Gastric cancer is one of the main health issues in Lithuania. The risk factors of the disease are related to nutrition and environment. There were no epidemiological studies on that subject in the country. The aim of the study was to assess a relationship between gastric cancer risk and lifestyle (diet, alcohol use, smoking, physical activity), work environment and some social factors. A hospital based case-control study included 379 cases with newly histologically confirmed diagnose of gastric cancer and 1137 controls that were cancer and gastric diseases free. Cases and controls matched by gender and age (+5yr.). Ratio of case and controls was 1:3. A questionnaire was used to collect information on possible risk factors of gastric cancer. The odds ratios (OR) and 95% confidence intervals (CI) for gastric cancer were calculated by a conditional logistic regression. Our data showed that salt and salt processed food items increased risk of gastric cancer. After adjustment for a certain confounders (alcohol use, smoking, family history on cancer, Body Mass Index at 20 yr of age, education level, residence, other dietary habits that were related to the outcome, and physical activity) subjects that like salty food or put salt additionally to prepared meal had three times higher risk of gastric than those who do not do that. The risk of the disease increased two times eating salted meat 1-3 times a month and more, having smoked meat 3-4 times a week and more, and using smoked... [to full text]

Skrandžio vėžys yra ketvirta pagal dažnį ir antra pagal mirtingumą onkologinė liga pasaulyje. Sergančių šia liga 5 metų išgyvenamumas siekia tik 25 proc. Esant didelei ligos atkryčio rizikai dažniausiai skiriama adjuvantinė chemoterapija, nors daugumoje atsitiktinių imčių studijų statistiškai reikšmingo išgyvenamumo pagerėjimo nenustatyta. Dažniausia skrandžio vėžio gydymo nesėkmės priežastis yra lokoregioninis recidyvas (40-65 proc. ligonių, kuriems atliktos radikalios operacijos) ir pilvaplėvės metastazės. Siekiant sumažinti lokoregioninių recidyvų dažnį, pradėtas taikyti suderintas chemospindulinis gydymas. Šio tyrimo tikslas- nustatyti adjuvantinio gydymo efektyvumą po radikalių skrandžio vėžio operacijų su D2 limfadenektomija ir pagrįsti šio gydymo metodo tikslingumą. Darbo tikslui įgyvendinti buvo suformuluoti šie uždaviniai. 1. Įvertinti radikaliai dėl skrandžio vėžio operuotų su D2 limfadenektomija pacientų išgyvenamumą taikant adjuvantinį chemospindulinį gydymą arba adjuvantinę chemoterapiją. 2. Įvertinti adjuvantinio chemospindulinio gydymo toksiškumą po radikalių operacijų su D2 limfadenektomija, palyginti jį adjuvantinės chemoterapijos 5-fluoruracilu ir leukovorinu sukeliamu toksiškumu. 3. Įvertinti ankstyvos pooperacinės intraperitoninės chemoterapijos toksiškumą ir palyginti jos efektyvumą taikant su adjuvantiniu chemospinduliniu gydymu. 4. Palyginti gyvenimo kokybę po radikalių operacijų dėl skrandžio vėžio atliekant gastrektomiją ir subtotalinę skrandžio... [toliau žr. visą tekstą] / Gastric cancer is the fifth most common cancer and the second leading cause of cancer-related death worldwide. The 5-year survival rate of these patients is approx. 25. Adjuvant chemotherapy is frequently used for treatment, despite the fact that many randomized studies failed to demonstrate a better patient survival. The high rate of recurrence, even in patients undergoing state-of-the art curative resection, suggests that effective adjuvant chemoradiation and chemotherapy might indeed be an attractive concept to improve the overall outcomes of patients with gastric cancer. The aim of this study was to evaluate the effectiveness of the adjuvant therapy after curative resection with D2 lymphadenectomy for gastric cancer and determine its role in the treatment of cancer patients. The goals of this study were: 1. To compare the survival of patients receiving adjuvant chemoradiation or adjuvant chemotherapy after the curative resection with D2 lymphadenectomy for gastric cancer. 2. To evaluate the toxicity of the adjuvant chemoradiation after the curative resection with D2 lymphadenectomy for gastric cancer and to compare it with the toxicity caused by adjuvant chemotherapy with 5- Fluorouracil and Leucovorin. 3. To assess the toxicity of the early postoperative intraperitoneal chemotherapy and compare its effectiveness with the combined intraperitoneal chemotherapy and adjuvant chemoradiation therapy. 4. To compare the quality of life after the total and subtotal... [to full text]

The pattern of mucosal blood flow in normal human stomachs, and benign gastric ulcers was assesed with laser Doppler flowmetry and the relationship between a single determination of ulcer blood flow and the systemic level of growth factors was investigated. A significant ascending gradient in mucosal blood flow from the antrum to fundus was demonstrated. Different levels of cellular activity in the regions of the stomach may explain this gradient. In the gastric ulcers that healed on standard medical therapy mucosal blood flow was significantly increased in comparison to normal stomachs. In the ulcers that were refractory to standard medical therapy mucosal blood flow was significantly lower than in normal stomachs and healing ulcers. Higher systemic levels of the growth factor bFGF were demonstrated in healing ulcers compared to non-healing ulcers. Gastric mucosal blood flow can increase in response to the increased metabolic demands of healing, however impairment of this response may be an important factor preventing healing of benign gastric ulcers. It would appear that non-healing of gastric ulcers can be predicted at initial diagnosis by reduced peri-ulcer gastric mucosal blood flow and low blood levels of bFGF. / Thesis (M.Med.Sc.)-University of Natal, Durban, 1999.

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This study investigated the antiviral, chemoprotective and proliferative effects of strawberry anthocyanins on herpes simplex virus type-1, cancerous cell lines HT-29 and AGS, and normal cell lines Hs 738.St/Int and CCD-18Co. Antiviral properties were measured by infecting vero cells from adult grivet (Cercopithecus aethiops) with herpes simplex virus type-1 (HSV-1) and treating with a concentration of 1.25-20 µg/mL of strawberry anthocyanins. Infectivity and replication were quantified for herpes simplex virus type-1 using the direct plaque assay and reporting PFU/mL. Strawberry anthocyanins (>20 µg/mL) inhibited the herpes simplex virus infectivity in vero cells by 100% (p<0.05). Strawberry anthocyanins at concentrations of 5, 10 and 20 μg/mL were reduced to 75.36, 57.98, and 31.46 percent of the control (100%) (p<0.05). Chemoprotective and proliferative effects of strawberry anthocyanins were analyzed for the human cell lines AGS, Hs 738.St/Int, HT-29, and CCD-18Co at a concentration of 25-200 µg/mL and quantified using the sulforhodamine-B assay. Growth inhibition occurred at a level of ≥87% for treatment concentrations 100 and 200 µg/mL for the cancerous AGS and HT-29 cell lines (p<0.0001). Proliferation rates for the normal Hs 738.St/Int and CCD-18Co cell lines increased at all treatment concentrations of 25-200 μg/mL (p<0.0001); suggestingthat the observed proliferative activity may be associated with anthocyanin treatment.Strawberry anthocyanin treatment concentration worked in a dose dependent manner for the HSV-1 and the cancerous AGS and HT-29 cells. The caspase-3 assay was performed to demonstrate potential mechanism of action and confirmed thatanthocyanin treatments play a role in apoptosisby the up regulation of caspase-3.Significantdifferences were seen between the growth characteristics of cancerous cell linescompared to their equivalent normal cell lines (p<0.0001). In summary, the antiviral findings suggest that strawberry anthocyanin extracts could be an effective topical treatment and/or prophylactic agent for oral herpetic infections (HSV-1). Also, the in vitro chemoprotective effect of strawberry anthocyanins found may be relevant to in vivo work in the future because when anthocyanins are consumed in the diet they come in direct contact with the gastrointestinal tract and may provide chemoprotection upon contact with the stomach and gastrointestinal tract’s epithelial cell layer.

Effective population management of green sea turtles (Chelonia mydas) necessitates understanding the temporal variation in foraging grounds used in ontogenetic stages, and the effect that the assimilated diet within those habitats has on nutritional gain, growth and eventual reproductive output. Texas coastal waters provide foraging grounds critical to meeting the nutritional needs of green turtles during early life history. To characterize temporal shifts in foraging strategy stomach contents combined with stable carbon (delta13C) and nitrogen (delta15N) isotopes of scute tissue were examined across size classes of stranded juvenile green turtles from the middle and lower Texas coast during 2007-2010. Findings from dietary analysis generally corroborated those from stable isotopes in scute samples. Results indicate green sea turtles exhibit multiple shifts in diet and habitat along the Texas coast. Although isotope values in the tissues of some <25 cm SCL turtles signified recent recruitment to jetty habitat, most in this size class exhibited depleted delta13C and enriched delta15N values indicative of oceanic life. Reinforcing oceanic occupancy from stable isotope results was forage material dominated by oceanic items such as Sargassum spp., Scyphozoa spp., and plastic debris. Diet analysis of 25-34.9 cm SCL turtles implied regional differences existed in macroalgae and seagrass consumption. Enriched delta13C and delta15N values in newest scute suggest most turtles inhabited the jetty environment, where macroalgae is the most available forage. A definitive shift by >35 cm SCL turtles to inshore seagrass habitat was revealed by a diet of seagrasses and tissue enriched in delta13C and depleted in delta15N. This is the first study to integrate stomach contents of several green turtle size classes with tissue analysis of stable isotopes. The combination of these techniques provided an assessment of the effectiveness of stable isotope analyses in documenting diet and habitat shifts. Stomach content examination determined the most recent diet consumed within the habitat occupied, whereas stable isotope analysis provided a time-integrated synopsis of diet and habitat shifts. Findings indicate integration of stomach content and stable isotope analysis is highly effective for characterizing habitat use and foraging strategy of ontogenetic-stage green sea turtles.

Additional appendix (5 p.) is pasted onto back end-paper. / Bibliography: leaves 219-244. / v, 244, [14] p., 67 leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Investigates the complexity of the vagal reflexes arising from the upper gastrointestinal tract by recording single unit vagal afferents and efferents in the ferret. The potential involvement of various neurotransmitters in mediating and modulating gastrointestinal tract inputs is also explored. / Thesis (Ph.D.)--University of Adelaide, Dept. of Medicine, 1999

Delayed gastric emptying, that manifests clinically as intolerance to enteral feeding, occurs in over 50% of critically ill patients and has a major impact on patient morbidity and mortality. Despite the recognition that the proximal stomach has a major role in gastric emptying of liquids, only the motor activity of the antro-pyloro-duodenal region has been evaluated in detail. In addition, many of the proposed risk factors for the gastric dysmotility, particularly a prior history of diabetes mellitus, have not been evaluated formally but have been extrapolated from data from non-critically ill patients. The currently available prokinetic drugs, erythromycin and metoclopramide, are considered to be the first line treatment for feed intolerance. However, neither data comparing the effectiveness of these agents nor the data on the effects of combination of therapy in the treatment of feed intolerance are available. The aims of this thesis were, therefore, to examine: (i) proximal gastric motor activity and the association between proximal and distal motility; (ii) the relationship between entero-gastric humoral responses to nutrients, gastric emptying and feed intolerance; (iii) the impact of admission diagnoses, choice of sedations, timing of initiation of feeding, and pre-existing history of diabetes mellitus on gastric emptying and feed intolerance; and (iv) the efficacy of erythromycin, metoclopramide and combination of these drugs in treatment of feed intolerance in critically ill patients. The current thesis indicates that motor activity is impaired in multiple regions of the stomach in the critically ill. When compared to healthy humans, proximal gastric relaxation was prolonged and fundic wave activity was educed during small intestinal nutrient infusion in critically ill patients. In addition, simultaneous assessment of proximal and distal gastric motility demonstrated a possible disruption of the motor integration between the proximal and distal stomach. In light of the recent data that suggested a significantly greater proportion of meal distributed proximally in critically ill patients with delayed gastric emptying (Nguyen, et al. 2006), the disruption of the gastric motor integration and the prolonged gastric relaxation in response to duodenal nutrients may play a significant role in the pathogenesis of slow gastric emptying during critical illness, especially as liquid formulae. The entero-gastric hormonal feedback responses were also disturbed during critical illness. Both fasting and duodenal nutrient-stimulated plasma CCK and PYY concentrations were significantly higher in critically ill patients, particularly those who did not tolerated gastric feeds. The rate of gastric emptying of a liquid meal was inversely related to both fasting and postprandial plasma CCK and PYY concentrations, supporting the potential role of plasma CCK and PYY in the pathogenesis of gastric dysmotility in critically ill patients. Admission diagnosis, choice of sedative drug and blood glucose control but not the timing of enteral feeds were important factors for delayed gastric emptying and feed intolerance in these patients. In particular, delaying enteral feeding by 4 days had no impact on the rate of gastric emptying, intra-gastric meal distribution, or plasma CCK and PYY concentrations. Contrary to traditional belief, critically ill patients with a pre-existing diagnosis of type 2 DM have only a minor disturbance to the proximal stomach, a relatively normal gastric emptying and are at no higher risk of feed intolerance than those without DM, suggesting the presence of pre-existing DM 2 in critically ill patients should not influence the standard practice of gastric feeding. Therapeutically, short-term treatment with low dose erythromycin was more effective than metoclopramide, but the effectiveness decreased rapidly overtime at similar rate as observed with metoclopramide. In patients who failed to response to either agent, treatment with both agents was highly effective in re-establishing feeding success. The use of combination therapy as the initial treatment for feed intolerance was also more effective than erythromycin alone and had less tachyphylaxis. Treatment with erythromycin and metoclopramide, either as a single agent or in combination did not associated with major cardiovascular adverse side effects. Although diarrhoea was a common side effect and was highest with combination therapy, it was not associated with Clostridium difficile infection and settled quickly after the cessation of the prokinetic therapy. In summary, the work performed in the current thesis has provided substantial insights into the understanding of the nature, risk factors, pathogenesis and treatment of disturbed gastric motor function in critically ill patients. Not only do these findings stimulate further research into the mechanisms responsible for gastric dysmotility in critical illness, they also lead to the development of new strategies for optimizing the management of feed intolerance. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1320667 / Thesis (Ph.D.) -- University of Adelaide, School of Medicine, 2008

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 4 uppsatser.