Lumen Of Digestive Tract Research Articles

Endoscopic ultrasound-guided tissue acquisition for focal liver lesions can be safely performed in patients with ascites

Background and study aim: In patients with ascites, percutaneous liver biopsy is generally contraindicated. Since endoscopic ultrasound-guided tissue acquisition (EUS-TA) allows tissue sample obtention from the digestive tract lumen, a biopsy without the intervention of ascites may prevent adverse events. This study aimed to evaluate the safety of EUS-TA for focal liver lesions in the presence of ascites. Patients and methods: A retrospective study was conducted using medical records of cases in which EUS-TA was performed on focal liver lesions between 2016 and 2022. Study participants were classified into two groups: those with ascites and those without it, and the outcomes were compared. The primary outcome was adverse events. Results: We included 109 cases of EUS-TA for focal liver lesions. Ascites was present in 20.1% (22/109) of cases and absent in 79.8% (87/109) of cases. There were no significant differences between the two groups in clinical backgrounds and EUS-TA procedure, although fine needle biopsy needles were significantly more frequently used in patients without ascites. In the ascites group, puncture without intervening ascites was successful in 90.9% (20/22) of cases. The incidence of adverse events was 4.5% (1/22) in the ascites group and 1.1% (1/87) in the non-ascites group, showing no significant difference. The two adverse events were mild self-limiting abdominal pain. Conclusions: In focal liver lesions with ascites, EUS-TA allows biopsy without the intervention of ascites in most cases. The incidence of adverse events did not differ significantly between patients with and without ascites.

Colonoscopic removal of an intrauterine device with rectal perforation: A case report.

The intrauterine device is one of the effective, safe, convenient, economical, and reversible contraceptive methods. Although its contraceptive effect is definite, some female patients may experience complications such as expulsion, bleeding, and pregnancy with the device in place. Rectal perforation is one of the rare and serious complications, which can lead to complications such as abdominal infection and intestinal adhesions, severely affecting the quality of life of patients. A 34-year-old female was sent to the Department of Gastroenterology with noticeable left lower quadrant abdominal pain. She had presented with abdominal discomfort and anal tenesmus 1 year earlier. Two months ago, her abdominal pain had gradually worsened and she was presented to our hospital. Investigations, including colonoscopy and computed tomography scan, had revealed an intrauterine device migrated and perforated into the rectum. The patient underwent successful colonoscopic removal of the intrauterine device. She recovered well after the treatment. This case proves that endoscopic therapy can be considered the preferred method for removing intrauterine devices displaced into the digestive tract lumen.

Transporter and metabolic enzyme-mediated intra-enteric circulation of SN-38, an active metabolite of irinotecan: A new concept

SN-38, an active metabolite of irinotecan (CPT-11), is thought to circulate enterohepatically via organic anion-transporting polypeptides (OATPs), UDP-glucuronyl transferases (UGTs), multidrug resistance-related protein 2 (MRP2), and breast cancer resistance protein (BCRP). These transporters and enzymes are expressed in not only hepatocytes but also enterocytes. Therefore, we hypothesized that SN-38 circulates between the intestinal lumen and the enterocytes via these transporters and metabolic enzymes. To test this hypothesis, metabolic and transport studies of SN-38 and its glucuronide (SN-38G) were conducted in Caco-2 cells. The mRNA levels of UGTs, MRP2, BCRP, and OATP2B1 were confirmed in Caco-2 cells. SN-38 was converted to SN-38G in Caco-2 cells. The efflux of intracellularly generated SN-38G across the apical (digestive tract) membranes was significantly higher than the efflux across the basolateral (blood, portal vein) membranes of Caco-2 cells cultured on polycarbonate membranes. SN-38G efflux to the apical side was significantly reduced in the presence of MRP2 and BCRP inhibitors, suggesting that SN-38G is transported across the apical membrane by MRP2 and BCRP. Treatment of Caco-2 cells with OATP2B1 siRNA increased the SN-38 residue on the apical side, confirming that OATP2B1 is involved in the uptake of SN-38 into enterocytes. No SN-38 was detected on the basolateral side with or without siRNA treatment, suggesting that the enterohepatic circulation of SN-38 is limited, contrary to previous reports. These results suggest that SN-38 is absorbed into the enterocytes via OATP2B1, glucuronidated by UGTs to SN-38G, and excreted into the digestive tract lumen by MRP2 and BCRP. SN-38G can be deconjugated by β-glucuronidase from intestinal bacteria in the digestive tract lumen to regenerate SN-38. We named this new concept of local drug circulation “intra-enteric circulation.” This mechanism may allow SN-38 to circulate in the intestine and cause the development of delayed diarrhea, a serious side effect of CPT-11.

Leptin receptor-deficient (knockout) zebrafish: Effects on nutrient acquisition

In mammals, knockout of LEPR results in a hyperphagic, morbid obese, and diabetic phenotype, which supports that leptin plays an important role in the control of appetite and energy metabolism, and that its receptor, LEPR, mediates these effects. To date, little is known about the role(s) of lepr in teleost physiology. We investigated a zebrafish (Danio rerio) homozygous lepr knockout (lepr−/−) line generated by CRISPR/Cas9 in comparison to its wt counterpart with respect to nutrient acquisition, energy allocation, and metabolism. The metabolic characterization included oxygen consumption rate and morphometric parameters (yolk sac area, standard length, wet weight, and condition factor) as proxies for use and allocation of energy in developing (embryos, larvae, and juveniles) zebrafish and showed no particular differences between the two lines, in agreement with previous studies. One exception was found in oxygen consumption at 72 hpf, when zebrafish switch from embryonic to early larval stages and food-seeking behavior could be observed. In this case, the metabolic rate was significantly lower in lepr−/− than in wt. Both phenotypes showed similar responses, with respect to metabolic rate, to acute alterations (22 and 34 °C) in water temperature (measured in terms of Q10 and activation energy) compared to the standard (28 °C) rearing conditions. To assess lepr involvement in signaling the processing and handling of incoming nutrients when an exogenous meal is digested and absorbed, we conducted an in vivo analysis in lepr−/− and wt early (8 days post-fertilization) zebrafish larvae. The larvae were administered a bolus of protein hydrolysate (0%, 1%, 5%, and 15% lactalbumin) directly into the digestive tract lumen, and changes in the mRNA expression profile before and after (1 and 3 h) administration were quantified. The analysis showed transcriptional differences in the expressions of genes involved in the control of appetite and energy metabolism (cart, npy, agrp, and mc4r), sensing (casr, t1r1, t1r3, t1r2-1, t1r2-2, pept1a, and pept1b), and digestion (cck, pyy, try, ct, and amy), with more pronounced effects observed in the orexigenic than in the anorexigenic pathways, suggesting a role of lepr in their regulations. Differences in the mRNA levels of these genes in lepr−/−vs. wt larvae were also observed. Altogether, our analyses suggest an influence of lepr on physiological processes involved in nutrient acquisition, mainly control of food intake and digestion, during early development, whereas metabolism, energy allocation, and growth seem to be only slightly influenced.

Definition and application of magnetic compression anastomosis

As a new technical discipline, magnetic surgery (MS) has attracted attention of many researchers all over the world for its broad application prospects in the diagnosis and treatment of diseases. MS can be grouped as the following five categories according to different applications and principles: Magnetic compression technique (MCT), magnetic navigation technique (MNT), magnetic anchor technique (MCT), magnetic levitation technique (MLT) and magnetic tracer technique (MTT). Among these techniques, the magnetic compression anastomosis can be used to accomplish certain surgical procedures through the special properties between magnetic materials, such as lumen anastomosis and recanalization, closure of abnormal channels between tissues or organs and restriction anomalous flow of lumen contents. Since being first described in 1978 by Obora, magnetic anastomosis has been initially attempted in treatment of esophageal atresia and diverticula, diversion of gastrointestinal tract, and recanalization of the biliary stricture. Because of the encouraging and broad perspective of magnetic anastomosis in clinical medicine, a new word “magnamosis” has been recommended by Dr. Michael Harrison, one of the leading scientists in this field. Magnetic anastomosis, as an important branch of magnetic compression anastomosis, is essentially a technique that uses magnetic force to transform the lumen anastomosis from the conventional “penetrating” anastomosis to a novel “non-penetrating” anastomosis to greatly simplify the procedure and reduce the rate of postoperative complications. For patients with gastrointestinal lumen occlusion or stenosis, magnetic anastomosis provides a new treatment strategy. This new method can complete the recanalization of digestive tract lumen under intervention method, and avoid major operations, such as laparotomy or thoracotomy. As such, magnetic anastomosis can greatly reduce surgical trauma, as well as incidence of postoperative complications. In addition, magnetic anastomosis can provide treatment options for conditions that cannot be treated with conventional methods, allowing patients to avoid life-long external drainage or fistulas in their lives. More commonly, magnetic anastomosis technology can also be applied to end-to-end, end-to-side, and side-to-side vascular anastomosis. Upon this technique, the time duration of anastomosis can be significantly shortened. Thus, the ischemia and congestion time of target organ can also be shortened, and postoperative complication incidence is significantly reduced. At present, this technique has been successfully applied in coronary and portosystemic bypass surgery, as well as organ transplantation. Surface modification and shape design of magnetic device are two key issues to be considered in magnetic anastomosis technology. The surface modification scheme of the magnetic device mainly depends on the time it remains in the body, while the shape design of the magnetic device mainly depends on the anatomical factors of the lumen to be anastomized, the way of implanting the magnet, and the amount of magnetic force required for the anastomosis. For more than 10 years, we have developed different types of magnets, and performed substantial pre-clinical and clinical studies on utilization of magnetic compression method in vascular, intestines, and biliary lumens connection or anastomosis, demonstrating its safety, which indicates a promising and broad application prospect of magnetic anastomosis. In view of the huge application potential of magnetic anastomosis technology in lumen anastomosis and recanalization, in the future, magnetic anastomosis technology will provide new treatment strategies for other lumen reconstruction (ureteral stenosis, urethral obstruction, etc.).

The Role of Endoscopic Procedure in Diagnosing Gastrointestinal Disorder in Children

Introduction: Gastrointestinal endoscopy in children requires more than the technical expertise needed to pass an endoscope through a smaller digestive tract lumen. Children require more careful attention to patient preparation and sedation compared with adults. The incidence of various disease varies through childhood and differs from the adult. Aim of this study is to elucidate profile esophagoduodenoscopic dan colonoscopic procedures in diagnosing gastrointestinal tract disorder in children in Soetomo Hospital, including role of nursing team role these procedures.Method: This study is a descriptive study which is done in Gastroenterlology Division Soetomo Hospital in October 2009–March 2012 for patients undergoing esophagoduodenoskopy and colonoscopy. Age, sex, indication, preparation, sedation, results, complication data were collected. Data from pathological examination were also collected. Data analysis were done descriptively such as mean, median and percentage, and presented in tables.Result: There were 114 patients undergo esophagoduodenoscopy procedure and 7 patients undergo colonoscopy procedures. The most indication for esophagoduodenoscopy was recurrent abdominal pain (71.1%) and for colonoscopy was chronic diarrhea (42.8%). Nill by mouth for 6 hours is preparation for esophagoduodenoscopy and for colonoscopy needs bowel preparation a day before. Bowel preparation is using Biphosphate Sodium Phosphate oral and enema. Most of all sedation was done by anasthesiologist. Nursing team role were start from preparation, relaxing patient, and monitoring during and after procedure. Chronic gastroduodenitis was found on 110 (96.4%) cases, 15 cases of it accompanied nodularity. Seventy cases (64.9%) from 114 cases of biopsy result were Helicobacter pylore positive, and 21 cases of it has Barret's esophagus. Colonoscopy procedure results 5 (71.4%) cases were colitis, and 3 of them are amoebic colitis. Discussion: Diagnosis of sructural and histological abnormalities could be establish with endoscopic procedure. This is an important role in diagnosing gastrointestinal disorder in children and nursing team have important role in it.

P‐glycoprotein ‐ an ABC Transporter: Toxin Removal to Chemotherapy Interference (LB109)

Cancer claimed 7.6 million lives worldwide in 2013. Despite improvements in chemotherapy, most relapsed cancers become drug resistant due to an ATP‐binding cassette transporter, P‐glycoprotein (P‐gp). P‐gp is a gatekeeper in multiple tissues, controlling exposure to drugs and toxins by pumping them out of the cell. This homodimeric protein of 1,280 amino acids is located on the apical surface and extrudes lipid soluble molecules. Pharmaceutical companies must determine if their drugs are P‐gp substrates before proceeding to clinical trials, as the amount of drug entering the body may vary widely due to P‐gp function. P‐gp may reduce the amount of drugs reaching circulation by transporting drugs back into the digestive tract lumen. Many chemicals act as modulators of P‐gp’s function; for example, the flavonoid naringin in grapefruit juice interacts with P‐gp and may significantly increase the uptake of some statin drugs. The active sites and conformational changes of P‐gp have not been elucidated, as it has been difficult to crystallize P‐gp with its substrates. P‐gp’s complex structure and multiple binding sites allow for interaction with many drug molecules, which enter P‐gp’s binding pocket via pairs of alpha‐helices on opposite sides of P‐gp. The Ironwood Ridge High School SMART team (Students Modeling A Research Topic) modeled P‐gp using 3D printing technology.Grant Funding Source: Supported by a grant from NIH‐SEPA and NIH‐CTSA.

Endoscopic Multiple Gastric Polypectomy in Two Phage of the Same Patient - A Case Report and Discussion

A POLYP is defined as a proliferative or neoplastic of gastrointestinal mucosal layer. It is a lesion which appeared at endoscopy, protruding into the lumen of digestive tract as discrete projection above the adjacent mucosal surface. In most cases, polyps are incidental findings during routine endoscopy, also they are typically found incidentally when upper gastrointestinal endoscopy is performed for an unrelated indication. These lesions have previously been accepted as completely benign but Gastric adenomas have a higher incidence of malignant transformation than adenomatous polyps in colon. Though polypectomy has various immediate and delayed complications, Specially in case of multiple polypectomy. Multiple polypectomy has been advised and applied in several phages for the achievement of complete removal of polypoid lesions in same patient. In the aim to reduce the frequency of this invasive procedure and to achieve a probable safe limit in a single phase we performed an evaluatory multiple endoscopic gastric polypectomy under extensive precaution and close supervision in two phages of a same patient. To avoid possible hazards and to minimize the complication as possible we choose a non-diabetic, non-hypertensive patient with no established cardiovascular disorder. In first phage a number of thirty two and in second phage twenty nine gastric polyps had been success fully removed by electro coagulation without any immediate or delayed complications.

Presence of a seawater-filled caecum in Echinocardium cordatum (Echinoidea: Spatangoida)

Heart urchins (Echinoidea: Spatangoida) are considered infaunal, deposit feeding sea urchins that utilize the surrounding sediment as a source of nutrients. Sediment occupies most of the digestive tract lumen but never enters the gastric caecum, a prominent structure that is filled with a transparent fluid. The aim of this study was to shed light on the nature of the fluid found inside the gastric caecum of a well-studied spatangoid species, Echinocardium cordatum. Our conclusions are based on a three-step-approach: firstly, by following the movement of dyed seawater from the mouth up to the caecal lumen; secondly, by comparing the osmolarity of various body fluids; and thirdly, by describing the particulate content of the gastric caecum. In addition, we employed magnetic resonance imaging (MRI) to reveal the absence of sediment within the gastric caecum. Our osmolarity measurements show that the coelomic fluid is significantly more concentrated than the caecal fluid, which in turn has an osmolarity similar to seawater. MRI reveals that the gastric caecum, in contrast to the rest of the digestive tract, is always devoid of sediment. Light and electron microscopy observations reveal the presence of a variety of detrital particles suspended in the caecal fluid that are identical to those occurring in seawater sampled over the seafloor. We argue that the fluid filling the gastric caecum must be predominantly seawater, and we propose a scenario that explains seawater circulation in E. cordatum. In this context, the gastric caecum could act as an internal trap for suspended particulate organic matter. We hypothesize that spatangoid sea urchins could have adopted internal suspension feeding as a secondary feeding mode in addition to deposit feeding.

Cnidosac-Related Structures in Embletonia (Mollusca, Nudibranchia) Compared with Dendronotacean and Aeolidacean Species

In defense against attack by predators, cnidosacs in the tips of cerata (dorsal appendages) of aeolidacean nudibranchs discharge masses of mature nematocysts that are derived from cnidarian food. Cnidosac-related structures in various nudibranchs may provide a reconstruction of potential steps in the evolution of cnidosacs. Such structures in the cerata of the two valid species of Embletoniidae, an enigmatic nudibranch family, are described in this report, and compared to cnidosacs in dendronotaceans and aeolidaceans. The Embletonia spp. ceratal tips are characterized by cnidophages, which are largely undifferentiated cells that take up the nematocysts from the digestive tract lumen and transport them to different surface locations of the cerata, where they are released. Organized muscular bags that force out the nematocysts, as those found in cnidosacs, are absent. These cnidosac-related structures and other characteristics weaken the case of including Embletoniidae incertae sedis within Aeolidacea.

Stability of Black Raspberry Anthocyanins in the Digestive Tract Lumen and Transport Efficiency into Gastric and Small Intestinal Tissues in the Rat

The fate of black raspberry anthocyanins in the gastrointestinal tract (GI) was evaluated. Fasted male rats (n = 30) were administered either 27 +/- 6.7 nmol of cyanidin 3-glucoside equivalent of anthocyanins and euthanized at 30, 60, 120, and 180 min or vehicle only and killed at 30 min (control) to collect bladder urine, GI contents, stomach, and small intestine. HPLC-MS analysis showed that anthocyanins in the gastric lumen decreased linearly over time (t(1/2) = 120 min). Anthocyanins in small intestinal tissue and lumen peaked at 120 min. Uptake by small intestinal tissue reached 7.5% of the administered dose, much higher than the reported bioavailability of these pigments. Ingested anthocyanin glycosides remain relatively stable in the GI contents (75-79% of administered dose). Selective decrease of cyanidin 3-glucoside in the small intestinal content likely resulted from beta-glucosidase activity. Urinary anthocyanin profiles reflected profiles present in the GI at the time of absorption.

A selective barrier in the midgut epithelial cell membrane of the nonvector whitefly Trialeurodes vaporariorum to Tomato yellow leaf curl virus uptake

We studied the presence of a potential transmission barrier that blocks Tomato yellow leaf curl virus in the nonvector greenhouse whitefly, Trialeurodes vaporariorum. Because T. vaporariorum can ingest and retain the virus after acquisition feeding on an infected plant, comparable to the vector whitefly Bemisia tabaci, circumstance evidence suggested that a transmission barrier presents at location(s) where the virus moves from the digestive tract lumen to the hemolymph. To provide direct evidence for the site of a transmission barrier in the nonvector insect, we compared the accumulation levels and localization of the virus between the two species of whiteflies. Quantitative real-time and conventional PCR analysis showed that accumulation of the virus during acquisition feeding and retention after a short acquisition period were indistinguishable between the two species, but the circulation of the virus within the whiteflies differed significantly between the species. In an immunofluorescence analysis using an antibody specific to the coat protein of the virus, the virus was restricted to the luminal surface of the midgut epithelial cells and did not enter their cytoplasm or that of the salivary glands in T. vaporariorum. In contrast, the virus was localized within the cytoplasm of the midgut epithelial cells and in the paired salivary glands of B. tabaci adults. This direct evidence shows that a selective transmission barrier at the luminal membrane surface of midgut epithelial cells in the nonvector whitefly blocks entrance of the virus into the midgut epithelial cells, resulting in incompetence as a vector of the virus.

Disposition and Metabolic Profiling of Bisphenol F in Pregnant and Nonpregnant Rats

The distribution of bisphenol F (4,4'-dihydroxydiphenyl-methane, BPF) was studied in female Sprague-Dawley rats. Pregnant and nonpregnant animals were gavaged with a single dose of 7 or 100 mg/kg [3H]BPF and were kept for 96 h in metabolic cages. The excretion of BPF residues occurred mainly in urine (43-54% of the administered dose), which was found to contain at least six different metabolites, and to a lesser extent in feces (15-20% of the administered dose). Sulfatase treatment and subsequent high-performance liquid chromatography analyses suggest that the major urinary metabolite (more than 50% of the radioactivity present in urine) is a sulfate conjugate of BPF. At 96 h, BPF residues were detectable in all tissues examined with the largest amounts in the liver (0.5% of the dose). In pregnant rats dosed at day 17 of gestation, BPF residues were detected in the uterus, placenta, amniotic fluid, and fetuses (0.9-1.3% of the administered dose). Large amounts of radioactivity (8-10% of the dose) were still located in the digestive tract lumen at the end of the study. After administration of a single oral dose of [3H]BPF, 46% of the distributed radioactivity was excreted in bile over a 6 h period. In rats, BPF and/or its metabolites very likely undergo enterohepatic cycling, which could be responsible for the relatively high amounts of residues still excreted 4 days after BPF administration. This bisphenol is efficiently absorbed and distributed to the reproductive tract in female rats, and its residues pass the placental barrier at a late stage of gestation in rats.

1037: Usefulness of contrast-enhanced EUS and EUS elastography in the diagnosis of pancreato-biliary diseases

Trans-abdominal ultrasonography (US) is usually positioned as the first-choice diagnostic procedure in the diagnosis of pancreato-biliary diseases from the low invasiveness in Japan. However, due to the unfavorable effect of air and diet residue in digestive tract intervening between the surface of the body and the targeted organs, the observation of the whole pancreato-biliary system is not always easy. On the other hand, endoscopic ultrasonography (EUS) can make satisfactory observation of pancreato-biliary system, because effect of obstacles stated above is not necessary to be taken into account as for EUS that observation of pancreato-biliary system is possible from digestive tract lumen.

Molecular mechanisms of virus spread and virion components as tools of virulence. A review.

Despite of differences in replication strategy among virus families, some basic principles have remained similar. Analogous mechanisms govern virus entry into cells and the use of enzymes which direct the replication of the virus genome. The function of many cell surface receptors (such as glycosoaminoglycans, glycoproteins, proteins) which interact with viral capsid proteins or envelope glycoproteins has recently been elucidated. The list of cellular receptors (Table I) is still far from being final. The capsid components, similarly as the envelope glycoproteins, may form specific pocket like sites, which interact with the cell surface receptors. Neutralizing antibodies usually react with antigenic domains adjacent to the receptor binding site(s) and hamper the close contact inevitable for virion attachment. In the case of more complex viruses, such as herpes simplex virus, different viral glycoproteins interact with several cellular receptors. At progressed phase of adsorption the virions are engulfed into endocytic vesicles and the virion fusion domain(s) become(s) activated. The outer capsid components of reoviruses which participate in adsorption and fusion may get activated already in the lumen of digestive tract, i.e. before their engulfment by resorptive epithelium cells. Activation of the hydrophobic fusion domain(s) is a further important step allowing to pass through the lipid bilayer when penetrating the cell membrane in order to reach the cytosol. Activation of the virion fusion domain is accomplished by a conformation change, which occurs at acid pH (influenza virus hemagglutinin, sigma 1 protein of the reovirus particle) and/or after protease treatment. The herpes simplex virus fusion factors (gD and gH) undergo conformation changes by a pH-independent mechanism triggered due to interaction with the cell surface receptor(s) and mediated by mutual interactions with the viral envelope glycoproteins. The virion capsid or envelope components participating in the entry and membrane fusion are not the only tools of virulence. The correct function of virus coded proteins, which participate in replication of the viral genome, and/or in the supply of necessary nucleotides, may be very essential. In the case of enteroviruses, which RNA interacts with ribosomes directly, the correct configuration of the non-coding viral RNA sequence is crucial for initiation of translation occurring in the absence of the classical "cap" structure.

Étude cytochimique ultrastructurale de la dégradation des lignines dans les résidus pariétaux de bois d'épicéa et de peuplier par le Reticulitermes lucifugus var. santonensis (Rhinotermitidae, Isoptera)

Free cell-wall residues were prepared by extracting wood samples of spruce (Populus euramericana cv. Fidzi Pauley) and poplar (Picea sitchensis). These species were chosen for their lignin types: guaiacyl in spruce and guaiacyl–syringyl in poplar. The parietal residues obtained were used as the sole food for the xylophagous termite Reticulitermes lucifugus var. santonensis and were compared before and after ingestion and transit in the digestive tracts. Differences due to the mechanical action of the gizzard were found in association with chemical changes. Polysaccharides were unmasked after digestion and could clearly be observed after reaction with periodic acid – thiocarbohydrazide – silver proteinate. A fibrillary meshwork was also observed inside the lignified cell walls. Biodegradation of cell wall material was particularly clear in poplar where granules formed an electron-dense plasma when uranyl acetate – lead citrate or periodic acid – thiocarbohydrazide – silver proteinate was used as a contrast medium. A selective biodegradation of syringyl monomers in poplar parietal residues was indicated by thioacidolysis but requires confirmation. Breakdown of lignified cell walls begins with a biodegradation of the lignin network associated with or followed by the digestion of polysaccharides. Syringyl-rich lignin fractions seemed to break down faster. Whether the enzymic pathway leading to ligninolysis originates from the termite digestive cells or from the endosymbionts present in their digestive tract lumen remains to be defined. Key words: Isoptera, Reticulitermes lucifugus var. santonensis, wood, lignin, spruce, poplar.

Active production and membrane anchoring of carcinoembryonic antigen observed in normal colon mucosa

Normal colon mucosa was found to produce carcinoembryonic antigen (CEA) quite actively as cancerous tissues do when maintained in an organ culture, although the fresh normal mucosae contained a very small quantity of CEA unlike cancerous tissues. This is consistent with an active expression of CEA mRNA in normal mucosa comparable to that in cancerous tissues actively producing CEA, and suggests that the normal cell product was rapidly released into the lumen of digestive tract and turned into normal fecal antigens (NFAs) previously found in feces. 3H-Labeled precursors of glycophospholipid such as ethanolamine and stearic acid were incorporated into CEA produced by both normal and cancerous tissues, suggesting that CEA in normal mucosa is anchored to the cell membrane through a glycophospholipid as in cancerous tissues.

An Attempt to Standardize the Protocol for Controlled Study in Postoperative Infections

No standard form of protocol for assessment criteria in the chemotherapy of infections has been well established in the field of surgery. This report describes an attempt to establish a good protocol for clinical assessment ofchemotherapeutic agents in postoperative infections based on a comparative clinical study of cefotiam and cefazolin.In order to secure reasonably homogeneous subgroups of subjects who would vary with respect to the symptoms and signs as well as the required duration of chemotherapy, the following categorical criteria for patient selection and stratifi-cation were provided: those with postoperative superficial purulent infections (stratum A); and those with postoperative localized peritonitis and/or dead space infections (stratum B), excluding those connected with an opened lumen of diges-tive tract. The duration of chemotherapy was determined to be 7 days for stratum A and 14 days for stratum B. As targets of observation, 8 items for stratum A and 11 for stratum B were selected among the symptoms and signs considered to be observable with high incidence in the patients of each respective stratum. The surgeons in charge were responsible for observing each patient by using these items throughout the trial and for judging the general outcome of the treatment.The data obtained from 89 stratum A patients and 79 stratum B patients Were subjected to the statistical analyses. Tentative criteria for grouping the observation items were established from the results of principal component analysis and cluster analysis, after which regression analysis was carried out on the data of these groupings and the overall impressions of the surgeons. Changes in suppurative discharge, local signs, fever, WBC, and abdominal signs (stratum B only) were found to correlate with the overall impressions. From these facts tentative criteria for overall assessment of the chemotherapy were adopted.When the patients who showed marked discrepancies between their surgeons' judgements and the results based on the criteria were examined, some minor cor-rections were found to be called for with regard to the criteria for patient selection, stratification and overall assessment.Changes in clinical isolate (s) from the inflammatory focus highly correlated with the alterations in discharge. This fact indicates that bacteriological examination of clinical isolates is also indispensable in the clinical evaluation of chemotherapeutic agents in postoperative surgical infections.