Effects of Ursodeoxycholate and Other Bile Salts on Levels of Rat Intestinal Alkaline Sphingomyelinase (A Potential Implication in Tumorigenesis)

Previous studies showed that bile salts had apromoting effect on colon cancer development and thiseffect was inhibited by ursodeoxycholate (UDC). Werecently found that both human colorectal adenomas and carcinomas were associated with a specificdecrease in alkaline sphingomyelinase activity. In thiswork, we compared the effects of ursodeoxycholate andother bile salts on the levels of rat intestinal alkaline sphingomyelinase both in theintestinal loops and after oral administration. Bilesalts at different concentrations were injected intointestinal loops and the dissociation of alkalinesphingomyelinase from the mucosa was assayed. We found that bilesalts, including taurocholate, taurodeoxycholate,glycocholate, glycochenodeoxycholate, and3-(3-cholamidopropyl dimethylammonio)-1-propanesulonate(CHAPS), dose dependently dissociated alkalinesphingomyelinase from the intestinal mucosa. UDC alonedid not dissociate the enzyme but significantlyinhibited the dissociation caused by other bile saltsand CHAPS. Feeding rats with 0.3% (w/w) taurocholate forfour days decreased peak activity of intestinal alkalinesphingomyelinase by 39% and total activity in theintestine by 20% and increased the output of the enzyme in the feces. In contrast, feeding 0.3%(w/w) UDC for four days increased the peak activity ofalkaline sphingomyelinase in the small intestine by 87%and the activity in the colon by 187% . The total activity of alkaline sphingomyelinase wasincreased by 80% and the output of the enzyme in thefeceswas only slightly increased by UDC administration.The changes in alkaline phosphatase after feeding taurocholate and UDC were much smaller. Ourresults indicate that UDC and other bile salts havedifferent effects on the levels of alkalinesphingomyelinase, which may be implicated in theirdifferent influences on cancer development reportedpreviously.     

Hand-Assisted Laparoscopic Revision of Previous Restrictive Operations to Vertical Banded Gastroplasty

Background: Revision of failed gastric restrictive procedures to proximal Roux-en-Y gastric bypass (RYGBP) is the standard for many bariatric surgeons. Where the patient is not a suitable candidate or simply refuses gastric bypass, an alternative is herewith proposed. Methods: 3 patients had undergone a gastric banding as the original operation and 1 patient had had a vertical banded gastroplasty (VBG). 1 patient presented with insufficient weight loss, 1 with regain of weight and 2 with complaints of food intolerance and vomiting. The gastric bands were removed by hand-assisted laparoscopy (HALS), with conversion to a VBG. In the patient with stomal stenosis after a VBG, HALS interposition of PTFE was performed to enlarge the collar. Results: In 2 patients, further weight reduction was achieved. In the other 2 patients, relief of symptoms was achieved.There were no complications during or after the revisional surgery. Conclusion: HALS conversion of a gastric banding to a VBG, or PTFE interposition in the case of stomal stenosis after a VBG, can be a valuable alternative for patients unsuitable for or refusing proximal RYGBP.     

Eliminating the Need for Dietary Restrictions When Using a Sensitive Guaiac Fecal Occult Blood Test

When using the peroxidase-sensitive guaiac fecaloccult blood test, Hemoccult Sensa (HOS), dietaryrestrictions are recommended so as to reduce its falsepositivity from ingested peroxidases. As dietary restrictions could reduce compliance for annualretesting, we reexamined their need. HOS was given to944 persons in an endoscopic screening/follow-upprogram. Only the first 403 received instructionsregarding a low peroxidase-containing diet for three daysbefore and during HOS collection. Development wasdelayed 3-14 days after HOS preparation, and there wereno significant differences in duration before HOS development in examinees with or withoutcolorectal neoplasia and having or not having a positivetest. Of the 901 persons without endoscopic evidence ofneoplasia, 377 had received and 524 had not received instructions on dietary restrictions. Their HOSpositivity was 7.2% and 5.5%, respectively (P = 0.26).When using HOS, delaying development by 3-14 days allowsbreakdown of ingested peroxidases, so dietary restrictions are not needed in our population,which has a low red meat intake.     

术后早期灌服小承气合剂对大鼠结肠吻合术后吻合口愈合的影响

【目的】观察大鼠结肠吻合术后早期灌服小承气合剂对吻合口愈合的影响。【方法】选用Wistar大鼠60只,随机分为中药组与模型组,2组均行结肠切除吻合术造模。中药组术后早期灌服小承气合剂（剂量为15g·kg^-1·d^-1）,模型组同期灌服净化自来水。分别于术后第3、7、14天每组取10只动物进行剖腹探查,观察吻合口评分并进行吻合口急性压力负载试验及组织学观察评分。【结果】中药组吻合口评分显著低于模型组（P〈0．05）,且术后第3、7天检测压力升高至40mmHg时均未见吻合口破裂情况出现。术后第14天检测2组吻合口破裂压力（ABS）,中药组显著高于模型组（P〈0．05）。组织学观察发现中药组吻合口组织愈合时间较模型组提早,愈合强度较模型组增强。【结论】结肠吻合术后早期灌服小承气合剂可以加快吻合口愈合,加强吻合口愈合强度,对吻合口有一定的保护作用。     

New Model of Colon Interposition Following Distal Gastrectomy in Rats

An interposed colon segment has been clinicallyused as a gastric substitute following anesophagogastric resection for benign or malignantesophageal and gastric cardia disease. The purpose ofthis study is to establish a rat model of colonicinterposition following distal gastrectomy and toinvestigate its serial mucosal changes. About 80% of theglandular stomach was resected, and a 3-cm segment ofthe transverse colon interposed isoperistalticallybetween the remnant stomach and duodenum. Epithelialproliferation and aberrant crypt foci in the interposedcolon segment were investigated serially. Crypt lengths in the interposed colon increasedsignificantly (P < 0.05) compared to the remnantcolon. The number of goblet cells per crypt per 1 mm inthe interposed colon also decreased significantly (P< 0.05) compared to the remnant colon. A PCNA labelingindex (LI) of the remnant colon was almost 30%. A PCNALI in the interposed colon at 4, 8, and 12 months aftersurgery was 30.8%, 31.8%, and 47.8%, respectively. The PCNA LI in the interposed colon increasedsignificantly (P < 0.05) 12 months after surgerycompared to the remnant colon at 4, 8, and 12 monthsafter surgery. Aberrant crypt foci were not detected in the interposed colon segment. In conclusion, weestablished a rat model of colonic interpositionfollowing distal gastrectomy. The interposed colonmucosa adapted well. Long-term mucosal changes of the interposed colon segment should now bestudied.     

Abnormal Vagal Cholinergic Function and Psychological Behaviors in Irritable Bowel Syndrome Patients A Hospital-Based Oriental Study

Irritable bowel syndrome (IBS) patients inWestern countries usually manifest autonomic nervedysfunctions and abnormal psychological behaviors. Thepurpose of this study was to assess whether Oriental IBS patients with predominant bowel symptomsalso exhibited similar abnormalities. We enrolled 40 IBSpatients from the outpatient clinic and 20 controls withnormal daily bowel habit for study. The IBS patients were further divided according totheir predominant bowel habit: 20 wereconstipation-predominant and 20 werediarrheapredominant. Sympathetic function was evaluatedby sympathetic skin response (SSR) while vagal cholinergic function wasdetermined by measuring R-R interval variation (RRIV) inelectrocardiography during rest and deep breathing.Psychological parameters were assessed by scales of the Minnesota Multiphasic Personality Inventory(MMPI) and the Hopkins Symptom Checklist (HSCL-90). IBSpatients, despite their bowel habit, showed normal SSRresponse. RRIV during deep breathing was significantly lower in constipation-predominant IBS patientsthan in controls or diarrhea-predominant IBS patients(16.5 ± 3.1% vs 20.5 ± 4.8% and 21.5± 4.6%, P < 0.001). IBS patients alsoexhibited abnormal MMPI measuring scores on depression, hysteria,paranoia, and masculinity/femininity scales. Inaddition, they also had more severe psychologicaldistress in the items of HSCL-90 measurement. Inconclusion, vagal dysfunction characterizes Orientalconstipation-predominant IBS patients seeking medicalhelp. Abnormal psychoneurotic profiles also exist inthese IBS patients, irrespective of their bowelhabits.     

Glutathione Content of Colonic Mucosa (Evidence for Oxidative Damage in Active Ulcerative Colitis)

Oxidative stress appears to play a role in thetissue damage of active ulcerative colitis, and it hasbeen suggested that a defect in mucosal antioxidantdefenses is a etiological factor in the disease. This study was undertaken to investigate themucosal content and oxidation state of glutathione inulcerative colitis in the active and inactive states andto examine the relationship between glutathione content and disease activity in this patientpopulation. Endoscopic biopsies of colon mucosa werecollected from normal subjects, from macroscopicallynormal tissue of patients with inactive and active ulcerative colitis, and from inflamed tissue ofpatients with active ulcerative colitis. The mucosalcontents of GSH and GSSG were determined by liquidchromatography. We found no significant differences in tissue contents of reduced glutathione amongthe four groups. The median tissue level of oxidizedglutathione in inflamed mucosa from patients with activeulcerative colitis was increased 1.7-fold (P = 0.017)over that of patients with inactive disease. Theoxidized glutathione content of the mucosa also showedsignificant positive correlations with clinical andhistological indices of disease severity among ulcerative colitis patients. Inconclusion, a change in the redox status of mucosalglutathione is associated with inflammation and diseaseactivity in ulcerative colitis. This change appears tobe a consequence of inflammation rather than apathogenic factor for the disease.     

重组人生长激素对人结肠癌移植瘤裸鼠CEA,cAMP及cGMP的影响

目的　建立人结肠癌细胞株COLO 3 2 0裸鼠移植瘤模型 ,探讨重组人生长激素 (γ hGH )对血清癌胚抗原 (CEA)、移植瘤中CEA、环磷酸腺苷 (cAMP)及环磷酸鸟苷 (cGMP)的影响。方法　经 4次传代 ,将生长稳定的 2 0只荷瘤裸鼠随机分为 4组 :( 1)对照组 ;( 2 )γ hGH组 ;( 3 )羟基喜树碱 (CPT )组 ;( 4 )γ hGH +CPT组 (联合组 )。接种次日开始给药 ,连续用药 3 5d后处死裸鼠 ,留取裸鼠血及移植瘤标本 ,测定血清及瘤组织中CEA ,瘤组织中cAMP及cGMP的含量。结果　γ hGH组移植瘤与对照组移植瘤比较 ,所有指标的差异均无统计学意义 (P >0 .0 5 ) ;γ hGH组与CPT组及联合组比较 ,所有指标的差异均有统计学意义 (P <0 .0 0 1) ;而GPT组与联合组间无显著性差异 (P >0 .0 5 )。结论　γ hGH对人结肠癌细胞株COLO 3 2 0移植瘤模型的CEA ,cAMP ,cGMP无影响。