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- Iwarzon, Marie, et al.
(författare)
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Functional status, health-related quality of life and symptom severity in patients with chronic intestinal pseudo-obstruction and enteric dysmotility
- 2009
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 44:6, s. 700-707
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To investigate whether patients with chronic intestinal pseudo-obstruction (CIP) differ from those with enteric dysmotility (ED) regarding self-reported measures of functional status, health-related quality of life (HRQoL) and gastrointestinal symptoms. Material and methods. The study comprised 28 patients with CIP (median age 48, range 28-80 years) and 26 with ED (median age 50, range 20-75 years). Three self-administered questionnaires were used: the Sickness Impact Profile (SIP), the Swedish HRQoL Questionnaire (SWED-QUAL) and the Gastrointestinal Symptom Rating Scale (GSRS). Results. Patients with CIP reported significantly greater functional impairment in the aggregated physical dimension of SIP (15.4 SD 19.7) than did patients with ED (5.0 SD 7.2, p0.01). They also reported significantly poorer general health (SWED-QUAL) (28.0 SD 20.8) compared to those with ED (44.8 SD 25.2, p 0.01). Symptom severity correlated with several measures of HRQoL and functional status in patients with CIP but abdominal pain severity was the only independent predictor of HRQoL. Abdominal pain alone explained between 21% and 67% of the variance in SWED-QUAL subscales. Likewise, the severity of indigestion symptoms among patients with CIP explained 20-24% of the variance in the SIP subscales, emotional behaviour and work. Much less correlation between symptom severity and functional impairment or HRQoL was found in patients with ED. We found no difference in symptom severity (GSRS) between the two groups. Conclusions. Patients with CIP reported a greater impairment of functional status and HRQoL than did patients with ED. Symptom severity had a stronger influence on functional status and HRQoL in patients with CIP.
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- Karling, Pontus, et al.
(författare)
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Function and dysfunction of the colon and anorectum in adults: working team report of the Swedish Motility Group (SMoG).
- 2009
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Ingår i: Scandinavian journal of gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 44:6, s. 646-60
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Forskningsöversikt (refereegranskat)abstract
- Symptoms of fecal incontinence and constipation are common in the general population. These can, however, be unreliably reported and are poorly discriminatory for underlying pathophysiology. Furthermore, both symptoms may coexist. In the elderly, fecal impaction always must be excluded. For patients with constipation, colon transit studies, anorectal manometry and defecography may help to identify patients with slow-transit constipation and/or pelvic floor dysfunction. The best documented medical treatments for constipation are the macrogols, lactulose and isphagula. Evolving drugs include lubiprostone, which enhances colonic secretion by activating chloride channels. Surgery is restricted for a highly selected group of patients with severe slow-transit constipation and for those with large rectoceles that demonstrably cause rectal evacuatory impairment. For patients with fecal incontinence that does not resolve on antidiarrheal treatment, functional and structural evaluation with anorectal manometry and endoanal ultrasound or magnetic resonance (MR) of the anal canal may help to guide management. Sacral nerve stimulation is a rapidly evolving alternative when other treatments such as biofeedback and direct sphincter repair have failed. Advances in understanding the pathophysiology as a guide to treatment of patients with constipation and fecal incontinence is a continuing important goal for translational research. The content of this article is a summary of presentations given by the authors at the Fourth Meeting of the Swedish Motility Group, held in Gothenburg in April 2007.
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- Knowles, Charles H., et al.
(författare)
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Gastrointestinal neuromuscular pathology: guidelines for histological techniques and reporting on behalf of the Gastro 2009 International Working Group
- 2009
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Ingår i: Acta Neuropathologica. - : Springer Science and Business Media LLC. - 1432-0533 .- 0001-6322. ; 118:2, s. 271-301
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Tidskriftsartikel (refereegranskat)abstract
- The term gastrointestinal neuromuscular disease describes a clinically heterogeneous group of disorders of children and adults in which symptoms are presumed or proven to arise as a result of neuromuscular, including interstitial cell of Cajal, dysfunction. Such disorders commonly have impaired motor activity, i.e. slowed or obstructed transit with radiological evidence of transient or persistent visceral dilatation. Whilst sensorimotor abnormalities have been demonstrated by a variety of methods in these conditions, standards for histopathological reporting remain relatively neglected. Significant differences in methodologies and expertise continue to confound the reliable delineation of normality and specificity of particular pathological changes for disease. Such issues require urgent clarification to standardize acquisition and handling of tissue specimens, interpretation of findings and make informed decisions on risk-benefit of full-thickness tissue biopsy of bowel or other diagnostic procedures. Such information will also allow increased certainty of diagnosis, facilitating factual discussion between patients and caregivers, as well as giving prognostic and therapeutic information. The following report, produced by an international working group, using established consensus methodology, presents proposed guidelines on histological techniques and reporting for adult and paediatric gastrointestinal neuromuscular pathology. The report addresses the main areas of histopathological practice as confronted by the pathologist, including suction rectal biopsy and full-thickness tissue obtained with diagnostic or therapeutic intent. For each, indications, safe acquisition of tissue, histological techniques, reporting and referral recommendations are presented.
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- Lindberg, Sylvia, et al.
(författare)
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Cadmium uptake and interaction with phytochelatins in wheat protoplasts : Cadmium uptake and interaction with phytochelatins in wheat protoplasts
- 2007
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Ingår i: Plant Physiology and Biochemistry: Plant Physiology and Biochemistry. ; 45:1, s. 47-53
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Tidskriftsartikel (refereegranskat)abstract
- In order to investigate the role of phytochelatins in short-time uptake of Cd2+ into the cytosol of wheat protoplasts, a new method wasapplied, using fluorescence microscopy and the heavy metal-specific fluorescent dye, 5-nitrobenzothiazole coumarin, BTC-5N. The uptake of Cd2+ into protoplasts from 5- to 7-day-old wheat seedlings (Triticum aestivum, L. cv. Kadett) was lower in protoplasts from seedlings raised inthe presence of 1 mM CdCl2, than in the absence. Presence of CdCl2 in the cultivation medium increased the content of phytochelatins (PCs) in the protoplasts. When seedlings were raised in the presence of both Cd2+ and buthionine sulfoximine (BSO), an inhibitor of glutathione (GSH) synthesis, only little PC was found in the protoplasts. Pre-treatment with BSO alone did not affect the content of PC, but inhibited that of GSH. The inhibition of GSH was independent of pre-treatment with Cd2+. Unidirectional flux analyses, using 109Cd2+, showed approximately the same uptake pattern of Cd2+ as did the fluorescence experiments showing the cytosolic uptake of Cd2+. Thus, the diminished uptake of Cd2+ into protoplasts from cadmium-pre-treated plants was not depending on PCs. Instead, it is likely that pre-treatment with Cd2+ causes a down-regulation of the short-term Cd2+ uptake, or an up-regulation of the Cd2+ extrusion. Moreover, since addition of Cd2+ to protoplasts from control plants caused a cytosol acidification, it is likely that a Cd2+/H+-antiport mechanism is involved in the extrusion of Cd2+ from these protoplasts.
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- Schmidt, Peter Thelin, et al.
(författare)
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Methods to assess gastric motility and sensation
- 2008
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Ingår i: Scandinavian Journal of Gastroenterology. - London : Informa Healthcare. - 0036-5521 .- 1502-7708. ; 43:11, s. 1285-1295
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Tidskriftsartikel (refereegranskat)
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- Vallin, Örjan, et al.
(författare)
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Polishing of quartz by rapid etching in ammonium bifluoride
- 2007
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Ingår i: IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control. - 0885-3010 .- 1525-8955. ; 54:7, s. 1454-1462
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Tidskriftsartikel (refereegranskat)abstract
- The etch rate and surface roughness of polished and lapped AT-cut quartz subjected to hot (90, 110, and 130 degrees C), concentrated (50, 65, 80 wt %) ammonium bi-fluoride have been investigated. Having used principal component analysis to verify experimental solidity and analyze data, we claim with confidence that this parameter space does not, as elsewhere stated, allow for a polishing effect or even a preserving setting. Etch rates were found to correlate well, and possibly logarithmically, with temperature except for the hottest etching applied to lapped material. Roughness as a function of temperature and concentration behaved well for the lapped material, but lacked systematic variation in the case of the polished material. At the lowest temperature, concentration had no effect on etch rate or roughness. Future efforts are targeted at temperatures and concentrations closer to the solubility limit.
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| 10. |
- Veress, Bela, et al.
(författare)
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Intestinal lymphocytic epithelioganglionitis: a unique combination of inflammation in bowel dysmotility: a histopathological and immunohistochemical analysis of 28 cases
- 2009
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Ingår i: Histopathology. - : Wiley. - 0309-0167 .- 1365-2559. ; 54:5, s. 539-549
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Tidskriftsartikel (refereegranskat)abstract
- Intestinal lymphocytic epithelioganglionitis: a unique combination of inflammation in bowel dysmotility: a histopathological and immunohistochemical analysis of 28 cases Visceral inflammatory neuropathies are enteric disorders underlying various forms of bowel dysmotility. The aim was to analyse the microscopic characteristics of a unique combination of intraepithelial lymphocytosis and myenteric ganglioneuritis. Paraffin sections of full-thickness proximal jejunal biopsy specimens from 28 patients, with proven disorders of gastrointestinal motility, were analysed following conventional and immunohistochemical staining. Serial transversal and tangential sectioning visualized large myenteric plexus areas. Between 1993 and 2005, 28 patients with inflammatory neuropathy (25 female and three male) showed this combination of lymphocytic infiltration. Two of the patients also had coeliac disease. The mean number of intraepithelial CD3+ lymphocytes was 36 per 100 epithelial cells (range 27-68; upper normal limit 25 lymphocytes). There was myenteric ganglionitis of variable severity (mean 4.6 myenteric lymphocytes per ganglion; upper normal limit two lymphocytes) with cytotoxic T-cell predominance. Myenteric neurons showed signs of degeneration and an abnormal immunohistological pattern. Hyperplasia and hypertrophy of Cajal cells were observed. The longitudinal muscle layer was thickened in many cases. A subset of patients with gastrointestinal motility disorders exhibit the combination of intraepithelial lymphocytosis and myenteric ganglionitis in full thickness biopsy specimens of the small bowel. We suggest calling this entity 'intestinal lymphocytic epithelioganglionitis'.
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