18 - World Journal of Gastroenterology

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Cerci C et al . Effects of GCSF on peritoneal defense mechanisms 2599 healing of colonic anastomoses. J Surg Res 1990; 48: 504-515 8 Unal AE, Cevikel MH, Ozgun H, Tunger A. Effect of granulocyte-macrophage colony stimulating factor on bacterial translocation after experimental obstructive jaundice. Eur J Surg 2001; 167: 366-370 9 Alexander JW, Boyce ST, Babcock GF, Gianotti L, Peck MD, Dunn DL, Pyles T, Childress CP, Ash SK. The process of microbial translocation. Ann Surg 1990; 212: 496-510; discussion 511-512 10 Deitch EA. The role of intestinal barrier failure and bacterial translocation in the development of systemic infection and multiple organ failure. Arch Surg 1990; 125: 403-404 11 Goris RJ, van Bebber IP, Mollen RM, Koopman JP. Does selective decontamination of the gastrointestinal tract prevent multiple organ failure? An experimental study. Arch Surg 1991; 126: 561-565 12 Deitch EA, Winterton J, Berg R. Effect of starvation, malnutrition, and trauma on the gastrointestinal tract flora and bacterial translocation. Arch Surg 1987; 122: 1019-1024 13 MacFie J. Enteral versus parenteral nutrition: the significance of bacterial translocation and gut-barrier function. Nutrition 2000; 16: 606-611 14 Roscher R, Oettinger W, Beger HG. Bacterial microflora, endogenous endotoxin, and prostaglandins in small bowel obstruction. Am J Surg 1988; 155: 348-355 15 Metcalf D. The colony stimulating factors. Discovery, development, and clinical applications. Cancer 1990; 65: 2185-2195 16 Bergman N, Bercovici B, Sacks T. Antibacterial activity of human amniotic fluid. Am J Obstet Gynecol 1972; 114: 520-523. 17 Wilkinson PC. Neutrophil leucocyte function tests. In: Thompson RA. Techniques in clinical immunology. Oxford: Blackwell Scientific, 1977: 217-218 18 Giercksky KE. Secondary peritonitis-a major clinical problem. Scand J Gastroenterol Suppl 1984; 100: 3-5 19 Hau T. Bacteria, toxins, and the peritoneum. World J Surg 1990; 14: 167-175 20 Berg RD, Garlington AW. Translocation of certain indigenous bacteria from the gastrointestinal tract to the mesenteric lymph nodes and other organs in a gnotobiotic mouse model. Infect Immun 1979; 23: 403-411 21 Von Bultzingslowen I, Adlerberth I, Wold AE, Dahlen G, Jontell M. Oral and intestinal microflora in 5-fluorouracil treated rats, translocation to cervical and mesenteric lymph nodes and effects of probiotic bacteria. Oral Microbiol Immunol 2003; 18: 278-284 22 Deng GY, Liu YW, He GZ, Jiang ZM. Effect of dietary fiber on intestinal barrier function of 5-Fu stressed rats. Res Exp Med (Berl) 1999; 199: 111-119 23 Nomoto K, Yokokura T, Nomoto K. Prevention of 5-fluorouracilinduced infection with indigenous Escherichia coli in tumorbearing mice by nonspecific immunostimulation. Can J Microbiol 1992; 38: 774-778 24 Itoh N, Nishimura H, Matsuguchi T, Yajima T, Mokuno Y, Hiromatsu T, Nimura Y, Yoshikai Y. CD8 alpha-deficient mice are highly susceptible to 5-fluorouracil-induced lethality. Clin Diagn Lab Immunol 2002; 9: 550-557 25 Hirata K, Horie T. Changes in intestinal absorption of 5-fluorouracil-treated rats. Pharmacol Toxicol 1999; 85: 33-36 26 Tancrede CH, Andremont AO. Bacterial translocation and gram-negative bacteremia in patients with hematological malignancies. J Infect Dis 1985; 152: 99-103 27 Roilides E, Walsh TJ, Pizzo PA, Rubin M. Granulocyte colonystimulating factor enhances the phagocytic and bactericidal activity of normal and defective human neutrophils. J Infect Dis 1991; 163: 579-583 28 Hebert JC, O'Reilly M, Gamelli RL. Protective effect of recombinant human granulocyte colony-stimulating factor against pneumococcal infections in splenectomized mice. Arch Surg 1990; 125: 1075-1078 29 Nelson S. Role of granulocyte colony-stimulating factor in the immune response to acute bacterial infection in the nonneutropenic host: an overview. Clin Infect Dis 1994; 18 Suppl 2: S197-S204 30 Sartorelli KH, Silver GM, Gamelli RL. The effect of granulocyte colony-stimulating factor (G-CSF) upon burn-induced defective neutrophil chemotaxis. J Trauma 1991; 31: 523-529; discussion 529-530 31 Tuo H, Sugiyama M, Nakashima M, Abe N, Atomi Y. Effects of granulocyte colony-stimulating factor on neutrophils and inflammatory cytokines in the early stage of severe acute pancreatitis in rats. J Gastroenterol 2005; 40: 186-191 32 Pajkrt D, Manten A, van der Poll T, Tiel-van Buul MM, Jansen J, Wouter ten Cate J, van Deventer SJ. Modulation of cytokine release and neutrophil function by granulocyte colony-stimulating factor during endotoxemia in humans. Blood 1997; 90: 1415-1424 33 Zhang P, Bagby GJ, Stoltz DA, Summer WR, Nelson S. Enhancement of peritoneal leukocyte function by granulocyte colony-stimulating factor in rats with abdominal sepsis. Crit Care Med 1998; 26: 315-321 S- Editor Liu Y L- Editor Roberts SE E- Editor Wang HF www.wjgnet.com
PO Box 2345, Beijing 100023, China World J Gastroenterol 2007 May 14; 13(18): 2600-2603 www.wjgnet.com World Journal of Gastroenterology ISSN 1007-9327 wjg@wjgnet.com © 2007 The WJG Press. All rights reserved. RAPID COMMUNICATION Study of the duodenal contractile activity during antral contractions Ahmed Shafik, Olfat El Sibai, Ali A Shafik Ahmed Shafik, Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt Olfat El Sibai, Department of Surgery, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt Ali A Shafik, Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt Correspondence to: Ahmed Shafik, MD, PhD, Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, 2 Talaat Harb Street, Cairo 11121, Egypt. shafik@ahmedshafik.com Telephone: +20-2-7498851 Fax: +20-2-7498851 Received: 2007-02-13 Accepted: 2007-03-26 Abstract AIM: To investigate the hypothesis that duodenal bulb (DB) inhibition on pyloric antrum (PA) contraction is reflex. METHODS: Balloon (condom)-tipped tube was introduced into 1 st duodenum (DD) and a manometric tube into each of PA and DD. Duodenal and antral pressure response to duodenal and then PA balloon distension with saline was recorded. These tests were repeated after separate anesthetization of DD and PA. RESULTS: Two and 4 mL of 1 st DD balloon distension produced no pressure changes in DD or PA (10.7 ± 1.2 vs 9.8 ± 1.2, 11.2 ± 1.2 vs 11.3 ± 1.2 on H2O respectively, P > 0.05). Six mL distension effected 1 st DD pressure rise (30.6 ± 3.4 cm H2O, P < 0.01) and PA pressure decrease (6.2 ± 1.4 cm H2O, P < 0.05); no response in 2 nd , 3 rd and 4 th DD. There was no difference between 6, 8, and 10 mL distensions. Ten mL PA distension produced no PA or 1 st DD pressure changes (P > 0.05). Twenty mL distension increased PA pressure (92.4 ± 10.7 cm H2O, P < 0.01) and decreased 1 st DD pressure (1.6 ± 0.3 cm H 2O, P < 0.01); 30, 40, and 50 mL distension produced the same effect as the 20 mL distension (P > 0.05). PA or DD distension after separate anesthetization produced no significant pressure changes in PA or DD. CONCLUSION: Large volume DD distension produced DD pressure rise denoting DD contraction and PA pressure decline denoting PA relaxation. PA relaxation upon DD contraction is postulated to be mediated through a reflex which we call duodeno-antral reflex. Meanwhile, PA distension effected DD relaxation which we suggest to be reflex and termed antro-duodenal reflex. It is suggested that these 2 reflexes, could act as investigative tools in www.wjgnet.com diagnosis of gastroduodenal motility disorders. © 2007 The WJG Press. All rights reserved. Key words: Duodenal bulb; Gastroduodenal disorders; Reflex; Pyloric antrum; Motility Shafik A, El Sibai O, Shafik AA. Study of the duodenal contractile activity during antral contractions. World J Gastroenterol 2007; 13(18): 2600-2603 http://www.wjgnet.com/1007-9327/13/2600.asp INTRODUCTION The stomach has two functions: secretion and motility. The main function of the proximal stomach is secretion, and so its motility pattern in the fed state takes the form of prolonged relaxation to delay intragastric food passage and provide ample time for contact with gastric enzymes [1-3] . The proximal stomach is often described as a receptive reservoir. Meanwhile the distal stomach functions to mechanically mix and crush the solid particles. Its motility pattern in the fed state presents a strong antral peristalsis that continues until complete evacuation of the chyme is achieved [1-3] . The antral peristalsis may be so strong as to raise the antral pressure to about 100 mm Hg [4] . The stomach and duodenum possess adaptive cytoprotection which represents an important defensive phenomenon [5] . However, this protection may be antagonized by drugs such as indomethacin. Nitric oxide increases HCO3-secretion in the duodenum. This action depends on cGMP- related COX-1 activation and is mediated by prostaglandins [6] . The antral mechanical contractions are believed to be under the control of a gastric pacemaker located at the junction of the upper with the lower two thirds of the greater curvature [7] . In the fed state, the duodenal bulb contracts but, unlike the antrum, not continuously throughout the fed state. Duodenal bulb contractions cease intermittently to allow gastric emptying [7-9] . The mechanism of duodenal bulb inhibition upon antral contraction is not exactly known; is it a direct or reflex action between the antrum and duodenal bulb? We hypothesized that the mechanism of duodenal bulb relaxation upon antral contraction for gastric emptying is reflex. This hypothesis was investigated in the current study.
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18 - World Journal of Gastroenterology

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