Fusobacterium nucleatum: Unraveling its potential role in gastric carcinogenesis.

Fusobacterium nucleatum (F. nucleatum) is a Gram-negative anaerobic bacterium that plays a key role in the development of oral inflammation, such as periodontitis and gingivitis. In the last 10 years, F. nucleatum has been identified as a prevalent bacterium associated with colorectal adenocarcinoma and has also been linked to cancer progression, metastasis and poor disease outcome. While the role of F. nucleatum in colon carcinogenesis has been intensively studied, its role in gastric carcinogenesis is still poorly understood. Although Helicobacter pylori infection has historically been recognized as the strongest risk factor for the development of gastric cancer (GC), with recent advances in DNA sequencing technology, other members of the gastric microbial community, and F. nucleatum in particular, have received increasing attention. In this review, we summarize the existing knowledge on the involvement of F. nucleatum in gastric carcinogenesis and address the potential translational and clinical significance of F. nucleatum in GC.

Development of novel rectal/uterine clamping device.

We developed a novel clamping device for laparoscopic surgery, free from conventional pinch structure, capable of uniformly occluding any ductal organ. This study aimed to evaluate performance of the new clamper compared to the pinch-type clamper. The new clamper consists of two metal bars with ties at each end, which enables parallel clamping. A resected porcine stomach was used, with an infusion tube at the anal end to increase intra-luminal pressure. The oral side of the stomach was clamped with either the new clamper or the pinch-type clamper, and their performances were evaluated in qualitative and semi-quantitative manner. Qualitative evaluation involved imaging the clamping site at intra-gastric pressures from 0 to 15 mmHg using microfocus computed tomography. The new clamper showed no gap even under increased intra-luminal pressure, while the pinch-type clamper showed a gap on the distal side. Quantitative evaluation measured bursting pressure under continuous air insufflation. Air leakages were observed in the new clamper at higher intra-luminal pressures than in the pinch-type clamper (46.1 mmHg vs. 13.6 mmHg, P < 0.01). Our new clamping device showed superior performance in preclinical setting compared to the conventional pinch-type clamper. We are currently working on its design freezing and aiming for early commercialization.

Porcine stomach surgical simulation model for cesarean section and cervical laceration suturing.

BACKGROUND: Junior OB/GYN residents lack opportunities for fundamental surgical skills training of cesarean section, and most OB/GYN residents lack the experience of cervical laceration suturing due to its low incidence. METHODS: A porcine stomach simulation model was designed for obstetrics surgical training. The surface of the stomach simulated the uterus, and the pylorus and cardia simulated the cervical canal. EXPERIENCE: Materials are available from the nearby market. The total cost of the model isï¿¥41. This model can be used in the training in uterus incision and repair of cesarean section and training in cervical laceration suturing. CONCLUSION: The porcine stomach simulation model is pragmatic and realistic. They can be applied in the OB/GYN skill courses to introduce the fundamental obstetrics process to medical students and residents.

Nomogram based on lymphocyte-associated inflammatory indexes predicts portal vein thrombosis after splenectomy with esophagogastric devascularization.

OBJECTIVE: The relationship between lymphocyte-associated inflammatory indices and portal vein thrombosis (PVT) following splenectomy combined with esophagogastric devascularization (SED) is currently unclear. This study aims to investigate the association between these inflammatory indices and PVT, and to develop a nomogram based on these indices to predict the risk of PVT after SED, providing an early warning tool for clinical practice. METHODS: We conducted a retrospective analysis of clinical data from 131 cirrhotic patients who underwent SED at Lanzhou University's Second Hospital between January 2014 and January 2024. Independent risk factors for PVT were identified through univariate and multivariate logistic regression analyses, and the best variables were selected using the Akaike Information Criterion (AIC) to construct the nomogram. The model's predictive performance was assessed through receiver operating characteristic (ROC), calibration, decision, and clinical impact curves, with bootstrap resampling used for internal validation. RESULTS: The final model incorporated five variables: splenic vein diameter (SVD), D-Dimer, platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and red cell distribution width-to-lymphocyte ratio (RLR), achieving an area under the curve (AUC) of 0.807, demonstrating high predictive accuracy. Calibration and decision curves demonstrated good calibration and significant clinical benefits. The model exhibited good stability through internal validation. CONCLUSION: The nomogram model based on lymphocyte-associated inflammatory indices effectively predicts the risk of portal vein thrombosis after SED, demonstrating high accuracy and clinical utility. Further validation in larger, multicenter studies is needed.

Successful emergency surgery for accidental ingestion of multiple neodymium magnets in an Argentine tegu (Salvator merianae).

A large Argentine tegu (Salvator merianae) presented with anorexia. Initial radiographs revealed a metallic foreign body in the stomach. The tegu vomited and became inactive two days later. A follow-up radiograph revealed the persistence of the foreign body in the same region. The foreign body was identified as a cluster of multiple magnets resembling neodymium magnets reported missing by the owner. An emergent laparotomy was performed due to gastrointestinal perforations caused by the multiple magnets. The surgical intervention revealed perforations in the walls of the stomach and small intestine and progressing acute peritonitis. Three magnets were extracted from the abdominal cavity and the tegu showed recovery. At 200 days postoperatively, the tegu continued to demonstrate good appetite and energy levels.

Two cases of intrathoracic herniation of the gastric tube from the retrosternal route requiring reoperation after oesophagectomy.

Intrathoracic herniation of the gastric tube pulled up through the retrosternal route after oesophagectomy is relatively rare and usually can be managed by conservative treatment.We present two patients who needed reoperation for intrathoracic herniation of gastric tube after minimally invasive oesophagectomy for thoracic oesophageal cancer. Postoperatively, both patients showed herniation and acute twist of the gastric tube. Due to the twist of the gastric tube, one patient had ischaemic change of the proximal tip of the gastric tube, and the other patient showed delayed gastric emptying, both of which led to surgical repairs. In this case report, we discuss why the herniation of gastric tube from the retrosternal route occurs, how to decide to do reoperation and how to prevent this complication.

Seasonal variation in the stomach microbiota of two sympatrically breeding Pygoscelis penguin species at Signy Island, South Orkney Islands.

The gut microbiomes of Antarctic penguins are important for the fitness of the host birds and their chicks. The compositions of microbial communities in Antarctic penguin guts are strongly associated with the birds' diet, physiological adaptation and phylogeny. Whilst seasonal changes in food resources, distribution and population parameters of Antarctic penguins have been well addressed, little research is available on the stability or variability of penguin stomach microbiomes over time. Here, we focused on two Pygoscelis penguin species breeding sympatrically in the maritime Antarctic and analysed their stomach contents to assess whether penguin gut microbiota differed over three austral summer breeding seasons. We used a high-throughput DNA sequencing approach to study bacterial diversity in stomach regurgitates of Adélie (Pygoscelis adeliae) and chinstrap (Pygoscelis antarctica) penguins that have a similar foraging regime on Signy Island (South Orkney Islands). Our data revealed significant differences in bacterial alpha and beta diversity between the study seasons. We also identified bacterial genera that were significantly associated with specific breeding seasons, diet compositions, chick-rearing stages and sampling events. This study provides a baseline for establishing future monitoring of penguin gut microbiomes in a rapidly changing environment.

Defatted Wheat Germ Protein-Derived Peptides Showed Multiple Biological Activities from the Stomach to Small Intestine: In Silico and In Vitro Approaches.

This study aimed to test the hypothesis that bioactive peptides can exert multiple bioactivities at different sites in the gastrointestinal tract. Our previous research identified 33 gastric-resistant peptides derived from wheat germ with potential antiadhesive activity against Helicobacter pylori in the stomach. In this work, in silico digestion of these peptides with trypsin, thermolysin, and chymotrypsin produced 67 peptide fragments. Molecular docking was conducted to predict their ACE and DPP-IV inhibitory activities in the small intestine. Three peptides (VPIPNPSGDR, VPY, and AR) were selected and synthesized for in vitro validation. Their generation in the gastrointestinal tract was verified via in vitro digestion, followed by mass spectrometry analysis. The IC50 values for ACE inhibition were 199.5 µM (VPIPNPSGDR), 316.3 µM (VPY), and 446.7 µM (AR). For DPP-IV inhibition, their IC50 values were 0.5, 1.6, and 4.0 mM, respectively. This research pioneers new directions in the emerging field of multifunctional peptides, providing scientific evidence to support the utilization of wheat germ as value-added food ingredients.

Comparison of Gastric Residual Volume After Ingestion of A Carbohydrate Drink and Water in Healthy Volunteers with Obesity: A Randomized Crossover Study.

INTRODUCTION: Preoperative carbohydrate intake is essential to enhance postoperative recovery. However, its safety for individuals with obesity remains unclear. This study investigated the safety of preoperative carbohydrate consumption compared to water intake in obese populations through gastric volume assessment. METHODS: A prospective randomized crossover study enrolled 30 healthy volunteers aged 18-65 years with a body mass index ≥ 30 kg/m2, following a minimum 6-h fast. The participants received either 400 ml of a carbohydrate drink (group C) or water (group W). Gastric ultrasonography, blood glucose level, hunger, and thirst assessments were conducted at baseline (T) and various time points (T2 to T6). The protocol was repeated with reverse interventions at least 1 week later. RESULTS: Group C had significantly higher gastric volume at T3, T4, and T5 compared to group W, with a prolonged time to empty the gastric antrum (94.4 ± 28.5 vs. 61.0 ± 33.5 min, 95% CI 33.41 [17.06,24.69]). However, glucose levels, degrees of hunger, and thirst showed no significant differences between the groups. CONCLUSION: Administering 400 ml of preoperative carbohydrates to healthy obese individuals 2 h preoperatively is safe and comparable to water intake. These findings support the integration of carbohydrate loading into perioperative care for obese individuals, consistent with the enhanced recovery after surgery protocols. Further research is warranted to refine preoperative fasting protocols and improve surgical outcomes in this population.

Starch in Emulsion-Type Sausage Reduced the Gastric Digestibility of Meat Protein by Reducing the Stability and Increasing the Viscoelasticity of Gastric Digests.

The effect of the addition of native starch (S) and modified starches (distarch phosphate (SP), acetylated distarch phosphate (AP), and starch acetate (SA)) in emulsion-type sausage on the digestion process of meat protein was studied in this work. The addition of native and modified starches reduced the release of -NH2 during the simulated gastric digestion stage, whereas the addition of SA increased the total release of -NH2 after the whole digestion. Peptidomic analysis revealed that the presence of starch decreased the release of peptides in the gastric digestion. The presence of starch reduced the stability of the digests but increased the viscosity of the gastric digestive fluid, which should largely be responsible for the decreased gastric digestibility of meat protein. These results highlighted the physical properties of digests as a key factor affecting the gastric digestion process of meat protein and provided guidance for the application of starches in meat products.

A proposed framework to establish in vitro-in vivo relationships using gastric digestion models for food research.

In vitro digestion methods have been utilized in food research to reduce in vivo studies. Although previous studies have related in vitro and in vivo data, there is no consensus on how to establish an in vitro-in vivo relationship (IVIVR) for food digestion. A framework that serves as a tool to evaluate the utility and limitations of in vitro approaches in simulating in vivo processes is proposed to develop IVIVRs for food digestion, with a focus on the gastric phase as the main location of food structural breakdown during digestion. The IVIVR consists of three quantitative levels (A, B, and C) and a qualitative level (D), which relate gastric digestion kinetic data on a point-to-point basis, parameters derived from gastric digestion kinetic data, in vitro gastric digestion parameters with in vivo absorption or appearance parameters, and in vitro and in vivo trends, respectively. Level A, B, and C IVIVRs can be used to statistically determine the agreement between in vitro and in vivo data. Level A and B IVIVRs can be utilized further evaluate the accuracy of the in vitro approach to mimic in vivo processes. To exemplify the utilization of this framework, case studies are provided using previously published static and dynamic gastric in vitro digestion data and in vivo animal study data. Future food digestion studies designed to establish IVIVRs should be conducted to refine and improve the current framework, and to improve in vitro digestion approaches to better mimic in vivo phenomena.

Caffeic acid phenethyl ester attenuates Enterococcus faecalis infection in vivo: antioxidants and NF-κB have a protective role against stomach damage.

The mammalian gastrointestinal tract hosts a significant microbial symbiont community, an intriguing feature of this complex organ system. This study aimed to investigate the anti-inflammatory, antioxidant, and protective effects of caffeic acid phenethyl ester (CAPE) against Enterococcus faecalis infection in the stomach at a dose of 106 CFU in Swiss mice. A total of 30 mice were randomly assigned to three groups of ten mice each. Group I was the negative control, Group II was infected orally with E. faecalis for 18 days, and Group III was infected with E. faecalis and treated with CAPE orally at a daily dose of 4 mg/kg for 18 days. We assessed the antioxidant activities of stomach homogenate and the immunohistochemical expressions of the transcription factor nuclear factor kappa B (NF-κB) and proliferating cell nuclear antigen (PCNA). Histopathological examination was performed on the stomachs of all mice. Group II had decreased levels of antioxidant activity and positive expressions of NF-κB and PCNA. Histological observations revealed an increase in mucosal and glandular thickness compared with Group I. Group III, treated with CAPE, showed a significant increase in antioxidant activities and a significant decrease in NF-κB and PCNA immunoreactivities compared with Group II. In addition, Group III showed restoration of the normal thickness of the non-glandular and glandular parts of the stomach. Our results revealed that E. faecalis infection has damaging effects on the stomach and proved that CAPE has promising protective, anti-inflammatory, and antioxidant effects against E. faecalis. Further studies may investigate the potential therapeutic effects of CAPE against E. faecalis infection.

Perforated ulcer at the gastrojejunal anastomosis: a rare complication of pancreaticoduodenectomy (case report).

Pancreaticoduodenectomy (PD) is recognized as one of the most intricate abdominal surgical procedures, often accompanied by high morbidity rates. The occurrence of an anastomotic ulcer at the gastrojejunal anastomosis post-pancreaticoduodenectomy surgery is a relatively uncommon complication, albeit potentially leading to severe, life-threatening consequences. The predominant symptomatology manifests as acute abdominal pain accompanied by peritonitis. Conventionally, diagnosis is achieved through computed tomography (CT) scans, facilitating subsequent management, and surgical management is recommended in the majority of instances. Herein, we present a rare case of a patient who experienced ulcer perforation at the gastrojejunal anastomosis site after undergoing pancreaticoduodenectomy with stomach preservation, and we reviewed the available literature to gain more comprehension of this rare complication of this type of surgical intervention.

Conduit Ischemia After Esophagectomy: A Spectrum of Clinical Manifestations, Prevention, and Management.

This article outlines the anatomic and physiologic basis for gastric conduit ischemia and the range of its possible manifestations, from superficial mucosal ischemia to gross conduit necrosis. Methods by which these complications are suspected and ultimately diagnosed are discussed, focusing on clinical and laboratory signs as the harbingers and the use of imaging and endoscopy for confirmation. From there, management options are detailed based on the Esophagectomy Complications Consensus Group classification of esophageal leak and gastric necrosis. Finally, the short- and long-term implications of these complications are reviewed.

Optimization of Helicobacter pylori Biofilm Formation in In Vitro Conditions Mimicking Stomach.

Helicobacter pylori is one of the most common bacterial pathogens worldwide and the main etiological agent of numerous gastric diseases. The frequency of multidrug resistance of H. pylori is growing and the leading factor related to this phenomenon is its ability to form biofilm. Therefore, the establishment of a proper model to study this structure is of critical need. In response to this, the aim of this original article is to validate conditions of the optimal biofilm development of H. pylori in monoculture and co-culture with a gastric cell line in media simulating human fluids. Using a set of culture-based and microscopic techniques, we proved that simulated transcellular fluid and simulated gastric fluid, when applied in appropriate concentrations, stimulate autoaggregation and biofilm formation of H. pylori. Additionally, using a co-culture system on semi-permeable membranes in media imitating the stomach environment, we were able to obtain a monolayer of a gastric cell line with H. pylori biofilm on its surface. We believe that the current model for H. pylori biofilm formation in monoculture and co-culture with gastric cells in media containing host-mimicking fluids will constitute a platform for the intensification of research on H. pylori biofilms in in vitro conditions that simulate the human body.

Magnamosis improves the healing of gastrojejunal anastomosis and down-regulates TGF-ß1 and HIF-1α in rats.

This study elucidated the unique pathological features of tissue healing by magnamosis and revealed the changes in landmark molecule expression levels related to collagen synthesis and tissue hypoxia. Forty-eight male Sprague-Dawley rats were divided into the magnamosis and suture anastomosis groups, and gastrojejunal anastomosis surgery was performed. Rats were dissected at 6, 24, and 48 h and 5, 6, 8, 10, and 12 days postoperatively. Hematoxylin, eosin, and Masson's trichrome staining were used to evaluate granulation tissue proliferation and collagen synthesis density at the anastomosis site. Immunohistochemistry was used to measure TGF-ß1 and HIF-1α expression levels. Magnamosis significantly shortened the operation time, resulting in weaker postoperative abdominal adhesions (P < 0.0001). Histopathological results showed a significantly lower granulation area in the magnamosis group than in the suture anastomosis group (P = 0.0388), with no significant difference in the density of collagen synthesis (P = 0.3631). Immunohistochemistry results indicated that the magnamosis group had significantly lower proportions of TGF-ß1-positive cells at 24 (P = 0.0052) and 48 h (P = 0.0385) postoperatively and HIF-1α-positive cells at 24 (P = 0.0402) and 48 h postoperatively (P = 0.0005). In a rat model of gastrojejunal anastomosis, magnamosis leads to improved tissue healing at the gastrojejunal anastomosis, associated with downregulated expression levels of TGF-ß1 and HIF-1α.

Microplastic in Gastric Fasting Liquid and Associated Gastric Pathology.

OBJECTIVE: To determine the presence of microplastics in the stomach, and the relationship between pathological changes in stomach tissue and microplastics. STUDY DESIGN: An analytical study. Place and Duration of the Study: Department of Internal Medicine, Sorgun State Hospital, Yozgat, Turkiye, from December 2022 to November 2023. METHODOLOGY: Fasting gastric fluid sampling and endoscopic sampling including mucosal and submucosal layers from the antrum were performed. The pH values of the gastric fluids were recorded. Samples were analysed gradually by adding iron solution, hydrogen peroxide, and sodium chloride (NaCl) in a beaker at 75 degrees for 30 minutes. Biopsy materials obtained from antrum were examined histopathologically and reported according to the Sydney classification. The relationship between gastric biopsy results and the presence of microplastic was evaluated using Chi-square test. The significance level was taken as p <0.005. RESULTS: The study included 61 individuals. The presence of microplastics was detected in 17 (27.86%) gastric fluid samples obtained from the individuals. A significant correlation was found between increased activity and inflammation in antrum biopsy and the presence of microplastic (χ2 = 8.55 p = 0.014; χ2 = 25.75, p = 0.001). The relationship between atrophy, metaplasia, and Helicobacter pylori in gastric tissue and the presence of microplastic was statistically insignificant (p >0.05). CONCLUSION: Microplastics were detected in gastric fasting fluid. These materials can cause histopathologic changes and inflammation in the gastric antrum. KEY WORDS: H. pylori, Intestinal metaplasia, Inflammation, Microplastic, Plastic, Sydney classification.