Pressure dynamics of the esophagogastric junction at rest and during inspiratory maneuvers after Nissen fundoplication

Low sphincter pressure and inability of the crural diaphragm to elevate it at the esophagogastric junction are important pathophysiological mechanisms of gastroesophageal reflux disease (GERD). The object of this study was to depict how Nissen fundoplication changed the resting and inspiratory pressures of the anti-reflux barrier. We selected 14 patients (eight males; mean age 42.7 years; mean body mass index 27.8) for surgery. They answered symptoms questionnaires and underwent high-resolution manometry (HRM) before and 6 months after Nissen fundoplication. We used a standard manometric protocol (resting and liquid swallows) and assessment of esophagogastric junction (EGJ) pressure metrics during standardized forced inspiratory maneuvers against increasing loads (Threshold Maneuvers). We used the Wilcoxon test for comparison of pre and postoperative data. After fundoplication, heartburn and regurgitation scores diminished remarkably (from 4.5 and 2, respectively, to zero; P = 0.002 and P = 0.0005, respective medians). Also, the median expiratory EGJ pressure had a significant increase from 8.1 to 18.1 mmHg (P = 0.002), while mean respiratory pressure and EGJ contractility integral (EGJ-CI) increased without statistical significance (P = 0.064 and P = 0.06, respectively). Axial EGJ displacement was lower after fundoplication. The EGJ relaxation pressure (P = 0.001), the mean distal esophageal intrabolus pressure (P = 0.01) and the distal latency (P = 0.017) increased after fundoplication. There was a reduction in the contraction front velocity (P = 0.043). During evaluation with standardized inspiratory maneuvers, the inspiratory EGJ pressures (under loads of 12, 24, 36 and 48 cmH2O) were lower after surgery for all loads (median for load 12 cmH2O: 145.6 vs. 102.7 mmHg; P = 0.004). Fundoplication and hiatal closure increased the expiratory EGJ pressure and promoted a great GERD symptom relief. The surgery seemed to overcompensate a reduced EGJ mobility and inspiratory pressure.

Development of Ti-Al-V alloys for usage as single-axis knee prostheses: evaluation of mechanical, corrosion, and tribocorrosion behaviors

Single-axis knee prosthesis is an artificial biomechanical device that provides motion to amputees without the need for assistance appliances. Besides it is mainly composed of metallic materials, the current commercial materials did not group adequate properties for long-term usage or accessible cost. This study produced and characterized Ti-(10 -x)Al-xV (x = 0, 2, and 4 wt.%) alloys for potential use as single-axis knee prostheses. The samples exhibited a gradual decrease in the density values, with proper chemical mixing of the alloying elements on the micro-scale. The phase composition exhibited a primary α phase with a minor α' + β phase for the Ti-8Al-2V and Ti-6Al-4V samples. Due to their different atomic radius compared to Ti, the addition of alloying elements changed the cell parameters. Their selected mechanical properties (Young's modulus, Vickers microhardness, and damping factor) performed better values than the CP-Ti grade 4. The samples also exhibited good corrosion properties against the simulated marine solution. The tribocorrosion resistance of the samples was better than the reference material, with the wear tracks composed of some tribolayers and grooves resulting from adhesive and abrasive wear. The Ti-10Al alloy displayed the best properties and estimated low cost to be used as single-axis knee prostheses.

Antiproliferative, genotoxic and mutagenic potential of synthetic chocolate food flavoring

Flavoring additives are of great technological importance for the food industry. However, there is little information regarding the toxicological properties of these micro-ingredients, especially at the cellular level. The present study used meristematic root cells of Allium cepa L. to evaluate the toxicity of a liquid, aroma and flavor synthetic chocolate additive, manufactured and widely marketed throughout Brazil and exported to other countries in South America. The flavoring concentrations evaluated were 100.00; 50.00; 25.00; 1.00; 0.50 and 0.25 µL/L, where the highest concentration established was one-hundred times lower than that commercially suggested for use. The concentration 100 µL/L substantially reduced cell division of meristems within 24- and 48-hours exposure. Concentrations from 100.00 to 0.50 µL/L resulted in a significant number of prophases to the detriment of the other phases of cell division, indicating an aneugenic activity, and induced a significant number of cellular changes, with emphasis on micronuclei, nuclear buds and chromosomal breaks. Under the established analysis conditions, with the exception of concentration 0.25 µL/L, the flavoring of chocolate caused cytotoxicity, genotoxicity and mutagenicity to root meristems.

A baseline evaluation of PAH body burden in sardines from the southern Brazilian shelf

The concentrations of 37 polycyclic aromatic hydrocarbons (PAHs) and their potential risk to human health were determined in fifty sardine muscle (Sardinella brasiliensis) samples collected along the southern Brazilian shelf. Parental and alkylated PAHs were identified and quantified using a pressurized liquid extraction with in-cell purification method and gas chromatography-mass spectrometry identification and quantification. The concentrations of Σ37 PAHs in muscle ranged between 6.02 and 4074 μg kg^-1 wet weight, which are comparable to levels reported for commercially important fish worldwide. The most abundant compounds were pyrene and fluoranthene, which originate from both petrogenic and pyrolytic hydrocarbon inputs. In only 4% of the samples the benzo[a] pyrene equivalent concentration was above the threshold of 6 μg kg^-1 suggested for safe fish consumption in Brazil. These findings will serve as baseline data for monitoring the quality of sardines consumed in the country and for studying fish populations.

0977 Risk Factors For Developing Sleep Disorders In Children

Introduction

Unidentified sleep disorders can affect emotional, cognitive and social development in children. Screening for sleep disorders within the pediatric population is not common practice during medical visits. The objective of this study is to identify specific questions related to behavioral and physiological factors having potential to screen and detect those at risk for sleep disorders in a general pediatric clinic.

Methods

A retrospective archive from electronic medical records was analyzed from 1,361 children patients, 0-18 years old, that visited a pediatric clinic from March-November of 2019. Children or their parents reported on the presence of eight objective behavioral and physiological factors on the Kids Sleep Screener Questionnaire (KSSQ), which were used as potential risk factors for sleep disorders. Propensity of daytime sleepiness was measured through the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD). Scores higher than 11 were considered a positive indicator of potential sleep disorders because of excessive daytime sleepiness. Positive scores from the ESS-CHAD were used for comparison with the KSSQ factors using chi-square test of SAS software.

Results

Among the eight factors, snoring was the strongest risk factor and increased sleep duration was the weakest risk factor associated with a positive ESS-CHAD. Relationships among risk factors and the increased likelihood for developing sleep disorders were statistically significant (p<0.05-p<0.0001) and identified as following: snoring by 2.46 times, restless sleeper by 2.03 times, behavioral or learning difficulties by 1.43 times, nocturnal awakenings by 1.16 times, excessive sleepiness during the day by 1.10 times. Sleep onset latency and increased sleep duration were weak indicators due to a likeliness of less than one time (p<0.05) to be associated with a positive ESS-CHAD. Abnormal sleep behavior was not a statistically significant risk factor (p≥0.05) for potential sleep disorders in children.

Conclusion

There were associations between seven behavioral and physiological risk factors with overall sleep propensity in children. These results exhibit that the KSSQ is an important tool to identify potential sleep disorders in children and the need for follow up with a sleep specialist. The KSSQ is under validation for becoming a standard sleep screener in pediatrics.

Support

N/A

Alanyl-glutamine protects the intestinal barrier function in trained rats against the impact of acute exhaustive exercise

Strenuous exercise triggers deleterious effects on the intestinal epithelium, but their mechanisms are still uncertain. Here, we investigated whether a prolonged training and an additional exhaustive training protocol alter intestinal permeability and the putative effect of alanyl-glutamine (AG) pretreatment in this condition. Rats were allocated into 5 different groups: 1) sedentary; 2 and 3) trained (50 min per day, 5 days per week for 12 weeks) with or without 6 weeks oral (1.5 g/kg) AG supplementation; 4 and 5) trained and subjected to an additional exhaustive test protocol with or without oral AG supplementation. Venous blood samples were collected to determine gasometrical indices at the end of the 12-week protocol or after exhaustive test. Lactate and glucose levels were determined before, during, and after the exhaustive test. Ileum tissue collected after all experimental procedures was used for gene expression analysis of Zonula occludens 1 (ZO-1), occludin, claudin-2, and oligopeptide transporter 1 (PepT-1). Intestinal permeability was assessed by urinary lactulose/mannitol test collected after the 12-week protocol or the exhaustive test. The exhaustive test decreased pH and base excess and increased pCO₂. Training sessions delayed exhaustion time and reduced the changes in blood glucose and lactate levels. Trained rats exhibited upregulation of PEPT-1, ZO-1, and occludin mRNA, which were partially protected by AG. Exhaustive exercise induced intestinal paracellular leakage associated with the upregulation of claudin-2, a phenomenon protected by AG treatment. Thus, AG partially prevented intestinal training adaptations but also blocked paracellular leakage during exhaustive exercise involving claudin-2 and occludin gene expression.

Polysaccharide from Gracilaria caudata protects the human esophageal mucosal barrier: A differential topical effect and structural dependence

This study aimed to evaluate the in vitro protective effect of topical treatment with a native sulfated polysaccharide of G. caudata (SP-Gc), hydrolyzed (H-SP-Gc), or desulfated (D-SP-Gc) polysaccharide of Gracilaria caudata in esophageal biopsies obtained from GERD patients. Biopsies were obtained from nonerosive reflux disease (NERD) patients and from erosive esophagitis patients. Then, the biopsies were mounted in an Ussing chamber to measure the basal transepithelial electrical resistance (TEER). The effect of mucosal exposure to an acid solution on TEER was analyzed with or without different concentrations (1, 0.3 or 1%) of SP-Gc, H-SP-Gc, or D-SP-Gc, precoated on the mucosa. Basal esophageal mucosal electrical resistance was significantly lower in erosive esophagitis than from NERD. Mucosal samples precoated with native SP-Gc (1%) significantly prevented TEER drop induced by an acidic solution in NERD, but this effect was not observed in erosive esophagitis. Topical application of D-SP-Gc showed no difference compared to native SP-Gc. However, when treated with chemically-modified SP-Gc, the protective effect observed with native SP-Gc was lost. The present study indicated that SP-Gc protects the human esophageal mucosal barrier in NERD patients. This effect is dependent on the structure but is independent of the presence of sulfate.

Preoperative biliary drainage in patients performing pancreaticoduodenectomy : guidelines and real-life practice

BACKGROUND AND AIM

Preoperative biliary drainage (PBD) in patients with pancreatic cancer remains debatable. The aim of this study was to analyse the indications for PBD in patients performing pancreaticoduodenectomy (PD) and to evaluate the impact of this procedure on postoperative outcome.

METHODS

Observational retrospective cohort study of patients undergoing PD for pancreatic cancer. Clinical data and postoperative outcome, namely complications and 90-day mortality, were prospectively collected and compared between patients performing PBD or direct surgery (DS).

RESULTS

Eighty-two patients were included: 40 underwent PBD and 42 performed DS. Major complications (27.5% vs 33.3%, P=0.156) and 90-day mortality (10% vs 16.7%, P=0.376) were similar between the two groups. There was a trend for higher mean total bilirubin in patients with PBD (P=0.073). The indication for PBD was suspicion of cholangitis/choledocholithiasis or need to perform neoadjuvant chemotherapy in 24 (60%) patients. In the remaining, elevated bilirubin was probably the only reason to perform PBD. Length of hospital stay was longer in PBD group (P=0.003). On multiple logistic regression, 90-day mortality was not related with preoperative bilirubin levels, biliary drainage or its indication, but solely with age (OR 1.15, 95%CI 1.05-1.31, P=0.008).

CONCLUSIONS

PBD is often performed in patients undergoing PD without a formal indication, mainly due to high bilirubin levels. No increased morbidity/mortality was observed but length of hospital stay was prolonged in patients performing PBD.

Acute Toxicity and Sub-lethal Effects of the Essential Oil of Aristolochia trilobata and Its Major Constituents on Nasutitermes corniger (Termitidae: Nasutitermitinae)

Nasutitermes corniger (Motschulsky, 1855) (Termitidae: Nasutitermitinae) is an important pest in urban environments and bioinsecticides can be an alternative to its control. Here, we determined the toxicity and repellence of the essential oil (EO) prepared from stems of Aristolochia trilobata L. (Aristolochiaceae) and its major constituents on N. corniger. We also investigated behavioral changes of individuals exposed to limonene. The lethal dose required to kill 50% of N. corniger population (LD₅₀) of EO of A. trilobata was 2.44 μg mg^-1. Limonene was the most toxic compound to N. corniger followed by linalool (LD₅₀ = 1.02 and 1.29 μg mg^-1, respectively). In addition, all treatments presented median lethal time (LT₅₀) less than 11 h. A. trilobata EO and its constituents showed irritability activity, but only limonene repelled soldiers more than workers. The negative behaviors of N. corniger groups were higher in individuals treated with limonene. A. trilobata EO and its constituents, especially the limonene, are promising for the control of N. corniger due the high toxicity, repellence, and possible disturbance in the colonies.

Acute exercise inhibits gastric emptying of liquids in rats: influence of the NO-cGMP pathway

We previously found that acute exercise inhibited the gastric emptying of liquid in awake rats by causing an acid-base imbalance. In the present study, we investigated the involvement of the nitric oxide-cyclic guanosine monophosphate (NO-cGMP) pathway, vasoactive intestinal peptide (VIP), and corticotropin-releasing factor (CRF) peptide in this phenomenon. Male rats were divided into exercise or sedentary group and were subjected to a 15-min swim session against a load (2.5 or 5% b.w.). The rate of gastric emptying was evaluated after 5, 10, or 20 min postprandially. Separate groups of rats were treated with vehicle (0.9% NaCl, 0.1 mL/100 g, ip) or one of the following agents: atropine (1.0 mg/kg, ip), the NO non-selective inhibitor Nω-nitro-L-arginine methyl ester hydrochloride (L-NAME; 10.0 mg/kg, ip), or the selective cGMP inhibitor 1H-(1,2,4)oxadiazole[4,3-a]quinoxalin-1-one (ODQ; 5.0 mg/kg, ip), the i-NOS non-specific inhibitor (aminoguanidine; 10.0 mg/kg, ip), the corticotropin-releasing factor receptor antagonist (astressin; 100 µg/kg, ip), or the vasoactive intestinal peptide (VIP) receptor antagonist Lys¹, Pro^2,5, Arg^3,4, Tyr⁶ (100 µg/kg, ip). Compared to sedentary rats, both the 2.5 and 5% exercise groups exhibited higher (P<0.05) values of blood lactate and fractional gastric dye recovery. Corticosterone and NO levels increased (P<0.05) in the 5% exercised rats. Pretreatment with astressin, VIP antagonist, atropine, L-NAME, and ODQ prevented the increase in gastric retention caused by exercise in rats. Acute exercise increased gastric retention, a phenomenon that appears to be mediated by the NO-cGMP pathway, CRF, and VIP receptors.

The Role of Resource Density on Energy Allocation in the Neotropical Termite Nasutitermes aff. coxipoensis (Termitidae: Nasutitermitinae)

Organisms acquire energy from environment and must allocate it among different life traits (growth, maintenance and reproduction). Social insects must manage the energy allocation to various levels such as colony growth and caste functions. Here, we addressed the question of whether resource density affects the energy allocation to the number of individuals and caste functions as well as nest's growth rate in the Neotropical termite Nasutitermes aff. coxipoensis (Homgren) (Termitidae: Nasutitermitinae). In a manipulative field experiment, colonies of N. aff. coxipoensis, with known volume, were maintained in plots with three different resource's density (0.32, 0.64 and 1.92 baits/m²) over 3 months. After this period, the number of individuals as well as the caste identity and nest volume were measured. Surprisingly, our results showed that colonies reared in the extremes of resource's density (0.32 and 1.92 baits/m²) produced a higher number of individuals compared with colonies reared with intermediate resource density (0. 64 baits/m²). The mean number of workers increased linearly with resource density; however, the average number of immature was higher in colonies reared with 0.32 baits/m² compared with colonies reared with 0.64 and 1.92 baits/m². No significant differences of resource density were observed in the mean number of soldiers, worker/soldier ratio as well as in the nest's growth rate. In conclusion, the resource's density seems to play an important role in determining the investment of energy in the number of individuals and caste in N. aff. coxipoensis colonies.

Role of TRPV1 receptor in inflammation and impairment of esophageal mucosal integrity in a murine model of nonerosive reflux disease

BACKGROUND

Microscopic inflammation and impairment of the esophageal epithelial barrier are considered relevant for perception of symptoms in patients with nonerosive reflux disease (NERD). In these patients, the receptor transient receptor potential vanilloid 1 (TRPV1) is overexpressed in the esophageal mucosa, but its role is not yet fully understood. We evaluated the role of TRPV1 in esophageal inflammation and mucosal barrier impairment in a murine model of NERD.

METHODS

Nonerosive reflux disease was surgically induced in Swiss mice by pyloric substenosis and ligature of the gastric fundus, and the mice were killed 7 days post surgery. The experimental groups were: I, sham surgery (negative control); II, NERD untreated; III and IV, NERD + SB366791 or capsazepine (TRPV1 antagonists); and V, NERD + resiniferatoxin (for long-term desensitization of TRPV1). The esophagus was collected for western blotting and histopathology and for evaluation of wet weight, myeloperoxidase (MPO), keratinocyte-derived chemokine (KC), transepithelial electrical resistance (TEER), and basal permeability to fluorescein.

KEY RESULTS

Compared to sham, NERD mice had increased esophageal wet weight and MPO and KC levels. The mucosa had no ulcers but exhibited inflammation. NERD mice showed mucosal TRPV1 overexpression, a more pronounced decrease in TEER at pH 0.5 (containing pepsin and taurodeoxycholic acid), and increased basal permeability. Pharmacological modulation of TRPV1 prevented esophageal inflammation development, TEER changes by acidic exposure, and increase in esophageal permeability.

CONCLUSIONS & INFERENCES

The TRPV1 receptor has a critical role in esophageal inflammation and mucosal barrier impairment in NERD mice, suggesting that TRPV1 might be a pharmacological target in patients with NERD.

Changes in cardiovascular performance, biochemistry, gastric motility and muscle temperature induced by acute exercise on a treadmill in healthy military dogs

Changes in physiological parameters that are induced by acute exercise on a treadmill in healthy military dogs have not been thoroughly investigated, especially with regard to age. This study investigated the effects of acute exercise on a treadmill on cardiovascular function, biochemical parameters and gastric antral motility in military dogs. Thermography was used to assess variations in superficial hindlimb muscle temperature. Nine healthy dogs were distributed into three groups according to their age (Group I: 25 ± 7 months; Group II: 51 ± 12 months; Group III: 95 ± 10 months) and sequentially subjected to running exercise on a treadmill for 12 min (3.2 km/h at 0° incline for 4 min, 6.4 km/h at 0° incline for 4 min and 6.4 km/h at 10° incline for 4 min). Heart rate, systolic and diastolic arterial pressure (DAP), gastric motility, haematocrit and biochemical analyses were performed at rest and after each session of treadmill exercise. Infrared thermographic images of muscles in the pelvic member were taken. Exercise decreased DAP in Group I, increased systolic arterial pressure in Groups II and III and increased mean arterial pressure in Group III (all p < 0.05). After the exercise protocol, plasma creatine kinase and aspartate aminotransferase levels increased only in Group I (p < 0.05). Exercise increased heart rate and decreased the gastric motility of a solid meal at 180 min in all groups (all p < 0.05). Exercise also elevated temperature in the femoral biceps muscles in Group I compared with the older dogs. The results indicate that acute exercise decreased gastric motility in dogs, regardless of age, and caused more pronounced cardiovascular changes in older dogs than in younger dogs. Acute exercise also altered biochemical parameters and superficial hindlimb muscle temperature in younger military dogs.

Seed rain generated by bats under Cerrado's pasture remnant trees in a Neotropical savanna

In this study we described the seed rain generated by bats under four Cerrado's tree species common within pastures, Buchenavia tomentosa, Couepia grandiflora, Licania humilis and Qualea grandiflora. We analyzed the similarity among the four tree species in terms of seed rain composition, and compared the number of seeds and seed species deposited under them. Besides that, we assessed the relationship between seed rain intensity and the density of each tree species. Then, we randomly selected 10 mature trees of each species to sample seed rain. We recorded a total of 4892 bat dispersed seeds from 11 species. Also, we observed that along the year seed deposition varied substantially under all trees. At least two seed sub-communities could be distinguished according to tree species used by bats as feeding roost. One related to Couepia grandiflora and Licania humilis, and the other to Buchenavia tomentosa and Qualea grandiflora trees. The variability of seed rain composition in any particular tree and the range of actual seed fall into a particular species indicate patchiness in seed rain, and the overall results appear to be consistent in terms of a substantial and diverse seed rain generated by bats in a highly anthropized landscape. This is the first study concerning seed dispersal by bats in modified Brazilian Cerrado, one of the most endangered biomes in the world. In this respect, by preserving a dense and diverse collection of remnant trees within today's pastures may, potentially, contribute to a faster Cerrado recovery in extensive areas that can be reclaimed for restoration in the future.

Alternate current biosusceptometry for the assessment of gastric motility after proximal gastrectomy in rats: a feasibility study

BACKGROUND

This study proposes an experimental model to assess the consequences of gastric surgeries on gastric motility. We investigated the effects of proximal gastrectomy (PG) using a non-invasive technique (alternate current biosusceptometry [ACB]) on gastric contractility (GC), gastric emptying (GE), and orocecal transit (OCT) after the ingestion of liquids and solids in rats.

METHODS

Twenty-four male rats were subjected to gastric motility assessment before and after the PG procedure. The GE and OCT results are expressed as the mean time of gastric emptying (MGET) and cecum arrival (MCAT). The GC recordings are presented as the frequency and amplitude of contractions.

KEY RESULTS

Mean time of gastric emptying after solid meals were significantly different (p < 0.001) between control and PG (113 ± 5 to 99 ± 6 min). Mean time of cecum arrival ranged from 265 ± 9 to 223 ± 11 min (p < 0.001) and 164 ± 9 to 136 ± 17 min (p < 0.050) for solid and liquid meals, respectively. The assessment of GC showed that surgery decreased the phasic frequency (4.4 ± 0.4 to 3.0 ± 1.1 cpm, p < 0.050) and increased the amplitude of contractions (3.6 ± 2.7 to 7.2 ± 3.0 V/s, p < 0.050). No significant difference was found in tonic frequency.

CONCLUSIONS & INFERENCES

The ACB system was able to assess GE, OCT, and GC in gastrectomized rats. Overall, PG accelerated GE and gastrointestinal transit, likely due to the increase in both intragastric pressure and amplitude contraction. Our data presented an efficient model to investigate functional consequences from gastric surgeries that will allow further studies involving different procedures.

Plant food resources exploited by Blue-and-Yellow Macaws (Ara ararauna, Linnaeus 1758) at an urban area in Central Brazil

In this study, we described the food plants available to Blue-and-Yellow Macaws (Ara ararauna), its feeding habits and the relationship between these parameters with feeding niche breadth. We established four transects, each one 12 km long, to sample fruiting plants and the feeding habits of this macaw (monthly 40 h, of observations), at the urban areas of Três Lagoas (Mato Grosso do Sul, Brazil). During all studied months, macaws foraged for palm fruits, mainly Syagrus oleracea and Acrocomia aculeata fruit pulp, both available all year, as well as Caryocar brasiliense and Anacardium occidentale seeds, in the wet season. The year-round feeding activity of macaws suggests Três Lagoas city as an adequate feeding area. The permanent availability of plant food resources, potentially, resulted from the diverse fruiting patterns of exotic and, mainly, native plant species, which provided a variety of suitable fruit patches.

Dyspeptic symptoms and delayed gastric emptying of solids in patients with inactive Crohn's disease

Background

Patients with Crohn’s disease (CD) have been shown to present dyspeptic symptoms more frequently than the general population. Some of these symptoms could be related to motility disorders to some degree. Then, we propose to investigate whether gastric emptying of solids in patients with inactive CD is delayed and to determine the relationships between gastric emptying and dyspeptic symptoms in inactive CD.

Methods

Twenty-six patients with inactive Crohn’s disease, as defined by a Crohn’s Disease Activity Index (CDAI) < 150, underwent a gastric emptying test by breath test using ¹³C octanoic acid coupled to a solid meal and answered a validated questionnaire (The Porto Alegre Dyspeptic Symptoms Questionnaire) to assess dyspeptic symptoms. Patients with scores ≥ 6 were considered to have dyspepsia. The control group was composed by 19 age- and sex-matched healthy volunteers.

Results

Patients with CD had a significantly longer t 1/2 and t lag (p<0.05) than the controls. CD patients with dyspepsia had significantly (p<0.05) prolonged gastric emptying when compared to patients without dyspeptic symptoms. When the individual symptom patterns were analyzed, only vomiting was significantly associated with delayed gastric emptying (p<0.05). There was no difference between the subgroups of patients with respect to gender, CDAI scores, disease location, clinical behavior (obstructive/obstructive) or previous gastrointestinal surgery.

Conclusion

Delayed gastric emptying in inactive Crohn’s disease patients seems to be associated with dyspeptic symptoms, particularly vomiting, even without any evidence of gastrointestinal obstruction.

Changes in GABAergic inputs in the paraventricular nucleus maintain sympathetic vasomotor tone in chronic heart failure

The paraventricular nucleus (PVN) of the hypothalamus is an important region of the brain involved in the regulation of sympathetic vasomotor tone. Accumulating evidence supports the idea that a change in hypothalamic γ-aminobutyric acid (GABA)-ergic inhibitory and glutamatergic excitatory inputs contribute to the exacerbated sympathetic drive in chronic heart failure (HF). The purpose of this study was to determine whether a possible imbalance between glutamatergic and GABAergic inputs to the PVN contributes to increased sympathetic outflow in HF in two different sympathetic territories. Renal (RSNA) and splanchnic sympathetic nerve activity (SSNA), mean arterial blood pressure (MAP) and heart rate were recorded from urethane-anesthetized HF or sham rats. The NMDA-glutamate and GABA-A receptor densities within the PVN were quantified in HF and sham rats by autoradiography. Bilateral microinjection of kynurenic acid (4nmol) into the PVN decreased MAP and RSNA and SSNA in HF but not in sham rats. Furthermore, in response to GABA-A blockade in the PVN by bicuculline (400 pmol), hypertension and SSNA were reduced in HF compared to sham. The quantification of ionotropic NMDA receptors and GABA-A receptors in the PVN showed a significant reduction of GABA-A in HF rats; however, the NMDA density in the PVN did not differ between groups. Thus, this study provides evidence that the sympathoexcitation is maintained by an imbalance between GABAergic and glutamatergic inputs in the PVN in HF. The reduced GABAergic input results in relatively augmented glutamatergic actions in the PVN of HF rats.

Morphocytochemical, immunohistochemical and ultrastructural characterization of the head kidney of fat snook Centropomus parallelus

This study characterized the structure and the morphocytochemical, immunohistochemical and ultrastructural aspects of the head kidney (HK) of the fat snook Centropomus parallelus. The HK is enclosed by a thin capsule of connective tissue, from which fine trabeculae originate and branch into the interior of organ. In the parenchyma, there are aggregates of lymphoid cells containing populations of lymphocytes T immunopositive for CDRO45, in a nodular arrangement, around blood vessels and melano-macrophage centres. Among the cells that constituted these aggregates and surrounded them, were macrophages and monocytes, and their precursors, with strong immunopositivity for CD68, along with cells of the granulocytic lineage in various phases of maturation positive for lysozyme and PAS. Macrophages and chromaffin and interrenal cells are also present. Ultrastructurally, the HK comprises a reticulum-endothelial stroma consisting of endothelial cells, reticulocytes of the fibroblast type and macrophage type and a parenchyma with increased cellularity, principally blood cells of the erythrocytic, granulocytic, lymphocytic, monocytic and thrombocytic series.

Sildenafil decreases rat tracheal hyperresponsiveness to carbachol and changes canonical transient receptor potential gene expression after antigen challenge

Inhibition of type-5 phosphodiesterase by sildenafil decreases capacitative Ca2+ entry mediated by transient receptor potential proteins (TRPs) in the pulmonary artery. These families of channels, especially the canonical TRP (TRPC) subfamily, may be involved in the development of bronchial hyperresponsiveness, a hallmark of asthma. In the present study, we evaluated i) the effects of sildenafil on tracheal rings of rats subjected to antigen challenge, ii) whether the extent of TRPC gene expression may be modified by antigen challenge, and iii) whether inhibition of type-5 phosphodiesterase (PDE5) may alter TRPC gene expression after antigen challenge. Sildenafil (0.1 µM to 0.6 mM) fully relaxed carbachol-induced contractions in isolated tracheal rings prepared from naive male Wistar rats (250-300 g) by activating the NO-cGMP-K+ channel pathway. Rats sensitized to antigen by intraperitoneal injections of ovalbumin were subjected to antigen challenge by ovalbumin inhalation, and their tracheal rings were used to study the effects of sildenafil, which more effectively inhibited contractions induced by either carbachol (10 µM) or extracellular Ca2+ restoration after thapsigargin (1 µM) treatment. Antigen challenge increased the expression of the TRPC1 and TRPC4 genes but not the expression of the TRPC5 and TRPC6 genes. Applied before the antigen challenge, sildenafil increased the gene expression, which was evaluated by RT-PCR, of TRPC1 and TRPC6, decreased TRPC5 expression, and was inert against TRPC4. Thus, we conclude that PDE5 inhibition is involved in the development of an airway hyperresponsive phenotype in rats after antigen challenge by altering TRPC gene expression.

Evaluation of gastrointestinal motility in awake rats: a learning exercise for undergraduate biomedical students

Current medical curricula devote scarce time for practical activities on digestive physiology, despite frequent misconceptions about dyspepsia and dysmotility phenomena. Thus, we designed a hands-on activity followed by a small-group discussion on gut motility. Male awake rats were randomly submitted to insulin, control, or hypertonic protocols. Insulin and control rats were gavage fed with 5% glucose solution, whereas hypertonic-fed rats were gavage fed with 50% glucose solution. Insulin treatment was performed 30 min before a meal. All meals (1.5 ml) contained an equal mass of phenol red dye. After 10, 15, or 20 min of meal gavage, rats were euthanized. Each subset consisted of six to eight rats. Dye recovery in the stomach and proximal, middle, and distal small intestine was measured by spectrophotometry, a safe and reliable method that can be performed by minimally trained students. In a separate group of rats, we used the same protocols except that the test meal contained (99m)Tc as a marker. Compared with control, the hypertonic meal delayed gastric emptying and gastrointestinal transit, whereas insulinic hypoglycemia accelerated them. The session helped engage our undergraduate students in observing and analyzing gut motor behavior. In conclusion, the fractional dye retention test can be used as a teaching tool to strengthen the understanding of basic physiopathological features of gastrointestinal motility.

Organic trace minerals and 25-hydroxycholecalciferol affect performance characteristics, leg abnormalities, and biomechanical properties of leg bones of turkeys

Leg problems and resulting mortality can exceed 1% per week in turkey toms starting at approximately 15 wk of age. Dietary supplementation of organic trace minerals (MIN) and 25-hydroxycholecalciferol (HyD) may improve performance, decrease incidence of leg abnormalities, and increase bone strength. Nicholas 85X700 toms were assigned to 4 treatments consisting of a factorial arrangement of 2 concentrations of MIN (0 and 0.1% of Mintrex P(Se), which adds 40, 40, 20, and 0.3 mg/kg of Zn, Mn, Cu, and Se, respectively) and 2 concentrations of HyD (0 and 92 microg/kg of HyD). Diets were formulated to be equal in nutrient content and fed ad libitum as 8 feed phases. Feed intake and BW were measured at 6, 12, 15, 17, and 20 wk of age. Valgus, varus, and shaky leg defects were determined at 12, 15, 17, and 20 wk of age. Tibia and femur biomechanical properties were evaluated by torsion and bending tests at 17 wk of age. There were no treatment effects on BW. Only MIN significantly improved feed conversion ratio through to 20 wk of age. Cumulative mortality at 3 wk of age was greater among the MIN birds, but it was lower by 20 wk (P = 0.085). The MIN decreased the incidence of varus defects at 17 wk of age; shaky leg at 12, 15, and 17 wk of age; and valgus defects at 15, 17, and 20 wk of age. There were no MIN x HyD interaction effects on individual gait problems. Maximum load and the bending stress required for tibias to break in a 4-point assay were increased with MIN supplementation, especially when HyD was also added. Maximum shear stress at failure of femoral bones in a torsion assay was increased by supplementation with both MIN and HyD together. Dietary supplementation of MIN and HyD may improve biomechanical properties of bones. Dietary MIN supplementation may improve feed conversion of turkeys, likely by decreasing leg problems.

Acute intracranial hypertension increases gastric tonus in anesthetized rats

We studied the acute effect of intracranial hypertension (ICH) on gastric tonus of anesthetized rats. Brain ventricles were cannulated bilaterally for intracerebro-ventricular pressure (ICP) monitoring and ICH induction. Next, a balloon catheter was inserted at the proximal stomach and coupled to a barostat for gastric volume (GV) monitoring by plethysmography. Arterial pressure (AP) and heart rate (HR) were monitored continuously during 80-min. After a 20-min basal period, they were submitted to control or ICH protocols. In controls, the ICP varied spontaneously up to the end. Other rats were subjected to ICP rising to 10, 20, 40 or 60 mmHg and kept at these levels for 30-min. Another group was subjected after basal period to stepwise ICH (ICP rising to 20, 40 and 60 mmHg at every 10-min interval). Next, the ICH rats were monitored for further 30-min. Other rats, previously submitted to a subdiaphragmatic vagotomy, splanchnicectomy plus ganglionectomy or their respective sham surgery, were also studied under ICH. Each subset consisted of 5-6 rats. Data were compared to respective basal values after ANOVA and Bonferroni's test. In controls, the GV, AP, HR values remained within stable levels. Besides inducing bradycardia and arterial hypertension, ICH10 mmHg decreased GV by 14.8% at the 50-min interval. In ICH20, 40 and 60 mmHg subsets, GV decreased 14.0, 24.5 and 30.6% at the 40-min interval, respectively. In stepwise ICH rats, GV decreased 10.2% and 12.7%, respectively under ICP of 40 and 60 mmHg. The GV values remained significantly lower than basal levels during the last 30-min of monitoring. Thus, ICH decreases the GV in an ICP-dependent pattern besides inducing Cushing's reflex.

Change in the ileal bacterial population of turkeys fed different diets and after infection with Salmonella as determined with denaturing gradient gel electrophoresis of amplified 16s ribosomal DNA

Changes in ileal bacterial populations of Salmonella-infected turkeys fed different diets were analyzed by using 16S-V3 PCR denaturing gradient gel electrophoresis. Turkeys raised on litter flooring were fed wheat- and corn-based diets with and without enzyme preparations (XY1 and XY2, respectively) from 0 to 126 d. Preparation XY1 contained exclusively endoxylanase, whereas preparation XY2 contained endoxylanase, protease, and alpha-amylase (Danisco, , Wiltshire, UK). The dietary activity levels of XY1 and XY2 were 2,500 and 650 endo-1,4-beta-xylanase units/kg of feed, respectively. Microbial DNA was extracted from the ileal content of 16-wk-old turkeys, and the 16S rDNA gene was amplified by PCR and analyzed by denaturing gradient gel electrophoresis. Diversity indexes, including richness (number of species, S), evenness (relative distribution of species, EH), diversity (using Shannon's index, H'), and Sorenson's pairwise similarities coefficient (measures the species in common between different habitats, Cs) were calculated. Additionally, diversity indexes were associated with Salmonella prevalence determined from fresh fecal droppings collected from each pen. On the basis of contrast analysis, the wheat-based diets resulted in higher microbial diversity indexes than the corn-based diets (S = 10 vs. 12; EH = 0.9 vs. 0.8; H' = 2.2 vs. 1.9, P < 0.05). Likewise, enzyme supplementation stimulated growth of the microbiota and increased the diversity indexes in comparison with unsupplemented treatments (S = 13 vs. 10; EH = 0.9 vs. 0.8; H' = 2.2 vs. 1.9, P < 0.05). Salmonella prevalence was higher (P < 0.05) at 15 wk in turkeys fed the corn-based diet (Salmonella prevalence = 50%) than in turkeys fed the corn-enzyme (Salmonella prevalence = 13%) and wheat-based (Salmonella prevalence = 0%) dietary treatments. Therefore, contrast analysis showed that birds fed the corn control diet had lower microbiota diversity but higher Salmonella prevalence than birds fed the enzyme-supplemented and wheat-based diets. In contrast, birds fed the wheat-based diets had higher diversity but lower Salmonella prevalence than birds fed the corn-based diets. High dietary nonstarch polysaccharides from wheat and dietary exogenous enzyme supplementation promoted microbial community diversity and apparently discouraged Salmonella colonization through competitive exclusion. Nonstarch polysaccharides and dietary exogenous enzyme supplementation may be practical tools to control enteric pathogens and benefit the intestinal health and food safety of the birds.

Influence of housing system, grain type, and particle size on Salmonella colonization and shedding of broilers fed triticale or corn-soybean meal diets

Salmonella colonization in poultry may be influenced by grain type and particle size. Broilers reared either in nonlitter cage-based housing or in a conventionally floored litter house from 0 to 42 d were assigned to 1 of 4 dietary treatments: 1) ground corn-soybean meal (C, 560 microm), 2) coarsely ground corn-soybean meal (CC, >1,700 microm), 3) ground triticale-soybean meal (T, 560 microm), or 4) whole triticale-soybean meal (WT). A 4-strain cocktail of Salmonella enterica was orally gavaged into each chick at placement. Growth performance, cecal and fecal Salmonella populations, gizzard and proventriculus pH, intestinal size, jejunum histomorphometry, and carcass yields were measured. Broilers responded differently to the dietary treatments according to the housing system used. At 42 d, birds reared on litter and fed ground grain had greater BW than those fed coarse grain (2.87 vs. 2.71 kg), whereas cage-reared broilers fed ground triticale were heavier than those fed corn (2.75 vs. 2.64 kg). Broilers raised on litter had a better feed conversion ratio than those raised in cages (1.71 vs. 1.81 g/g). Independent of the housing system, relative eviscerated carcass weights of birds fed T and C were heavier than those of CC- and WT-fed broilers (762 vs. 752 g/kg). Generally, the jejunum villus area and mucosal depth were larger, whereas the small intestine was lighter and shorter in broilers raised on litter. Relative gizzard weights of broilers raised on litter and fed the coarser diets were heavier than those of broilers reared in cages and fed finely ground diets. Feeding whole or coarsely ground grains decreased cecal Salmonella populations in 42-d-old broilers (3.8, 3.9, 4.4, and 4.4 log most probable number/g for CC, WT, C, and T, respectively). Additionally, 42-d-old broilers reared on litter had lower cecal Salmonella populations than those in cages (3.8 vs. 4.4 log most probable number/g). In conclusion, as a feed ingredient, triticale is a good alternative to corn, resulting in improved BW and reduced Salmonella colonization. Broilers raised on litter may have achieved lower cecal Salmonella populations than caged birds because access to litter may have modulated the intestinal microflora by increasing competitive exclusion microorganisms, which discouraged Salmonella colonization.

Haemodynamic changes after spinal cord transection are anaesthetic agent dependent

1 To evaluate the effect of high spinal cord transection (SCT), between T4 and T5, on the mean arterial pressure (MAP) and heart rate in animals anaesthetized with different anaesthetic agents: ether (n = 12), 20% urethane, 1.2 g kg(-1) (n = 12), 2% tri-bromide-ethanol, 200 mg kg(-1) (n = 12); chloral hydrate and urethane, 75 and 525 mg kg(-1) respectively (n = 12). 2 In the animals anaesthetized with ether or urethane, SCT caused an immediate major drop in MAP, with hypotension and bradycardia throughout the next 10 min. In the animals anaesthetized with urethane + chloralose or tri-bromide-ethanol, SCT transiently increased MAP with subsequent hypotension and bradycardia. 3 In summary, the haemodynamic changes after complete, high SCT are anaesthetic agent dependent. Further research about the exact mechanisms responsible for these diverse autonomic changes is warranted.

Role of the NO/cGMP/K(ATP) pathway in the protective effects of sildenafil against ethanol-induced gastric damage in rats

BACKGROUND AND PURPOSE

Sildenafil is a selective inhibitor of cGMP-specific phosphodiesterase. Sildenafil, acting via NO-dependent mechanisms, prevents indomethacin-induced gastropathy. Activation of ATP-sensitive potassium channels (K(ATP)) is involved in gastric defence. Our objective was to evaluate the role of the NO/cGMP/K(ATP) pathway in the protective effects of sildenafil against ethanol-induced gastric damage.

EXPERIMENTAL APPROACH

Rats were treated with L-NAME (1 or 3 mg kg(-1), i.p.) or with L-arginine (200 mg kg(-1), i.p.) + L-NAME (3 mg kg(-1), i.p.), the guanylate cyclase inhibitor, ODQ (10 mg kg(-1), i.p.), glibenclamide (0.1, 0.3, 1 or 3 mg kg(-1), i.p.) or with glibenclamide (1 mg kg(-1), i.p.) + diazoxide (3 mg kg(-1), i.p.). After thirty minutes, the rats received sildenafil (1 mg kg(-1), by gavage), followed by intragastric instillation of absolute ethanol (4 ml kg(-1)) to induce gastric damage. One hour later, gastric damage (haemorrhagic or ulcerative lesions) was measured with a planimetry programme. Samples of stomach were also taken for histopathological assessment and for assays of tissue glutathione and haemoglobin.

KEY RESULTS

Sildenafil significantly reduced ethanol-induced gastric damage in rats. L-NAME alone, without L-arginine, significantly reversed the protection afforded by sildenafil. Inhibition of guanylate cyclase by ODQ completely abolished the gastric protective effect of sildenafil against ethanol-induced gastric damage. Glibenclamide alone reversed sildenafil's gastric protective effect. However, glibenclamide plus diazoxide did not alter the effects of sildenafil.

CONCLUSIONS

Sildenafil had a protective effect against ethanol-induced gastric damage through the activation of the NO/cGMP/K(ATP) pathway.

Cyclooxygenase-2 inhibition increases gastric tone and delays gastric emptying in rats

We evaluated the effects of cyclooxygenase-2 (COX-2) selective inhibitors, COX-1 selective inhibitor, or COX non-selective inhibitor on gastric emptying and intestinal transit of liquids, and evaluated the effect of a COX-2 selective inhibitor on gastric tonus (GT). Male Wistar rats were treated per os with saline (control), rofecoxib, celecoxib, ketorolac, rofecoxib + ketorolac, celecoxib + ketorolac, or indomethacin. After 1 h, rats were gavage-fed (1.5 mL) with the test meal (5% glucose solution with 0.05 g mL(-1) phenol red) and killed 10, 20 or 30 min later. Gastric, proximal, medial or distal small intestine dye recovery (GDR and IDR, respectively) were measured by spectrophotometry. The animals of the other group were treated with i.v. valdecoxib or saline, and GT was continuously observed for 120 min using a pletismomether system. Compared with the control group, treatment with COX-2 inhibitors, alone or with ketocolac, as well as with indomethacin increased GDR (P < 0.05) at 10-, 20- or 30-min postprandial intervals. Ketorolac alone did not change the GDR, but increased the proximal IDR (P < 0.05) at 10 min, and decreased medial IDR (P < 0.05) at 10 and 20 min. Valdecoxib increased (P < 0.01) GT 60, 80 and 100 min after administration. In conclusion, COX-2 inhibition delayed the gastric emptying of liquids and increased GT in rats.

Cardiovascular Control After Spinal Cord Injury

Spinal cord injury (SCI) leads to profound haemodynamic changes. Constant outflows from the central autonomic pattern generators modulate the activity of the spinal sympathetic neurons. Sudden loss of communication between these centers and the sympathetic neurons in the intermediolateral thoracic and lumbar spinal cord leads to spinal shock. After high SCI, experimental data demonstrated a brief hypertensive peak followed by bradycardia with escape arrhythmias and marked hypotension. Total peripheral resistance and cardiac output decrease, while central venous pressure remains unchanged. The initial hypertensive peak is thought to result from direct sympathetic stimulation during SCI and its presence is anaesthetic agent dependent. Hypotension improves within days in most animal species because of reasons not totally understood, which may include synaptic reorganization or hyper responsiveness of alpha receptors. No convincing data has demonstrated that the deafferented spinal cord can generate significant basal sympathetic activity. However, with the spinal shock resolution, the deafferented spinal cord (in lesions above T6) will generate life-threatening hypertensive bouts with compensatory bradycardia, known as autonomic hyperreflexia (AH) after stimuli such as pain or bladder/colonic distension. AH results from the lack of supraspinal control of the sympathetic neurons and altered neurotransmission (e.g. glutamatergic) within the spinal cord. Despite significant progress in recent years, further research is necessary to fully understand the spectrum of haemodynamic changes after SCI.

Structural, cytochemical, immunocytochemical and ultrastructural characterization of blood granulocytes of the roadside hawk Buteo magnirostris (Gmelin, 1788) (Avian, Falconiform)

In the peripheral blood of the roadside hawk, Buteo magnirostris, the following types of granulocytic leucocytes were identified: heterophil, eosinophil and basophil. The heterophils presented acidophilic and spindle shaped granules, the eosinophils possess spherical eosinophilic granules and the basophils showed spherical and basophilic granules. The heterophils and eosinophils presented positive cytochemical reaction to glycogen and basic polyaminoacid, while the eosinophils presented sudanophilic granules, which were also positive for myeloperoxidase. The heterophils, alone, presented positivity for acid phosphatase in some granules and immunoreactivity to TGF-beta1 was observed only in the cytoplasm of the eosinophils. Electron microscopy demonstrated the heterophil granules as predominantly spindle shaped, being strongly electron-dense, while the eosinophils had numerous uniformly electron-dense spherical granules and the basophils presented three different types of granules identified according to their electron-density and the aspect of their matrix.

Variations in gastric compliance induced by acute blood volume changes in anesthetized rats

The impact of acute volume imbalances on gastric volume (GV) was studied in anesthetized rats (250-300 g). After cervical and femoral vessel cannulation, a balloon catheter was positioned in the proximal stomach. The opposite end of the catheter was connected to a barostat with an electronic sensor coupled to a plethysmometer. A standard ionic solution was used to fill the balloon (about 3.0 ml) and the communicating vessel system, and to raise the reservoir liquid level 4 cm above the animals' xiphoid appendix. Due to constant barostat pressure, GV values were considered to represent the gastric compliance index. All animals were monitored for 90 min. After a basal interval, they were randomly assigned to normovolemic, hypervolemic, hypovolemic or restored protocols. Data were compared by ANOVA followed by Bonferroni's test. Mean arterial pressure (MAP), central venous pressure (CVP) and GV values did not change in normovolemic animals (N = 5). Hypervolemic animals (N = 12) were transfused at 0.5 ml/min with a suspension of red blood cells in Ringer-lactate solution with albumin (12.5 ml/kg), which reduced GV values by 11.3% (P<0.05). Hypovolemic rats (N = 12) were bled up to 10 ml/kg, a procedure that increased GV values by 15.8% (P<0.05). In the restored group (N = 12), shed blood replacement brought GV values back to basal levels in bled animals (P>0.05). MAP and CVP values increased (P<0.05) after hypervolemia but decreased (P<0.05) with hypovolemia. In conclusion, blood volume level modulates gastric compliance, turning the stomach into an adjustable reservoir, which could be part of the homeostatic process to balance blood volume.

Improved methods for examination of Toxoplasma gondii cytoskeleton at ultrastructural level

To evaluate an improved method for identifying the presence of the structural elements of the cytoskeleton of Toxoplasma gondii and their influence on invasion of the parasite in host cells, copper grids coated with plastic film were used for adhesion of whole parasites. Tachyzoites were incubated with 0.5% Triton X-100 in PHEM buffer containing protease inhibitors, post-fixed in 1% glutaraldehyde, stained with uranyl acetate and submitted to critical point drying. In order to analyze the presence of the structural elements of the cytoskeleton, immunolocalization was carried out using colloidal gold. Invasion of the parasite was examined on cell culture after treatment of tachyzoites with cytochalasin B (CB). In order to observe this effect, an immunocytochemical assay using alkaline phosphatase was carried out. A very well conserved extraction of the cytoskeleton elements of T. gondii, such as conoid and microtubules, as well as the rhoptries, was observed. By immunolocalization with colloidal gold, it was possible to detect the actin in its globular form. In the assay of invasion of the parasite on the host cell, after treatment of the T. gondii tachyzoites with CB, the invasion process was totally inhibited.

Inhibition of gastric emptying and intestinal transit in anesthetized rats by a Tityus serrulatus scorpion toxin

The effects of a fraction (T1) of Tityus serrulatus scorpion venom prepared by gel filtration on gastric emptying and small intestinal transit were investigated in male Wistar rats. Fasted animals were anesthetized with urethane, submitted to tracheal intubation and right jugular vein cannulation. Scorpion toxin (250 microg/kg) or saline was injected iv and 1 h later a bolus of saline (1.0 ml/100 g) labeled with 99m technetium-phytate (10 MBq) was administered by gavage. After 15 min, animals were sacrificed and the radioactivity remaining in the stomach was determined. Intestinal transit was evaluated by instillation of a technetium-labeled saline bolus (1.0 ml) through a cannula previously implanted in the duodenum. After 60 min, the progression of the marker throughout 7 consecutive gut segments was estimated by the geometric center method. Gastric retention of the liquid test meal in rats injected with scorpion toxin (median: 88%; range: 52-95%) was significantly higher (P<0.02) than in controls (54%; 21-76%), an effect which was not modified by gastric secretion blockade with ranitidine. The progression of the isotope marker throughout the small intestine was significantly slower (P<0.05) in rats treated with toxin (1.2; 1.0-2.5) than in control animals (2.3; 1.0-3.2). Inhibition of both gastric emptying and intestinal transit in rats injected with scorpion toxin suggests an increased resistance to aboral flow, which might be caused by abnormal neurotransmitter release or by the local effects of venom on smooth muscle cells.

[Hysterosalpingography in the diagnosis of pelvic endometriosis]

Endometriosis is a common cause of chronic pelvic pain. Laparoscopy is considered the gold standard for definitive diagnosis. This work aims to evaluate whether hysterosalpingography (14SG), a cheaper and more accessible examination, is worth while as a diagnostic tool in this pathology. Thirty patients submitted to laparoscopy for chronic pelvic pain where retrospectively studied. Three different observers evaluated their hysterosalpingographies. The imaging diagnoses were classified as suggestive or not suggestive of external pelvic endometriosis. With laparoscopy, 18 patients had endometriosis, 11 with mild lesions by Acosta classification. Compared to laparoscopy, HSG diagnosis, when made by at least two observers, revealed a sensitivity of 55.5%, a specificity of 75%, a positive predictive value of 77%, and a negative predictive value of 53%. In the presence of clinical pathologic uterosacral--US ligaments and/or sterility, the specificity of HSG may be 100%, but the sensitivity falls below the 40%. We concluded that in a population with chronic pelvic pain, HSG is not a first choice diagnostic tool. This examination only permits the identification of 1/3 of the patients with external endometriosis, being unable to exclude its presence. However, it may be useful in patients with infiltrative endometriosis of the US ligaments.

Mast cell types and cell-to-cell interactions in lymph nodes of the opossum Didelphis albiventris

Previous light-microscopic studies have shown a unique population of mast cells in lymphatic sinuses of lymph nodes located in the head, neck, axillary fossa and inguinal region of the opossum. In the present work, scanning and transmission electron-microscopic studies in the opossum mandibular and superficial axillary lymph nodes have strengthened the differences between connective-tissue mast cells (CTMC) and the lymphatic-sinus mast cells (LSMC). Further, close appositions of mast cells to other cells were described. At the nodal capsule, CTMC contacted fibroblast and granulocytes. In the lymphatic sinuses a few CTMC contacted LSMC, macrophages and reticular cells. The LSMC contacted macrophages, reticular cells and other LSMC. A few LSMC could be located in the medullary cord in close contact with plasma cells or other lymphoid cells, keeping the same ultrastructural features of those found in the lymphatic sinuses. An important new finding was provided by light-microscopic studies in nine abdominal lymph nodes. Most of them (para-aortic, common iliac, cardial, cecocolic and those of the body and tail of the pancreas) displayed numerous LSMC with the same distribution and histological features described herein. However, the mesenteric, pyloric and head-of-pancreas lymph nodes were virtually devoid of LSMC. Instead, their mast cells occurred mainly at the medullary cords and were very similar to the CTMC. Ultrastructural studies at the mesenteric lymph nodes confirmed the CTMC character of the mast cells located at both medullary cords and sinuses, and disclosed interactions with macrophages and lymphoid cells.

A plethysmometric method for gastric compliance studies in anesthetized rats

A new method to study gastric volume by plethysmography is presented. Twenty male Wistar rats (250-300 g) were fasted for 24 h. After anesthesia with urethane (1.2 g/kg, i.p.), a tracheostomy was performed, and cervical vessels were cannulated. A balloon catheter was introduced per os and positioned in the proximal stomach. The opposite end of the catheter was connected to a reservoir (volume = 30 ml; inside diameter = 2.5 cm), coupled to a plethysmometer. A standard ionic solution was used to fill the balloon ( approximately 3.0 ml) and the communicating vessel system. Calibration experiments (n = 5) displayed a strong (r(2) = 0.99) correlation between graded balloon-volume changes and plethysmometric recordings. Because distending pressure of the stomach remained constant, the balloon-volume recordings were taken as gastric compliance index. Gastric volume changes, mean arterial pressure, and heart rate of animals of control and experimental groups were monitored for 90 min. The data were analyzed by analysis of variance and the Student-Newman-Keuls test. In control animals (n = 5), no significant changes on gastric volume and hemodynamic values were found. Experimental animals were treated with either yohimbine (n = 5) or bethanechol (n = 5) i.v. injections. The rats received consecutive doses of yohimbine (0.5 and 1 mg/kg) or bethanechol (1.5 and 3 microg/kg), 30 min apart. Both doses of each treatment transiently induced hypotension and bradycardia (p < 0.05). Yohimbine treatment (1 mg/kg) increased gastric volume by half (p < 0.05), whereas bethanechol (3 microg/kg) decreased it by 35% (p < 0.05). In summary, this work shows a suitable method to directly assess gastric compliance in anesthetized rats.

Neural mechanisms involved in the delay of gastric emptying of liquid elicited by acute blood volume expansion in awake rats

We have previously reported that acute blood volume expansion in awake rats delays the gastric emptying of a liquid meal, using the phenol red method. In this study we attempted to investigate the neural mechanisms involved in this phenomenon. Blood volume expansion, due to Ringer-bicarbonate infusion up to a volume equivalent to 5% of body weight, decreased the gastric emptying of a liquid meal by half (38.2 +/- 1.8 vs 18.7 +/- 3.2%, P < 0.05). The blood volume expansion effect on gastric emptying of liquid was prevented by separate pretreatments, consisting of subdiaphragmatic vagotomy or i.v. injection of hexamethonium (20 mg kg-1) or yohimbine (3 mg kg-1). Intravenous injection of atropine (0.5 mg kg-1), guanethidine (10 mg kg-1), L-NAME (3 mg kg-1), prazosin (1 mg kg-1) or propranolol (2 mg kg-1) did not prevent the blood volume expansion effect on gastric emptying. Bilateral adrenalectomy or coeliac ganglionectomy were also ineffective. The results indicate that blood volume expansion decreases gastric emptying of liquid through vagal-dependent pathways, sensitive to hexamethonium and yohimbine. Evidence for the participation of the peripheral sympathetic nervous system was not found.

Variations in gastric emptying of liquid elicited by acute blood volume changes in awake rats

We have observed that acute blood volume expansion increases the gastroduodenal resistance to the flow of liquid in anesthetized dogs, while retraction decreases it (Santos et al. (1991) Acta Physiologica Scandinavica, 143: 261-269). This study evaluates the effect of blood volume expansion and retraction on the gastric emptying of liquid in awake rats using a modification of the technique of Scarpignato (1980) (Archives Internationales de Pharmacodynamie et de Therapie, 246: 286-294). Male Wistar rats (180-200 g) were fasted for 16 h with water ad libitum and 1.5 ml of the test meal (0.5 mg/ml phenol red solution in 5% glucose) was delivered to the stomach immediately after random submission to one of the following protocols: 1) normovolemic control (N = 22), 2) expansion (N = 72) by intravenous infusion (1 ml/min) of Ringer-bicarbonate solution, volumes of 1, 2, 3 or 5% body weight, or 3) retraction (N = 22) by controlled bleeding (1.5 ml/100 g). Gastric emptying of liquid was inhibited by 19-51.2% (P < 0.05) after blood volume expansion (volumes of 1, 2, 3 or 5% body weight). Blood volume expansion produced a sustained increase in central venous pressure while mean arterial pressure was transiently increased during expansion (P < 0.05). Blood volume retraction increased gastric emptying by 28.5-49.9% (P < 0.05) and decreased central venous pressure and mean arterial pressure (P < 0.05). Infusion of the shed blood 10 min after bleeding reversed the effect of retraction on gastric emptying. These findings suggest that gastric emptying of liquid is subject to modulation by the blood volume.

Acute blood volume expansion delays the gastrointestinal transit of a charcoal meal in awake rats

The present study evaluates the effect of blood volume expansion on the gastrointestinal transit of a charcoal meal (2.5 ml of an aqueous suspension consisting of 5% charcoal and 5% gum arabic) in awake male Wistar rats (200-270 g). On the day before the experiments, the rats were anesthetized with ether, submitted to left jugular vein cannulation and fasted with water ad libitum until 2 h before the gastrointestinal transit measurement. Blood volume expansion by i.v. infusion of 1 ml/min Ringer bicarbonate in volumes of 3, 4 or 5% body weight delayed gastrointestinal transit at 10 min after test meal administration by 21.3-26.7% (P < 0.05), but no effect was observed after 1 or 2% body weight expansion. The effect of blood volume expansion (up to 5% body weight) on gastrointestinal transit lasted for at least 60 min (P < 0.05). Mean arterial pressure increased transiently and central venous pressure increased and hematocrit decreased (P < 0.05). Subdiaphragmatic vagotomy and yohimbine (3 mg/kg) prevented the delay caused by expansion on gastrointestinal transit, while atropine (0.5 mg/kg), L-NAME (2 mg/kg), hexamethonium (10 mg/kg), prazosin (1 mg/kg) or propranolol (2 mg/kg) were ineffective. These data show that blood volume expansion delays the gastrointestinal transit of a charcoal meal and that vagal and yohimbine-sensitive pathways appear to be involved in this phenomenon. The delay in gastrointestinal transit observed here, taken together with the modifications of gastrointestinal permeability to salt and water reported by others, may be part of the mechanisms involved in liquid excess management.

[Asymmetric septate uterus with unilateral menstrual retention. A rare uterine malformation]

A case is reported of a patient with an asymmetric septate uterus and menstrual retention in the blind cavity localized on the right side of the septum. A review is made of the literature about this rare malformation first described by Robert, is made.

Gastroduodenal resistance and neural mechanisms involved in saline flow decrease elicited by acute blood volume expansion in anesthetized rats

We have previously demonstrated that blood volume (BV) expansion decreases saline flow through the gastroduodenal (GD) segment in anesthetized rats (Xavier-Neto J, dos Santos AA & Rola FH (1990) Gut, 31: 1006-1010). The present study attempts to identify the site(s) of resistance and neural mechanisms involved in this phenomenon. Male Wistar rats (N = 97, 200-300 g) were surgically manipulated to create four gut circuits: GD, gastric, pyloric and duodenal. These circuits were perfused under barostatically controlled pressure (4 cmH2O). Steady-state changes in flow were taken to reflect modifications in circuit resistances during three periods of time: normovolemic control (20 min), expansion (10-15 min), and expanded (30 min). Perfusion flow rates did not change in normovolemic control animals over a period of 60 min. BV expansion (Ringer bicarbonate, 1 ml/min up to 5% body weight) significantly (P < 0.05) reduced perfusion flow in the GD (10.3 +/- 0.5 to 7.6 +/- 0.6 ml/min), pyloric (9.0 +/- 0.6 to 5.6 +/- 1.2 ml/min) and duodenal (10.8 +/- 0.4 to 9.0 +/- 0.6 ml/min) circuits, but not in the gastric circuit (11.9 +/- 0.4 to 10.4 +/- 0.6 ml/min). Prazosin (1 mg/kg) and yohimbine (3 mg/kg) prevented the expansion effect on the duodenal but not on the pyloric circuit. Bilateral cervical vagotomy prevented the expansion effect on the pylorus during the expansion but not during the expanded period and had no effect on the duodenum. Atropine (0.5 mg/kg), hexamethonium (10 mg/kg) and propranolol (2 mg/kg) were ineffective on both circuits. These results indicate that 1) BV expansion increases the GD resistance to liquid flow, 2) pylorus and duodenum are important sites of resistance, and, 3) yohimbine and prazosin prevented the increase in duodenal resistance and vagotomy prevented it partially in the pylorus.

Use of growth hormone for postoperative respiratory failure

BACKGROUND

The authors examined the efficacy of human growth hormone (HGH) in patients dependent on mechanical ventilation who were being weaned from the respirator.

METHODS

A total of 53 patients were chosen by the primary surgical team in consultation with the critical care service to undergo HGH therapy. These patients had been receiving standard ICU support and had failed standard ventilator weaning protocols. As such, they were treated with HGH in an attempt to increase respiratory muscle strength and facilitate weaning from mechanical ventilation.

RESULTS

General demographic information was recorded. Patients suffered from a high incidence of co-morbid conditions and infectious complications. The average duration of HGH therapy was 38 days, and 81% of the previously unweanable patients were eventually weaned from mechanical ventilation with an overall survival of 76%. Mortality as predicted by APACHE II Scores was significantly less than actual mortality (24% actual mortality vs. 42% predicted mortality, P < 0.05).

CONCLUSIONS

This phase I study presents clinical evidence supporting the safety and efficacy of HGH in promoting respiratory independence in a selected group of surgical ICU patients. Randomized, blinded, controlled trials now seem warranted.

Tropical pyomyositis presenting in the upper extremity

Tropical pyomyositis is a staphylococcal infection, usually of a single large muscle, most commonly seen in young men in tropical regions. The following presents a case of tropical pyomyositis in a 62-year-old man that affected all four extremities, including the muscles of the forearms. Computed tomography was a useful guide for directing surgical explorations. To decrease the degree of disability from the multiple operative sites, we successfully used limited longitudinal incisions and conservative débridements.

Hypercalcemia associated with the use of human growth hormone in an adult surgical intensive care unit

BACKGROUND

The anabolic properties of human growth hormone (HGH) may prove beneficial in critically ill surgical patients. Potential effects of hypercalcemia with HGH therapy have not been addressed for adult patients in the intensive care unit.

METHODS

We performed a retrospective review of the past 100 patients treated with HGH in a surgical intensive care unit. Laboratory data, including serum calcium levels, were recorded at baseline and during HGH therapy. Additionally, calcium levels in 27 burn patients receiving HGH were compared with calcium levels in a well-matched group of 27 burn patients not receiving HGH. The incidence and severity of hypercalcemia were recorded, with attention to contributing factors and overall outcome.

RESULTS

There was a statistically significant increase in the mean +/- SD serum calcium level with the institution of HGH therapy (2.50 +/- 0.20 mmol/L [10.0 +/- 0.8 mg/dL] before HGH vs 2.74 +/- 0.27 mmol/L [11.0 +/- 1.1 mg/dL] during HGH, P < .05). Before HGH, 14% of the patients had hypercalcemia, defined as a calcium level greater than 2.74 mmol/L (11.0 mg/dL). During HGH, 43% of the patients developed hypercalcemia. Before HGH, no patient exhibited severe hypercalcemia, defined as a calcium level greater than 3.12 mmol/L (12.5 mg/dL). However, during HGH, 10% of the patients developed severe hypercalcemia. Elevations in serum calcium levels were correlated with the duration of HGH therapy and renal dysfunction. Burn patients receiving HGH exhibited significantly higher mean +/- SD calcium levels than controls (2.87 +/- 0.32 mmol/L [11.5 +/- 1.3 mg/dL] vs 2.50 +/- 0.17 mmol/L [10.0 +/- 0.7 mg/dL], P < .001). Studies performed in selected patients demonstrated that alterations in parathyroid function, vitamin D metabolism, and thyroid function did not appear to contribute to this effect.

CONCLUSION

Prolonged HGH therapy in critically ill surgical patients may result in severe hypercalcemia, particularly in patients with altered renal function. Possible mechanisms for HGH-induced hypercalcemia include increased intestinal absorption and decreased urinary excretion. Outcome was not adversely affected by this biochemical alteration, but careful monitoring of calcium levels should be undertaken in this population receiving HGH.