Ultrastructural differences between diabetic and idiopathic gastroparesis

The ultrastructural changes in diabetic and idiopathic gastroparesis are not well studied and it is not known whether there are different defects in the two disorders. As part of the Gastroparesis Clinical Research Consortium, full thickness gastric body biopsies from 20 diabetic and 20 idiopathic gastroparetics were studied by light microscopy. Abnormalities were found in many (83%) but not all patients. Among the common defects were loss of interstitial cells of Cajal (ICC) and neural abnormalities. No distinguishing features were seen between diabetic and idiopathic gastroparesis. Our aim was to provide a detailed description of the ultrastructural abnormalities, compare findings between diabetic and idiopathic gastroparesis and determine if patients with apparently normal immunohistological features have ultrastructural abnormalities. Tissues from 40 gastroparetic patients and 24 age‐ and sex‐matched controls were examined by transmission electron microscopy (TEM). Interstitial cells of Cajal showing changes suggestive of injury, large and empty nerve endings, presence of lipofuscin and lamellar bodies in the smooth muscle cells were found in all patients. However, the ultrastructural changes in ICC and nerves differed between diabetic and idiopathic gastroparesis and were more severe in idiopathic gastroparesis. A thickened basal lamina around smooth muscle cells and nerves was characteristic of diabetic gastroparesis whereas idiopathic gastroparetics had fibrosis, especially around the nerves. In conclusion, in all the patients TEM showed abnormalities in ICC, nerves and smooth muscle consistent with the delay in gastric emptying. The significant differences found between diabetic and idiopathic gastroparesis offers insight into pathophysiology as well as into potential targeted therapies.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92113/1/jcmm1451.pd

Clinical‐histological associations in gastroparesis: results from the Gastroparesis Clinical Research Consortium

Background  Cellular changes associated with diabetic (DG) and idiopathic gastroparesis (IG) have recently been described from patients enrolled in the Gastroparesis Clinical Research Consortium. The association of these cellular changes with gastroparesis symptoms and gastric emptying is unknown. The aim of this study was to relate cellular changes to symptoms and gastric emptying in patients with gastroparesis. Methods  Earlier, using full thickness gastric body biopsies from 20 DG, 20 IG, and 20 matched controls, we found decreased interstitial cells of Cajal (ICC) and enteric nerves and an increase in immune cells in both DG and IG. Here, demographic, symptoms [gastroparesis cardinal symptom index score (GCSI)], and gastric emptying were related to cellular alterations using Pearson’s correlation coefficients. Key Results  Interstitial cells of Cajal counts inversely correlated with 4 h gastric retention in DG but not in IG (r = −0.6, P  = 0.008, DG, r = 0.2, P  = 0.4, IG). There was also a significant correlation between loss of ICC and enteric nerves in DG but not in IG (r = 0.5, P  = 0.03 for DG, r = 0.3, P  = 0.16, IG). Idiopathic gastroparesis with a myenteric immune infiltrate scored higher on the average GCSI (3.6 ± 0.7 vs 2.7 ± 0.9, P  = 0.05) and nausea score (3.8 ± 0.9 vs 2.6 ± 1.0, P  = 0.02) as compared to those without an infiltrate. Conclusions & Inferences  In DG, loss of ICC is associated with delayed gastric emptying. Interstitial cells of Cajal or enteric nerve loss did not correlate with symptom severity. Overall clinical severity and nausea in IG is associated with a myenteric immune infiltrate. Thus, full thickness gastric biopsies can help define specific cellular abnormalities in gastroparesis, some of which are associated with physiological and clinical characteristics of gastroparesis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92097/1/j.1365-2982.2012.01894.x.pd

Follow the Pattern

Collage of rooster and man making circle with his fingers and a tape measure, white matte.https://digitalcommons.jsu.edu/artgalleries_permanent/1150/thumbnail.jp

A Study of the Effectiveness of Citizenship Education as it is Taught in the Public Secondary Schools of Texas

The purpose of this study is to determine whether students in Texas high schools are receiving adequate citizenship education, to see what factors are responsible for the present situation, and finally to search for possible improvements in civic education and possible solutions for specific problems

The influence of quality grade, fat trim level and degree of doneness on the fatty acid composition of beef

Due to the character of the original source materials and the nature of batch digitization, quality control issues may be present in this document. Please report any quality issues you encounter to [email protected], referencing the URI of the item.Includes bibliographical references.Not availabl