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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK; Malden, USA : Blackwell Science Inc
    Wound repair and regeneration 13 (2005), S. 0 
    ISSN: 1524-475X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Actin cytoskeletal polymerization is associated with a pro-proliferative, pro-survival state. We hypothesized that the actin polymerization of wound cells is increased in the presence of wound matrix attachment and is decreased after disruption of this attachment. Musculocutaneous flap and wound splinting models were used to investigate the effect of wound matrix attachment on the actin cytoskeleton. Disruption of wound matrix attachment was accomplished by incision of the wound matrix/dermis interface (wound matrix release) and/or desplinting. Polymerized actin was assayed with phalloidin labeling of wound specimens 24 hours after disruption of attachment and a method to quantify the content and organization of polymerized actin in granulation tissue was used. Disruption of wound matrix attachment decreased the content of polymerized actin, the actin staining intensity, and the actin fiber organization in the granulation tissue of both the flap and splint models. Disruption of wound matrix attachment decreased actin polymerization and fiber organization in the granulation tissue. Our data support the concept that the state of wound matrix attachment regulates the actin cytoskeleton of wound cells.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Diseases of the colon & rectum 35 (1992), S. 87-89 
    ISSN: 1530-0358
    Keywords: Continent ileostomy ; Surgical technique
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A technique is described for revising an incompetent nipple valve of a continent ileostomy. The procedure involves preserving the incompetent valve and using it as a collar around the base of the new valve to improve function.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Diseases of the colon & rectum 38 (1995), S. 215-218 
    ISSN: 1530-0358
    Keywords: Ileal pouch-anal anastomosis ; Anal sphincteroplasty ; Incontinence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: This report reviews two patients who underwent anal sphincteroplasty to improve continence after ileal pouch-anal anastomosis (IPAA). METHODS: A retrospective study of two patients was performed. RESULTS: Two patients underwent anal sphincteroplasty after IPAA for incontinence, one diagnosed preoperatively and one postoperatively. Both had had previous anal surgery. Satisfactory continence was achieved in both cases, despite modest changes in manometric studies. CONCLUSION: Anal sphincteroplasty should be considered after IPAA. The value of anorectal manometry in this situation is equivocal.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1530-0358
    Keywords: Peptide YY ; Gastrointestinal transit time ; Restorative proctocolectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: This study evaluates peptide tyrosine-tyrosine (PYY), intestinal transit, fecal retention time, and anal sphincter manometry in colectomized patients with ileal pouch-anal anastomosis. METHODS: Plasma and pouch PYY, mouth-to-pouch transit time, fecal retention time, and anal canal pressures were studied in 27 patients with ileoanal pouches a mean of 50 (range, 3–84) months after loop ileostomy closure. RESULTS: Basal and peak postprandial plasma PYY were significantly reduced in patients with pouches compared with controls (P〈0.0001). Pouch PYY was decreased compared with control ileal PYY (P=0.0003). No significant correlation was noted between intestinal transit and total integrated PYY response in patients with pouches (r=0.36;P=0.06). Fecal retention time was related to postprandial total integrated response of plasma PYY (r=0.43;P=0.02), mouth-to-pouch transit (r=0.87;P〈0.0001), and resting (r=0.44;P=0.02) and squeeze (r=0.62;P=0.0006) anal sphincter pressures. CONCLUSIONS: Colectomized ileoanal patients with pouches showed decreased plasma and pouch PYY compared with controls. Intestinal transit was not significantly related to PYY release. However, prolonged pouch fecal retention was associated with greater PYY release, mouth-to-pouch transit, and anal sphincter pressures.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 3 (1988), S. 303-311 
    ISSN: 1437-9813
    Keywords: Short bowel syndrome ; Parenteral nutrition ; Intestinal absorption
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Long-term survival after massive intestinal resection is now possible with parenteral nutritional support. The expense, morbidity, and inconvenience of this therapy, however, has led to continued interest in alternatives for the treatment of the short bowel syndrome. The goals of surgical therapy in the short bowel syndrome are to increase the area of absorption, slow intestinal transit, and reduce gastric hyperacidity. Selected patients with dilated bowel segments benefit from intestinal tapering or lengthening. Growing neomucosa to increase surface area is not yet clinically efficacious. The results of transplantation remain unsatisfactory despite recent advances in immunosuppression. Antiperistaltic segments, colon interposition, and intestinal valves may benefit patients with sufficient absorptive area but rapid intestinal transit. Recirculating loops are associated with prohibitive morbidity and mortality. Intestinal pacing is currently being investigated. Surgical treatment of the short bowel syndrome is not sufficiently safe and effective to recommend its routine use. Operations should be performed only on selected patients to achieve specific goals. Adjunct procedures should not be carried out at the initial intestinal resection. Most important is continued emphasis on the prevention of intestinal resection and conservation of the intestine when massive resection is necessary.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 36 (1991), S. 1582-1588 
    ISSN: 1573-2568
    Keywords: Crohn's disease ; diamine oxidase
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Plasma postheparin diamine oxidase (DAO) activity has been evaluated for assessing disease activity in Crohn's disease (CD) and other intestinal disorders. Since the mechanism of the reduced plasma DAO activity is poorly understood, our aim was to determine the effect of extent and location of disease and prior resection and therapy on plasma DAO activity in Crohn's disease. Plasma postheparin DAO activity was significantly lower (17.4±3.0 vs 32.8±30.8 units/ml) and Crohn's disease activity index (178±105 vs 14±19,P〈0.05) (CDAI) higher in 37 patients with CD compared to 30 normal volunteers. There was no overall correlation between DAO activity and CDAI. Effective medical or surgical therapy increased DAO activity and decreased CDAI, while clinical recurrence had the opposite effect. DAO activity was not related to the extent of small bowel disease (13.2±9.1; 〈30 cm, 18.5±11.8; 30–60 cm, and 5.7±6.4 units/ml; 〉60 cm) or colonic disease (13.0±6.9 segmental vs 24.0±15.4 units/ml, pancolitis). DAO activity was similar with small or large bowel disease (14.3±10.6 vs 18.8±13.1 units/ml). Prior enterectomy or colectomy did not significantly influence DAO activity. DAO activity responds predictably after effective therapy and recurrence and may prove useful in monitoring individual patients with CD. Failure of extent and location of disease and prior resection to influence DAO activity suggests that DAO activity is not directly related to enterocyte mass.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 34 (1989), S. 1434-1442 
    ISSN: 1573-2568
    Keywords: motility ; myoelectrical activity ; small intestine ; sphincter ; ileocolonic sphincter ; artificial sphincter
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied the effects of an ileocolonic sphincter substitute on canine small intestine motor activity. Recordings of fasting and postprandial myoelectrical activity were performed in three groups of animals in whom the following procedures had been performed: (1) electrode placement alone, intestinal continuity undisturbed (controls); (2) ileocolonic sphincter substitute fashioned in mid-jejunum; and (3) transection and reanastomosis at a similar location in mid-jejunum. Transection alone resulted in a decrease in slow-wave frequency, a shortening of the period of the interdigestive myoelectrical complex (IDMEC) and a prolongation of phase III of the IDMEC in the jejunum distal to the site of transection. The IDMEC period was also shorter at proximal electrode sites, but the incidence of IDMEC phase III complexes was similar on either side of the transection. However, in those animals in whom a sphincter substitute had been fashioned at the site of the transection, the incidence of IDMEC phase III complexes was significantly suppressed in the proximal intestine; IDMEC phase III frequency per hour (mean±sd transection vs sphincter substitute) was 0.59±0.20 vs 0.23±0.24,P〈0.002; 0.61±0.24 vs 0.28±0.30,P〈0.006; 0.61±0.24 vs 0.29±0.30,P=0.008, at electrodes 10, 35, and 85 cm proximal to the sphincter substitute, respectively. In addition, the sphincter-substitute animals alone demonstrated, during fasting, recurrent propagated bursts of spike clusters and occasional prolonged spike bursts in electrodes proximal to the sphincter substitute. No significant differences with respect to the pattern of postprandial spike activity were noted between the various animal groups during limited postprandial recordings. None of the animals demonstrated clinical, radiographie, or autopsy evidence of intestinal obstruction. We conclude that placement of a sphincter substitute, of a type advocated for replacement of the ileocolonic sphincter, results in significant disruption of interdigestive myoelectrical activity in the proximal small intestine.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1573-2568
    Keywords: transplant ; small intestine ; jejunoileum ; gastrointestinal hormones ; neuropeptides ; gastrin ; GIP ; neurotensin ; PYY
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Plasma gastrointestinal hormones were measured before and during feeding in eight dogs, more than one year after total autotransplant of the entire jejunoileum, and in controls. At sacrifice, tissues were taken from the transplanted segment and intact bowel for measurement of hormone and enteric neuropeptide content. Gastrin levels were reduced in autotransplanted dogs (fasting 63% of control, incremental response 67% of control, bothP〈0.05), reflecting the loss of acid inhibitory reflexes. Secretin and cholecystokinin responses were identical between the two groups. Postprandial levels of gastric inhibitory peptide (incremental response 175% of control,P〈0.005), insulin, and peptide YY (158% of control,P〈0.05) were elevated following denervation, the former suggesting more rapid gastric emptying while the latter may reflect malabsorption. The neurotensin meal response was obtunded by denervation (incremental response 43% of control,P〈0.05), providing evidence for a neural pathway for its release. Pancreatic polypeptide responses were identical between the groups, suggesting intact pancreatic innervation. Abnormal hormone secretion may contribute to the impaired fed motor responses seen following extrinsic denervation of the small bowel. In contrast, the neuropeptide content of the autotransplanted small intestine is normal, suggesting that extrinsic denervation has no long-term effects on peptide content of the enteric nervous system.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 41 (1996), S. 1194-1203 
    ISSN: 1573-2568
    Keywords: small bowel resection ; adaptation ; enterectomy ; gastrointestinal hormones ; neuropeptides ; vasoactive intestinal polypeptide ; calcitonin gene-related peptide ; gastrin ; cholecystokinin ; glucose-dependent insulinotropic peptide ; peptide YY ; enteroglucagon
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Basal and postprandial concentrations of gastrointestinal hormones were measured in 12 dogs before and at one and three months after a 75% small bowel resection. Five animals were studied again at six months. Concentrations of enteric hormones and neuropeptides, measured in the proximal jejunum and distal ileum adjacent to the anastomotic site at the time of euthanasia, were compared with concentrations in control tissues taken from each animal at the time of resection. Increased basal and postprandial levels of gastrin (P〈0.05), cholecystokinin (CCK,P〈0.05), glucose-dependent insulinotropic peptide (GIP,P〈0.01), peptide YY (PYY,P〈0.001), and enteroglucagon (P〈0.001), were seen at one month after small bowel resection. In contrast, no significant changes were seen in concentrations of secretin, motilin, neurotensin, somatostatin, PP, or glucagon. Concentrations of enteroglucagon, GIP, and PYY remained high throughout the six-month study period. In contrast, gastrin and CCK had normalized by three months. Thus, only enteroglucagon, PYY, and GIP showed sustained elevations following enterectomy; the gastrin and CCK changes were transient. Following enterectomy, concentrations of vasoactive intestinal polypeptide (VIP) were reduced by about 50% in mucosal (P〈0.001) and muscle (P〈0.05) layers of proximal and distal gut. In contrast, calcitonin gene-related peptide (CGRP) was increased by about twofold in jejunal and ileal mucosa (P〈0.05), and CGRP elevations were even more marked in the muscle layers (P〈0.001). Somatostatin and neuropeptide Y (NPY) concentrations were similar to controls in all areas except for a small decrease in NPY in ileal mucosa (P〈0.05). These findings suggest that the increased motilin and PP concentrations previously reported after bowel resection in man are more likely to reflect underlying inflammatory bowel disease rather than enterectomy. The normalization of hypergastrinemia explains why the increased acid secretion after small bowel resection is transient. These results provide evidence for independent secretory control of enteroglucagon and PYY, which are both products of intestinal L cells. In addition, these studies reveal marked changes in enteric neuropeptide concentrations following bowel resection. VIP, which is thought to be a major inhibitory transmitter in the gut, is markedly reduced, while CGRP, which is mainly localized in sensory afferent fibers, is increased. These major neuropeptide changes are likely to be of importance in the adaptive responses to massive small bowel resection.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1573-2568
    Keywords: ileocolonic sphincter ; short bowel syndrome ; intestinal motor activity ; nipple valve ; cluster activity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied the effects of a sphincter substitute on motility in the intestinal remnant following an extensive distal intestinal resection. Two groups of adult dogs were studied; each underwent a 75% resection of the distal small intestine, and in one group a nipple valve was fashioned at the distal end of the remnant. Nutritional status, absorptive function, motility, and transit were studied over a three-month period. While the nipple valve animals had less diarrhea, steatorrhea, and hypoalbuminemia, motor activity and transit were similar in both groups. Thus, in both groups, fasting motor activity was dominated by clusters of phasic pressure activity. (Cluster frequency, per hour, mean±se, resection vs resection with nipple valve: 4.8±1.05 vs 3.58±0.54, NS). We conclude that the beneficial effects of a sphincter substitute in ameliorating the short bowel syndrome in this dog model are not related to any modification of the motor response to resection but may simply reflect those of a low-grade mechanical obstruction.
    Type of Medium: Electronic Resource
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