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- Månsson, Peter, et al.
(författare)
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Anastomotic healing in the rat colon: comparison between a radiological method, breaking strength and bursting pressure.
- 2002
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Ingår i: International Journal of Colorectal Disease. - : Springer Science and Business Media LLC. - 1432-1262 .- 0179-1958. ; 17:6, s. 420-425
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: While mechanical parameters (breaking strength, bursting pressure) are used to measure colonic anastomotic healing, reported values are inconsistent. This study developed a novel approach to study colonic anastomotic repair and compared it with mechanical methods. Methods and materials: We created standardized four- and eight-suture colonic anastomoses and performed contrast enemas in rats. Results: All eight-suture anastomoses were tight at completion. In contrast, all four-suture anastomoses leaked immediately after the operation, but the integrity increased progressively, and at 12 h all were closed. No changes in breaking strength were observed up to 3 days postoperatively, in contrast to anastomotic bursting pressure which increased progressively over the same period. Integrity and bursting pressure increased in parallel to the anastomotic content of myeloperoxidase (MPO), indicating that neutrophil infiltration is not detrimental in normal healing. Moreover, local irradiation, which enhanced MPO activity, did not increase leakage, suggesting that neutrophil accumulation per se has no effect on the integrity of colonic anastomosis. In addition, administration of 5-fluorouracil, which decreased anastomotic MPO levels, increased anastomotic leakage. Conclusion: We present a novel approach to study anastomotic healing using radiological examination. While bursting pressure appears to be suitable for measuring early anastomotic healing in the colon, we demonstrate that breaking strength is not sufficiently sensitive to be used in examination of early healing. Moreover, our data suggest that the acute inflammatory response and associated neutrophil recruitment in the anastomosis does not negatively affect healing in the rat colon.
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- Rolny, P., et al.
(författare)
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Longer term outcome of steroid refractory ulcerative colitis treated with intravenous cyclosporine without subsequent oral cyclosporine maintenance therapy
- 2002
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Ingår i: International Journal of Colorectal Disease. - : Springer Science and Business Media LLC. - 0179-1958 .- 1432-1262. ; 17:2, s. 67-69
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Intravenous cyclosporine (Cy) is increasingly used in patients with severe ulcerative colitis who fail to respond to corticosteroids. However, in spite of subsequent oral Cy maintenance therapy almost one-half of the initial responders need colectomy within a year. In light of the drug's limited efficacy and potential toxicity use of oral long-term Cy can be questioned. Patients and methods: Nineteen patients with steroid refractory severe ulcerative colitis were treated intravenously with Cy. Results: Of the 19 patients 14 (76%) achieved remission. Six of the patients (46%) remained in remission for 12-61 months. Eight patients experienced one to four flares during the year after treatment. However, except for one patient who needed another course of intravenous Cy, all responded to corticosteroids. The duration of remission since the last flare in these patients (five received azathioprin) was 10-36 months. None of the patients needed colectomy because of symptoms. Conclusion: These preliminary data suggest that a course of intravenous Cy can turn corticosteroid-refractory ulcerative colitis to corticosteroids responsive. The outcome of patients not receiving oral Cy maintenance therapy appears to be satisfactory. Azathioprin maintenance therapy can probably be reserved for select patients.
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- Yang, H, et al.
(författare)
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Bidirectional supply of glutamine maintains enterocyte ATP content in the in vitro Ussing chamber model
- 2000
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Ingår i: International Journal of Colorectal Disease. - 0179-1958 .- 1432-1262. ; 15:5-6, s. 291-296
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Tidskriftsartikel (refereegranskat)abstract
- Glutamine is the principal energy source for enterocytes, but it is not known whether parenteral or enteral supplementation is most beneficial to gut integrity. The aim of this study was to evaluate the effects of glutamine in uni- or bidirectional supply on the viability of intestinal mucosa of starved rats during incubation in Ussing chambers. Segments of jejunum from rats starved for 48 h were randomly mounted in Ussing chambers with three nutrient solutions: Krebs buffer without glutamine, 6 mM glutamine added to the mucosal side, 6 mM glutamine added to the mucosal side and 0.6 mM glutamine to the serosal side. ATP content of the mucosa, electrophysiology, and Cr-51-ethyl-enediaminetetraacetate (EDTA) permeability were studied during 180 min of incubation. The addition of glutamine to both sides of the stripped mucosa improved ATP levels compared to the Krebs solution (P<0.05), and the addition of glutamine resulted in an increase in short circuit current (P<0.05). No significant differences were seen in Cr-51-EDTA permeability or epithelial electrical resistance. Glutamine supplementation to both the luminal and serosal side in the Ussing chamber was more effective than luminal glutamine only in maintaining ATP levels of intestinal mucosa. Bidirectional supplementation of glutamine might improve intestinal energy metabolism and viability in in vitro studies.
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- Öberg, Åke, 1954-, et al.
(författare)
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Different occurrence of CD8+, CD45R0+, and CD68+ immune cells in regional lymph node metastases from colorectal cancer as potential prognostic predictors
- 2002
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Ingår i: International Journal of Colorectal Disease. - : Springer. - 0179-1958 .- 1432-1262. ; 17:1, s. 25-29
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: To study whether there are differences in the immunohistochemical staining of CD8, CD45R0, and CD68 of immune cells in regional lymph node metastases from colorectal cancer that are of potential interest in prognostic prediction.MATERIALS AND METHODS: Analysis of archival specimens from 93 patients operated on for colorectal cancer (based on monoclonal antibodies, the ABC technique, and semiquantitative classification).RESULTS: There was a significant difference in survival time between patients with respect to the number of positive immune cells. The cancer-specific 5-year survival rate was 77% for patients with high numbers of CD8+ cells, compared to 33% for those with lower numbers. The corresponding figures for patients with CD45R0+ cells were 66% vs. 33%, and for patients with CD68+ cells 60% vs. 38%. Significant differences remained among the 74 patients without adjuvant radio/chemotherapy regarding CD8 and CD45R0 but not CD68.CONCLUSION: The presence of CD8+, CD45R0+, and CD68+ immune cells in regional lymph node metastases may serve as predictors of patients survival in colorectal cancer Dukes' stage C.
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