.  


Various methods of sampling and analyzing intestinal fluids have been applied over the years. In this report, data that have been published to date about the composition of fasted-state human intestinal fluid (HIF) and its physicochemical properties are summarized and the influence of the methods used to generate the data is discussed. Key physiological parameters summarized include pH, buffer capacity, osmolarity, and ionic strength in both the fasted duodenum and jejunum. Furthermore, the bile salts and phospholipids in the fasted small intestine are addressed in terms of both qualitative and quantitative composition with respect to the different types and degrees of hydroxylation of bile salts. Taurocholate, glycocholate, and glycochenodeoxycholate were identified as the main bile salts. Lysolecithin was identified as the predominant phospholipid species in fasted HIF because of the enzymatic degradation of lecithin. Together with other intestinal surfactants, such as cholesterol and free fatty acids, the influence of bile acids and phospholipids on the surface tension of fasted HIF was evaluated. A good working knowledge of all the above-mentioned parameters is important to optimize the composition of biorelevant media, with a view to improving the prediction of in vivo dissolution and release performance of drugs and dosage forms. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci 103:3398-3411, 2014. PMID:25277073

Fuchs, Alexander; Dressman, Jennifer B



Endoscopic duodenal "windsock" diverticulotomy.  


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

Stevens, Tyler; Chand, Bipan; Winans, Charles



CCL20/CCR6-mediated migration of regulatory T cells to the Helicobacter pylori-infected human gastric mucosa  

PubMed Central

Background Helicobacter pylori-induced peptic ulceration is less likely to occur in patients with a strong gastric anti-inflammatory regulatory T cell (Treg) response. Migration of Tregs into the gastric mucosa is therefore important. Objective To identify the homing receptors involved in directing Tregs to the gastric mucosa, and investigate how H pylori stimulates the relevant chemokine responses. Design Gastric biopsy samples and peripheral blood were donated by 84 H pylori-infected and 46 uninfected patients. Luminex assays quantified gastric biopsy chemokine concentrations. Flow cytometry was used to characterise homing receptors on CD4+CD25hi Tregs. H pylori wild-type and isogenic mutants were used to investigate the signalling mechanisms behind CCL20 and IL-8 induction in gastric epithelial cell lines. Transwell assays were used to quantify Treg migration towards chemokines in vitro. Results CCL20, CXCL1-3 and IL-8 concentrations were significantly increased in gastric biopsy samples from H pylori-infected patients. CCR6 (CCL20 receptor), CXCR1 and CXCR2 (IL-8 and CXCL1-3 receptors) were expressed by a higher proportion of peripheral blood Tregs in infected patients. Most gastric Tregs expressed these receptors. H pylori induced CCL20 production by gastric epithelial cells via cag pathogenicity island (cagPAI)-dependent NF-?B signalling. Foxp3+, but not Foxp3?, CD4 cells from infected mice migrated towards recombinant CCL20 in vitro. Conclusions As well as increasing Treg numbers, H pylori infection induces a change in their characteristics. Expression of CCR6, CXCR1 and CXCR2 probably enables their migration towards CCL20 and IL-8 in the infected gastric mucosa. Such qualitative changes may also explain how H pylori protects against some extragastric inflammatory disorders. PMID:24436142

Cook, Katherine W; Letley, Darren P; Ingram, Richard J M; Staples, Emily; Skjoldmose, Helle; Atherton, John C; Robinson, Karen



Histological changes in small bowel mucosa induced by gliadin sensitive T lymphocytes can be blocked by anti-interferon gamma antibody  

Microsoft Academic Search

The isolation of gliadin specific HLA-DQ2 restricted T lymphocyte clones from the intestinal mucosa of patients with coeliac disease supports a role for cell mediated immunity in the pathogenesis of this condition. Whether supernatants from immune activated T cell clones could produce histological damage to duodenal mucosa in vitro was studied. Biopsy specimens were obtained from 18 patients without coeliac

R T Przemioslo; K E Lundin; L M Sollid; J Nelufer; P J Ciclitira



Non-innervated Merkel cells and Merkel-neurite complexes in human oral mucosa revealed using antiserum to protein gene product 9.5.  


Merkel cells are non-keratinized cells present in many different epithelia, but whose origin and functional role are still controversial. They were here investigated by means of antisera to the neural and neuroendocrine markers protein gene product 9.5 (PGP 9.5), and neurone-specific enolase. The expression of both markers in Merkel cells of human gingival and palatal mucosa was confirmed. Merkel cell-neurite complexes and isolated non-innervated Merkel cells had a similar morphology when stained by either antiserum. Merkel-neurite complexes were clustered in relatively large numbers in the lingual gingiva, thus constituting structures closely similar to the 'touch domes' in the skin. Clusters of non-innervated cells showing the same immunohistochemical features as Merkel cells were also demonstrated. In other areas of the oral mucosa, the innervated and non-innervated elements were only occasionally seen but there were many encapsulated Meissner-like receptors. When comparing the two different antisera, anti-PGP 9.5 appeared to provide a more consistent labelling of small fibres inside the epithelium and of bulb-like terminals on Merkel cells. PMID:1387783

Ramieri, G; Panzica, G C; Viglietti-Panzica, C; Modica, R; Springall, D R; Polak, J M



Acquired duodenal obstruction in children.  


Traumatic intramural hematoma of the duodenum is a rare cause of acquired duodenal obstruction in children, and a high degree of suspicion is therefore required to make an early and accurate diagnosis. We report a 6-year-old boy whose epigastrium was impacted by the handlebar of his bicycle during a traffic accident. The boy then experienced epigastralgia. Six days later, progressive bilious vomiting suggestive of gastrointestinal obstruction was noted. Imaging studies revealed a large hematoma extending from the fourth portion of the duodenum to the jejunum. Conservative methods of treatment failed to manage his condition. He underwent laparoscopic surgery to evacuate the hematoma. We also report a case of duodenal obstruction in a previously healthy 2-year-old girl who presented for the first time with acute symptoms of proximal intestinal obstruction. Contrast examinations showed apparent barium retention over the stomach and proximal duodenum. She underwent surgery due to persistent obstruction, and a mushroom-like foreign body was detected embedded in the orifice of the windsock duodenal web. After duodenoduodenostomy and removal of the bezoar, she had a smooth recovery and tolerated feeding well. We conclude that blunt abdominal trauma and incomplete duodenal obstruction, such as that caused by duodenal web, should be considered as possible causes of acquired proximal gastrointestinal obstruction in previously healthy children, despite their rarity. PMID:19133572

Chien, Jen-Hung; Ho, Tsyr-Yuh; Shih-Peng, Lin; Lee, Chi-Ling; Ou, Shan-Fu



Sonographic windsock sign of a duodenal web.  


We report a neonate with a duodenal web demonstrating the windsock appearance on US. In neonates, duodenal web is rare and its windsock appearance is also rarely seen. The windsock sign of duodenal web has been a well-known finding on upper gastrointestinal series. The corresponding windsock appearance may be demonstrated on US. Duodenal web can, therefore, be accurately diagnosed by identifying the sonographic windsock sign even in neonates. PMID:11727020

Yoon, C H; Goo, H W; Kim, E A; Kim, K S; Pi, S Y



Duodenal nonheme iron content correlates with iron stores in mice, but the relationship is altered by Hfe gene knock-out.  


Hereditary hemochromatosis is a common iron-loading disorder found in populations of European descent. It has been proposed that mutations causing loss of function of HFE gene result in reduced iron incorporation into immature duodenal crypt cells. These cells then overexpress genes for iron absorption, leading to inappropriate cellular iron balance, a persistent iron deficiency of the duodenal mucosa, and increased iron absorption. The objective was to measure duodenal iron content in Hfe knock-out mice to test whether the mutation causes a persistent decrease in enterocyte iron concentration. In both normal and Hfe knock-out mice, duodenal nonheme iron content was found to correlate with liver iron stores (P <.001, r = 0.643 and 0.551, respectively), and this effect did not depend on dietary iron levels. However, duodenal iron content was reduced in Hfe knock-out mice for any given content of liver iron stores (P <.001). PMID:12468424

Simpson, Robert J; Debnam, Edward S; Laftah, Abas H; Solanky, Nita; Beaumont, Nick; Bahram, Seiamak; Schümann, Klaus; Srai, S Kaila S



Foveolar gastric metaplasia of the duodenum: a frequent, so far neglected type of duodenal polyp.  


Foveolar gastric metaplasia of the duodenum (FGM) is considered as imperfect mucosal healing in the context of H. pylori gastritis and intake of NSAIDs or ASS.? Typical endoscopic findings are redness of the mucosa, erosion/ulcer and loss of mucosal folds. During diagnostic histological examinations we observed a frequent so far not described association of FGM with endoscopically observed duodenal polyps. The archives of two institutes of pathology with high gastroenterological workload (approximately 100?000 patients per year) were investigated for an association between "duodenal polyp" and "foveolar gastric metaplasia". In Institute 1, of 481 duodenal polyps 41?% were classified as FGM, 9?% as adenoma and 2?% as heterotopic gastric mucosa. In 48?% no histological correlate was present. In Institute 2, 217 cases of FGM were diagnosed. Of these, in 69 cases the endoscopic finding was "polyp" (32?%). In the other cases, the endoscopic findings were mucosal defect (18?%), redness/inflammation (16?%), suspicion for gastric heterotopia (5?%) and scar (3?%). In 26?% of cases no pathologic endoscopic finding was reported. Both groups of patients with FGM showed a similar distribution of age ranges (24?-?83 years and 16?-?88 years), median age (62 years and 61 years, respectively) and a dominance of male sex (both 1.5:1). In conclusion, foveolar gastric metaplasia is a frequent, so far neglected correlate of endoscopically detected duodenal polyps. PMID:24718939

Sarbia, M; Sauer, G; Karimi, D; Berndt, R



Chronic duodenitis in Zaria, northern Nigeria.  


Thirty-four consecutive patients presenting to the Endoscopy clinic of the Ahmadu Bello University Teaching Hospital, Zaria with symptoms of upper abdominal pain were investigated for chronic duodenitis by endoscopy and histology and for associated diseases. Twenty-two patients had histological evidence of chronic duodenitis. No clinical features separated these from those who had no duodenitis. Endoscopy was a good enough tool for diagnosis. Stool parasites were significantly commoner in those with histological duodenitis. Gastritis was also commoner in those with duodenitis. Ranitidine appeared superior to polycrol in relieving symptoms. Endoscopy is useful in the diagnosis of severe duodenitis. Specific ulcer healing drugs may be tried in treating symptoms associated with duodenitis, though their effectiveness is still open to further research. PMID:7685620

Malu, A O; Kazmi, R; Wali, S S; Fakunle, Y M; Bhusnurmath, S R



Melatonin decreases duodenal epithelial paracellular permeability via a nicotinic receptor-dependent pathway in rats in vivo.  


Intestinal epithelial intercellular tight junctions (TJs) provide a rate-limiting barrier restricting passive transepithelial movement of solutes. TJs are highly dynamic areas, and their permeability is changed in response to various stimuli. Defects in the intestinal epithelial TJ barrier may contribute to intestinal inflammation or leaky gut. The gastrointestinal tract may be the largest extrapineal source of endogenous melatonin. Melatonin released from the duodenal mucosa is a potent stimulant of duodenal mucosal bicarbonate secretion (DBS). The aim of this study was to elucidate the role of melatonin in regulating duodenal mucosal barrier functions, including mucosal permeability, DBS, net fluid flux, and duodenal motor activity, in the living animal. Rats were anesthetized with thiobarbiturate, and a ~30-mm segment of the proximal duodenum with an intact blood supply was perfused in situ. Melatonin and the selective melatonin receptor antagonist luzindole were perfused luminally or given intravenously. Effects on permeability (blood-to-lumen clearance of (51)Cr-EDTA), DBS, mucosal net fluid flux, and duodenal motility were monitored. Luminal melatonin caused a rapid decrease in paracellular permeability and an increase in DBS, but had no effect on duodenal motor activity or net fluid flux. Luzindole did not influence any of the basal parameters studied, but significantly inhibited the effects of melatonin. The nonselective and noncompetitive nicotinic acetylcholine receptor antagonist mecamylamine abolished the effect of melatonin on duodenal permeability and reduced that on DBS. In conclusion, these findings provide evidence that melatonin significantly decreases duodenal mucosal paracellular permeability and increases DBS. The data support the important role of melatonin in the neurohumoral regulation of duodenal mucosal barrier. PMID:23009576

Sommansson, Anna; Nylander, Olof; Sjöblom, Markus



Fibrolipoma of buccal mucosa  

PubMed Central

The lipoma is a very common benign tumor of adipose tissue, but its presence in the oral and oropharyngeal region is relatively uncommon. Fibrolipoma, a histological variant of lipoma, mostly affect the buccal mucosa and causes functional and cosmetic disabilities. Hence, accurate histopathological examination of lipomas is important for a correct treatment plan. This article describes a case of 10 year old girl with fibrolipoma of the buccal mucosa with a relevant review of tumors. PMID:22629049

Khubchandani, Monika; Thosar, Nilima R.; Bahadure, Rakesh N.; Baliga, M. S.; Gaikwad, Rahul N.



Fibrolipoma of buccal mucosa.  


The lipoma is a very common benign tumor of adipose tissue, but its presence in the oral and oropharyngeal region is relatively uncommon. Fibrolipoma, a histological variant of lipoma, mostly affect the buccal mucosa and causes functional and cosmetic disabilities. Hence, accurate histopathological examination of lipomas is important for a correct treatment plan. This article describes a case of 10 year old girl with fibrolipoma of the buccal mucosa with a relevant review of tumors. PMID:22629049

Khubchandani, Monika; Thosar, Nilima R; Bahadure, Rakesh N; Baliga, M S; Gaikwad, Rahul N



[Surgical treatment of duodenal ulcer].  


The medical and endoscopic treatment of duodenal ulcer are decreasing the frequency of surgical treatment in this disease. The authors study the operations performed for duodenal ulcer within the period 1989-1999 in the County Hospital Baia Mare. The decrease of the rate of surgical interventions is the pure effect of the medical treatment, as long as the endoscopic treatment is not yet available in our service. The rate of ulcer--induced perforations remained, however, unmodified (48% of total operatory indications), as well as the postoperative morbidity and--mortality (18% respectively 9%). The last category seems not to be influenced by the type of chosen surgical procedure, but by the patient's age, duration of the disease, and associated pathology. PMID:12731191

Lese, M; Naghi, I; Pop, C



Management of complicated duodenal diverticula.  


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

Oukachbi, N; Brouzes, S



Extra-ampullary Duodenal Adenocarcinoma.  


Extra-ampullary duodenal adenocarcinomas are rare, and when studied, frequently have been grouped with jejunoileal adenocarcinomas. Nevertheless, anecdotal experiences suggest that these neoplasms may present 2 or more distinct phenotypes. To better characterize these neoplasms, we performed a retrospective review of 38 cases with a special focus on the morphologic and immunophenotypic characteristics and their clinicopathologic significance. Our cohort of extra-ampullary duodenal adenocarcinomas was classified on the basis of the morphologic features into gastric type (n=19, 50%), intestinal type (n=14, 37%), pancreaticobiliary type (n=2, 5%), and others (n=3, 8%). Most gastric-type adenocarcinomas (n=18, 95%) developed in the proximal duodenum, whereas the other types were located equally in the proximal and distal duodenum. Intestinal-type dysplasia was present at the periphery of 8 (57%) intestinal-type adenocarcinomas, and 8 (42%) gastric-type adenocarcinoma were associated with gastric-type dysplasia. Gastric foveolar metaplasia (n=12) and Brunner gland hyperplasia (n=10) were exclusively recognized adjacent to gastric-type adenocarcinomas. Notably, intestinal-type histology and the absence of lymph node metastasis were significantly associated with favorable disease-free survival in univariate and multivariate analyses. In summary, this study demonstrated that 2 major subsets of extra-ampullary duodenal adenocarcinoma, intestinal type and gastric type, are associated with distinct histopathologic features and clinical behavior. PMID:25310836

Ushiku, Tetsuo; Arnason, Thomas; Fukayama, Masashi; Lauwers, Gregory Y



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

Microsoft Academic Search

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

Bruce K Bowen; William J Krause; Kevin J Ivey



Heterotopic gastric mucosa of the gastrointestinal tract: a histopathologic study of 158 cases.  


The author retrieved and retrospectively investigated biopsy specimens of heterotopic gastric mucosa registered in our computer database. There were 1008 cases affecting the esophagus, 684 cases affecting the duodenum, and 1636 cases affecting the colorectum. A total of 158 cases of heterotopic gastric mucosa were identified (84 cases affecting the esophagus, 74 cases affecting the duodenum, and no case affecting the colorectum). The frequency amounted to 8% in the esophagus, 11% in the duodenum, and 0% in the colorectum. The male to female ratio was 112:46, and the mean age was 62.22±14.29 years. Pathologically, two types of heterotopic gastric mucosa were identified. The first type consisted of gastric glands and foveolar epithelium, and the second type was composed only of foveolar epithelium. The first type was recognized in 69 of 84 cases (82%) in the esophagus, and in 54 of 74 cases (73%) in the duodenum. The second type was encountered in 15 of 84 cases (18%) in the esophagus, and in 20 of 74 cases (27%) in the duodenum. The first type appeared to be of congenital origin, while the second type was reminiscent of foveolar metaplasia. Foveolar hyperplasia and mild lymphocytic infiltration were frequent in the heterotopic gastric mucosa. Goblet cell metaplasia was recognized in 11 cases. The most frequent clinical diagnosis of heterotopic gastric mucosa of the esophagus was heterotopic gastric mucosa, followed in order by iodine-unstained area, reflux disease, flat elevation, polyp, carcinoma, ulcer, erosion, redness, submucosal tumor, esophagitis, adenoma, and tumor. The most frequent clinical diagnosis of heterotopic gastric mucosa in the duodenum was polyp, followed in order by ulcer, tumor, submucosal tumor, carcinoma, and duodenitis. The data suggest that esophageal gastric mucosa and duodenal heterotopic gastric mucosa are common lesions, with a frequency of about 9% in biopsy specimens in Japan. PMID:21242038

Terada, Tadashi



Duodenal mucosal risk markers in patients with familial adenomatous polyposis: effects of celecoxib/ursodeoxycholic acid co-treatment and comparison with patient controls  

PubMed Central

Background Familial adenomatous polyposis (FAP) is a disease characterized by the development of hundreds to thousands of adenomatous polyps in the colorectum early in life. Virtually all patients with FAP will develop colorectal cancer before the age of 40 to 50 years, unless prophylactic colectomy is performed, which significantly improves their prognosis. The mortality pattern has changed and duodenal cancer now is one of the main cancer-related causes of death in these patients. Practically all patients with FAP develop premalignant duodenal adenomas, which may develop to duodenal cancer in approximately 3-7% of patients. Duodenal cancer in patients with FAP has a poor prognosis. The clinical challenge is to identify patients at high-risk for duodenal carcinoma. Chemoprevention would be desirable to avoid duodenectomy. The main goal of this study is to identify risk markers in normal duodenal mucosa of patients with FAP, that could help identify patients at increased risk for malignant transformation. Methods Messenger RNA (mRNA) levels of glutathione S-transferase A1 (GSTA1), glutathione S-transferase P1 (GSTP1), KIAA1199, E-cadherin, peroxisome proliferative activated receptor ? (PPAR?), caspase-3, cyclin D1, ?-catenin, and cyclooxygenase-2 (COX-2) were measured in duodenal mucosa, using the QuantiGene 2.0 Plex assay. Levels in normal appearing mucosa of patients with FAP (n?=?37) were compared with levels in non-FAP patient controls (n?=?16). In addition, levels before and after treatment with either celecoxib & ursodeoxycholic acid (UDCA, n?=?14) or celecoxib & placebo (n?=?13) were evaluated in patients with FAP. Results mRNA levels of glutathione S-transferase A1 (28.16% vs. 38.24%, p?=?0.008) and caspase-3 (3.30% vs. 5.31%, p?=?0.001) were significantly lower in patients with FAP vs. non-FAP patient controls, respectively. COX-2 mRNA levels in normal duodenal mucosa of patients with FAP were found to be unexpectedly low. None of the potential risk markers was influenced by celecoxib or celecoxib & UDCA. Conclusions Protection against toxins and carcinogens (GSTA1) and apoptosis (caspase-3) is low in patients with FAP, which could contribute to increased susceptibility for malignant transformation of duodenal mucosa. Trial registration number NCT00808743 PMID:24245549



Somatostatin depletion by cysteamine: mechanism and implication for duodenal ulceration  

SciTech Connect

Cysteamine (CSH) and its close derivatives deplete immunoreactive somatostatin (SS) in rat organs. The effect of CSH is dose and time dependent and reversible. Structural requirements of the analogs are the presence of either -SH or -NH2 on a two- or three-carbon alkyl molecule; both radicals together increase, whereas insertion of carboxyl abolishes potency. The duodenal ulcerogenic potency of CSH derivatives is correlated significantly with their SS-depleting activity in the gastric mucosa. The mechanism of this action of CSH is poorly understood, but it is not caused by increased release, enhanced degradation of the peptide, or selective necrosis of SS cells. It is likely that in the intracellular environment CSH causes a conformational change in the peptide that affects the antigenic and functional properties of SS.

Szabo, S.; Reichlin, S.



Detection of Human Papillomavirus DNA and p53 Gene Mutations in Esophageal Cancer Samples and Adjacent Normal Mucosa  

Microsoft Academic Search

Background\\/Aim: There is evidence of a possible etiological role of human papillomaviruses (HPVs) in the development of esophageal tumors. Loss of function of the wild-type p53 tumor suppressor gene product by binding to E6 oncoproteins of high-risk HPVs is considered an important event in tumor development. The aim of this study was to verify the prevalence of HPV infection and

Giuseppe Astori; Sonia Merluzzi; Alessandra Arzese; Piero Brosolo; Giovanni de Pretis; Roberto Maieron; Corrado Pipan; Giuseppe A. Botta



Corticotropin-releasing factor receptor subtype 2 in human colonic mucosa: Down-regulation in ulcerative colitis  

PubMed Central

AIM: To assess corticotropin-releasing factor receptor 2 (CRF2) expression in the colon of healthy subjects and patients with ulcerative colitis (UC). METHODS: We examined CRF2 gene and protein expression in the distal/sigmoid colonic mucosal biopsies from healthy subjects and patients with UC (active or disease in remission), human immunodeficiency virus (HIV) and functional bowel disease (FBD) by reverse transcription-polymerase chain reaction and immunofluorescence. RESULTS: Gene expression of CRF2 was demonstrated in the normal human colonic biopsies, but not in the human colorectal adenocarcinoma cell line Caco2. Receptor protein localization showed immunoreactive CRF2 receptors in the lamina propria and in the epithelial cells of the distal/sigmoid biopsy samples. Interestingly, CRF2 immunoreactivity was no longer observed in epithelial cells of patients with mild-moderately active UC and disease in remission, while receptor protein expression did not change in the lamina propria. No differences in CRF2 expression profile were observed in distal/sigmoid intestinal biopsies from HIV infection and FBD patients, showing no signs of inflammation. CONCLUSION: The down-regulation of the CRF2 receptor in the distal/sigmoid biopsies of UC patients is indicative of change in CRF2 signalling associated with the process of inflammation. PMID:23539366

Chatzaki, Ekaterini; Anton, Peter A; Million, Mulugeta; Lambropoulou, Maria; Constantinidis, Theodoros; Kolios, George; Tache, Yvette; Grigoriadis, Dimitri E



Endoscopic Management of a Primary Duodenal Carcinoid Tumor  

PubMed Central

Carcinoids are rare, slow-growing tumors originating from a variety of different neuroendocrine cell types. They are identified histologically by their affinity for silver salts and by positive reactions to neuroendocrine markers such as neuron-specific enolase, synaptophysin and chromogranin. They can present with various clinical symptoms and are difficult to diagnose. We present the case of a 43-year-old woman who was referred for evaluation of anemia. Upper endoscopy showed a duodenal bulb mass around 1 cm in size. Histopathological and immunohistochemistry staining were consistent with the diagnosis of a carcinoid tumor. Further imaging and endoscopic studies showed no other synchronous carcinoid lesions. Endoscopic ultrasound (EUS) revealed a 1 cm lesion confined to the mucosa and no local lymphadenopathy. Successful endoscopic mucosal resection of the mass was performed. Follow-up surveillance 6 months later with EUS and Octreoscan revealed no new lesions suggestive of recurrence. No consensus guidelines exist for the endoscopic management of duodenal carcinoid tumors. However, endoscopic resection is safe and preferred for tumors measuring 1 cm or less with no evidence of invasion of the muscularis layer. PMID:22679400

Abraham, Albin; Singh, Jaspreet; Siddiqui, Ghulam; Prasad, Apsara; Rashid, Sadat; Vardaros, Magdalene; Garg, Vikas; Rizvon, Kaleem; Subramani, Krishnaiyer; Mustacchia, Paul



Pathogenesis of digitoxin-induced duodenal ulcers in pregnant rats. Roles of gastric acid and duodenal alkaline secretion.  


Late-stage pregnant rats (day 17) had higher rates of gastric acid secretion (45-55 mu eq/15 min) as compared to nonpregnant and middle-stage pregnant (day 10) rats (20-25 mu eq/15 min). In contrast, basal rates of duodenal alkaline secretion were significantly lower (2-3 mu eq/15 min) in pregnant rats (day 10 and 17) than those in nonpregnant rats (approximately 5 mu eq/15 min), although the duodenal mucosa responded to acid with a significant rise in HCO3- output in these three groups of rats. In pregnant rats (day 17), a single injection of digitoxin, a Na+ K+-ATPase inhibitor (10 mg/kg, subcutaneously), had no effect on basal acid and alkaline secretions, but significantly blocked the acid-induced HCO3- secretion for more than 18 hr from 6 hr after administration. This drug, when given once daily for four days (10 mg/kg, subcutaneously), produced well-defined ulcers in the proximal duodenum with few lesions in the stomach of female rats, and the severity and incidence were significantly higher in late-stage pregnant rats than in the other two groups of rats. Following repeated administration of digitoxin (10 mg/kg) to late-stage pregnant rats (days 17-20), acid secretion significantly declined after two days of treatment, while the acid-induced HCO3- secretion was significantly attenuated after one day of treatment and remained inhibited during the whole period. These results suggest that an impairment of the mechanisms related to acid-induced HCO3- secretion may be associated with the induction of duodenal ulcers caused by digitoxin in female rats, and the high incidence of these ulcers in late-stage pregnant rats may be due to acid hypersecretion. PMID:3378483

Furukawa, O; Takeuchi, K; Nishiwaki, H; Okabe, S



Gender-Specific Protection of Estrogen against Gastric Acid-Induced Duodenal Injury: Stimulation of Duodenal Mucosal Bicarbonate Secretion  

PubMed Central

Because human duodenal mucosal bicarbonate secretion (DMBS) protects duodenum against acid-peptic injury, we hypothesize that estrogen stimulates DMBS, thereby attributing to the clinically observed lower incidence of duodenal ulcer in premenopausal women than the age-matched men. We found that basal and acid-stimulated DMBS responses were 1.5 and 2.4-fold higher in female than male mice in vivo, respectively. Acid-stimulated DMBS in both genders was abolished by ICI 182,780 and tamoxifen. Estradiol-17? (E2) and the selective estrogen receptor (ER) agonists of ER? [1,3,5-Tris(4-hydroxyphenyl)-4-propyl-1H-pyrazole] and ER? [2,3-bis(4-hydroxyphenyl) propionitrile], but not progesterone, rapidly stimulated ER-dependent murine DMBS in vivo. E2 dose dependently stimulated murine DMBS, which was attenuated by a Cl?/HCO3? anion exchanger inhibitor 4,4?-didsothio- cyanostilbene-2, 2?-disulfonic acid, removal of extracellular Cl?, and in cystic fibrosis transmembrane conductance regulator knockout female mice. E2 stimulated murine DMBS in vitro in both genders with significantly greater response in female than male mice (female to male ratio = 4.3). ER? and ER? mRNAs and proteins were detected in murine duodenal epithelium of both genders; however, neither ER? nor ER? mRNA and protein expression levels differed according to gender. E2 rapidly mobilized intracellular calcium in a duodenal epithelial SCBN cell line that expresses ER? and ER?, whereas BAPTA-AM abolished E2-stimulated murine DMBS. Thus, our data show that E2 stimulates DMBS via ER dependent mechanisms linked to intracellular calcium, cystic fibrosis transmembrane conductance regulator, and Cl?/HCO3? anion exchanger. Gender-associated differences in basal, acid- and E2-stimulated DMBS may have offered a reasonable explanation for the clinically observed lower incidence of duodenal ulcer in premenopausal women than age-matched men. PMID:18499763

Smith, Anders; Contreras, Cheyanne; Ko, Kwang Hyun; Chow, Jimmy; Dong, Xiao; Tuo, Biguang; Zhang, Hong-hai; Chen, Dong-bao; Dong, Hui



Pictorial review CT of duodenal pathology  

Microsoft Academic Search

This pictorial review presents the CT findings in different pathological entities of the duodenum. The aim of the article is to demonstrate the contribution of a common imaging modality, i.e. abdominal CT, in the diagnosis of various duodenal disorders. The current widespread use of abdominal CT has resulted in the detection, sometimes as an incidental finding, of various duodenal abnorm-



Duodenal mucosal permeability: Relevance to ulcerogenesis  

Microsoft Academic Search

Duodenal mucosal integrity is determined by the balance between physiological defense mechanisms and aggressive factors. Derangements in any of the defense mechanisms or excessive aggressive forces will most likely result in a disturbance of mucosal integrity and eventually in gastroduodenal disease. To better understand the pathogenesis of duodenal ulcers and other gastrointestinal disorders, it is of importance to characterize the

Olof Nylander; Anneli Hällgren



Duodenal obstruction in Nigerian newborns and infants.  


Experience with the management of congenital duodenal obstruction in a tropical environment is analysed with a view to highlighting some of the problems and suggesting solutions. 30 infants with duodenal obstruction were treated at the Lagos University Teaching Hospital between 1978 and 1985. 15 (50%) infants had duodenal atersia. 7 (23%) had Ladd's bands, 6 (20%) had duodenal diaphragm and there was one bay with partial duodenal obstruction caused by a duplication cyst. The associated abnormalities encountered in 7 infants are distal bowel atresia (3), partial situs inversus (3) and Trisomy 21 (1). Delay in presentation and inadequate facilities constituted the major constraints. 7 of the 25 infants that had corrective surgery died, a mortality of 28%. All the infants that were treated within the first 8 days of life survived. After this period survival was restricted to those with incomplete obstruction. Mortality can be reduced by the provision of adequate facilities and health education. PMID:3508631

Adeyemi, S D



Interleukin8 expression in Helicobacter pylori infected, normal, and neoplastic gastroduodenal mucosa  

Microsoft Academic Search

AIMS--To investigate the expression of interleukin-8 (IL-8) in Helicobacter pylori infected normal and neoplastic gastroduodenal mucosa, and in established gastric cancer cell lines. METHODS--Immunofluorescence techniques were used to localise IL-8 in cryosections of gastric (n = 25) and duodenal (n = 17) endoscopic biopsy specimens an in resected gastric tumour tissue samples from 16 patients. Two gastric cancer cell lines

J E Crabtree; J I Wyatt; L K Trejdosiewicz; P Peichl; P H Nichols; N Ramsay; J N Primrose; I J Lindley



Gluten sensitivity and ‘normal’ histology: is the intestinal mucosa really normal?  

Microsoft Academic Search

Background. Early pathogenetic events of gluten intolerance may be overlooked in patients with serologic markers of celiac disease and normal intestinal mucosa by both conventional histology and immunohistochemistry.Aims. To investigate if a submicroscopical damage of the absorptive cell surface was associated with developing gluten sensitivity.Patients and methods. Duodenal biopsies of seven subjects with positive anti-endomysial antibodies and normal histology underwent

A Sbarbati; E Valletta; M Bertini; M Cipolli; M Morroni; L Pinelli; L Tatò



Tissue-Engineered Buccal Mucosa Urethroplasty—Clinical Outcomes  

Microsoft Academic Search

IntroductionWhilst buccal mucosa is the most versatile tissue for urethral replacement, the quest continues for an ideal tissue replacement for the urethra when substantial tissue transfer is needed. Previously we described the development of autologous tissue-engineered buccal mucosa (TEBM). Here we report clinical outcomes of the first human series of its use in substitution urethroplasty.

Saurabh Bhargava; Jacob M. Patterson; Richard D. Inman; Sheila MacNeil; Christopher R. Chapple



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


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

Krause, W J



Dopamine D1 receptors mediate dopamine-induced duodenal epithelial ion transport in rats.  


Dopamine (DA) is synthesized in gastrointestinal epithelial cells and performs important regulatory effects on the duodenal mucosa. However, the underlying mechanism remains largely unknown. The present study investigated the effect of DA on the duodenal epithelial ion transport in rats by means of short-circuit current (ISC), real-time pH titration, enzyme-linked immunosorbent assay, and immunohistochemistry. The results indicate that basolateral, but not apical, application of DA induced a concentration-dependent ISC downward deflection with an apparent IC50 of 5.34 ?mol/L. Basolateral application of dopaminergic receptor D1 (D1) antagonist, SCH-23390, inhibited DA-induced change in ISC (?ISC) in a dose-dependent manner. D1 agonist, SKF38393, mimicked the effect of DA on the ISC. The clear immunoreactivity of D1 subtype D5 (D1b) was at the both apical and basolatoral sides of Brunner's glands and intestinal crypts. Basolateral pretreatment with adenylate cyclase inhibitor, MDL12330A, significantly inhibited DA- and forskolin-induced ?ISC. DA and SKF38393 increased the level of intracellular cyclic adenosine monophosphate (cAMP) from 1.55 ± 0.11 to 2.07 ± 0.11 and 5.91 ± 0.25 pmol/L·mg(-1), respectively. Furthermore, the serosal DA-induced ?ISC was remarkably inhibited by apical administration of K(+) channel blockers, Ba(2+) and tetraethylammonium, but not by Cl(-) channel blockers. Serosal DA and D1 agonist did not affect duodenal HCO3(-) secretion. In conclusion, the present results demonstrate that serosal DA is able to promote rat duodenal epithelial K(+) secretion, not HCO3(-) secretion through D1-mediated and cAMP-dependent pathway. The study provides a new insight in the modulation of DA on the ion transport of duodenal epithelia in rats. PMID:23276732

Feng, Xiao-Yan; Li, Yun; Li, Li-Sheng; Li, Xiao-Feng; Zheng, Li-Fei; Zhang, Xiao-Li; Fan, Rui-Fang; Song, Jin; Hong, Feng; Zhang, Yue; Zhu, Jin-Xia



[Congenital duodenal stenosis in adulthood].  


A high-grade duodenal stenosis in adults can, in rare cases, be congenital, and its cause is found in an intraduodenally sited membrane. The anamnesis reveals growth disorders with vomiting and meteorism and abdominal complaints. A perforation opening in this membrane is the reason for survival into adulthood. The X-ray appearance and deep duodenoscopy make the diagnosis easy. Volvulus in cases of malrotation, Ladd's ligaments, annular pancreas, and compression of the duodenum by mesenteric vessels must be considered in the differential diagnosis. When the intraduodenal membrane is resected it is most important to expose the papilla Vateri, since this not uncommonly ends in the area of the septum. If necessary, a duodenoduodenostomy is performed. If the windsock web abnormality is present the duodenum should be opened at the point of attachment of the diaphragm. The construction of a gastrojejunostomy should be avoided. PMID:8145619

Klein, P; Anetsberger, R; Stangl, R; Hümmer, H P



[The serum content of gastrin-17 and pepsinogen-1 in patients with duodenal ulcerative disease in occupational contact with nitrogenous compounds].  


The levels of serum gastrin-17 (G-17) and pepsinogen-1 (P-1) were studied in 54 patients with duodenal ulcerative disease (UD) who worked at chemical plants manufacturing nitrogenous compounds and in 15 healthy individuals (a control group). There are objective data on the time course of changes in the functional characteristics (G-17 and P-1) of the gastric mucosa (GM) in the patients with duodenal UD, which vary with the chemical compositions of hazardous substances and the length of service at a chemical plant. Basic therapy for UD causes positive changes in the functional parameters reflecting the state of GM. PMID:20030266

Pomytkina, T E



Gastric emptying abnormal in duodenal ulcer  

SciTech Connect

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.

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



Duodenal-mucosal bacteria associated with celiac disease in children.  


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

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



Hypoalgesic effect of EMLA and lidocaine gel applied on human oral mucosa: quantitative evaluation by sensory and pain thresholds to argon laser stimulation.  

PubMed Central

Sensory and pain thresholds to argon laser stimulation were used to evaluate the analgesic efficacy and duration of a eutectic mixture of local anesthetics (EMLA) and a 2% lidocaine gel applied topically on the oral mucosa. Application of EMLA for 2 min on the tongue and gingiva increased the pain thresholds by 92.8% and 63.4% respectively. Corresponding values for lidocaine gel were 53.6% and 21.9%. Standardized variation of the EMLA application period (2, 5, and 15 min) produced significantly different analgesic profiles on the tongue but not on the gingiva. Application of EMLA for 5 and 15 min on the tongue and for 2, 5, and 15 min on the gingiva increased the pain thresholds to a predefined analgesic level (2.15 W) for 2 to 25 min. The present experimental model for assessment of oral mucosa pain is suggested to be well-suited for investigations of intraoral analgesia. PMID:8507024

Svensson, P.; Bjerring, P.; Arendt-Nielsen, L.; Kaaber, S.



Measurements of duodenal wall motility, mucosal fluid transport and alkaline secretion. Description and evaluation of a methodological approach in the anaesthetized cat.  


This paper describes and evaluates a method for simultaneous recordings of duodenal motility and mucosal secretions in chloralose-anaesthetized cats. Biliary and pancreatic secretions were diverted by separate cannulation of each duct. A 2 cm segment of the proximal duodenum was isolated between two luminally situated balloons (the proximal balloon being positioned immediately distal to the pylorus). Each balloon was connected to a barostatic device maintaining a constant pressure within the balloon independent of the degree of contraction. Motor activity in the duodenal wall was recorded as changes in balloon volume. The duodenal segment was perfused at a constant rate with isotonic saline containing [14C]PEG 4000 as a non-absorbable marker. The recovered perfusate was sampled in 5 min fractions and analysed with regard to alkalinity (back titration) and concentration of marker (liquid scintillation). Net alkalinization and net fluid transport was calculated with conventional equations. The sensitivity of the analytical procedures was tested bench-side. The technique was evaluated in vivo during basal conditions and during acid exposure of the mucosa. Exposing the duodenal segment to 30 mM HCl induced a marked change in the duodenal functional state with the occurrence of a polarized duodenal motility pattern, net fluid secretion and an increased alkaline secretion. PMID:8237423

Fändriks, L



Duodenal adenomatosis in familial adenomatous polyposis  

PubMed Central

Background: The prevalence of duodenal carcinoma is much higher in familial adenomatous polyposis (FAP) than in the background population, and duodenal adenomatosis is found in most polyposis patients. Aims: To describe the long term natural history of duodenal adenomatosis in FAP and evaluate if cancer prophylactic surveillance of the duodenum is indicated. Methods: A prospective five nation study was carried out in the Nordic countries and the Netherlands. Patients: A total of 368 patients were examined by gastroduodenoscopy at two year intervals during the period 1990–2001. Results: At the first endoscopy, 238 (65%) patients had duodenal adenomas at a median age of 38 years. Median follow up was 7.6 years. The cumulative incidence of adenomatosis at age 70 years was 90% (95% confidence interval (CI) 79–100%), and of Spigelman stage IV 52% (95% CI 28–76%). The probability of an advanced Spigelman score increased during the study period (p<0.0001) due to an increasing number and size of adenomas. Two patients had asymptomatic duodenal carcinoma at their first endoscopy while four developed carcinoma during the study at a median age of 52 years (range 26–58). The cumulative incidence rate of cancer was 4.5% at age 57 years (95% CI 0.1–8.9%) and the risk was higher in patients with Spigelman stage IV at their first endoscopy than in those with stages 0–III (p<0.01). Conclusions: The natural course of duodenal adenomatosis has now been described in detail. The high incidence and increasing severity of duodenal adenomatosis with age justifies prophylactic examination, and a programme is presented for upper gastrointestinal endoscopic surveillance. PMID:14960520

Bulow, S; Bjork, J; Christensen, I J; Fausa, O; Jarvinen, H; Moesgaard, F; Vasen, H F A



Congenital duodenal diaphragm and enteroliths: A Unique complication  

PubMed Central

We report an unusual case of duodenal diaphragm (DD) with “wind-sock” anomaly in a 6-year-old male. The child presented with an acute duodenal obstruction precipitated by multiple pigmented stones completely blocking the duodenum. PMID:20419028

Bhat, Nisar Ahmad



Duodenal diverticula: potential complications and common imaging pitfalls.  


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

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



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

PubMed Central

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, identifier NCT00808743 PMID:23919274



Choledochoduodenal fistula at the anterior wall of the duodenal bulb: a rare complication of duodenal ulcer.  


A 38 year-old man was admitted to our hospital with the chief complaint of epigastralgia. His laboratory data revealed leukocytosis and increased serum amylase, and abdominal ultrasonography revealed diffuse swelling of the pancreas. Thus, he was diagnosed as having acute pancreatitis. Moreover, abdominal computed tomography showed pneumobilia in the gallbladder and the common bile duct. Gastroduodenal fiberscopy demonstrated peptic ulcer scars around a foramen with smooth margins at the anterior wall of the duodenal bulb. The bile juice flowed from the bottom of the foramen. Endoscopic retrograde cholangiopancreatography revealed the fistula between the common bile duct and the anterior wall of the duodenal bulb, but not the posterior wall. However, there was no pancreatico-biliary maljunction and no stones in the gallbladder or bile duct. This is a rare case of choledochoduodenal fistula at the anterior wall of the duodenal bulb caused by duodenal peptic ulcer disease. PMID:10228804

Shimao, K; Yamaue, H; Nishimoto, N; Terasawa, H; Saigan, S; Onishi, H; Tanimura, H; Hashimoto, T




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...


Duodenal web presenting with acute pancreatitis.  


An 8-year-old boy presented with acute pancreatitis and was found to have a fenestrated duodenal web (windsock) and associated anomalies. After partial excision of the web and duodenoplasty, he has remained well with no further symptoms. PMID:9269984

Alizai, N K; Puntis, J W; Stringer, M D



Pancreatic arteriovenous malformation with duodenal ulcer  

Microsoft Academic Search

Summary We report the color Doppler ultrasonography features of arteriovenous malformation (AVM) of the pancreas, a very rare disease. The patient was a 52-year-old man with congenital AVM of the pancreas and a duodenal ulcer that had been resistant to medication. Endoscopic color Doppler ultrasonography (color Doppler EUS) revealed many abnormal color signals showing pulsatile wave form at the portion

Shigeo Tano; Norio Ueno; Tomio Ueno; Shin-Ichi Wada; Toshiyuki Aizawa; Ken Kimura



Ultrastructural changes in malignant transformation of oral mucosa.  


Transmission electron microscopy (EM) has been used to identify the ultrastructural details of normal and cancerous human oral mucosa. However, inconsistent reports of structural descriptions have rendered transmission EM valueless in the diagnosis of oral squamous cell carcinoma (SCC) or as a prognostic indicator. To identify features of dysplasia for diagnostic purposes, normal mucosa, severe dysplasia, oral SCC and normal margin adjacent to oral SCC were used to compare the ultrastructural features of normal and premalignant oral mucosa and oral SCC. The preparatory stages of dehydration, embedding, cutting and positive staining for transmission EM were modified and tested to improve ultrastructural definition. Thin and discontinuous basal laminas were found in mucosa with severe dysplasia and normal margin adjacent to oral SCC. No basal lamina was identified in oral SCC. This study has shown that there are some ultrastructural changes during malignant transformation of oral mucosa. Together with other laboratory investigative techniques, transmission EM may be helpful in detecting malignant changes in oral mucosa. PMID:12054710

Cheng, L H-H; Hudson, J



Duodenal ulceration: review of 110 cases.  

PubMed Central

This paper describes 110 cases of childhood duodenal ulcer, which were diagnosed over 26 years: 63 were diagnosed by barium meal examination; 47 by upper gastrointestinal endoscopy. The mean age at diagnosis was 11.2 years, with symptoms reported in 46% before 10 years and in 15% before 6 years of age. There was often a considerable delay in diagnosis, particularly in the younger age group. Nocturnal pain (61%) and a close family history of duodenal ulcer disease (62%) were the most valuable pointers to the diagnosis. Fifteen children had required surgery for persistent symptoms. Thirty four had received treatment with an H2 receptor antagonist, and all but four had had a satisfactory initial response. Seventy per cent relapsed within six months of discontinuing treatment, and long term maintenance treatment may therefore be necessary. PMID:3619471

Murphy, M S; Eastham, E J; Jimenez, M; Nelson, R; Jackson, R H



Intramural duodenal diverticulum mimicking a periampullary neoplasm.  


A 34-year-old woman presented with epigastric pain, nausea, and dyspepsia. Contrast-enhanced computerized tomography revealed a small mass in the duodenal wall mimicking a periampullary neoplasm and, at endoscopic examination, a periampullary submucosal tumor was suspected. The diagnosis of intramural duodenal diverticulum (IDD) was made by an x-ray barium meal that showed a finger-like sac filled with barium, the so-called "windsock sign." IDD is a rare congenital abnormality caused by an anomalous process of recanalization of the primitive foregut. The intermittent filling and emptying of the IDD is responsible for epigastric pain, nausea, and vomiting. When IDD is symptomatic, surgical or endoscopic treatment is recommended. PMID:18614138

Clemente, Gennaro; Sarno, Gerardo; Giordano, Marco; De Rose, Agostino M; Nuzzo, Gennaro



Refractory Duodenal Crohn's Disease Successfully Treated with Infliximab  

PubMed Central

Crohn's disease (CD) may involve any part of the gastrointestinal tract, from the mouth to the anus. Approximately >90% of cases occur in the small bowel and colon. Upper gastrointestinal involvement, especially duodenal manifestation, is relatively rare. Therefore, adequate medical treatment for duodenal CD has not yet been established. We report a case of CD with duodenal involvement. A 46-year-old man with Crohn's ileocolitis presented to our hospital with right upper quadrant pain. An endoscopy showed a deep excavated ulcer with deformity at the duodenal bulb, and he was initially treated with azathioprine (1 mg/kg), Pentasa (3.0 g/day), and a proton pump inhibitor for 1 year. However, the deep ulcer did not heal. Therefore, infliximab infusion therapy was initiated, and the duodenal lesion completely resolved on follow-up esophagogastroduodenoscopy. We report a case of duodenal CD that completely resolved following infliximab infusion, with a review of the literature. PMID:25349566

Kim, You Lim; Park, Eun Kyoung; Park, Dae Rim; Choi, Gyu Sik; Ahn, Sang Bong; Kim, Seong Hwan; Jo, Yun Ju



Diagnosis and management of intraluminal duodenal diverticulum  

Microsoft Academic Search

The descending part of duodenum is the principal site for an intraluminally projecting mucosal pouch or diverticulum, but\\u000a this unusual lesion may also occur elsewhere in the upper gastrointestinal tract. We report three patients in whom a large\\u000a intraluminal duodenal diverticulum (IDD) was diagnosed radiographically at the ages of 15, 27, and 68 years, respectively.\\u000a Fiberoptic duodenoscopy was performed in

Monty P. Karoll; Gary G. Ghahremani; Ronald B. Port; James L. Rosenberg



Successful Treatment of Duodenal Variceal Bleeding by Endoscopic Clipping  

PubMed Central

Duodenal varix bleeding is an uncommon cause of gastrointestinal bleeding in patients with portal hypertension but can cause severe and potentially fatal bleeding. However, the incidence is low and a good treatment method has not been well established yet. Duodenal variceal bleeding can be treated surgically or nonsurgically. We have successfully treated a patient with duodenal variceal bleeding secondary to liver cirrhosis using hemoclips to control the bleeding. PMID:23964340

Park, Su Bin; Kim, Jin Hee; Lee, Hyun Jung; Jang, Sung Pil; Lee, Jae Nam; Hwang, Jong Ho



Plasmablastic lasmablastic lymphoma of the duodenal and jejunum  

PubMed Central

Plasmablastic lymphoma (PBL) is a rare B-cell neoplasm with an aggressive clinical behavior that predominantly occurs in the oral cavity of human immunodeficiency virus (HIV)-positive patients. HIV-negative PBL has not been extensively reported. A 65-year-old female presented with anemia, who was HIV-negative. Gastrointestinal fiberscope (GIF), and colon fiberscope (CF) were performed. However, we could not detect the bleeding sites. We detected the tumor by capsule endoscopy, and obtained the tumor cells from the duodenal and jejunal sites. The neoplastic cells were diffusely positive for CD56, epithelial membrane (EMA), CD4, ?, and EBV-encoded RNA1 (EBER1) and partially positive for CD138 and CD79a. This patient was diagnosed as PBL. The small intestine is a rare extra-oral site of involvement in PBL patients, and only four cases in HIV-negative patients have been reported. PMID:25120837

Koike, Michiaki; Masuda, Azuchi; Ichikawa, Kunimoto; Shigemitu, Ayako; Komatus, Norio



Increased rates of duodenal mucosal protein synthesis in vivo in patients with untreated coelia disease.  

PubMed Central

BACKGROUND AND AIMS: A robust, reproducible method for the measurement of protein synthesis in the gastrointestinal mucosa was applied to investigate possible differences between the rate of duodenal mucosal protein synthesis in coeliac patients and normal control subjects. PATIENTS AND METHODS: Eight patients, means (SD) (51 (10) years, 57 (11) kg, 160 (6) cm) with newly diagnosed untreated coeliac disease and seven control subjects (48 (11) years, 71.5 (12) kg, 172 (10) cm) received primed, continuous, intragastric (IG) and intravenous (i.v.) infusions of L-[1-13C]leucine and L-[1-13C]valine after an overnight fast. Distal duodenal biopsy specimens were obtained at endoscopy performed after 240 minutes of infusion. Protein synthesis was calculated from protein labelling relative to intracellular free amino acid enrichment, after appropriate mass spectrometric measurements. RESULTS: Rates of duodenal protein synthesis were significantly greater in coeliac patients than in control subjects (i.v. tracer, coeliac v control, 3.58 (0.45) v 2.26 (0.22)%/h, p< 0.05; IG tracer, 6.25 (0.97) v 2.34 (0.52)%/h respectively, p < 0.01). The rates of mucosal protein synthesis calculated on the basis of the tracer infused via the intragastric route were higher in patients with coeliac disease than in control subjects. Tissue protein/DNA ratios were significantly reduced in coeliac patients (coeliac v control, 9.2 (1.6) mg/micrograms v 13.0 (2.2) mg/micrograms respectively, p < 0.05) suggesting smaller mucosal cell size in coeliac patients. CONCLUSIONS: Despite the villous atrophy and reduced cell size observed in coeliac disease, the rates of mucosal protein synthesis are considerably increased. These results suggest that a high rate of protein synthesis may be adaptive to a high rate of protein breakdown or mucosal cell loss in coeliac patients. PMID:8991854

Nakshabendi, I M; Downie, S; Russell, R I; Rennie, M J



A study of changes in stomach wall at sites other than the ulcer in chronic duodenal ulcer patients.  


It is known that at least 90% of duodenal ulcers are caused by infection with the bacterium Helicobacter pylori. Eradicating this organism usually results in complete resolution of the disease (Rosengren, Br J Gen Pract 46(409):491-492, 1996). To study the different changes if any in stomach wall at sites other than the ulcer in chronic duodenal ulcer patients by upper Gastro-Intenstinal Endoscopy followed by histopathological examination of different parts of stomach. This study was a retrospective study conducted in the Department of General surgery, V.S.S. Medical College, Burla, Sambalpur, odisha during the period of June 2007 to May 2009. Subjects were patients with chronic duodenal ulcer who underwent endoscopic examination, gastric biopsy and rapid urease test. Chronic gastritis of antrum, followed by erythematous pangastritis was the prominent feature both in endoscopy and histopathological examination. The Inflammatory change affected the mucosa and submucosa of the stomach wall. The prevalence rate of Helicobacter pylori was 84%, the antrum being the most common affected part (84%) followed by gastric fundus (41%). Chronic superficial atrophic gastritis of antrum, followed by pangastritis is the most common pathological abnormality in stomach wall in CDU cases. Gastric antrum is the most common site for H. pylori colonization followed by fundus. Presence of H. pylori in stomach wall is associated with active on chronic gastritis. PMID:22851838

Mishra, Jagmohan; Panigrahi, Souvagya



Comparison of relapse rates and of mucosal abnormalities after healing of duodenal ulceration and after one year's maintenance with cimetidine or sucralfate: a light and electron microscopy study.  

PubMed Central

Forty six patients with endoscopically diagnosed duodenal ulceration were randomly allocated to treatment with either sucralfate 1 g qds (n = 24) or cimetidine 200 mg tds and 400 mg nocte (n = 22). When the ulcers healed, a maintenance dose of sucralfate 1 g bd or cimetidine 400 mg nocte was given for one year (or until relapse if earlier). Biopsies of duodenal mucosa adjacent to ulcer sites for light and electron microscopy were obtained before and after healing and again after one year's maintenance if the ulcer remained healed. Duodenal biopsies were also taken from 20 age and sex matched controls. Rates of healing and relapse during maintenance did not differ between the two treatments, although relapses occurred earlier with cimetidine. In the three year post-maintenance follow up period 10/13 cimetidine patients relapsed compared with four of 11 sucralfate patients (p less than 0.05), the relapses occurring significantly earlier in the cimetidine treated patients (p less than 0.05). Mucosal biopsies from both treatment groups still showed considerable abnormalities after healing. During maintenance, however, the sucralfate scores fell significantly (p less than 0.02) to near control levels unlike the cimetidine scores which remained raised at pretreatment values. The histological and ultrastructural changes were not predictive of later relapse. These findings favour the use of sucralfate in preference to cimetidine for maintenance treatment in the prevention of relapse of healed duodenal ulcers. Images Fig. 1 Fig. 2 PMID:2731750

Tovey, F I; Husband, E M; Yiu, Y C; Baker, L; McPhail, G; Lewin, M R; Jayaraj, A P; Clark, C G



Duodenal perforation associated with norovirus and rotavirus gastroenteritis  

PubMed Central

Key Clinical Message Norovirus (NoV) and rotavirus (RV) gastroenteritis are usually self-limiting. However, few pediatric cases of bowel perforation and no duodenal perforation with NoV gastroenteritis were reported. We describe two children with duodenal perforation due to NoV or RV gastroenteritis. Suspicion for this association enables prompt intervention, preventing lethal outcomes of these common infections.

Ueda, Norishi; Shimotake, Takashi; Ohama, Kazunori



Electromagnetic measurements of duodenal digesta flow in cannulated sheep  

E-print Network

Electromagnetic measurements of duodenal digesta flow in cannulated sheep C. PONCET, M. IVAN M of duodenal digesta flow were made in sheep implanted with an electromagnetic flowmeter probe on the ascending to frequent oscillation of the digesta. It was concluded that accurate quantitative electromagnetic

Paris-Sud XI, Université de


Duodenal Switch: Long-Term Results  

Microsoft Academic Search

\\u000a Background  This report summarizes our 15-year experience with duodenal switch (DS) as a primary procedure on 1,423 patients from 1992\\u000a to 2005.\\u000a \\u000a \\u000a \\u000a Methods  Within the last 2 years, follow-up of these patients, including clinical biochemistry evaluation by us or by their local physician\\u000a is 97%.\\u000a \\u000a \\u000a \\u000a Results  Survival rate was 92% after DS. The risk of death (Excess Hazard Ratio (EHR)) was 1.2, almost that

Picard Marceau; Simon Biron; Frédéric-Simon Hould; Stéfane Lebel; Simon Marceau; Odette Lescelleur; Laurent Biertho; Serge Simard



Cytochrome P4502A6 stability in a mini organ culture model of human nasal mucosa for genotoxicology studies as detected by flow cytometry  

Microsoft Academic Search

Three dimensional mini organ cultures (MOCs) of human nasal turbinate epithelia have been shown to be a relevant tool in genotoxicology\\u000a studies. MOCs allow repetitive or chronic exposure of cells in an organ specific mucosal architecture for an extended period\\u000a of time and monitoring of possible adverse effects with, e.g., the comet assay. It is the aim to demonstrate whether

Norbert H. Kleinsasser; Ulrich A. Harréus; Fernando Gamarra; Oliver Driemel; Rudolf Hagen; Michael Buehrlen



Duodenal perforation: an unusual complication of sickle cell anemia  

PubMed Central

Duodenal perforation in childhood is a rare condition with a high mortality rate if not treated surgically. Primary gastroduodenal perforation is frequently associated with peptic ulcer and exhibits a positive family history. Helicobacter pylorus is the most significant agent. Secondary gastroduodenal perforation may be a finding of specific diseases, such as Crohn disease, or more rarely may be associated with diseases such as cystic fibrosis or sickle cell anemia. A 14-year-old boy presented with abdominal and back pain. The patient was operated on for acute abdomen and diagnosed with duodenal perforation. Helicobacter pylorus was negative. There was no risk factor to account for duodenal perforation other than sickle cell anemia. Surgical intervention was successful and without significant sequelae. Duodenal perforation is a rare entity described in patients with sickle cell anemia. To our knowledge, this is the first report of duodenal perforation in a patient sickle cell anemia.

Ac?payam, Can; Ald?ç, Güliz; Akçora, Bülent; Çelikkaya, Mehmet Emin; A?kar, Hasan; Dorum, Bayram Ali



Duodenal diverticula occurring in a family--chance or inheritance?  

PubMed Central

The incidence, aetiology and possible inheritance of duodenal diverticula remain controversial. These aspects are discussed through the presentation of a family, in which duodenal diverticula occurred in a man and his two sons. To the best of our knowledge, this is the first such family documented in the medical literature. This familial occurrence may be attributed solely to the high incidence of duodenal diverticula in the general population (set by various authors at up to 14.2%), and, therefore, of no hereditary significance at all. We believe a screening study of the families of individuals with proven duodenal diverticula is most desirable, for it could shed light upon the controversial questions of incidence, aetiology, and inheritance patterns of duodenal diverticula. PMID:6431400

Sternberg, A.; Deutsch, A. A.; Kott, I.; Reiss, R.



Formation of duodenal atresias in Fibroblast growth factor receptor 2IIIb-/- mouse embryos occurs in the absence of an endodermal plug  

PubMed Central

Purpose Duodenal atresia in humans has been hypothesized to arise from a failure of the duodenal lumen to recanalize after formation of an endodermal plug. Recently, mutations in the Fibroblast Growth Factor Receptor 2 gene have been shown to cause atretic defects of the duodenum in mice (Fgfr2IIIb). However, work in rats suggests that murine species do not form an endodermal plug during normal duodenal development. These lines of data led us to hypothesize that mice are able to form a duodenal atresia in the absence of an endodermal plug. To test this hypothesis we examined duodenal development in wild-type and Fgfr2IIIb-/- embryos. Methods Paraffin sections were generated for either hematoxylin and eosin, E-cadherin or terminal deoxynucleotidyl transferase mediated X-dUTP nick end labeling (TUNEL) staining from Fgfr2IIIb-/- and wild-type embryos between Embryonic Days (E) 10.5 and E14.5. Sections were photographed and reconstructed into 3-dimensional display using Adobe Photoshop and Amira Visage software. Results Normal mouse duodenum does not form an endodermal plug, although a plug does form in the pyloric region of the stomach at E14.5. Fgfr2IIIb-/- embryos experience significant apoptosis in the duodenal region at E10.5, followed by the disappearance of the endoderm in the atretic precursor by E11.5. Thereafter, the mesoderm of the atretic precursor involutes over the next 2 days in the absence of further apoptosis. Interestingly, an endodermal plug was not observed at any point during the formation of a duodenal atresia. Conclusions These results suggest that duodenal atresia in the Fgfr2IIIb-/- model does not arise from persistence of an epithelial plug. Rather it appears to result from the loss of the endoderm due to apoptosis very early in development. PMID:22813799

Botham, Robert; Franco, Marta; Reeder, Amy; Lopukhin, Anastasia; Shiota, Kohei; Yamada, Shigehito; Nichol, Peter F.



Symptomatic duodenal Crohn's disease: is strictureplasty the right choice?  


Primary duodenal localization of Crohn's disease (CD) is rare. Medical therapy can control symptoms, but surgery is required when progressive obstructive symptoms occur. Surgical options include bypass, resection, or strictureplasty, but it is still not clear which should be the treatment of choice. Reviewing the medical records of 1253 patients undergoing surgery for CD between January 1986 and December 2011 at the Digestive Surgery Unit of the Department of Clinical Physiopathology of the University of Florence, 10 patients (6 males and 4 females) underwent operations for duodenal CD. Four patients had only a duodenal localization, 6 patients had synchronous involvement of other intestinal tracts. Strictures were distributed in all the duodenal portions: in 7 patients there were single lesions, in 3 patients there were multiple lesions. Eight patients were treated with strictureplasty: 5 with the Heineke-Mikulicz technique, 2 with Jaboulay, and 1 with a pedunculated jejunal patch. Two patients were treated with resection: one with a B2 gastro-duodenal resection, and 1 with a duodenal-jejunal resection and an end to side duodeno-jejunal anastomosis. Follow up of the patients was from 2 to 18 years. No recurrence of duodenal CD was observed in the 2 patients treated with resection, while 2 of the 8 patients treated with strictureplasty had a recurrence. In our experience, strictureplasty is indicated when less than 2 strictures are present in the 2nd or 3rd duodenal portion. In cases with multiple strictures localized in the 1st or the distal duodenal portion, resection is preferable. PMID:23165121

Tonelli, Francesco; Alemanno, Giovanni; Bellucci, Francesco; Focardi, Adriana; Sturiale, Alessandro; Giudici, Francesco



Duodenal obstruction due to a preduodenal portal vein.  


An infant presented with clinical signs and symptoms suggestive of a pyloric stenosis. On abdominal ultrasound, pyloric stenosis was excluded, and other causes for proximal duodenal obstruction, such as a duodenal web or annular pancreas, were suspected. At surgery, the cause was found to be due to an anterior portal vein or preduodenal portal vein, compressing the duodenum. There were no associated findings such as midgut malrotation, duodenal web and congenital anomalies. The treatment was a diamond-shaped duodeno-duodenostomy anterior to the portal vein. The patient improved after surgery. PMID:25323190

Vilakazi, Mnc; Ismail, F; Swanepoel, H M; Muller, E W; Lockhat, Z I



Effect of inflammatory mediators on nasal mucosa.  


A technique used for study of permeability and vasodilation in the middle ear has been adapted to study the response of nasal mucosa to common inflammatory mediators involved in the natural production of allergic or infectious rhinitis. All of the mediators tested (histamine, prostaglandin E1, bradykinin, the C3a fraction of complement, Escherichia coli endotoxin, and lysozyme) were found to increase nasal permeability to the isotopic tracer 99mTc as the pertechnetate ion. Histamine increased the permeability of nasal mucosa to technetium-labeled plasma protein. Results indicate that the nasal mucosa is approximately ten times as permeable to the pertechnetate ion as middle ear mucosa. Nasal mucosa was also noted to be permeable to protein, even in the absence of inflammatory mediator, in contrast to prior studies of middle ear mucosa that showed little or no permeability in the absence of inflammatory mediator. In almost all cases, a corresponding change in vasodilation accompanied permeability changes. PMID:327989

Jackson, R T; Burson, J H



Neuropathologic analysis of Lewy-related ?-synucleinopathy in olfactory mucosa.  


We analyzed the incidence and extent of Lewy-related ?-synucleinopathy (LBAS) in the olfactory mucosa, as well as the central and peripheral nervous systems of consecutive autopsy cases from a general geriatric hospital. The brain and olfactory mucosa were immunohistochemically examined using antibodies raised against phosphorylated ?-synuclein. Thirty-nine out of 105 patients (37.1%) showed LBAS in the central or peripheral nervous systems. Seven patients presented LBAS (Lewy neurites) in the olfactory lamina propria mucosa. One out of the seven cases also showed a Lewy neurite in a bundle of axons in the cribriform plate, but ?-synuclein deposits were not detected in the olfactory receptor neurons. In particular, high incidence of ?-synuclein immunopositive LBAS in the olfactory mucosa was present in the individuals with clinically as well as neuropathologically confirmed Parkinson's disease and dementia with Lewy bodies (6/8 cases, 75%). However, this pathologic alteration was rare in the cases with incidental or subclinical Lewy body diseases (LBD) (one out of 31 cases, 3.2%). In the olfactory bulb, the LBAS was usually present in the glomeruli and granular cells of most symptomatic and asymptomatic cases with LBD. Our studies further confirmed importance of the olfactory entry zone in propagation of LBAS in the human aging nervous system. PMID:22672612

Funabe, Sayaka; Takao, Masaki; Saito, Yuko; Hatsuta, Hiroyuki; Sugiyama, Mikiko; Ito, Shinji; Kanemaru, Kazutomi; Sawabe, Motoji; Arai, Tomio; Mochizuki, Hideki; Hattori, Nobutaka; Murayama, Shigeo



The H2-receptor antagonist era in duodenal ulcer disease.  

PubMed Central

This paper reviews the remarkable impact of H2-receptor antagonists on duodenal ulcer management. The development and the scientific rationale of these agents are presented, and efficacy and safety aspects in the short- and long-term treatment of duodenal ulcer disease discussed. Attention is focused on the possible role of "acid rebound" in ulcer relapse following the withdrawal of therapy and on the clinical relevance of prolonged suppression of acid secretion in patients on long-term therapy. PMID:1364125

Marks, I. N.



Further Experience with Epigastric Pain Reproduction Test in Duodenal Ulceration  

Microsoft Academic Search

Further evidence is presented that the epigastric pain of duodenal ulceration, situated between the rib margins and just below the xiphisternum, arises from the lower oesophagus.One-hundred patients with duodenal ulceration were divided into those with epigastric pain (61) and those with pain in the upper abdomen but not in the epigastrium (39). Perfusion of 0·1 N HCl into the lower

Richard J. Earlam



CT-appearance of intraluminal duodenal diverticulum. The "halo" sign.  


The barium appearance of intraluminal duodenal diverticulum has been classically described as a "windsock" appearance. However, the CT-scan appearance of this abnormality has not been well documented. A case report of a patient with intraluminal duodenal diverticulum is presented. The authors believe the CT-scan findings in the patient are virtually pathognomonic for this lesion and propose the term "halo" sign be applied to this previously undescribed finding. PMID:9745949

Tu, A S; Tran, M H; Larsen, C R



Comparison of quantitative and qualitative duodenal fluid versus duodenal mucosa cultures in German Shepherd Dogs with spontaneous small bowel bacterial overgrowth  

E-print Network

motility and the ileocolic valve. ~~ The low gastric pH is bactericidal to most bacteria and generally only bacteria encased within food particles survive passage through the stomach. " Use of antacids or H, -receptor antagonists to neutralize... motility and the ileocolic valve. ~~ The low gastric pH is bactericidal to most bacteria and generally only bacteria encased within food particles survive passage through the stomach. " Use of antacids or H, -receptor antagonists to neutralize...

Delles, Edward Kevin



Duodenal web associated with malrotation and review of literature  

PubMed Central

Intestinal obstruction due to midgut malrotation in neonates is well known. The incidence of malrotation in newborns is around 1:500 and the symptomatic incidence is 1:6000 births. Duodenal web as a cause of intestinal obstruction is less common and is reported to be 1:10 000–1:40 000. Malrotation is known to be associated with other congenital obstructive anomalies including duodenal atresia, stenosis and duodenal web. But, intestinal obstruction due to malrotation associated with duodenal web has been reported only rarely with a few published cases in our literature review. We present a case of intestinal obstruction diagnosed in the prenatal period via sonogram. A plain X-ray of the abdomen after birth showed a distended duodenum with paucity of air distally suggesting duodenal obstruction. An exploratory laparotomy showed a duodenal web proximal to the sphincter of oddi. The patient also had an associated malrotation and underwent Ladd's procedure and appendectomy. The post-operative period was uneventful. PMID:24968440

Eksarko, Polikseni; Nazir, Sharique; Kessler, Edmund; LeBlanc, Patrick; Zeidman, Michael; Asarian, Armand P.; Xiao, Philip; Pappas, Peter J.



Failure to demonstrate specificity of the morphological and histochemical changes in mucosa adjacent to colonic carcinoma (transitional mucosa)  

Microsoft Academic Search

Characteristic morphological and histochemical changes in mucosa adjacent to colorectal adenocarcinomas have been described. It has been suggested that this type of mucosa, labelled transitional mucosa (TM) because of its specific association with colorectal adenocarcinoma, is indicative of a premalignant change. In an investigation of mucosa adjacent to anal tumours extending into the rectum and mucosa from solitary ulcer syndrome

P Isaacson; P R Attwood



Changes in Plasma and Colonic Mucosa Fatty Acid Profiles in Rats with Ulcerative Colitis Induced by Trinitrobenzene Sulfonic Acid  

Microsoft Academic Search

Polyunsaturated fatty acids have a key role inthe pathogenesis of inflammatory bowel disease sincesome of the arachidonic acid-derived eicosanoids havebeen found to be increased in inflamed intestinal mucosa in the acute phase of human disease. Theaim of this study was to prospectively assess plasma andcolon mucosa fatty acid patterns in rats withexperimental ulcerative colitis. Twenty rats weretreated with trinitrobenzene sulfonic

N. Nieto; M. D. Giron; M. D. Suarez; A. Gil



Correlation of tissue transglutaminase antibody with duodenal histologic marsh grading.  


BACKGROUND Recent guidelines have proposed that there is a correlation between tissue transglutaminase (tTG) antibody titers and degrees of duodenal biopsy, and that duodenal biopsy can be omitted in some patients with high levels of tTG antibody. Using data of registered patients in a gastrointestinal clinic we aimed to assess the correlation between tissue transglutaminase antibody with duodenal histologic Marsh grading in Iranian patients with celiac disease. METHODS We retrospectively reviewed hospital files of registered patients in the gastrointestinal clinic of Firoozgar Hospital, Tehran, Iran. Demographic, laboratory, and histology data of those who had tTG titer and pathology reports of duodenal biopsy based on the modified Marsh classification were extracted and used for the study. RESULTS 159 patients with available tTG titer and pathology reports were enrolled in our study. Mean ±SD of the patients was 35.6±15.2 and 100 (62.9%) of them were women. 133 out of 153 patients had villous atrophy (Marsh IIIa-IIIc). Anemia was the most common sign and bloating, abdominal pain, and diarrhea were the first three common symptoms in these patients. Mean tTG titers was significantly higher in patients graded as Marsh III (p for trend=0.003). Our results showed that tTG titer more than 9 folds higher than the kit's cut-off value was about 97.2% sensitive for Marsh II and more duodenal damage. CONCLUSION There was a correlation between tTG titers and degrees of duodenal damage in patients with celiac disease. Duodenal biopsy is not always necessary for diagnosing celiac disease and when tTG level is more than 9 folds higher than the manufacture's recommended cut-off value it can be avoided. Meanwhile small intestinal biopsy should always be considered in case of high clinical suspicion, regardless of the results of serologic testing. PMID:25093060

Rahmati, Atieh; Shakeri, Ramin; Sohrabi, Masoudreza; Alipour, Abbass; Boghratian, Amirhossein; Setareh, Massomeh; Zamani, Farhad



Purinergic regulation of duodenal surface pH and ATP concentration: Implications for mucosal defense, lipid uptake, and cystic fibrosis  

PubMed Central

The duodenum secretes HCO3? as part of a multi-layered series of defense mechanism against damage from luminal acid. In the 1980s, an alkaline surface layer was measured over the mucosa which correlated with the rate of HCO3? secretion. Since all biological processes are regulated, we investigated how the alkaline pH of the surface layer was maintained. Since the ecto-phosphorylase alkaline phosphatase (AP) is highly expressed in the duodenal brush border, we hypothesized that its extreme alkaline pH optimum (~pH 8-9) combined with its ability to hydrolyze regulatory purines such as ATP was part of an ecto-purinergic signalling system, consisting also of brush border P2Y receptors and CFTR-mediated HCO3? secretion. Extracellular ATP increases the rate of HCO3? secretion through this purinergic system. At high surface pH (pHs), AP activity is increased, which then increases the rate of ATP hydrolysis, decreasing surface ATP concentration ([ATP]s), with a resultant decrease of the rate of HCO3? secretion, which subsequently decreases pHs. This feedback loop is thus hypothesized to regulate pHs over the duodenal mucosa, and in several other HCO3? secretory organs. Since AP activity is directly related to pHs, and since AP hydrolyzes ATP, [ATP]s and pHs are co-regulated. Since many essential tissue functions such as ciliary motility and lipid uptake are dependent on [ATP]s, dysregulation of pHs and [ATP]s may help explain the tissue dysfunction characteristic of diseases such as cystic fibrosis. PMID:20560899

Kaunitz, Jonathan D; Akiba, Yasutada



Telomere shortening in the colonic mucosa of patients with ulcerative colitis.  


Telomere length in human somatic cells gradually decreases with the number of cell divisions and is regarded as a marker of somatic cell turnover. Mucosal cells of the affected colon show rapid turnover in individuals with active ulcerative colitis (UC). Telomere length was determined by Southern blot analysis of terminal restriction fragments (TRFs) from the colonic mucosa of 17 patients with UC in remission, two of whom showed dysplasia, and 17 control subjects without colitis. For each individual, mean TRF length was compared between rectal mucosa and unaffected cecal mucosa. The mean TRF length of the rectal mucosa was significantly less than that of cecal mucosa in UC patients (7.87 +/- 0.36kb versus 8.77 +/- 0.21 kb; P = 0.0015, Wilcoxon signed rank test), whereas no significant difference was detected in the control subjects. The extent of telomere shortening was 10.6 +/- 3.35% in UC patients, compared with 0.8 +/- 0.64% in noncolitis controls (P = 0.0024, Mann-Whitney U-test). Four UC patients, two of whom had dysplasia, showed telomere shortening of more than 20% in the rectal mucosa. These observations suggest that telomere shortening in the colonic mucosa of individuals with UC may represent the history of mucosal inflammation during disease of long duration, and that it may contribute to aneuploidy in UC. PMID:9658312

Kinouchi, Y; Hiwatashi, N; Chida, M; Nagashima, F; Takagi, S; Maekawa, H; Toyota, T



Percutaneous Management of Postoperative Duodenal Stump Leakage with Foley Catheter  

SciTech Connect

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.

Oh, Jung Suk, E-mail:; Lee, Hae Giu, E-mail:; Chun, Ho Jong; Choi, Byung Gil [Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Department of Radiology (Korea, Republic of)] [Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Department of Radiology (Korea, Republic of); Lee, Sang Hoon; Hahn, Seong Tai [Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Department of Radiology (Korea, Republic of)] [Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Department of Radiology (Korea, Republic of); Ohm, Joon Young [Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Department of Radiology (Korea, Republic of)] [Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Department of Radiology (Korea, Republic of)



Surface studies of duodenal lesions induced by thoracic irradiation  

SciTech Connect

Acute duodenal ulcers are produced in mice as a remote (abscopal) effect of irradiation to the lower mediastinum. Such lesions have been examined with scanning electron microscopy at 5, 8 and 28 days after irradiation with 18 Gy of X-rays. All the ulcers occur within the first 1 cm long segment of the duodenum which is endowed with Brunner's glands. The single lesions vary in size, shape and position. The damaged area often includes much of the duodenal circumference and is distinguished by conical or rudimentary villi, or even by the complete absence of villi. In contrast, around the periphery of the ulcer the villi are mostly vertical. Although the floor of these lesions appears to be covered with a continuous epithelial layer, during the first 4 weeks after irradiation the severity of the focal duodenal damage seems to increase gradually with time. The lesions have been compared with specimens from unirradiated mice and also with samples taken 3 days after partial thoracic irradiation when little damage is seen. The pattern of fully developed duodenal lesions differs greatly from that seen after direct irradiation where damage has not included localised ulceration in the samples of jejunum so far examined. The lesions induced by partial thoracic irradiation may be related to radiation injury to vascular or autonomic nerve targets in the lower mediastinum. Such injury could result in malfunction of the pyloric sphincter or could alter the secretion by Brunner's glands and thus lead to duodenal ulceration.

Carr, K.E.; Ellis, S.; Michalowski, A.



Condyloma acuminatum of the buccal mucosa.  


Condyloma acuminatum is a human papillomavirus (HPV)-induced disease. It is usually transmitted sexually, and it frequently occurs in the anogenital area. A finding of condyloma acuminatum in the oral cavity is rare. Besides HPV, other risk factors for oral condyloma include chewing betel quid and smoking. We report the case of a 52-year-old man who presented with a 2 × 2-cm verrucous white patch on his buccal mucosa. He was habituated to both betel quid and cigarette smoking. A biopsy of the lesion identified it as a verrucous hyperplasia of the squamous epithelium with HPV-related koilocytic changes. The lesion was excised, and further histopathology identified it as condyloma acuminatum. The patient was disease-free 9 months postoperatively. The possibility of condyloma acuminatum should be considered in the differential diagnosis of an oral white lesion. The most common treatments are surgical excision, cryosurgery, electrocautery, and laser excision. There is no known role for antiviral therapy. PMID:24932820

Jaiswal, Rashmi; Pandey, Manoj; Shukla, Mridula; Kumar, Mohan



Laparoscopic partial cystectomy with mucosal stripping of extraluminal duodenal duplication cysts  

PubMed Central

Duodenal duplication cysts are rare congenital anomalies. Duodenal duplication should be considered in the differential diagnosis of patients who present with abdominal symptoms with cystic structures neighboring the duodenum. Here, we present an 8-year-old girl with a duodenal duplication cyst treated with partial cystectomy with mucosal stripping performed laparoscopically. Laparoscopic surgery can be considered as a treatment option for duodenal duplication cysts, especially in extraluminal locations. PMID:24574788

Byun, Jeik; Oh, Hyoung-Min; Kim, Soo-Hong; Kim, Hyun-Young; Jung, Sung-Eun; Park, Kwi-Won; Kim, Woo-Sun



Periampullary duodenal duplication cyst masquerading as a choledochocele.  


Enteric duplication cysts are rare congenital anomalies of unclear etiology. While they can occur anywhere in the gastrointestinal tract, they typically occur in the ileum or ileocecal region and very rarely in the duodenum. Here, we report a case of a periampullary duodenal duplication cyst in a 13-year-old male who presented with clinical and laboratory evidence of small bowel obstruction, hepatitis, and pancreatitis. Based on radiologic imaging, the patient was thought to have a type III choledochal cyst (choledochocele) within the duodenal lumen. Intraoperative findings and postoperative pathological evaluation, however, revealed that the lesion was a duodenal duplication cyst masquerading as a choledochal cyst. Interestingly, the duplication cyst was communicating with the common bile duct, simultaneously causing biliary and small bowel obstruction. PMID:22752148

Koffie, Robert M; Lee, Sang; Perez-Atayde, Antonio; Mooney, David P



Gastric and duodenal antiulcer and cytoprotective effects of proglumide in rats  

SciTech Connect

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.

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



Duodenal histoplasmosis presenting with upper gastrointestinal bleeding in an AIDS patient.  


Gastrointestinal histoplasmosis (GIH) is common in patients with disseminated disease but only rarely comes to clinical attention due to the lack of specific signs and symptoms. We report the unusual case of a 33-year-old Caucasian male with advanced AIDS who presented with upper GI bleeding from diffuse erosions throughout the duodenum. Biopsy of the lesions revealed small bowel mucosa with granulomatous inflammation and macrophages with small intracellular yeasts consistent with disseminated histoplasmosis. The patient demonstrated significant clinical improvement following a two-week course of liposomal amphotericin B. To our knowledge, this is the first case report of duodenal histoplasmosis leading to clinically significant bleeding, manifesting with worsening anemia and melanotic stools. Given our findings, we maintain that GIH should be considered on the differential diagnosis for GI bleeding in AIDS patients at risk, specifically those with advanced immunosuppression (i.e., CD4(+) cell counts <100?cells/mm(3)) who reside in endemic areas (Ohio or Mississippi river valleys) and/or have a prior history of histoplasmosis. For diagnostic evaluation, we recommend checking a urine Histoplasma quantitative antigen EIA as well as upper and/or lower endoscopy with biopsy. We recommend treatment with a two-week course of liposomal amphotericin B followed by indefinite itraconazole. PMID:23091745

Spinner, Michael A; Paulin, Heather N; Wester, C William



Gastroduodenal mucosa and dyspeptic symptoms in arthritic patients during chronic nonsteroidal anti-inflammatory drug use.  


Gastroduodenal intolerance is one of the major factors limiting the use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAID) in patients with arthritic conditions. We evaluated the endoscopic appearance of the gastroduodenal mucosa in 65 patients (63 men and two women) taking regular daily doses of NSAIDs over a long period for osteoarthritis or rheumatoid arthritis. Eight different drugs (indomethacin, ibuprofen, naproxen, sulindac, piroxicam, aspirin, salsalate, and tolmetin) had been taken continuously for at least 6 wk. Seven patients took two different NSAIDs. No other drug known to damage the mucosa was used. Twenty-one patients (32%) had an endoscopically completely normal stomach and duodenum, and 44 (68%) had evidence of injury (mucosal hemorrhage 44.6%, erosions 53.8%, both mucosal hemorrhage and erosions 34%). Ten patients had ulcers detected (seven gastric, two pyloric channel, one duodenal bulb) for a point prevalence of 15.4%. Ulcers were found in patients taking naproxen, indomethacin, tolmetin, sulindac, and ibuprofen, either alone, or in combination with aspirin. Dyspeptic symptoms were present in 19% of those with completely normal endoscopy and in only 9% of those with abnormal endoscopic findings. Only three of the 10 patients with ulcer had dyspeptic symptoms. There was no significant difference between drugs in tendency to cause gastroduodenal injury. We confirm that fairly severe gastroduodenal injury occurs in asymptomatic patients with rheumatoid and osteoarthritis, and that symptoms do not predict the presence of damage. PMID:3499815

Larkai, E N; Smith, J L; Lidsky, M D; Graham, D Y



Effect of antisecretory agents and vagotomy on healing of chronic cysteamine-induced duodenal ulcers in rats  

SciTech Connect

Penetrated cysteamine-induced duodenal ulcers in rats have a very prolonged course of healing. In this study, it was investigated how much the healing of these ulcers is accelerated by some treatments. The treatments included omeprazole, cimetidine, and truncal vagotomy. In addition, the effect of omeprazole and cimetidine on gastric acid secretion was investigated in chronic gastric fistula rats. After 25 days of treatment, significantly more rats in the treated groups had healed ulcers than in the control group. There was little further improvement up to 100 days of treatment, and the difference between treated and untreated groups decreased. The morphology of healing ulcers in treated and untreated rats was also compared. In controls, there was a simultaneous regeneration of mucosa and the submucosal Brunner's glands from the edges of the ulcer, the slow proliferation rate of the latter probably being decisive for the prolonged healing. In the treated rats, the mucosa first regenerated with formation of crypts and low villi and subsequently, the Brunner's glands were formed by proliferation from the bottom of the crypts.

Poulsen, S.S.; Raaberg, L.; Therkelsen, K.; Skov Olsen, P.; Kirkegaard, P.



Effect of glyprolines PGP, GP, and PG on homeostasis of gastric mucosa in rats with experimental ethanol-induced gastric ulcers.  


The decrease in the severity of erosions and ulcer lesions after preventive treatment with PGP or PG correlated with a decrease in the content of lipid peroxidation products to a control level. Activities of SOD and catalase also returned to control values. GP produced the weakest effect on pro- and antioxidant state of the gastric mucosa. We concluded that the pronounced preventive effect of PGP and PG on the development of ethanol-induced erosions and ulcer lesions is largely determined by their antioxidant properties. Glyprolines can be considered as a promising means for prevention and treatment of stomach and duodenal ulcers. PMID:21165422

Falalyeyeva, T M; Samonina, G E; Beregovaya, T V; Andreeva, L A; Dvorshchenko, E A



Vagal sensors in the rat duodenal mucosa: distribution and structure as revealed by in vivo DiI-tracing  

Microsoft Academic Search

Results from functional studies point to the importance of chemoreceptive endings in the duodenum innervated by vagal afferents in the regulation of gastrointestinal functions such as gastric emptying and acid secretion, as well as in the process of satiation. In order to visualize the vagal sensory innervation of this gut segment, vagal afferents were selectively labeled in vivo by injecting

Hans-Rudolf Berthoud; Michael Kressel; Helen E. Raybould; Winfried L. Neuhuber



Choledochoduodenal fistula secondary to duodenal peptic ulcer. A case report.  


Spontaneous choledochoduodenal fistula (CDDF) is a rare form of biliary enteric fistula which usually occurs as a complication of duodenal peptic ulcer disease. The more common form is cholecystoduodenal fistula (CCDF) which is generally associated with gallbladder disease. We report on a case of ulcerogenic CDDF diagnosed by upper gastrointestinal barium study, ultrasonography, and gastroduodenal endoscopy. PMID:9394658

Topal, U; Savci, G; Sadikoglu, M Y; Tuncel, E



Review article Estimation of the duodenal flow of microbial nitrogen  

E-print Network

on cattle and sheep fed diets with for- age only. A statistical analysis of YMP was conducted with neutral,isapoorindicationfortheduodenalflowofmicrobialN(g·kg­1 DMintake)inruminants fed diets with forages only. rumen / microbial nitrogen / legumes / grasses was to evaluate the estimation of the duodenal flow of micro- bial nitrogen (N) in ruminants fed forage only, per

Paris-Sud XI, Université de



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...


Life events and chronic duodenal ulcer: a case control study  

Microsoft Academic Search

The frequency of life events during the two years before an exacerbation of ulcer in a duodenal ulcer population was compared with the frequency of these events over the same time period in an age-sex matched probability sample of the community population. The mean number of events and the associated distress and life change scores were similar for both groups.

D W Piper; J H McIntosh; D E Ariotti; J V Calogiuri; R W Brown; C M Shy



Low back pain caused by a duodenal ulcer  

Microsoft Academic Search

The common diagnoses in low back pain are lumbar strain, lumbosacral radiculopathy, osteoarthritis, degenerative disc disease, spinal stenosis, and sacroiliac joint dysfunction. Unusual causes of low back pain that have been previously identified include abdominal aortic aneurysms, pelvic neoplasms, and retroperitoneal hemorrhages. This report describes a case of back pain that was apparently caused by a duodenal ulcer. A 54-year-old

David J. Weiss; Theodore Conliffe; Narayan Tata



Very-low dose antacid in treatment of duodenal ulcer  

Microsoft Academic Search

Antacid (AA) in a very low dose (88 mmol\\/day) was compared to the standard 800-mg dose of cimetidine in healing duodenal ulcers. The influence of sex, age, symptom duration at entry, night pain, smoking, coffee consumption, and alcohol on ulcer healing was studied. The antacid was given in two different schedules: group I-20 ml 1 hr after breakfast and at

S. Zaterka; F. Cordeiro; L. G. C. Lyra; M. M. Toletino; S. J. Miszputen; J. L. Jorge; E. P. Silva; F. E. Vieira; J. L. Modena; H. K. Massuda; J. N. Eisig; D. Chinzon; A. A. Pereira; L. Altieri; C. E. Gantois; R. B. Wilson; M. C. B. Martins; H. Rosa; E. Dallaverde Neto



Duodenal Toxicity After Fractionated Chemoradiation for Unresectable Pancreatic Cancer  

SciTech Connect

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.

Kelly, Patrick; Das, Prajnan; Pinnix, Chelsea C.; Beddar, Sam; Briere, Tina; Pham, Mary; Krishnan, Sunil; Delclos, Marc E. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)] [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Crane, Christopher H., E-mail: [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)



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


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

Ruiz Jiménez, J I; Gualda Cantón, J; Sánchez, E B



The buccopharyngeal mucosa of the turtles (testudines).  


Gross and histological examination of all extant families of turtles revealed that the buccopharyngeal mucosa is morphologically highly varied. The tongues of aquatic species have small lingual papillae or lack them entirely, while terrestrial species have tongues with numerous glandular papillae. The pharynx and the esophagus also have papillae in some species. These either facilitate swallowing in which case they are long, pointed, keratinized, and occur commonly in marine turtles, or they are vascular and nonkeratinized, facilitate respiratory gas exchange and are found in the Trionychidae, Dermatemyidae, and Carettochelyidae. The morphology of the buccopharyngeal mucosa of turtles reflects their diet, feeding behavior, habitat, and relationships. Convergence in the morphology of the buccopharyngeal mucosa occurs among families, especially among the Emydidae and other familes of turtles. Intergeneric parallelism is also seen within the Emydidae. PMID:3373540

Winokur, R M



Cell sheet technology for regeneration of esophageal mucosa  

PubMed Central

The progress of tissue-engineering technology has realized development of new therapies to treat various disorders by using cultured cells. Cell- and tissue-based therapies have been successfully applied to human patients, and several tissue-engineered products have been approved by the regulatory agencies and are commercially available. In the review article, we describe our experience of development and clinical application of cell sheet-based regenerative medicine. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) have been shown to be useful for removal of gastrointestinal neoplasms with less invasiveness compared with open surgery, especially in esophageal surgery. However, postoperative inflammation and stenosis are major complications observed after intensive mucosal resection. Therefore, we have developed novel regenerative medicine to prevent such complications and promote wound healing of esophageal mucosa after EMR or ESD. Transplantable oral mucosal epithelial cell sheets were fabricated from patients’ own oral mucosa. Immediately after EMR or ESD, fabricated autologous cell sheets were endoscopically transplanted to the ulcer sites. We performed a preclinical study with a canine model. In human clinical settings, cell culture and cell sheet fabrication were performed in clean rooms according to good manufacturing practice guidelines, and pharmaceutical drugs were used as supplements to culture medium in place of research regents used in animal study. We believe that cell-based regenerative medicine would be useful to improve quality of life of patients after EMR or ESD. PMID:23066307

Takagi, Ryo; Yamato, Masayuki; Kanai, Nobuo; Murakami, Daisuke; Kondo, Makoto; Ishii, Takaaki; Ohki, Takeshi; Namiki, Hideo; Yamamoto, Masakazu; Okano, Teruo



Portal hypertensive gastric mucosa: an endoscopic study  

Microsoft Academic Search

The endoscopic features of the gastric mucosa in patients with cirrhosis have not been systematically investigated. In these patients, we observed an endoscopic aspect, consisting of multiple small erythematous areas, outlined by a subtle yellowish network (resembling a mosaic), mainly located in the proximal part of the stomach. We tested the value of this sign by comparing two groups: 100

A Papazian; A Braillon; J L Dupas; F Sevenet; J P Capron



Early Rupture of an Ultralow Duodenal Stump after Extended Surgery for Gastric Cancer with Duodenal Invasion Managed by Tube Duodenostomy and Cholangiostomy  

PubMed Central

When dealing with gastric cancer with duodenal invasion, gastrectomy with distal resection of the duodenum is necessary to achieve negative distal margin. However, rupture of an ultralow duodenal stump necessitates advanced surgical skills and close postoperative observation. The present study reports a case of an early duodenal stump rupture after subtotal gastrectomy with resection of the whole first part of the duodenum, complete omentectomy, bursectomy, and D2+ lymphadenectomy performed for a pT3pN2pM1 (+ number 13 lymph nodes) adenocarcinoma of the antrum. Duodenal stump rupture was managed successfully by end tube duodenostomy, without omental patching, and tube cholangiostomy. Close assessment of clinical, physical, and radiological signs, output volume, and enzyme concentration of the tube duodenostomy, T-tube, and closed suction drain, which was placed near the tube duodenostomy site to drain the leak around the catheter, dictated postoperative management of the external duodenal fistula. PMID:24159410

Blouhos, Konstantinos; Boulas, Konstantinos A.; Konstantinidou, Anna; Salpigktidis, Ilias I.; Katsaouni, Stavroula P.; Ioannidis, Konstantinos; Hatzigeorgiadis, Anestis



Breast Cancer-Associated pS2 Protein: Synthesis and Secretion by Normal Stomach Mucosa  

Microsoft Academic Search

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

M. C. Rio; J. P. Bellocq; J. Y. Daniel; C. Tomasetto; R. Lathe; M. P. Chenard; A. Batzenschlager; P. Chambon



Oral Mucosa Harvest: An Overview of Anatomic and Biologic Considerations  

Microsoft Academic Search

ObjectivesThe authors review the biologic characteristics of the oral mucosa. In addition, the authors report a contemporary harvesting technique of the oral mucosa for urethral transplantation, using biologically sound principles, modified by current literature.

Michael R. Markiewicz; Joseph E. Margarone; Guido Barbagli; Frank A. Scannapieco



[Paraplegia after surgical treatment of primary aorto-duodenal fistula].  


A 68-year-old patient with chronic cirrhosis underwent surgical repair of the subrenal abdominal aorta presenting an aorto-duodenal fistula. The fistula was considered to be a primary fistula because it occurred without prior surgery and because the aorta had ruptured without formation of an aneurysm. The postoperative period was complicated by paraplegia further compromising the outcome in this severe condition. In general, there are several problems involved in the management of aorto-duodenal fistulae. Neither computed tomography of the abdomen nor gastroduodenal endoscopy are able to provide the diagnosis in all cases before surgery. Surgical treatment is most often conducted in an emergency setting requiring repair of both the digestive tract and of the vascular lesions. It is also important to recognize the risk of neurological events occurring intra-operatively. Prognosis is usually poor. PMID:8668690

Picard, E; Demaria, R; Branchereau, P; Meunier, J P; Frapier, J M; Chaptal, P A



L-Glutamate Supplementation Improves Small Intestinal Architecture and Enhances the Expressions of Jejunal Mucosa Amino Acid Receptors and Transporters in Weaning Piglets  

PubMed Central

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 Ca2+-sensing receptor (CaR), metabotropic glutamate receptor 1 (mGluR1) and metabotropic glutamate receptor 4 (mGluR4), and neutral amino acid transporter B0-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

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



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


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 Ca2+-sensing receptor (CaR), metabotropic glutamate receptor 1 (mGluR1) and metabotropic glutamate receptor 4 (mGluR4), and neutral amino acid transporter B0-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

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



Perforated duodenal diverticulae: importance for the surgeon and gastroenterologist.  


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

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



Perforated duodenal ulcer: an unusual complication of gastroenteritis.  

PubMed Central

A 7 year old boy was admitted to hospital with gastroenteritis, which was complicated by an acute perforated duodenal ulcer. After oversewing of the perforation he made an uncomplicated recovery. Peptic ulceration is under-diagnosed in childhood and this leads to delay in diagnosis and appropriate management. Ulceration is associated with severe illness and viral infections, but perforation is rare. Images p991-a PMID:2221974

Wilson, J M; Darby, C R



Intraluminal duodenal diverticulum causing recurrent pancreatitis: treatment by endoscopic incision.  

PubMed Central

Intraluminal duodenal diverticulum is a recognised but rare cause of acute pancreatitis. This patient had three attacks of pancreatitis, each requiring a stay in hospital, within a four month period. The apex of the diverticulum was incised endoscopically, whereupon peas and food debris gushed from the incision site. The patient has had no further symptoms in the 12 months since the endoscopic procedure. Images Figure 1 Figure 2 Figure 3 PMID:8174997

Finnie, I A; Ghosh, P; Garvey, C; Poston, G J; Rhodes, J M



Peripheral Neuropathy and Severe Malnutrition following Duodenal Switch  

Microsoft Academic Search

Severe thiamine (vitamin B-1) deficiency is a medical emergency that has long been recognized as a potential complication\\u000a of bariatric surgery. The incidence of this rare complication is largely unknown. We describe a super-obese male patient with\\u000a extreme lower limb weakness 3 months following a duodenal switch operation, occurring in association with persisting vomiting.\\u000a Excessive malabsorption led to severe malnutrition, with

Erlend T. Aasheim; Dag Hofsø; Jøran Hjelmesæth; Rune Sandbu



Surgical Excision of Duodenal/Pancreatic Metastatic Renal Cell Carcinoma  

PubMed Central

Renal cell carcinoma (RCC) has a potential to metastasize to almost any site and this may occur many years following nephrectomy. We present six cases with uncommon sites of metastasis: four patients presented with distal pancreatic metastasis and two with duodenal/head of the pancreas metastasis. Time to metastatic disease varied from 1 to 19?years following renal surgery. For patients are alive and two succumbed to their disease. Long-term survival can be achieved with aggressive surgical excision of disease.

Espinoza, Eduardo; Hassani, Ali; Vaishampayan, Ulka; Shi, Dongping; Pontes, J. Edson; Weaver, Donald W.



Anomalous intracranial drainage of the nasal mucosa: a vein of the foramen caecum?  


The existence of the vein of the foramen caecum (VFC) in humans is still controversial. We present 2 patients with intracranial drainage of the nasal mucosa by a frontal cortical vein into a superior sagittal sinus, demonstrated by digital subtraction angiography. In both, the position of the intracranial passage was found to be slightly paramedian. An analogy to the VFC is made. PMID:16418371

San Millán Ruíz, D; Gailloud, P; Rüfenacht, D A; Yilmaz, H; Fasel, J H D



Treatment for superficial non-ampullary duodenal epithelial tumors  

PubMed Central

Because of the low prevalence of non-ampullary duodenal epithelial tumors (NADETs), standardized clinical management of sporadic superficial NADETs, including diagnosis, treatment, and follow-up, has not yet been established. Retrospective studies have revealed certain endoscopic findings suggestive of malignancy. Duodenal adenoma with high-grade dysplasia and mucosal cancer are candidates for local resection by endoscopic or minimally invasive surgery. The use of endoscopic treatment including endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), for the treatment for superficial NADETs is increasing. EMR requires multiple sessions to achieve complete remission and repetitive endoscopy is needed after resection. ESD provides an excellent complete resection rate, however it remains a challenging method, considering the high risk of intraoperative or delayed perforation. Minimally invasive surgery such as wedge resection and pancreas-sparing duodenectomy are beneficial for superficial NADETs that are technically difficult to remove by endoscopic treatment. Pancreaticoduodenectomy remains a standard surgical procedure for treatment of duodenal cancer with submucosal invasion, which presents a risk of lymph node metastasis. Endoscopic or surgical treatment outcomes of superficial NADETs without submucosal invasion are satisfactory. Establishing an endoscopic diagnostic tool to differentiate superficial NADETs between adenoma and cancer as well as between mucosal and submucosal cancer is required to select the most appropriate treatment. PMID:25253950

Kakushima, Naomi; Kanemoto, Hideyuki; Tanaka, Masaki; Takizawa, Kohei; Ono, Hiroyuki



Endoscopic duodenal perforation: surgical strategies in a regional centre  

PubMed Central

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



Splenosis mimicking an extramural duodenal mass: A case report  

PubMed Central

Splenosis is a common disease, patients with splenosis are generally asymptomatic and therapy is not indicated. Splenosis is frequently observed in the abdomen and pelvic cavity and may mimic malignancy on imaging, often leading to unnecessary surgical intervention. The current study presents the case of a 55-year-old female patient, with a rare case of duodenal splenosis, who underwent unnecessary laparotomy due to a misdiagnosis of a malignant duodenal stromal tumor. Although splenosis was confirmed by intraoperative tissue biopsy, this mass was resected due to the lack of information with regard to this condition, an increased suspicion of progressive growth of the mass and chronic duodenal compression. The aim of this report is to raise the awareness of this entity in patients post-splenectomy, to avoid unnecessary surgery, particularly with an increased prevalence of patients with previous splenic trauma due to road traffic accidents. Therefore, the possibility of abdominal splenosis must be included in the differential diagnosis of patients with abdominal mass as the main clinical manifestation, where there is a history of splenic trauma or splenectomy and no other systemic symptoms. In the future noninvasive nuclear scintigraphy may serve as a suitable diagnostic approach for splenosis, thereby avoiding unnecessary laparotomies. PMID:25364471




Duodenal cytochrome B and hephaestin expression in patients with iron deficiency and hemochromatosis  

Microsoft Academic Search

Background & Aims: An increased duodenal expression of the iron transporters, divalent-metal-transporter-1, and ferroportin is observed in patients with iron deficiency or hereditary hemochromatosis. Two oxidoreductases, termed duodenal cytochrome b and hephaestin, are proposed to co-operate with divalent-metal-transporter-1 and FPN1, respectively, to transfer iron from the duodenal lumen to the circulation. Methods: In the present study, we investigated the mRNA

Heinz Zoller; Igor Theurl; Robert O. Koch; Andrew T. Mckie; Wolfgang Vogel; Gü Weiss



Tobacco cigarette smoke attenuates duodenal ulcer margin hyperemia in the rat  

Microsoft Academic Search

The hyperemia at the duodenal ulcer margin is important for ulcer healing. We studied the effect of tobacco cigarette smoke on the hyperemia at the margin of mepirizole-induced duodenal ulcer. Duodenal mucosal blood flow values measured by iodo[14C]antipyrine (IAP) autoradiography and hydrogen gas clearance (HGC) were compared. Twenty-four hours after rats were injected with an ulcerogenic dose of mepirizole, they

Fumihiro Iwata; Oscar U. Scremin; Felix W. Leung



Glycophenotypic Alterations Induced by Pteridium aquilinum in Mice Gastric Mucosa: Synergistic Effect with Helicobacter pylori Infection  

PubMed Central

The bracken fern Pteridium aquilinum is a plant known to be carcinogenic to animals. Epidemiological studies have shown an association between bracken fern exposure and gastric cancer development in humans. The biological effects of exposure to this plant within the gastric carcinogenesis process are not fully understood. In the present work, effects in the gastric mucosa of mice treated with Pteridium aquilinum were evaluated, as well as molecular mechanisms underlying the synergistic role with Helicobacter pylori infection. Our results showed that exposure to Pteridium aquilinum induces histomorphological modifications including increased expression of acidic glycoconjugates in the gastric mucosa. The transcriptome analysis of gastric mucosa showed that upon exposure to Pteridium aquilinum several glycosyltransferase genes were differently expressed, including Galntl4, C1galt1 and St3gal2, that are mainly involved in the biosynthesis of simple mucin-type carbohydrate antigens. Concomitant treatment with Pteridium aquilinum and infection with Helicobacter pylori also resulted in differently expressed glycosyltransferase genes underlying the biosynthesis of terminal sialylated Lewis antigens, including Sialyl-Lewisx. These results disclose the molecular basis for the altered pattern of glycan structures observed in the mice gastric mucosa. The gene transcription alterations and the induced glycophenotypic changes observed in the gastric mucosa contribute for the understanding of the molecular mechanisms underlying the role of Pteridium aquilinum in the gastric carcinogenesis process. PMID:22719879

Gomes, Joana; Magalhaes, Ana; Carvalho, Ana S.; Hernandez, Gilberto E.; Papp, Suzanne L.; Head, Steven R.; Michel, Valerie; David, Leonor; Gartner, Fatima; Touati, Eliette; Reis, Celso A.



Glycophenotypic alterations induced by Pteridium aquilinum in mice gastric mucosa: synergistic effect with Helicobacter pylori infection.  


The bracken fern Pteridium aquilinum is a plant known to be carcinogenic to animals. Epidemiological studies have shown an association between bracken fern exposure and gastric cancer development in humans. The biological effects of exposure to this plant within the gastric carcinogenesis process are not fully understood. In the present work, effects in the gastric mucosa of mice treated with Pteridium aquilinum were evaluated, as well as molecular mechanisms underlying the synergistic role with Helicobacter pylori infection. Our results showed that exposure to Pteridium aquilinum induces histomorphological modifications including increased expression of acidic glycoconjugates in the gastric mucosa. The transcriptome analysis of gastric mucosa showed that upon exposure to Pteridium aquilinum several glycosyltransferase genes were differently expressed, including Galntl4, C1galt1 and St3gal2, that are mainly involved in the biosynthesis of simple mucin-type carbohydrate antigens. Concomitant treatment with Pteridium aquilinum and infection with Helicobacter pylori also resulted in differently expressed glycosyltransferase genes underlying the biosynthesis of terminal sialylated Lewis antigens, including Sialyl-Lewis(x). These results disclose the molecular basis for the altered pattern of glycan structures observed in the mice gastric mucosa. The gene transcription alterations and the induced glycophenotypic changes observed in the gastric mucosa contribute for the understanding of the molecular mechanisms underlying the role of Pteridium aquilinum in the gastric carcinogenesis process. PMID:22719879

Gomes, Joana; Magalhães, Ana; Carvalho, Ana S; Hernandez, Gilberto E; Papp, Suzanne L; Head, Steven R; Michel, Valérie; David, Leonor; Gärtner, Fátima; Touati, Eliette; Reis, Celso A



Multiphoton morpho-functional imaging of healthy colon mucosa, adenomatous polyp and adenocarcinoma  

PubMed Central

Two-photon spectral resolved imaging was used to image fresh human biopsies of colon tissue and to characterize healthy colon mucosa, adenomatous polyp and adenocarcinoma by means of a morpho-functional analysis. Morphological examination, performed using endogenous tissue fluorescence, discriminated adenomatous and adenocarcinoma tissues from normal mucosa in terms of cellular asymmetry and nucleus-to-cytoplasm ratio. Good agreement was found between multiphoton images and histological examination performed on the same samples. Further characterization, performed by means of spectral-resolved analysis of NADH and FAD fluorescence, demonstrated an altered metabolic activity in both adenomatous and adenocarcinoma tissues compared to healthy mucosa. This morpho-functional approach may represent a powerful method to be used in combination with endoscopy for in vivo optical diagnosis of colon cancer and may be extended to other tissues. PMID:23847743

Cicchi, Riccardo; Sturiale, Alessandro; Nesi, Gabriella; Kapsokalyvas, Dimitrios; Alemanno, Giovanni; Tonelli, Francesco; Pavone, Francesco S.



Evaluation of gastric acid secretion in two patients (each aged over 90 years) with Helicobacter pylori-negative nonsteroidal anti-inflammatory drug-caused duodenal ulcers.  


We treated two patients (each aged over 90 years) with Helicobacter pylori-negative nonsteroidal anti-inflammatory drug (NSAID)-caused duodenal ulcers, and had the opportunity to determine gastric acidity by means of 24-h pH monitoring. Endoscopic and histological examination showed no remarkable atrophic change in the gastric mucosa. The gastric pH was low throughout the day and night, and the gastric pH > or = 3 holding time ratio during 24 h was 17.1% and 25.8%, respectively in the two patients, so it was considered that they had gastric acid secretion of the same level as that in normal subjects of the same age or that in the young without H. pylori infection. Because of the complication of reflux esophagitis with a hiatal hernia, rabeprazole sodium, one of the proton pump inhibitors (PPIs), was administered and both patients made excellent progress. In conclusion, gastric acid secretion in patients with H. pylori-negative NSAID-caused duodenal ulcers is fully maintained even in the elderly, so PPIs may be the first choice of treatment. PMID:12640531

Shimatani, Tomohiko; Inoue, Masaki; Yokoya, Hitoshi; Daimaru, Yutaka



Calcium secretion in canine tracheal mucosa  

SciTech Connect

Calcium (Ca) affects many cellular functions of the respiratory tract mucosa and might alter the viscoelastic properties of mucus. To evaluate Ca homeostasis in a respiratory epithelium we investigated transport of Ca by the canine tracheal mucosa. Mucosal tissues were mounted in Ussing-type chambers and bathed with Krebs-Henseleit solution at 37 degrees C. Unidirectional fluxes of 45Ca were determined in tissues that were matched by conductance and short-circuit current (SCC). Under short-circuit conditions there was a significant net Ca secretion of 1.82 +/- 0.36 neq . cm-2 . h-1 (mean +/- SE). Under open-circuit conditions, where the spontaneous transepithelial potential difference could attract Ca toward the lumen, net Ca secretion increased significantly to 4.40 +/- 1.14 compared with 1.54 +/- 1.17 neq . cm-2 . h-1 when the preparation was short-circuited. Addition of a metabolic inhibitor, 2,4-dinitrophenol (2 mM in the mucosal bath), decreased tissue conductance and SCC and slightly decreased the unidirectional movement of Ca from submucosa to lumen. Submucosal epinephrine (10 microM) significantly enhanced Ca secretion by 2.0 +/- 0.63 neq . cm-2 . h-1. Submucosal ouabain (0.1 mM) failed to inhibit Ca secretion. The data suggest that canine tracheal mucosa secretes Ca; this secretory process is augmented by epinephrine or by the presence of a transepithelial potential difference as found under in vivo conditions.

Al-Bazzaz, F.J.; Jayaram, T.



Unusual presentation of duodenal plasmablastic lymphoma in an immunocompetent patient: A case report and literature review  

PubMed Central

Plasmablastic lymphoma (PBL) is a rare and recently described entity of large B-cell lymphoma. It predominantly occurs in the oral cavity of human immunodeficiency virus (HIV)-positive patients and exhibits a highly aggressive clinical behavior without effective treatment. Recently, sporadic cases describing PBL in extraoral locations of HIV-negative patients have been reported; frequently in patients with underlying immunosuppressive states. To develop the understanding of PBL, the current study reports the unusual presentation of duodenal PBL and reviews the pathogenesis, immunohistochemical features, clinical and differential diagnoses, as well as the treatment of PBL as described in previous studies. The case of a 75-year-old female with duodenal PBL without definite immunosuppression is presented in the current report. The tumor was composed of large B-cell-like cells, and was positive for cluster of differentiation 138 and melanoma ubiquitous mutated-1, with ~80% of the tumor cells positive for Ki-67. The features of the tumor were as follows: Extraoral location, HIV-negative, immunoglobulin M ?-type M protein expression, light chain restriction (monoclonal) and Epstein-Barr virus-encoded small RNA-negative, which are considered to be unusual for PBL. These unusual features complicate the differentiation of PBL from other plasma cell diseases. To the best of our knowledge, this is the first study to report a case of duodenal PBL in an immunocompetent patient. To date, the standard treatment of PBL remains elusive, however, the most commonly administered chemotherapy treatments are CHOP [intravenous cyclophosphamide (750 mg/m2, day 1), intravenous doxorubicin (50 mg/m2, day 1), intravenous vincristine (1.4 mg/m2, day 1) and prednisone (100 mg, days 1–50)]-like regimens. The patient was administered two cycles of CHOP chemotherapy for 56 days, however, ultimately succumbed as a result of disease progression. Therefore, PBL represents a diagnostic and therapeutic challenge. PBL must be considered in the differential diagnosis of gastrointestinal tumors in daily practice, even in immunocompetent patients. Furthermore, CHOP does not appear to be an optimal treatment regimen and more intensive regimens are required. PMID:25364423




18?-Glycyrrhetinic Acid Delivered Orally Induces Isolated Lymphoid Follicle Maturation at the Intestinal Mucosa and Attenuates Rotavirus Shedding  

PubMed Central

Glycyrrhizin, an abundant bioactive component of the medicinal licorice root is rapidly metabolized by gut commensal bacteria into 18?-glycyrrhetinic acid (GRA). Either or both of these compounds have been shown to have antiviral, anti-hepatotoxic, anti-ulcerative, anti-tumor, anti-allergenic and anti-inflammatory activity in vitro or in vivo. In this study, the ability of GRA to modulate immune responses at the small intestinal mucosa when delivered orally was investigated. Analysis of cytokine transcription in duodenal and ileal tissue in response to GRA treatment revealed a pattern of chemokine and chemokine receptor gene expression predictive of B cell recruitment to the gut. Consistent with this finding, GRA induced increases in CD19+ B cells in the lamina propria and B220+ B cell aggregates framed by CD11c+ dendritic cells in structures resembling isolated lymphoid follicles (ILF). Using a mouse model of rotavirus infection, GRA reduced the duration of viral antigen shedding, and endpoint serum antibody titers were higher in GRA-treated animals. Together the data suggest GRA delivered orally augments lymphocyte recruitment to the intestinal mucosa and induces maturation of B cell-rich ILF independently of ectopic antigenic stimulus. These results provide further support a role for dietary ligands in modulation of dynamic intestinal lymphoid tissue. PMID:23152913

Hendricks, Jay M.; Hoffman, Carol; Pascual, David W.; Hardy, Michele E.



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

SciTech Connect

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.

Kapoor, Baljendra S., E-mail: bkapoor@uabmc.ed [University of Alabama at Birmingham NHB H623, Vascular and Interventional Radiology (United States); Berscheid, Bruce [St. Paul's Hospital, Interventional Radiology (Canada); Saddekni, Souheil [University of Alabama at Birmingham NHB H623, Vascular and Interventional Radiology (United States)



Is there a role for pyloric exclusion after severe duodenal trauma?  


Duodenal trauma is an infrequent injury, but linked to high morbidity and mortality. Surgical management of duodenal injuries is dictated by: patient's hemodynamic status, injury severity, time of diagnosis, and presence of concomitant injuries. Even though most cases can be treated with primary repair, some experts advocate adjuvant procedures. Pyloric exclusion (PE) has emerged as an ancillary method to protect suture repair in more complex injuries. However, the effectiveness of this procedure is debatable. The "Evidence Based Telemedicine - Trauma & Acute Care Surgery" (EBT-TACS) Journal Club performed a critical appraisal of the literature and selected three relevant publications on the indications for PE in duodenal trauma. The first study retrospectively compared 14 cases of duodenal injuries greater than grade II treated by PE, with 15 cases repaired primarily, all of which penetrating. Results showed that PE did not improve outcome. The second study, also retrospective, compared primary repair (34 cases) with PE (16 cases) in blunt and penetrating grade > II duodenal injuries. The authors concluded that PE was not necessary in all cases. The third was a literature review on the management of challenging duodenal traumas. The author of that study concluded that PE is indicated for anastomotic leak management after gastrojejunostomies. In conclusion, the choice of the surgical procedure to treat duodenal injuries should be individualized. Moreover, there is insufficient high quality scientific evidence to support the abandonment of PE in severe duodenal injuries with extensive tissue loss. PMID:25140657

Cruvinel Neto, José; Pereira, Bruno Monteiro Tavares; Ribeiro, Marcelo Augusto Fontenelle; Rizoli, Sandro; Fraga, Gustavo Pereira; Rezende-Neto, João Baptista



Reevaluation of duodenal endoscopic markers in the diagnosis of celiac disease  

Microsoft Academic Search

Background: Loss or reduction of duodenal folds, scalloping of Kerkring folds and a micronodular or mosaic duodenal mucosal pattern have been described in celiac disease (CD), endoscopic findings that are considered reliable in the diagnosis of this disorder. However, most data have been obtained in patients with suspected or certain disease. We assessed the accuracy of the above markers in

Maria Teresa Bardella; Giorgio Minoli; Franco Radaelli; Maurizio Quatrini; Paolo A. Bianchi; Dario Conte



A Case Report of Primary Duodenal Tuberculosis Mimicking a Malignant Tumor  

PubMed Central

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

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



Limited utilization of serologic testing in patients undergoing duodenal biopsy for celiac disease  

PubMed Central

Background Clinical algorithms for the workup of celiac disease often recommend the use of serologic assays for initial screening, followed by duodenal biopsy for histologic confirmation. However, the majority of duodenal biopsies submitted to pathology for “rule out celiac” are negative. The objective of this study was to determine the underlying causes for this low diagnostic yield. Methods We performed a retrospective review of pathology reports from 1432 consecutive duodenal biopsies submitted for pathologic assessment to “rule out celiac” and correlated biopsy results with results for concurrent serologic testing for celiac autoantibodies. Results The majority of patients had no record of serologic testing prior to biopsy, and evidence of positive serology results was found in only 5% of patients. Most duodenal biopsies were submitted as part of a multi-site GI sampling strategy that included biopsies from other locations. In this context, serologic results correlated with the likelihood of significant duodenal and non-duodenal findings, and were also helpful in evaluating patients with indeterminate duodenal histology. Conclusions The presence of a positive screening test for celiac autoantibodies does not appear to be a major driver in the decision to submit duodenal biopsies for evaluation of celiac disease, which accounts for the low incidence of findings in these samples. In patients where celiac serology testing was performed, the results were a good predictor of the likelihood of findings on biopsy. PMID:24209459



Protein kinase A (PK-A) regulatory subunit expression in colorectal cancer and related mucosa.  

PubMed Central

Photoaffinity labelling (PAL) with [32P]8-azido-cAMP and polyacrylamide gel electrophoresis (PAGE) has been used to identify three specific cAMP-binding proteins (cAMP-BPs) within cytosols derived from the centre and periphery of 32 human colorectal cancers and from related adjacent (less than 5 cm from the tumour) and distant (more than 5 cm from the tumour) microscopically benign mucosa. By immunoprecipitation with specific anti-RI and anti-RII antibodies these proteins have subsequently been characterised as a single form of RI (48 kDa) and two forms of RII (50 and 52 kDa). The relative expression of isoforms in each specimen has been quantified by laser densitometry. There was significantly more RI expressed in both tumour centre and periphery than in either adjacent or distant mucosa (P < 0.008 by Wilcoxon signed-rank test). There was no significant difference in relative RI expression between tumour centre and periphery, or between adjacent and distant mucosa. There was no association between relative RI expression and Dukes' stage. Poorly differentiated tumours expressed significantly more RI than those that were either moderately or well differentiated (P = 0.016 by Mann-Whitney U-test). This study is the first to have characterised cAMP-BPs within human colorectal tissues and has demonstrated that colorectal cancers, and in particular those of poor histological grade, relatively overexpress RI when compared with related benign mucosa. Images Figure 1 Figure 2 PMID:8142263

Bradbury, A. W.; Carter, D. C.; Miller, W. R.; Cho-Chung, Y. S.; Clair, T.



Palliation of Malignant Biliary and Duodenal Obstruction with Combined Metallic Stenting  

SciTech Connect

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.

Akinci, Devrim, E-mail:; Akhan, Okan; Ozkan, Fuat; Ciftci, Turkmen; Ozkan, Orhan S.; Karcaaltincaba, Musturay; Ozmen, Mustafa N. [Hacettepe University School of Medicine, Department of Radiology (Turkey)



Adenoid cystic carcinoma of buccal mucosa.  


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

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



Protection from pulmonary tissue damage associated with infection of cynomolgus macaques by highly pathogenic avian influenza virus (H5N1) by low dose natural human IFN-? administered to the buccal mucosa.  


Using an established nonhuman primate model for H5N1 highly pathogenic influenza virus infection in humans, we have been able to demonstrate the prophylactic mitigation of the pulmonary damage characteristic of human fatal cases from primary influenza virus pneumonia with a low dose oral formulation of a commercially available parenteral natural human interferon alpha (Alferon N Injection®). At the highest oral dose (62.5IU/kg body weight) used there was a marked reduction in the alveolar inflammatory response with minor evidence of alveolar and interstitial edema in contrast to the hemorrhage and inflammatory response observed in the alveoli of control animals. The mitigation of severe damage to the lower pulmonary airway was observed without a parallel reduction in viral titers. Clinical trial data will be necessary to establish its prophylactic human efficacy for highly pathogenic influenza viruses. PMID:25111905

Strayer, David R; Carter, William A; Stouch, Bruce C; Stittelaar, Koert J; Thoolen, Robert J M M; Osterhaus, Albert D M E; Mitchell, William M



Calcium transport by rat duodenal villus and crypt basolateral membranes  

SciTech Connect

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.

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



The buccal mucosa as an alternative route for the systemic delivery of risperidone.  


The purpose of this study was to investigate the potential of the buccal mucosa for the systemic delivery of risperidone (RISP), and to determine the impact of Azone® (AZ) on the transport of RISP via this route. The permeability of RISP through porcine buccal mucosa was assessed in modified Ussing chambers at various concentrations to determine the mechanisms involved in transport across the tissue. The effect of AZ was assessed by administering AZ 5% (w/w) to the tissue as a pretreatment or together with RISP in solution or in a mucoadhesive gel formulation. RISP permeated the buccal mucosa via a passive diffusion mechanism and pretreatment or coadministration of AZ 5% did not significantly modify the permeation of RISP. Application of a RISP mucoadhesive gel resulted in a steady state flux of 64.65 ± 8.0?µg/cm(2)/h, which when extrapolated to the in vivo setting, is predicted to result in RISP plasma concentrations of 11.2-56.1?µg/L for mucosal application areas between 2 and 10 cm(2). Given that these predicted concentrations are within the therapeutic range of RISP required in humans, delivery of RISP via the buccal mucosa has the potential to result in therapeutically relevant plasma concentrations for the treatment of schizophrenia. PMID:20845457

Heemstra, Lars B; Finnin, Barrie C; Nicolazzo, Joseph A



Involvement of glutamate-cystine/glutamate transporter system in aspirin-induced acute gastric mucosa injury.  


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

Du, Jie; Li, Xiao-Hui; Zhang, Wang; Yang, Yong-Mei; Wu, Yue-Han; Li, Wen-Qun; Peng, Jun; Li, Yuan-Jian



Culture and successful eradication of Helicobacter pylori from heterotopic gastric mucosa.  


Helicobacter pylori colonizes the gastric mucosa of humans and can cause chronic gastritis, peptic ulcer disease, gastric cancer or mucosa-associated-lymphoid tissue (MALT) lymphoma. Here, we report the case of a 61-year-old male patient who presented with tickle of the throat, globus sensation and heartburn. In an esophagogastroduodenoscopy subpharyngeal localized heterotopic gastric mucosa (HGM), reflux esophagitis and a chronic gastritis were diagnosed. HGM and stomach were H. pylori positive as proven by culture and histopathological examination. After eradication therapy with a proton pump inhibitor (PPI), amoxicillin and clarithromycin followed by PPI treatment, the patient reported clinical improvement and the histopathological changes in the HGM due to H. pylori infection improved, too. This case report demonstrates that culture and susceptibility testing of H. pylori using established protocols succeeds not only from tissue samples of the stomach but also from heterotopic gastric mucosa. Eradication therapy may not only improve typical H. pylori associated discomforts of the stomach but also extragastric signs and symptoms of H. pylori infection. PMID:22760679

Wüppenhorst, N; Viebahn, B; Theile, A; Radü, H J; Kist, M



Perforated Duodenal Ulcer -A Rare Cause of Acute Abdomen in Pregnancy  

PubMed Central

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

Rani, Jyotsna; Huria, Anju; Gupta, Pratiksha; Dalal, Usha



An Option of Conservative Management of a Duodenal Injury Following Laparoscopic Cholecystectomy  

PubMed Central

Duodenal injury following laparoscopic cholecystectomy is rare complications with catastrophic sequelae. Most injuries are attributed to thermal burns with electrocautery following adhesiolysis and have a delayed presentation requiring surgical intervention. We present a case of a 47-year-old gentleman operated on for laparoscopic cholecystectomy with a bilious drain postoperatively; for which an ERC was done showing choledocholithiasis with cystic duct stump blow-out and a drain in the duodenum suggestive of an iatrogenic duodenal injury. He was managed conservatively like a duodenal fistula and recovered without undergoing any intervention.

Modi, MA; Deolekar, SS; Gvalani, AK



Mutagenic Activation of Environmental Carcinogens by Microsomes of Gastric Mucosa with Intestinal Metaplasia1  

Microsoft Academic Search

Coexpression of cytochrome P450 monooxygenases (CYPs) and reduc- tase was found in human gastric mucosa with intestinal metaplasia. Im- munohistochemistry showed reactivity to P450 reductase in metaplastic epithelial cells and in pyloric gland cells in glands showing intestinal metaplasia. These cells exhibit NADPH-diaphorase activity. Reverse tran- scription-PCR analysis and Western blotting showed that CYP1A1 and CYP1A2 were expressed in specimens

Masayuki Tatemichi; Sachiyo Nomura; Tsutomu Ogura; Hideko Sone; Hiroshi Nagata; Hiroyasu Esumi


[The gastric mucosa barrier and gastropathy].  


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

Speranza, V; Lezoche, E



Products used on female genital mucosa.  


A wide variety of products are used by women in the genital area and, therefore, come into contact with the genital mucosa. The largest category of such products would be those used for cleanliness and odor control, such as soaps and body washes, douches, premoistened wipes and towelettes, dusting powder and deodorant sprays. A second large category of products are those intended to absorb fluids, such as products used for menstrual protection (tampons, pads and panty liners) and incontinence protection. Lubricants and moisturizers, and aesthetic products (hair removal products and dyes) are also fairly common. In addition, over the counter medications are now available for the treatment of fungal infections. This chapter briefly discusses the products women use on or around the genital area, the perceived or real benefits, and the potential health effects of these products. PMID:21325843

Farage, Miranda A; Lennon, Lisa; Ajayi, Funmi



Carbon Dioxide Exchange via the Mucosa in Healthy Middle Ear  

Microsoft Academic Search

Background: Recent studies have shown that gas ex- change via the middle ear mucosa, which is performed be- tween the middle ear cleft and capillaries in the submu- cosal connective tissue, has an essential role in ventilation and pressure regulation in the middle ear cleft. We specu- lated that gas exchange via the mucosa is induced by the gas diffusion

Fumio Ikarashi; Sugata Takahashi; Yutaka Yamamoto



Edinburgh Research Explorer Pancreatic secretory trypsin inhibitor in gastrointestinal mucosa  

E-print Network

and cloned.5 PSTI is thought to protect the pancreas from prematurely activated proteases but the recentEdinburgh Research Explorer Pancreatic secretory trypsin inhibitor in gastrointestinal mucosa, L, Young, J & Calam, J 1990, 'Pancreatic secretory trypsin inhibitor in gastrointestinal mucosa

MacDonald, Andrew


Gastric and duodenal squamous cell carcinoma: metastatic or primary?  


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

Hu, Jian-Bin; Zhu, Yan-Hong; Jin, Mei; Sun, Xiao-Nan



Duodenal nutrient exclusion improves metabolic syndrome and stimulates villus hyperplasia  

PubMed Central

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

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; Muller, Timo D; Pfluger, Paul T; Kohli, Rohit; Perez-Tilve, Diego; Seeley, Randy J; Tschop, Matthias H



Aberrant gene expression in mucosa adjacent to tumor reveals a molecular crosstalk in colon cancer  

PubMed Central

Background A colorectal tumor is not an isolated entity growing in a restricted location of the body. The patient’s 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



Analysis of 4-hydroxy-1-(-3-pyridyl)-1-butanone (HPB)-releasing DNA adducts in human exfoliated oral mucosa cells by liquid chromatography-electrospray ionization-tandem mass spectrometry  

PubMed Central

Quantitation of DNA adducts could provide critical information on the relationship between exposure to tobacco smoke and cancer risk in smokers. In this study, we developed a robust and sensitive liquid chromatography-tandem mass spectrometry method for the analysis of 4-hydroxy-1-(3-pyridyl)-1-butanone (HPB1)-releasing DNA adducts in human oral cells, a non-invasive source of DNA for biomarker studies. Isolated DNA undergoes acid hydrolysis, after which samples are purified by solid-phase extraction and analyzed by LC-ESI-MS/MS. The developed method was applied for analysis of samples obtained via collection with a commercial mouthwash from 30 smokers and 15 nonsmokers. In smokers, the levels of HPB-releasing DNA adducts averaged 12.0 pmol HPB/mg DNA (detected in 20 out of 28 samples with quantifiable DNA yield) and in nonsmokers, the levels of adducts averaged 0.23 pmol/mg DNA (detected in 3 out of 15 samples). For the 30 smoking subjects, matching buccal brushings were also analyzed and HPB-releasing DNA adducts were detected in 24 out of 27 samples with quantifiable DNA yield, averaging 44.7 pmol HPB/mg DNA. The levels of adducts in buccal brushings correlated with those in mouthwash samples of smokers (R = 0.73, p < 0.0001). Potentially the method can be applied in studies of individual susceptibility to tobacco-induced cancers in humans. PMID:23252610

Stepanov, Irina; Muzic, John; Le, Chap T.; Sebero, Erin; Villalta, Peter; Ma, Bin; Jensen, Joni; Hatsukami, Dorothy; Hecht, Stephen S.



Ex vivo permeation characteristics of venlafaxine through sheep nasal mucosa.  


Venlafaxine, a dual acting antidepressant is a new therapeutic option for chronic depression. Depression is a common mental disorder associated with the abnormalities in neuronal transport in the brain. Since the nose-to-brain pathway has been indicated for delivering drugs to the brain, we analyzed the transport of venlafaxine through sheep nasal mucosa. Transmucosal permeation kinetics of venlafaxine were examined using sheep nasal mucosa mounted onto static vertical Franz diffusion cells. Nasal mucosa was treated with venlafaxine in situ gel (100 ?l; 1% w/v) for 7h. Amount of venlafaxine diffused through mucosa was measured using validated RP-HPLC method. After the completion of the study histopathological investigation of mucosa was carried out. Ex vivo studies through sheep nasal mucosa showed sustained diffusion of venlafaxine with 66.5% permeation in 7h. Transnasal transport of venlafaxine followed a non-Fickian diffusion process. Permeability coefficient and steady state flux were found to be 21.11×10(-3) cmh(-1) and 21.118 ?g cm(-2)h(-1) respectively. Cumulative amount permeated through mucosa at 7h was found to be 664.8 ?g through an area of 3.14 cm(2). Total recovery of venlafaxine at the end of the permeation study was 87.3% of initial dose distributed (i) at the mucosal surface (208.4 ?g; 20.8%) and (ii) through mucosa (664.8 ?g; 66.5%). Histopathological examinations showed no significant adverse effects confirming that the barrier function of nasal mucosa remains unaffected even after treatment with venlafaxine in situ gel. Permeation through sheep nasal mucosa using in situ gel demonstrated a harmless nasal delivery of venlafaxine, providing new dimension to the treatment of chronic depression. PMID:23159662

Pund, Swati; Rasve, Ganesh; Borade, Ganesh



Filariasis of the buccal mucosa: A diagnostic dilemma  

PubMed Central

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

Kurup, Seema; Veeraraghavan, Ravi; Jose, Renju; Puthalath, Ushass



Intraoral Wound Closure with Tissue-Engineered Mucosa: New Perspectives for Urethra Reconstruction with Buccal Mucosa Grafts  

Microsoft Academic Search

In urethra reconstruction, the creation of a new ure- thra from a free oral mucosa graft is an established surgical technique. The oral mucosa is removed at the same time that the urethra reconstruction procedure is performed. Depending on the size of graft required, the intraoral wound is closed primarily or left to heal secondarily. The latter method limits this

Ronald Schimming; Alexander Frankenschmidt



The permeation of nalmefene hydrochloride across different regions of ovine nasal mucosa.  


The permeability of nalmefene hydrochloride (NH) across different regions of ovine nasal mucosa was investigated in vitro. Five different regions of ovine nasal mucosa (superior turbinate mucosa, middle turbinate mucosa, inferior turbinate mucosa, posterior septum mucosa, and anterior septum mucosa) were studied. The results showed that the permeability coefficients of NH through different regions of nasal mucosa were different, and the suitable regions for the absorption of NH were the middle turbinate mucosa, the posterior septum mucosa and the superior turbinate. At the same time, the middle turbinate mucosa was the largest region among the five regions, thus it was the main absorption region for NH. The high uniformity of the middle turbinate mucosa also made it the most suitable model for the permeation of NH in vitro. PMID:17139110

Du, Gani; Gao, Yongliang; Nie, Shufang; Pan, Weisan



Modeling data for pancreatitis in presence of a duodenal diverticula using logistic regression  

NASA Astrophysics Data System (ADS)

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.

Dineva, S.; Prodanova, K.; Mlachkova, D.



Chronic diarrhea due to duodenal candidiasis in a patient with a history of kidney transplantation.  


Candida infection in the small intestine is uncommon. We report an unusual case of duodenal candidiasis that presented as chronic diarrhea in a patient who had previously undergone kidney transplantation. A 60-year-old man presented with profuse watery diarrhea that had lasted 6 months 13 years after kidney transplantation. Upper gastrointestinal endoscopy results indicated candidiasis within the esophagus and duodenum. Biopsy results revealed active duodenitis with hyphal and yeast forms of Candida overlying the duodenal epithelium in periodic acid Schiff staining. The patient was successfully treated with fluconazole. After 6 months of follow-up, the patient had no complaint of diarrhea. Duodenal candidiasis may be the result of chronic diarrhea in patients with a history of kidney transplantation. PMID:25362226

Nouri-Majalan, Nader; Moghaddasi, Sarasadat; Qane, Mohammad Davud; Shefaie, Farzane; Masoumi Dehshiri, Roghayyeh; Amirbaigy, Mohammad Kassem; Baghbanian, Mahmoud



Technical aspects of the laparoscopic management of a late presenting duodenal web.  


The value of laparoscopy in repair of congenital duodenal webs is yet to be established and techniques are evolving. Described are technical details of a successful laparoscopic web ablation without duodenoplasty. PMID:19021465

Mahomed, Anies; D'hondt, Beelke; Khan, Khalid; Butt, Assad



Simple diversion by duodenojejunostomy for a retroperitoneal perforation of the second portion of the duodenal diverticulum.  


Abstract 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

Fujisaki, Shigeru; Takashina, Motoi; Sakurai, Kenichi; Tomita, Rhyouichi; Takayama, Tadatoshi



[Post-traumatic intramural duodenal hematoma as a cause of high ileus in a child].  


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

Soudek, K; Husek, J; Randa, V; Dan?k, J



Small bowel perforation after duodenal stent migration: An interesting case of a rare complication  

PubMed Central

Duodenal stents are frequently used for palliating malignant gastric outlet obstruction. Successful stent placement relieves obstructive symptoms, is cost effective, and has a relatively low complication rate. However, enteral stents have the potential of migrating distally and rarely, even lead to bowel perforation. We present a rare case of a duodenal stent placed as a palliative measure for gastric outlet obstruction due to unresectable pancreatic cancer that migrated distally after a gastrojejunostomy resulting in small bowel perforation. PMID:21860709

Lee, Peter HU; Moore, Robert; Raizada, Akshay; Grotz, Richard



Septic Complication After Balloon-Occluded Retrograde Transvenous Obliteration of Duodenal Variceal Bleeding  

SciTech Connect

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.

Akasaka, Thai; Shibata, Toshiya, E-mail:; Isoda, Hiroyoshi [Kyoto University Graduate School of Medicine, Department of Radiology (Japan); Taura, Kojiro [Kyoto University Graduate School of Medicine, Department of Surgery (Japan); Arizono, Shigeki; Shimada, Kotaro; Togashi, Kaori [Kyoto University Graduate School of Medicine, Department of Radiology (Japan)



Prostaglandin E 1 (Misoprostol) overcomes the adverse effect of chronic cigarette smoking on duodenal ulcer healing  

Microsoft Academic Search

Chronic cigarette smoking adversely affects duodenal ulcer healing despite treatment by potent gastric acid-reducing agents. Prostaglandins of the E series possess antisecretory and cytoprotective properties and theoretically offer advantages over existing therapeutic agents. A double-blind randomized study was performed to compare complete duodenal ulcer healing as assessed by endoscopies every two weeks for up to 12 weeks. Two hundred twenty-nine

Shiu-Kum Lam; Wan-Yee Lau; Tat-Kuen Choi; Ching-Lung Lai; Anna S. F. Lok; Wai-Mo Hui; Matthew M. T. Ng; Samuel K. Y. Choi



A comparative immunohistochemical study of cytokeratin and vimentin expression in middle ear mucosa and cholesteatoma, and in epidermis  

Microsoft Academic Search

Cytokeratin expression was studied in human middle ear cholesteatoma lesions, using a variety of immunohistological techniques and a wide range of polyclonal antisera and monoclonal antibodies against cytokeratin (CK) subgroups or individual CK polypeptides. The expression of the other cytoskeletal proteins, vimentin and desmin, was also investigated. Middle ear mucosa and epidermal tissues were used as reference tissues. Our investigations

D. Broekaert; A. Cornille; H. Eto; I. Leigh; F. Ramaekers; G. Muijen; P. Coucke; J. Bersaques; P. Kluyskens; E. Gillis



Effect of tyrosine administration on duodenal ulcer induced by cysteamine in the rat  

SciTech Connect

Duodenal ulcers were produced by administering cysteamine to rats. Pretreatment with the catecholamine precursor, L-tyrosine (40 mg/100 g i.p. for 5 days), decreased the intensity of duodenal ulcers induced by cysteamine. Equimolar doses of tyrosine methyl ester (51.2 mg/100 g i.p. or s.c.) were equally effective in reducing ulcer intensity. Other amino acids (i.e., alanine, aspartic acid, glutamic acid, glycine, leucine, lysine, tryptophan and valine) did not prevent experimental duodenal ulcers. Coadministration of other large neutral amino acids (e.g., leucine and valine) that compete with tyrosine for uptake into the brain did not inhibit the effect of tyrosine on duodenal ulcers induced by cysteamine. Gastric, duodenal and brain dopamine concentrations were increased 1 hr after the injection of tyrosine methyl ester (25.6 mg/100 g s.c.). These results suggest that the effect of tyrosine on duodenal ulcer induced by cysteamine may be mediated by changes in gastrointestinal dopamine metabolism.

Oishi, T.; Szabo, S.



Duodenal lipid sensing activates vagal afferents to regulate non-shivering brown fat thermogenesis in rats.  


Previous evidence indicates that duodenal lipid sensing engages gut-brain neurocircuits to determine food intake and hepatic glucose production, but a potential role for gut-brain communication in the control of energy expenditure remains to be determined. Here, we tested the hypothesis that duodenal lipid sensing activates a gut-brain-brown adipose tissue neuraxis to regulate thermogenesis. We demonstrate that direct administration of lipids into the duodenum increases brown fat temperature. Co-infusion of the local anesthetic tetracaine with duodenal lipids abolished the lipid-induced increase in brown fat temperature. Systemic administration of the CCKA receptor antagonist devazepide blocked the ability of duodenal lipids to increase brown fat thermogenesis. Parenchymal administration of the N-methyl-d-aspartate receptor blocker MK-801 directly into the caudomedial nucleus of the solitary tract also abolished duodenal lipid-induced activation of brown fat thermogenesis. These findings establish that duodenal lipid sensing activates a gut-brain-brown fat axis to determine brown fat temperature, and thereby reveal a previously unappreciated pathway that regulates thermogenesis. PMID:23251649

Blouet, Clémence; Schwartz, Gary J



Cigarette smoking, gastric acid secretion, and serum pepsinogen I concentrations in duodenal ulcer patients.  

PubMed Central

Cigarette smoking has been linked with duodenal ulcer disease although the mechanism of this association is unclear. This study assessed basal gastric secretory response to acute smoking of smokers with an active duodenal ulcer; in addition the possible effects of chronic smoking on gastric secretory capacity, as expressed by pentagastrin stimulated gastric acid secretion and fasting serum pepsinogen I (PG I) concentrations, were investigated in patients with active duodenal ulcer, or non-ulcer dyspepsia. In 10 smokers with duodenal ulcer smoking four cigarettes during 40 minutes did not influence basal gastric secretion of acid and pepsin, or serum PG I and gastrin concentrations. In 136 patients with duodenal ulcer and 90 controls with non-ulcer dyspepsia, pentagastrin stimulated acid secretion and fasting serum PG I concentrations were significantly higher among habitual heavy smokers than among non-smokers. These findings suggest that in heavy smokers with duodenal ulcer acid- and pepsin-secreting cell function is not affected by acute cigarette smoking. By contrast, chronic cigarette smoking seems to be associated either with an increase of parietal- and chief-cell mass, or with an enhancement of their secretory capacity. PMID:3936754

Parente, F; Lazzaroni, M; Sangaletti, O; Baroni, S; Bianchi Porro, G



Characterization of epidermal growth factor receptors on plasma membranes isolated from rat gastric mucosa  

SciTech Connect

The binding of human epidermal growth factor (hEGF), beta-urogastrone, to plasma membranes isolated from rat gastric mucosa was studied to characterize gastric EGF receptors. The binding of ({sup 125}I)hEGF was temperature dependent, reversible, and saturable. A single class of binding sites for EGF with a dissociation constant of 0.42 nM and maximal binding capacity of 42 fmol/mg protein was suggested. There was little change in the binding of ({sup 125}I)hEGF upon addition of peptide hormones (secretin, insulin), antiulcer drugs (cimetidine), or an ulcer-inducing reagent (aspirin). Cross-linking of ({sup 125}I)hEGF to gastric plasma membranes with the use of disuccinimidyl suberate resulted in the labeling of a protein of 150 kDa. These results indicate the presence of EGF receptors on plasma membranes of rat gastric mucosa.

Hori, R.; Nomura, H.; Iwakawa, S.; Okumura, K. (Kyoto Univ. Hospital (Japan))



Large duodenal hematoma associated with transcatheter arterial embolization following endoscopic hemostasis in a cirrhosis patient: case report.  


To date, there has been no report on duodenal intramural hematoma following transcatheter arterial embolization in bleeding duodenal ulcer refractory to endoscopic hemostasis. We experienced a case of obstructive cholangitis and pancreatitis secondary to duodenal intramural hematoma associated with transcatheter arterial embolization, following endoscopic hemostatic procedures for a bleeding duodenal ulcer in a patient with cirrhosis. The patient was successfully treated with percutaneous transhepatic biliary drainage. We suggest that transcatheter arterial embolization can be a cause of duodenal intramural hematoma, and that percutaneous transhepatic biliary drainage, rather than surgical intervention, can be useful in the treatment of biliary or pancreatic obstruction secondary to duodenal intramural hematoma, especially in patients with bleeding diathesis. PMID:22287407

Won, Moon; Jung, Park Mi; Ja, Park Seun; In, Park Moo; La, Jang Lee; Sik, Jung Gyoo



Retention of small foreign objects in the stomach and duodenum. A sign of partial obstruction caused by duodenal anomalies.  


Small round, oval, or cuboidal foreign objects nearly always pass through the gastrointestinal tract promptly, and stasis of such objects in the stomach or duodenum is extremely uncommon. The authors describe 3 cases of prolonged retention in children with no clinical or plain-film evidence of duodenal obstruction. In each case, a barium meal demonstrated a congenital anomaly of the duodenum producing partial obstruction: duodenal stenosis, prolapse of the duodenal diaphragm ("windsock duodenum"), and an annular pancreas. PMID:1118573

Kassner, E G; Rose, J S; Kottmeier, P K; Schneider, M; Gallow, G M



Different effect of antiulcer agents on rat cysteamine-induced duodenal ulcer after sialoadenectomy, but not gastrectomy  

Microsoft Academic Search

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)

Vlado Bedekovic; Stjepan Mise; Tomislav Anic; Mario Staresinic; Miroslav Gjurasin; Mario Kopljar; Livije Kalogjera; Petar Drvis; Alenka Boban Blagaic; Lovorka Batelja; Sven Seiwerth; Predrag Sikiric



Negative Regulation of Pancreatic and Duodenal Homeobox-1 by Somatostatin Receptor Subtype 5  

PubMed Central

Somatostatin receptor subtype 5 (SSTR5) mediates the inhibitory effect of somatostatin and its analogs on insulin expression/secretion and islet cell proliferation. We provide biochemical and genetic evidence that SSTR5 exerted its physiological actions via down-regulating pancreatic and duodenal homeobox-1 (PDX-1), a ?-cell-specific homeodomain-containing transcription factor. Cotransfection of SSTR5 with PDX-1 resulted in dose-dependent inhibition of PDX-1 expression in human embryonic kidney 293 cells. SSTR5 agonist RPL-1980 inhibited PDX-1 expression and abolished glucagon-like peptide 1-stimulated PDX-1 expression in mouse insulinoma ?-TC-6 cells. SSTR5 knockdown by short hairpin RNA led to increased PDX-1 expression that was accompanied by enhanced insulin secretion stimulated by high glucose in ?-TC6 cells and alternated expressions of cell cycle proteins that favor cell proliferation in mouse insulinoma MIN6 cells. Quantitative RT-PCR analysis showed that cotransfected SSTR5 inhibited PDX-1 mRNA expression, whereas knockdown of SSTR5 increased PDX-1 mRNA expression. In addition, we found that cotransfected wild-type SSTR5 increased PDX-1 ubiquitination in human embryonic kidney 293 cells, whereas SSTR5 P335L, a hypofunctional single nucleotide polymorphism of SSTR5, inhibited PDX-1 ubiquitination. SSTR5 knockout resulted in increased expression of PDX-1, insulin, and proliferating cell nuclear antigen in the islets of sstr?/? mice. Immunohistochemistry analysis showed that SSTR5 P335L was associated with elevated expression of PDX-1 in human pancreatic neuroendocrine tumor. Taken together, our studies demonstrated that SSTR5 is a negative regulator for PDX-1 expression and that SSTR5 may mediate the inhibitory effects of somatostatin and its analogs on insulin expression/secretion and cell proliferation via down-regulating PDX-1 at both transcriptional and posttranslational levels. PMID:22669743

Zhou, Guisheng; Liu, Shi-He; Shahi, Kelly M.; Wang, Hua; Duan, Xueyan; Lin, Xia; Feng, Xin-Hua; Li, Min; Fisher, William E.; DeMayo, Francesco J.; Dawson, David



Negative regulation of pancreatic and duodenal homeobox-1 by somatostatin receptor subtype 5.  


Somatostatin receptor subtype 5 (SSTR5) mediates the inhibitory effect of somatostatin and its analogs on insulin expression/secretion and islet cell proliferation. We provide biochemical and genetic evidence that SSTR5 exerted its physiological actions via down-regulating pancreatic and duodenal homeobox-1 (PDX-1), a ?-cell-specific homeodomain-containing transcription factor. Cotransfection of SSTR5 with PDX-1 resulted in dose-dependent inhibition of PDX-1 expression in human embryonic kidney 293 cells. SSTR5 agonist RPL-1980 inhibited PDX-1 expression and abolished glucagon-like peptide 1-stimulated PDX-1 expression in mouse insulinoma ?-TC-6 cells. SSTR5 knockdown by short hairpin RNA led to increased PDX-1 expression that was accompanied by enhanced insulin secretion stimulated by high glucose in ?-TC6 cells and alternated expressions of cell cycle proteins that favor cell proliferation in mouse insulinoma MIN6 cells. Quantitative RT-PCR analysis showed that cotransfected SSTR5 inhibited PDX-1 mRNA expression, whereas knockdown of SSTR5 increased PDX-1 mRNA expression. In addition, we found that cotransfected wild-type SSTR5 increased PDX-1 ubiquitination in human embryonic kidney 293 cells, whereas SSTR5 P335L, a hypofunctional single nucleotide polymorphism of SSTR5, inhibited PDX-1 ubiquitination. SSTR5 knockout resulted in increased expression of PDX-1, insulin, and proliferating cell nuclear antigen in the islets of sstr(-/-) mice. Immunohistochemistry analysis showed that SSTR5 P335L was associated with elevated expression of PDX-1 in human pancreatic neuroendocrine tumor. Taken together, our studies demonstrated that SSTR5 is a negative regulator for PDX-1 expression and that SSTR5 may mediate the inhibitory effects of somatostatin and its analogs on insulin expression/secretion and cell proliferation via down-regulating PDX-1 at both transcriptional and posttranslational levels. PMID:22669743

Zhou, Guisheng; Liu, Shi-He; Shahi, Kelly M; Wang, Hua; Duan, Xueyan; Lin, Xia; Feng, Xin-Hua; Li, Min; Fisher, William E; Demayo, Francesco J; Dawson, David; Brunicardi, F Charles



Morphological evaluation of tongue mucosa in burning mouth syndrome  

Microsoft Academic Search

ObjectiveThe aim of the present study was to perform a morphological evaluation by immunofluorescence of biomarkers of keratinocyte intercellular adhesion, and of differentiation in the tongue mucosa of burning mouth syndrome patients (BMS), compared with a control group.

Andrea Sardella; Alice Gualerzi; Giovanni Lodi; Chiarella Sforza; Antonio Carrassi; Elena Donetti


Melatonin inhibits alcohol-induced increases in duodenal mucosal permeability in rats in vivo.  


Increased intestinal permeability is often associated with epithelial inflammation, leaky gut, or other pathological conditions in the gastrointestinal tract. We recently found that melatonin decreases basal duodenal mucosal permeability, suggesting a mucosal protective mode of action of this agent. The aim of the present study was to elucidate the effects of melatonin on ethanol-, wine-, and HCl-induced changes of duodenal mucosal paracellular permeability and motility. Rats were anesthetized with thiobarbiturate and a ~30-mm segment of the proximal duodenum was perfused in situ. Effects on duodenal mucosal paracellular permeability, assessed by measuring the blood-to-lumen clearance of ?¹Cr-EDTA, motility, and morphology, were investigated. Perfusing the duodenal segment with ethanol (10 or 15% alcohol by volume), red wine, or HCl (25-100 mM) induced concentration-dependent increases in paracellular permeability. Luminal ethanol and wine increased, whereas HCl transiently decreased duodenal motility. Administration of melatonin significantly reduced ethanol- and wine-induced increases in permeability by a mechanism abolished by the nicotinic receptor antagonists hexamethonium (iv) or mecamylamine (luminally). Signs of mucosal injury (edema and beginning of desquamation of the epithelium) in response to ethanol exposure were seen only in a few villi, an effect that was histologically not changed by melatonin. Melatonin did not affect HCl-induced increases in mucosal permeability or decreases in motility. Our results show that melatonin reduces ethanol- and wine-induced increases in duodenal paracellular permeability partly via an enteric inhibitory nicotinic-receptor dependent neural pathway. In addition, melatonin inhibits ethanol-induced increases in duodenal motor activity. These results suggest that melatonin may serve important gastrointestinal barrier functions. PMID:23639810

Sommansson, Anna; Saudi, Wan Salman Wan; Nylander, Olof; Sjöblom, Markus



Retroperitoneal lymphangioma with a duodenal lesion in an adult.  


A multilocular-cystic and cavernous, retroperitoneal tumor was found in a 40-year-old man whose past medical history was unremarkable. On admission, he complained of a large and still growing intra-abdominal mass associated with dull pain and a low-grade fever. Laboratory findings revealed leukocytosis and C-reactive protein elevation, compatible with inflammation of the tumor. Percutaneous aspiration of the tumor was performed under transabdominal ultrasonographic guidance, and continuous drainage of fluid from within the tumor ameliorated his symptoms. From preoperative examinations, including radiological imaging, fluid aspiration, and endoscopy with biopsy, a diagnosis of retroperitoneal lymphangioma was made. Laparotomy revealed extensive adhesions between the tumor and both the duodenum and the pancreatic head. A pancreaticoduodenectomy was therefore performed. At 3-year follow-up, there was no sign of recurrence. Retroperitoneal lymphangioma is an uncommon disorder, and the cavernous type is extremely rare. The duodenal lesion was an important feature of the present case, and endoscopic biopsy of this lesion facilitated precise preoperative diagnosis of retroperitoneal lymphangioma. PMID:12051538

Fujishiro, Mitsuhiro; Kamoshida, Toshiro; Hotra, Soichi; Hirai, Shinji; Oka, Yuji; Sato, Munekatsu; Okumura, Minoru; Inadome, Yukinori; Takahashi, Atsushi



Helicobacter pylori in humans: Where are we now?  

PubMed Central

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

Hussain, Syed Arshad; Hamid, Shamila



Presence of task-1 channel in the laryngeal mucosa in the newborn lamb.  


Nearly 40 potassium channels have been described in respiratory epithelial cells. Of these are found several members of the 4-transmembrane domain, 2-pore K(+) channel family (K2P family), namely Twik-1 and -2, Trek-1 and -2, Task-2, -3, and -4, Thik-1, and KCNK7. The aim of this study was to verify whether the Twik-related acid-sensitive K(+) channel, subtype 1 (Task-1) (also known as KCNK3), is present in the laryngeal mucosa in the newborn lamb. Through the use of immunohistochemistry and nested polymerase chain reaction (PCR) amplification, results indicate that Task-1 protein and mRNA are present in the laryngeal mucosa, in both the ciliated, pseudostratified columnar (respiratory) epithelium and the nonkeratinized, stratified squamous epithelium. The complete ovine Task-1 protein sequence showed high homology levels with previously reported mouse, bovine, and human Task-1 sequences. This includes a complete homology for the C-terminal amino acid sequence, which is mandatory for protein trafficking to the cell membrane. These results represent the first demonstration that Task-1, a pH-sensitive channel responsible for setting membrane potential, is present in the laryngeal mucosa of a newborn mammal. PMID:21309733

Bournival, Véronique; Desjardins, Roxane; Campbell, Shirley; Roberge, Claude; Doueik, Alexandre; Gendron, Louis; Payet, Marcel Daniel; Gallo-Payet, Nicole; Day, Robert; Praud, Jean-Paul



Attenuated TLRs in middle ear mucosa contributes to susceptibility of chronic suppurative otitis media.  


The variability in the recovery of otitis media (OM) is not well understood. Recent data have shown a critical role for toll-like receptors (TLRs) in inflammatory responses to bacteria. It remains unclear whether TLRs-mediated mucosal immunity plays a role in the OM recovery. The etiology, pathological profile, expression levels of TLR2, TLR4, TLR5, TLR9 and proinflammatory cytokines were measured in human middle-ear mucosae sampled from three subject groups: non-OM group, chronic otitis-media (COM) group, and chronic suppurative otitis-media (CSOM) group. Of the 72 ears, 86.11% CSOM patients were positive for bacteria. The cellular makeup of the middle ear mucosa differs among the three groups. Mucosae from the CSOM group presented chronic inflammation or suppurative inflammation in the rudimentary stroma, mainly with infiltration of monocytes and macrophages. The mRNA and protein levels of TLR2, TLR4, and TLR5 exhibited no difference between the non-OM and COM groups but were significantly lower in the CSOM group. Conversely, there was no significant difference in the TLR9 level among the three groups. Furthermore, proinflammatory cytokines TNF-?, IL-1?, IFN-?, IL-6 were up-regulated in the CSOM group. This study provides evidence that the variability in clinical otitis media recovery might be associated with the variability in the expression of mucosal TLRs. Reduced TLR levels in the middle-ear mucosa might cause weak host response to bacteria, persistent inflammation and susceptibility to CSOM. PMID:24882571

Si, Yu; Zhang, Zhi Gang; Chen, Sui Jun; Zheng, Yi Qing; Chen, Yu Bin; Liu, Yi; Jiang, Huaili; Feng, Lian Qiang; Huang, Xi



Pyloric exclusion in the treatment of severe duodenal injuries: results from the National Trauma Data Bank.  


Pyloric exclusion (PEX) has traditionally been used in the management of complicated duodenal injuries to temporarily protect the duodenal repair and prevent septic abdominal complications. We used the American College of Surgeons National Trauma Data Bank (v 5.0) to evaluate adult patients with severe duodenal injuries [American Association for the Surgery of Trauma (AAST) Grade > or = 3] undergoing primary repair only or repair with PEX within 24 hours of admission. Propensity scoring was used to adjust for relevant confounding factors during outcomes comparison. Among 147 patients with severe duodenal injuries, 28 (19.0%) underwent PEX [15.9% (11/69) Grade III vs 34.0% (17/50) Grade IV-V]. Despite similar demographics, PEX was associated with a longer mean hospital stay (32.2 vs 22.2 days, P = 0.003) and was not associated with a mortality benefit. There was a trend toward increased development of septic abdominal complications (intra-abdominal abscess, wound infection, or dehiscence) with PEX that was not statistically significant. After multivariable analysis using propensity score, no statistically significant differences in mortality or occurrence of septic abdominal complications was noted between those patients undergoing primary repair only or PEX. The use of PEX in patients with severe duodenal injuries may contribute to longer hospital stay and confers no survival or outcome benefit. PMID:18942615

DuBose, Joseph J; Inaba, Kenji; Teixeira, Pedro G R; Shiflett, Anthony; Putty, Bradley; Green, D J; Plurad, David; Demetriades, Demetrios



p38 MAP kinase interacts with and stabilizes pancreatic and duodenal homeobox-1.  


Pancreatic and duodenal homeobox-1 (PDX-1) is a homeodomain-containing transcription factor that plays a critical role in pancreatic development, ?-cell differentiation, maintenance of normal ?-cell function and tumorigenesis. PDX-1 is subjected to extensive post-translational modifications for its stability, subcellular location and transactivity. We report here that PDX-1 expression is up-regulated by p38 MAP kinase. Antibody array screen identified p38 as a candidate PDX-1-interacting protein in GFP-PDX-1 stable HEK293 cells. The p38-PDX-1 interaction was confirmed by immunoprecipitation/Western blotting analysis in both transient transfection system of HEK293 cells and endogenous system of ?-TC-6 cells stimulated by glucagon-like peptide 1 (GLP-1). Co-transfection of p38 with PDX-1 resulted in increased PDX-1 expression in HEK293 cells, which was accompanied by a decreased PDX-1 ubiquitination. Mass spectrometry analysis showed that Ser 268 of human PDX-1 was phosphorylated in GFP-PDX-1 stable HEK293 cells. Functional mutagenesis analysis showed that mutation of Ser 269 of mouse PDX-1 (corresponding to Ser 268 of human PDX-1) into nonphosphorylatable alanine abolished the stabilizing effect of p38 on PDX-1, which was in line with enhanced PDX-1 ubiquitination and shortened half-life of PDX-1. p38 showed kinase activity towards PDX-1 in vitro, suggesting that Ser 269 is a potential p38-regulated phosphorylation site within PDX-1. GLP-1-stimulated PDX-1 expression was accompanied by p38 kinase activation in mouse insulinoma ?-TC-6 cells and p38 inhibitor SB202190 inhibited GLP-1-stimulated PDX-1 expression with accompanied inhibition of p38 kinase activation. Taken together, our studies indicated that p38 MAP kinase is a positive regulator of PDX-1 stability and that p38 exerts its stabilizing effect on PDX-1 through a phosphorylation-dependent inhibition of PDX-1 ubiquitination. PMID:23331010

Zhou, G; Wang, H; Liu, S-H; Shahi, K M; Lin, X; Wu, J; Feng, X-H; Qin, J; Tan, T-H; Brunicardi, F C



A Case of Acute Ischemic Duodenal Ulcer Associated with Superior Mesenteric Artery Dissection After Transarterial Chemoembolization for Hepatocellular Carcinoma  

SciTech Connect

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.

Jang, Eun Sun; Jeong, Sook-Hyang, E-mail:; Kim, Jin Wook; Lee, Sang Hyub [Seoul National University Bundang Hospital, Department of Internal Medicine, College of Medicine (Korea, Republic of); Yoon, Chang Jin; Kang, Sung Gwon [Seoul National University Bundang Hospital, Department of Radiology (Korea, Republic of)



Duodenal Tube Feeding: An Alternative Approach for Effectively Promoting Weight Gain in Children with Gastroesophageal Reflux and Congenital Heart Disease  

PubMed Central

We tested whether duodenal tube feeding effectively improves the clinical symptoms and body weight gain in children with congenital heart disease (CHD) and gastroesophageal reflux (GER). In the retrospective analysis of 17 consecutive children with CHD who were treated with duodenal tube feeding for symptomatic GER, we found that clinical symptoms of persistent emesis or respiratory wheezing after feeding disappeared with duodenal tube feeding in all patients. Duodenal tube feeding facilitated a stable nutritional supply, resulting in marked improvement of weight gain from 6 to 21?g/day (P < .0001). In a patient with trisomy 21 and persistent pulmonary hypertension after the closure of a ventricular septal defect, duodenal tube feeding ameliorated pulmonary hypertension, as evidenced by the improvement of the pressure gradient of tricuspid regurgitation from 77 to 41?mm?Hg. In 14 of the 17 patients, the duodenal tube was successfully removed, with the spontaneous improvement of GER (median duration of duodenal tube feeding: 7 months). In conclusion, duodenal tube feeding improves the weight gain of infants with GER who need treatment for CHD-associated heart failure. It also allows for the improvement of pulmonary hypertension. PMID:23653635

Kuwata, Seiko; Iwamoto, Yoichi; Ishido, Hirotaka; Taketadu, Mio; Tamura, Masanori; Senzaki, Hideaki



Association of Transjugular Intrahepatic Portosystemic Shunt with Embolization in the Treatment of Bleeding Duodenal Varix Refractory to Sclerotherapy  

Microsoft Academic Search

Background: Bleeding from duodenal varices are often severe (mortality as high as 40%), and more difficult to sclerose than esophageal varices. We report a patient with a bleeding duodenal varix, refractory to sclerotherapy, successfully treated by the association of portosystemic shunt placement and varix embolization, via the same transjugular intrahepatic route. Methods: A 40-year-old Black male underwent emergency TIPS and

Giulio Illuminati; Allaoua Smail; Daniel Azoulay; Denis Castaing; Henri Bismuth



Vagal reflex inhibition of motility in the abomasal body of sheep by antral and duodenal tension receptors  

Microsoft Academic Search

Vagally-mediated regulation of motility in the abomasal body by duodenal and abomasal antral motility was demonstrated in acutely prepared anaesthetized sheep. The enteric plexuses between the abomasal body, antrum and duodenum were interrupted by transection. Antral contractions were more effective than duodenal contractions at causing inhibition of the abomasal body, and antral isometric conditions were more effective than antral isotonic

D. F. Cottrell



Polypoid tumors of the major duodenal papilla: preoperative staging with intraductal US, EUS, and CT — a prospective, histopathologically controlled study  

Microsoft Academic Search

Background: An adenoma-carcinoma sequence also applies to adenomas of the major duodenal papilla. Therefore accurate preoperative diagnosis and tumor staging are essential to select the appropriate patients for adequate treatment. In a prospective, histopathologically controlled study of tumors of the main duodenal papilla, the preoperative diagnostic value of ultrasound (US) catheter probes applied during endoscopic retrograde cholangiopancreatography (ERCP) was investigated.

Josef Menzel; Nicolas Hoepffner; Udo Sulkowski; Peter Reimer; Axel Heinecke; Christopher Poremba; Wolfram Domschke



Combined duodenal and pancreatic major trauma in high risk patients: can a partial reconstruction be safe?  


Pancreatic trauma is an uncommon injury, occurring in only about 0.2% of blunt abdominal injuries, while duodenal injuries represent approximately 4% of all blunt abdominal injuries. When trauma of the pancreas and duodenum do not permit reparation, pancreatoduodenectomy (PD) is mandatory. In the reconstructive phase, the use of ductal ligation as an alternative to standard pancreaticojejunostomy has been reported by some authors. We report a case of polytrauma with pancreatic and duodenal injury in which the initial diagnosis failed to recognize the catastrophic duodenal and pancreatic situation. The patient was submitted for PD and the pancreatic stump was abandoned in the abdominal cavity after main pancreatic ductal ligation. This technique can minimize the morbidity and mortality of PD in patients with other organs or apparatus involved severely and extensively in trauma. PMID:24847897

Toro, A; Li Destri, G; Mannino, M; Arcerito, M C; Ardiri, A; Politi, A; Bertino, G; Di Carlo, I



[Duodenal fistula following Port-à-cath--a rare complication of regional hepatic chemotherapy].  


Arterial port systems are frequently used in the adjuvant and palliative therapy of colorectal hepatic metastasis. Specific complications are rarely documented in literature. The perforation of an arterial Port-à-cath followed by duodenal fistula is an uncommon complication of regional hepatic chemotherapy. Besides systemic disorders caused by the chemotherapeutic agents, such as vomiting, sickness, or gastritis and duodenitis, gastroduodenal ulcers can occur as a local complication of treatment. Thrombosis of the hepatic artery or occlusion of the port device are the most common reasons for withdrawal of treatment in our series. Based on our experience and the case report of a duodenal fistula we recommend angiography of the port system prior to each cycle of chemotherapy. PMID:10501673

Ophoff, K; Truong, S; Riesener, K P; Schippers, E; Schumpelick, V



Wilkie's Syndrome and Left Adnexal Mass: Unusual Presentation of Duodenal Adenocarcinoma.  


Duodenal adenocarcinoma (DACa) is a rare malignancy, the presenting symptoms of which are vague and nonspecific. We report the case of a patient presenting with symptoms of subacute small bowel obstruction whose CT scan revealed i) left adnexal mass and ii) compression of 3(rd) portion of duodenum with reduced aortomesentric angle consistent with Wilkie's syndrome (WS). Laparatomy in addition revealed a distal duodenal stricture, which showed a well differentiated DACa causing subtotal intestinal obstruction. The ovarian mass revealed adenocarcinoma with similar morphology. Immunophenotypic analysis revealed positive expression of CK 20 and CDX 2 and absence of CK 7 staining in the tumours consistent with Primary DACa with ovarian metastasis. We further concluded that the WS resulted from reduced mesenteric fat pad caused by DACa induced cachexia. The case highlights the elusive nature of duodenal malignancy and emphasises the importance of meticulous small bowel examination during exploration of ovarian masses. PMID:25302201

Devadass, Clement Wilfred; Okaly, Geetha V Patil; Hm, Sudha; Pai, Sreekar Agumbe; Sridher, H



Wilkie's Syndrome and Left Adnexal Mass: Unusual Presentation of Duodenal Adenocarcinoma  

PubMed Central

Duodenal adenocarcinoma (DACa) is a rare malignancy, the presenting symptoms of which are vague and nonspecific. We report the case of a patient presenting with symptoms of subacute small bowel obstruction whose CT scan revealed i) left adnexal mass and ii) compression of 3rd portion of duodenum with reduced aortomesentric angle consistent with Wilkie’s syndrome (WS). Laparatomy in addition revealed a distal duodenal stricture, which showed a well differentiated DACa causing subtotal intestinal obstruction. The ovarian mass revealed adenocarcinoma with similar morphology. Immunophenotypic analysis revealed positive expression of CK 20 and CDX 2 and absence of CK 7 staining in the tumours consistent with Primary DACa with ovarian metastasis. We further concluded that the WS resulted from reduced mesenteric fat pad caused by DACa induced cachexia. The case highlights the elusive nature of duodenal malignancy and emphasises the importance of meticulous small bowel examination during exploration of ovarian masses. PMID:25302201

Okaly, Geetha V Patil; HM, Sudha; Pai, Sreekar Agumbe; Sridher, H.



Values of endoscopic ultrasonography for diagnosis and treatment of duodenal protruding lesions*  

PubMed Central

Objective: The diagnoses of patients with duodenal protruding lesions are difficult when using conventional examinations such as computed tomography (CT) and conventional endoscope etc. Thus, we investigated the clinical value of endoscopic ultrasonography (EUS) with miniature ultrasonic probes on the diagnosis and treatment of duodenal protruding lesions. Methods: Patients with duodenal protruding lesions who were indicated for EUS were examined by EUS with 12~15 MHz miniature ultrasonic probes and double-cavity electronic endoscope. According to diagnosis of EUS, those patients were indicated for biopsy and treatment received biopsy, endoscopic resection or surgical excision. The postoperative histological results were compared with the preoperative diagnosis of EUS. Those patients without endoscopic resection or surgical excision were periodically followed up with EUS. Results: A total of 169 patients with duodenal protruding lesions were examined by EUS, of which 40 were diagnosed with cysts, 36 with inflammatory protruding or polyp, 25 with Brunner’s gland adenoma, 19 with ectopic pancreas, 17 with gastrointestinal stromal tumor, 12 with extrinsic compression, 12 with minor papilla, 6 with lipoma, 1 with adenocarcinoma and 1 with lymphoma. After EUS examinations, 75 patients received biopsy, endoscopic resection or surgical excision respectively. The postoperative histological results of 70 patients were completely consistent with the preoperative diagnosis of EUS, with 93.33% diagnostic accuracy. The results of follow-up with EUS indicated that duodenal cyst, Brunner’s gland adenoma, ectopic pancreas, gastrointestinal stromal tumor and lipoma remained unchanged within 1~3 years. No related complications occurred among all patients that received EUS examinations. Conclusion: EUS is an effective and reliable diagnostic method for duodenal protruding lesions. PMID:18381809

Xu, Guo-qiang; Wu, Yi-qun; Wang, Li-jun; Chen, Hong-tan



Resolving sphincter of Oddi incontinence for primary duodenal Crohn's disease with strictureplasty  

PubMed Central

INTRODUCTION Crohn's involvement of duodenum is a rare event and may be associated to proteiform symptoms and uncommon pathological aspects which make diagnosis and treatment complex. PRESENTATION OF CASE The peculiar aspect of this case was a suspected duodeno-biliary fistula. The patient (female, 22 years old) was affected by duodenal Crohn's disease. Magnetic resonance imaging showed a dilated common bile duct, whose final part linked to a formation containing fluid, and characterized by filling of the contrast medium in the excretory phase. Abdominal ultrasound showed intra-hepatic and intra-gallbladder aerobilia. At surgery, the duodenum was mobilized showing an inflammatory stricture and a slight dilatation of the common bile duct, with no signs of fistulas. The opened duodenum was anastomized side to side to a transmesocolic loop of the jejunum. After surgery, the general condition of the patient improved. DISCUSSION Only two cases of fistula between a narrow duodenal bulb and the common bile duct have been described in literature and the Authors were not be able to verify the occurrence of a duodenal biliary fistula at surgery. The association between duodenal Crohn's disease and Sphincter of Oddi incontinence is a very rare finding with different etiology: chronic intestinal pseudo-obstruction, common bile duct stones, progressive systemic sclerosis. CONCLUSION The treatment to resolve Sphincter of Oddi incontinence for primary duodenal Crohn's disease is not clear. Strictureplasty could be the treatment of choice, because, resolving the stricture, the duodenal pressure is likely to decrease and the reflux through the incontinent sphincter can be avoided. PMID:23276753

Alemanno, G.; Sturiale, A.; Bellucci, F.; Giudici, F.; Tonelli, F.



[Changes in duodenal lymphoid structures in rats with various behavioral activity, caused by delta sleep-inducing peptide and following acute emotional stress].  


The effect of delta sleep-inducing peptide (DSIP) on the lymphoid structures of small intestine, was investigated. Studies were conducted on 42 male Wistar rats, which were previously assessed in an "open field" test. According to the results of the test, rats were divided into behaviorally active animals (prognostically resistant to stress) and passive ones (resistant to the effects of stress). As a stress, immobilization of the animals in pens with an electrical stimulation of their back for 1 hour, was used. Intraperitoneal injection of DSIP resulted in a reduction of eosinophil number in rats of all the experimental groups. After DSIP injection to the active rats of the control group, the increase in small and medium lymphocyte numbers was detected that was more expressed than in the passive rats. After an acute exposure of behaviorally active rats to stress, the number of the cells of lymphoid series was increased,mainly due to the increase in small and medium lymphocytes. In the group of passive rats, stress exposure and DSIP injection resulted in the increase of plasma cell number in all the duodenal mucosa structures studied. PMID:20572393

Ivanova, E A; Koplik, E V



Viewpoints on Acid-Induced Inflammatory Mediators in Esophageal Mucosa  

PubMed Central

We have focused on understanding the onset of gastroesophageal reflux disease by examining the mucosal response to the presence of acid in the esophageal lumen. Upon exposure to HCl, inflammation of the esophagus begins with activation of the transient receptor potential channel vanilloid subfamily member-1 (TRPV1) in the mucosa, and production of IL-8, substance P (SP), calcitonin gene related peptide (CGRP) and platelet activating factor (PAF). Production of SP and CGRP, but not PAF, is abolished by the neural blocker tetrodotoxin suggesting that SP and CGRP are neurally released and that PAF arises from non neural pathways. Epithelial cells contain TRPV1 receptor mRNA and protein and respond to HCl and to the TRPV1 agonist capsaicin with production of PAF. PAF, SP and IL-8 act as chemokines, inducing migration of peripheral blood leukocytes. PAF and SP activate peripheral blood leukocytes inducing the production of H2O2. In circular muscle, PAF causes production of IL-6, and IL-6 causes production of additional H2O2, through activation of reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidases. Among these, NADPH oxidase 5 cDNA is significantly up-regulated by exposure to PAF; H2O2 content of esophageal and lower esophageal sphincter circular muscle is elevated in human esophagitis, causing dysfunction of esophageal circular muscle contraction and reduction in esophageal sphincter tone. Thus esophageal keratinocytes, that constitute the first barrier to the refluxate, may also serve as the initiating cell type in esophageal inflammation, secreting inflammatory mediators and pro-inflammatory cytokines and affecting leukocyte recruitment and activity. PMID:21103419

Harnett, Karen M; Rieder, Florian; Behar, Jose



Reflectance confocal endomicroscope with optical axial scanning for in vivo imaging of the oral mucosa  

PubMed Central

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.

Jabbour, Joey M.; Bentley, Julie L.; Malik, Bilal H.; Nemechek, John; Warda, John; Cuenca, Rodrigo; Cheng, Shuna; Jo, Javier A.; Maitland, Kristen C.



Local anaesthesia through the action of cocaine, the oral mucosa and the Vienna group.  


Local anaesthesia through the action of cocaine was introduced in Europe by the Vienna group, which includeed Freud, Koller and Königstein. Before using the alkaloid in animal or human experimentation all these scientists tested it on their oral mucosa - so-called self-experimentation. Some of them with different pathologies (that is, in the case of Freud), eventually became addicted to the alkaloid. Here we attempt to describe the people forming the so-called 'Vienna group', their social milieu, their experiences and internal disputes within the setting of a revolutionary discovery of the times. PMID:25012333

López-Valverde, A; de Vicente, J; Martínez-Domínguez, L; de Diego, R Gómez



Simultaneous Gastric and Duodenal Erosions due to Adjustable Gastric Banding for Morbid Obesity  

PubMed Central

Erosion is an uncommon but feared late complication of adjustable gastric banding for morbid obesity. A high index of clinical suspicion is required, since symptoms are usually vague and nonspecific. Diagnosis is confirmed on upper gastrointestinal endoscopy and band removal is the mainstay of treatment, with band revision or conversion to other bariatric modalities at a later stage. Duodenal erosion is a much rarer complication, caused by the connection tubing of the band. We present our experience with a case of simultaneous gastric and duodenal erosions, managed by laparoscopic explantation of the band, primary suture repair of the duodenum, and omentopexy. PMID:24883218

Manatakis, Dimitrios K.; Terzis, Ioannis; Kyriazanos, Ioannis D.; Dontas, Ioannis D.; Stoidis, Christos N.; Stamos, Nikolaos; Davides, Demetrios



Heterotopic gastrointestinal mucosa in the oral cavity of adults.  


Heterotopic gastrointestinal mucosa (HGM) is a rare entity observed in the head and neck region and occurs more frequently in male infants and children. The floor of the mouth and anterior aspects of the tongue are the most commonly affected sites. Histologically, HGM resembles gastric, intestinal or colonic mucosa with areas of squamous epithelium, which can be cystic or solid. In the current report, 2 cases of HGM affecting the oral mucosa in patients over 35 years of age are presented, and one of these cases presented 2 nodules in different locations. Both cases represented solid lesions instead of the more common cystic presentation showing gastric glandular-type tissue that was lined with pseudostratified columnar epithelium containing crypts and fundic glands. Immunohistochemical analysis revealed positive expression of cytokeratins 7, 8 and 18 and smooth muscle actin (SMA). In both cases, the final diagnosis was HGM, and conservative surgical excision was performed. PMID:23453613

Martins, Fabiana; Hiraki, Karen Renata; Mimura, Maria Ângela; de Almeida Milani, Basílio; Gallottini, Marina; Martins, Marília Trierveiler; de Sousa, Suzana Orsini Machado



Oral focal mucinosis of palatal mucosa: A rare case report  

PubMed Central

Oral focal mucinosis (OFM), an oral counterpart of cutaneous focal mucinosis, is a rare disease of unknown etiology. Its pathogenesis may be due to the overproduction of hyaluronic acid by a fibroblast, at the expense of collagen production, resulting in focal myxoid degeneration of the connective tissue, primarily affecting the mucosa overlying the bone. It has no distinctive clinical features, as the diagnosis is solely based on the histopathological features. This article reports of a 32-year-old female having the rare disease of oral focal mucinosis, involving the posterior palatal mucosa, and discusses its clinicopathological features and differential diagnosis of myxomatous lesions of the oral cavity. PMID:23230367

Bharti, Vipin; Singh, Jagmohan



Spontaneous healing of pancreatic abscess after fistulization to the duodenal bulb.  


A 70-year-old man was admitted to the hospital because of sudden, upper abdominal and back pain. Laboratory and image data indicated acute pancreatitis. Shortly after the admission, pancreatic and liver abscess with bacteremia developed. Antibiotic therapy seemed effective. A month later, spontaneous fistulization of the pancreatic abscess to the duodenal bulb was found by gastroduodenal fiberscopy. Injection of contrast medium into the duodenal orifice showed that the fistula was draining the abscess and that no other fistula formed from the abscess. Endoscopic retrograde cholangiopancreatogram indicated no fistula formation to the pancreatic duct. The pancreatic abscess became smaller and was not visible using computerized tomography and ultrasonography 3 months later and thereafter. Closure of the duodenal orifice was ascertained by the endoscopy. It is suggested that retrograde infection from the fistula was prevented by the single fistulization to the acidic duodenal bulb, which is not supposed to allow most bacterial growth. Pancreatic abscess usually necessitates operative treatment, even with fistulization to the alimentary tract. It seems likely that the single, small fistulization to the bulb, in addition to the lack of underlying disease and medical and nutritional support, facilitated the spontaneous healing process. PMID:9216441

Kawachi, S; Ogawa, T; Ukita, M; Shiroko, J; Kawase, Y; Adachi, S; Kametani, M; Kamikubo, K



Duodenal perforation due to compression necrosis by the tip of percutaneous endoscopic gastrostomy tube.  


Percutaneous endoscopic gastrostomy (PEG) is a common and safe procedure for enteral nutrition. There are few reports concerning its complications. We managed a 31-y-old bedridden case with punched out duodenal perforation without inflammation, from which the tip of the PEG tube protruded. Simple x-ray and computed tomography showed incarceration of the balloon in the duodenal bulb and extravasation of the tip of the tube. We performed simple closure with omental patching for duodenal perforation. Postoperative gastrointestinal fiberscopy on the 11th day revealed scar phase. Some PEG tubes have a balloon, which can prevent the removal of the tube, fix the position of the tube, and prevent the leakage of gastric contents from fistula. However, in our case, the inflated balloon was transferred into the duodenal bulb according to gastric strong peristalsis. This pathophysiologic mechanism is the same as ball bulb syndrome, which is known as gastroduodenal obstruction by incarceration of the gastric submucosal tumor. There is a risk of wedging of the inflated balloon of the PEG tube and perforation of the duodenum. We must not insert the tube too deeply, must not continue to inflate the balloon for a long time, and must check its position using a stethoscope, simple x-ray examination, or ultrasound. PMID:21497055

Moriwaki, Yoshihiro; Arata, Shinju; Tahara, Yoshio; Toyoda, Hiroshi; Kosuge, Takayuki; Suzuki, Noriyuki



Laparoscopic versus open management of duodenal perforation: a comparative study at a District General Hospital  

PubMed Central

Introduction Duodenal perforation is one of the common pathologies in patients presenting in emergency with acute abdominal pain in an emergency ward and requires prompt surgery as life saving and curative intervention. The present study was conducted to determine whether the minimal access approach by laparoscopy was equally feasible as the open method. Aim To compare laparoscopic vs. open management duodenal perforation in all aspects. Material and methods Inclusion criteria: patients presenting to the emergency ward with acute pain in the abdomen with clinical signs of peritonitis and air under the diaphragm on X-ray abdomen standing were selected. Exclusion criteria were: patient age < 15 years and > 70 years, presentation > 2 days, shock with systolic blood pressure < 90 mm Hg which did not improve after hydration with 2000 ml of Ringer lactate solution, respiratory distress, history of cardiac disorder or respiratory disorders such as ischemic heart disease, arrhythmias, chronic obstructive pulmonary disease or asthma, bleeding and clotting disorders, pregnancy in females, previous upper abdominal surgery, and intra-operatively patients having perforation other than duodenal perforation. After excluding patients fitting the above criteria, two groups – test and control – were formed. Results We found that complications both early and late were significantly fewer in patients treated by laparoscopy. Thus laparoscopy was both feasible and had comparable mortality and leakage rate. Conclusions Laparoscopic management of perforated duodenal ulcer is feasible, effective and decreases morbidity and overall treatment time and cost if performed in properly selected patients. PMID:24868276

Motewar, Ashish; Tilak, Mandar; Bhamare, Nikhil; Bhople, Laxmikant



Laparoscopic repair of duodenal atresia in a low birth weight neonate.  


The small volume of the infant abdomen limits the application of laparoscopic procedures. We successfully repaired a duodenal atresia in a 2-kg female infant using a standard diamond-shaped anastomosis and intracorporeal suturing and knot-tying techniques. Anesthesia and positive pressure ventilation assured adequate gas exchange during pneumoperitoneum during the procedure. PMID:25197863

Rosales-Velderrain, Armando; Betancourt, Abraham; Alkhoury, Fuad



Curing Helicobacter pylori infection in patients with duodenal ulcer may provoke reflux esophagitis  

Microsoft Academic Search

BACKGROUND & AIMS: We have shown previously that cure of Helicobacter pylori infection leads to the disappearance of acid-neutralizing substances. Also, patients with ulcer after cure may gain weight. The aim of this study was to investigate whether cure of the infection increases the risk of reflux esophagitis. METHODS: Patients with duodenal ulcer without reflux esophagitis at the time of

J Labenz; AL Blum; E Bayerdorffer; A Meining; M Stolte; G Borsch



Helicobacter pylori infection and abnormalities of acid secretion in patients with duodenal ulcer disease  

Microsoft Academic Search

Background & Aims: The mechanism by which Helicobacter pylori predisposes to duodenal ulcers (DUs) remains unclear. The aim of this study was to investigate the effect of the infection on acid secretion. Methods: Acid output was examined basally and in response to gastrin-releasing peptide (GRP) and gastrin in healthy volunteers with and without H. pylori infection and in patients with

Emad M. El-Omar; Ian D. Penman; Joy E. S. Ardill; Ravi S. Chittajallu; Catherine Howie; Kenneth E. L. McColl



Malignant Gastric and Duodenal Stenosis: Palliation by Peroral Implantation of a Self-Expanding Metallic Stent  

SciTech Connect

Purpose: To assess the use of self-expanding metallic stents in patients with inoperable malignant antrum-pylorus-duodenal obstruction. Methods: Six patients underwent implantation of a Wallstent self-expanding metallic endoprosthesis (20 mm in five patients and 16 mm in one). In five patients a catheter (Berenstein) was introduced perorally into the stomach. A guidewire (Terumo) was introduced through the catheter and advanced through the antrum-pylorus-duodenal stenosis. The guidewire was removed and a 260-cm-long, 0.035'' superstiff guide (Amplatz) was introduced. After the catheter was removed the stent assembly was introduced. In the last patient the stent was implanted through a percutaneous gastrostomy. Results: Treatment of inoperable gastric outlet obstruction caused by tumor compression is difficult and unsatisfactory. Peroral implantation of self-expanding metallic stents resulted in successful palliative therapy of antrum-pylorus-duodenal stenosis in six patients in whom surgery was not possible because of advanced disease and poor general condition. On average, patients were able to eat during 41 days. One patient is tolerating oral intake at 3 months. Conclusion: Implantation of stents resulted in palliative relief of malignant antrum-pylorus-duodenal obstructions.

Pinto, Isabel T. [Department of Radiology, Hospital Universitario de Getafe, Ctra. de Toledo, Km. 12.5, E-28905 Getafe, Madrid (Spain)



Case report: Portal and systemic venous gas in a patient with perforated duodenal ulcer: CT findings  

PubMed Central

Gas within the portal circulation has been known to be associated with a number of conditions most commonly mesenteric ischemia and necrosis. Systemic venous gas is described with few conditions and is mostly iatrogenic in nature. We describe a case of combined portal and systemic venous gas detected by computed tomography in a patient with perforated duodenal ulcer.

Fam, Maged Nassef Abdalla; Attia, Khaled Mostafa Elgharib; Khalil, Safaa Maged Fathelbab



Duodenal stenosis resulting from a preduodenal portal vein and an operation for scoliosis.  


A preduodenal portal vein (PDPV) is known to be a rare cause of duodenal stenosis. We treated a 22-year-old male patient with malnutrition as a result of PDPV and a previously performed operation for scoliosis, who showed an improvement in quality of life after being treated with a combination of nutritional support and surgery. The patient with PDPV had been admitted to our department with duodenal stenosis, ranging from the first to third portions. He had suffered from vomiting since 1 year of age, and he developed malnutrition during the last 6-mo period after orthopedic surgery for scoliosis. The stenosis was related to both the PDPV and the previously performed operation for scoliosis. After receiving nutritional support for 6 mo, a gastrojejunostomy with Braun's anastomosis for the first portion and a duodenojejunostomy for the second and third portions were performed. The postoperative course was almost uneventful. Three months later, he was discharged and able to attend university. In patients with widespread duodenal stenosis, there may be a complicated cause, such as PDPV and duodenal stretching induced by previous spinal surgery. PMID:19701980

Masumoto, Kouji; Teshiba, Risa; Esumi, Genshiro; Nagata, Kouji; Nakatsuji, Takanori; Nishimoto, Yuko; Yamaguchi, Sadako; Sumitomo, Kenzo; Taguchi, Tomoaki



Duodenal stenosis resulting from a preduodenal portal vein and an operation for scoliosis  

Microsoft Academic Search

A preduodenal portal vein (PDPV) is known to be a rare cause of duodenal stenosis. We treated a 22-year- old male patient with malnutrition as a result of PDPV and a previously performed operation for scoliosis, who showed an improvement in quality of life after being treated with a combination of nutritional support and surgery. The patient with PDPV had

Kouji Masumoto; Risa Teshiba; Genshiro Esumi; Kouji Nagata; Takanori Nakatsuji; Yuko Nishimoto; Sadako Yamaguchi; Kenzo Sumitomo; Tomoaki Taguchi



Effects of rapeseed oil duodenal infusion on dairy cow performances and blood metabolites during early lactation  

E-print Network

Effects of rapeseed oil duodenal infusion on dairy cow performances and blood metabolites during. Milk fat and protein contents were non- significantly increased (+ 1.3 gA) and de- creased (-1.0 g/1 (but not postprandi- al) plasma glucose was decreased (0.46 vs 0.55 g/l, P

Boyer, Edmond


Spontaneous intramural duodenal hematoma in type 2B von Willebrand disease  

PubMed Central

Intramural duodenal hematoma is a rare cause of a proximal gastrointestinal tract obstruction. Presentation of intramural duodenal hematoma most often occurs following blunt abdominal trauma in children, but spontaneous non-traumatic cases have been linked to anticoagulant therapy, pancreatitis, malignancy, vasculitis and endoscopy. We report an unusual case of spontaneous intramural duodenal hematoma presenting as an intestinal obstruction associated with acute pancreatitis in a patient with established von Willebrand disease, type 2B. The patient presented with abrupt onset of abdominal pain, nausea, and vomiting. Computed tomography imaging identified an intramural duodenal mass consistent with blood measuring 4.7 cm × 8.7 cm in the second portion of the duodenum abutting on the head of the pancreas. Serum lipase was 3828 units/L. Patient was managed conservatively with bowel rest, continuous nasogastric decompression, total parenteral nutrition, recombinant factor VIII (humateP) and transfusion. Symptoms resolved over the course of the hospitalization. This case highlights an important complication of an inherited coagulopathy. PMID:24222967

Eichele, Derrick D; Ross, Meredith; Tang, Patrick; Hutchins, Grant F; Mailliard, Mark



Laparoscopic drainage of an intramural duodenal haematoma: a novel technique and review of the literature.  


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

Nolan, Gregory J; Bendinelli, Cino; Gani, Jon



Cimetidine or propantheline combined with antacid therapy for short-term treatment of duodenal ulcer  

Microsoft Academic Search

Seventy-one patients with duodenal ulcer disease completed a 3-to 6-week controlled randomized trial in which cimetidine (1 g daily) was compared with an optimally effective dose of propantheline. Both groups had free access to an antacid suspension. There were no significant differences between the groups concerning ulcer healing, relief of ulcer symptoms, antacid consumption, or patient compliance. After 3 weeks

Hans-olov Adami; Olle Björklund; Lars-Krister Enander; Sven Gustavsson; Lars Lööf; Arne Nordahl; Anders Rosén



Risk factors for healing of duodenal ulcer under antacid treatment: do ulcer patients need individual treatment?  

Microsoft Academic Search

In order to identify the risk factors affecting the healing of duodenal ulcer, a clinical trial with effective dose of antacid was carried out in 53 patients. Duration of ulcer history, number of relapses, duration of the last and present relapse, number, duration and severity of pain attacks in the present ulcer relapse, pain radiation to back, vomiting, appetite, smoking

S Massarrat; H G Müller; P Schmitz-Moormann



Vagal cholinergic control of gastric alkaline secretion in normal subjects and duodenal ulcer patients  

Microsoft Academic Search

Gastric alkaline secretion was determined in ranitidine treated healthy subjects and duodenal ulcer (DU) patients using gastric perfusion aspiration system and back titration of gastric perfusate to original pH 6.0. Basal alkaline secretion showed periodic fluctuations reaching peaks at phase III of the migrating motor complex (MMC) in the stomach. Mean basal alkaline secretion in healthy normals and DU patients

S J Konturek; N Kwiecie?; W Obtu?owicz; P Thor; J W Konturek; T Popiela; J Oleksy



In Vivo Adaptation and Persistence of Neisseria meningitidis within the Nasopharyngeal Mucosa  

PubMed Central

Neisseria meningitidis (Nme) asymptomatically colonizes the human nasopharynx, yet can initiate rapidly-progressing sepsis and meningitis in rare instances. Understanding the meningococcal lifestyle within the nasopharyngeal mucosa, a phase of infection that is prerequisite for disease, has been hampered by the lack of animal models. Herein, we compare mice expressing the four different human carcinoembryonic antigen-related cell adhesion molecules (CEACAMs) that can bind the neisserial Opa protein adhesins, and find that expression of human CEACAM1 is necessary and sufficient to establish intranasal colonization. During infection, in vivo selection for phase variants expressing CEACAM1-specific Opa proteins occurs, allowing mucosal attachment and entry into the subepithelial space. Consistent with an essential role for Opa proteins in this process, Opa-deficient meningococci were unable to colonize the CEACAM1-humanized mice. While simple Opa-mediated attachment triggered an innate response regardless of meningococcal viability within the inoculum, persistence of viable Opa-expressing bacteria within the CEACAM1-humanized mice was required for a protective memory response to be achieved. Parenteral immunization with a capsule-based conjugate vaccine led to the accumulation of protective levels of Nme-specific IgG within the nasal mucus, yet the sterilizing immunity afforded by natural colonization was instead conferred by Nme-specific IgA without detectable IgG. Considered together, this study establishes that the availability of CEACAM1 helps define the exquisite host specificity of this human-restricted pathogen, displays a striking example of in vivo selection for the expression of desirable Opa variants, and provides a novel model in which to consider meningococcal infection and immunity within the nasopharyngeal mucosa. PMID:23935487

Johswich, Kay O.; McCaw, Shannon E.; Islam, Epshita; Sintsova, Anna; Gu, Angel; Shively, John E.; Gray-Owen, Scott D.



Development of an improved three-dimensional in vitro intestinal mucosa model for drug absorption evaluation.  


Human epithelial cell culture models of monolayer Caco-2 cells have been widely employed to assess the absorption of drug molecules across intestinal mucosa. However, cautions should be taken when interpreting the conclusions from those models due to their undesirable phenotype and functionality when compared with the native intestinal tissue. In the present study, an improved, more physiologically relevant three-dimensional (3D) culture model of the intestinal mucosa was developed to study drug absorption, in which a coculture of epithelial cells, including Caco-2 cells and HT29-methotrexate cells, was indirectly seeded on a Transwell filter insert with collagen gel and stromal cells (fibroblasts and immunocytes) incorporation. This setting-up provided a compatible environment to improve the phenotype and functionality of the epithelial cells. Compared with the monolayer culture of Caco-2 cells, the reconstructed 3D model displayed more physiologically relevant characteristics evidenced by its decreased TEER value and mucus-like layer formation. A decreased expression of P-gp and an increased expression of BCRP were also observed in the current 3D culture model, leading to a changed secretory permeability of their substrates. More importantly, an improved correlation (R(2)=0.843) was obtained between the absorptive permeability across the 3D coculture model and the human absorption fraction especially for those model compounds with moderate or high permeability. Thus, this engineered 3D coculture model presents a unique, improved opportunity to evaluate drug permeability in vitro. PMID:23350801

Li, Na; Wang, Dandan; Sui, Zhigang; Qi, Xiaoyi; Ji, Liyun; Wang, Xiuli; Yang, Ling



Gastric mucosa lesions in drowning: its usefulness in forensic pathology  

Microsoft Academic Search

In a retrospective study of 52 autopsy cases of drowning fatalities, death circumstances, macroscopical and histological findings of the stomach mucosa were carefully studied. Results were compared with a control group, composed by 80 cases of different kinds of asphyxia (hanging, chocking and suffocation), skull injuries, sudden cardiac death and poisonings. The spectrum of gastric lesions observed during autopsy in

J. Blanco Pampín; S. A. García Rivero; Noemí M. Tamayo; R. Hinojal Fonseca



Larva migrans in the oral mucosa: report of two cases.  


Cutaneous Larva migrans is a very common disease in tropical regions. In the oral mucosa, the infection occurs in the same way as in the skin, but it is rarer. This report describes two cases of Larva migrans in the oral mucosa. The first case was in a 27-year-old woman who presented an erythematous plaque located on the buccal mucosa, extending to a posterior direction, following a linear pattern, to other areas of the mouth. After incisional biopsy of the anterior-most portion of the lesion, morphological details obtained in multiple examined sections suggested Necator or Ancylostoma braziliense larvae as the cause of infection. The second case was in a 35-year-old male who presented a fusiform erythematous plaque in the palatal mucosa. This area was removed and submitted to microscopic examination under a presumptive diagnosis of "parasite migratory stomatitis". The histological characteristics were suggestive of a larva pathway. In both cases the lesion disappeared after biopsy and the patients were symptom-free. PMID:21537593

Damante, José Humberto; Chinellato, Luiz Eduardo Montenegro; Oliveira, Fernando Toledo de; Soares, Cleverson Teixeira; Fleury, Raul Negrão



Iodine and gliadin challenge on oral mucosa in dermatitis herpetiformis.  


Oral lesions and mucosal inflammatory changes may appear in dermatitis herpetiformis (DH). We examined whether potassium iodine, known to initiate blisters in the DH skin, or wheat gliadin, responsible for T-cell-dependent intestinal damage, can induce visible or microscopic changes in oral mucosa. Six patients with active DH were challenged with crude gliadin and 50% potassium iodine applied in patch test chambers on buccal mucosa for 12 h. After reading, biopsies were taken from the challenged and non-challenged mucosa. No macroscopic or microscopic vesicles were seen. However, gliadin- but not iodine-challenged epithelium showed increased numbers of CD4+ lymphocytes in all 5 patients with representative specimens (p = 0.06). No marked changes were found in the numbers of CD8+ or TcR alpha/beta+ lymphocytes, and the numbers of TcR gamma/delta+ cells remained at a low level. The results show that oral mucosa is resistant to production of macroscopic or microscopic DH lesions. It is, however, capable of reacting to locally applied gliadin by a T-cell response consisting of CD4+ lymphocytes. PMID:12125958

Patinen, P; Hietane, J; Malmström, M; Reunala, T; Savilahti, E



Role of AmiA in the Morphological Transition of Helicobacter pylori and in Immune Escape  

E-print Network

´ Paris-Sud, Orsay, France The human gastric pathogen Helicobacter pylori is responsible for peptic ulcers with chronic gastritis, and less often with severe duodenal ulcers, gastric adenocarcinoma, or mucosa

Paris-Sud XI, Université de


Hemorrhagic gastric and duodenal ulcers after the Great East Japan Earthquake Disaster  

PubMed Central

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 year’s 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

Yamanaka, Kenichi; Miyatani, Hiroyuki; Yoshida, Yukio; Asabe, Shinichi; Yoshida, Toru; Nakano, Misaki; Obara, Shin; Endo, Hidehiko



History of Helicobacter pylori, duodenal ulcer, gastric ulcer and gastric cancer  

PubMed Central

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

Graham, David Y



Cat scratch disease, a rare cause of hypodense liver lesions, lymphadenopathy and a protruding duodenal lesion, caused by Bartonella henselae.  


A 46-year-old woman presented with right upper abdominal pain and fever. At imaging, enlarged peripancreatic and hilar lymph nodes, as well as hypodense liver lesions, were detected, suggestive of malignant disease. At endoscopy, the mass adjacent to the duodenum was seen as a protruding lesion through the duodenal wall. A biopsy of this lesion, taken through the duodenal wall, showed a histiocytic granulomatous inflammation with necrosis. Serology for Bartonella henselae IgM was highly elevated a few weeks after presentation, consistent with the diagnosis of cat scratch disease. Clinical symptoms subsided spontaneously and, after treatment with azithromycin, the lymphatic masses, liver lesions and duodenal ulceration disappeared completely. PMID:25355744

van Ierland-van Leeuwen, Marloes; Peringa, Jan; Blaauwgeers, Hans; van Dam, Alje



Cadmium inhibits acid secretion in stimulated frog gastric mucosa  

SciTech Connect

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.

Gerbino, Andrea, E-mail: gerbino@biologia.uniba.i [Dept. of General and Environmental Physiology, University of Bari, 70126 Bari (Italy); Debellis, Lucantonio; Caroppo, Rosa [Dept. of General and Environmental Physiology, University of Bari, 70126 Bari (Italy); Curci, Silvana [VA Boston Healthcare System and the Department of Surgery, Harvard Medical School, and Brigham and Women's Hospital, 1400 VFW Parkway, West Roxbury MA 02132 (United States); Colella, Matilde [Dept. of General and Environmental Physiology, University of Bari, 70126 Bari (Italy)



[Cancers of the oral and genital mucosa].  


Squamous cell carcinomas account for over 90 % of cancers of the oral cavity in France. Alcohol and tobacco are the main risk factors. Delay in diagnosis is unfortunately frequent. The management of the cancer is based on surgery, possibly associated to radiation therapy and chemotherapy. The survival rate at 5 years does not exceed 30-40%. We hope to see a decrease in the number of oral cancer thanks to the development of preventive medicine (alcohol and tobacco cessation and early detection of potentially malignant lesions). Vulvar squamous cell carcinoma is a rare disease which traditionally affect elderly woman but continues to rise in incidence especially in younger women. There are at least 2 forms of genital squamous cell carcinoma. The most common form is found on older women arising in a background of lichen sclerosus and the second is associated with "high risk" human papillomavirus infection affecting younger women. A biopsy is usually required for diagnosis. Attempts to reduce genital cancer must focus on treating precursor lesions, namely lichen sclerosus and HPV-related intraepithelial neoplasia (VIN and PIN). Most genital cancer occur on undiagnosed or untreated lichens sclerosus, vulvar inspection when women attend for their cervical smears or seeking about significance of any chronic genital symptom by a clinical examination. PMID:24167879

Dehen, Laure; Schwob, Emilie; Pascal, Francis



Biliogastric diversion for the management of high-output duodenal fistula: report of two cases and literature review.  


High-output duodenal fistula occurs as a result of a duodenal wall defect caused by gastroduodenal surgery, endoscopic sphincterotomy, duodenal injury, and tumors with high morbidity and mortality rate. A new technique for its management is reported along with literature review. This procedure consists of transection of the duodenum 2 cm distally to the pylorus, transection of the common bile duct, and end duodenostomy with or without suturing the duodenal wall defect. The continuity of the alimentary tract is reinstated by an end-to-end duodenojejunostomy, end-to-side choledochojejunostomy, and end-to-side Roux-en-Y jejunojejunostomy, obtaining biliogastric diversion from the duodenum and closure of the fistula. This technique was performed in two patients with excellent results. PMID:18825468

Milias, Konstantinos; Deligiannidis, Nikolaos; Papavramidis, Theodossis S; Ioannidis, Konstantinos; Xiros, Nikolaos; Papavramidis, Spiros



Evaluation of Selected Cytokine Gene Expression in Colonic Mucosa from Dogs with Idiopathic Lymphocytic-plasmacytic Colitis.  


Lymphocytic-plasmacytic colitis (LPC) is a common form of inflammatory bowel disease (IBD) affecting the canine large intestine. Cytokines are thought to be involved in the pathogenesis of IBD. However, to date, few studies have investigated cytokine mRNA expression in dogs with LPC. In this study, we investigated mRNA transcription levels of T helper cell cytokines, such as IFN-?, IL-4, IL-17 and IL-10 and pro-inflammatory cytokines, such as IL-1?, IL-6, TNF-?, IL-8, IL-12 and IL-23, in colonic mucosa from LPC dogs by quantitative real-time RT-PCR. No significant differences were detected in cytokine mRNA expressions between dogs with LPC and controls, except for IL-23p19. Dogs with LPC failed to express a predominant cytokine profile in inflamed colonic mucosa as opposed to human IBD. PMID:24976586

Tamura, Yu; Ohta, Hiroshi; Yokoyama, Nozomu; Lim, Sue Yee; Osuga, Tatsuyuki; Morishita, Keitaro; Nakamura, Kensuke; Yamasaki, Masahiro; Takiguchi, Mitsuyoshi



Cytokine expression in an ex vivo culture system of duodenal samples from dogs with chronic enteropathies: Modulation by probiotic bacteria  

Microsoft Academic Search

There is evidence that probiotics have immune-modulating effects on intestinal inflammation during chronic enteropathies (CE). In an ex vivo culture system we investigated the influence of probiotics on mRNA and protein expression levels of cytokines in intestinal samples from dogs suffering from CE. Duodenal samples of client-owned dogs with CE (group CE; n=12) were collected during diagnostic endoscopy. Additional duodenal

S. N. Sauter; K. Allenspach; F. Gaschen; A. Gröne; E. Ontsouka; J. W. Blum



Increased disomic homozygosity in the telomeric region of chromosome 21 among Down Syndrome individuals with duodenal atresia  

Microsoft Academic Search

Although duodenal atresia (DA) is present in only 4-7% of all Down Syndrome (DS) individuals, 30-50% of all congenital duodenal atresias occur in the DS population, suggesting the presence of gene(s) on chromosome 21 that play an important role in intestinal development. We recently proposed a chromosome 21 gene dosage model to explain the phenotypic variance seen among DS individuals

N. E. Lamb; E. Feingold; S. L. Sherman



Tissue Factor and Tissue Factor Pathway Inhibitor in Chronically Inflamed Gallbladder Mucosa  

PubMed Central

We characterised a tissue factor (TF) and tissue factor pathway inhibitor (TFPI) expression in relation to severity of inflammatory infiltration of the gallbladder mucosa in a chronic cholecystitis. We prospectively studied the gallbladder specimens obtained from 54 patients who had undergone cholecystectomy due to chronic calculous cholecystitis and 16 calculosis-free gallbladder specimens obtained from patients who underwent cholecystectomy due to the polyp/polyps as well as in cases of gallbladder injury. To assess TF and TFPI immunoreactivity by immunohistochemistry, the monoclonal anti-human TF and TFPI antibodies were used. The inflammatory infiltration of the gallbladder mucosa was reflected by the number of CD3 and CD68 positive cells. The expression of TF and TFPI differed significantly between the cholecystitis and the control group. Most capillary endothelial cells of the cholecystitis group presented weak expression for TFPI. The mean number of CD3 positive lymphocytes in the cholecystitis group was 18.6 ± 12.2, but the mean number of CD68 positive cells was 29.7 ± 13.9. In the control sections, it was 3.1 ± 1.9 and 8.8 ± 3.9, respectively (P < 0.001). The results of the current study suggest that the tissue procoagulant state found may be engaged in the etiopathogenesis of the cholecystitis. PMID:24716194

Liczko, Jacek; Zaba, Malgorzata; Kurek, Jozef; Sabat, Daniel; Wyrobiec, Grzegorz; Domal-Kwiatkowska, Dorota; Dudek, Damian; Helewski, Krzysztof



Tissue factor and tissue factor pathway inhibitor in chronically inflamed gallbladder mucosa.  


We characterised a tissue factor (TF) and tissue factor pathway inhibitor (TFPI) expression in relation to severity of inflammatory infiltration of the gallbladder mucosa in a chronic cholecystitis. We prospectively studied the gallbladder specimens obtained from 54 patients who had undergone cholecystectomy due to chronic calculous cholecystitis and 16 calculosis-free gallbladder specimens obtained from patients who underwent cholecystectomy due to the polyp/polyps as well as in cases of gallbladder injury. To assess TF and TFPI immunoreactivity by immunohistochemistry, the monoclonal anti-human TF and TFPI antibodies were used. The inflammatory infiltration of the gallbladder mucosa was reflected by the number of CD3 and CD68 positive cells. The expression of TF and TFPI differed significantly between the cholecystitis and the control group. Most capillary endothelial cells of the cholecystitis group presented weak expression for TFPI. The mean number of CD3 positive lymphocytes in the cholecystitis group was 18.6 ± 12.2, but the mean number of CD68 positive cells was 29.7 ± 13.9. In the control sections, it was 3.1 ± 1.9 and 8.8 ± 3.9, respectively (P < 0.001). The results of the current study suggest that the tissue procoagulant state found may be engaged in the etiopathogenesis of the cholecystitis. PMID:24716194

Liczko, Jacek; Stawski, Tomasz; Zaba, Ma?gorzata; Kurek, Józef; Sabat, Daniel; Wyrobiec, Grzegorz; Domal-Kwiatkowska, Dorota; Dudek, Damian; Kucharzewski, Marek; Helewski, Krzysztof



HIV target cells in Schistosoma haematobium-infected female genital mucosa.  


The parasite Schistosoma haematobium frequently causes genital lesions in women and could increase the risk of human immunodeficiency virus (HIV) transmission. This study quantifies the HIV target cells in schistosome-infected female genital mucosa. Cervicovaginal biopsies with and without schistosomiasis were immunostained for quantification of CD4(+) T lymphocytes (CD3, CD8), macrophages (CD68), and dendritic Langerhans cells (S100 protein). We found significantly higher densities of genital mucosal CD4(+) T lymphocytes and macrophages surrounding schistosome ova compared with cervicovaginal mucosa without ova (P = 0.034 and P = 0.018, respectively). We found no increased density of Langerhans cells (P = 0.25). This study indicates that S. haematobium may significantly increase the density of HIV target cells (CD4(+) T lymphocytes and macrophages) in the female genitals, creating a beneficial setting for HIV transmission. Further studies are needed to confirm these findings and to evaluate the effect of anti-schistosomal treatment on female genital schistosomiasis. PMID:22144444

Jourdan, Peter Mark; Holmen, Sigve Dhondup; Gundersen, Svein Gunnar; Roald, Borghild; Kjetland, Eyrun Floerecke



Impaired sulphation of phenol by the colonic mucosa in quiescent and active ulcerative colitis.  

PubMed Central

Substantial amounts of phenols are produced in the human colon by bacterial fermentation of protein. In the colonic mucosa of animals, phenols are inactivated predominantly by conjugation with sulphate. The purpose of this study was to confirm sulphation of phenols by isolated colonocytes from man and to evaluate mucosal sulphation in inflammatory bowel disease using the phenol, paracetamol, in rectal dialysis bags. The incubation of paracetamol with colonocytes isolated from resected colon specimens (n = 7) yielded a mean (SE) value of 7.0 (0.9) mumols/g dry weight of paracetamol sulphate after 60 minutes but virtually undetectable values of paracetamol glucuronide. Paracetamol sulphate was detected in rectal dialysates from all control subjects, with a mean (SE) value of 4.2 (0.8) nmol/hour. Sulphation was significantly impaired (p less than 0.01) in 19 patients with active ulcerative colitis (0.6 (0.2) nmol/hour) and in 17 patients with ulcerative colitis in remission (1.1 (0.4) nmol/hour). Sulphation in eight patients with Crohn's colitis (4.3 (2.1) nmol/hour) was similar to that in control subjects. Impairment of the capacity of the mucosa to sulphate phenols in quiescent and active ulcerative colitis may pose a metabolic burden on colonic epithelial cells, which are continuously exposed to endogenous phenols from the colonic lumen. PMID:1991638

Ramakrishna, B S; Roberts-Thomson, I C; Pannall, P R; Roediger, W E



Applying Convolution-Based Processing Methods To A Dual-Channel, Large Array Artificial Olfactory Mucosa  

NASA Astrophysics Data System (ADS)

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.

Taylor, J. E.; Che Harun, F. K.; Covington, J. A.; Gardner, J. W.



Laryngeal lymphoma derived from mucosa-associated lymphoid tissue.  


Extranodal lymphomas account for as many as 40% of non-Hodgkin's lymphomas, and most arise in the gastrointestinal tract, but other mucosal organs may be involved, especially the upper aerodigestive tract. Low-grade B-cell lymphomas arising in the gastrointestinal tract and other mucosae have been found to recapitulate the structure and cytologic features of mucosa-associated lymphoid tissue (MALT). Histologically low-grade MALT lymphomas are characterized by centrocyte-like B-cells with a phenotype similar to that of so-called marginal zone B-cells. Tumors evolving from MALT are generally rare among lymphomas of the upper aerodigestive tract, but a few cases of laryngeal lymphomas derived from MALT have been reported. Primary MALT lymphoma of the larynx should always be considered in tumors with histopathologic features of low-grade B-cell lymphoma, or so-called pseudolymphoma. PMID:8678438

Horny, H P; Ferlito, A; Carbone, A



Endotoxin protects the gastric mucosa against ulcerogenic stimuli.  


It is well-documented that large amounts of endotoxin produce hemorrhagic mucosal lesions in the stomach. To determine whether endotoxin, when injected at small doses, similarly exerts ulcerogenic actions, endotoxin (0.4-40 micrograms/kg) was injected into 24 hr-fasted rats. These small doses of endotoxin did not affect the integrity of the gastric mucosa. Unexpectedly, however, pretreatment with these minute amounts of endotoxin protected the gastric mucosa against various ulcerogenic stimuli such as stress, nonsteroidal anti-inflammatory drugs and ethanol. The anti-ulcer actions of endotoxin were not observed in endotoxin-insensitive animals (C3H/HeJ mice), thereby suggesting that endogenous cytokines such as interleukin-1 may mediate these protective actions. These findings stand in contrast to the toxic effect of endotoxin as an ulcerogen and indicate that endotoxin, albeit its term "toxin," may have a beneficial effect for the host. PMID:8280150

Tsuji, K; Uehara, A; Santos, S B; Namiki, M



Pharmacokinetics of EMLA cream 5% application to oral mucosa.  

PubMed Central

Plasma concentrations of lidocaine and prilocaine were measured following the application of a 5% eutectic mixture of local anesthetics (EMLA) topical anesthetic cream to the oral mucosa of twelve subjects. For each subject, a total of 8 g of EMLA was occluded to 18 cm2 of buccal mucosa for 30 min. Analysis was carried out by high-pressure liquid chromatography, and results showed peak concentrations at 40 min for lidocaine and prilocaine. The maximum concentration measured in any subject was 418 ng/ml for lidocaine and 223 ng/ml for prilocaine, well below known toxic levels. No adverse local effects were observed from a 30-min application of EMLA. A follow-up pilot study assessing the clinical efficacy of EMLA for achieving sufficient analgesia for restorative procedures showed that the cream was successful in 75% of subjects tested. PMID:9481979

Vickers, E. R.; Marzbani, N.; Gerzina, T. M.; McLean, C.; Punnia-Moorthy, A.; Mather, L.



Increased Prevalence of Colorectal Neoplasia in Korean Patients with Sporadic Duodenal Adenomas: A Case-Control Study  

PubMed Central

Background/Aims Recent data from Western populations have suggested that patients with sporadic duodenal adenomas are at a higher risk for the development of colorectal neoplasia. In this study, we compared the frequency of colorectal neoplasia in patients with sporadic duodenal adenomas to healthy control subjects. Methods This retrospective case-control study used the databases of 3 teaching hospitals in Gyeonggi-do Province, South Korea. The colonoscopy findings of patients with sporadic duodenal adenomas were compared with those of age- and gender-matched healthy individuals who had undergone gastroduodenoscopies and colonoscopies during general screening examinations. Results Between 2001 and 2008, 45 patients were diagnosed endoscopically with sporadic duodenal adenomas; 26 (58%) of these patients received colonoscopies. Colorectal neoplasia (42% vs 21%; odds ratio [OR], 2.8; 95% confidence interval [CI], 1.1 to 7.4) and advanced colorectal adenoma (19% vs 3%; OR, 9.0; 95% CI, 1.6 to 50.0) were significantly more common in patients with sporadic duodenal adenomas than in healthy control subjects. Conclusions Compared with healthy individuals, patients with sporadic duodenal adenomas were at a significantly higher risk for developing colorectal neoplasia. Such at-risk patients should undergo routine screening colonoscopies. PMID:22195240

Chung, Woo Chul; Lee, Bo-In; Roh, Sang Young; Kwak, Jae Wuk; Hwang, Sun-Mee; Ko, Yoon Ho; Oh, Jung-Hwan; Cho, Hyunjung; Chae, Hiun-Suk



Evaluation of endoscopically obtained duodenal biopsy samples from cats and dogs in an adapter-modified Ussing chamber  

PubMed Central

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

DeBiasio, John V.; Suchodolski, Jan S.; Newman, Shelley; Musch, Mark W.; Steiner, Jorg M.



Urethral fistula following circumcision: salvaged by buccal mucosa graft urethroplasty  

Microsoft Academic Search

Fistula following circumcision and at times accompanied by disfigurement of the glans penis is a common problem in our country,\\u000a where a large number of circumcision is performed by untrained professionals. These complications may have profound negative\\u000a psychological impact on the growing child. Herein, we report the successful closure of such fistula using buccal mucosa, which\\u000a occurred following circumcision (for

Rahul Janak Sinha; Divakar Dalela; S. N. Sankhwar; Vishwajeet Singh



Untersuchungen zur Regeneration des Hinterendes bei Anaitides mucosa (Polychaeta, Phyllodocidae)  

NASA Astrophysics Data System (ADS)

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.

Röhrkasten, A.



Keratocyst of the buccal mucosa: is it odontogenic?  


Odontogenic keratocyst (OKC) of the buccal mucosa, the diagnosis of which is based on subjective histologic evaluation, is a controversial entity of questionable existence. This report describes 2 rare cases of parakeratinized cyst arising from the buccal mucosa. Case 1 was a 60-year-old man with a 3-cm cyst and case 2 was a 16-year-old boy with a microcyst incidentally discovered on histology. Both lesions were essentially identical in histologic appearance and immunophenotype to intraosseous and gingival OKC, but they were clearly different from orthokeratinized odontogenic cysts and buccal mucosal epidermoid cysts. Step sections failed to reveal any kind of odontogenic tissue or skin adnexa in the cyst wall. These microscopic characteristics reflexively lead to the diagnosis of OKC, if the extragingival occurrence in the buccal mucosa cannot be considered. An alternative nonodontogenic origin includes a keratocyst of the skin, ie, an unusual mucosal presentation of cutaneous keratocyst. Because its true nature, either odontogenic or epidermal, cannot be conclusively proven at this time, we propose a more descriptive and noncommittal term, "mucosal keratocyst," for a particular cyst in a buccal location that is morphologically indistinguishable from OKC. PMID:20955942

Ide, Fumio; Kikuchi, Kentaro; Miyazaki, Yuji; Mishima, Kenji; Saito, Ichiro; Kusama, Kaoru



Effect of N-nitrosomethylbenzylamine on nasal mucosa in rats.  


N-nitrosomethylbenzylamine (NMBA) is one of the most potent organ-specific carcinogens routinely used in rat esophageal tumorigenesis. The aim of the study was to evaluate NMBA effect on nasal mucosa, one of the non-target organs. NMBA was administered subcutaneously to 20 male albino rats of Wistar strain for 5 weeks (0.5mg/kg/dose; three doses/week). The experiment was terminated on week 22. In each case, seven standard frontal sections of the nose were taken after fixation for assessment of all the parts of the nasal mucosa. Microscopic examination revealed one small squamous cell papilloma located on the ventro-lateral surface of the left superior nasal concha, one focus on simple hyperplasia and two foci of squamous epithelium dysplasia within the mucosa covering nasal vestibule near the respiratory part of the nasal cavity. Furthermore, statistically significant increase of proliferation activity in both lesional and non-lesional nasal squamous epithelium in NMBA-exposed animals was also found. These phenomena could be potentially induced by carcinogen exposure. PMID:17145176

Szumilo, Justyna



Endoscopic treatment of postgastrectomy duodenal fistula with an over-the-scope clip.  


Bleeding peptic ulcer is a life threatening condition with high mortality rate but often treatable by endoscopy. Surgical indications in case of gastroduodenal ulcers are confined to endoscopic and radiological failures in bleeding control. Duodenal fistula (DF) is a rare complication of gastric resection and even if a rare event it may be a life threatening condition. Surgical and medical options could not solve the DF. Herein we report a case of an old patient underwent emergency gastrectomy for ulcer's bleeding who developed DF associated to sepsis, malnutrition and, hydro-electrolyte disorders not responding to surgical and medical attempts. We demonstrated, for the first time, the efficacy of over the scope clips (OTSC®) in the treatment of postoperative duodenal fistulas not responding to surgical and medical treatment in high risk patient. PMID:21245069

Bini, Roberto; Coppola, Franco; Recchia, Serafino; Fusca, Marcella; Gaia, Silvia; Leli, Renzo



Delayed duodenal obstruction after intramural hematoma in a patient with paroxysmal nocturnal hemoglobinuria: A case report  

PubMed Central

INTRODUCTION Paroxysmal nocturnal hemoglobinuria (PNH) is a clonal stem cell disorder of hematopoietic cells. Gastrointestinal complications of PNH are rare and mostly related with intravascular thrombosis or intramural hematoma. PRESENTATION OF CASE We describe a case of a man with PNH complicated by intramural duodenal hematoma initially treated with supportive care. Three months after his first admission; he was admitted to the emergency department with abdominal pain, nausea and vomiting. He had undergone to surgery because of duodenal obstruction was treated with duodenojejunal by-pass surgery. DISCUSSION Patients were healed from gastrointestinal complications could suffer from gastrointestinal strictures, which cause wide spread symptoms ranging from chronic abdominal pain and anorexia to intestinal obstruction. CONCLUSION We report a rare intestinal obstruction case caused by stricture at the level of ligamentum Treitz with PNH. The possibility simply has to be borne in mind that strictures can be occurring at hematoma, ischemia or inflammation site of gastrointestinal tract. PMID:25123648

Tezcaner, Tugan; Ekici, Yahya; K?rnap, Mahir; Kural, Feride; Moray, Gokhan



Thioproline prevents carcinogenesis in the remnant stomach induced by duodenal reflux.  


An excessive duodenal reflux induced by surgery has been widely accepted to cause gastric carcinogenesis in the remnant stomach. As one of causative factors for malignancy, N-nitroso compounds produced by enteric bacteria have been postulated. However, there is no concrete information to prove this hypothesis. This study was undertaken to elucidate the factors underlying the remnant stomach carcinogenesis, by giving thiazolidine-4-carboxylic acid (thioproline; TPRO) to the rats with duodenal reflux as a nitrite scavenger. Operated 39 animals were used, divided into 2 groups; one with a diet containing 0.5% TPRO (n=18), and the other with a diet without TPRO (n=21). Adenocarcinoma developed in 16 rats out of 21 (76.2%) of untreated rats, whereas adenocarcinoma was detected in 1 rat of the TPRO-treated rats (5.6%). TPRO thus prevented the development of gastric cancer in the remnant stomach, thereby suggesting a concern of nitroso compounds to the carcinogenesis. PMID:16051425

Suo, Masashi; Mukaisho, Ken-Ichi; Shimomura, Akihiko; Sugihara, Hiroyuki; Hattori, Takanori



Gastric emptying of combined liquid-solid meals in healed duodenal ulcer  

SciTech Connect

The gastric emptying rates of combined liquid and solid radioisotopically labeled meals in 47 healed duodenal ulcer subjects and 17 healthy control subjects are compared. No significant differences were found between the groups in emptying slopes and the emptying half-times or in the percent retention values at any of the counting intervals for either the liquid or solid meals. These results are compatible with the observation that the rapid gastric emptying in many patients with duodenal ulcer is associated with the disease and that healing results in a return to normal gastric emptying rates. However, since gastric emptying rates during active ulceration were not determined in our patients, a more definitive interpretation awaits a study comparing emptying rates obtained during and after healing of active ulceration in the same patient.

Moore, J.G.; McIntyre, B.; Alazraki, N.



Postendoscopic duodenal hematoma in children: Ultrasound diagnosis and follow-up.  


Intramural duodenal hematomas have most frequently been reported in children in a traumatic setting. We present two cases of duodenal hematoma that occurred after upper gastrointestinal tract endoscopy with biopsy in children without significant prior medical history. The diagnosis was made by ultrasound, in correlation with the clinical presentation. Because the patients were hemodynamically stable, they were treated conservatively and the regression of the hematoma was followed up with ultrasound until its complete resolution. These cases demonstrate the risks of endoscopy, which are not to be neglected even in children without impaired coagulation, and the manner in which ultrasound can provide the correct diagnosis and follow-up. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 42:550-553, 2014. PMID:24615821

Dumitriu, Dana; Menten, Renaud; Smets, Françoise; Clapuyt, Philippe



Down syndrome: Molecular mapping of the congenital heart disease and duodenal stenosis  

SciTech Connect

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.

Korenburg, J.R. (University of California, Los Angeles (United States)); Bradley, C.; Disteche, C.M. (University of Washington, Seattle (United States))



Endoscopic treatment of intraluminal duodenal ("windsock") diverticulum: varying techniques from five cases.  


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

Law, R; Topazian, M; Baron, T H



Coexistence of meconium ileus with duodenal atresia and trisomy 21 in a newborn: a case report.  


The coexistence of duodenal atresia (DA) may mask the antenatal ultrasound findings of meconium ileus (MI) and delay its postnatal diagnosis. We report a rare case of MI in a newborn infant diagnosed antenatally to have trisomy 21 and DA. The diagnosis of MI was only established intraoperatively after the patient showed persistent signs of intestinal obstruction following the surgical repair of the DA. PMID:25359414

Akinloye, O W; Truong, W; Giacomantonio, M; Mateos, D; El-Naggar, W



Gastric pneumatosis associated with preduodenal portal vein, duodenal atresia, and asplenia  

Microsoft Academic Search

An 8-day-old newborn presented with non-bilious vomiting, upper abdominal fullness, and failure to pass meconium. Plain radiographs\\u000a revealed gastric pneumatosis (GP). At operation, he was found to have a non-obstructive preduodenal portal vein, preampullary\\u000a duodenal atresia, asplenia, and malrotation. The baby was treated by duodeno-duodenostomy without mobilizing the portal vein\\u000a and correction of the malrotation according to Ladd's procedure. He

R. Kataria; V. Bhatnagar; S. Wadhwa; D. K. Mitra



‘Hybrid’ Bariatric Surgery: Bilio-pancreatic Diversion and Duodenal Switch - Preliminary Experience  

Microsoft Academic Search

Background: Hybrid, combined or mixed bariatric surgery is the combination of a degree of ‘malabsorption’ (as achieved by the intestinal bypass) with a ‘rrestriction’\\u000a (as achieved by gastric bypass or gastroplasty), thereby simultaneously reducing the absorption of fats in the small bowel\\u000a and decreasing the intake of food. Methods: A modification of the bilio-pancreatic diversion (BPD) with a duodenal switch

A. Baltasar; R. Bou; L. A. Cipagauta; E. Marcote; G. R. Herrera; J. J. Chisbert



Laparoscopic Versus Open Treatment of Congenital Duodenal Obstruction: Multicenter Short-Term Outcomes Analysis  

PubMed Central

Abstract Background Laparoscopic repair of congenital duodenal obstruction has become popularized over the past decade. Comparative data on outcomes, however, are sparse. We hypothesized that laparoscopic repair of congenital duodenal obstruction could be performed with similar outcomes to traditional open repair. Patients and Methods Medical records for all cases of congenital duodenal obstruction from 2005 to 2011 at three academic teaching hospitals were retrospectively reviewed. Patients were excluded from the analysis if they had confounding surgical diseases, did not have duodenoduodenostomy during the first hospital admission, had the repair performed before transfer from a referring hospital, or weighed less than 1.7?kg at the time of surgery. Analysis was performed as intention to treat, with laparoscopic converted to open cases included in the laparoscopic group. Results Sixty-four cases were included in the analysis (44 open, 20 laparoscopic). Baseline characteristics were similar between the two groups with the exception that the open group, on average, underwent repair later than the laparoscopic group (6 days versus 4 days, respectively). Seven laparoscopic cases were converted to an open procedure (35%), most commonly for difficulty in exposing the decompressed distal duodenum. Laparoscopic repair did take significantly longer than open repair (145 minutes versus 96 minutes, respectively), but clinical outcomes were similar. Complications were rare and were similar between methods of repair. Two patients in the laparoscopic group required subsequent open revision. Conclusions Laparoscopic duodenoduodenostomy for congenital duodenal obstruction is a technically challenging procedure with a steep learning curve. Despite a relatively high conversion rate, clinical outcomes remained similar to the traditional open repair in selected patients. PMID:24079961

Short, Scott S.; Anselmo, Dean M.; Torres, Manuel B.; Frykman, Philip K.; Shin, Cathy E.; Wang, Kasper; Nguyen, Nam X.



Recurrent pancreatitis due to an intraluminal duodenal diverticulum: report of a case.  


We report the investigation and treatment of a 14-year-old girl in whom a detailed assessment of recurrent episodes of pancreatitis revealed a large intraluminal 'windsock'-like duodenal diverticulum. As the diverticulum was closely attached to the papilla of Vater, it was resected by a transduodenal approach. This report focuses on the significance of rare congenital anomalies of the duodenum (e.g., duplication cyst, intraluminal diverticulum) during the diagnostic workup of recurrent pancreatitis in children. PMID:22270334

Pumberger, Wolfgang; Maier-Hiebl, Beate; Kargl, Simon



Two-step laparoscopic duodenal switch for superobesity: a feasibility study  

Microsoft Academic Search

Background   The laparoscopic duodenal switch (LDS) is a complex bariatric procedure that can be split into two steps to lower the rate\\u000a of morbidity and mortality. This strategy also identifies patients who do not require the second malabsorptive step to achieve\\u000a substantial weight loss.\\u000a \\u000a \\u000a \\u000a Methods   From October 2005 to January 2008, 77 superobese patients underwent laparoscopic sleeve gastrectomy. The 15

Antonio Iannelli; Anne Sophie Schneck; Moucef Dahman; Chiara Negri; Jean Gugenheim



TNF\\/LTA polymorphisms and risk for gastric cancer\\/duodenal ulcer in the Korean population  

Microsoft Academic Search

The tumor necrosis factor-? (TNF) and lymphotoxin-? (LTA) are proinflammatory cytokines with immunoregulatory effects. TNF is also known to inhibit gastric acid secretion. Previously we have shown that the known proinflammatory genotypes, IL-1B ?31C\\/+ and IL-1RN *2\\/*2, were not associated with increased risks for gastric cancer\\/duodenal ulcer in the Korean population. In this study, we tested the association between the

Seong-Gene Lee; Byungsik Kim; Jung-Hwan Yook; Sung-Tae Oh; Inchul Lee; Kyuyoung Song



Caloric content of a meal affects duration but not contractile pattern of duodenal motility in man  

Microsoft Academic Search

The variability of the fasted duodenal contractile pattern and the patterns of contraction during the fed phase was examined in normal volunteers. Prolonged recordings from the duodenum and proximal jejunum were achieved using a series of transducers mounted on a 2.3-mm catheter. A total of 58 interMMC intervals and the response to 18 meals was examined. There was marked inter-

Ann Ouyang; Alan G. Sunshine; James C. Reynolds



Factors affecting the healing rate of duodenal and pyloric ulcers with low-dose antacid treatment  

Microsoft Academic Search

In 80 patients with duodenal ulcer, the effects of various factors--symptoms, endoscopic findings, and peak acid output (PAO)--on the healing rate were studied during eight weeks of outpatient therapy with low-dose antacid (neutralising capacity less than 50 mmol HCl\\/d). Fifty-six per cent of the ulcers healed. The following unfavourable factors were found to cause a significant delay in ulcer healing:

S Massarrat; A Eisenmann



Ranitidine bismuth citrate with clarithromycin for the treatment of duodenal ulcer  

PubMed Central

Background/Aims—To investigate the effect of the new Helicobacter pylori eradication regimen, ranitidine bismuth citrate (RBC) and clarithromycin (CLAR) dual therapy, on duodenal ulcer healing and absence of ulcer recurrence during 24 weeks follow up (overall success). ?Methods—Two hundred and thirty two H pylori positive patients with active duodenal ulcer received four weeks treatment with RBC 400 mg twice daily alone (RBC400) (n=82), or RBC 400 or 800mg twice daily co-prescribed with clarithromycin 250 mg four times daily for 14 days, followed by 14 days of RBC 400 mg twice daily alone (RBC400+CLAR and RBC 800+CLAR, respectively, n=75 for each). ?Results—The co-prescription regimens gave high H pylori eradication rates determined using two tests (CLOtest and 13C-urea breath test) for the presence of the organism. These rates were 92% and 81% for RBC400+CLAR (n=62) and RBC800+CLAR (n=63) respectively, compared with 2% for RBC400 (n=66) (p<0.001). With respect to overall success as estimated by life table analysis, RBC400+CLAR (89%) and RBC800+ CLAR (87%) were significantly more effective than RBC400 alone (51%) (p<0.001). All regimens were safe and well tolerated. Trough plasma bismuth concentrations at week 4 were low (treatment medians less than 6.6 ng bismuth/ml). ?Conclusions—Ranitidine bismuth citrate is a well tolerated and efficacious ulcer healing drug which, when co-prescribed with clarithromycin, affords effective H pylori eradication therapy and prevents ulcer relapse in most patients with duodenal ulcer. ?? Keywords: ranitidine bismuth citrate; duodenal ulcer; Helicobacter pylori eradication PMID:9301496

Bardhan, K; Dallaire, C; Eisold, H; Duggan, A



Inhibition of nocturnal acidity is important but not essential for duodenal ulcer healing.  

PubMed Central

We have determined the relative importance of day and night time gastric acid inhibition for duodenal ulcer healing by comparing the anti-ulcer efficacy of a single morning with that of a single bedtime dose of ranitidine. One hundred and thirty patients with active duodenal ulcer were randomly assigned to a double-blind therapy with ranitidine 300 mg at 8 am or the same dose at 10 pm for up to eight weeks. The antisecretory effects of these regimens were also assessed by 24 h intragastric pH monitoring in 18 of these patients. At four weeks ulcers had healed in 41/61 (67%) of patients taking the morning dose and in 47/63 (75%) of those receiving the nocturnal dose (95% CI for the difference -0.09 +0.25; p ns). At eight weeks, the corresponding healing rates were 82% and 85.5%, respectively (95% CI for the difference -0.11 +0.17; p ns). Both treatments were significantly superior to placebo in raising 24 h intragastric pH, although the effects of the morning dose were of shorter duration than those of the nocturnal dose. These findings suggest that suppression of nocturnal acidity is important but not essential to promote healing of duodenal ulcers; a prolonged period of acid inhibition during the day (as obtained with a single large morning dose of H2-blockers) may be equally effective. PMID:2186980

Bianchi Porro, G; Parente, F; Sangaletti, O



Omeprazole maintenance therapy prevents recurrent ulcer bleeding after surgery for duodenal ulcer  

PubMed Central

AIM: To evaluate the omeprazole maintenance therapy in patients with recurrent ulcer bleeding after surgery for duodenal ulcer. METHODS: We studied 15 consecutive patients with recurrent ulcer bleeding after surgery for duodenal ulcer. Omeprazole (20 mg/d) maintenance therapy was given after ulcer healing. In addition to clinical follow-up, ambulatory 24-h gastric pH assay was performed before and during omeprazole therapy in those patients and controls with previous duodenal ulcer surgery but no ulcer recurrence. RESULTS: All the 15 ulcers were healed after being treated with omeprazole (40 mg/d) for 2 mo. Eleven patients with two (1-9) episodes of recurrent ulcer bleeding completed the follow-up (43, 12-72 mo). None of them had a bleeding episode while on omeprazole. One patient discontinued the therapy and had recurrent bleeding. The median 24-h fraction time of gastric pH <4 in patients was 80, 46-95%, and was reduced to 32, 13-70% by omeprazole (P?=?0.002). CONCLUSION: Long-term maintenance therapy with omeprazole (20 mg/day) is effective in preventing recurrent ulcer bleeding. PMID:16521197

Demertzis, Konstantinos; Polymeros, Dimitrios; Emmanuel, Theodoros; Triantafyllou, Konstantinos; Tassios, Pericles; Ladas, Spiros D



Occult duodenal perforation complicating cerebral infarction: new problems in diagnosis of Cushing's ulcer.  


Cushing's ulcers of the duodenum are well known complications of neurosurgery, head trauma, and other causes of increased intracranial pressure. Perforation of Cushing's ulcer of the duodenum is infrequently described. That the use of high-dose corticosteroids for cerebrovascular infarct in an aphasic patient may obscure the symptomatology and physical findings of a perforated Cushing's ulcer has not been described to our knowledge. We report a patient with a large left hemispherical infarct and resultant aphasia who developed a perforated duodenal ulcer and extensive chemical peritonitis while receiving high dose corticosteroids for increased intracranial pressure. She was unable to register any complaints and the typical physical findings of perforated duodenal ulcer with chemical peritonitis were virtually absent. A high index of suspicion must be maintained for a perforated Cushing's duodenal ulcer in the patient receiving high dose dexamethasone despite the presence of nonspecific symptomatology and abdominal findings. Elevated serum gastrin levels, as in this patient, may also indicate the patients with increased intracranial pressure who are at greater risk for developing Cushing's ulcer. PMID:7114024

Walsh, T J; Raine, T; Chamberlin, W H; Rice, C L



Efficacy of ilaprazole in the treatment of duodenal ulcers: A meta-analysis  

PubMed Central

AIM: To compare the efficacy and tolerance of ilaprazole compared with other proton pump inhibitors (PPIs) in the treatment of duodenal ulcer. METHODS: An electronic database search of Medline, Embase, the Cochrane controlled trials register, Web of Science, PubMed, and the Chinese Biomedical Literature Database (updated to July 2013), and manual searches were conducted. A meta-analysis of randomized controlled trials comparing the efficacy and tolerance of ilaprazole and other PPIs in the treatment of duodenal ulcers was performed. RESULTS: Five articles involving 1481 patients were included. The meta-analysis showed no difference in the 4-wk healing rate between ilaprazole and other PPIs [89.7% vs 87.0%; relative risk (RR) = 1.02; 95%CI: 0.98-1.06; Z = 1.00; P = 0.32]. The results did not change in the sensitivity analyses. The meta-analysis indicated that the adverse effect rate in the ilaprazole group was lower than that in the control group, but the difference was not significant (9.7% vs 13.0%; RR = 0.81; 95%CI: 0.60-1.07; Z = 1.47; P = 0.14). CONCLUSION: Ilaprazole is a highly effective and safe PPI in the treatment of duodenal ulcers. Ilaprazole can be recommended as a therapy for acid-related disorders, especially in Asian populations. PMID:24803828

Ji, Xi-Qing; Du, Jun-Feng; Chen, Gang; Chen, Guang; Yu, Bo



Role of duodenal iron transporters and hepcidin in patients with alcoholic liver disease.  


Patients with alcoholic liver disease (ALD) often display disturbed iron indices. Hepcidin, a key regulator of iron metabolism, has been shown to be down-regulated by alcohol in cell lines and animal models. This down-regulation led to increased duodenal iron transport and absorption in animals. In this study, we investigated gene expression of duodenal iron transport molecules and hepcidin in three groups of patients with ALD (with anaemia, with iron overload and without iron overload) and controls. Expression of DMT1, FPN1, DCYTB, HEPH, HFE and TFR1 was measured in duodenal biopsies by using real-time PCR and Western blot. Serum hepcidin levels were measured by using ELISA. Serum hepcidin was decreased in patients with ALD. At the mRNA level, expressions of DMT1, FPN1 and TFR1 genes were significantly increased in ALD. This pattern was even more pronounced in the subgroups of patients without iron overload and with anaemia. Protein expression of FPN1 paralleled the increase at the mRNA level in the group of patients with ALD. Serum ferritin was negatively correlated with DMT1 mRNA. The down-regulation of hepcidin expression leading to up-regulation of iron transporters expression in the duodenum seems to explain iron metabolism disturbances in ALD. Alcohol consumption very probably causes suppression of hepcidin expression in patients with ALD. PMID:24894955

Dostalikova-Cimburova, Marketa; Balusikova, Kamila; Kratka, Karolina; Chmelikova, Jitka; Hejda, Vaclav; Hnanicek, Jan; Neubauerova, Jitka; Vranova, Jana; Kovar, Jan; Horak, Jiri



Duodenal gastrinoma--clinical features and usefulness of selective arterial secretin injection test.  


Duodenal gastrinoma is recognized as a relatively common cause of Zollinger-Ellison syndrome, but its clinical and biological features are not well known. Here we report a case of duodenal gastrinoma with lymph node metastasis which was confirmed by pathology examinations. Hypergastrinemia and gastric acid hypersecretion were documented, but the secretin test showed negative results. An enlarged peripancreatic lymph node lying close to the pancreas head was the only positive finding on preoperative imaging studies. The results of the selective arterial secretin injection (SASI) test suggested that the primary tumor was located in the gastrinoma triangle. Finally, surgical exploration was carried out and a submucosal tumor, approximately 15 mm in size, was detected by intraoperative palpation at the posterior wall of the proximal portion of the duodenum. Intraoperative pathology examination demonstrated metastases to regional lymph nodes. The present case calls attention to the unique features of duodenal gastrinomas, which differ from those of pancreatic origin: a highly malignant potential for its small size, and submucosal location in the proximal duodenum. The SASI test is recommended for assessing the location of a primary lesion if it cannot be identified by various conventional imaging studies. PMID:9773940

Takasu, A; Shimosegawa, T; Fukudo, S; Asakura, T; Uchi, M; Kimura, K; Kashimura, J; Satoh, K; Koizumi, M; Sasaki, I; Hongo, M; Suzuki, T; Toyota, T



The early transcriptional response of pig small intestinal mucosa to invasion by Salmonella enterica serovar typhimurium DT104.  


Salmonella enterica serovar typhimurium (S. typhimurium) species are a leading cause of human invasive gastroenteritis. There is increasing in vitro evidence about Salmonella interaction with isolated cells or cell lines (macrophages, and enterocytes) on the molecular level, however, very little is known about in vivo interactions during actual invasion. We investigated the early interaction of S. typhimurium with intact small intestinal mucosa, in a pig model. Intestinal segments were infected with or without S. typhimurium DT104, and perfused. Whole mucosal gene expression was analyzed by cDNA array on 0, 2, 4, and 8h post-infection. Invasion resulted in the upregulation of only eight transcripts in jejunal mucosa, among those the proinflammatory IL-8 (at 4h only), and the antiinflammatory STAT3 (at 4 and 8h). The limited number of differentially expressed genes found here in vivo compared to in vitro is most likely due to the presence of multiple, heterogenous cell interactions in intact mucosa. Furthermore, it is concluded that S. typhimurium evades strong host responses by downregulating the local inflammatory response. PMID:16884775

Niewold, Theo A; Veldhuizen, Edwin J A; van der Meulen, Jan; Haagsman, Henk P; de Wit, Agnes A C; Smits, Mari A; Tersteeg, Monique H G; Hulst, Marcel M



Gas exchange function through the middle ear mucosa in piglets: comparative study of normal and inflamed ears.  


The gas exchange function through the middle ear (ME) mucosa was investigated by comparing normal and inflamed ears in an animal model. Piglets were examined (n = 15) because their tympanic bulla closely resembles the human mastoid air cell system. Four untreated ears served as controls. Eleven ears were injected with glycerin into the tympanic bulla to induce inflammation and were studied as inflamed ears. Two respiratory conditions, spontaneous respiration and hyperventilation by a ventilator, were alternated repeatedly. ME pressure was measured intermittently by a tympanometer and blood gas was measured simultaneously. In all four normal ears, both ME pressure and carbon dioxide (CO2) partial pressure in the blood decreased in parallel following alternation of the respiratory conditions from spontaneous respiration to hyperventilation, while both pressure levels increased in parallel when respiration was changed from hyperventilation to spontaneous respiration. This result indicates that there is a gas exchange between the ME and the blood through the mucosa. However, ME pressure change in inflamed ears was limited, though the change in CO2 partial pressure in the blood was the same as that in normal ears. There was a significant difference in the degree of ME pressure change occurring in normal ears compared to that in inflamed ears, suggesting that inflammation of the mucosa reduced gas exchange function in the ME. PMID:10219389

Yamamoto, Y



A Dosimetric Model of Duodenal Toxicity After Stereotactic Body Radiotherapy for Pancreatic Cancer  

SciTech Connect

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.

Murphy, James D.; Christman-Skieller, Claudia; Kim, Jeff; Dieterich, Sonja; Chang, Daniel T. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States); Koong, Albert C., E-mail: akoong@stanford.ed [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States)



SIV Infection Induces Accumulation of Plasmacytoid Dendritic Cells in the Gut Mucosa  

PubMed Central

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 gut—the 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

Reeves, R. Keith; Evans, Tristan I.; Gillis, Jacqueline; Wong, Fay E.; Kang, Guobin; Li, Qingsheng; Johnson, R. Paul



Comparative pathology of the nasal mucosa in laboratory animals exposed to inhaled irritants  

SciTech Connect

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.

Harkema, J.R. (Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM (USA))



Systemically Administered IgG Anti-Toxin Antibodies Protect the Colonic Mucosa during Infection with Clostridium difficile in the Piglet Model  

PubMed Central

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

Cohen, Ocean R.; Steele, Jennifer A.; Zhang, Quanshun; Schmidt, Diane J.; Wang, Yuankai; Hamel, Philip E. S.; Beamer, Gillian; Xu, Bingling; Tzipori, Saul



Enhanced Transferrin Receptor Expression by Proinflammatory Cytokines in Enterocytes as a Means for Local Delivery of Drugs to Inflamed Gut Mucosa  

PubMed Central

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

Harel, Efrat; Rubinstein, Abraham; Nissan, Aviram; Khazanov, Elena; Nadler Milbauer, Mirela; Barenholz, Yechezkel; Tirosh, Boaz



Mucin gene expression in reflux laryngeal mucosa: histological and in situ hybridization observations.  


Objectives/Hypothesis. To determine if laryngopharyngeal reflux alters mucin gene expression in laryngeal mucosa. Methods. In situ hybridization was employed to study the expression of the 8 well-characterised mucin genes MUC1-4, 5AC, 5B, 6, and 7 in reflux laryngeal mucosa from laryngeal ventricles, posterior commissures, and vocal folds compared to control/normal laryngeal mucosa. Results. MUC1-5 genes are expressed in normal and reflux laryngeal mucosa. MUC1, 3 and 4 are expressed in respiratory and squamous mucosa whereas MUC2 and 5AC are expressed in respiratory mucosa only. MUC3, 4 and 5AC are downregulated in reflux mucosa. MUC5AC expression is significantly reduced in the 3 mucosal sites and when mucosal type was taken into account, this remains significant in combined laryngeal and ventricular mucosa only. Conclusions. MUC3, 4 and 5AC expression is downregulated in laryngopharyngeal reflux. This may be due to laryngeal mucosal metaplasia and/or alteration of mucin gene expression in the preexisting mucosa. Altered mucin gene expression might predispose laryngeal mucosa to the damaging effect of reflux. PMID:24790604

Ali, Mahmoud El-Sayed; Bulmer, David M; Dettmar, Peter W; Pearson, Jeffrey P



Reactivity of gliadin and lectins with celiac intestinal mucosa.  


The binding patterns of gliadin and selected lectins to jejunal biopsy specimens obtained from children with total villous atrophy during active celiac disease (CD; 19 patients) and in remission (16 patients) were examined by light microscopy. Three categories of carbohydrate-specific lectins were chosen for the study: those recognizing mannose/glucose residues, those recognizing N-acetyl-glucosamine/glucose (glcNAc/glc) residues, and those recognizing N-acetylgalactosamine/galactose (galNAc/gal) residues. The galNAc/gal lectins, with the exception of phaseolus vulgaris agglutinin variants, presented a typical staining of the luminal surface of the jejunal mucosa obtained from CD patients. However, these lectins displayed no reactivity to jejunal sections of CD patients in remission or control biopsies that included healthy children (25 children) and patients suffering from cow milk protein allergy (10 children). The glcNAc/glc lectin showed a strong preferential recognition of CD jejunal tissue but also bound with less intensity to specimens from patients with cow milk allergies and healthy children. Unlike other galNAc/gal lectins, phaseolus vulgaris agglutinin variants were indistinguishable in their binding patterns to the mucosa of control groups and CD patients in remission and failed to react to CD biopsies. The mannose/glc lectins were not distinctive in their binding patterns. In all cases, lectin binding was specifically inhibited by the lectins' competitive saccharides. Atypical of lectin binding patterns, gliadin reactivity was restricted to intracellular areas of enterocytes and was unique to active CD mucosa. The distinctive binding patterns of lectins and gliadin provide a diagnostic tool to distinguish patients with active CD from those in remission or patients with other intestinal disorders.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7877884

Pittschieler, K; Ladinser, B; Petell, J K



Extensive amalgam tattoo on the alveolar-gingival mucosa.  


Amalgam tattoos are common exogenous pigmented lesions of the oral mucosa occurring mainly by inadvertent placement of amalgam particles into soft tissues. The diagnosis of amalgam tattoo is simple, usually based on clinical findings associated with presence or history of amalgam fillings removal. Intraoral X-rays may be helpful in detecting amalgam-related radiopacity. In cases where amalgam tattoo cannot be differentiated from other causes of oral pigmentation, a biopsy should be performed. This article deals with an extensive amalgam tattoo lesion which required a biopsy for a definitive diagnosis. PMID:22147048

Galletta, Vivian C; Artico, Gabriela; Dal Vechio, Aluana M C; Lemos Jr, Celso A; Migliari, Dante A



[Characteristics of duodenal ruptures depending on topographical and anatomical properties of this organ and circumstances of blunt abdominal trauma].  


We have studied specific morphological properties of duodenal rupture depending on the topographic and anatomical features of this organ and circumstances of blunt abdominal trauma suffered in a car crash (with the victim found in the passenger compartment or involved in an automobile-pedestrian accident) and a railway crash (a train-pedestrian accident) or resulting from a blunt-force trauma, a fall from height, a fall on the stomach, and traumatic compression of the body. We took into consideration the anatomical peculiarities of the duodenal rupture, such as its circular, horseshoe, and loop-like shape. The study has demonstrated that the frequency of duodenal injury associated with a blunt abdominal trauma shows a stronger dependence on the topographical and anatomical peculiarities of duodenum than on the circumstances of the case. Specifically, the circular duodenum and especially its descending portion are more readily subjected to the damage than the organs of a different shape. The position of the break with respect to the duodenal axis is an important diagnostic signs allowing to clarify circumstances of the blunt injury. Transverse ruptures are typical of strong impacts associated with the short-term interaction between the damaging object and the affected part of the body whereas longitudinal ruptures more commonly occur as a result the long-term traumatic impact. Bile imbibition of paraduodenal and peripancreatic retroperitoneal adipose tissue may be used as an additional diagnostic sign of duodenal rupture. PMID:24428049

Pigolkin, Iu I; Dubrovin, I A; Chirkov, R N; Dubrovina, I A; Khachaturian, B S; Mosoian, A S; Dallakian, V F



Expression of COX2 and p53 in Rat Esophageal Cancer Induced by Reflux of Duodenal Contents  

PubMed Central

Aim. Reflux of duodenal contents can induce mucosal injury, stimulate cell proliferation, and promote tumorigenesis. We examined the expression of COX2 and p53 in rat esophageal lesions induced by duodenal content reflux. Methods. Thirty 8-week-old male Wistar rats were exposed to duodenal content esophageal reflux. All animals underwent an esophagoduodenal anastomosis (EDA) with total gastrectomy in order to produce chronic esophagitis. Ten rats were the sham. Control. They were sacrificed at the 40th week. Their esophagi were examined for HE, COX2, p53, and proliferating cell nuclear antigen (PCNA). Results. After 40 weeks of reflux, dysplasia, squamous cell carcinoma (SCC), and adenocarcinoma (ADC) were found. PCNA labeling index was higher in dysplastic and cancer tissue than that in normal. Overexpression of COX2 was shown in ADC and SCC. Wild-type p53 accumulation was found in ADC, and not in SCC. Conclusion. Reflux of duodenal contents into the esophagus led to ADC and SCC in rats. COX2 may play an important role in esophageal cancer by duodenal content reflux. Our present results suggest an association between wild-type p53 accumulation and COX2 expression in ADC, with no such relation seen in SCC. PMID:22272378

Hashimoto, Naoki



Different effect of antiulcer agents on rat cysteamine-induced duodenal ulcer after sialoadenectomy, but not gastrectomy.  


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

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



Functional perturbation of classical natural killer and innate lymphoid cells in the oral mucosa during SIV infection  

PubMed Central

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

Li, Haiying; Reeves, R. Keith



Isolation of lymphocytes from mouse genital tract mucosa.  


Mucosal surfaces, including in the gastrointestinal, urogenital, and respiratory tracts, provide portals of entry for pathogens, such as viruses and bacteria. Mucosae are also inductive sites in the host to generate immunity against pathogens, such as the Peyers patches in the intestinal tract and the nasal-associated lymphoreticular tissue in the respiratory tract. This unique feature brings mucosal immunity as a crucial player of the host defense system. Many studies have been focused on gastrointestinal and respiratory mucosal sites. However, there has been little investigation of reproductive mucosal sites. The genital tract mucosa is the primary infection site for sexually transmitted diseases (STD), including bacterial and viral infections. STDs are one of the most critical health challenges facing the world today. Centers for Disease Control and Prevention estimates that there are 19 million new infectious every year in the United States. STDs cost the U.S. health care system $17 billion every year, and cost individuals even more in immediate and life-long health consequences. In order to confront this challenge, a greater understanding of reproductive mucosal immunity is needed and isolating lymphocytes is an essential component of these studies. Here, we present a method to reproducibly isolate lymphocytes from murine female genital tracts for immunological studies that can be modified for adaption to other species. The method described below is based on one mouse. PMID:22972306

Jiang, Janina; Kelly, Kathleen A



Dynamic ventrorostral displacement of the dorsal laryngeal mucosa in horses.  


The objectives of this report were to describe the occurrence and features of dynamic ventrorostral displacement of the dorsal laryngeal mucosa (VRDDLM) in a group of Thoroughbred horses presented for investigation of poor performance and/or abnormal respiratory noise. Records from 600, dynamic, endoscopic examinations of the upper respiratory tract of horses were reviewed. Horses with VRDDLM were identified as those in which the dorsal laryngeal mucosa progressively obscured the interarytenoid notch and dorsoaxial portion of the corniculate processes of the arytenoid cartilages during high-speed exercise. The condition was recognised in 12 horses. Concurrent abnormalities of the respiratory tract of eight horses were also identified and included, axial deviation of the aryepiglottic folds, vocal cord prolapse, unilateral and bilateral ventromedial luxation of the apex of the corniculate process of the arytenoid cartilage, and intermittent dorsal displacement of the soft palate. VRDDLM is a rare abnormality of the upper portion of the respiratory tract of horses that may be associated with abnormal respiratory noise and potentially poor performance. The significance of the condition is not known, but the presence of this condition in combination with other, obstructive diseases of the equine airway warrants further investigation. PMID:23559426

Pollock, P J; Kelly, P G; Reardon, R J M; Kelly, G M



[Tobacco-associated lesions of the oral mucosa].  


Consumption of tobacco can result not only in a multitude of different general health problems like carcinoma of the lung, ischaemic cardiac diseases, peripheral vascular diseases, stroke, chronic-obstructive pulmonary diseases or peptic ulcers, but also in pathologic lesions of the oral mucosa. Benign oral lesions from smoking or consumption of smokeless tobacco are the so-called smoker's palate and smoker's melanosis. On the other hand, tobacco-associated lesions like oral leukoplakia or oral squamous cell carcinoma are already potentially life-threatening diseases that in general require active treatment. The following review article will present and discuss the typical lesions of the oral mucosa that result from chronic tobacco consumption. The aim of this article is to demonstrate dental health care providers the needs and benefits of tobacco use cessation in a dental setting, especially regarding stomatologic sequelae and consequences. The present article is the first in a series of articles from the Swiss task force "Smoking - Intervention in the private dental office" on the topic "tobacco use and dental medicine". PMID:17233324

Bornstein, Michael M; Klingler, Karl; Saxer, Ulrich P; Walter, Clemens; Ramseier, Christoph A



Preparation and characterization of a biologic scaffold from esophageal mucosa.  


Biologic scaffolds composed of extracellular matrix (ECM) are commonly used to facilitate a constructive remodeling response in several types of tissue, including the esophagus. Surgical manipulation of the esophagus is often complicated by stricture, but preclinical and clinical studies have shown that the use of an ECM scaffold can mitigate stricture and promote a constructive outcome after resection of full circumference esophageal mucosa. Recognizing the potential benefits of ECM derived from homologous tissue (i.e., site-specific ECM), the objective of the present study was to prepare, characterize, and assess the in-vivo remodeling properties of ECM from porcine esophageal mucosa. The developed protocol for esophageal ECM preparation is compliant with previously established criteria of decellularization and results in a scaffold that maintains important biologic components and an ultrastructure consistent with a basement membrane complex. Perivascular stem cells remained viable when seeded upon the esophageal ECM scaffold in-vitro, and the in-vivo host response showed a pattern of constructive remodeling when implanted in soft tissue. PMID:23777917

Keane, Timothy J; Londono, Ricardo; Carey, Ryan M; Carruthers, Christopher A; Reing, Janet E; Dearth, Christopher L; D'Amore, Antonio; Medberry, Christopher J; Badylak, Stephen F



Electrical impedance, ultrastructure and ion transport in foetal gastric mucosa.  


1. The voltage transient developed across rabbit foetal gastric mucosa in response to rectangular current pulses was measured under in vitro conditions. The short-circuit current was also measured.2. The voltage transients were used to calculate equivalent circuit parameters. The mucosa could be represented as two large capacitances in series, each shunted by a high conductance.3. Electron microscopy was carried out on some preparations after the electrical measurements had been made. An extensive smooth membrane tubular system was observed on the apical sides of the cells, with openings into the gastric lumen.4. Anoxia resulted in a reversible reduction in value of the large capacitance and short-circuit current: the relative changes in these two quantities were very closely linked. Electron microscopy showed a large and reversible decline in the extent of the apical tubular system during anoxia.5. It was concluded that the apical tubular system plays an important role in ion transport in this preparation. Considerations of the magnitude of the capacitances and of membrane area suggest that the smaller capacitor represents the plasma membrane. The dieletric constant of the smooth membrane of the tubular system is an order of magnitude lower than that of the plasma membrane. PMID:4449051

Wright, G H



Isolation of Arcanobacterium pyogenes from the porcine gastric mucosa.  


Arcanobacterium (Actinomyces) pyogenes is an inhabitant of the mucous membranes of the respiratory and genital tracts of a number of domestic animal species. However, following a precipitating physical or microbial insult, A. pyogenes can become an opportunistic pathogen, associated with suppurative infections. The isolation of A. pyogenes from the bovine ruminal wall indicated that this organism may also inhabit the gastrointestinal tract of, at least, cattle. To determine whether A. pyogenes was also present on the gastric mucosa of a monogastric animal, porcine stomachs were cultured for the presence of this organism. Of 13 stomachs sampled, A. pyogenes was isolated from 5 (39%). The identity of the organism was confirmed by PCR with primers specific to the plo gene, which encodes the A. pyogenes haemolytic exotoxin pyolysin. In addition, an isolate from each positive stomach was subjected to 16S rRNA gene sequencing and the identification as A. pyogenes was confirmed. These data indicate that A. pyogenes may be resident on the gastric mucosa of pigs. PMID:12241094

Jost, B H; Post, K W; Songer, J G; Billington, S J



Preparation and Characterization of a Biologic Scaffold from Esophageal Mucosa  

PubMed Central

Biologic scaffolds composed of extracellular matrix (ECM) are commonly used to facilitate a constructive remodeling response in several types of tissue, including the esophagus. Surgical manipulation of the esophagus is often complicated by stricture, but preclinical and clinical studies have shown that the use of an ECM scaffold can mitigate stricture and promote a constructive outcome after resection of full circumference esophageal mucosa. Recognizing the potential benefits of ECM derived from homologous tissue (i.e., site-specific ECM), the objective of the present study was to prepare, characterize, and assess the in-vivo remodeling properties of ECM from porcine esophageal mucosa. The developed protocol for esophageal ECM preparation is compliant with previously established criteria of decellularization and results in a scaffold that maintains important biologic components and an ultrastructure consistent with a basement membrane complex. Perivascular stem cells remained viable when seeded upon the esophageal ECM scaffold in vitro, and the in-vivo host response showed a pattern of constructive remodeling when implanted in soft tissue. PMID:23777917

Keane, Timothy J.; Londono, Ricardo; Carey, Ryan M.; Carruthers, Christopher A.; Reing, Janet E.; Dearth, Christopher L.; D’Amore, Antonio; Medberry, Christopher J.; Badylak, Stephen F.



Multiple recurrent vesicles in oral mucosa suggestive of superficial mucocele: An unusual presentation of allergic stomatitis  

PubMed Central

Background: Superficial mucocele presents as small, clear vesicle on noninflamed mucosa. In this study, we report several vesicles on the bucal mucosa of a woman diagnosed as superficial mucocele. Case Presentation: A 48-year old woman presented with multiple vesicles on her labial mucosa, ventral surface of the tongue, floor of the mouth and palate. A mucosal biopsy was taken from the vesicle. Histopathologically, intraepithelial mucocele was diagnosed. The lesion was successfully treated with mouthwash betamethasone. There has been no recurrence for 18 months. Conclusion: In the present study, several mucoceles were seen in the oral mucosa. No similar case was reported previously. PMID:24294477

Motallebnejad, Mina; Shirzad, Atena; Molania, Tahere; Seyedmajidi, Maryam



Five- to Eight-year Results of Truncal Vagotomy and Pyloroplasty for Duodenal Ulcer  

PubMed Central

From January 1963 to December 1965 inclusive 192 men with duodenal ulcer were treated by elective truncal vagotomy and pyloroplasty with one death. Ten subsequent deaths were due to causes unrelated to the ulcer or operation, and 17 patients became untraceable. The remaining 164 patients have been followed up for five to eight years. The late results have been compared with those obtained in a previous study of patients five to eight years after truncal vagotomy and gastroenterostomy, truncal vagotomy and antrectomy, and subtotal gastrectomy respectively for duodenal ulcer. Of the various postgastric operation syndromes early dumping, late dumping, bilious vomiting, and diarrhoea were all less frequent, but not significantly so, after vagotomy and pyloroplasty than after vagotomy and gastroenterostomy. Recurrent ulceration was commoner after vagotomy and pyloroplasty than after all the other operations, the incidence of proved and suspected recurrent ulcers being respectively 6·7 and 7·3% after vagotomy and pyloroplasty, but only 2·5 and 5·9% after vagotomy and gastroenterostomy, 0 and 5·2% after vagotomy and antrectomy, and 0·9 and 3·7% after subtotal gastrectomy. The differences between vagotomy and pyloroplasty and vagotomy and antrectomy or subtotal gastrectomy are statistically significant, but those between vagotomy and pyloroplasty and vagotomy and gastroenterostomy are not. Overall assessment (Visick grading) of the outcome gave poorer results after vagotomy and pyloroplasty than after any other operation, with 14% of category IV cases after vagotomy and pyloroplasty, 11% after vagotomy and gastroenterostomy, 8% after vagotomy and antrectomy, and 6% after subtotal gastrectomy—differences that are significant between vagotomy and pyloroplasty and vagotomy and antrectomy or subtotal gastrectomy but not between vagotomy and pyloroplasty and vagotomy and gastroenterostomy. In the light of these findings it is suggested that truncal vagotomy and pyloroplasty has not lived up to expectations and its place as the currently most popular procedure in the elective surgical treatment of duodenal ulcer should be reconsidered. PMID:5008373

Goligher, J. C.; Pulvertaft, C. N.; Irvin, T. T.; Johnston, D.; Walker, B.; Hall, R. A.; Willson-Pepper, J.; Matheson, T. S.



Duodenal CCK cells from male mice express multiple hormones including ghrelin.  


Enteroendocrine (EEC) cells have a pivotal role in intestinal nutrient sensing and release hormones that orchestrate food digestion and regulate appetite. EEC cells are found scattered throughout the intestine and have typically been classified based on the primary hormone they contain. I cells represent a subset of EEC cells that secrete cholecystokinin (CCK) and are mainly localized to the duodenum. Recent studies have shown that I cells express mRNAs encoding several gut hormones. In this study, we investigated the hormonal profile of murine fluorescence-activated cell sorting-sorted duodenal I cells using semiquantitative RT-PCR, liquid chromatography tandem mass spectrometry, and immunostaining methods. We report that I cells are enriched in mRNA transcripts encoding CCK and also other key gut hormones, including neurotensin, glucose-dependent insulinotropic peptide (GIP), secretin, peptide YY, proglucagon, and ghrelin (Ghrl). Furthermore, liquid chromatography tandem mass spectrometry analysis of fluorescence-activated cell sorting-purified I cells and immunostaining confirmed the presence of these gut hormones in duodenal I cells. Immunostaining highlighted that subsets of I cells in both crypts and villi coexpress differential amounts of CCK, Ghrl, GIP, or peptide YY, indicating that a proportion of I cells contain several hormones during maturation and when fully differentiated. Our results reveal that although I cells express several key gut hormones, including GIP or proglucagon, and thus have a considerable overlap with classically defined K and L cells, approximately half express Ghrl, suggesting a potentially important subset of duodenal EEC cells that require further consideration. PMID:25004095

Sykaras, Alexandros G; Demenis, Claire; Cheng, Lei; Pisitkun, Trairak; Mclaughlin, John T; Fenton, Robert A; Smith, Craig P



Common bile duct obstruction due to a duodenal gastrinoma in a dog.  


In dogs gastrinomas are rare endocrine neoplasms that have always been reported to arise from the pancreas. We report here what we believe to be the first case of a duodenal gastrinoma in a dog. A nine-year-old, male, Pekinese dog was presented with a three-day history of anorexia, vomiting and mucous diarrhoea. Clinical examination and laboratory findings suggested the presence of a severe hepatobiliary disorder. Abdominal ultrasonography showed a diffuse increase in echogenicity of the liver, with severe gallbladder dilation and marked dilation of the cystic duct, common bile duct and extrahepatic bile ducts. Based on these findings, an extrahepatic biliary tract obstruction (EBTO) of unknown cause was suspected. At laparotomy, the gallbladder and the extrahepatic bile ducts appeared severely dilated. The gallbladder was tense and could not be compressed suggesting an outflow obstruction. The duodenum at the level of the common duct orifice appeared slightly thickened and severely hardened for a length of 1 cm. Biopsies from the duodenum and liver were obtained and a cholecystoduodenostomy was performed. The duodenal biopsy revealed severe fibrosis of the submucosa and a infiltrate of small pockets and cords of round to polygonal cells with granular cytoplasm. Based on this appearance the differential diagnoses included neuroendocrine tumours and poorly differentiated carcinoma. Despite surgery and supportive therapy the dog continued to be anorexic and to vomit 3-6 times daily. After euthanasia and necropsy, histopathology showed the presence of a neuroendocrine neoplasia involving the duodenal wall with focal invasion of the adjacent pancreas and small liver metastases. On immunohistochemistry, the cytoplasm of approximately 90% of neoplastic cells intensely expressed neuron specific enolase and gastrin. These findings were consistent with a diagnosis of gastrinoma. PMID:15993800

Vergine, Marzia; Pozzo, Sergio; Pogliani, Elena; Rondena, Marco; Roccabianca, Paola; Bertazzolo, Walter



The occurrence of c-myc, p53 and Bcl-2 family proteins in the early phase of development of duodenal epithelium.  


In last few years, numerous groups of proteins participating in the regulation of cell proliferation, differentiation and death during ontogenesis have been described. In this study we compared the occurrence of Bcl-2, p53 and myc protein families with the level of proliferative activity and apoptosis during development of duodenal epithelium. Paraffin embedded tissues of eight human embryos and foetuses aged from the 6th-18th week of IUD were used. For the detection of apoptotic cells the TUNEL method was performed, the proliferative marker PCNA and all the proteins studied were detected by means of indirect three-step immunohistochemical method. In the 6th and 8th week of intrauterine development we observed isolated TUNEL positive epithelial cells only and this was accompanied by the disperse presence of PCNA as well as by all the studied proteins: Bcl-2, Bax, Bcl-XL, c-myc, N-myc, p53, p63 and p73. In the early foetal period of duodenal development we registered changes in PCNA and TUNEL positivity in accordance with the constitution of the stem cell pool on base of villi, where more numerous Bcl-2 positive cells were also found. The separation of primitive crypts and villi was not accompanied by any differences in distribution of Bax, Bcl-XL, c-myc, N-myc, p63 and p73 proteins between those compartments: all the studied proteins showed dispersed character. P53 rapidly decreased in this period. In the 18th week of intrauterine development the balance between proliferation in crypts and apoptosis of villi epithelium was well established and no p53 positive cells were found. In the presence of Bcl-2, Bax, Bcl-XL, p63 and p73 we did not find any dramatic changes. The myc proteins were restricted within the epithelium of the Lieberkuhn crypts only. PMID:15744383

Kylarová, Dana; Vrchovecký, Jan; Holinka, Martin; Erdösová, Bela



Stimulation of duodenal biopsies and whole blood from dogs with food-responsive chronic enteropathy and healthy dogs with Toll-like receptor ligands and probiotic Enterococcus faecium.  


The composition of the microbiome plays a significant role in the pathogenesis of inflammatory bowel disease (IBD) in humans and chronic enteropathies (CE) in dogs. The administration of probiotic micro-organisms is one way of modulating the microbiome, but experiments elucidating mechanisms of action of probiotics in the intestine of healthy and CE dogs are lacking. The aim of our study was to investigate the effects of different Toll-like receptor (TLR) ligands and Enterococcus faecium (EF) on ex vivo cultured duodenal samples and whole blood (WB) from dogs with food-responsive chronic enteropathy (FRE) when compared to healthy dogs. Biopsy stimulation was performed in 17 FRE and 11 healthy dogs; WB stimulation was performed in 16 FRE and 16 healthy dogs. Expression of TLR2, 4, 5 and 9, IL-17A, IL-22, IFNy, TNF?, IL-4, IL-10, TGF? and PPARy was determined in biopsies by quantitative polymerase chain reaction (PCR). In addition, production of TNF?, IL-10, IFNy and IL-17A protein in WB and biopsy supernatants was assessed by ELISA. Treatment with individual TLR ligands or EF induced a variety of changes in the expression of different TLRs and cytokines, but not necessarily a consistent change with a single stimulating agent. Even though cytokine protein could not be detected in supernatants from ex vivo stimulated biopsies, we found TNF? protein responses in blood to be opposite of the transcriptional responses seen in the biopsies. Stimulation of canine duodenal biopsies with TLR ligands can potentially induce anti-inflammatory gene expression, especially in healthy tissue, whereas the effects of EF were limited. PMID:24813376

Schmitz, S; Henrich, M; Neiger, R; Werling, D; Allenspach, K



Probiotics against neoplastic transformation of gastric mucosa: Effects on cell proliferation and polyamine metabolism  

PubMed Central

Gastric cancer is still the second leading cause of cancer death worldwide, accounting for about 10% of newly diagnosed neoplasms. In the last decades, an emerging role has been attributed to the relations between the intestinal microbiota and the onset of both gastrointestinal and non-gastrointestinal neoplasms. Thus, exogenous microbial administration of peculiar bacterial strains (probiotics) has been suggested as having a profound influence on multiple processes associated with a change in cancer risk. The internationally accepted definition of probiotics is live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. The possible effects on the gastrointestinal tract following probiotic administration have been investigated in vitro and in animal models, as well as in healthy volunteers and in patients suffering from different human gastrointestinal diseases. Although several evidences are available on the use of probiotics against the carcinogen Helicobacter pylori, little is still known about the potential cross-interactions among probiotics, the composition and quality of intestinal flora and the neoplastic transformation of gastric mucosa. In this connection, a significant role in cell proliferation is played by polyamines (putrescine, spermidine, and spermine). These small amines are required in both pre-neoplastic and neoplastic tissue to sustain the cell growth and the evidences here provided suggest that probiotics may act as antineoplastic agents in the stomach by affecting also the polyamine content and functions. This review will summarize data on the most widely recognized effects of probiotics against neoplastic transformation of gastric mucosa and in particular on their ability in modulating cell proliferation, paying attention to the polyamine metabolism. PMID:25309063

Russo, Francesco; Linsalata, Michele; Orlando, Antonella



Cybrd1 (duodenal cytochrome b) is not necessary for dietary iron absorption in mice.  


Mammalian nonheme iron absorption requires reduction of dietary iron for uptake by the divalent metal ion transport system in the intestine. This was thought to be mediated by duodenal cytochrome b (Cybrd1), a ferric reductase enzyme resident on the luminal surface of intestinal absorptive cells. To test its importance in vivo, we inactivated the murine Cybrd1 gene and assessed tissue iron stores in Cybrd1-null mice. We found that loss of Cybrd1 had little or no impact on body iron stores, even in the setting of iron deficiency. We conclude that other mechanisms must be available for the reduction of dietary iron. PMID:15961514

Gunshin, Hiromi; Starr, Carolyn N; Direnzo, Cristina; Fleming, Mark D; Jin, Jie; Greer, Eric L; Sellers, Vera M; Galica, Stephanie M; Andrews, Nancy C



Ultrasound, CT and FDG PET-CT of a Duodenal Granuloma in a Dog  

PubMed Central

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

JEON, Sunghoon; KWON, Seong Young; CENA, Rohani; LEE, Ju-hwan; CHO, Kyoung-Oh; MIN, Jung-Joon; CHOI, Jihye



[Effectiveness of the treatment of gastric and duodenal ulcers by low-intensity electromagnetic (laser) radiation].  


The effectiveness of treatment of ulcer patients with various types of laser radiation by the argon, heliun-neon and crypton lasers was studied in 137 patients. The results of laser treatment were compared with those in controls constituting 60 patients who were treated with commonly used therapeutic methods. The sparing techniques of laser therapy promote much earlier cicatrization of gastric and duodenal ulcers, shorter terms of hospital stay and reduction of temporary working disability. Laser therapy leads to a decrease in the number of disease recurrences in the first two months and has no significant influence on the incidence of recurrences in the remote period. PMID:2747142

Nogaller, A M; Zvonkov, V S



Abdominal wall defect with large duodenal disruption treated by a free tissue flap with a help of temporary expandable metallic stent  

PubMed Central

Abdominal wall defect with large duodenal disruption after penetrating abdominal injury is a rare emergency situation that can result in life-threatening complications. We report on a 64-year-old man who had abdominal wall defect with large duodenal disruption after penetrating abdominal injury. The patient presented with intra-abdominal exsanguinating bleeding, duodenal disruption, and multiple small bowel perforation. The rarity of this complex injury and its initial presentation as a posttraumatic large duodenal disruption with abdominal wall defect warrant its description. The present case indicates that combining a free tissue flap with a covered expandable metallic stent can effectively and successfully repair an abdominal wall defect that is associated with a large duodenal disruption. PMID:24266016

Park, Jung-Hoon; Song, Ho-Young; Kim, Eun Key; Lee, Sung Koo; Jung, Yooun Joong



Role of Escherichia coli O157:H7 Virulence Factors in Colonization at the Bovine Terminal Rectal Mucosa  

PubMed Central

The human pathogen Escherichia coli O157:H7 causes hemorrhagic colitis and life-threatening sequelae and transiently colonizes healthy cattle at the terminal rectal mucosa. This study analyzed virulence factors important for the clinical manifestations of human E. coli O157:H7 infection for their contribution to the persistence of E. coli in cattle. The colonizing ability of E. coli O157:H7 was compared with those of nonpathogenic E. coli K-12 and isogenic deletion mutants missing Shiga toxin (Stx), the adhesin intimin, its receptor Tir, hemolysin, or the ?92-kb pO157. Fully ruminant steers received a single rectal application of one E. coli strain so that effects of mucosal attachment and survival at the terminal rectum could be measured without the impact of bacterial passage through the entire gastrointestinal tract. Colonization was monitored by sensitive recto-anal junction mucosal swab culture. Nonpathogenic E. coli K-12 did not colonize as well as E. coli O157:H7 at the bovine terminal rectal mucosa. The E. coli O157:H7 best able to persist had intimin, Tir, and the pO157. Strains missing even one of these factors were recovered in lower numbers and were cleared faster than the wild type. In contrast, E. coli O157:H7 strains that were missing Stx or hemolysin colonized like the wild type. For these three strains, the number of bacteria increased between days 1 and 4 postapplication and then decreased slowly. In contrast, the numbers of noncolonizing strains (K-12, ?tir, and ?eae) decreased from the day of application. These patterns consistently predicted long-term colonization or clearance of the bacteria from the bovine terminal rectal mucosa. PMID:16861656

Sheng, Haiqing; Lim, Ji Youn; Knecht, Hannah J.; Li, Jie; Hovde, Carolyn J.



Comparative studies on cytotoxic and genotoxic effects of two organic mercury compounds in lymphocytes and gastric mucosa cells of Sprague-Dawley rats  

Microsoft Academic Search

Human lymphocytes (HL) as well as lymphocytes (RL), hepatocytes (RH), and gastric mucosa cells (GM) of Sprague-Dawley rats were treated in vitro for 1 h with methylmercury chloride (MMC, 0.5 -4 [mu]g\\/ml) and dimethylmercury (DMM, 5-40 [mu]g\\/ml). The cytotoxicity of the two organic mercury compounds was assessed by dye exclusion, and the extent of induced DNA fragmentation was measured with

C. Betti; R. Barale; B. L. Pool-Zobel



Gastric mucosa analysis using speckle patterns: a medical diagnosis alternative  

NASA Astrophysics Data System (ADS)

Speckle techniques have been extensively employed in biomedical applications. It has been shown, that these non invasive optical techniques are useful to discriminate healthy tissues from those presenting some type of pathology. In this work we analyze speckle patterns from histological samples of gastric mucosa obtained by means of digestive endoscopies with three different histopathological confirmed diagnoses: atrophy, metaplasia and dysplasia. We studied biopsies from 27 patients and formed groups following the corresponding speckle contrast features. Three different groups according to the speckle contrast were established: higher for intestinal metaplasia, intermediate for gastric dysplasia and low for gastric atrophy. The comparison with histopathology shows a high value of concordance between both tests, making this methodology emerges as a possible new classification system for qualitative and quantitative gastric biopsy using optical techniques.

Andrade Eraso, Carlos Augusto; Patiño Velasco, Mario Milver; Vásquez Lopez, Jairo Alfonso; Tellez, Jaury Leon; Bravo, Luis Eduardo; Rabal, Hector; Trivi, Marcelo



Solitary Angiokeratoma of Oral Mucosa: A Rare Presentation  

PubMed Central

Solitary angiokeratoma of oral mucosa is rare entity. The term Angiokeratoma is used to refer to several lesions, whose common denominator is the presence of dilated blood vessels in association with epidermal hyperplasia. Mucosal involvement, including oral cavity is occasionally found either as a component of the systemic variety, cutaneous involvement or isolated oral involvement. Clinically, the lesion is irregular, whitish to dark brown in color, with female predominance. The etiological factors include injury, trauma, or chronic irritation to the wall of a papillary dermis. Histologically, it is characterized by hyperkeratosis, acanthosis, and dilated vascular spaces with or without organizing thrombi in papillary dermis. The vascular spaces are partly or completely enclosed by elongated ret-ridges. Along with this reporting a case of solitary angiokeratoma affecting tongue in a 38-year-old male patient, along with the literature review is presented. PMID:23936686

Kandalgaonkar, Shilpa; Tupsakhare, Suyog; Patil, Ashok; Gabhane, Mahesh; Sonune, Shrikant



Myoepithelial carcinoma of buccal mucosa: A rare tumor.  


Myoepithelial carcinoma is a rare neoplasm of salivary glands that account for < 1% of all salivary gland tumors. The most common sites of involvement are major salivary glands mainly parotid gland. Intraorally, it can arise from minor salivary glands; palate is the most common site of occurrence. It also occurs in nasopharynx, paranasal sinuses, nasal cavity and larynx in head and neck region. Myoepithelial tumors were first described in 1943. Their malignant variant, myoepithelial carcinoma, was first reported by Stromeyer et al., in 1975, characterized by distinct morphologic heterogeneity and an infiltrative growth pattern into adjacent tissues. Here, we report a rare case of a 55-year-old female with myoepithelial carcinoma of buccal mucosa. It was also rare because of unusual location of tumor. Our patient was treated with wide local resection and remained free of disease for 15 months. PMID:24963257

Lata, Jeevan; Ahmad, Fahad; Chand, Vimal



Chromatographic Separation of Odorants by the Nose: Retention Times Measured across in vivo Olfactory Mucosa  

Microsoft Academic Search

The column of a standard gas chromatograph was replaced with in vivo frog olfactory sac. The wide range of relative retention times as measured across the olfactory mucosa for 15 different odorants supports the concept of a chromatographic separation along the mucosa as a mechanism for distinguishing different odorants.

Maxwell M. Mozell; Morris Jagodowicz



Oral Diseases / Review Oral mucosa lesions in hypereosinophilic syndrome: an update  

E-print Network

: Hypereosinophilic syndrome and oral ulcers Keywords: hypereosinophilic syndrome, oral ulcers, myeloproliferative. Oral mucosa ulcerations can be early clinical signs in severe forms. They are discrete, round or oval, sometimes confluent ulcers or erosions, located on non-keratinized, unattached oral mucosa. In the last

Paris-Sud XI, Université de


Impaired Adaptive Cytoprotection to Ethanol-Induced Damage in Gastric Mucosa of Portal Hypertensive Rats  

Microsoft Academic Search

Portal hypertension predisposes gastric mucosato increased damage by noxious agents. Adaptivecytoprotection has not been studied in portalhypertensive gastric mucosa. We evaluated adaptivecytoprotection in the gastric mucosa of portal hypertensiverats by exposure to ethanol. The injury index (percentgross lesions) was significantly higher in portalhypertensive rats than in sham-operated rats. The ratio of adaptive cytoprotection, calculated as thedegree of decrease in the

Koichi Ninomiya; Seigo Kitano; Takanori Yoshida; Toshio Bandoh; Dolgor Baatar; Sadaki Tsuboi



A standard picture of healthy oral mucosae by direct oral microscopy  

PubMed Central

Introduction Direct oral microscopy constitutes a novel technique of in vivo oral mucosae examination. The basic principles of this method derive from colposcopy and dermoscopy. The main goal of direct oral microscopy is the earliest possible detection of oral precancerous lesions in order to implement their treatment as quickly as possible and prevent malignant transformation. Aim To establish a standard picture of healthy oral mucosae with direct oral microscopy applying standard colposcopic criteria in order to create a reference point for further diagnosis of precancerous lesions. Material and methods Thirty patients of both genders with clinically unaltered oral mucosae were examined. For every individual, clinical examination with the naked eye was performed, followed by direct oral microscopy with colposcopic assessment criteria. Oral mucosae at various sites (lip, cheek, floor of mouth, ventral and lateral sides of the tongue, alveolar ridge and soft palate) were examined. Results Subepithelial blood vessel patterns, mucosal surface, colour tone and transparency were described for healthy oral mucosae. Moreover, cases with clinically unaltered oral mucosae where direct oral microscopy revealed subclinical alterations were described. Conclusions Direct oral microscopy with colposcopic assessment criteria enables establishment of a repeated picture of unaltered oral mucosae. The standard picture of healthy oral mucosae is an essential reference point for application of this technique to early diagnose potentially malignant oral mucosal lesions as well as apply their early treatment. PMID:24278068

Drogoszewska, Barbara; Michcik, Adam; Polcyn, Adam