Part Of Gastrointestinal Tract Research Articles

P1202 Genome wide association study result for inflammatory bowel disease: A single institute experience in Taiwan

Abstract Background Inflammatory bowel disease (IBD) have two major subtype disease, including Crohn’s disease(CD) and Ulcerative colitis(UC). These two diseases of IBD in which abnormal reactions of the immune system induced inflammation and ulcers in any part of gastrointestinal tract from oral cavity to rectum, especially in colon and small intestine. Now, IBD still not have an identifiable cause and many articles that discussion about risk loci of IBD was published in recent years. Hence, we try to identify the risky locus related with IBD. Methods From January 1992 to December 2023, we retrospectively reviewed the medical records of patients diagnosed as inflammatory bowel disease at our hospital. We also use Phecode Map with ICD9 codes for finding out more pateints. Then, we used the our hospital’s genetic data warehouse to assay these patient’s genome for identifying the specific loci associated with inflammatory bowel disease. Results A total of 286 patients with inflammatory bowel disease from January 1992 to December 2023 was in medical record. The number of Crohn's disease and ulcerative colitis were 102 and 184 respectively. However, only 85 patient with CD and 145 patient with UC were in our hospital’s genetic data warehouse. In addition, we seek cooperation with our hospital’s artificial Intelligence Center for using Phecode Map with ICD9 codes for finding out more patients. Finally, 660 case was in genetic data warehouse.The our result of Genome-wide association study (GWAS) for inflammatory bowel disease that identified 15 potential SNPs, such as RTN4, EML6, CLHC1, MYO10, EFEMP1, ADCY2, TPD52 etc.. Two of 15 potential SNPs, NPAS3, DSCAM has been found to be a risky SNPs of IBD in past study and our result of GWAS for IBD. Another 13 SNPs was potential association with IBD in our result, but not well-known risky gene in past research. Only one genetic locus: CRY2 had statistically significant difference and vaule of -log10(p) is more than 6. But, no similar thesis was reported after we review other published papers about loci associated with inflammatory bowel disease. The relationship between CRY2 and inflammatory bowel disease is still pending investigation. Conclusion Although, around 200 genomic loci was considered to be associated with inflammatory bowel disease. But, the precise mechanism by which these loci contribute to IBD were still being investigated. However, more genetic loci associated with IBD was identified can lead us to approach the understanding of the underlying biology of the disease.

Mechanisms of regulation of motility of the gastrointestinal tract and the hepatobiliary system under the chronic action of nanocolloids

Modern cutting edge technologies of chemical synthesis enable the production of unique nanostructures with excess energy and high reactivity. Uncontrolled use of such materials in the food industry and pharmacology entail a risk for the development of a nanotoxicity crisis. Using the methods of tensometry, mechanokinetic analysis, biochemical methods, and bioinformatics, the current study showed that chronic (for six months) intragastrical burdening of rats with aqueous nanocolloids (AN) ZnO and TiO2 caused violations of the pacemaker-dependent mechanisms of regulation of spontaneous and neurotransmitter-induced contractions of the gastrointestinal tract (GIT) smooth muscles (SMs), and transformed the contraction efficiency indices (AU, in Alexandria units). Under the same conditions, the fundamental principle of distribution of physiologically relevant differences in the numeric values of the mechanokinetic parameters of spontaneous SM contractions between different parts of GIT is violated, which can potentially cause its pathological changes. Using molecular docking, typical bonds in the interfaces of the interaction of these nanomaterials with myosin II, a component of the contractile apparatus of smooth muscle cells (SMC) were investigated. In this connection, the study addressed the question of possible competitive relations between ZnO and TiO2 nanoparticles and actin molecules for binding sites on the myosin II actin-interaction interface. In addition, using biochemical methods, it was shown that chronic long-term exposure to nanocolloids causes changes in the primary active ion transport systems of cell plasma membranes, the activity of marker liver enzymes and disrupts the blood plasma lipid profile, which indicates the hepatotoxic effect of these nanocolloids.

Oral manifestations associated with inflammatory bowel disease and early endoscopic findings in patients with spondyloarthritis

Background and aimsSpondyloarthritis (SpA) is a group of autoinflammatory disorders, of which the primary extra-articular manifestation is inflammatory bowel disease (IBD). The oral cavity being a part of gastrointestinal tract, is significantly compromised in IBD, and in many cases, it is the first site of clinical manifestations of IBD. This study aimed to identify changes in the oral mucosa associated with the onset of IBD and their association with endoscopic/histological findings.Materials and methodsThe study assessed 80 patients with SpA and 52 healthy controls. Oral, rheumatological, and gastroenterological assessments were performed. The ileocolonoscopy was performed via digital magnification chromoendoscopy. The statistical analysis consisted of Chi-square, Fisher's exact, and multiple correspondence discriminant analysis tests.ResultsFrom the disease cohort, 63.0% patients showed oral lesions (p = 0.050). These manifestations ranged from gingivitis (55.0%, p = 0.001), aphthous stomatitis (3.8%, p = 0.091), angular cheilitis (2.6%, p = 0.200), and perioral erythema with scaling (1.3%, p = 0.300). All patients who presented with alterations in colonic mucosa also had oral lesions associated with IBD (p = 0.039), specifically gingivitis/aphthous stomatitis (p = 0.029).ConclusionThe patients with SpA without IBD present significant oral signs and symptoms. Gingivitis seems to be the most relevant because of its associations with early endoscopic and histological findings.Clinical relevanceAn integral approach to the diagnostic tests that includes evaluations of oral, rheumatological and gastroenterological tissues may favor timely attention and improve patients’ quality of life.

New perspectives on treatment of gastrointestinal diseases: therapeutic potential of mesenchymal stromal cells

Mesenchymal stromal cells (MSCs) are a promising resource for cell therapy of different organs and systems, including the gastrointestinal tract (GIT). Therapeutic effect of MSC transplantation in GIT diseases may be partly due to their differentiation into various cellular components of the digestive tube. However, more significant is regulatory influence of MSCs on survival, proliferation, and differentiation of the gastric and intestinal epithelial cells, as well as their immunomodulatory, pro-angiogenic and antifibrotic effects. Data from experiments on animals and clinical trials indicate prospect of using MSCs in various diseases affecting any parts of GIT. However, effective and safe clinical use of MSCs requires an in-depth study of the mechanisms of their therapeutic effect, the development of optimal methods of administration, and risk assessment of adverse effects. This review analyzes MSC participation in regeneration of GIT and systematizes data on the potential of using MSCs in the treatment of gastroenterological diseases.

Floating Microsponge: An Emerging Drug Delivery System

Floating microsponges are a method to extend gastric residence time, there with the aid of using concentrated on site-responsive medicament liberate withinside the top GIT for locally or systemic effect. Gastro retentive dosage forms (GRDFs) are getting utilized from a totally long term to enhance treatment with numerous main medications. Floating microsponge significantly enhances the therapy of stomach with the aid of using liberating the medication locally and for that reason used for medication selecting at specific organ. This may be sustained over an extended period of time. Floating drug delivery allow extended and non-stop release of the drug to the top a part of Gastro intestinal tract and this expressively amplify the period of drug release and enhance pharmacokinetic of medication which have slim healing window, with the aid of using this method dosing frequency and affected person compliance is increased. A microsponge’s drug delivery system is a particularly cross-linkage, spongy, polymeric microsphere, polymeric device consisting permeable microspheres. Microsponges are prepared with the aid of using numerous techniques consisting of liquid-liquid suspension polymerization and quasi emulsion solvent diffusion method. Microsponge,s preparations are strong over variety of pH 1 to 11; microsponge,s preparations are strong on the temperature as much as 1300C well suited with maximum vehicles and ingredients. The present assessment introduces microsponge,s technology at the side of its techniques of preparation, characterization, advantages, evaluation and release mechanism of microsponge,s drug delivery system, advertised product and up to date studies regarding microsponge.
 Keywords: Floating microsponge, Oral administration, Controlled release, Quasi emulsion, Target release.

Intestinal aldosterone synthase activity and aldosterone synthesis in mouse.

Aldosterone is the most important mineralocorticoid hormone regulating water and electrolyte absorption in the distal convoluted tubule of the kidney. Recently, we detected the presence of the whole chain of aldosterone production from the precursor corticosterone, transcription factor liver receptor homologue-1 (LRH-1), the aldosterone synthase enzyme protein (CYP11B2) as well as the gene to the final product aldosterone in murine large intestine. Here, we decided to correlate the amount of this synthase protein with its enzymatic activity in different parts of gastrointestinal tract and also with the aldosterone concentration in the respective tissue. Considering the physiological behavior of the animals in light and dark environment, we measured these variables at four time points - two in the light, the others during darkness. In vitro activity of CYP11B2 was measured as the amount of aldosterone formed from the precursor deoxycorticosterone using enzyme preparations from homogenized intestinal sections. CYP11B2 enzyme activity was higher in the large than in the small intestine. In ileum and colon, the CYP11B2 activity increased in the dark time. The highest aldosterone concentration was detected in the dark in the large intestine. In summary, enzyme activity of CYP11B2 was present in all parts of intestine; the large intestine formed more aldosterone during the darkness. No difference was seen in any of the variables between the early and late light hours.

FORMULATION AND INVITRO EVALUATION OF PRAZOSIN HYDROCHLORIDE UNFOLDING TYPE GASTRO RETENTIVE FILM

The present work is based on the formulation and In-vitro evaluation of a gastroretentive mucoadhesvie based drug delivery system containing prazosin hydrochloride for controlled release. It consists of a drug loaded polymeric film folded into a hard gelatin capsule. After administration film unfolds and its swelling and bioadhesion to the gastric mucosa. Prazosin hydrochloride, a histamine H2 receptor antagonist used for gastroesophageal reflux disease (GERD), duodenal ulcer and gastric ulcer. Prazosin hydrochloride absorbed only in the initial part of gastro intestinal tract (GIT) and has less bioavailability. Thus by retaining the drug in the gastric region improves its bioavailability. Films were prepared by solventcasting method using HPMC K4M, and Carbopol 971P NF as polymers and PEG 400 as the plasticizer. The prepared film were evaluated for various parameters such as film thickness, folding endurance, uniformity of weight, surface pH, determination of drug content, moisture content, swelling index, In-vitro mucoadhesive study retention time, In-vitro unfolding behavior and In-vitro drug release studies and drug release kinetics. Differential scanning calorimetry revealed there were no polymorphic changes in drug as well as polymers during the formulation of polymeric film. Optimized formulation showed 99.02 % drug release at the end of 12 hrs and it follows the Korsmeyer-peppas kinetics model of drug release. Keywords: Gastroretentive mucoadhesive film, Solvent casting method, Prazosin hydrochloride

Flaxseed Mucilage Hydrogel based Floating Drug Delivery System: Design and Evaluation

Natural polymer-based plant polysaccharides and proteins have been most widely explored as an adjuvant in the dosage form formulation. Here we design a novel gastro-retentive floating tablet, based on a polysaccharide material from Flaxseed (Linum usitatissimum L.) for Domperidone. After oral administration; Domperidone showed good solubility in acidic pH but significantly reduced solubility in alkaline medium. So that to increase the absorption and bioavailability of Domperidone, it is necessary to increase the retention time in the upper part of the Gastrointestinal tract (GIT) by developing a floating sustained drug delivery system. The directly compressible floating tablets of domperidone were formulated using varying amount of hydroxypropyl methylcellulose K 100 M (HPMC K100 M), Carbopol 934 and Flaxseed mucilage. Hardness, friability, weight variation, thickness, disintegration time of tablet formulations were within acceptable limits. The overall results explained that the optimized formulation F5 prepared by the exact ratio of Flaxseed mucilage, HPMC K100 M, Carbopol, could be more efficient on floating and sustained release of Domperidone in the upper part of GIT as compared to the tablets prepared by using HPMC K100 M and Carbopol 934 only. These findings indicated that Flaxseed can be used to develop novel gastro-retentive sustained release drug delivery system with the double advantage of sustained drug release at the upper part of GIT.

Inflamatorní myofibroblastický tumor v otorinolaryngologii

Introduction: Inflammatory myofibroblastic tumour (IMT) is a rare tumour with borderline biological behaviour composed of fibroblasts and myofibroblasts and accompanied by non-neoplastic inflammatory cells. It occurs mostly in children and young adults. The disease is most commonly seen in abdominal soft tissues (omentum, mesentery, etc.), in the lungs and also has been reported in other parts of gastrointestinal tract and other organs. In the head and neck region IMT is not so common, it may occur in larynx, trachea or nasal sinuses. The primary therapeutic approach is a complete surgical excision. Radiation, chemotherapy or biological treatment modalities are used in aggressive, non-resectable, and recurrent tumours or in case of metastases. Aims: Through a case report on a small set of patients and up-to-date information from the literature, the authors want to share knowledge about the rare diagnosis of IMT in ENT, its possible clinical manifestations, differential diagnosis and appropriate treatment. The group of patients, the case report: The paper presents patients with IMT treated at the Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove in the years 2013–2020. The case of a 11-year-old boy with progressive dyspnoea caused by polypoid tracheal tumour is discussed in more detail. The tumour was removed by external surgical approach with bronchoscopy assistance. Histological examination proved an IMT. Conclusion: IMT is a rare neoplasm which must be included in the differential diagnosis of tumours of the respiratory tract, especially in children and young adults. The treatment consists of complete surgical removal and regular follow-up due to the risk of local recurrence. Keywords: inflammatory myofibroblastic tumour – dyspnoea in a child – tracheal tumour

FORMULATION AND IN-VITRO CHARACTERIZATION OF ABACAVIR SULPHATE EFFERVESCENT FLOATING TABLETS

fter oral administration of Abacavir, rapid absorption occurs from upper part of gastro intestinal tract with peak concentrations occurring at 0.63 - 1 hr after dosing. Conventional drug therapy with tablets produce relatively rapid and high peak blood levels that requires frequent administration to maintain effective range of plasma drug levels. This conventional therapy leads to reduced effectiveness with poor therapeutic management. To overcome the inadequacy of conventional therapy with tablets, floating sustained release Abacavir tablets were developed. Floating sustained release Abacavir Sulphate tablets were prepared by using direct compression method. Tablet were formulated using Ethyl Cellulose with hydrocolloids like Hydroxypropyl Methylcellulose (HPMC K4M) and Carbopol 974P as release retarding polymers, Sodium bicarbonate (NaHCO3) and Citric acid as effervescent agents. Tablets were then evaluated for various physical parameters including hardness, thickness, weight variation, friability, drug content, in-vitro buoyancy, Swelling index and Invitro gastro retentive drug release were conducted. Drug and excipient compatibility studies show that they are compatible with each other. The optimized formulation (F9) shows the hardness of 5.7kg/cm2, tablet thickness of 2.74mm, 0.45% of friability, in-vitro buoyancy was up to 6 hours and % drug release was 90.56% in 6 hours. Drug release kinetics was found to follow non-fickian diffusion. Hence, F9 is considered as optimized formulation based on invitro buoyancy and % drug release.

Multiple gastrointestinal magnetic foreign bodies in children

Objective: To introduce the analysis of the clinical picture, treatment strategy and complications among children having multiple foreign magnetic bodies (FB).Methods: Retrospective analysis of the treatment of 796 children from 2013 to September 2021 having stomach and intestine FB. Comprehensive study included plan radiography of the abdomen, fiberoptic gastroduodenoscopy, etc.Results: Magnets were detected in 33 (4.15%) out of 796 cases. 9 patients swallowed multiple foreign magnetic bodies (FB) within time interval. The parts fixed in different parts of gastrointestinal tract (GIT) and required surgical removal. All patients had multiple perforations of different GIT parts. It required suturing gut wall, bowel resection applying gastrointestinal anasto mosis and celiogrhaphy, resection applying anastomosis and by leaving the programmed laparostomy. Every patient recovered. Algorithm of supervision of children having FB GIT.Conclusions: Multiple foreign magnetic bodies of GIT among children in the current moment are the most dangerous foreign objects accompanied with big amount of complications. They are observed among children of any age and gender and require complicated and long surgical interventions. Multiple foreign magnetic bodies of GIT can be suspected in case of severe surgical pathology along with the lack of passage of radiopaque FB in GIT. Urgent surgical intervention is required in case of detecting it.

Abdominal and pelvic imaging findings in COVID-19

Pulmonary imaging findings of Coronavirus disease 2019 (COVID-19) has been widely described, but recently few studies have been published about abdominal and pelvic radiological presentation. The aim of this study was to provide an overview of abdominal imaging findings in patients with COVID-19. After investigation of recent published literature we came to conclusion that most common findings are associated with gastrointestinal abnormalities with mural thickening of part of gastrointestinal tract being the most common, followed by vascular and less frequently described solid organ and gallbladder abnormalities. It is important to be familiar with abdominal COVID-19 manifestations, since they’re often implicated with the development of poor clinical outcomes.

Pan-Gastrointestinal Tract Mucosal Pathologies in Patients with Celiac Disease with the Demonstration of IgA Anti-Transglutaminase Mucosal Deposits: A Case-Control Study.

While celiac disease (CeD) is considered to affect primarily the small intestine, pathological changes in other parts of the gastrointestinal tract (GIT) are also known to occur. IgA anti-tissue transglutaminase-2 antibody (anti-TG2 Ab) deposits at the site of involvement is one of the methods to establish CeD-related tissue pathology. To explore the utility of IgA anti-TG2 Ab deposits in pan-gastrointestinal mucosal biopsies as evidence of CeD-related pathologies. Forty-two treatment-naive patients with CeD and 45 patients with irritable bowel syndrome were included as cases and controls, respectively. Mucosal biopsies were collected from the esophagus, stomach, duodenum, and rectosigmoid regions at baseline from cases and controls, and additionally after 6-months of gluten-free diet in cases. All biopsies were evaluated for histological changes and subjected to dual-color immunohistochemical staining for identifying IgA anti-TG2 Ab deposits. Significantly higher number of patients with CeD had lymphocytic esophagitis (9.7% vs. 0%, P = 0.05), lymphocytic gastritis (35% vs. 8.8%, P < 0.01) and lymphocytic colitis (17.4% vs. 0%, P < 0.05) than that in controls. IgA anti-TG2 Ab deposits were observed in significantly more numbers in esophagus (30.9% vs. 6%, P < 0.001), stomach (62.2% vs. 9.3%, P < 0.01), duodenum (88.5% vs. 0%, P < 0.001) and rectum (17.4% vs. 0%, P < 0.05) than that in controls. There was a decline, but not statistically significant, in severity of lymphocytosis and intensity of IgA anti-TG2 Ab deposits in follow-up biopsies. Significantly higher number of patients with CeD had evidence of lymphocytic infiltration and IgA anti-TG2 deposits along GIT suggesting that CeD affects other parts of GIT.

Anastomosis of gallbladder with different parts of gastrointestinal tract. Gatewood, Poppens (Surg. Gyn. and Obst., 1922)

The authors performed 42 gallbladder anastomoses in dogs, 20 to the stomach, 17 to the duolenum, and 5 to the colon.

A Review on Updates to Increase the Residence Time of Drug in the Stomach for Gastro Retentive Drug Delivery System

Orally-administered controlled-release drug delivery systems are associated with the shortcomings of relatively short residence times in the human stomach as well as highly variable gastrointestinal (GI) transit times. Thus, considerable intra-individual and inter-individual differences in the bioavailability of drugs are observable. There are numerous drug substances which may benefit from prolonged and controlled GI passage times. As a solution to the problem, gastroretentive drug delivery systems (GRDDS), which feature an enhanced gastric residence time (GRT), were developed. Several approaches are currently used including Floating Drug Delivery System (FDDS), swelling and expanding system, polymeric bioadhesive systems, modified-shape systems, high density system and other delayed gastric emptying devices. The drugs having absorption window in the upper part of Gastro Intestinal Tract (GIT) have enhanced bioavailability when formulated through these techniques. The recent technological development for enhancing GRT including the physiological and formulation variables affecting gastric retention, patented delivery systems, approaches to design single-unit and multiple-unit floating systems, and their classification and formulation aspects are covered in detail. Despite the extensive research performed in the field of GRDDS, the development, the production, and the evaluation of floating devices are still challenging. The purpose of writing this review was to compile recent literature on pharmaceutical approaches used in enhancing the Gastric Residence Time (GRT). Enhancing the GRT may explore new potentials of stomach as drug-absorbing organ. © 2020 iGlobal Research and Publishing Foundation. All rights reserved.

Surgical Treatment of Liver Metastases from Gastrointestinal Stromal Tumor

Introduction: Gastrointestinal stromal tumors (GISTs) are rare tumors which can arise within in most parts of gastrointestinal tract. Most common sites of metastatic spread are liver and the peritoneum. Thyrosinkinase inhibitors greatly improved prognosis of the locally advanced and metastatic disease allowing patients to gain several years of overall survival, yet majority of them will eventually develop progression and succumb to disease. The role of surgical therapy in metastatic setting still remains unclear. Methods: Within the years 2011 - 2020, we performed 29 surgical procedures on 24 patients with liver metastasis from GISTs. We monitored postoperative morbidity, DFI and overall survival in all patients. Results: We identified 24 patients (range 32-80 years), 17 men and 7 women. In 15 patients a metachronous occurrence of metastases was found, most often within the median 2 years after the primary resection (range 2 - 9 years). 9 patients had synchronous disease. 6 synchronous resections were performed (primary tumor and liver), 3 stage resection were performed. 6 large resections were performed, otherwise mainly extraanatomical resections, eventualy combined with RFA (4x) were performed. Only RFA was performed 5 times. The morbidity according to Clavien – Dindo cassification > 2 was 24 %. 20 patients (83%) received systemic treatment before the surgery, and 21 patients (88%) after the surgery. The 1-, 3- and 5-year survival rate was 91%, 86%, and 72%. Conclusion: Surgical treatment of liver metastases from GIST is a safe method. RO resection and a good therapeutic response to systemic thyrosinkinase inhibitors therapy is an important predictive factor of reccurrence. A multidisciplinary approach for treatment of liver metastases from GISTs is necessary. We need further studies to determine the benefits of surgical treatment.

Bacterial overgrowth syndrome of upper parts of gastrointestinal tract in acute necrotizing pancreatitis

Aim: to study the changes in the microflora of the upper part of digestive tract during acute necrotizing pancreatitis.&#x0D; Material and methods. Acute necrotizing pancreatitis was induced in 42 white rats; changes in the mucous microflora of the upper part of digestive tract were studied. Bacteriological examination of the contents of the proximal small intestine was performed in 42 patients with acute necrotic pancreatitis during gastrofibroscopy.&#x0D; Results and discussion. Induction of acute necrotic pancreatitis was accompanied by impaired colonization resistance of the intestinal mucosa due to the elimination of bifidobacteria and lactobacilli: the frequency of their growth from the mucosa decreased threefold (p&lt;0.01), and the population level, respectively, by 25% (p&lt;0.05) and by 36% (p&lt;0.02). The mucosa was actively colonized by gram-negative pathogenic and conditionally pathogenic enterobacteria at high population level (3.07‒5.39 lg CFU/g), which allowed this microflora to overcome the damaged intestinal barrier and translocate. Pathogenic Escherichia spp. and Proteus spp. were cultivated from the mesenteric lymph nodes in 24 hours; Enterobacteria spp. and Staphylococci spp. were isolated from portal blood, pancreatic tissue, and peritoneal cavity 48 hours after induction of acute pancreatitis. Eight strains of gram-negative microorganisms were identified in small intestine in 69% of patients before surgery. Similar microflora was cultivated from pathological foci in 57.4% of patients after surgery.&#x0D; Conclusion. Severe deficiency of autochthonous anaerobic microflora occurred in the upper parts of the digestive tract in acute necrotizing pancreatitis, causing excessive colonization by pathogenic and conditionally pathogenic microorganisms and promoting bacterial translocation.

Мethodical Recommendations for sampling and Preserving of gastrointestinal Nematodes of Ruminants

The purpose of the research is improving the accuracy of studies of nematodes parasitizing in the digestive tract of ruminants. Materials and methods. The literature data and own research results concerning sampling and preserving of nematodes parasitizing various parts of gastrointestinal tract of domestic and wild ruminants have been analyzed. The possibility of using the samples of nematodes, both in morphological and molecular studies, has been taken into account. Results and discussion. The methods for sampling and preserving of gastrointestinal nematodes of ruminants are described in detail. The features of sampling nematodes parasitizing in various parts of the digestive tract are considered. The ways for minimizing of losses of nematode samples during helminthological necropsy are proposed. Using of 96% ethanol as a preserving liquid is recommended and allows the DNA study of samples.

CHANGES IN SMALL INTESTINE MICROFLORA IN PATIENTS WITH ACUTE INTESTINAL OBSTRUCTION

Among urgent surgical diseases of abdominal cavity, an acute intestinal obstruction is the most difficult to be diagnosed and treated. Leading factor, determining the development of pathophysiological processes is considered to be the progressive manifestations of enteric insufficiency syndrome, resulting in intestinal barrier impairment, negative changes in ecology of intestinal flora, increased endotoxins. To identify the small intestine microflora in acute intestinal obstruction and determine the role of dysbiotic disorders in clinical manifestations of main pathological process, a study was conducted in 60 patients with mechanical intestinal obstruction. The small intestine has a relatively rare microflora, consisting mainly of gram−positive facultative aerobic microorganisms, streptococci, lactobacilli. The distal ileum in nearly 30−55 % of healthy people contains scanty microflora, and yet the flora of this area differs from the microbial population of the higher gastrointestinal tract due to higher concentration of gram−negative bacteria. Optional−anaerobic coliform bacilli, anaerobic bifidobacteria and fusobacteria, bacteroids, the number of which starts exceeding the one of gram−positive species, are presented in significant quantities. Distal to the ileocecal valve there are significant changes in the microflora quantitative and species composition. Obligatory anaerobic bacteria become the predominant part of microflora, exceeding the number of aerobic and facultative anaerobic bacteria. The bacterial flora in different parts of gastrointestinal tract has its own specifics and is quite constant, as a result of the interaction of many factors, regulating the bacterial population in small intestine. The most important among them are: acidity of gastric juice, normal peristaltic activity of the intestine, bacterial interactions and immune mechanisms. Disorders of the intestine motor and evacuation function with its obstruction lead to slow passage of the chyme and contamination of the upper gastrointestinal tract with new types of microbes. There is a syndrome of small intestine excessive colonization, which means an increased concentration of bacterial populations in it, similar in species composition to the colon microflora. Pathological intra−intestinal contents become a source of endogenous infection and re−infection of the patient, leads to internal digestive disorders, which is manifested by syndrome of malabsorption of proteins, carbohydrates and vitamins. Key words: acute intestinal obstruction, small intestinal microflora, conditionally pathogenic microorganisms, intestinal biocenosis.

Colon Targeted Drug Delivery: A Review on Novel Approaches

Both local and systemic delivery of drugs can take place in colon. There are day by day new developments in field of colon specific drug delivery system. Colonic drug delivery has gained importance for the delivery of the drugs for the treatment of local diseases associated with the colon like Crohn’s disease, ulcerative colitis, etc. It has also used for the systemic delivery of proteins, therapeutic peptides, anti-asthmatic drugs, antihypertensive drugs and anti-diabetic agents drugs. Thereby reducing the systemic side effects treatment can be made effective if the drugs can be targeted directly into the colon. A drug need to be protected from degradation to achieve successful colon targeted drug delivery, release and absorption in upper portion of the GI tract and then to be ensured controlled release in the proximal colon. pH-dependent systems, time-dependent systems, and microbial triggered systems are the usual methods for delivering the drug to the last part of Gastro Intestinal tract. Pressure controlled colonic delivery capsules, CODESTM, and the osmotic controlled drug delivery are the newer technologies namely which are having in vivo site specificity, and feasibility of manufacturing process. The merits and demerits, novel approaches in the colon targeted drug delivery, clinical evaluation techniques and some information on the marketed dosage forms are one focused on in this review. To overcome pervious method’s limitations new systems and technologies have been developed for colon targeting. Colon targeting still need more innovative work even tough it holds a great potential and there are new developments in field of colon specific drug delivery system day by day.