ABSTRACT
To determine the effect of glucagon-like peptide-2 (GLP-2) on sucrase-isomaltase and caudal-related homeobox protein-2 (Cdx-2) gene expression, male Wistar rats were divided into total parenteral nutrition (TPN)-fed and GLP-2-treated, TPN-fed groups. TPN was given via a jugular line, inserted under anesthesia, for 7 days. The treatment group received 40 microg/day of GLP-2 intravenously with the TPN diet. The small intestine and colon were weighed and measured. Tissue was obtained from the jejunum, terminal ileum, and midcolon. RNA analysis, morphometry, and microdissection were performed. The weight of the small intestine of GLP-2-treated rats was greater than that of TPN-fed rats (P < 0.001). GLP-2 increased the mean metaphase arrests/crypt in both the jejunum and ileum (P < 0.001). Ileal expression of sucrase-isomaltase was increased by 1. 6-fold (P < 0.05). Jejunal expression was increased by a similar amount, although not significantly (P = 0.08). There was no change in Cdx-2 gene expression. Thus GLP-2 can maintain small intestinal morphology and function, but effects on gene expression are not mediated by gross changes in the level of the mRNA for the homeobox protein Cdx-2.
Subject(s)
Gene Expression/drug effects , Homeodomain Proteins/genetics , Peptides/pharmacology , Sucrase-Isomaltase Complex/genetics , Animals , CDX2 Transcription Factor , Colon/physiology , Glucagon-Like Peptide 2 , Glucagon-Like Peptides , Ileum/physiology , Jejunum/physiology , Male , Parenteral Nutrition, Total , Rats , Rats, Wistar , Trans-ActivatorsABSTRACT
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is a common procedure and accounts for an increasing proportion of an endoscopist's workload. Serious complications can occur from inaccurate abdominal wall puncture. Electronic three-dimensional imaging has been used to aid colonoscopy. We adapted the principles of this technique to PEG insertion in a procedure called magnetic positional imaging. METHODS: Magnetic positional imaging was used to determine the abdominal wall puncture site and angle of insertion that would provide the shortest distance from abdominal wall to the stomach. The pull-through technique was used to perform PEG. RESULTS: PEG insertion with magnetic positional imaging was performed on four patients without complications. The average distance between the internal and external sensors was 5 mm. CONCLUSION: A new technique, magnetic positional imaging, facilitates the pull-through technique for PEG. Additional studies are needed to clarify the potential benefit in endoscopic practice.
