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.

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.

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.

Congenital Right Intrathoracic Stomach Secondary to Hiatus Hernia in an Infant.

A four month old, female infant presented with acute onset respiratory distress and persistent, non-bilious vomiting for one day. The initial chest radiograph showed two large, fluid filled structures in the right hemi thorax. An upper GI contrast study showed right intrathoracic stomach with hold-up of barium in the pylorus. A diagnosis of congenital right intra-thoracic stomach with organo-axial torsion was made and patient underwent laparotomy and repair of the hiatal defect. The child is asymptomatic on follow up. The case is reported for unusual symptomatic presentation on early infancy.

Laparoscopic excision of heterotopic pancreas of stomach

Heterotopic pancreas [HP] in stomach is a rare pathological entity that poses clinical dilemma for diagnosis and management. It carries a risk of developing serious benign and malignant complications. This is a case of 37-year-old lady who presented with dyspeptic symptoms and was found to have a 1.5 cm umblicated lesion in the distal stomach on gastroscopy. Endoscopic biopsy showed normal gastric mucosa and CT scan of stomach did not show any specific abnormality. A laparoscopic wedge excision was performed. Histology showed features of heterotopic pancreas. Endoscopic and histological pictures are presented to increase the awareness of this rare entity. Laparoscopic wedge excision's of a localized HP is recommended as a safe procedure to achieve diagnosis and plan for further management

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.

Volvulus complicating dextrogastria in an infant.

We report eventration of right hemi-diaphragm resulting in gastric volvulus of the right sided stomach in an infant. The diagnosis of this rare association was made with contrast CT scan. Patient was initially managed with reduction of stomach, plication of right hemi diaphragm, anterior gastropexy and Ladds procedure, but required re-laparotomy after two months for recurrent volvulus.

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.

Complete gastric duplication cyst.

We report a 13-year-old boy who was detected to have an abdominal mass on ultrasonography. A possibility of tuberculous lymph nodes was considered in view of history of pain, low fever, and anorexia. Histology of the excised mass showed complete gastric duplication cyst.

Imaging of congenital anomalies of the gastrointestinal tract.

The radiological imaging plays a vital role in the evaluation of patients with congenital anomalies of the gastrointestinal tract. The evaluation of these patients, most of which present early after birth, frequently requires the use of various imaging modalities for making the correct diagnosis and planning surgical correction. This article reviews the common congenital anomalies of the gastrointestinal tract including obstructive lesions, anomalies of rotation and fixation, anorectal anomalies, and intestinal duplications. The plain radiograph is often diagnostic in neonates with complete gastric of upper intestinal obstruction and further radiologic evaluation may be unnecessary. An upper gastrointestinal series should be performed in all patients with incomplete intestinal obstruction. Sonography is useful in the evaluation of many congenital anomalies affecting pediatric gastrointestinal tract especially hypertrophic pyloric stenosis, enteric duplication cysts, midgut malrotation, meconium ileus and meconium peritonitis. Moreover, CT and MRI has assumed a greater importance as these provide excellent anatomic details which may be necessary for correct diagnosis as well as treatment planning. This is particularly true in evaluation of congenital anomalies such as esophageal/enteric duplications, vascular rings and anorectal anomalies. It is important to be familiar with the role nad usefulness of the various imaging modalities so that these can be used judiciously to avoid unnecessary radiation exposure while minimizing the patient discomfort.

The TACRD association is distinct from VACTERL association--a case report.

Tracheal agenesis is a rare malformation. A case of tracheal agenesis with associated ventricular septal defect, gastric hypoplasia, hiatus hernia, duodenal atresia, isomerism of the lungs, hypoplastic spleen with polysplenia, Meckel's diverticulum and fused crossed ectopia of the kidneys is presented. This case fits into a newly proposed TACRD association, an extremely rare condition composed of tracheal agenesis, cardiac, renal and duodenal malformations. It is distinct from the more common VACTERL association of which tracheo-esophageal fistula and not tracheal agenesis is a part. TACRD association has complex internal malformations and lacks the external skeletal manifestations of VACTERL association. Awareness amongst pathologists conducting neonatal autopsies is necessary for correct identification of this condition.

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

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.