Alteration in intestinal permeability after ileal pouch-anal anastomosis

PPURPOSE: The physiologic changes that occur when the small bowel is used as a reservoir, as in the ileal pouchanal anastomosis, are poorly understood. Alterations in bowel permeability, which may lead to bacterial translocation that could result in illness or dysfunction of the pouch, may be one such consequence of the pouch procedure. METHODS: Whole-bowel permeability was evaluated in patients with and without the pouch through the use of an orally consumed nonmetabolizable sugar clearance technique. Patients in whom the ileal pouchanal anastomosis was performed for ulcerative colitis (17 patients) and patients with familial polyposis (7 patients) were compared with normal healthy volunteers (10 patients) and patients with ulcerative colitis with and without curative colectomy and ileostomy (6 and 5 patients, respectively). RESULTS: Measured by this technique, no differences were noted in bowel permeability between the volunteers and patients with ulcerative colitis, even after colectomy and ileostomy (1.7±0.4 in normal healthy volunteers, 1.8±0.5 in patients with ulcerative colitis without stoma, and 1.4±0.2 in patients with ulcerative colitis with ileostomy). The group of patients with an ileal reservoir, however, had a significantly increased index of measured bowel permeability (3.5±0.5 in patients with ulcerative colitis and 5.1±0.7 in patients with familial polyposis; P<0.05 by analysis of variance compared with normal healthy volunteers and patients with ulcerative colitis with or without ileostomy). CONCLUSION: The exact site, cause, and consequence of this possible alteration of bowel permeability are unclear but appear to be related to the presence of the pouch and are not caused by the underlying pathologic diagnosis.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Boston, Massachusetts, May 12 to 17, 1991. Winner of the New Jersey Society of Colon and Rectal Surgeons Award, 1991.     

Isolated hydrothorax of a fetus--description of the clinical situation

A diagnostic procedure in the medical treatment of middle hydrothorax at haemodynamically efficient fetus has been presented in the research. Container of the liquid in the fetal thorax has been observed since the eleventh week of pregnancy. Infection by TORCH viruses has been excluded and typical 46,XX female karyotype has been found in the cytogenic test. A liquid in the pericardial sack (without any sings of the fetal heart defect) was observed in the ECHO examination from 23 to 37 week of pregnancy. Cesarean section was made after 37 weeks of pregnancy and the new-born baby was found to be in good condition, with body mass of 3130g and 9 points in the Apgar scale. The child cardiologist did not diagnose any heart disorders. Awaiting attitude, while monitoring the state of the fetus, seems to be the right course of action in cases of haemodynamically efficient fetus with isolated hydrothorax.     

THE FLUORIDATION OF PUBLIC MATER SUPPLIES STATEMENT OF RECOMENDED POLICY

A statement approved "by the Board of Directors on May 29, 1949, and presented on'June 1, 1949, at the annual Conference, Chicago," by, A P. Black, Chairman, Special Committee on A. W. W. A. Policy re Fluoridation of public Water Supplies.     

Doublet of action potentials evoked by intracellular injection of rectangular depolarization current into rat motoneurones

A doublet of action potentials is frequently observed at the beginning of motoneuronal discharge patterns and its appearance leads to a considerable increase in the motor unit force. The aims of this study were (1) to determine the relationship between the intensity of rectangular depolarization currents injected into motoneurones and their ability to generate doublets and (2) to evaluate the influence of the initial doublets on changes in motoneuronal firing frequency. Experiments were performed on anesthetized rats, and recordings were taken from motoneurones located in the L4–L5 segments of the spinal cord. The depolarization current necessary to evoke the initial doublet of action potentials was measured and expressed in multiples of the rheobase. A gradual increase in the intensity of current injected into motoneurones resulted in initial doublets in 80% of the cases studied, at doublet threshold ranges between 1.25 and 4.0 times the rheobase. This suggests that doublets are an effect of strong synaptic excitation of motoneurones that may precede a sudden change in force during a movement. Moreover, in the great majority of the studied motoneurones, this initial doublet caused changes in the subsequent firing rate by the prolongation of the first interspike interval.     

Sarcoidosis and its otolaryngological implications

Sarcoidosis and its aetiopathogenesis, epidemiology and diagnostic procedures (including the Kveim reaction) are presented in this paper. The clinical manifestations of this disease, especially in otolaryngological organs, including the larynx, salivary glands, nose and paranasal sinuses, are described. Treatment procedures, including surgical interventions and prognosis, are also discussed.     

Exogenous hormones,reproductive history,and colon cancer (Seattle,Washington, USA)

The associations between exogenous hormones, reproductive history, and colon cancer were investigated in a case-control study among women aged 30–62 years. The study was conducted in the Seattle, Washington (USA) metropolitan area between 1985 and 1989 and included 193 incident cases of colon cancer and 194 controls. There was little overall association between colon cancer and oral contraceptive use, parity, age at first birth, hysterectomy or oophorectomy status, or age at menopause. Use of noncontraceptive hormones at or after age 40, most likely hormone replacement therapy (HRT), was associated with decreased risk of colon cancer (adjusted odds ratio [OR]=0.60, 95 percent confidence interval [CI]=0.35–1.01), particularly among women with more than five years of use (OR=0.47, 95 percent CI=0.24–0.91). While results from previous studies have not been consistent, any protective effect of HRT against colon cancer would be important given the continuing debate over its potential risks and benefits.Support for this study was provided by grant CA44790. Mr Jacobs was supported by the Cancer Prevention Training Grant T32 CA09661. This study was performed at the Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, WA.     

Biochemical and molecular analyses in three patients with 3-hydroxy-3-methylglutaric aciduria

Two methods, spectrophotometry and HPLC, were compared in the analyses of 3-hydroxy-3-methylglutaryl-CoA lyase (HL) activity in three unrelated Czech patients with 3-hydroxy-3-methylglutaric (HMG) aciduria and their family members. The HL activities in cultured fibroblasts and/or isolated lymphocytes of probands were below the detection limits of the methods used. Both methods were also suitable for recognition of all heterozygotes in affected families. We searched for pathogenic mutations in the HL gene. Molecular analyses revealed that two patients are homozygous for known mutation H233R and R41Q, respectively, whereas the third patient is a compound heterozygote for the mutation H233R and a novel mutation Pro9fs(−1). This study expands the knowledge of the genotypic variability of the HMG aciduria. This revised version was published online in September 2006 with corrections to the Cover Date.