Mesenteric and omental cysts: An ultrasonographic and clinical study of 15 patients

The clinical and ultrasonographic (US) features of 15 cases of mesenteric or omental cyst are herein described. This series included seven male and eight female patients, whose age ranged from 2–89 years. Correct clinical diagnosis was made in two children only, but preoperative US examination accurately demonstrated the lesion in 11 of 13 patients (85%). These cystic lesions usually had a thin wall, internal septations, and fluid content with sedimentation. Enteric duplication cysts had a relatively thick wall merging with the muscle layer of bowel loop, and multiloculation was noted mainly with cystic lymphangiomas or pseudocysts. The diagnostic and surgical management of these lesions are briefly reviewed and their US appearance is illustrated.     

腹腔镜在急性肠梗阻手术治疗中的应用

目的:评价腹腔镜在急性肠梗阻手术治疗中的价值。方法:对腹腔镜急性肠梗阻手术的适应证、禁忌证、手术方式、注意事项、手术并发症及优缺点等进行了总结与分析。结果:腹腔镜手术已成功地用于治疗由既往腹部手术后粘连、内疝(包括膈疝)、腹壁疝、肠扭转等所引起的急性肠梗阻。结论:腹腔镜急性肠梗阻手术仍是一种探索性的手术,可以代替开腹手术治疗选择性的急性肠梗阻。对于梗阻原因不明者,腹腔镜手术是一种即可以明确梗阻原因,又可以同时进行有效治疗的方法。     

胃粘膜癌前病变的形态定量研究——胃粘膜核腺比值的定量分析

应用自动化图象分析仪对131个胃粘膜肠型病灶(单纯性肠化27个;异型增生:轻度30,中度35个,重度20个;肠型胃癌19个)进行定量分析。以单个腺管内细胞核总面积与细胞面积之比(ING)作为反映细胞核大小、数量及覆层排列程度的客观定量指标。结果发现:单纯性肠化(对照组)0.165±0.025,轻度异型增生0.21±0.023,中度异型增生0.259±0.026,重度异型增生0.32±0.028,分化型胃癌0.371±0.052,各组ING值呈正态,各组间的均值有非常显著的差异(P<0001)。因而,ING可作为胃粘膜癌前病变诊断的指标。     

“肠梗”治疗粘连性肠梗阻425例

本文对采用自行研制的中草药浓缩剂“肠梗”治疗的粘连性肠梗阻４２５例进行临床分析。根据不同的病理及临床特征将其分为三种类型，其中广泛粘连型是“肠梗”治疗的最佳适应症，粘连扭转型是其禁忌证。并对中转手术的指征、时间等问题进行了讨论。认为该方法具有简单易行、安全可靠、成功率高的特点，是一种易于推广的治疗粘连性肠梗阻的有效方法，具有较高的临床实际应用价值     

原发性小肠恶性肿瘤的CT诊断

本文回顾性分析３４例经病理证实的原发性小肠恶性肿瘤的ＣＴ表现。病变包括腺癌１６例，平滑肌肉瘤１２例，淋巴瘤６例。ＣＴ扫描能明确肿瘤向腔内和腔外侵犯的程度，清晰显示肿瘤与邻近结构的关系，有无局部及远处转移等，为临床治疗提供帮助。鉴别诊断应包括小肠良性肿瘤、炎性病变和转移性肿瘤等。     

10Gyγ线照射后小鼠两相邻肠段运动变化

本文用同时记录两相邻空肠段的收缩活动来观察经10Gyγ线照射后小肠运动的变化,以了解照射后是否出现逆蠕动,以便进一步分析肠套叠形成的原因.结果表明,照射后两相邻肠段出现强度不一的收缩活动,并且可以产生逆蠕动;但是这种逆蠕动发生的机率是不大的.本实验未观察到逆蠕动发生的规律性.因此,逆蠕动的产生可能是照射后发生肠套叠的部分原因.     

Effects of enteral feedback inhibition on motility,luminal flow,and absorption of nutrients in proximal gut of minipigs

We wanted to clarify whether the postprandial intestinal feedback control activated by nutrients in the distal gut exerts different effects on motility, transit of digesta, and absorption of nutrients in the proximal gut. Additionally, interrelationships among motility, transit, and absorption were to be elucidated because these relationships have only been investigated in the fasted state. In five minipigs, a 150-cm segment of the proximal jejunum was isolated by two cannulas. Motility of the jejunal segment was recorded by multiple strain gauges and analyzed by computerized methods. Markers (Cr- and Cu-EDTA) were used for the measurement of the flow rate, transit time, and absorption of nutrients. After a meal, the test segment was perfused with 2 kcal/min of an elemental diet over a period of 90 min. A feedback inhibition was activated by infusion of nutrients into the midgut at rates of 1–4 kcal/min. Saline was infused as control. With increasing energy loads infused into the midgut, the motility index and the length of contraction waves decreased, whereas the incidence of stationary contractions increased, ie, the motility changed from a propulsive to a segmenting pattern. These modulations of motility were associated with a linear decrease in the flow rate and a linear increase in transit time. Flow and transit were linearly correlated with each other. Additionally, the reduction in flow rate and the delay in luminal transit were associated with a linear increase in the absorption of nutrients. However, the increase in absorption induced by the feedback mechanism was small (7.3–13.4%) compared to the marked inhibition of the motility parameters (54–64%), the flow rate (59%), and the delay of transit (5.8-fold). Feedback control primarily modulated motor patterns and luminal flow, whereas the small increase in absorption was only a side effect due to the longer contact time of the nutrients with the mucosa.The study was supported by the Deutsche Forschungsgemeinschaft, grant Eh 64/6-3.     

Absorption of Propranolol in Humans Following Oral,Jejunal, and Heal Administration

Pharmaceutical Research -     

Comparison of the Permeability Characteristics of a Human Colonic Epithelial (Caco-2) Cell Line to Colon of Rabbit,Monkey, and Dog Intestine and Human Drug Absorption

The in vitro permeabilities of Caco-2 monolayers and permeabilities in tissue sections from colon of monkey, rabbit, and dog were compared using a series of compounds. The selected compounds differed in their physicochemical properties, such as octanol/water partition coefficient, water solubility, and molecular weight. Their structure included steroids, carboxylic acids, xanthins, alcohols, and polyethylene glycols. A linear permeability relationship was established between Caco-2 and colon tissue from both rabbit and monkey. The results suggest that Caco-2 is twice as permeable as rabbit and five times as permeable as monkey colon. However, no clear relationship could be established between Caco-2 monolayers and dog colon permeability. A relationship between permeability in Caco-2 monolayers and human absorption was found. The results suggest that within certain limits, permeability of Caco-2 monolayers may be used as a predictive tool to estimate human drug absorption.     

Interactions between peripheral blood CD8 T lymphocytes and intestinal epithelial cells (iEC)

Intestinal intraepithelial lymphocytes (iIEL) are primarily CD8 cells and most of them have a CD28^? phenotype, the phenotype of effector cytotoxic T cells. We asked whether the predominance of CD8⁺ CD28^? T cells in the gut may result from peripheral blood T cells preferentially migrating to the iIEL compartment and adhering to iEC. Compared with CD4 cells, adhesion of resting CD8⁺ T cells to iEC cell lines was significantly higher. Adhesion could be blocked with a MoAb to gp180, a molecule expressed on iEC which is known to interact with CD8/lck. No significant difference in the level of adhesion was observed between CD8⁺ CD28⁺ and CD8⁺ CD28^? T cells. Thus CD8 cells may preferentially migrate to the iIEL compartment, but loss of CD28 expression could occur in situ after migration. Consistent with this hypothesis, the CD8⁺ CD28^? cells became enriched after co-culturing T cells with iEC cell lines and primary iEC. Induction of the CD8⁺ CD28^? phenotype in cord blood and adult T cells was observed in co-cultures with iEC and also with mitogens and superantigens. In the latter case, CD28 down-modulation was seen specifically in the Vβ subset targeted by the superantigen, indicating that loss of CD28 expression is a direct result of T cell receptor (TCR)-mediated stimulation. The combined results suggest that CD8⁺ CD28^? T cells are antigen experienced T cells, and that they may have a survival advantage in the presence of gut epithelial cells in vitro. This may contribute to the predominance of CD8⁺ CD28^? T cells in the iIEL compartment.