Megaloblastic anemia, associated with surgically produced gastrointestinal abnormalities.
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Two of the mechanisms for vitamin B(12) deficiency, leading to megaloblastic anemia, are the result of surgically produced abnormalities of the gastrointestinal tract. The basic mechanism is different for each lesion. Total gastrectomy results in complete lack of intrinsic factor which is necessary for vitamin B(12) absorption. It is believed that if patients survive long enough and are not given prophylactic vitamin B(12) therapy, all would develop megaloblastic anemia. Intestinal anastomosis leading to stasis of intestinal contents, with overgrowth of bacteria may cause vitamin B(12) deficiency through bacterial interference with the utilization of vitamin B(12). Use of radioactive vitamin B(12) (cobalt(60)-labeled B(12)) has led to a better understanding of the pathogenesis of both types of megaloblastic anemia. The radioactive vitamin provides a useful tool for study of its absorption from the gastrointestinal tract. (+info)
Management of upper gastrointestinal hemorrhage.
(10/3143)
In the past few years gastric resection has become the therapy of choice for patients with massive hemorrhage from duodenal ulcer. When this is done as an emergency procedure the ability of the surgeon is often taxed to the limit. Although sometimes easy, control is often extraordinarily difficult. Many important technical details must be considered in order to attain a successful outcome. This method of therapy has proved to be very satisfactory with patients who are in good condition for operation, and even in the poorer risks seen on ward service has resulted in a surgical mortality of only 7 per cent in all patients less than 60 years of age treated for this extremely severe type of hemorrhage. In the older age groups mortality rates still remain high. (+info)
Turnover of S35-sulfate in the mucosa of the gastrointestinal tract of rats as seen in autoradiograms.
(11/3143)
Segments of the gastrointestinal tract removed from rats after intervals of time following injection of S(35)-sulfate were fixed in aqueous formalin and then washed in water. Contact and coated autoradiograms were prepared. The suggestion made by others that more of the labelled sulfate is fixed by the mucosa than by the underlying coats of the gastrointestinal tract is confirmed. In addition it was found that the isotope is fixed to a greater extent in the lower intestine than in the middle or upper portions of it. Coated autoradiograms revealed that 6 hours after administration of S(35)-sulfate more of the label was present in the goblet cells lying deep in the crypts of the mucosa than in those adjacent to the intestinal lumen. By the 24th hour the concentration of the isotope was strikingly higher and more uniform from cell to cell. The mucus in the intestinal lumen was also highly radioactive. At the end of 48 hours very little of the sulfur-35 remained in the intestinal wall or could be made out in the mucus of the lumen: the autoradiographic reaction was faint and diffuse as contrasted with the punctiform and intense reaction given by the specimens removed at the end of shorter intervals of time. (+info)
The effect of ether and pentobarbitone sodium on gastrointestinal function in the intact rat.
(12/3143)
The effect of ether and pentobarbitone anaesthesia on gastrointestinal motility and absorption has been studied by measuring simultaneously gastric emptying, small intestinal transit and intestinal absorption of glucose and iodide in intact rats. Both gastric emptying and intestinal transit are very slow under ether anaesthesia, but with pentobarbitone there is no significant delay. The absorption of glucose by the small intestine is significantly impaired by ether but not by pentobarbitone, and a tracer dose of iodide is absorbed normally under both forms of anaesthesia. (+info)
Comparative effects of analgesics on pain threshold, respiratory frequency and gastrointestinal propulsion.
(13/3143)
In the rat, the ratio of the analgesic to the respiratory depressant potency was the same for morphine, codeine, diamorphine, methadone, dipipanone, piperidylisomethadone, phenadoxone, dextromoramide, and propoxyphene. The relative respiratory depressant activity of pethidine tended to be less, but the difference was not significant. The ratio of the analgesic dose to the dose preventing transport of a charcoal meal in the rat was about the same for morphine, codeine, pethidine, methadone, phenadoxone, dimethylthiambutene, and propoxyphene; the relative activities of these compounds in inhibiting the peristaltic reflex of the isolated guinea-pig ileum were also similar. However, because of differences in the slopes of regression lines in the charcoal meal test, some compounds (for example, morphine) had a greater effect on gastrointestinal propulsion than others (for example, pethidine) when given at moderate analgesic dose levels.In studies of the effects of intracisternal morphine in the rat, effects on the spinal reflex of the tail were to some extent dissociated from effects on the threshold for a squeak response. Further, the delaying of transport of a charcoal meal paralleled depression of respiratory rate, and this is evidence for the participation of a central as well as a peripheral action in the effect of morphine on the gastrointestinal tract. The delay in propulsion was reduced by nalorphine and increased by atropine and two general anaesthetic substances, but was unaffected by a number of other pharmacological agents. (+info)
Use and abuse of nasogastric intubation.
(14/3143)
The value of nasogastric intubation in the treatment of paralytic ileus and in some cases of mechanical obstruction, as well as in the preparation of obstructed patients for operation, cannot be denied. However, it is felt that intubation is oftentimes employed unnecessarily, and that the complications of this procedure are not fully appreciated. Fluid and electrolyte loss, sinusitis, parotitis, laryngeal obstruction, esophagitis, knotting and difficulty in withdrawing tubes and perforations of the gastrointestinal tract are complications that can occur when nasogastric intubation is employed. Two hundred consecutive operations on the gallbladder and bile ducts were reviewed, and the need for intubation in these cases was evaluated. It was needed in only 7.5 per cent of the cases in the series. In light of the hazards and the rather rare necessity for nasogastric intubation, "routine" use should be eschewed. (+info)
Wireless telemetering from the digestive tract.
(15/3143)
This paper describes the construction and use of "radio pills" which transmit changes in intraluminar pressure. (+info)
The turnover and shedding of epithelial cells. I. The turnover in the gastro-intestinal tract.
(16/3143)
This paper confirms that the epithelial lining of the small intestine is in a state of continuous replacement and demonstrates that the whole of the gastrointestinal epithelium has a similar dynamic equilibrium. (+info)