**7. References**

408 New Advances in the Basic and Clinical Gastroenterology

study, we observed a post-weaning decrease in the height of villi significant on day 35 of age in the jejunum (p < 0.01). Elongation of the crypts post-weaning has been observed in several studies (Hampson & Kidder, 1986; Hedemann et al., 2003) and was confirmed in the present experiment. In our study, in the first week after weaning, conventional piglets showed significant deepening of crypts in duodenal (p < 0.001), jejunal (p < 0.01) and ileal (p < 0.05) segments. Villous atrophy may result both from increased rate of cell loss leading to higher rate of mitosis in crypts and their hyperplasia and from slower rate of cell renewal resulting from the reduction of cell division, i.e. in case of underfeeding. During the time of weaning villous shape also undergoes modifications. The marked and abrupt morphological response to weaning in the small intestine, characterized by transformation from a dense finger-like villi population to a smooth, compact, tongue-shaped luminal villi was observed in previous study (Skrzypek et al., 2005) and in the present study. The morphological changes observed in the small intestine around weaning are closely related to changes in the mucosal enzyme activity observed at the same time. When shortening of the villi is associated with cell loss, loss of mature enterocytes where digestive enzymes are located also occurs. The disaccharidases have been the most commonly investigated mucosal enzymes in relation to weaning of piglets (Kelly et al., 1991). Morphological changes in the small intestine of piglets after weaning are accompanied by smaller activity of brush border enzymes, lactase and sucrase (Pacha, 2000). In our study we registered that of lactase activity of gnotobiotic piglets decreased in the weeks 4 (p < 0.001) and 5 (p < 0.001) to levels similar to those noticed at birth. Similarly, we recorded a post-weaning decrease in lactase specific activity also in conventional piglets. The results of these studies have been used to interpret the digestive and absorptive capacity of the small

Gnotobiotic animals are a very useful model in studying the physiology of the digestive tract. The gnotobiotic model allowed us to carry out systematic examination of the effect of a defined microbial population on postnatal intestinal development. We characterized regional variations in morphological and functional responses of the small intestine. We also identified that morphological and functional responses were affected differently by respective bacterial species, supporting the assumption that postnatal bacterial colonization patterns play an important role in neonatal intestinal development. Very good application of gnotobiotic animals is anticipated in the field of study of mutual interaction of natural microflora and pathogens in the digestive tract, mechanisms of probiotic effects of microorganisms. We can conclude that the development of the intestinal mucosa membrane is in direct junction to breeding conditions. In connection with postnatal differentiation and the development of the small intestine in piglets, currently there is increasingly high interest in the explanation of the important role that can be played by colostrum and by milk containing growth factors, hormones and other bio-active compounds. It is likely that removal of milk will have a profound influence upon the processes regulating the growth of

This study was supported by the project SK0021, co-financed through the EEA financial mechanism, the Norwegian financial mechanism and the state budget of the Slovak

intestine as well as the maturity of the enterocytes.

cells in the small intestine, their differentiation and function.

**5. Conclusion** 

**6. Acknowledgments** 


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**18** 

*United Kingdom* 

**Superior Mesenteric Artery Syndrome** 

Superior mesenteric artery syndrome (SMAS) mostly occurs in adolescent or young adults and is a rare disorder. The syndrome was first described by the Von Rokitansky in 1842 and since then about 400 cases has been reported in literature but SMAS is not well recognised and often diagnosed late till the patients are far advanced with their symptoms (Geer 1990, Raissi et al1996). In general population the incidence with the help of upper gastrointestinal barium studies were reported to be around 0.013-0.3 %(Ylinen et al 1989). However after the scoliosis surgery the prevalence was reported to be in range of 0.5-4.7 %( Tsirikos, Jeans 2005). Geer (1990) reported that 75% of the cases occurred in patients aged between 10-30 years. In a large series of 75 patients it was reported that two third of the cases were women and one third men and the average age was around 40 years (Wilkie 1927). The morbidity caused by this syndrome and the difficulty in diagnosing it prompted this review, and at the

The superior mesenteric artery (SMA) originates behind the neck of the pancreas at the level of the first lumbar vertebra and leaves the aorta at an acute angle. It forms an angle of approximately 45° with the abdominal aorta. The third part duodenum crosses caudal to the origin of superior mesenteric artery (SMA), coursing between SMA and aorta just inferior to the left renal vein from right to left (Fig 1). Any factor that sharply narrows the aortomesenteric angle from approximately 45º (range between 38-56°) to 6-25° will thus reduce the aortomesenteric distance to about 2-8mm (Hines et al 1984, Neri et al 2005). The mean radiographic aortomesenteric distance is 10–28 mm (Neri et al 2005).This can cause entrapment and compression of the third part of duodenum. Thus conditions such as loss of mesenteric and retroperitoneal fat and subsequent decrease of the aortomesenteric distance can cause SMAS.


same time it will also act as a fresh reminder for the clinicians.





**1. Introduction** 

**2. Anatomy and pathology** 


**3. Causes** 

Rani Sophia and Waseem Ahmad Bashir

*Yeovil Hospital NHS Foundation Trust, Yeovil, Somerset* 

