Mycobacterium mucogenicum bacteremia in an immunocompetent host: A case report and concise review.

Rapidly growing mycobacterium (RGM) bloodstream infections (BSI) have been described in the literature mostly in immunocompromised patients such as those with malignancies. Here, we describe a case of a RGM, Mycobacterium mucogenicum, bloodstream infection in an immunocompetent host who was receiving antibiotics via a peripherally inserted central catheter (PICC).

A novel GPCR mediates pancreatic cancer associated fibroblast-cancer cell interaction / 中国药理学与毒理学杂志

OBJECTIVE Pancreatic ductal adenocarcinoma (PDAC), a lethal cancer in need of new, effective therapies, has a unique tumor microenvironment characterized by a dense fibrotic stroma (desmoplasia) that is generated by pancreatic cancer- associated fibroblasts (PCAFs) derived from pancreatic stellate cells (PSCs) and pancreatic fibroblasts (PFs). METHEDS and RESULTS Hypothe?sizing that G protein-coupled receptors (GPCRs) may regulate PCAFs, we used an unbiased GPCRomic array approach to compare GPCR expression in PCAFs, PFs and PSCs and identified 82 GPCRs commonly expressed by PCAFs derived from primary tumors of five PDAC patients. We discovered that PCAFs have increased expression of numerous GPCRs, in particular aGPCR with much higher expression in PCAFs compared to both PFs and PSCs. Immunohistochemistry revealed increased expression of this GPCR in PDAC tumors. Co- culture of PSCs with PDAC cells or incubation with TNFα induced its expression. Activation of the GPCR in PCAF sincreased expression of interleukin-6 (IL-6) via a cAMP/PKA/CREB signaling pathway. GPCR knockdown with siRNA diminished IL-6 production and secretionby PCAFs and ability of PCAF conditioned media to enhance proliferation of PDAC cells. CONCLUSION We conclude that PDAC cells induce expression by PCAFs of a novel GPCR, resulting in increased IL-6 production by PCAFs and promotion of PDAC cell proliferation. This PCAF-expressed GPCR thus contributes to PDAC cell-PCAF interaction and as such, may be a novel therapeutic target for PDAC tumors.

Slowed rate of gastric emptying of solid food in man by high caloric parenteral nutrition.

We studied the effect of high caloric parenteral nutrition on the rate of gastric emptying of solid food. The linear pattern of gastric emptying was not altered by parenteral nutrition, but the gastric emptying rate was consistently slowed. The degree of slowing of gastric emptying while on parenteral nutrition correlated with the increase in blood glucose induced by the intravenous nutrient load. These findings may explain the oral food intolerance displayed by some persons receiving both oral and high caloric intravenous nutrition.

Gastric, pancreatic, and biliary secretion and the rate of gastric emptying after parietal cell vagotomy.

We compared the gastric, pancreatic, and biliary secretory responses to a liquid test meal and the rates of gastric emptying of liquid and solid test meals in six patients at least 1 year after parietal cell vagotomy with eight unoperated subjects, one with duodenal ulcer disease and seven normal control subjects. Parietal cell vagotomy decreased gastric acid secretion to one third of normal, but total trypsin and bile salt secretion during the first 150 postcibal minutes were normal. The liquid test meal emptied from the stomach faster after parietal cell vagotomy, the pattern of emptying being exponential in the vagotomy patients and linear in the normal subjects. The rate of gastric emptying of a liquid meal, although faster than normal, was less precipitous after parietal cell vagotomy than after truncal vagotomy plus drainage or subtotal gastrectomy, and trypsin and bile salt concentrations were not diluted to abnormal levels, as occurs after these other procedures. Furthermore, emptying and dispersion of solid food remained normal after parietal cell vagotomy. These findings probably explain, at least in part, the decreased incidence of postprandial dumping and diarrhea that accompanies parietal cell vagotomy compared with the other popular operations for duodenal ulcer.

The effect of hyperthyroidism on gastric emptying rates and pancreatic exocrine and biliary secretion in man.

Malabsorption and diarrhea in hyperthyroidism has been attributed in part to an increased rate of gastrointestinal transit as measured with barium sulfate suspension. Data are unavailable on the effect of hyperthyroidism on gastric emptying rates of normal food and pancreatic enzyme secretion. These functions have been studied in 4 hyperthyroid patients and compared to results obtained when treatment achieved euthyroidism. Pancreatic trypsin secretion was half the euthyroid level in the hyperthyroid state. No significant change in bile salts occurred, although there was a tendency for a greater proportion of dihydroxy bile salts while hyperthyroid. Gastric emptying rates of a mixed fat, protein, and carbohydrate liquid meal were normal. Similarly the gastric emptying rate of a beef stew plus chicken liver meal was normal. We conclude that in hyperthyroidism gastric emptying rates of "physiologically active" food is normal. Pancreatic enzyme secretion is depressed in hyperthyroidism and may contribute to maldigestion.

Gastric emptying rates of solid food in relation to body size.

The relationship of body size to rates of gastric emptying of solid food was investigated in order to obtain data that may allow this variable to be considered when populations of varying size are studied. Rates of gastric emptying were measured using a beef stew meal to which were added pieces of chicken liver tagged with [99mTc]sulfur colloid, and following the passage of the isotope through the gastrointestinal tract with intermittent gamma-imaging. Results showed an inverse linear relationship between gastric emptying rates and body surface area, and between gastric emptying rates and body weight. The variable of body size must be taken into account when measurements of gastric emptying of solid food are measured.

The role of bile acids in determining ileal flow rates in normal subjects and following ileostomy.

The possibility that intraluminal bile acid concentrations contribute to fluid and electrolyte movement in the normal ileum, and that alterations following ileostomy aid ileostomy adaptation, has been investigated. A significant correlation between the concentration of chenodeoxycholic acid plus deoxycholic acid, and volume flow through the normal ileum and ileostomy effluent volume was found. However, the regression lines relating bile acid concentrations to volume flow in the two groups were clearly separated, indication that factors besides altered bile acid metabolism are predominant in ileostomy adaptation.

Effect of pentagastrin infusion on gastric emptying rate of solid food in man.

The effect of intravenous pentagrastin (4 microgram/kg-hr) on the rate of gastric emptying of solid food was studied in 6 normal men. A mean consisting of one 99mTc-tagged chicken liver mixed with beef stew and taken with 200 ml of water was followed on its passage through the gastrointestinal tract by intermittent scanning with a gamma camera. The rate of the linear gastric emptying pattern was slowed by pentagastrin in every individual. The pH and titratable acidity of the gastric contents were similar in the pentagastrin and the control infusions. Neutralization of the gastric contents with bicarbonate in the pentagastrin studies did not alter gastric emptying rates. The results indicate that pentagastrin slows gastric emptying of solid food in man by an effect apart from acid secretion. The myoelectrical correlates of such an observation are uncertain.