Foreign bodies in the digestive tract

In the past two years time 128 patients-prisoners, who had swallowed foreign bodies, have been observed. Six anchors and crosses, which had been stuck in the esophagus, were immediately and successfully removed endoscopically. Long rods and crosses (60 cases) situated mostly in the stomach or descending part of the duodenum were operated without any complications. A few weeks delay of operation caused the covered perforation of the alimentary tract wall nearly 20% of cases and one of which died. Ingested small foreign bodies (less than 10 cm in length) are harmless, pass spontaneously through the gastrointestinal tract and don't need any surgical intervention. In a few cases those small foreign bodies perforated the guts, covered outside the digestive tract without any complaints.     

Malignant systemic diseases of the digestive tract

In about 5-6% of all patients with malignant myeloproliferative disorders the gastrointestinal tract is involved with macroscopic lesions. The most common sites of digestive manifestations are stomach, small bowel, pancreas and colon. Multiple irregular ulcers, doughy infiltration of the bowel wall, multiple nodules and diffuse polyposis of the colon are classic patterns of secondary lymphoma of the gut. Prognosis is considerably impaired by gastroenterological symptoms.     

The absorption of phosphate from the digestive tract of ruminant animals

The late competence protein ComF1 is required for genetic transformation in Bacillus subtilis. Because of the sequence similarities of ComF1 to known ATP-dependent DNA helicases and translocases, we have hypothesized that this protein either unwinds bound double-stranded DNA or helps in the translocation of the transforming single-stranded DNA across the cell membrane. Two important implications of this hypothesis (the association of ComF1 with the membrane and its specific requirement for DNA uptake) have been tested in this report. Using cell fractionation techniques and Western blotting analysis, we show that ComF1 is located almost exclusively on the cell membrane and that it is membrane-targeted independently of other competence proteins. Moreover, ComF1 behaves like an integral membrane protein in extractability and detergent partition assays. We also show that this protein is required for the DNA-uptake step during transformation but not for DNA binding to the cell surface. DNA uptake is blocked in strains with null mutations or in-frame deletions in comF1 but also in strains that overproduce the ComF1 protein under competence conditions. This last observation suggests that ComF1 expression must be balanced with that of other competence proteins, with which it may interact to form a multisubunit complex for DNA uptake.     

The endoscopic treatment of postoperative stenoses of the upper digestive tract

The authors compare their experience in dilatation of postoperative benign esophageal strictures. A total of 60 patients (37 males, 23 females: mean age 52), all with severe dysphagia, from January 1985 to September 1995, underwent endoscopic dilatation: 32 of these with Savary dilators and 28 with balloon dilators. Dilatation was effective in 93% in both groups. Two severe complications were recorded (1 heart attack and 1 perforation) in the group that underwent endoscopic dilatation with Savary dilators. During endoscopic management, pain recurred in 43% and 87% of cases after balloon or Savary dilatations, respectively. The authors believe balloon dilators are more effective, better tolerated and with less complications than Savary dilators. They reserve the management with Savary dilators to the extremely severe esophageal strictures.     

The adhesive system of the planarian Dendrocoelum lacteum: its structure and innervation

Light and electron microscopy of ventral surface of triclada D. lacteum allowed to distinguish four regions, containing ducts of adhesive glands. Every zone described has several morphological features connected to their role in various physiological processes. In every case structural unit of adhesive system is a complex of two unicellullar glands which according to the structure of secretory granules secrete different chemical products and are responsible for different processes such as adhesion an secretion. Adhesive structures of D. lacteum involved in vital behavior acts as movement on substrate surface, food capture an reaction of avoiding are heavily innervated. Cerebral ganglion neurons play the leading role in innervation of adhesive channel and area of additional secretion. The margin and caudal sucktio are innervated by axons originated from lateral neural cord. Neurons of peripheral plexuses play an important role in innervation of the whole adhesive system. Most dense accumulation of nerve endings is located in the vicinity of ducts of adhesive glands.     

The effects of aging on the rat bladder and its innervation

1) Measurements of the cystometrogram, of the responsiveness of bladder muscle to pelvic nerve efferent stimulation and of the sensitivity of the pelvic nerve afferents to pressure and volume during distensions have been made in the bladders of young adult (2-3 months) and aged (26-29 months) rats, anesthetized with mixtures of urethane and chloralose. 2) The pressure-volume relationship differed in young adult and aged rats. The bladders of the aged rats held up to nearly six times the volume of the young animals, and these volumes were accommodated at lower pressures in the aged animals. The pressure at which micturition contractions appeared was similar in young adult and aged animals. 3) The passive pressure associated with each of a series of distending volumes was recorded when a pelvic nerve was cut unilaterally. The distal cut end of this cut pelvic nerve was stimulated for 10 s at 20 Hz, using square wave pulses of 10 V and 1.0 ms. The active pressure-volume relationship was constructed from this data. Both the active and the passive relationships were shifted to the right in the aged animals, and it was evident that aging was associated with a reduction in the maximal pressure generated during pelvic nerve stimulation. Also the change in intravesical pressure induced by bladder contraction was less in aged animals. 4) The most sensitive mechanoreceptor afferents appear to have pressure and volume thresholds that do not change significantly during aging. While the distension-sensitive afferents in the pelvic nerve appear to have a similar sensitivity to intravesical pressure in young adult and aged rats, they were less able to monitor volume in the aged animals. The stimulus response relationship for volume was often less steep in the aged animals. 5) In this study, aging was shown to be associated with a large increase in bladder volume and a reduced sensitivity of pelvic nerve afferents to volume, and a reduced ability to raise bladder pressure during contraction of bladder smooth muscle. The changes in bladder function associated with aging are discussed.     

Conflict and somatization: psychoanalytic treatment of the psychophysiologic response in the digestive tract

Somatization of intrapsychic conflicts, as manifested in the mouth, the stomach, the small intestine, the large bowel, and the anus, is described in this long-term study of the psychoanalytic treatment of three patients with peptic ulcer, regional ileitis, and ulcerative colitis respectively. The theoretical and practical aspects of treatment are considered, and the efficacy of and indications for psychoanalysis as the treatment of choice are discussed.     

Treatment of MALT lymphoma of the digestive tract]

Mucosa-associated lymphoid tissue (MALT) is an autonomous part of the immune system with a specific function, histological structure and circulation of cells. As a result of malignant transformation of this tissue maltomas develop, peripheral extranodal non-Hodgkin lymphomas of B-origin more than two-thirds of which are found in the digestive system. The authors investigated in a retrospective study the effectiveness of different types of treatment of maltomas of the digestive tract with a low and high grade of malignity in 16 patients. It appears that splenectomy is not necessary in these patients and that the effectiveness of primary chemotherapy with a view of inducing complete remission of the disease is comparable with surgical treatment and subsequent adjuvant treatment without deterioration of the patient s life by mutilating surgery. An integral part of treatment of gastric maltomas is eradication of infection caused by Helicobacter pylori.     

Hydatid liver cyst perforation into the digestive tract

Complications of liver hydatid disease include those related to the compression of adjacent viscus, to the infection of the cyst's contents or to the perforation of the cyst. Perforations into hollow abdominal organs are rare, and can occur secondary to the infection of the cyst or to a primary pathology of the perforated organ. We report on 2 cases of perforation of a liver cyst into the duodenum, 1 due to the presence of a duodenal ulcer, and 1 secondary to a hydatid abscess. The surgical treatment of the lesions and their complications was, in both cases, successful.     

Upper digestive tract dyspepsia and early gastric cancer

AIM: The study of the frequency and evolution of upper digestive tract dyspepsia in a group of patients operated for early gastric cancer (EGC) and to perform a strategy of diagnosis for the patients with long term upper digestive tract dyspepsia. METHODS: Clinical data of 35 patients operated for EGC were retrospectively evaluated. The frequency, characteristics and evolution time of upper digestive tract dyspepsia, main when it began more than 6 months before surgery, were analyzed. Radiologic and endoscopic exams carried out for diagnosis were also evaluated. Histological diagnosis of surgical specimens were considered, looking for the presence of chronic atrophic gastritis, intestinal metaplasia, and peptic gastric ulcer. RESULTS: Long-term upper digestive tract dyspepsia was present in 27 patients (mean evolution time of 43.4 months). Clinical changes of previous symptoms that suggested gastric carcinoma were not found in 15 patients. Concurrent peptic gastric carcinoma were not found in 15 patients. Concurrent peptic gastric ulcer along with EGC was diagnosed by histology in 11 patients, and chronic atrophic gastritis and intestinal metaplasia were both present in the non-tumoral gastric mucosa in all cases. CONCLUSIONS: 1) Unspecific upper digestive tract dyspepsia is frequently found in patients with EGC. 2) Endoscopy should be the first exam performed in patients with upper digestive tract dyspepsia. 3) The patients with gastric ulcer, chronic atrophic gastritis or intestinal metaplasia must be submitted to sequential endoscopic follow-up.     

Beta-carotenoids and their potential use in diseases of the digestive tract

Flying personal with chronic hepatitis received beta-caratinoid vetoron. The latter proved to be an effective immunomodulator improving lipid peroxidation, clinical and morphological characteristics in the personnel with chronic persistent hepatitis. Follow-up gives proves on longer physical fitness for service of those pilots who have taken beta-caratinoids.     

The diagnosis of autoimmune thyroiditis by the symptoms of the upper respiratory tract and the digestive canal

Overall ninety-eight patients with autoimmune thyroiditis (AIT) were studied for the condition of upper respiratory and digestive tracts depending on the hormonal status of the thyroid gland. AIT patients display characteristic alterations in ENT organs, which were found to correlate with the thyroid levels of hormones.     

Ileal lipoma: a cause of severe lower digestive tract hemorrhage

We report a case of major lower digestive tract hemorrhage caused by an ileal lipoma. The main clinical signs of this uncommon pathology are presented together with the necessary paraclinical investigations. Ileal lipoma may be spontaneously complicated and requires surgical treatment.     

Use of Caproiod thread in surgery of the digestive tract

The results of experimental and clinical studied of the suture material "Caproiod" are presented. The advantage of the material suggested is its favourable effect on regenerative processes in the region of suture and anastomoses which resulted in their increased hermeticity. Use of "Caproiod" permits to prevent the development of postoperative complications caused by a quality of the suture material.