Maturation of the fetal gastrointestinal tract (GIT) is influenced by both luminal stimuli (e.g. swallowed fluid) and hormonal factors (e.g. endogenous cortisol release). The aims of the present study were 1) to investigate GIT growth and maturation during the last 20% of gestation in pigs (term = 114 +/- 2 d), and 2) to investigate the effect of esophageal ligation, to prevent fetal swallowing, at 80% to 91% gestation. In normal fetuses, marked increases occurred during late gestation in body weight (+95%), relative intestinal weight (+79%, g kg(-1) body weight), activity of some digestive enzymes (1.5- to 10-fold), and absorption of glucose and intact proteins (3- to 6-fold). Fetuses with ligated esophagi had lowered body weight (-20%), reduced intestinal weight (-43%), aminopeptidase A activity (-24%), and glucose absorption (-27%), while lactase, sucrase, and dipeptidylpeptidase IV activities were increased (+40-50%), compared with sham-operated fetuses (all p < 0.05). Other parameters of GIT function remained unchanged by esophageal obstruction (absorption of amino acids and immunoglobulin, activity of chymosin, amylase, trypsin, chymotrypsin, maltase, aminopeptidase N -- all expressed per gram GIT tissue). Ligated fetuses had elevated cortisol levels, which is known to stimulate fetal GIT maturation. We conclude that the rapid development of GIT function in late gestation is diminished by esophageal obstruction, mainly due to slower GIT growth and not inhibition of normal functional development of enterocytes.
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http://dx.doi.org/10.1203/00006450-200209000-00019 | DOI Listing |
Surg Endosc
January 2025
Department of Internal Medicine, National Taiwan University Hospital, No.7, Chung-Shan South Road, Taipei, Taiwan.
Background: This study aimed to investigate the clinical characteristics and esophageal motility of patients with gastric cardia submucosal tumors (SMTs) and the associated changes after endoscopic resection based on high-resolution impedance manometry (HRIM).
Methods: From our electronic database, we identified patients who underwent pre-operative evaluation of gastric cardia SMTs between 2015 and 2023. All patients completed standardized symptom questionnaires and underwent endoscopic ultrasonography and HRIM.
Expert Rev Gastroenterol Hepatol
January 2025
Department of Surgery, Trinity St. James's Cancer Institute, Dublin, Ireland.
Introduction: Advances in treatment strategies for gastric and esophageal cancer have led to improved long-term outcomes, however the local and systemic effects of tumor growth, neoadjuvant therapies and surgery, results in specific nutritional challenges. Comprehensive nutritional evaluation and support represents a core component of multidisciplinary holistic care for this patient population.
Areas Covered: This review provides a detailed overview of the nutritional challenges in gastric and esophageal cancer, with a focus on malignant obstruction, preoperative optimization and nutrition in survivorship.
World J Gastroenterol
January 2025
Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China.
Background: Minimally invasive esophagectomy (MIE) is a widely accepted treatment for esophageal cancer, yet it is associated with a significant risk of surgical adverse events (SAEs), which can compromise patient recovery and long-term survival. Accurate preoperative identification of high-risk patients is critical for improving outcomes.
Aim: To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.
Medicine (Baltimore)
January 2025
Gastroenterology, Chongqing University Cancer Hospital, Chongqing, China.
Rationale: Aortoesophageal fistula (AEF) is an exceedingly rare yet critically life-threatening condition, with mortality rates nearing 100% if not addressed promptly. AEF often develops in the context of thoracic aortic aneurysms, esophageal malignancies, or as a complication of foreign body ingestion and prior thoracic aortic surgeries. This study reports an exceptionally severe and clinically rare case of AEF associated with a pseudaneurysm induced by esophageal stenting.
View Article and Find Full Text PDFEosinophilic esophagitis is a chronic allergic inflammatory disease, and its incidence and prevalence have recently increased. Eosinophilic esophagitis has not become a rare disease; thus, knowledge for diagnosing it is needed in current clinical practice. The adequate management of endoscopic procedures is particularly important for the diagnosis and evaluation of inflammatory activity and therapeutic responses.
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