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  • 1
    ISSN: 1860-1499
    Keywords: Ultrastructure ; Esophagus ; Candida albicans ; Candidial lesion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Although the esophagus is the most frequent site ofCandida infections in the gastrointestinal tract, and many clinical studies about it have been reported, little attention has been directed toward experimental candidiasis of the esophagus, especially with regard to its ultrastructure. Using transmission electron microscopy, this study was performed to clarify the ultrastructure of experimental lesions, obtained from five New Zealand white male rabbits which were given a suspension ofCandida albicans cells (107/ml) for 13 days. The results showed that the lesions consisted of exfoliating, squamous epithelial cells with mycelial elements ofCandida albicans cells penetrating through them, and that a widened intercellular space between individual cells in the area of candidial invasion seems to be a characteristic finding of candidial infection.
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  • 2
    ISSN: 1573-2568
    Keywords: peptic ulcer ; gastric cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To examine the relationship between peptic ulcer and gastric cancer, we investigated 2529 patients with peptic ulcer diagnosed from 1963 to 1975. During the follow-up period of 9–23 years, we found 38 in whom gastric cancer developed or who died of gastric cancer. Included were nine in whom gastric cancer was detected at the same site as the gastric ulcer initially diagnosed, and 22 in whom the gastric cancer was detected at another site. In the remaining seven, gastric cancer was given on the death certificate, but the details were unknown. When the data on gastric ulcer initially diagnosed were reevaluated, gastric cancer was suspected or could not be completely ruled out in seven of the nine in whom gastric cancer was detected at the same site. In the remaining two, a diagnosis of benign ulcer was made even when the initial data were reviewed. In these two, however, there was the possibility that the initially diagnosed gastric ulcer represents a phase of the “malignant cycle.” The number of deaths from gastric cancer in patients with gastric ulcer was significantly low, compared with that expected and computed by the age- and sex-matched general population. These results suggest that gastric ulcers rarely become malignant.
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  • 3
    ISSN: 1573-2568
    Keywords: nonsteroidal antiinflammatory drugs ; indomethacin ; small intestine ; cytokine ; immunosuppressant
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The mechanism of nonsteroidal antiinflammatory drug-induced intestinal ulcers is not clearly understood. To evaluate whether immunosuppressants have a preventive effect against indomethacin-induced gastrointestinal damage, we investigated the effects of prednisolone, cyclosporin, and the newly developed immunosuppressant FK-506 in intracolonically indomethacin-treated rats: 24 mg/kg of indomethacin, administered intracolonically for two days, caused gastric ulcers and two types of small intestinal ulcers (longitudinal ulcers and scattered small ulcers). Pretreatment with intraperitoneal immunosuppressants reduced the size of gastric ulcers. Both cyclosporin (10 mg/kg) and FK-506 (1 mg/kg, 2 mg/kg) treatments significantly reduced the incidence and the length of the longitudinal ulcers of the small intestine when compared to the vehicle-treated controls, whereas prednisolone (20 mg/kg) did not show any preventive effect. Furthermore, the number of small scattered ulcers of the small intestine was significantly reduced by the high dose of FK-506 (2 mg/kg), but not by cyclosporin or prednisolone. These findings indicate that immunosuppressants have protective and antiinflammatory effects in indomethacin-induced gastroenteropathy, suggesting that cytokines may be important mediators in the pathogenesis of enteropathy induced by nonsteroidal antiinflammatory drugs.
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  • 4
    ISSN: 1573-2568
    Keywords: brain ischemia ; gastric mucosal blood flow ; integrity of the gastric mucosa ; vagal adrenergic pathway
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Brain ischemia is often accompanied by acute gastric lesions. To clarify the underlying mechanism, the influence of acute ischemic insult to the brain on gastric hemodynamics and mucosal integrity was examined in spontaneously hypertensive rats. One hour after brain ischemia, gastric mucosal blood flow decreased to 71% of the preischemic levels in the control rats but was preserved significantly better, at 94 and 108%, in the prazosin-treated and guanethidine-treated rats, respectively. Vagotomy almost abolished the decrease in gastric mucosal blood flow during cerebral ischemia. Intragastric 0.6 N hydrochloric acid administered just after reperfusion induced more severe hemorrhagic ulcers in the control than in the prazosin-treated and vagotomized groups. These results suggest that noradrenergic neurons acting through α1-adrenoceptors contributes to the decrease in gastric mucosal blood flow, and the subsequent disturbed integrity of the gastric mucosa, through the vagal adrenergic pathway during brain ischemia in spontaneously hypertensive rats.
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  • 5
    ISSN: 1573-2568
    Keywords: small bowel transit time ; hydrogen breath test ; anorexia nervosa
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The gastrocecal transit time was measured in 10 patients suffering from anorexia nervosa,using a lactulose hydrogen breath test, and was compared with the orocecal transit time in 11 healthy controls. One of the 10 patients and one of the 11 controls were excluded from this study because of no discernible increase in hydrogen excretion. The transit time was significantly prolonged in patients with anorexia nervosa compared with controls (117 min ±31 sd vs 81 min + 33 SD, P 〈0.02). In addition to delayed gastric emptying, which has hitherto been well known, the small bowel transit time was considered to be prolonged in patients with anorexia nervosa. Both these abnormalities seem to contribute to the development of various gastrointestinal symptoms in patients with anorexia nervosa.
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  • 6
    ISSN: 1573-2568
    Keywords: amyloidosis ; gastrointestinal motility ; breath hydrogen test ; orocecal transit time ; fasting breath hydrogen concentration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To investigate small bowel motility in gastrointestinal amyloidosis, lactulose breath hydrogen tests were performed on 16 patients with histologically proven amyloidosis and 12 age- and sex-matched controls. Fasting breath hydrogen concentration (FBHC) was not significantly different between the two groups, but there was a tendency for FBHC in symptomatic amyloidosis patients (median 31.5, range 3–78 ppm) to be higher than in asymptomatic amyloidosis patients (4, 0–34 ppm, 0.05〈P〈0.1) and controls (6, 1–19 ppm, 0.05〈P〈0.1). Orocecal transit time (OCTT) was significantly delayed in the amyloidosis group (median 150, range 40–220 min) when compared to the controls (60, 20–110 min,P〈0.01), but OCTT was not statistically different between symptomatic and asymptomatic amyloidosis patients. These data suggest an impaired motility of the stomach and small intestine in gastrointestinal amyloidosis and the possible role of small intestinal dysfunction such as bacterial overgrowth and malabsorption in the occurrence of symptoms in this disorder.
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  • 7
    ISSN: 1573-2568
    Keywords: CROHN'S DISEASE ; FATTY ACIDS ; ESSENTIAL FATTY ACIDS ; N3 POLYUNSATURATED FATTY ACIDS ; EICOSAPENTAENOIC ACID
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To determine fatty acid patterns in Crohn'sdisease, we measured various serum fatty acids by gaschromatography in 20 patients with the disease andcompared them with those in 18 healthy controls. All the patients had been free from any nutritionalsupplementation during preceding six months or had nohistory of intestinal resection. Eight of the patientswere affected in the small bowel only, three in the large bowel only, and the remaining ninein both the small and large bowel. Both serumconcentrations and percentages of C20:4n6,C20:5n3, C22:0,C22:6n3, total n3 polyunsaturated fattyacids, and total polyunsaturated fatty acids were lower in the patients than inthe controls. Both essential fatty acids(C18:2n6, C18:3n3) andC20:3n9 levels were not different between thetwo groups. Among nine fatty acids that correlated with the Crohn's disease activity index,C20:5n3 and total n3 polysaturated fattyacids showed the most significant negative correlations.These findings suggest that essential fatty aciddeficiency rarely occurs in Crohn's disease and alsothat n3 polyunsaturated fatty acids may be relevantto the activity of the disease.
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  • 8
    ISSN: 1435-5922
    Keywords: Crohn's disease ; prognosis ; operation ; reoperation ; quality of life ; complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The long-term outcome of Crohn's disease was reviewed in 74 patients who had a history of more than 10 years (range 10.8–27.3) since disease onset. The observation period was between 4.3 and 18.5 years, the mean and SD being 10.6±3.1 years. The means and SD of age at onset and final observation were 21±7 and 37±8 years, respectively. Fifty-eight of the 74 patients had not undergone bowel resection at the time of diagnosis; of these 58, 31 (53.4%) had an operation for the disease during the follow-up period. Thus, of the 74 patients, 47 (63.5%) (these 31, plus the 16 who had undergone bowel resection at the time of diagnosis) had an operation at least once during a follow-up period of 10 years or more. The cumulative operation rates 5, 10, and 15 years after onset in the 74 and 58 patients above were 18.9%, 6.9%, and 40.8%, and 34.8%, 49.1%, and 46.0%, respectively. The corresponding figures 5 and 10 years after diagnosis in all 74 patients and the 58 patients were 32.3% and 28.6% and 47.3% and 46.3%, respectively. There were no significant differences in the incidence of operation rate in relation to anatomical involvement. Cumulative reoperation rates 1, 3, 5, and 10 years after the first operation in the 31 patients who were operated on during the follow-up period were 3.4%, 6.9%, 25.5%, and 51.7%, respectively. Three patients died, the causes of death in one being directly related to Crohn's disease. The cumulative survival rate in all patients was compared with the expected survival rate in a sex- and age-matched general population. There was no significant difference between the two groups in survival rates in the-year period since onset. When the degree of satisfaction with quality of life in the previous 1 month and 1 year was evaluated by the patients themselves on an 11-point scale, in which a higher score indicated a better quality of life, about 30% of the patients had scores of 8–10. In the previous 1 year, 53% of the patients had been able to continue the same work, whereas 17% of the patients were not able to work. In conclusion, the prognosis for survival in Crohn's disease was very good; however, about 50% of patients required at least one surgical treatment during the 15-year followup period since onset, and about 70% of patients had some bowel or systemic symptoms, or emotional or social problems.
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  • 9
    ISSN: 1435-5922
    Keywords: Candida infection ; adherence ; esophagus ; nonimmunocompromised host
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Candida infection of the esophagus has been reported not only in immunocompromised hosts but also in healthy individuals. However, its mechanisms of action in healthy individuals have not been clarified. Our previous study suggested that physical contact was an important factor for the adherence ofCandida albicans. The aim of the present study was to test our hypothesis and clarify the adherence mechanisms. Suspensions ofCandida albicans cells were given to rabbits in drinking water without the use of immunosuppressive drugs and/or antibiotics, and the esophagus was examined. Candidial lesions were observed in 14 of 15 rabbits given the suspensions held in water with and without 30% sucrose for 13 days. The number ofCandida albicans cells adhering to the esophagus per square millimeter by subepithelial cell insertion was significantly larger than that adhering by attachment. These results indicate that adherence ofCandida albicans to the esophagus occurs by sustained physical contact alone under a nonimmunosuppressive state, and that subepithelial cell insertion results in greater attachment on adherence. Our findings provide a clue that may help clarify the mechanism ofCandida infection in healthy individuals.
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  • 10
    ISSN: 1436-0691
    Keywords: Pancreatic neoplasms ; pancreaticoduodenectomy ; colonic polyps ; adenomatous polyposis coli
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Pancreatic carcinoma is rarely associated with familial adenomatous polyposis (FAP). Ten patients with this association have been reported in the literature. However, detailed data were available in only a few cases. The first case of pancreatic acinar cell carcinoma associated with FAP is reported. A 51-year-old man who had undergone total colectomy and ileoproctostomy for colonic polyposis 29 years previously was admitted with a cancer in the residual rectum. Preoperative examinations revealed a tumor in the head of the pancreas. Pancreaticoduodenectomy and very low anterior resection of the rectum were performed. Histologically, the tumor of the pancreas was acinar cell carcinoma. In patients with FAP, we recommend careful surveillance of not only the gastrointestinal tract but also of other organs such as those of the pancreaticobiliary system and the endocrine organs.
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