Gastrointestinal Organs Research Articles

COLONOSCOPIC TREATMENT FOR EARLY STAGE RECTUM ADENOCARCINOMA

Colorectal cancer is a malignant neoplasm that arises in the colon or rectum, characterized by the uncontrolled growth of epithelial cells, forming invasive tumors that can metastasize. It is the third most common neoplasm globally, with approximately 1.9 million new cases per year. In Brazil, in 2022, 5,573 deaths from rectal cancer were recorded, with a high incidence among women and a growing concern in younger age groups. Risk factors include type II Diabetes Mellitus, use of anti-inflammatory drugs, smoking and obesity, which is related to chronic inflammation and hormonal changes that favor cancer. Approximately 20% of patients with non-metastatic tumors can develop metastases, often affecting the gastrointestinal tract and organs such as the liver and lungs. The main treatment involves surgery and, in some cases, radiotherapy. Recommended screening for people aged 50 and over includes colonoscopy, with recent suggestions to start screening five years earlier, due to the global increase in the incidence of these conditions.

Histology-Proven Gastrointestinal Metastasis from Nongastrointestinal Malignancies: Experience of This Rare Occurrence in a Single Center

Introduction Lymph nodes, lung, liver, bone, and brain are the commonest metastatic sites for malignancies arising in various body sites. Gastrointestinal (GI) tract is a very uncommon metastatic site and the present study describes the single-center experience of GI metastases from non-GI malignancies. Aims and Objectives To study the spectrum of metastatic tumors to GI tract and elucidate their clinicopathological characteristics. Materials and Methods This was a retrospective study done on cases diagnosed from 2015 to 2023 at our institute. All cases of non-GI malignancies metastatic to hollow GI tract were included. Cases with GI primary, hematological malignancies, cases with exclusive serosal deposits, and direct invasion of a GI organ from an adjacent primary tumor were excluded. Apart from hematoxylin & eosin (H&E)-stained slides, immunohistochemistry findings of these were reviewed. Results Thirty-six patients were histologically proven GI metastases from non-GI malignancies diagnosed during the study period. Most cases were seen in 5th to 7th decade with a significant female preponderance (M:F of 1:8). The commonest metastatic GI sites were small bowel (n = 11), sigmoid colon (n = 9), and rectum (n = 7), followed by stomach (n = 3), appendix (n = 3), gall bladder (n = 2), and ampulla (n = 1). Stricture, perforation, and nodular mucosa were the most common endoscopic findings. The most common primary malignancies in females were ovarian serous carcinoma (n =21) followed by squamous cell carcinoma (SCC) of cervix (n = 8). In males, there was no site preference, and the primary sites included prostate, lung, kidney, and oral mucosa. Conclusion The study highlights the rare occurrence of GI metastases from non-GI malignancies. Females are at greater risk of such metastases primarily from ovarian serous carcinoma and cervical SCCs.

Systemic amyloidosis following inflammatory bowel disease, follicular lymphoma, and diffuse large B-cell lymphoma: a case report

Systemic amyloidosis is a rare disorder characterized by the widespread deposition of misfolded amyloid proteins in several organs, leading to organ failure and potentially death if not promptly recognized. The occurrence of inflammatory bowel disease (IBD), follicular lymphoma, and diffuse large B-cell lymphoma (DLBCL) developing into systemic amyloidosis is uncommon. Here is a case of a 55-year-old Asian woman with a history of IBD, follicular lymphoma, and abdominal DLBCL who developed systemic amyloidosis affecting her gastrointestinal, cardiac, and renal organs. Gastrointestinal symptoms (abdominal pain and melena) initially manifested in this patient with systemic amyloidosis. She underwent treatment with three cycles of rituximab and bendamustine. However, she passed away after 2 months of hospitalization due to multiple organ failure. Hence, physicians must be vigilant in recognizing amyloidosis as a potential complication of lymphoma or other inflammatory diseases, as early recognition can contribute to improved clinical outcomes.

Lack of cell proliferation activity in gastrointestinal organs in a subacute oral exposure of known tumor promoters in rats

Lack of cell proliferation activity in gastrointestinal organs in a subacute oral exposure of known tumor promoters in rats

Bioavailability profiling shows differences in OA, DTX1 and DTX2 toxins that justify their toxicity

The marine toxins of the Okadaic acid (OA) group are natural compounds produced by dinoflagellates that enters the food chain by accumulating in seafood. They are responsible for Diarrhetic Shellfish Poisoning (DSP) events in humans over the world and therefore are also jointly named as Diarrhetic Shellfish Toxins (DSTs). The main objective of this study was to evaluate symptoms, toxicity, absorption, distribution, and elimination of OA, Dinophysistoxin-1 (DTX1), and Dinophysistoxin-2 (DTX2) at the sublethal dose of 90 μg toxin/kg bw administered through voluntary feeding to mice. The toxin comparison highlighted that OA and DTX1 induced more severe and specific symptoms such as diarrhea. After oral ingestion toxins were distributed through the entire organism being detected in liver, kidney, stomach, small and large intestine. Predominant excretion of the toxins was observed in feces, with OA exhibiting fast elimination, while DTX2 was showing prolonged excretion. The passage and accumulation of toxins in gastrointestinal organs instigated macroscopic damage in the stomach, small and large intestine that could persist up to 120 h. These findings highlight the importance of pharmacokinetic of sublethal doses of DSTs administered by voluntary feeding in their toxicity and their implication for public health.

Effects of Platelet-Activating Factor (PAF) on the Mechanical Activities of Lower Urinary Tract and Genital Smooth Muscles.

Since its first discovery as a bioactive phospholipid inducing potent platelet aggregation, platelet-activating factor (PAF) has been shown to be involved in a wide variety of inflammatory and allergic disease states. Many pharmacological studies in the 1980s and 1990s also showed that PAF induces endothelium-dependent vascular relaxation and contraction of various smooth muscles (SMs), including those in the airway, gastrointestinal organs, and uterus. However, since the late 1990s, there have been few reports on the SM contractions induced by PAF. The lower urinary tract (LUT), particularly the urinary bladder (UB) has attracted recent attention in SM pharmacology research because patients with LUT dysfunctions including overactive bladder are increasing as the population ages. In addition, recent clinical studies have implicated the substantial role of PAF in the inflammatory state in LUT because its production increases with smoking and with cancer. However, the effects of PAF on mechanical activities of LUT SMs including UBSM have not been investigated to date. Recently, we found that PAF very strongly increased mechanical activities of UBSM in guinea pigs and mice, and partly elucidated the possible mechanisms underlying these actions of PAF. In this review, we describe the effects of PAF on LUT SMs by introducing our recent findings obtained in isolated UBSMs and discuss the physiological and pathophysiological significance. We also introduce our data showing the effects of PAF on the SM mechanical activities of genital tissues (prostate and vas deferens).

Efficacy and Safety of Valganciclovir in Congenital Cytomegalovirus Infection with Isolated Intrahepatic Cholestasis: A Randomized Controlled Trial.

Cytomegalovirus (CMV) infection affects the hepatic, neurologic, hematopoietic, respiratory, gastrointestinal, and other organs, resulting in a high mortality rate and long-term sequelae. It may cause acute or chronic hepatitis, or even lead to hepatic cirrhosis. Valganciclovir (VGCV) is an effective, safe, and well-tolerated treatment for congenital CMV infection, without any serious adverse effects. This study was conducted to evaluate the clinical, biochemical, and virological profiles of infants with CMV with intrahepatic cholestasis and to determine the outcomes with or without treatment with VGCV. Twenty infants aged <6 months diagnosed with congenital CMV infection with evidence of intrahepatic cholestasis were included in this study. Randomization was used to divide the study participants into 2 groups. The control group (n=10) was treated with only supportive management, and the intervention group (n=10) was treated with oral VGCV at 16 mg/kg/dose 12 hours a day for 6 weeks plus supportive treatments. Physical examinations and biochemical, serological, and virological tests were performed at the time of diagnosis and at the end of 6 weeks and 6 months. The control and intervention groups were compared in terms of clinical and laboratory parameters such as jaundice, dark urine, pale stool, hepatomegaly, total bilirubin, aminotransferases, gamma-glutamyl transferase, alkaline phosphatase, and CMV polymerase chain reaction load, which showed a significant reduction after treatment in the intervention group (p<0.05) with oral VGCV, with very few side effects, whereas the control group showed no significant changes. Oral VGCV can be used to effectively treat CMV infection with intrahepatic cholestasis without notable side effects.

An innovative educational approach to teach high school students the physiological mechanisms and nutrition concepts associated with the development of obesity.

An interdisciplinary team-teaching session was introduced to high school students who participated in the Oakland University William Beaumont Future Physician Summer Enrichment Program. The rising prevalence of adolescent obesity necessitates innovative educational strategies that effectively engage high school students in understanding the complex physiologic mechanisms and nutrition concepts underlying its development. This submission presents a session that is designed to integrate the physiological concepts and nutrition that are associated with the development of obesity. Foundational information about the different food ingredients and physiology of the gastrointestinal organ system followed by concepts associated with the development of obesity and its complications were introduced. The session was delivered using combined educational approaches such as a dialogical-narrative approach and hands-on application activities by two discipline experts, physiology and nutrition. This innovative approach was well received, as evidenced by high satisfaction rates among participants. While direct measures of critical thinking and practical skills development were not captured, the positive feedback suggests that students appreciated the engaging, hands-on application of theoretical concepts. The sessions fostered an awareness of personal health responsibilities, with students actively participating and connecting learned material with practical scenarios. We believe that using combined educational approaches in interdisciplinary team-teaching sessions promotes inclusiveness and interactive engagement and enhances long-life learning.NEW & NOTEWORTHY An interdisciplinary team-teaching session was introduced to high school students who participated in the Oakland University William Beaumont Future Physician Summer Enrichment Program. The session aimed to integrate physiological concepts and nutrition that are associated with the development of obesity. The session was delivered using combined educational approaches including a dialogical-narrative approach and hands-on application activity that are guided by combined learning theories such as dialogism, narrative, theories of engagement, and multimedia active learning.

Real-world safety profile of once-weekly semaglutide in people with type 2 diabetes: Analysis of pooled data from the SemaglUtide Real-world Evidence (SURE) programme.

To investigate, through post hoc analysis of nine studies from the SemaglUtide Real-world Evidence (SURE) programme,the safety of once-weekly (OW) semaglutide in adults with type 2 diabetes (T2D) and in subpopulations in routine clinical practice, complementing findings from the phase 3 randomized clinical trial (RCT) SUSTAIN programme. The SURE studies had a duration of ~30 weeks and included adults with diagnosed T2D treated with OW semaglutide. Safety information, including hypoglycaemic events, were collected and analysed for the total study population and for patient subgroups based on baseline patient characteristics, baseline co-medication and prescriber specialty. Of the total 3505 patients, 24.3% reported adverse events (AEs), with most patients reporting non-serious (22.3%) and mild (17.1%) AEs. AEs mainly belonged to the gastrointestinal disorders system organ class (16.3% of patients). In total, 5.1% of patients reported AEs that led to treatment discontinuation, 0.5% reported serious adverse drug reactions and 0.2% had an AE with a fatal outcome, reported as unrelated to treatment. Overall, 1.1% and 0.1% of patients reported level 2 and 3 hypoglycaemic events, respectively. A higher rate of level 2 hypoglycaemia was observed in patients with baseline microvascular complications treated with insulin versus those on insulin without these complications. Safety data reported in the real-world SURE studies were generally consistent with observations in phase 3 OW semaglutide RCTs. No new safety concerns were identified, highlighting that OW semaglutide is well tolerated by adults with T2D and in subpopulations in routine clinical practice.

Comparative study of gastrointestinal tract size in three parent breeds for the production of dual-purpose organic chickens.

An alternative to culling male hatchlings of layers is breeding dual-purpose chickens. One breeding objective is the ability to digest low-quality feed. Certain measurements of the gastrointestinal tract may be useful indicators of this ability. The present study compared the gastrointestinal tract of adult hens of two layer-type breeds (White Rock (WR), New Hampshire (NH)) and the meat-type ÖTZ (Ökologische Tierzucht gGmbH) Bresse Gauloise (BR), used for the production of dual-purpose organic chickens. Flocks had the same housing and feeding conditions. At slaughter at 19 months, the body weight and gastrointestinal organs of 134 hens (51 WR, 55 NH and 28 BR) were measured. The muscle thickness of the proventriculus and ventriculus and the length and width of the duodenum, jejunoileum, caeca and colorectum were measured and variances between the groups were analysed using a one-factor covariance analysis. Significant differences between the breeds were found in total intestine length and the lengths and/or widths of single gastrointestinal segments. For example NH showed the highest mean total intestinal length and BR showed the lowest mean (NH: 186.73 cm, WR 185.86 cm, BR 157.91 cm; p = 0.001). To our knowledge, this is the first study comparing the gastrointestinal tract size of adult female layer- and meat-type chicken breeds kept under the same feeding and housing conditions. Given the possible relationship between intestinal length parameters and chicken performance, measurement of the gastrointestinal tract may be a simple, quick and inexpensive additional method to help select layer-, meat-type and dual-purpose chickens suitable for organic production when a selection process using genetic markers is not possible.

Treatment outcome of localized prostate cancer using transperineal ultrasound image-guided radiotherapy

BackgroundWe report the results of a retrospective analysis of localized prostate cancer (LPCa) treated with transperineal ultrasound image-guided radiotherapy (TPUS-IGRT).MethodsA total of 124 patients (median age: 74 y, 46–84 y) with LPCa who underwent TPUS-IGRT (Clarity Autoscan system; CAS, Elekta; Stockholm, Sweden) between April 2016 and October 2021 for curative/after hormone induction were enrolled. The number of patients by risk (National Comprehensive Cancer Network 2019) was 7, 25, 42, and 50 for low (LR), good intermediate (good IR), poor intermediate (poor IR), and high (HR)/very high (VHR), respectively. Ninety-five patients were given neoadjuvant hormonal therapy. The planning target volume margin setting was 3 mm for rectal in most cases, 5–7 mm for superior/inferior, and 5 mm for anterior/right/left. The principle prescribed dose is 74 Gy (LR), 76 Gy (good IR), and 76–78 Gy (poor IR or above). CAS was equipped with a real-time prostate intrafraction monitoring (RTPIFM) system. When a displacement of 2–3 mm or more was detected, irradiation was paused, and the patients were placed on standby for prostate reinstatement/recorrection. Of the 3135 fractions in 85 patients for whom RTPIFM was performed, 1008 fractions (32.1%) were recorrected at least once after starting irradiation.ResultsA total of 123 patients completed the radiotherapy course. The 5-year overall survival rate was 95.9%. The 5-year biological prostate-specific antigen relapse-free survival rate (bPFS) was 100% for LR, 92.9% for intermediate IR, and 93.2% for HR/VHR (Phoenix method). The 5-year late toxicity rate of Grade 2+ was 7.4% for genitourinary (GU) and 6.5% for gastrointestinal (GI) organs. Comparing the ≤ 76 Gy group to the 78 Gy group for both GU and GI organs, the incidence was higher in the 78 Gy group for both groups.ConclusionThese results suggest that TPUS-IGRT is well tolerated, as the bPFS and incidence of late toxicity are almost comparable to those reported by other sources of image-guided radiotherapy.

Establishing the Interrelations of the Laboratory Parameters in the Gut-Kidney Axis in Cats with Signs of Triple Phosphate Urolithiasis

Introduction. Efficient treatment of the feline urolithiasis much depends on the early diagnosis of the disease, however, the diagnostic algorithm of this type of pathology is extremely poor due to the various reasons, in particular, it does not take into account the interrelations in the gut-kidney axis. Analysis of the state of gastrointestinal tract functioning and the composition of the gut microbiota can improve the potential of diagnosing the urolithiasis, predict the risk, improve the prognosis and choose the correct treatment strategy. The aim of this publication is to establish the interrelations of the laboratory parameters in the gut-kidney axis in cats with struvite urolithiasis with the signs of cystolithiasis.Materials and Methods. The objects of the research were the outbred cats with the triple phosphate urolithiasis with the signs of cystolithiasis: 1st experimental group — females; 2nd experimental group — neutered males; the control group — clinically healthy animals of both sexes. The laboratory and clinical examinations of sick animals included: ultrasonography of abdominal organs; macroscopic and biochemical urine tests; microscopy of urine sediment and urine culture test without determination of antibiotic sensitivity; macroscopic, microscopic and simple chemical examinations of freshly excreted feces; bacteriological culture test of rectal flushes without determination of antibiotic sensitivity.Results. In the urine of cats of the experimental groups, under the activity of gram-negative microorganisms Escherichia coli (0.03±0.01×106 CFU (colony forming units) and 1.00±0.03×106 CFU) and gram-positive microorganisms Staphilococcus intermedius (1.05±0.07×106 CFU and 1.00±0.08×107 CFU) there were recorded within the microscope field of view: alkalization, development of hypersthenuria, proteinuria, hypercalciuria, hematuria, including microhematuria and leukocyturia, crystalluria. The results of coprological examinations in sick cats indicated the presence of stercobilin, well-digested muscle fibres, undigested and digested cellulose, extracellular and intracellular starch, as well as impurities of non-food origin (wool). The data of microbiological examinations of feces indicated the growth of Escherichia coli (1.00±0.05×105 CFU and 1.04±0.08×107 CFU). Along with the cystolytiasis, the acoustic shadowing of the gastrointestinal tract organs in the experimental animals revealed the hyperechogenicity of liver capsule and parenchyma and heterogeneity of the pattern.Discussion and Conclusion. The revealed character of the laboratory parameter changes in the experimental animals, such as the increase of protein and creatinine levels in urine and growth of Escherichia coli in feces, proved the existence of the pathogenetic relationship between the urogenital tract lesion caused by the gram-negative microorganisms and the gut microbiota in the gut-kidney axis. The results of our study of the sick animals’ urine indicated on the infection of the urogenital tract with the urease-producing microorganisms, which led to the alkalization of urine and formation of the infection struvite stones. Urolithiasis, in turn, had an impact on the gut microbiome due to the topographic proximity of the urogenital and gastrointestinal tracts: examination of feces in cats of the experimental group had confirmed the disorder of gastrointestinal tract functioning due to dysbiotic processes in the large intestine.

Controlled Reversible Visceral Arterial Ischemia, Venous Congestion and Combined Malperfusion via Midline Laparotomy in Rats.

Besides sepsis and malignancy, malperfusion is the third leading cause of tissue degradation and a major pathomechanism for various medical and surgical conditions. Despite significant developments such as bypass surgery, endovascular procedures, extracorporeal membrane oxygenation, and artificial blood substitutes, tissue malperfusion, especially of visceral organs, remains a pressing issue in patient care. The demand for further research on biomedical processes and possible interventions is high. Valid biological models are of utmost importance in enabling this kind of research. Due to the multifactorial aspects of tissue perfusion research, which include not only cell biology but also vascular microanatomy and rheology, an appropriate model requires a degree of biological complexity that only an animal model can provide, rendering rodents the obvious model of choice. Tissue malperfusion can be differentiated into three distinct conditions: (1) isolated arterial ischemia, (2) isolated venous congestion, and (3) combined malperfusion. This article presents a detailed step-by-step protocol for the controlled and reversible induction of these three types of visceral malperfusion via midline laparotomy and clamping of the abdominal aorta and caval vein in rats, underscoring the significance of precise surgical methodology to guarantee uniform and dependable results. Prime examples of possible applications of this model include the development and validation of innovative intraoperative imaging modalities, such as Hyperspectral Imaging (HSI), to objectively visualize and differentiate malperfusion of gastrointestinal, gynecological, and urological organs.

PCSK9 Inhibitors and Infection-Related Adverse Events: A Pharmacovigilance Study Using the World Health Organization VigiBase.

Protein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) are novel lipid-lowering agents used in patients with cardiovascular disease. Despite reassuring safety data from pivotal trials, increasing evidence from real-world studies suggests that PCSK9i increase the risk of bacterial and viral infections. Therefore, this study aimed to identify signals of infection-related adverse events (AEs) associated with PCSK9i. We performed an observational pharmacovigilance study using the World Health Organization's VigiBase, recorded up to December 2022. We included individual case safety reports (ICSRs) of PCSK9 inhibitors, alirocumab and evolocumab, and compared them with those of other drugs. Infection-related ICSRs were retrieved from the Medical Dictionary for Regulatory Activities System Organ Class 'infections and infestations.' Among 114,293 reports (258,099 drug-AE pairs) related to PCSK9 inhibitors, 54% included female patients, 41% included patients aged ≥65 years, and 82% included patients who received evolocumab. Additionally, beyond AEs recognized by regulatory authorities, organ infections such as influenza (reporting odds ratio [ROR] 2.89, 95% confidence interval [CI] 2.74-3.05), gastric infections (ROR 2.47, 95% CI 1.63-3.75), and kidney infections (ROR 1.36, 95% CI 1.06-1.73) were observed. Sensitivity analysis indicated a heightened risk of infection-related AEs associated with PCSK9i regardless of the specific drug type. In addition to the labelled respiratory infections, six infection-related symptoms in the gastrointestinal, urinary, and renal organs were identified. Our findings support the need for systematic surveillance of infections among PCSK9i users.

Illness is more prevalent than injury in trail runners participating in a mountainous ultra trail race

ABSTRACT Objectives Trail running is a popular off-road sport involving running in natural environments over various terrains, often in remote locations. This study aims to investigate the epidemiology and risk factors of injuries and illnesses, i.e. medical encounters, on race day among trail runners in a high-altitude ultra trail race. Methods This descriptive cross-sectional study on an ultra trail race (38 km, 65 km and 100 km) in South Africa, included participants 18 years or older. Of the 331 race participants, 285(86.1%) consented to participate in the study. Data collection included demographic details, injuries (body region, specific body area, tissue type, pathology) and illnesses (organ system, symptom cluster, etiology). Risk factor analysis includes sex, age, weight, height, race distance, illness and injury history, training and running experience. Frequency (n, %), prevalence (%) and odds ratios (OR; 95%CI) are reported. Results Eighty-nine (31.2%) individuals reported 131 medical encounters [49 injuries (37.4%); 82 illnesses (62.6%)]. Injuries were sustained by 14.7% of athletes, and 22.5% reported illnesses. For injuries, the lower limb was mainly involved (n = 41; 83.7%). Most injuries affected the foot (n = 18; 36.7%), ankle (n = 10; 20.4%) and knee (n = 7; 14.3%). Tissue types mainly involved skin (n = 21; 42.8%), ligament (n = 7; 14.3%) and muscle (n = 7; 14.3%). Multiple (n = 45; 54.9%) and gastrointestinal (n = 17; 20.7%) organ systems were mainly involved in illnesses. Only 100 km runners reported dehydration (n = 28; 31.5%), and one in every six of these runners (n = 5; 17.9%) did not finish. Runners reporting fatigue (n = 21; 23.6%) had a high (n = 8; 38.1%) did not finish rate. Two in every five participants (n = 36; 40.4%) with a medical encounter, did not finish. No medical encounter-associated risk factors were identified. Conclusions Illnesses were more common than injuries during the mountainous ultra trail race. Sustaining a medical encounter increased the chance of not completing the race. Further research on the epidemiology of race day medical encounters in trail running is required.

Intestinal protection by nitric oxide supply in the simulation of artificial blood circulation and circulatory arrest: an experimental study

Cardiac surgery is associated with high risks of complications, and these risks increase when it comes to aortic surgery because of the technical complexity of the surgeries, the use of cardiopulmonary bypass (CPB) and “circulatory arrest” (CA) that leads to ischemia-reperfusion damage. Abdominal complications in cardiovascular surgery are not the most common complications but are associated with high mortality. Protecting the gastrointestinal (GI) organs from ischemia-reperfusion injury is still a serious problem. According to a study of the organoprotective properties of nitric oxide (NO), its effectiveness in the treatment of diseases of the cardiovascular system, lungs, and kidneys has been proven, and observational results have shown that patients who were administered NO were less prone to complications from the gastrointestinal tract.The aim of the study was to evaluate the protective properties of NO for the intestines during simulated surgery under CPB and hypothermic CA. Methods. The study was conducted on sheep (n = 24). The animals were divided into 4 groups: the “CPB” group with the standard CPB protocol, the “CPB + NO” group with CPB and NO administration, the “CPB + CA” group with the standard CPB and CA protocol, and the group “CPB + CA + NO” with CPB and CA and NO administration. Instrumental and laboratory parameters were monitored at all stages of the experiment to assess the effectiveness and safety of CPB and CA simulation. In intestinal biopsy samples, the changes in the defecation rate, the concentration of a biochemical marker of intestinal ischemia (intestinal enterocyte fatty acid binding protein – i-FABP), and tissue concentrations of adenosine triphosphate (ATP) and lactate were assessed.Results. A higher rate of defecation was established (p = 0.046) in the “CPB + NO” group after CPB compared to the “CPB” group. The concentration of i-FABP in the CPB + NO group after CPB was lower compared to that in the CPB group (p = 0.002), and it was lower in the “CPB + CA + NO” group compared to the “CPB + CA” group (p = 0.033). 1 hour after CPB, the tissue concentration of ATP in intestinal biopsies in the “CPB + NO” group was higher than in the CPB group (p = 0.005).Conclusion. When modeling CPB and CA in the experiment, a positive effect of NO therapy on the intestine was noted: the functional state improved, the concentration of i-FABP decreased, and the concentration of ATP in intestinal biopsies increased.

Clinicopathologic Features of Gastrointestinal Tract Langerhans Cell Histiocytosis

Gastrointestinal (GI) tract involvement by Langerhans cell histiocytosis (LCH) is rare and its clinicopathologic characteristics have only been described in case reports and small series. We reviewed hematoxylin and eosin and CD1a, S100, and Langerin immunohistochemical–stained slides from 47 patients with well-documented demographic and clinical findings. Our cases included 8 children and 39 adults, with a mean follow-up of 63 months. All pediatric patients had concurrent multisystem LCH, presented with GI symptoms, and showed nonpolypoid lesions. Seven (88%) showed multifocal GI disease, including 5 with multiple GI organ involvement. All sampled lesions from children exhibited infiltrative growth. More than half had died of the disease or manifested persistent LCH at last follow-up. Twenty-five of 39 (64%) adults had LCH involving only the GI tract (single system), with the remaining 14 (36%) exhibiting multisystem disease. Adult single-system GI LCH was typically encountered incidentally on screening/surveillance endoscopy (72%). Most exhibited isolated colorectal involvement (88%) as a solitary polyp (92%), with a well-demarcated/noninfiltrative growth pattern (70%), and excellent prognosis (100%). In comparison, adult patients with multisystem LCH more frequently presented with GI symptoms (92%, P < .001), noncolorectal GI site involvement (50%, P = .02), multifocal GI lesions (43%, P = .005), nonpolypoid lesions (71%, P < .001), infiltrative histologic growth pattern (78%, P = .04), and persistent disease (57%, P < .001). Adult patients with multisystem LCH appear to exhibit similar clinicopathologic features to those of pediatric patients. These results demonstrated that adults with single-system LCH involving the GI tract have an excellent prognosis, whereas multisystem LCH occurring at any age carries an unfavorable prognosis. High-risk features of GI LCH include pediatric age, GI symptomatology, noncolorectal GI involvement, multifocal GI disease, nonpolypoid lesions, and infiltrative growth pattern.

Selective and sensitive CQD-based sensing platform for Cu2+ detection in Wilson’s disease

Excessive Cu2+ intake can cause neurological disorders (e.g. Wilson’s disease) and adversely affect the gastrointestinal, liver, and kidney organs. The presence of Cu2+ is strongly linked to the emergence and progression of Wilson's disease (WD), and accurately measuring the amount of copper is a crucial step in diagnosing WD at an early stage in a clinical setting. In this work, CQDs were fabricated through a facile technique as a novel fluorescence-based sensing platform for detecting Cu(II) in aqueous solutions, and in the serum samples of healthy and affected individuals by WD. The CQDs interact with Cu(II) ions to produce Turn-on and Turn-off states at nano-molar and micro-molar levels, respectively, with LODs of 0.001 µM and 1 µM. In fact, the Cu2+ ions can act like a bridge between two CQDs by which the charge and electron transfer between the CQDs may increase, possibly can have significant effects on the spectroscopic features of the CQDs. To the best of our knowledge, this is the first reported research that can detect Cu(II) at low levels using two different complexation states, with promising results in testing serum. The potential of the sensor to detect Cu(II) was tested on serum samples from healthy and affected individuals by WD, and compared to results obtained by ICP-OES. Astonishingly, the results showed an excellent correlation between the measured Cu(II) levels using the proposed technique and ICP-OES, indicating the high potential of the fluorimetric CQD-based probe for Cu(II) detection. The accuracy, sensitivity, selectivity, high precision, accuracy, and applicability of the probe toward Cu(II) ions make it a potential diagnostic tool for Wilson's disease in a clinical setting.

ADVANCEMENTS IN UNDERSTANDING THE MOLECULAR MECHANISMS REGULATING URIC ACID METABOLISM IN THE INTESTINE

This review provides contemporary insights into the direct and indirect pathogenetic connections between purine compound metabolism and biochemical processes within the cells of the gastrointestinal system. A thorough analysis of recent publications from 2000 to 2024, sourced from databases including Scopus, PubMed, eLIIBRARY, and Google Scholar, was conducted. Uric acid serves as the end product of purine-containing compound catabolism. Its concentration is intricately regulated through the collaboration of the kidneys and gastrointestinal organs, namely the small intestine and liver. Gout, a chronic condition, emerges from the interplay between molecular genetic factors and external influences. Elevated levels of urates in the blood serum (hyperuricemia) and the deposition of sodium urate crystals in organs and tissues set off a cascade of inflammatory and fibrotic processes within mucosal, smooth muscle, parenchymal, and endothelial cells, including those within the gastrointestinal tract. Normally, a person excretes about 1.5 g of uric acid per day. Under physiological conditions, two-thirds of uric acid is excreted from the body by the kidneys, one-third through the intestines, and a small part is excreted with bile. The hypothesis that links the pathogenesis of hyperuricemia with “renal overload” suggests that the disease may develop as a result of impaired renal excretion with insufficient elimination of uric acid through the intestines. Part of uric acid transport systems actively works in hepatocytes and enterocytes, which determines its formation and clearance. Uric acid transporter proteins are divided into two categories: urate reabsorption transporters and urate excretion transporters, their expression is regulated by transcription factors, hormones and metabolites of intestinal microflora. The influence of intestinal microbiota on uric acid metabolism is related to its participation in purine metabolism, decomposition and elimination of uric acid with metabolites of intestinal flora and inhibition of gouty inflammation and is evaluated as a new therapeutic potential in gout and hyperuricemia, which allows to avoid kidney damage and urolithiasis.

Clinical case of median arcuate ligament syndrome in the practice of a pediatric surgeon

Recurrent abdominal pain in childhood and adolescence may be indicative of chronic mesenteric ischemia with median arcuate ligament syndrome as a result of compression of the celiac artery by the median arcuate ligament of the diaphragm and its internal crura, neurofibrous tissue of the celiac plexus. The presence of symptoms characteristic of various diseases of gastrointestinal tract organs, absence of pathognomonic signs and complex approach in diagnostics of abdominal cavity vascular system, insufficient awareness of specialists of children’s outpatient clinics determine the urgency of timely diagnostics and treatment of patients with this pathology. Median arcuate ligament syndrome, or Dunbar syndrome, is more often a congenital malformation. This syndrome can be considered as an acquired pathology in the case of compression of the celiac artery by enlarged lymph nodes and neurofibrous tissue of the celiac plexus. In addition to hemodynamically significant disorders of blood supply to the gastrointestinal tract, Dunbar syndrome in children and adolescents is also accompanied by psycho-emotional disorders due to the presence of unstable stools, recurrent abdominal pain, and often repeated ineffective requests for medical care. Clinical observation, methods of diagnosis and surgical treatment of median arcuate ligament syndrome in a 14-year-old patient are presented in the study.