BALB/c and C57BL/6 mouse strains influence gastric function outcomes with administration of cisplatin and dexamethasone

Abstract Our aim was to evaluate the effects of cisplatin and dexamethasone alone and combined on gastric contractility and histomorphometry of BALB/c and C57BL/6 mice. BALB/c and C57BL/6 male mice (8-week-old) were randomly separated into: Control; Cisplatin (7.5 mg/Kg); Dexamethasone (2.0 mg/Kg); and Dexamethasone plus Cisplatin (2.0 mg/Kg of dexamethasone 1-hour prior to 7.5 mg/Kg of cisplatin). Drugs were administered intraperitoneally for three days. Body weight and food intake were evaluated on 2nd day. Alternating Current Biosusceptometry technique was employed to measure gastric contractions on 3rd day. Afterward, mice were killed for gastric histomorphometric analysis. Cisplatin decreased food intake and caused bradygastria in BALB/c mice; however, the amplitude of gastric contractions decreased in both BALB/c and C57BL/6. Dexamethasone and cisplatin combined restored the gastric frequency and food intake only in BALB/c, but drug combination reduced the gastric amplitude of contractions in both strains. Dexamethasone alone increased gastric mucosa thickness in C57BL/6 and decreased muscular thickness in BALB/c. In conclusion, the mouse strains presented differences in acute effects of cisplatin and dexamethasone alone and combined on gastric function. This reinforces the importance of choosing the appropriate mouse strain for studying the acute effects of drugs on the gastrointestinal tract.

Gastroprotective potential and mechanisms of action of Hedera nepalensis

Abstract Hedera nepalensis (H. nepalensis) , belonging to the family Araliaceae, is a medicinal plant traditionally used to treat stomach problems. The current study investigated the gastroprotective potential and the mechanism of action of H. nepalensis in diclofenac-and ethanol-induced ulcer models. Anti-oxidant and lipid peroxidation inhibitory prospects of H. nepalensis were checked out by free radical scavenging assay and UV spectrophotometer respectively. Effect of H. nepalensis on the pH, gastric total acidity of gastric juice and protective effects of H. nepalensis against ulcer models have been examined. Histopathological studies have been carried out. The aqueous methanol extract of H. nepalensis (100 µg/mL) showed anti-oxidant (83.55%) and lipid peroxidation inhibitory (70.88%) potential at 1000 µg/mL; the extract had no buffer potential. The extract (400 mg/kg) significantly (81.12% and 63.46%) showed gastroprotective effect in diclofenac and ethanol-induced rat ulcer models respectively. Histopathological studies confirmed the biochemical findings. FTIR analysis showed the presence of carboxylic acid, alkanes, conjugated alkanes, aldehydes and alkyl-aryl ethers. Gallic acid, M-coumaric acid and quercetin were found by HPLC analysis. H. nepalensis exhibited significant protection against diclofenac and ethanol induced gastric damage by anti-oxidant and lipid peroxidation suppression effects suggesting potential broad utility in treatment of diseases characterized with gastric damage.

Development of fluorescent- and radio-traceable T1307-polymeric micelles as biomedical agents for cancer diagnosis: biodistribution on 4T1 tumor-bearing mice

Abstract In recent years, nanocarriers have been studied as promising pharmaceutical tools for controlled drug-delivery, treatment-efficacy follow-up and disease imaging. Among them, X-shaped amphiphilic polymeric micelles (Tetronic®, poloxamines) display great potential due to their biocompatibility and non-toxic effects, among others. In the present work, polymeric micelles based on the T1307 copolymer were initially decorated with a 4,4-difluoro-4-bora-3a,4a-diaza-s-indacene (BODIPY)-fluorophore in order to determinate its in vivo biodistribution on 4T1 tumor-bearing mice. However, unfavorable results with this probe led to two different strategies. On the one hand, the BODIPY-micelle-loaded, L-T1307-BODIPY, and on the other hand, the 99mTc-micelle-radiolabeled, L-T1307- 99m Tc, were analyzed separately in vivo. The results indicated that T1307 accumulates mainly in the stomach, the kidneys, the lungs and the tumor, reaching the maximum organ-accumulation 2 hours after intravenous injection. Additionally, and according to the results obtained for L-T1307- 99m Tc, the capture of the polymeric micelles in organs could be observed up to 24 hours after injection. The results obtained in this work were promising towards the development of new radiotracer agents for breast cancer based on X-shaped polymeric micelles.

Enhancement of dissolution rate of racecadotril by liquisolid compact technology

Abstract The current investigation was used to improve the rate of dissolution of an anti-diarrheal drug i.e., racecadotril (RT) at low pH conditions (i.e., in the stomach) by reducing the water secretion and electrolyte in to the intestine by liquisolid tablets. Different formulations (liquisolid) were prepared using Avicel PH 102 as a carrier. Aerosil 200 as a coating material and sodium starch glycolate used as a disintegrant. Polyethylene glycol 200 was used as a non-volatile vehicle to dissolve the drug. FTIR, DSC, XRD and dissolution studies were conducted to characterise liquisolid tablets. Characterisation studies indicated that no interactions between carrier and drug. Solid state characterization had shown a reduction in crystallinity that further supports increment in solubility and dissolution. The optimised formulation showed a significant increase in dissolution i.e., 99.54±0.62% in 30 min compared to directly compressible tablets (38.47±0.26%). The % dissolution efficiency of racecadotril liquisolid tablets 76.86% compared to marketed tablet (27.56%) and conventional direct compression tablet (17.11%). Significant reduction in mean dissolution time of racecadotril from liquisolid tablets (6.84 min) compared to direct compression tablet (44.57 min), indicating faster release of drug and faster onset of action. Formulation of liquisolid tablets could enhance solubility, dissolution and bioavailability of racecadotril

Quiste de duplicación gástrica en el adulto: una rara entidad / Gastric duplication cyst in the adult: a rare entity

Resumen Objetivo Reportar el caso clínico de un quiste de duplicación gástrica en un paciente adulto. Materiales y Método Paciente de sexo masculino de 70 años con una tumoración quística supramesocólica, con síntomas digestivos inespecíficos. La imagenología solicitada no determinó la etiología ni origen de la misma planteándose múltiples diagnósticos diferenciales. Se realizó una laparotomía exploradora. Resultados La laparotomía confirmó el origen gástrico de la tumoración. Se realizó la resección completa de la misma con resección gástrica en forma de gastrectomía atípica. El estudio anatomopatológico de la pieza confirmó un quiste de duplicación gástrica. Discusión Los quistes de duplicación gástrica son una enfermedad congénita rara, se diagnostican principalmente en la etapa neonatal, siendo raro en el adulto. La mayoría son lesiones únicas, no comunicantes, asintomáticas y de difícil diagnóstico preoperatorio siendo habitual el diagnostico definitivo en el intraoperatorio y con el estudio histológico de la pieza. Conclusión El quiste de duplicación gástrica debe tenerse en cuenta en los diagnósticos diferenciales de toda lesión quística supramesocólica. Son lesiones potencialmente malignas siendo la resección completa la que brinda el diagnóstico y tratamiento definitivo.

Aim To report the clinical case of a gastric duplication cyst in an adult patient. Materials and Method 70 year old male patient with a symptomatic supramesocolic cystic lesion. Preoperative imagenology was not able to determine the exact origin or etiology. Several differential diagnosis were made and finally an exploratory laparotomy was performed. Results The laparotomy determined the gastric origin and a complete resection including gastric wall was done. The anatomopathological study confirmed it was a gastric duplication cyst. Discussion Gastric duplication cysts are a rare congenital disease, diagnosed mainly in the neonatal stage, with rare presentation in the adult stage. Most of these lesions are unique, non-communicating, usually asymptomatic and difficult to diagnose preoperatively, with definitive diagnosis being common in intraoperative and histological study of the piece. Conclusion The gastric duplication cyst must be taken into account in the differential diagnosis of any supramesocolic cystic lesion. They are potentially malignant lesions, and complete resection provides the definitive diagnosis and treatment.

Gastric duplication cyst in the adult. A case report.

Gastric duplication cyst is a very rare congenital anomaly accounting up to 4-9% of all gastrointestinal tract duplications. It is a quite rare anomaly in adults, the majority of cases are diagnosed in the neonatal period. Gastric duplication cysts are usually asymptomatic in the adult. They are usually discovered incidentally in TAC or RMN, although the best specificity diagnostic test is the echoendoscopy. The best election treatment is the surgical complete extirpation. We describe a case of an adult patient who is diagnosed of the incidentally gastric cyst duplication.

El quiste de duplicación gástrico es una anomalía congénita muy rara que representa entre 4 y 9% de todas las duplicaciones del aparato digestivo. Es una alteración bastante rara en el adulto y la mayoría de los casos se diagnostica en el periodo neonatal. En el adulto suele cursar de forma asintomática y la TC o RMN la descubren de forma incidental, aunque la prueba que la diagnóstica con mayor eficacia es la ecoendoscopia. La extirpación quirúrgica completa de la lesión se considera el tratamiento de elección. Se presenta el caso clínico de una paciente con un quiste de duplicación gástrico diagnosticado de forma incidental.

Sonographic Markers in the Prediction of Fetal Complex Gastroschisis.

OBJECTIVE: To investigate the ultrasound (US) markers predictive of complex gastroschisis (CG), mortality, and morbidity in fetuses with gastroschisis. MATERIALS AND METHODS: This was a retrospective cohort study of 186 pregnancies with isolated fetal gastroschisis. Eight US markers were analyzed. The predictions and associations of US markers with CG, mortality, and morbidity were assessed. Combinations of US markers predictive of CG were investigated. RESULTS: Extra-abdominal bowel dilatation (EABD), intra-abdominal bowel dilatation (IABD), and polyhydramnios were predictive of CG. EABD between 25 and 28 weeks had a sensitivity of 64%, a specificity of 89%, a positive predictive value (PPV) of 56.2%, and negative predictive value (NPV) of 91.8%. The predictions of IABD were sensitivity = 26.7%, specificity = 96.7%, PPV = 61.5%, and NPV = 86.8%. The odds ratios for CG in the presence of 1 and 2 US markers, compared with the absence of a US marker, were 18.3 (95% CI, 3.83-87.64) and 73.3 (95% CI, 6.14-876), respectively. CONCLUSION: US markers predictive of CG were established. The combination of these markers increases the probability of CG.

[Gastric duplication in adults: a case report and literature review]. / Duplicación gástrica en adultos; informe de un caso y revisión de la bibliografía.

Duplications of the gastrointestinal tract are a rare congenital malformations that usually presents in the first 2 years of life with symptoms of poor weight gain and abdominal palpable mass. The present is a case report of 41 year-old woman who was evaluated for upper abdominal pain. Upper endoscopy revealed a submucosal mass in the greater curvature of the stomach with initial suspect diagnosis of gastrointestinal stromal tumor. Endoscopic ultrasound confirmed partially cystic submucosal mass which was removed with a distal gastric wedge resection without complications. Histopathological report was congenital gastric duplication.

[Gastric duplication. A case report and review of the literature]. / Duplicación gástrica. Reporte de un caso y revisión de la literatura.

Duplications of the alimentary tract are rare congenital anomalies. They can occur anywhere throughout the gastrointestinal tract. Gastric duplications represent only 7% of all gastrointestinal duplications. Symptoms and signs often can include vomiting, abdominal pain and palpable mass, and in some cases symptoms related to its complications may be present. The etiology has not been well characterized yet. Although radiographic studies, ultrasonography and computerized axial tomography may help to the preoperative diagnosis, this diagnosis is usually confirmed at surgery. The objective of this paper was to report the case of a 2-year-old girl with recurrent vomiting and abdominal palpable mass with histopathology diagnosis of gastric duplication.

Tricobezoar na infância: relato de três casos e revisão da literatura / Trichobezoar in children: report of three cases and review of literature

Tricobezoares são corpos estranhos gástricos compostos por cabelos dos próprios pacientes. São mais comuns em crianças, principalmente do sexo feminino. Cursam freqüentemente com sintomas gastrintestinais como dor abdominal, náuseas, vômitos, anorexia, perda de peso e plenitude pós-prandial. Massa epigástrica, alopécia e antecedentes de tricofagia podem estarpresentes. O tratamento de eleição é o cirúrgico, acompanhado de tratamento psiquiátrico. Este trabalho tem como objetivo relatar três casos de pacientes com tricobezoar gástrico e realizar uma revisão da literatura. Todos os casos deste estudo eram de crianças dosexo feminino. Dois pacientes cursaram com quadro de suboclusão intestinal, apresentando dor abdominal evômitos. Em um caso havia dor abdominal não acompanhada por vômitos. Todos apresentaram antecedentes de tricofagia, bem como massa epigástrica palpável. Um com áreas de alopécia. O principal examede imagem empregado foi a seriografiaesofagogastroduodenal. Todos foram submetidos a tratamento cirúrgico mediante gastrotomia e encaminhados para serviço de psicologia, com boaevolução clínica.

Trichobezoars are concretions of ingested hair that most often lodge in the stomach. They are commonlyseen in young girls with psychiatric disorders. Upper gastrointestinal symptoms usually are progressive andmay include abdominal pain, nausea and vomiting, early satiety, weight loss, bloating, diarrhea or constipation. Ahistory of tricophagia is common. Physical examination may include the presence of nontender palpable massand bald spot. Gastric trichobezoars require removal through an anterior gastrotomy. Postoperatively, psychiatric intervention is often appropriate. The purpose of this study was to describe three cases of patients with gastric trichobezoar and make a review of literature. All patients studied were yo ung girls. Two patients presented abdominal pain and vomiting. In one case there was abdominal pain without vomiting. All cases presented tricophagia and palpable mass. One had bald spot. Barium contrast study was the most beneficial in the diagnosis. In our cases, bezoars were removed easily via single gastrotomy. Postoperatively they were evaluated by psychology. The remainder of their hospital course wasunremarkable.

Sarcoma granulocítico gástrico: Reporte de caso y revisión de literatura / Gastric granulocytic sarcoma: Case report and literature review

Presentamos el caso de un niño de 5 años de edad, con tiempo de enfermedad de 5 semanas, caracterizado por vómitos post-prandiales, dolor abdominal en cuadrante superior derecho, presencia de una tumoración de crecimiento lento a ese nivel. Clínicamente paciente con abdomen asimétrico, con abombamiento en cuadrante superior derecho y circulación colateral, se palpaba una tumoración de 6 x 5 cm de consistencia aumentada en cuadrante superior derecho, poco móvil, no dolorosa, el resto del examen físico era negativo. Los exámenes de laboratorio mostraron un hemograma normal. Estudio de estómago y duodeno doble contraste: marcada alteración en la morfología de la cámara gástrica que se confirmaron con TAC de abdomen y pelvis. El estudio de médula ósea y citometría de flujo no evidenció infiltración de células neoplásicas y el cariotipo fue normal. Se envió a revisar las láminas y taco con la sospecha inicial de linfoma resultando con marcadores de inmunohistoquímica negativos (CD79a (-), CD20(-),CD3(-)) con TdT (+/-), ACL (+), CD117 (+), CD34 (+) y MPO(+) se concluye en SARCOMA GRANULOCÍTICO GÁSTRICO, el diagnóstico demoró 2 semanas, inició tratamiento con quimioterapia para Leucemia Mieloide con evolución clínica favorable, pero persistencia de enfermedad según estudios de imágenes posteriores.

We report the case of a five year-old boy, who presented with a five month history of post prandial vomiting, abdominal pain in the right upper quadrant and the presence of a slow growing tumor in that area. On examination the abdomen was asymmetrical, with protrusion of the right upper quadrant,collateral circulation was visible, and a 6 x 5 cm non-tender, non-painful mass was found in the upper right quadrant. There were no other positive findings on physical exam. The laboratory tests revealed a normal CBC. The stomach and duodenum double-contrast X ray showed asevere deformity of the gastric chamber, which was confirmed with a CT scan of the abdomen and pelvis.The bone marrow aspiration and flow cytometry showed no evidence of neoplastic infiltration, and the karyotype was normal. The slides and paraffin block from a biopsy taken elsewhere were reviewed and the immunohistochemistry markers were negative CD79a (-), CD20(-),CD3(-)) con TdT (+/-), ACL (+), CD117 (+), CD34 (+) y MPO(+). The final diagnosis was GRANULOCYTIC SARCOMA OF THE STOMACH. The diagnosis was delayed for two weeks beca use of the unusual pathology. The patient was treated with chemotherapy for Acute Myelogenous Leukemia, with favorable clinical response, but with persistent disease according to later imaging studies.

[Severe gastric dysplasia with intramucosal carcinoma in a 16-year-old male]. / Displasia gástrica severa con carcinoma intramucoso en un hombre de 16 años.

Gastric dysplasia is a rare adult condition affecting a small area near polyps, ulcers or is an inflammatory process. Adenocarcinoma develops in severe gastric dysplasia, and this process may take 1 year. Mild and moderate dysplasias regress and only a small proportion progresses to severe dysplasia. We report a severe dysplasia in a 16-year-old male with no clinical history of gastric disease with acute and severe upper gastrointestinal bleeding that lowered hemoglobin levels to 2.8 g/dL. Bleeding persisted and subtotal gastrectomy was performed on an emergency basis. At gross examination, bleeding and congestion were found with superficial ulcers. Microscopically, severe dysplasia was observed with intramucosal areas of carcinoma limited to foveolar mucosa. The ulcers were congested and there was no inflammation, no polyps or other alterations in the mucosal layer. Ki-67 and P53 markers were positive, p16 with sporadic positivity. The purpose here is to report an exceptional case because of the young age and extensive and severe dysplasia with areas of intramucosal carcinoma and no previous clinical history. No similar cases of severe dysplasia with carcinoma in situ are reported in the literature.

Duplicación gástrica / Gastric duplication

Introducción: La duplicación gástrica es una malformación poco frecuente del tubo digestivo, que en algunos casos puede dar sintomatología secundaria a una complicación. Objetivo: Reportar dos pacientes portadores de una duplicación gástrica que fueron resueltos por vía laparoscópica. Se detallan los aspectos clínicos, radiológicos y los beneficios de la técnica utilizada. Casos: Un lactante de 9 meses portador de una neurofibromatosis que en su estudio abdominal aparece como hallazgo una malformación quística del estómago, y un recién nacido que presenta vómitos frecuentes, dolor abdominal y masa palpable. Ambos tratados con cirugía laparoscópica, con buena evolución. Conclusión: La duplicación gástrica es una entidad poco frecuente que requiere tratamiento quirúrgico, ya sea por vía abierta o laparoscópica, siendo esta última una técnica recomendable y segura en la actualidad.

Quiste de duplicación gástrica: diagnóstico mediante ecografía, TC y RM / Gastric duplication cyst: US, CT and MRI features

Los quistes de duplicación gástrica son una patología poco frecuente que suele diagnosticarse en forma incidental en un estudio de diagnóstico por imágenes. Suelen encontrarse durante la infancia, pero pueden ser hallados en adultos. Los estudios de diagnóstico por imágenes colaboran en el hallazgo y presunción diagnóstica de los mismos, siendo el diagnóstico definitivo el análisis anatomopatológico de la pieza. Presentamos el caso de una adolescente de 15 años con dolor abdominal persistente (dominante en epigastrio), en la que se observó en una ecografía, una imagen quística ubicada por detrás del estómago y en íntimo contacto con el páncreas, el riñón izquierdo y la gándula suprarrenal izquierda. La TC y RM contribuyeron a una mejor delimitación anatómica. Se procedió a escisión laparoscópica sin complicaciones. La anatomía patológica reveló un quiste de duplicación gástrica, sin ulceración

Quiste de duplicación gástrica: diagnóstico mediante ecografía, TC y RM / Gastric duplication cyst: US, CT and MRI features

Los quistes de duplicación gástrica son una patología poco frecuente que suele diagnosticarse en forma incidental en un estudio de diagnóstico por imágenes. Suelen encontrarse durante la infancia, pero pueden ser hallados en adultos. Los estudios de diagnóstico por imágenes colaboran en el hallazgo y presunción diagnóstica de los mismos, siendo el diagnóstico definitivo el análisis anatomopatológico de la pieza. Presentamos el caso de una adolescente de 15 años con dolor abdominal persistente (dominante en epigastrio), en la que se observó en una ecografía, una imagen quística ubicada por detrás del estómago y en íntimo contacto con el páncreas, el riñón izquierdo y la gándula suprarrenal izquierda. La TC y RM contribuyeron a una mejor delimitación anatómica. Se procedió a escisión laparoscópica sin complicaciones. La anatomía patológica reveló un quiste de duplicación gástrica, sin ulceración (AU)

Microgastria congénita: presentación de un caso / Congenital microgastria: clinical case

Se presenta el caso de un lactante de 10 meses de edad que debido a vómitos persistentes se realiza serie que muestra esófago dilatado principalmente en tercio inferior y estómago de 4 cm de forma tubular. A la endoscopia se aprecia un esófago dilatado principalmente tercio inferior, cardias abierto y estómago muy pequeño con píloro puntiforme, que requirió manejo quirúrgico, el cual no tuvo el éxito esperado y que fallece de septicemia. Lo interesante de este caso es mostrar las características endoscópicas de la microgastria que no encontramos referidas en artículos previos.