Corticotropin-releasing factor and acute post-operative gut function in truamatic abdominal injury and elective abdominal surgery

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dc.contributor.advisorKidson, Sueen_ZA
dc.contributor.authorHill, Laurenen_ZA
dc.date.accessioned2014-07-28T18:16:46Z
dc.date.available2014-07-28T18:16:46Z
dc.date.issued2009en_ZA
dc.descriptionIncludes abstract.
dc.descriptionIncludes bibliographical references (leaves 108-128).
dc.description.abstractShocked trauma patients in the Intensive Care Unit undergo a powerful, neuro-endocrine stress response driven by cytokine release and the hypothalamic-pituitary-adrenal axis. The response is activated under stress by corticotropin-releasing factor (CRF), the well-known 41 amino acid peptide neuro-hormone. Evidence from animal and human studies suggests that peripheral CRF is present in the gastrointestinal tract and associated with inflammatory changes. Critically ill patients frequently display somewhat unexplained gastrointestinal dysfunction including delayed gastric emptying, ileus and increased bowel permeability. The aim of the study was to investigate the role of CRF in critically ill adults with traumatic abdominal injury compared with elective surgical patients, and describe any association of CRF levels with alterations in acute post-operative gastrointestinal function. Eight patients with haemorrhagic shock following penetrating abdominal injury and seventeen patients undergoing elective surgery for hepato-biliary disease were studied for serial plasma and intestinal tissue CRF levels using radio-immunoassay. A RT-PCR technique was used to detect mRNA for CRF in intestinal tissue. Light microscopy was used to determine the quantity and distribution of mast cells in intestinal tissue. Post-operative gastric emptying was assessed using the paracetamol absorption test and intestinal permeability by measuring urinary lactulose:mannitol ratios following a bolus of these sugars. The study was approved by University of Cape Town Human Research Ethics Committee. Informed consent (retrospectively in the case of the trauma patients), was obtained from all subjects.en_ZA
dc.identifier.apacitationHill, L. (2009). <i>Corticotropin-releasing factor and acute post-operative gut function in truamatic abdominal injury and elective abdominal surgery</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Human Biology. Retrieved from http://hdl.handle.net/11427/3247en_ZA
dc.identifier.chicagocitationHill, Lauren. <i>"Corticotropin-releasing factor and acute post-operative gut function in truamatic abdominal injury and elective abdominal surgery."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Human Biology, 2009. http://hdl.handle.net/11427/3247en_ZA
dc.identifier.citationHill, L. 2009. Corticotropin-releasing factor and acute post-operative gut function in truamatic abdominal injury and elective abdominal surgery. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Hill, Lauren AB - Shocked trauma patients in the Intensive Care Unit undergo a powerful, neuro-endocrine stress response driven by cytokine release and the hypothalamic-pituitary-adrenal axis. The response is activated under stress by corticotropin-releasing factor (CRF), the well-known 41 amino acid peptide neuro-hormone. Evidence from animal and human studies suggests that peripheral CRF is present in the gastrointestinal tract and associated with inflammatory changes. Critically ill patients frequently display somewhat unexplained gastrointestinal dysfunction including delayed gastric emptying, ileus and increased bowel permeability. The aim of the study was to investigate the role of CRF in critically ill adults with traumatic abdominal injury compared with elective surgical patients, and describe any association of CRF levels with alterations in acute post-operative gastrointestinal function. Eight patients with haemorrhagic shock following penetrating abdominal injury and seventeen patients undergoing elective surgery for hepato-biliary disease were studied for serial plasma and intestinal tissue CRF levels using radio-immunoassay. A RT-PCR technique was used to detect mRNA for CRF in intestinal tissue. Light microscopy was used to determine the quantity and distribution of mast cells in intestinal tissue. Post-operative gastric emptying was assessed using the paracetamol absorption test and intestinal permeability by measuring urinary lactulose:mannitol ratios following a bolus of these sugars. The study was approved by University of Cape Town Human Research Ethics Committee. Informed consent (retrospectively in the case of the trauma patients), was obtained from all subjects. DA - 2009 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2009 T1 - Corticotropin-releasing factor and acute post-operative gut function in truamatic abdominal injury and elective abdominal surgery TI - Corticotropin-releasing factor and acute post-operative gut function in truamatic abdominal injury and elective abdominal surgery UR - http://hdl.handle.net/11427/3247 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/3247
dc.identifier.vancouvercitationHill L. Corticotropin-releasing factor and acute post-operative gut function in truamatic abdominal injury and elective abdominal surgery. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Human Biology, 2009 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/3247en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Human Biologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherPhysiologyen_ZA
dc.titleCorticotropin-releasing factor and acute post-operative gut function in truamatic abdominal injury and elective abdominal surgeryen_ZA
dc.typeDoctoral Thesis
dc.type.qualificationlevelDoctoral
dc.type.qualificationnamePhDen_ZA
uct.type.filetypeText
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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