Stomach Of Man Research Articles

Trends in gender-based disparity in incidence, mortality and survival for major digestive disease cancers in the U.S. (2000-2016).

e13621 Background: Males have excess risk of most digestive cancers; whether cancer mainly due to virus (stomach), lifestyle including obesity/alcohol (colon/esophagus), or both (liver). We evaluated for secular trends in gender-specific incidence, mortality and survival for these cancers in the U.S. Methods: We used official U.S. Cancer Statistics [USCS] data (2000-2016) to calculate annual age-adjusted incidence and mortality rates (IR/MR). It covers >98% population/all states (vs. SEER-10 statewide registries, covers <1/3rd African-Americans/Whites). We calculated mortality-to-incidence rate ratios (MIR), an established 5-year survival proxy. We used Joinpoint to assess trends in average annual percentage change (AAPC). Results: Table shows age-adjusted IRs and MRs for colon, esophagus and stomach cancer decreased for men and women (all AAPCs negative, all significant but stomach IR women), with both liver IR/MR significantly increasing in both genders. Gender differences in relative burden were seen (e.g., MRs in colon>esophagus>liver>stomach in men vs. colon>stomach>liver>esophagus in women), with greatest male excess in esophagus (e.g., 4.4-fold IR). MIRs suggested less favorable survival (higher=worse) for men for esophagus/colon. Conclusion: Substantial gender disparity persists in digestive cancers, with male excess gap decreasing for colon and increasing for liver. [Table: see text]

The Role of Allelic Variants of Several Genes of Cytokines in the Development of Gastric Cancer

Pro- and anti-inflammatory cytokines modulate the inflammatory response in the gastric mucosa. The analysis of associations of allelic variants of cytokine genes in the process of tumorous transformation of the gastric mucosa is an urgent problem. Its solution could make it possible to identify the features of production of inflammatory mediators by the immunocompetent cells during gastric carcinogenesis. The frequencies of alleles and genotypes of the rs1143634 and rs16944 loci of the IL1β gene, rs71941886 of the IL1RN gene, rs4073 of the IL8 gene, and rs1800872 of the IL10 gene were analyzed in 221 patients with established diagnosis of gastric cancer, as well as in 279 unrelated healthy individuals from the Republic of Bashkortostan. We discovered an association of the allele С and genotype C/C of the rs1143634 locus of the IL1β gene with a risk of development of malignant tumors of the stomach in men. We identified statistically significant differences in between patients and the control group in the distribution of frequencies of alleles and genotypes of the polymorphic variants: rs16944 of the IL1β gene and rs1800872 of the IL10 gene. Dependence of the associations with clinical features of the disease was also shown. Application of the APSampler algorithm revealed the combinations of alleles and genotypes associated with reduced and increased risk of the development of gastric cancer. The most significant were IL1β (rs1143634)*T + IL1β (rs16944)*T/T, IL8*A + IL10*A + IL1β (rs1143634)*T + IL1β (rs16944)*T, and IL10*A + IL1RN*2/2. The obtained results confirm the influence of the investigated allelic variants of cytokine genes on the risk of developing gastric cancer and play an important role in understanding the genetic structure of the studied pathology.

Lifestyle among former cancer patients in Brazil in 2013.

People who have been diagnosed with cancer tend to adopt healthier lifestyles. This study analyzes the prevalence of smoking, eating fruits and vegetables, exercise and the use of alcoholic beverages among individuals who reported to have been diagnosed with cancer in the PNS (Pesquisa Nacional de Saúde or National Health Survey). The prevalence and corresponding 95% confidence intervals were calculated for consuming fruits and vegetables, sedentary lifestyle (no exercise), use of alcoholic beverages, being overweight and tobacco use. The associa-tion between having received a diagnosis of cancer and the risk and protection factors was analyzed using a Poisson regression, adjusted by sociodemographic variables and other chronic comorbidities. The analyses were stratified by time since the diagnosis and the type of cancer related to the factors analyzed. The types of cancer most often reported were breast and cervix in women, and prostate and stomach in men. Among those who had cancer diagnoses, there was a higher consumption of fruits and vegetables, higher proportion of ex-smokers, however, increased use of alcohol. There was no difference in the frequency of exercise or incidence of being overweight between the two groups. Measures to promote health and prevent chronic diseases should be implemented in the follow-up of people who have had cancer, in an effort to ensure integrated healthcare.

The Way to a Man's Stomach Is Through His Heart

Question: A 74-year-old man underwent gastroscopy owing to severe nausea, vomitus, and fluctuating mild epigastric discomfort of 2 months’ duration. He had known chronic renal failure with a creatinine clearance of 32 mL/min (Modification of Diet in Renal Disease formula), diabetes mellitus, and coronary heart disease with a history of myocardial infarction. The patient reported initiation of his current gastrointestinal (GI) symptoms within several hours after a coronary angiography with stent implantation in the right coronary artery owing to worsening chest pain.

A placebo‐controlled trial of the 5‐HT1A agonist R‐137696 on symptoms, visceral hypersensitivity and on impaired accommodation in functional dyspepsia

Acute studies suggested a therapeutic benefit for fundus-relaxing drugs in functional dyspepsia (FD) with visceral hypersensitivity (VH) to gastric distention or impaired accommodation (IA), but long-term studies are lacking. R-137696 is a serotonin-1A (5-HT(1A)) receptor agonist which relaxes the proximal stomach in man. Our aim was to investigate the influence of R-137696 on symptoms in FD with VH or IA. Randomized, double-blind, placebo-controlled, parallel group study of 4 weeks R-137696 2 mg t.i.d. in FD with VH or IA. Symptoms were assessed using the patient assessment of upper gastrointestinal symptom severity index (PAGI-SYM) total score and individual symptom subscales. Barostat studies were performed before and after 4 weeks of treatment. Fifty-three patients (33 VH and 20 IA), 18 men, mean age 40 +/- 13 years were recruited. Twenty-four received placebo and 29 received R-137696. In VH patients, both placebo and R-137696 improved total symptom scores, with a tendency for superiority of placebo (-1.12 vs-0.51, P = 0.07). Placebo was superior for the subscales of early satiety, bloating, fullness and discomfort (all P < 0.05). In IA, both placebo and R-137696 had no significant influence on total or individual symptom scores (-0.08 and -0.27). In VH, both placebo and R-137696 increased the discomfort volume, without a statistical difference between both arms (+120 and +164 mL). In IA, both placebo and R-137696 enhanced accommodation, without a statistical difference between both (+77 and +159 mL). Adverse events were similar for drug and placebo. A 4-week administration of the fundus-relaxing 5-HT(1A) agonist R-137696 failed to significantly improve symptoms, VH or gastric accommodation compared to placebo.

856 Remote Magnetic Manipulation of a Wireless Capsule Endoscope in the Esophagus and Stomach of Man

856 Remote Magnetic Manipulation of a Wireless Capsule Endoscope in the Esophagus and Stomach of Man

No effects of high intake of nitrate in drinking-water on urinary mutagenicity and cytogenetic tests in pigs.

High levels of nitrogen-containing compounds like nitrate, nitrite and ammonium are not seldom found in drinking water. The conversion of nitrate to nitrite and the subsequent reaction with an amine to nitrosamines could take place under physiological conditions similar to those existing in the stomach of man or in the pig. Many nitrosamines have shown to be mutagenic and/or carcinogenic in test systems (BOGOVSKI and BOGOWKI 1981). It is probably impossible to study the mutagenic effect of nitrate in drinking water in man since the intake comes from various resources. The contribution of nitrate and nitrite from other foodstuffs is also difficult to control. The daily intake of water of growing pigs varies between 3 and 7 1 and they usually drink the same water during their entire life. Unlike man, they are also brought up on a standardized diet. Since man and pig have similar intestinal conditions, the possibility of nitrosamine formation would be the same in both species. Therefore, pigs ought to be suitable objects when studying the possible mutagenic effects caused by high levels of nitrate in drinking water. The aims of the present study were to investigate these effects by different mutagenicity tests like the formation and excretion of mutagens (thioether and fluctuation tests on urine) and the appearance of cytogenetic damage (micronuclei in peripheral blood lymphocytes and bone marrow cells).

Venous anatomy of the lower oesophagus in portal hypertension: practical implications.

The venous anatomy of the lower oesophagus and upper stomach in man was studied using high resolution resin casts obtained from ten fresh cadavers. Four layers of veins were identified in the oesophagus of both normal and portal hypertension patients. Intra-epithelial channels drained into a superficial venous plexus which connected to larger deep intrinsic veins. Both the superficial plexus and the deep intrinsic veins communicated directly with their counterpart veins in the stomach. Perforating veins connected the deeper veins with the adventitial plexus, the fourth layer. In patients with portal hypertension all of these veins were significantly dilated. Typical large oesophageal varices arose from the main trunks of the deep intrinsic veins which communicated directly with gastric varices. This study clarifies the anatomy of oesophageal varices and may explain why sclerotherapy is usually effective. The venous communications are probably partly responsible for the recurrence of varices after sclerotherapy.

Effect of selective gastric vagotomy on histamine concentration in gastric mucosa of patients with duodenal ulcer.

Abstract In a prospective controlled trial, histamine concentrations in human gastric mucosa were determined fluorometrically in 23 patients 6–11 months after selective gastric vagotomy with drainage and in patients who had undergone other types of operation for duodenal ulcer. The study was in two parts: part 1, a synchronous investigation of mucosal histamine concentrations in patients who had undergone vagotomy, in duodenal ulcer patients before operation and in control subjects; part 2, a consecutive study of the same patients before and after vagotomy. In part 1, patients with Hollander-negative vagotomy were found to have significantly higher mucosal histamine concentrations than ‘healthy’ control subjects or duodenal ulcer, however, had as low mucosal histamine concentrations as duodenal ulcer patients who had not been operated on. In part 2, all duodenal ulcer patients showed an increase in gastric mucosal histamine concentration after vagotomy (P &amp;lt; 0·01). The smallest increase was in a patient with an incomplete vagotomy. Control patients who were not operated on but who underwent endoscopy and biopsy twice in the period of investigation, did not show any increase in mucosal histamine concentration between the times of the first and the second biopsy. The overall results of selective vagotomy and drainage in this study, with respect both to clinical Visick gradings and to radiological and acid secretory findings, were comparable to those reported by other authors. No significant change in numbers of parietal cells was found after vagotomy. Thus, selective gastric vagotomy with a drainage procedure leads to increased concentrations of histamine in the mucosa of the body of the stomach in man. The mechanism is not clear, but might be through inhibition of histamine release from mast cell stores.

Estimates of Cancer Incidence in China for 2000 and Projections for 2005

Abstract Knowledge of the incidence of cancer is a fundamental requirement of rational planning and monitoring of cancer control programs. The lack of national-level information systems on health indicators in China means that estimation methods are required. Estimates and projections of national level cancer mortality have been previously made using sample surveys of deaths. Using these mortality data, incidence rates in 2000 and 2005 were estimated by means of the ratio of cancer cases/deaths (by site, age, and sex) in good quality cancer registries in China. A total of 2.1 million cancer cases were estimated for the year 2000 (1.3 million in men, 0.8 million in women), with the most common sites being lung, liver, and stomach in men, and breast, lung, and stomach in women. The total number of new cases is expected to increase by 14.6% by 2005, primarily as a result of population growth and aging. In addition, the rising rates of lung cancer incidence (in both sexes) and breast cancer mean that there will be much greater increases in the number of cases at these two sites (27% for lung cancer in men, 38% for lung and breast cancer in women). These two cancers are now the priorities for cancer prevention, early detection, and therapy in China.

438 The influence of LPS and ethanol stimulation on n-nitrosodimethylamine (NDMA) synthesis by transfected HEPG2 cells

The extent of formation of N-nitrosodimethylamine (NDMA) in the stomachs of rats and mice after simultaneous oral administration of [14C]dimethylamine and potassium nitrite was determined by measuring the methylation of liver DNA. With doses of around 1 mg dimethylamine hydrochloride/kg body weight and 50 mg potassium nitrite/kg body weight, 0.8% of the amine was nitrosated on average. The individual fluctuations ranged from 0.2 to 1.3% in the rat and from 0.2 to 1.9% in the mouse. Simultaneous administration of 50 mg sodium ascorbate (vitamin C)/kg body weight inhibited the nitrosation by about 80% while 50 mg α-tocopherol acetate (vitamin E)/kg body weight reduced the nitrosation by about a half. Assuming similar kinetics and conditions of nitrosation in rats and man, a comparison of the formation of NDMA in vivo from dietary dimethylamine and nitrite with the estimated human uptake of preformed NDMA revealed that in vivo formation in the stomach of man is probably negligible.

Regional differences of the stomach in the motor and sensory response to gastric distension and the role of simultaneous distending stimuli

Background: [inputted gastric accommodation, wltb redistribution of the meal to the distal stomach, }*as been imphcated m the pathogenesis of functional dyspepsia symptoms. However, it rentains unclear Which part of the stomach is responsible for symptom generation. Recent studies suggest differential sensitivities of each region, but simukaneons barostat studies have not been pertbrmed The aim of the present study was to investigate the effect at separate and simukaneous bamstat distention of proximal and distal stomach in man. Methods: In 11 beahby volunteers (10 males: age 29• 1 years), a long tube assembly was placed through the py!orus Two bamstat balloons were attached to the tube at distances ensuring location irt the proximal and distal stomach Stepwise isobanc distentiorts of either bag were perfonned in a randomized order. VAt scores at each distending step assessed intensity of discomior~, balhress, bloating, nausea, belching, epigastric burning and satiety Distentions were pe~tormed with or without background distentim~ of the other bag at MDP + 2mmHg Finally, accommodation of the proxin*al stomach was assessed alter ingestion of a liquid meal w*th background antraI distention. Resnhs: The distal stomach had s*gnificandy lower compliance (56 • 4 vs 93 • 6 mUmmHg; p<0.001) Pressures and corresponding volumes at perception threshold d*d not differ between proximal and distal stomach (4 • 1 vs, 5 • 1 mmHg, 213 • (54vs. 219 • 66 mL; NS). At diseomtort threshold, pressures were not slgnflcantly different (12 • 2vs. 14 • 2mmHg, NS) but corresponding distal stomach volumes were slgndtcantly lower (959_+. 89 vs. 651 • 71 nil.; p<0.001) Perception scores and severity of individuaI symptoms at tim same distending pressures did not differ between the proximal and distal stomach. Backgeound distention did not significantly affect the pressures and the corresponding volumes at the thresholds tar perception and tbr discomfort, Conclusions: The sensi i*`aty to distension and the symptoms reduced bydistensmns do not differ between the proximal and distal stomach in man A low level of simultaneous distension does not modiI} 9 the percepuon of gastric distension.

Activity of class I, II, III, and IV alcohol dehydrogenase isoenzymes in human gastric mucosa.

The gastric alcohol dehydrogenase (ADH) plays an important role in the "first pass" metabolism of ethanol. Human ADH exists in multiple forms, grouped into six classes and located in different tissues. In present study we investigated the activity of four classes (I, II, III, and IV) of alcohol dehydrogenase isoenzymes in the different parts of stomach (corpus and antrum) in patients with suspected gastric ulcer. The aim of the study was assess the particular role of different classes of ADH in the gastric dehydrogenase activity. For the measurement of the activity of class I and class II isoenzymes, we employed new fluorometric methods with specific substrates. The activity of class III alcohol dehydrogenase was measured by the photometric method with n-octanol and class IV with m-nitrobenzaldehyde as a substrate, respectively. All biopsy specimens were taken from less changed areas of the antrum and body of the stomach of 68 patients suspected of having gastric ulcer. It was found that ADH IV (gastric) activity was the highest (14.76 +/- 0.68 in the corpus of the stomach in men; and 7.61 +/- 0.68 in women, respectively). The activity of the ADH III isoenzyme was lower than that of ADH IV. The activities of class I and II ADH isoenzymes were barely detectable. All tested classes of ADH had higher activity in the corpus than in the antrum and in males than in females. In conclusion, the most important form of gastric ADH is isoenzyme of class IV, less important is the isoenzyme of class III. ADH classes I and II seem to have no role in the stomach.

Flatland optics: fundamentals.

"Flatland" is the title of a 120-year-old science fiction story. It describes the life of creatures living in a two-dimensional (2D) Flatland. A superior creature living in the three-dimensional (3D) spaceland, as we do, can easily inspect, for example, the inside of a Flatland house, as well as the content of a flat man's stomach without leaving any trace. Furthermore, the 3D person has supernatural powers that enable him to change the laws of physics in Flatland. We present here the concept of a 2D Flatland optics with one transversal coordinate x and one longitudinal coordinate z. The other transversal coordinate y allows total inspection of Flatland optics, and the freedom to change the wavelength, without using something like nonlinear optics or a Doppler shift. Monochromatic 3D light can be converted reversibly into polychromatic 2D light. A large variety of 2D systems and 2D effects will be presented here and in follow-up contributions. An epilogue faces the question, how "real" is Flatland optics?

Helicobacter pylori Determinants of Pathogenicity

The bacterium Helicobacter pylori colonises the stomach of man and induces a strong inflammatory response. Differences in the possession of pathogenicity determinants by H. pylori isolates could account in part for the different clinical outcomes of infection. The main H. pylori pathogenic factors, i.e. urease, the cytotoxin VacA, and the genes involved in virulence contained in the pathogenicity island (PAI) cag, may promote tissue damage and ulceration, and could contribute to gastric cancer development. Strains with the mosaic vacA allelic type s1a/m1 and possessing the cag insertion are considered endowed with increased inflammatory potential, and are more likely to be isolated from patients with peptic ulcer and gastric cancer. The presence in H. pylori cag PAI of operons involved in the stimulation of gastric epithelial cells to secrete high levels of inflammatory cytokines, in mobilisation of DNA, and formation of secretory mechanisms and conjugation apparati, could contribute to increase the risk of gastric cancer development in patients infected by this microorganism.

Helicobacter pylori infection.

Helicobacter pylori colonizes the stomach of man, especially during childhood. However, H. pylori strains are not created equal, with major differences in virulence factors such as the vacuolating cytotoxin A and the cytotoxic-associated gene A, probably accounting for different clinical symptoms. The majority of infected subjects remain asymptomatic. Symptoms are aspecific. Helicobacter pylori infection is correlated with socioeconomic conditions and hygienic circumstances, resulting in an extremely high prevalence in children in developing countries. The golden standard technique to diagnose Helicobacter infection is culture of gastric biopsies; specificity and sensitivity of serology are low during childhood. Carbon-13 urea breath tests are a useful in the diagnosis but especially during follow-up. Recommended treatment consists of proton pump inhibitors in combination with two antibiotics out of amoxycillin, clarithromycin and metronidazole. The importance or clinical relevance of Helicobacter infection in asymptomatic individuals remains to be determined.

Venous drainage of the stomach in the golden hamster ( Mesocricetus auratus) and the guinea pig ( Cavia aperea f. porcellus)

Venous drainage patterns of the stomach were studied in 30 golden hamsters (Mesocricetus auratus) and in 30 guinea pigs (Cavia aperea f. porcellus). In golden hamsters the most frequent group had a v. gastroepiploica dextra (85.6% of cases). The v. gastroepiploica sinistra was found in 63.3% of cases. In the second group, the venous drainage pattern was without a v. gastroepiploica dextra (13.3% of cases). The only constant venous channel from the stomach was the v. gastrica sinistra. Other veins draining the stomach were vv. gastricae (tributaries of the v. lienalis) and interorgan venous anastomoses with neighbouring organs. A venous arch along the curvatura ventriculi major was not observed in any of the cases. In the guinea pig, the first group with a v. gastroepiploica dextra accounted for 90.0% of cases while the second group without this vein represented 10.0% of cases. The only constant venous channel was, once again, the v. gastrica sinistra. Other veins of the stomach were similar to those in the golden hamster. A venous arch along the curvatura ventriculi major was found in 76.6% of cases. Some differences in the venous pattern between the two animal species can be explained by zoological differences in these mammals. The results obtained also stimulate interest in the study of possible variations in venous patterns of the stomach in man.

Helicobacter pylori infection in children.

Helicobacter pylori colonises the stomach of man, especially during childhood. However, Helicobacter pylori strains are not created equal, with major differences in virulence characteristics which probably account for different clinical symptoms. The majority of infected subjects remain asymptomatic. H. pylori infection is correlated with socioeconomic conditions and hygienic circumstances, resulting in an extremely high prevalence in (children of) developing countries. Commercial available screening tests are not capable to separate the more virulent strains (type I with vacuolating toxin VacA and CagA protein) from the less virulent strains (Type II, vacA and CagA negative). Type I strains, but not Type II, are associated with an increased risk for duodenal ulcer and gastric cancer. Therefore, (future) screening tests (and vaccination) should focus on the Type I strains.

Perception of phasic tension changes in the proximal stomach in man

Distension protocols of the proximal stomach in volunteers elicit symptoms resembling those observed postprandially in functional dyspepsia patients. There is increasing evidence that fundic tension more than fundic elongation determines the intensity of those symptoms. In distension studies, there is a simultaneous activation of tension and elongation receptors. When phasic contractions occur on a fixed volume, phasic tension changes are generated. Erythromycin (Ery) enhances fasting gastric fundus tone and phasic fundic contractions in man (Bruley des Varannes, 1995). Aim: To study the perception of spontaneous and erythrnmycin induced phasic changes in fundic wall tension in healthy volunteers. Methods: In 24 healthy volunteers (8 women, mean age 24.0 + 2.0 y) a barostat balloon was placed in the stomach after an overnight fast. Simultaneously stationary antro-duodenal manometry was performed. The correct position of both probes was checked fluoroscnpically. After an accommodation period of 20 min graded isnvolumetric distentions were applied (100 ml increments during 2 rain). Perception was noted using a validated score (0-6) at each distension step to determine the threshold for sensation. After a 20 minute accommodation period, the balloon was inflated with a fixed volume just below the volume necessary to induce the first perception during 10 minutes. The volunteers were asked to indicate a perception score, at least every 30 seconds or sooner if they noticed any change in perception, on a keypad connected to the recording computer. In this isovolumetric mode, phasic tension rises are recognized as pressure peaks. Tracings were visually analyzed. An increase of intra-balloon pressure of 5 mmHg above the baseline was considered as a phasic contraction. If this increase of pressure was followed within 10 seconds with an increase in perception score, contraction was considered as recognized. Twenty minutes later, 200 mg of Ery was given IV over 20 rain. After 10 minutes the balloon was again inflated at the same volume. Results (mean -+ SEM) were compared using paired t test. Results: Before Ery 48.4 + 4.2% of phasic fundic contractions were recognized. Only 48.5% of these fundic contractions were followed by propagated antral contractions. The percentage recognized contractions was similar whether the fundic contraction was followed by an antral contraction or not. During Ery the recognition of phasic contractions rose to 59.8 + 3.1% (p=0.05). Conclusions: In healthy volunteers, phasic fundic tension changes can be generated and perceived. Increasing the intensity of those changes with Ery sensitizes the recognition scores. These findings provide further evidence that fundic tension receptor activation causes epigastric symptoms.

The use of glutamine in the treatment of gastrointestinal disorders in man

The human gastrointestinal tract (GIT) is a major site of glutamine utilisation accounting for more than half of the net splanchnic utilisation (∼15 g/day) of glutamine obtained from the systemic circulation. Dietary glutamine (∼5 g/day) is less important than circulating glutamine, especially in disease conditions associated with substantial reduction in food intake. Glutamine has multiple effects on the structure and function of the GIT, and effects in improving morbidity and mortality in animal models of GIT damage has led to a series of studies in man, which have produced variable results. Glutamine administration to treat mucositis of the upper GIT (mouth, oesophagus) due to cytotoxic drug therapy, has produced no evidence of benefit. Early studies suggested improved healing, as do recent studies of small intestinal mucositis resulting from chemotherapy. Investigations in colitis are lacking although in experimental rat models of colitis, no benefit has been reported. Multiple explanations can be put forward to explain the overall results, including the GIT distribution of enzymes involved in glutamine metabolism. Apart from the lower stomach in man (upper stomach in the rat) there is very little weak activity of glutamine synthetase, suggesting that the gut derives glutamine formed in other tissues and from the diet. The activity of glutaminase, which is key flux generating enzyme involved in glutaminolysis is very weak in mucosa with stratified squamous epithelium (oesophagus), where intermediate in the same intestine, and highest in the small intestinal mucosa which accounts for about 80% of the total glutaminase in the entire human GIT mucosa.