Previous studies have shown that L-tryptophan treatment has been known to reduce blood pressure (BP) in hypertensive rats. L-tryptophan is converted to serotonin (5-HT), a potent vasoconstrictor agonist. The direct vascular effects of L-tryptophan, an essential amino acid, and the mechanism that contributes to the fall in BP have not been fully explored. The present study aims to examine the direct vascular responses to both D- and L- tryptophan using perfused mesenteric vascular bed, an ex-vivo preparation that represents the resistance function of circulation. Perfusion was maintained at a constant flow rate (5 mL/min) with Krebs buffer (pH 7.4, 37˚C) after isolation from 12 to 14 week old male Sprague-Dawley rats. The basal perfusion pressure (PP) (mean ± SEM) was 27 ± 3 mmHg. Inclusion of D- and L-isomers in the perfusion medium led to concentration-dependent increase in PP. While the maximal response (Emax) was similar, D-tryptophan (EC50: 0.25 ± 0.12* µmol; Emax: 128 ± 8 mmHg) was more potent (lower EC50 value; *p < 0.01) than L-tryptophan (EC50: 0.79 ± 0.30 µmol; Emax: 141 ± 7 mmHg). Inclusion of increasing concentrations (2, 5 and 10 nM) of the 5-HT2A selective antagonist, ketanserin, led to parallel right-ward shifts in the concentration-response curves to D- and L-tryptophan with restoration of their Emax. In contrast, the α1 selective agonist, methoxamine (30 µM), constricted preparations, both D- (IC50: 0.94 ± 0.30* µmol; Imax: 96 ± 2%) and L-tryptophan (IC50: 2.8 ± 1.0 µmol Imax: 88± 1%) evoked concentration-dependent vasodilatation, an effect that was resistant to blockade by either ketanserin or other 5-HT antagonists. Again, D-tryptophan was more potent than L-tryptophan in the presence of 5-HT antagonist (*p < 0.05). Neither the removal of endothelium nor incubation with selective inhibitors of dilatory mediators released from the endothelium, failed to alter the vasodilator responses to D- and L-tryptophan. In potassium chloride depolarized preparations, L-tryptophan evoked an additive vasoconstrictor response. The vasodilator responses to L-tryptophan persisted in the presence of glibenclamide, a KATP channel inhibitor, or tetraethyl ammonium, a BKCa channel inhibitor, or BaCl2, a Kir channel inhibitor, or ouabain, a Na+-K+-ATPase pump inhibitor. These data confirm that the essential amino acid, L-tryptophan, as well as its D-isomer, evoke a biphasic vasoconstrictor and vasodilator responses in the resistance type mesenteric vascular bed. While the vasoconstrictor responses are mediated by activation of vascular 5-HT receptors, the endothelium-independent vasodilator responses are not linked to activation of vascular 5-HT receptors, vascular potassium channels, Na+-K+-ATPase pump or via inhibition of voltage-operated Ca2+-channels. Plasma concentration of L-tryptophan is about 90 - 120 µM. The endothelium/5-HT independent direct vasodilator responses characterized here for the first time could account for the antihypertensive/ BP lowering effect of L-tryptophan reported earlier by other laboratories.

Endophyte-infected tall fescue produces many ergot alkaloids, which have been shown to be vasoconstrictive in various vessel types of bovine. On the other hand, substantial evidence has been reported on the vasodilative effects of formononetin and biochanin A in different vessel types in humans and rats. So, a study was conducted using mesenteric vasculature collected from heifers shortly after slaughter. After 2-h incubation with formononetin (F), biochanin A (B), or an ergovaline-containing tall fescue seed extract (EXT) and their combinations, vessels were mounted in a multi-myograph to determine their ergotamine-induced contractility. Results indicated that F and B at 1 × 10-6 M and their combination did not impact the contractile response to ergotamine in mesenteric vasculature. The pre-myograph incubation of mesenteric vasculature with EXT altered the contractile response manner to ergotamine. However, at higher concentration, F and B may alleviate the reduction of vasoconstriction caused by prior exposure to EXT. To our knowledge, this study was the first to investigate the interaction of ergot alkaloids and isoflavones on in vitro bovine mesenteric vasculature. However, further investigations are necessary to understand the mechanism behind the interaction of ergot alkaloids and isoflavones on vasoactivity.

Diss. (sammanfattning) Uppsala : Univ., 2004. / Härtill 6 uppsatser.

Thoracic duct (TD) ligation has long been the treatment of choice for canine idiopathic chylothorax. Clear identification of all the TD branches at the surgical site is critical to facilitate complete ligation, and this can be difficult due to the highly variable nature of the TD system in number, location and patency of TD branches. Failure to ligate all of the TD branches may result in persistent flow of chyle into the pleural cavity through any missed ducts, and this is the single most common cause of failure with TD ligation. Performing direct positive contrast lymphography with a water soluble contrast medium, administered through a surgically implanted mesenteric lymphatic vessel catheter has been the conventional method used to identify TD branches. This procedure involves invasive surgery to both implant and remove the mesenteric lymphatic catheter, which increases patient risk and discomfort, as well as the diagnostic time and cost. Ultrasound (US) guided percutaneous administration of contrast medium into either a popliteal or mesenteric lymph node (LN) have been proposed as alternatives to mesenteric lymphatic vessel catheterisation, however their comparability with the conventional approach has not been assessed. Computed tomographic (CT) lymphography of the caudal canine TD was performed in seven beagles with contrast medium administered through a mesenteric lymphatic catheter, and by US guided percutaneous injection into a popliteal LN. Images of the TD system were collected using both helical and sequential CT modalities for each contrast medium administration technique. It was found that percutaneous popliteal lymphography had a total diagnostic procedure time just 46% of that found with mesenteric lymphatic vessel administration, and resulted in a time saving of 52 minutes. It also incurred only 29% of the total costs, and patients were assessed to have significantly less discomfort compared to mesenteric lymphatic vessel lymphography. There was no significant difference in the number of TD branches identified by the two contrast medium administration techniques (P = 0.256). However administration of contrast medium into a mesenteric lymphatic vessel did result in the largest TD branch having a significantly greater widest diameter (P < 0.001), cross-sectional area (P < 0.001) and mean Hounsfield unit (HU) value (P < 0.001) than popliteal administration. The significant difference in TD size and contrast medium concentration may help to explain the trend for popliteal administration of contrast medium to detect slightly fewer TD branches (CR = 0.830), however this study could not confirm this trend nor its possible causes. There was no significant difference in the number of TD branches identified by the two CT modalities (P = 0.417). However helical CT did result in the largest TD branch having a significantly greater widest diameter (P < 0.001), cross-sectional area (P < 0.001) and higher mean HU value (P < 0.001). It should be noted however that in this study sequential CT was consistently performed after the helical CT was completed, which could explain the differences seen between the two CT modalities in TD branch size and contrast medium concentration. Despite helical CT having the apparent advantage of a larger TD branch which contained a higher concentration of contrast medium, it was actually found that there was a trend for helical CT to detect slightly fewer TD branches (CR = 0.876). This is possibly due to the positive pressure breath hold that was used to minimise thoracic respiratory movement for the helical CT; while the sequential CT was performed during normal respiration and was therefore not subject to abnormally elevated intrapleural pressure. This study could not confirm the slight superiority of sequential CT in detecting TD branches nor the possible reasons for this apparent difference. / Dissertation (MMedVet)--University of Pretoria, 2010. / Companion Animal Clinical Studies / unrestricted

Introduction: Sclerosing mesenteritis is a rare autoimmune disease that eventually evolves into fibrotic changes affecting the adipose tissue around the mesenteric vessels. It can present through a myriad of gastroenterological as well as constitutional symptoms including but not limited to abdominal pain, diarrhea, fever, nausea or vomiting. Although the exact etiology of the disease is yet to be determined, there are several predisposing factors the most common of which is history of previous abdominal trauma and/or surgery. This is a case report of abdominal mesenteric panniculitis that presented with abdominal pain in a middle-aged male with history of cholecystectomy. Case Presentation: The patient was a 53-year-old male with past medical history of hypertension who presented with a 2-week history of intolerance to food and liquids and abdominal pain, colicky in nature, radiating to both flanks with no alleviating or relieving factors. One year before, the patient had cholecystectomy due to biliary dyskinesia. His hospital stay at that time was complicated by biliary leak treated with biliary stenting. He later also developed multiloculated abscess collection in the gallbladder fossa that was managed with external drainage and IV antibiotics. In the ER his vital signs were as the following: BP between 120-130/70-80, HR 70s, temperature 97, oxygen saturation was more than 95%. On physical examination, he had abdominal tenderness in all four quadrants with no rigidity, rebound tenderness, masses or skin changes. CBC showed WBC of 7K with no shift to the left, hemoglobin of 15.6 and platelets of 107. CMP showed Na of 142, K 4.2, Chl 19, Glu 99, Ca 9.5, AG 18, lactic acid 1, lipase 50, phos 2.7, beta-hydroxybutyrate 0.12 and Mg of 1.9. urine analysis and Troponins were within normal limits. EKG showed sinus rhythm. Urine drug screen was negative. CRP and ESR were within normal limits. Porphyria workup was negative. Alpha-1-antitrypsin was 123. Ceroluplasmin level was 17. Actin antibody was negative as well as mitochondria M2 antibody. CT angiogram of the abdomen showed patent mesenteric vessels. However, fat stranding was noticed especially at the root of the mesenteric vessels. The patient was placed on prednisone 40mg once daily and tamoxifen. His abdominal pain greatly improved after 2 days. He was discharged with a prolonged prednisone taper. He was scheduled for an appointment with his primary care at discharge but didn’t show up and was lost to follow up. Conclusion: Mesenteric panniculitis is a rare cause of abdominal pain. it is divided based on histological features into sclerosing (retractile) mesenteritis, mesenteric panniculitis and mesenteric lipodystrophy. Diagnoses is usually rarely inferred from the clinical presentation and is often suggested by radiological features. Distinctive findings on CT include fat ring sign and pseudotumor capsule. Although radiological characteristics are helpful, histological proof is essential for definitive diagnosis, especially with an atypical clinical and radiological appearance. There is no consensus on the optimal treatment option but prolonged steroid taper has been used with various degrees of success.

Sclerosing mesenteritis is a rare autoimmune disease that eventually evolves into fibrotic changes that usually affect the adipose tissue around the mesenteric vessels. It can present through a myriad of gastroenterological as well as constitutional symptoms, including but not limited to abdominal pain, diarrhea, fever, nausea, or vomiting. Although the exact etiology of the disease is yet to be determined, there are several predisposing factors, the most common of which is a previous history of abdominal trauma and/or surgery. Several case series have reported the association of sclerosing mesenteritis with prior abdominal surgery ranging from as low as 24% to as high as 53%.

Purpose Chronic mesenteric ischemia (CMI) is a rare but life-threatening disease. This study reviewed outcomes in patients treated surgically for CMI by open treatment (OT) and endovascular treatment (ET), analyzing risk factors for endovascular failure. Methods Clinical data for 36 patients treated for CMI from 2007 to 2017 were retrospectively analyzed. The study’s primary endpoint was symptom-free survival. The secondary endpoint was the primary technical success for endovascular and open surgical treatments. Risk factors for endovascular failure were identified by using univariate analysis. Results Patients were analyzed as treated: 21 patients (58.3%) in the ET and 15 (41.6%) in the OT group. Overall, 20 patients (56%) presented with abdominal angina, 9 (25%) with rest pain, and 7 (19%) without symptoms. An ET was initially attempted in 31 patients (86.1%). The conversion rate from ET to OT was 32.3%, which resulted in a primary technical success of 67.6% in ET and 100% in OT. Six patients from the ET group (19.3%) required surgical revision due to restenosis. One-year (OT 91.6% vs. ET 96.8%; n.s.) and three-year primary patency (OT 91.6% vs. ET 80.6%; n.s.) as well as 3-year symptom-free survival did not differ between the groups (OT 62.5% vs. ET 69.4%; n.s). Overall, in-hospital mortality was 2.8% (n = 1), which was not statistically different between the groups (OT 6% vs. ET 0%; n.s.). High-grade stenosis of the superior mesenteric artery tended to be associated with higher technical failure (P = 0.06). Conclusions ET showed a comparable perioperative outcome with higher technical failure. OT was distinguished by excellent early and late technical success.

Acute occlusion of the superior mesenteric artery (SMA) is a condition associated with high mortality and morbidity. The aim of this thesis is to evaluate diagnostic and therapeutic approaches for acute SMA occlusion. In a prospective study of patients with suspected intestinal ischemia, no biomarker was sufficiently accurate to detect this condition. In a second retrospective study, pancreatic amylase and troponin-I were elevated in a substantial proportion of patients with verified SMA occlusion. In an experimental animal model of acute SMA occlusion, microarray studies of ischemic small bowel wall were used to characterize the mRNA response to ischemia. Thrombospondin, Monocyte Chemoattractant Protein 1 and Gap Junction Alpha 1 were consistently up-regulated in all pigs with intestinal ischemia. Genes encoding previously proposed biomarkers for intestinal ischemia were either up-regulated, such as lactate dehydrogenase and creatine kinase, or down-regulated, such as intestinal fatty acid binding protein and glutathione S-transferase. In a study of the role of computed tomography in the diagnosis of SMA occlusion, it was shown that computed tomography with intravenous contrast was associated with improved survival. A retrospective analysis of all acute SMA revascularizations in Sweden 1999-2006 revealed that D-dimer was elevated in all 35 measured cases.  Endovascular surgery was associated with better outcome than open surgery, both in short and in long term. The presence of postoperative short bowel syndrome was a strong independent risk-factor for decreased long-term survival. Conclusions: Data affirm that D-dimer may serve as an exclusion test for acute SMA occlusion, whereas elevated troponin-I and pancreatic amylase are potential diagnostic pitfalls. Contrast-enhanced computed tomography of the visceral arteries seems to be the best diagnostic method. Endovascular surgery is an option to open surgery in selected cases, and was associated with favourable outcome.

Os gânglios pertencentes ao Sistema Nervoso Autônomo (SNA) estão divididos em grupos de acordo com sua localização. Os gânglios celíaco e mesentérico superior são gânglios simpáticos pré-vertebrais. Estes se localizam anteriormente à coluna vertebral e à aorta abdominal ao nível das vértebras T12 a L1. Conectando o Sistema Nervoso Central (SNC), por meio dos nervos esplênico maior e menor, ao Sistema Nervoso Periférico (SNP), formando um emaranhado de nervos denominado plexo nervoso. Ambos participam do controle da motilidade gastrointestinal, sendo assim, estão envolvidos na fisiopatologia dos distúrbios inerentes ao seu território de inervação. Foram dissecados e fixados a solução de formol a 4%, 33 blocos anatômicos de seres humanos contendo a parte abdominal da aorta e o pâncreas, obtidos de 15 indivíduos do gênero masculino e 18 do feminino com idades variando de 20 a 90 anos, divididos em três grupos: Grupo I (jovens - 20 a 40: 3 homens e 4 mulheres); Grupo II (adulto - 45 a 60: 8 homens e 6 mulheres) e Grupo III (idosos - 70 a 90: 4 homens e 8 mulheres), onde avaliou-se aspectos estruturais e ultraestruturais dos gânglios celíacos e mesentérico superior, quanto à sua topografia e componentes microscópicos por meio das colorações de Hematoxilina e Eosina, Tricromo de Masson, Violeta Cresil, Verhoff e Picro-Sirius, observou-se respectivamente, a identificação geral dos componentes ganglionares, fibra elástica e o componente colágeno ganglionar, assim como análises por método de Microscopia Eletrônica de Varredura (MET). Quanto ao aspecto macroscópico os gânglios celíacos foram contados em número de 58, sendo 25 espécimes (86% dos casos) apresentaram-se bilateralmente de formato retangular, 7 (12%) estavam fusionados na linha mediana, e 1 (1,7%) no antímero esquerdo, ambos de aspecto irregular. Relativamente todos pertencentes a este antímero estavam em situação inferior aos do antímero direito. Já o gânglio mesentérico superior, de formato preferencialmente estrelado, ocorreu em 10 espécimes (30%) ele estava situado anteriormente à artéria mesentérica superior, e em 17 (51%), posteriormente a ela, em 3 casos foi encontrado um entrecruzamento de fibras nervosas espessas com presença de corpos celulares espaçados, e em 3 casos (9%), o gânglio não foi encontrado, apenas um emaranhado de feixes com fibras nervosas. Referente a parte qualitativa, notou-se que à medida que o ser humano envelhece há uma diminuição das fibras colágenas do tipo III, passando a predominar fibras do tipo I nos grupos: GII e GIII e quantitativamente, foram analisados 9 gânglios sendo 3 de cada grupo: GI (20-40: 2 homens e 1 mulher); GII (45-60: 3 homens) e GIII (70-90: 3 mulheres), embora não se tenha realizado uma análise estatística a média das áreas dos nervos do GIII foi maior em relação ao GI, por outro lado as áreas dos fascículos nervosos não exibiram diferenças aparentes. A área do corpo neuronal de GI, GII e GIII houve uma progressiva diminuição desse parâmetro nos grupos GII e GIII. O material foi fornecido pelo Sistema de Verificação de Óbito da Capital SP (SVOC-SP/USP) e após a sua coleta as peças foram processadas no Laboratório de Anatomia Funcional Aplicada a Clínica e à Cirurgia (LAFACC) do Departamento de Anatomia do Instituto de Ciências Biomédicas III da Universidade de São Paulo (ICB III USP). O estudo estrutural e ultraestrutural de gânglios simpáticos em humanos abre perspectivas futuras para pesquisas correlacionadas a morfologia e sua função. Os resultados podem ter importância para a neurociência humana, dando embasamento para tratamentos de doenças relacionadas ao trato gastrointestinal (TGI), o que pressupõe grande relevância deste estudo. / The ganglia belonging to the Autonomic Nervous System (ANS) are divided into groups according to their location. The superior celiac and mesenteric ganglia are pre-vertebral sympathetic ganglia. These are located anterior to the vertebral column and to the abdominal aorta at the level of the vertebrae T12 to L1. Connecting the Central Nervous System (CNS), via the major and minor splenic nerves, to the Peripheral Nervous System (SNP), forming a tangle of nerves called the nervous plexus. Both are involved in the control of gastrointestinal motility and are therefore involved in the pathophysiology of the disorders inherent to their territory of innervation. A total of 33 human anatomical blocks containing the abdominal part of the aorta and the pancreas, obtained from 15 male and 18 female subjects with ages varying from 20 to 90 years, divided into three groups: Group I (young - 20 to 40: 3 men and 4 women); Group II (adult - 45 to 60: 8 men and 6 women) and Group III (elderly - 70 to 90: 4 men and 8 women), where structural and ultrastructural aspects of the celiac and mesenteric superior ganglia were evaluated for their topography and microscopic components through the staining of Hematoxylin and Eosin , Masson\'s trichrome, Violet Cresil, Verhoff and Picro-Sirius, the general identification of the ganglionic components, elastic fiber and the ganglionic collagen component, as well as the Scanning Electron Microscopy (MET) method were observed. As to the macroscopic aspect, the celiac ganglia were counted in 58, 25 specimens (86% of the cases) were bilaterally rectangular, 7 (12%) were fused at the median line, and 1 (1,7%) in the antimer left, both of irregular appearance. Relatively all belonging to this antimer were inferior to those of the right antimer. The superior mesenteric ganglion, with a predominantly star-shaped shape, occurred in 10 specimens (30%), located anterior to the superior mesenteric artery, and in 17 (51%), posterior to it, in 3 cases a \"cross-linking\" of and in 3 cases (9%), the ganglion was not found, only a tangle of bundles with nerve fibers. Regarding the qualitative part, it was noticed that as the human being grows older there is a decrease of type III collagen fibers, and type I fibers predominate in the groups: GII and GIII and quantitatively, 9 glands were analyzed, 3 in each group: GI (20-40: 2 men and 1 woman); GII (45-60: 3 men) and GIII (70-90: 3 women), although no statistical analysis was performed the mean of the GIII nerve areas was higher in relation to the GI; on the other hand, the areas of the nerve fascicles showed no apparent differences. The area of the neuronal body of GI, GII and GIII showed a progressive decrease of this parameter in the GII and GIII groups. The material was supplied by the São Paulo State Capital Surveillance System (SVOC-SP / USP) and after its collection the pieces were processed in the Laboratory of Functional Anatomy Applied to Clinic and Surgery (LAFACC) of the Department of Anatomy of the Institute of Biomedical Sciences III of the University of São Paulo (ICB III - USP). The structural and ultrastructural study of sympathetic ganglia in humans opens future perspectives for research correlated with morphology and its function. The results may be important for human neuroscience, giving support to treatments of diseases related to the gastrointestinal tract (GIT), which presupposes great relevance of this study.

A destruição crônica do aparato periodontal devido a resposta inflamatória a bactérias, leva a um quadro clínico conhecido como doença periodontal. Patógenos periodontais podem ser translocados e liberados do sulco gengival à circulação sanguínea e apresentar efeitos periféricos. A bolsa periodontal também é importante reservatório de mediadores inflamatórios. A periodontite pode apresentar efeitos em órgãos distantes. Estudos passaram a documentar a relação entre doença periodontal e disfunção endotelial, reversível pelo tratamento odontológico. Nosso laboratório estudou a resposta vasomotora in vitro de anéis de aorta de ratos com periodontite, e os resultados preliminares mostram um aumento da resposta contrátil destes anéis à norepinefrina, quando comparado aos animais controle. O presente estudo objetiva avaliar a influência da periodontite induzida por ligadura em ratos sobre a resposta vasomotora in vitro de anéis de artéria mesentérica. Ainda, caracterizar os mediadores envolvidos, com ênfase nas enzimas ciclooxigenase e óxido nítrico sintase. / Chronic destruction of periodontal apparatus due to an intense inflammatory response to bacteria leads to a clinical condition known as periodontal disease. Periodontal pathogens can then translocate to the gingival sulcus and reach the bloodstream, and thus have peripheral effects. The periodontal pocket is also an important reservoir of inflammatory mediators. The periodontitis may have effects on organs distant. Studies have also documented the relationship between periodontal disease and endothelial dysfunction, which was reversible by dental treatment. In our laboratory we are studying the vasomotor response \"in vitro\" of aortic rings from rats with periodontitis, and the preliminary results show an increase in the contractile response of the rings to norepinephrine, when compared with control animals. This project aims to evaluate the influence of ligature-induced periodontitis in rats on the \"in vitro\" vascular reactivity of mesenteric artery vessels. Also, the characterization of the mediators involved, with emphasis on the enzyme of cyclooxygenase and nitric oxide synthase.