Effect of cholesterol deprivation on piglet small intestine and serum lipids

Using the neonatal piglet, the effects of dietary cholesterol deprivation on growth, intestinal enzyme activity, intestinal and hepatic 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMG-CoA reductase), and serum lipid were studied. Six litters of piglets were randomly assigned to one of two feeding regimens: restricted (800 ml of formula/24 h) versus unrestricted (1,200 ml of formula/24 h). Within litters, piglets were separated by sex, then randomly assigned to a formula containing low cholesterol (less than 2 mg/dl) or high cholesterol (145 mg/dl). Piglets were fed for 2 weeks. Male piglets in the restricted low cholesterol group gained significantly less weight per milliliter of formula than the restricted high cholesterol males. No effect was observed in the females. Microvillus membrane lactase activity was greater in males fed a high versus low cholesterol diet. Intestinal and hepatic HMG-CoA reductase activities and serum lipid profiles showed a trend toward compensation for dietary cholesterol deprivation but did not differ statistically between the cholesterol-fed versus -deprived groups. It is concluded that dietary cholesterol deprivation in the male neonatal pig causes alterations in growth, but no other statistically significant responses were detectable in this study.     

Developmental biology of oxidant-producing enzymes and antioxidants in the piglet intestine

The pathogenesis of neonatal necrotizing enterocolitis is unknown, but a possible role for reactive oxygen metabolites has been postulated. We evaluated whether developmental differences exist in the levels of 1) the free radical-generating enzyme xanthine oxidase, 2) granulocyte peroxidase, an index of the resident granulocyte population, 3) free radical-scavenging enzymes (superoxide dismutase, catalase, and glutathione peroxidase), and 4) reduced glutathione, an endogenous antioxidant, in the ileal and colonic mucosa of 1-d-old, 3-d-old, 2-wk-old, and 1-mo-old piglets. We found no xanthine dehydrogenase/oxidase activity in 1-d to 1-mo-old piglets. Mucosal granulocyte peroxidase activity was higher in older animals, indicating that there was an age-dependent infiltration of granulocytes (eosinophils, neutrophils) in the distal bowel. The peroxidase activity per circulating granulocyte, however, did not vary with age. Superoxide dismutase activity was significantly higher in 1-d-old piglets than in all older age groups; glutathione peroxidase activity was significantly lower in 1-d-old animals than that of older age groups. There was no detectable catalase activity in the mucosa when tissue was corrected for catalase activity of blood. Finally, ileal GSH levels were significantly lower in 1-d-old than in 2-wk-old and 1-mo-old animals, whereas colonic reduced glutathione activity did not differ among age groups. In conclusion, the distal bowel of the neonatal piglet appears to have a limited capacity to generate oxidants via xanthine oxidase and resident granulocytes. However, the neonatal piglet intestine has a lower capacity to detoxify hydrogen peroxide than that of older animals.     

Leiomyoblastoma of small intestine

Gastrointestinal tumours are rare in children and leiomyoblastoma of small intestine is still rarer. We report a case of leiomyoblastoma of small intestine in a child who presented with acute intestinal obstruction.     

Effects of protein deprivation on growth and small intestine morphology are not improved by glutamine or glutamate in gastrostomy-fed rat pups

OBJECTIVES: Critically ill neonates often have their enteral intake severely limited shortly after birth. Whether glutamine (Gln) or glutamate (Glu) can preserve intestinal structure and function in the neonate undergoing limited enteral feeding is not clear. We hypothesize that Gln and Glu can similarly preserve intestinal structure in the developing small intestine of infant rats fed a low protein diet. METHODS: Using a gastrostomy-fed "pup-in-a-cup" rat model, the effects of Gln and Glu on the developing rat small intestine were examined. Four groups of 6- to 7-day-old pups were fed rat milk substitute (RMS) via gastrostomy tube. One group was provided 100% and three were provided 25% of the protein normally received from their mothers. Two of the groups fed 25% protein received additional Gln or Glu for 6 days. RESULTS: Pups receiving the 100% protein RMS were larger than pups receiving the 25% protein RMS with or without Gln/Glu supplementation (P < 0.001). Average villus height (P < 0.01) and area (P < 0.01) were greater in pups receiving 100% protein RMS than in pups given 25% protein RMS formula. There was no significant difference among the groups in mucosal maltase or alkaline phosphatase activities. Tight junction protein claudin-1 was significantly higher in the group fed 100% protein RMS diet, while occludin did not differ among the 4 groups. Neither Gln nor Glu increased claudin-1 or occludin in rats fed 25% protein. CONCLUSIONS: These results suggest that neither Gln nor Glu supplementation can substitute effectively for whole protein in the developing rat small intestine for the outcomes that were evaluated.     

Short-bowel syndrome associated with subtotal necrosis of small intestine after rectal trauma.

We report on a 4-year-old girl who experienced rectal trauma during swimming, sitting on an uncovered draining valve in the swimming pool. This resulted in a powerful suction effect on her rectum, followed by rupture of the sigmoid colon and evisceration of the small intestine. Laparotomy showed a near complete necrosis of the small bowel because of thrombotic lesions and wall lacerations of the superior mesenteric artery (SMA). A subtotal bowel removal associated with a jejuno-ileostoma was carried out, a total length of about 35 cm of the small intestine could be left in situ. Parenteral nutrition was stopped after eight months. At the moment defecation takes place 2-3 times a day, growth and weight gain are quite normal.     

Ewing sarcoma of the small intestine

This report describes a rare case of Ewing sarcoma (ES) of the small intestine. The patient was a 9-year-old girl with progressive abdominal distension. Computed tomography showed a large mass in the small bowel. Histopathologic examination of the resected tumor showed ES with typical histologic, immunohistochemical, and ultrastructural features. The tumor recurred in the pelvic cavity 18 months after the original surgery. Molecular study of the recurrent tumor confirmed a diagnostic EWS-FLI1 gene fusion. This patient illustrates the unique occurrence of ES in the small intestine.     

Extensive resection of the small intestine in children

Thirteen children aged 2 to 16 years have had a subtotal resection of small bowel, following a mid-gut volvulus in 10 cases. All children are still alive, and their growth was normal; 36 cumulative patient-years of parenteral nutrition and 11 years of constant rate enteral nutrition were performed. In 7 cases, where residual small bowel varied between 30 to 120 cm, termination of all artificial nutritional support was possible at a mean of 30 months after intestinal resection. On the other hand if resection was near total with less than 20 cm remaining, life long dependence on parenteral nutrition is unavoidable unless intestinal transplantation becomes feasible; with cyclic parental nutrition at home, their quality of life is near normal.     

Mechanism of D-xylose transport in human small intestine

The transport mechanism of D-xylose across the mucosal border of small intestine was investigated in humans both in vitro and in vivo. A comparative study was also made between infants and adults. We investigated the Na+ dependence of D-xylose influx from the mucosal solution into the epithelial cells, the phlorizin sensitivity of the influx, transport kinetics and electrogenic property of the D-xylose transport. The results of kinetic study indicated that the transport of D-xylose was completely diffusional. The influx of D-xylose across the mucosal border of human small intestine was Na+ independent and phlorizin insensitive. The electrical property of D-xylose transport could not be observed. There was no difference in the characteristics of D-xylose transport between small intestines of infants or adults. These results in the present study suggest that D-xylose does not share a common transport mechanism of D-glucose, and xylose tolerance test does not give any information about the absorptive capacity of D-glucose.     

Multifocal leiomyosarcoma of the small intestine in childhood

We recently observed a 4-year-old Chinese boy with multifocal leiomyosarcoma of the small intestine with evidence of dissemination. Complete surgical excision was not possible and the response to postoperative chemotherapy was poor. The patient died 3 months after diagnosis. The prognosis for disseminated intestinal leiomyosarcoma in childhood appears to be poor.     

Enterocyte migration in the foetal sheep small intestine

The migration of enterocytes was studied in the small intestine of foetal sheep at 115 and 136 days of gestation in utero. The speed of migration in all cases was slower than that reported in the adult. At 115 days, the migration rate was 4.88 and 4.96 percent villus height/day for the proximal and distal small intestine, respectively. At 136 days, the migration rate was significantly increased (p less than 0.05) to 12.0 for the proximal and to 8.5%, for the distal small intestine. Rates of villus length increase were between 0.007 and 0.012 mm/day over the time course studied. The migration rates, expressed as millimeters per day, were between 0.23 and 0.76 mm/day, hence the rate of migration was much greater (between 3 and 16 times) than the villus growth rate.