Large Stomach Research Articles

Abstract 3817: Deciphering the immune system in small intestine: Multiplex strategies for inflammatory bowel disease

Abstract Introduction Inflammatory bowel disease (IBD) can affect the lower part of the small intestine (ileum) and the colon. It can, however, occur in any part of the large intestine, small intestine, or stomach. Recent evidence suggests that several factors may tip the balance between homeostasis and intestinal inflammation, presenting future challenges for the development of new therapies for IBD. In this study, we use normal small intestine as a model to identify multiple immune targets using mouse and rabbit monoclonal antibodies. Peyer Patches are lymphoid tissues in the wall of the small intestine that are involved in the development of immunity to antigens presented in that milieu. Small intestine and cases of IBD were evaluated as a potential model using immunohistochemistry (IHC) to identify categories of immune cells including cytotoxic T-cells, costimulatory cells (agonists), T-regulatory cells (TREGs), T-cell effector cells (regulators) and checkpoint inhibitors. cases of IBD were also examined for the utilization of single and double/triple stains. Design Formalin-fixed paraffin-embedded cases of small intestine and IBD were cut to 4 micron thickness and stained with H&E. Mouse and rabbit monoclonal antibodies including CD56 (natural killer cells), CD163 (macrophages), CD8 and CD4 (cytotoxic T-cells and helper T- cells), CD103, OX40 and CD137 (costimulatory), FOXP3 and LAG3 (TREGs), T-bet and RORγT (T-cell effectors), and PD-1 and PD-L1 (immune checkpoints) were tittered for optimization and evaluated for IHC. Several IHC multiplex stains (double and triple stains) were also developed and compared with the relevant single stains. Results Single, double and triple stains utilizing CD56, CD163, CD4, CD8, CD103, OX40, CD137, FOXP3, LAG3, T-Bet, RORγT, PD-1 and PD-L1 antibodies were successfully established using small intestine as staining model for IBD cases. All single stains versus double and triple stains gave equivalent results. Double stains and/or co-expression of CD8 + CD103, CD8 + PD-1, and triple stain CD8 + PD-1 + FOXP3 were easily visualized with blue, brown, red or black chromogen staining. Conclusion Small intestine is a good model to develop single or multiplex stains for a host of immune cell targets. Enhanced visualization of these targets is possible with the use of double and triple stains; thus, this technique may help facilitate acquisition of important prognostic information and help support new strategies for inflammatory bowel disease in targeted therapeutic treatment. Note: This abstract was not presented at the meeting. Citation Format: David Altree-Tacha, Wei Wei Yuan, George Yang. Deciphering the immune system in small intestine: Multiplex strategies for inflammatory bowel disease [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3817. doi:10.1158/1538-7445.AM2017-3817

The Complete Embryonic and Larval Stages of the Oophagous FrogKurixalus eiffingeri(Rhacophoridae)

Abstract: We studied and documented the normal development of the tree-hole breeding frog Kurixalus eiffingeri from oocyte to completion of metamorphosis in the laboratory at a temperature of 25±2 C. We divided its development into 46 stages and then described and illustrated its external features at each stage. Uncleft eggs at the stage 1 of development were 2.10 mm (SD=0.14) in diameter. Most larvae hatched at the stage 25, usually by seven days after fertilization. Soon after hatching, tadpoles fed on unfertilized eggs that were supplied periodically by the parent female as observed in the field. Dorsally situated eyes, a frontally placed mouth, scarce teeth (dental formula 2/2), and a large stomach of this tadpole may be adaptive for eating trophic eggs that are generally soft and supplied periodically from the surface of water. By 43 days on the average, the tadpoles attained their maximum size, reaching stage 41 and 29.74 mm (SD=1.13) in total length, with a relatively long tail, which is also an ad...

Closure of large full thickness stomach wall defect with a newly designed hemostatic clip

Objective To design a hemostatic clip and evaluate its efficacy and success rate of closure of stomach wall defect after full thickness resection (FTR). Methods A full thickness circular or linear resection (3 to 5 cm) was made on each model's antrum with needle knife and insulated-tip knife. The specimens were divided into 2 groups, using either an interrupted or continuous suturing method. Then the closure condition, suturing time, number of clips required and success rate of closure were compared. Results All 12 defects were successfully closed. The average closing time of interrupted and continuous suturing group were 13.33±1.09 and 10.17±2.11 minutes, and the mean number of clips used were 4.67±0.82 and 2.67±0.82. The success rate was 100%. Conclusion This newly designed clip is a fast, reliable and convenient tool for stomach wall defect closure after FTR. Key words: Suture techniques; Hemostatic clip; Stomach wall defect; Treatment

Assessment of the length of myotomy in peroral endoscopic pyloromyotomy (G-POEM) using a submucosal tunnel technique (video).

Peroral endoscopic pyloromyotomy is a novel technique that has recently been described in the literature. There is little data to guide the length of myotomy created. The aim of study was to evaluate the proper incision length of the muscular layer during peroral endoscopic pyloromyotomy using a submucosal tunnel technique. The study was designed as a prospective ex vivo study. Fresh ex vivo porcine stomachs from animals weighing 80-100 kg and porcine stomachs from animals weighing 15-25 kg were used for pyloromyotomy. Four different myotomy lengths (1, 2, 3, and 4) were compared in the large animal series and three different myotomy lengths (1, 2, and 3) were compared in the small series. A total of 23 cases of the submucosal tunnel technique were performed by two endoscopists using 12 large stomachs and 11 small stomachs. The mean overall procedure time (± SD) of pyloromyotomy was 65.7 (± 14.3) min. In the large stomach series, the mean pyloric diameter (± SD) and change from baseline (as percentage) following a 1, 2, 3, and 4 pyloromyotomy were 13.3 ± 9.5 mm (7.1 %), 20.7 ± 11.7 mm (10.6 %), 31.1 ± 15.0 mm (15.2 %), and 33.0 ± 15.0 mm (16.0 %), respectively. In the small stomach series, the changes of mean pyloric diameter following a 1, 2, and 3 cm pyloromyotomy were 12.2 ± 5.6 mm (7.5 %), 23.1 ± 7.6 mm (13.1 %), and 28.0 ± 10.4 mm (15.5 %), respectively. A 3 cm pyloromyotomy for a large animal series and 2 cm for the small animal series appeared to be most appropriate for enlargement of the pylorus.

A Hepatoid Adenocarcinoma of the Stomach Evaluated With 18F-FDG PET/CT

The condition of a 55-year-old man was diagnosed with unresectable advanced gastric cancer, and initial biopsy revealed adenocarcinoma. On evaluation of treatment response after chemotherapy, F-FDG PET/CT showed large residual stomach cancer with increased FDG uptake (SUVmax, 13.6), lymph node metastasis with mild FDG uptake (SUVmax, 2.5), and no distant metastasis. Palliative subtotal gastrectomy was done, and the finding was hepatoid adenocarcinoma. Compared with the previous report of Pan et al (Clin Nucl Med. 2011;36:1137-1139), our patient had more increased FDG uptake of SUVmax (13.6 vs 1.9) in the gastric mass and lymph node metastases but no liver metastasis.

Braun Gastrointestinal Bypass Surgery Exerts Similar Hypoglycemic Effects, with Minimal Operation Time and Earlier Functional Recovery, than Roux-en-Y Bypass in Type 2 Diabetic Rats

Despite the beneficial hypoglycemic and potentially curative effects in type 2 diabetes, large stomach volume deficits caused by Roux-en-Y gastrointestinal bypass (RYGB) surgery increase complications. Hypoglycemic effects of Braun surgery and RYGB surgery, both modified to maximally preserve stomach volume, were compared in rat type 2 diabetes models. Three-month-old, male Goto-Kakizaki (GK) rats (n = 40) were randomly divided into equal groups and not treated (control) or treated with sham surgery (sham group), modified stomach-preserving Braun gastrointestinal bypass (Braun group), or modified RYGB (RYGB group). Pre- and postoperative body weight and water intake were recorded, along with operative and defecation times. Fasting blood glucose at 12h, and blood glucose 180min after intragastric glucose administration, were measured at weeks 1, 2, 3, 4, 10, and 11 along with glycosylated hemoglobin (preoperatively, week 11). Statistically similar (P > 0.05) increased body weight and decreased water intake, fasting blood glucose, blood glucose after intragastric glucose administration, and glycosylated hemoglobin were observed in Braun and RYGB groups compared with control and sham groups (P < 0.05). By week 1, RYGB and Braun groups exhibited sustained reductions in fasting blood glucose from 13.0 ± 4.1 to 6.9 ± 1.4mmol/L and 12.4 ± 4.4 to 7.3 ± 0.9mmol/L, respectively (P < 0.05); mean operative times were 139.1 ± 4.9 and 81.6 ± 6.4min, respectively; and postoperative defecation times were 74.3 ± 3.1 and 29.4 ± 4.1h, respectively (P < 0.05). Stomach volume-preserving Braun gastrointestinal bypass surgery was faster and produced hypoglycemic effects similar to RYGB bypass surgery, potentially minimizing metabolic disruption.

Spatial distribution of the stomach weights of juvenile anchovy (Engraulis encrasicolus L.) in the Bay of Biscay

Abstract Bachiller, E., Cotano, U., Boyra, G., and Irigoien, X. 2013. Spatial distribution of the stomach weights of juvenile anchovy (Engraulis encrasicolus L.) in the Bay of Biscay. – ICES Journal of Marine Science, 70: 362–378. Previous studies have shown that the survival of larval and juvenile anchovy off the continental shelf in the Bay of Biscay is not significantly different from that observed on the shelf, even though the food concentration is significantly higher on the shelf. In this paper we investigate the causes for the lack of relationship between food and survival for anchovy juvenile through analyses of feeding activity versus zooplankton distribution (in the transition from summer to fall from 2003 to 2010). The spatial distribution of the stomach weights of juvenile anchovy in relation to body size on and off the shelf revealed higher stomach fullness in areas off the shelf, where less zooplankton biomass was available. This result indicates that the food concentration is not always the main factor determining ingestion in fish. A situation of comparatively lesser prey abundance may provide better feeding conditions when combined with lower predation risk and lower light attenuation. In addition, the relatively heavier stomachs found in anchovies caught in years of higher recruitment indices suggest a large stomach content may be a symptom of good biological condition that may favour the winter survival of a larger fraction of the juvenile stock.

Genetic variation of Haemonchus contortus (Trichostrongylidae) in sheep and goats from Malaysia and Yemen

The large stomach worm, Haemonchus contortus, commonly known as “the barber's pole worm”, is a blood-sucking nematode found in the abomasa of sheep and goats. This work is the first documentation on the ND4 sequences of H. contortus from sheep and goats in Malaysia and Yemen and the results provide a preliminary insight on the genetic differences of H. contortus found in the two countries. In general, this study showed a high degree of diversity and low population structure of this species within the same country in comparison with higher genetic structuring at a wider geographical scale. The results also showed that the majority of genetic variance was within H. contortus populations. The Malaysian sheep and goat populations investigated appeared to share the same isolate of H. contortus while different isolates may be found in Yemen which must be taken into account in the design of an effective control strategy. Analysis of the internal transcribed spacer-2 (ITS-2) confirmed that all samples investigated in this study belonged to H. contortus. However presence of other Haemonchus species parasitizing these two hosts can only be confirmed by further detailed studies.

A New Stalked Filter-Feeder from the Middle Cambrian Burgess Shale, British Columbia, Canada

Burgess Shale-type deposits provide invaluable insights into the early evolution of body plans and the ecological structure of Cambrian communities, but a number of species, continue to defy phylogenetic interpretations. Here we extend this list to include a new soft-bodied animal, Siphusauctum gregarium n. gen. and n. sp., from the Tulip Beds (Campsite Cliff Shale Member, Burgess Shale Formation) of Mount Stephen (Yoho National Park, British Columbia). With 1,133 specimens collected, S. gregarium is clearly the most abundant animal from this locality.This stalked animal (reaching at least 20 cm in length), has a large ovoid calyx connected to a narrow bilayered stem and a small flattened or bulb-like holdfast. The calyx is enclosed by a flexible sheath with six small openings at the base, and a central terminal anus near the top encircled by indistinct openings. A prominent organ, represented by six radially symmetrical segments with comb-like elements, surrounds an internal body cavity with a large stomach, conical median gut and straight intestine. Siphusauctum gregarium was probably an active filter-feeder, with water passing through the calyx openings, capturing food particles with its comb-like elements. It often occurs in large assemblages on single bedding planes suggesting a gregarious lifestyle, with the animal living in high tier clusters. These were probably buried en masse more or less in-situ by rapid mud flow events. Siphusauctum gregarium resembles Dinomischus, another Cambrian enigmatic stalked animal. Principal points of comparison include a long stem with a calyx containing a visceral mass and bract-like elements, and a similar lifestyle albeit occupying different tiering levels. The presence in both animals of a digestive tract with a potential stomach and anus suggest a grade of organization within bilaterians, but relationships with extant phyla are not straightforward. Thus, the broader affinities of S. gregarium remain largely unconstrained.

Diagnosis of large stomach stone: A report of one case

Diagnosis of large stomach stone: A report of one case

Phenotypic differences of Haemonchus contortus from sheep and goats in the States of Perak and Kelantan, Peninsular Malaysia

AbstractThe large stomach worm, Haemonchus contortus is a highly pathogenic nematode parasite of sheep (Ovis aries) and goats (Capra hircus). It sucks blood and causes acute disease, anaemia and severe economic losses due to morbidity and mortality. This paper compares characteristics of surface cuticular ridges (synlophe) and morphometrics of total body length, cervical papillae, spicules, barbs, gubernaculum and vulvar flap morphology of H. contortus recovered in the two hosts from the States of Perak and Kelantan, Peninsular Malaysia. The morphological variation in H. contortus samples recovered from the two hosts in Kelantan was found to be higher than from Perak. A discriminant function, based on three measurements of the spicule, confirmed the identity of male worms in the two hosts as belonging to the same species H. contortus.

Trachypithecus cristatus (Primates: Cercopithecidae)

Trachypithecus cristatus (Raffles, 1821), silvered lutung, is a colobine monkey of the Malay Peninsula and Archipelago. It has a pointed crest and outward-projecting cheek hairs, and gray skin and pelage with some grayish white hairs that are lighter distally, giving a silvered appearance. Diurnal and arboreal, it runs and jumps quadrupedally, with limited semibrachiation. Its large stomach and foregut fermentation allow it to digest a diet with a high proportion of leaves. It lives in single male-multifemale groups and smaller multimale groups in a polygynous, cooperative-breeding mating system. As with other nonhuman primates, it is threatened throughout its range by logging, hunting for meat and medicinal uses, and capture for the pet trade. DOI: 10.1644/862.1.

Bloody Emesis in a Newborn

A 6-day-old term male born via spontaneous vaginal delivery was transferred to the neonatal intensive care unit because of difficulty feeding, abdominal distention, and bloody emesis. The infant was born to a 28-year-old gravida 2 para 1 Hispanic mother. The pregnancy and the delivery were uncomplicated. The Apgar scores were 8 and 9 at 1 and 5 minutes, respectively. On the second postnatal day, the infant experienced frequent “spit-ups,” abdominal distention, and an episode of “coffee-ground” emesis. Feedings were held and a kidney-ureter-bladder (KUB) radiograph was obtained, which revealed a large stomach bubble with scant distal bowel gas. The patient remained NPO for the next 24 hours. Over the next several days, attempted feedings were unsuccessful. A KUB radiograph obtained on arrival at the neonatal intensive care unit revealed significant stomach distention with minimal distal bowel gas. ### Vital Signs ### Admission Laboratory Studies

Calculation of radiation doses to human organs from consumption of marine fish

In the present work, radiation doses are estimated from the analysis of 40K, 137Cs, 226Ra and 228Ra radionuclides in marine fish of the Bay of Bengal, accumulated in ten different human organs: red marrow, lung, thyroid, lower large intestine, upper large intestine, small intestine, breast, stomach, gonads and bone surface. The lowest equivalent dose is calculated in the thyroid as 2.7×10−3 µSv/y and the highest on the bone surface as 1.1×10−1 µSv/y. The effective dose due to 226Ra is the highest (1.2×10−1 µSv/y) in the whole body, whereas the lowest dose is for 40K (3.6×10−2 µSv/y).

Gastrointestinal: Infantile hypertrophic pyloric stenosis

Infantile hypertrophic pyloric stenosis causes gastric outlet obstruction because of anatomical changes around the pyloric canal. The most important change is abnormal thickening of the circular muscle that is often associated with redundant pyloric mucosa. The incidence ranges from 1 to 8 per 1000 live births and males are more commonly affected than females (ratio 4:1). The etiology remains unclear but cases cluster within families and associations have been reported with a variety of congenital disorders including Hirschsprung disease and esophageal atresia. The typical symptom is recurrent vomiting that develops 2–10 weeks after birth and is often associated with failure to thrive and dehydration. At least 70% of infants have an epigastric mass (‘olive’) and some have visible peristaltic waves. The diagnosis is usually confirmed by an abdominal ultrasound study that shows a ‘donut’ sign with thickening of the circular muscle to greater than 3 mm. Barium studies will also show gastric outlet obstruction but can be difficult in young infants and should be preceded by gastric aspiration. Definitive therapy is a Ramstedt pyloromyotomy that includes a longitudinal incision through the hypertrophied muscle down to the submucosa. Almost all infants have an excellent short and longer-term outcome. The patient illustrated below was a 12-year-old Chinese girl who was investigated because of episodes of abdominal pain and vomiting since the age of 4 years. There were no other significant medical problems. A barium study showed a large stomach with a narrow elongated pylorus (arrow) and ‘shoulders’ in the antrum of the stomach (Fig. 1). The appearance was consistent with hypertrophic pyloric stenosis. However, the diagnosis could not be confirmed by an upper abdominal ultrasound study. At endoscopy, pyloric narrowing prevented passage of the endoscope into the duodenum. She subsequently had an endoscopic ultrasound study that confirmed hypertrophy of circular muscle to 7 mm (Fig. 2). Attempted therapy using balloon dilators was unsuccessful and she was subsequently treated with a Ramstedt pyloromyotomy. This resulted in a rapid improvement in her symptoms. Contributed by

Gastric femoral hernia in a male cadaver with gastroptosis: case report and review of the literature

The shape and the position of the stomach and its anatomic relations to the round viscera vary from individual to individual, but they also vary in the same subject depending on many factors. The downward displacement of the stomach is called gastroptosis. In the literature, there are only five case reports where the stomach constituted the content of a femoral hernia. The current study presents a case of a gastric femoral hernia in a cadaver along with a review of the relevant literature. During routine dissection of a 67-year-old male cadaver with a very large stomach and gastroptosis, a femoral hernia containing a part of the great curvature of the stomach was found. The length of the hernia sac was 5 cm, and its width was 3.5 cm. There was a disposition of the intestinal coils to the posterior wall and the lesser pelvis. The cadaver's former medical history and skin observation before dissection excluded any previous abdominal surgery. This is the second case of stomach herniation through the femoral ring in a male subject ever reported. The symptoms in this pathology vary from complete absence to symptoms due to high stenosis of the digestive tract, stomach strangulation and stomach wall necrosis.

Daily feeding rhythm and rations of Pacific salmon of the genus Oncorhynchus in the period of marine prespawning migrations

The daily feeding rhythm and rations of the humpback salmon Oncorhynchus gorbuscha, the sockeyed salmon O. nerka, and the chum salmon O. keta during marine prespawning migrations is investigated with consideration of materials collected at daily stations in waters off eastern Kamchatka in June–July 1999 and 2001 (from catches of drift nets). The bulk of humpback salmon and sockeyed salmon food consists of euphausiids, hyperiids, large copepods, pteropods, and fish juveniles. In the food of chum salmon, pteropods dominated. In a 24-h period, salmon manifest a pronounced evening peak of stomach fullness, while at night feeding discontinues. Samples collected in the morning consisted of fish who had just started feeding after the night pause. In addition to nightly period of rest, all species manifested a daytime decrease in foraging activity, though less pronounced than in the night. The daily rhythm of Pacific salmons’s feeding depends on the vertical migrations of their food items (representatives of sound-scattering layers). During the marine feeding period, the most intensive feeding is recorded in the humpback salmon and chum salmon. The daily ration of the humpback salmon is lower than that of the chum salmon but includes animals of higher food value. Due to a high digestion rate in combination with a large stomach volume, the chum salmon can consume a large quantity of low-calorific food in a short time. The daily ration of the sockeyed salmon is considerably lower than that of other salmon species.

Characteristics of treating Bi condition with acupuncture

The information concerning the treatment of Bi condition in 93 ancient medical books has been statistically analyzed through computer. The results showed that there were a total of 149 items of literature and 102 acupoints (276 times in frequency) in association with Bi condition. The common acupoints are Hegu (LI4), Zusanli (ST36), Fengshi (GB31), diseased foci, Quchi (LI11), Weizhong (BL40), Yanglingquan (GB34), Yangfu (GB 38), et al. The common meridians are Gallbladder Meridian, Bladder Meridian, Large Intestine Meridian, Stomach Meridian, Lung Meridian, Liver Meridian and Triple Energizer Meridian. The common parts are the lateral aspect of leg, arm, and foot, the medial aspect of foot, the lateral aspect of hand, the medial aspect of arm, and head. The common acupuncture techniques and their frequencies are moxibustion (54), needling (9), blood-letting (9), fire needling (2), ironing (2) and compression (1). Statistical analysis on the above information showed in the ancient times in treating Bi condition with acupuncture, selecting acupoints are according to meridian distribution, the body parts and syndrome differentiation.

Redescriptions of Haemonchus mitchelli and Haemonchus okapiae (Nematoda: Trichostrongyloidea) and description of a unique synlophe for the haemonchinae.

In the course of a revision of Haemonchus Cobb, 1898 (Nematoda), commonly referred to as large stomach worms, significant new morphological information was discovered that allows the recognition of 2 species believed for more than 50 yr to be synonymous. Both species, Haemonchus mitchelli Le Roux, 1929, from the eland Taurotragus oryx and other African ruminants and H. okapiae van den Berghe, 1937, from the okapi Okapia johnstoni, have a synlophe of 42 ridges, but the synlophe of H. mitchelli is longer than that of H. okapiae. The distal tip of the left spicule of H. mitchelli bears a barb that is about twice as long as the short barb and half as long as the long barb on the right spicule. In contrast, the barb on the left spicule of H. okapiae is similar in size to the short barb and about 25% as long as the long barb of the right spicule. The dorsal ray of H. mitchelli is bifurcated distally for 25-39% (32%) of its length and its stem is expanded proximally, but the dorsal ray of H. okapiae is bifurcated 37-50% (42%) and its stem is of uniform thickness.

Toxicology: a case-oriented approach

Toxicology: a case-oriented approach