S. Matsuno

Effect of Glucagon, Glicentin, Glucagon-like Peptide-1 and-2 on Interdigestive Gastroduodenal Motility in Dogs with a Vagally Denervated Gastric Pouch

Background: We previously reported that inhibition of gastric motility and hypertrophy of the small intestinal mucosa were observed after ileo-jejunal transposition which induced hypersecretion of enteroglucagon. Our aim was to study the effect of four enteroglucagon-related peptides (glucagon, glucagon-like peptide (GLP)-1, -2 and glicentin) on gastroduodenal motility and their mechanisms of action. Methods: The effect of these four peptides on motilin-induced interdigestive contractions was studied in dogs with vagally denervated gastric pouches equipped with four strain gauge force transducers on the pouch, gastric body, antrum and duodenum. Whether or not nitric oxide synthase inhibitor or phentolamine and propranolol reverses the inhibitory effect of those peptides was also studied. Results: Glucagon inhibited contractions in the pouch and stomach but had no effect on duodenal contractility. GLP-1 inhibited contractions at all sites. GLP-2 inhibited contractions in the pouch but did not affect motility in the neurally intact gastroduodenum. Glicentin had no effect on contractions at any site. Pretreatment with either a nitric oxide synthase inhibitor or phentolamine and propranolol reversed the inhibitory effect of glucagon, GLP-1 and GLP-2 on contractions in the pouch, but did not alter the inhibitory effect of glucagon and GLP-1 on motility in the neurally intact stomach and duodenum. Conclusions: These results suggest that the effects of four peptides on gastroduodenal motility differ, and changes occur in the enteric neural modulation of motor activity after chronic surgical extrinsic denervation.BACKGROUND We previously reported that inhibition of gastric motility and hypertrophy of the small intestinal mucosa were observed after ileo-jejunal transposition which induced hypersecretion of enteroglucagon. Our aim was to study the effect of four enteroglucagon-related peptides (glucagon, glucagon-like peptide (GLP)-1, -2 and glicentin) on gastroduodenal motility and their mechanisms of action. METHODS The effect of these four peptides on motilin-induced interdigestive contractions was studied in dogs with vagally denervated gastric pouches equipped with four strain gauge force transducers on the pouch, gastric body, antrum and duodenum. Whether or not nitric oxide synthase inhibitor or phentolamine and propranolol reverses the inhibitory effect of those peptides was also studied. RESULTS Glucagon inhibited contractions in the pouch and stomach but had no effect on duodenal contractility. GLP-1 inhibited contractions at all sites. GLP-2 inhibited contractions in the pouch but did not affect motility in the neurally intact gastroduodenum. Glicentin had no effect on contractions at any site. Pretreatment with either a nitric oxide synthase inhibitor or phentolamine and propranolol reversed the inhibitory effect of glucagon, GLP-1 and GLP-2 on contractions in the pouch, but did not alter the inhibitory effect of glucagon and GLP-1 on motility in the neurally intact stomach and duodenum. CONCLUSIONS These results suggest that the effects of four peptides on gastroduodenal motility differ, and changes occur in the enteric neural modulation of motor activity after chronic surgical extrinsic denervation.

Extended strictureplasty for multiple short skipped strictures of Crohn's disease

PURPOSE: We will describe a new procedure for treatment of multiple short strictures involving a short segment of Crohns disease. METHODS: This procedure involves the following: 1) stay sutures at the mid portion of the two strictures; 2) an antimesenteric longitudinal enterotomy of 12 cm or more; 3) two or three interrupted transmural sutures in the four lateral portions of the two stenoses; 4) a transverse running suture, according to Heineke-Mikulicztype strictureplasty; and 5) interrupted seromuscular sutures. RESULTS: We performed four such “double HeinekeMikulicz”-type strictureplasties in three patients with Crohns disease without postoperative complications. CONCLUSION: This type of double Heineke-Mikulicz-type strictureplasty is suitable for multiple short skipped strictures of Crohns disease in selected patients.

Intraduodenal capsaicin inhibits gastric migrating motor complex via an extrinsic neural reflex in conscious dogs

Abstract  The aim was to study the effect of intraduodenal capsaicin on interdigestive gastric contractions. Mongrel dogs were equipped with strain‐gauge force transducers to measure gastroduodenal motility. The effects of intraduodenal capsaicin with or without pharmacological antagonists on spontaneous and motilin‐induced interdigestive gastric contractions and on plasma motilin were studied in dogs with intact stomachs. The effect of intraduodenal capsaicin on gastric contractions was also studied in vagally denervated gastric (Heidenhain) pouch and vagally innervated antral pouch. Intraduodenal capsaicin inhibited spontaneous and motilin‐induced gastric contractions. The spontaneous peak in plasma motilin was inhibited by intraduodenal capsaicin. The effect of intraduodenal capsaicin on motilin‐induced gastric contractions was not affected by blockade of nitric oxide synthase, or by β‐adrenoceptor antagonist. Administration of α‐adrenergic blocker inhibited basal interdigestive gastric motility. Intraduodenal capsaicin had no effect on contractions in the Heidenhain pouch but inhibited those in vagally innervated antral pouch. Duodenal afferent fibres stimulated by capsaicin inhibit gastric contractions via a nitric oxide‐independent extrinsic neural reflex.

Granulocyte-colony stimulating factor-producing esophageal carcinoma: serum level as a marker for monitoring the effects of treatment

Abstract We report here a case of granulocyte-colony stimulating factor (G-CSF)-producing esophageal carcinoma in a 66-year-old man. The International Union Against Cancer (UICC) staging was IV A, and a diagnosis of moderately differentiated squamous cell carcinoma was made, based on histopathology. The diagnosis was based on marked leukocytosis (41 500 leukocytes/mm3) and an elevated serum level of G-CSF (154 pg/ml). Immunofluorescent histochemistry and northern blot analysis confirmed the expression of G-CSF protein in cancer cells and its mRNA in cancer tissue. We paid special attention to any change in serum G-CSF levels during aggressive cancer treatment. Subtotal esophagectomy induced a significant decrease in G-CSF level. Adjuvant chemo-radiotherapy, targeting celiac lymph node metastasis, and radiotherapy, targeting solitary lung metastasis, together effectively maintained a low serum G-CSF level, despite a recurrence of the tumor in the lungs, in the form of multiple metastases, with an increase in serum G-CSF levels. The patients clinical course suggested that serum G-CSF would be a useful marker for monitoring the effects of treatment on G-CSF-producing carcinoma.

Taurocholate-Induced Gastric Damage in Rats with Obstructive Jaundice

We examined the severity of taurocholate-induced gastric mucosal damage in rats with obstructive jaundice. Oral administration of 100 mM taurocholate induced severer gastric mucosal damage in rats with jaundice than in intact rats. Pretreatment with 5 mM taurocholate significantly protected the gastric mucosa against 100 mM taurocholate-induced damage, suggesting adaptive cytoprotection in rats with jaundice. The reductions in the gastric mucosal potential difference and hexosamine contents in the gastric mucosa in response to 100 mM taurocholate were significantly attenuated by prior administration of 5 mM taurocholate in both intact rats and rats with jaundice.