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Anastomosis in rabbit ileum (IL) and colon (CO) affects smooth muscle contractility and mitochondrial respiratory activity
Small Bowel
101 Endoscopicappearanceofjejooel mucosein celiac disease:role of sobmucosalfibrosis SStaibaoo,E.Mezza,L.Iosabato, F.Lebanca,R.Romano,R.Cavallem, L.&sic, G.De Rosa, G.Mazzacca And C.Ciecci PathologyUnit and GastmmtestinalUnit Federico II University ofNapoli relatore C.Ciacci FedericoII Napoli Background: eodoscopicapp-ce of small intestineof untreatedceliec patientsceo very from normal to variableloss of duodenalfolds, s&lopping of folds, micnmodulcs or mosaic pattem of the mocose.No dataare available aboutclinical and histologicalcorrelates of duodenalappearance in untreated end treatedceliac patients. Aim of the study was to retrospectively evaluate eodoscopicmarkers of celiec disease,histology andclinical presentationin celiec diseasepatientsin unfreetedandhpetedconditions.Metbods:date from clinical records (symptoms, labontorv.recorded videoeodosMmv.histolow) andendoscoovmarkers of celiec disease(loss of folds, s&lioppiog, gram&u or mozc ouoo~&em) of 15’&eated celiac peheots beiom and after I year of alutcn-tixe diet were collected in a comooterizeddatabase(SPSS 10.0).Momholonic and &rphom&c evaluationofjejonel biopsiesW&Edoneby acompote&ed image &y& system. Presenceof submocosalfibrosis was evaluatedby measuringcollagenstainedwith Sirius red F3B (Gorr-BDH ChemicalsLtd. Poole. U.K). The imeee muccssine &xitbms used aotom&ally catacted fibmsis uaidg tbresholdig andmoGh;logic filt&io~. Fibmtic areas were aotometicellvauantified in absolute(:2) and relative (%I values (Leica Ouantimet500 IW hmge An&&, Leica, Cambridge,‘U.K eom&ing a 200 k &miom &). A p&sting databasefor normal controls W&Eused for compmisonsP.esolts:endoscopicmarkers of celiec dxesse do not comlate with oreseoceendaeveritv of snnotoms. In two cases endoswoic markers of diseasewere presentin &mptomatic petieots&ith fo&ete recovny of intestioel‘mocosa Fibrosis areasdisclosed two clusters ofceliac oetieots(low and hi&) and WBSsreseot in 23 % of untreatedand 10% of treatedpatients.Sobmo~oselfibisis is bon&&e relatedto loss of duodenal folds. Conclusions: thereis no conelation with presenceof coy ccl&c diseeeemarker and presence and severity of symptoms.Celiecdiseaseendoscopicmarkers may not diseppeu with recovery of intestinalmocosafollowing gloteo withdrawal. Tbe role of fibmsis in determiningmacroscopic qpennce of duodenallesionsneedsto be clarified. The image analysis-basedevaluation constitutesa reproducible,objective and reliable method,which could conhlbute to the cunent nebulousdeftition afmucasel fibrosis
103 ANASTOMOSIS IN RABBIT ILEUM (IL) AND COLON (CO) AFFECTS SMOOTH MUSCLE CONTRACTILITY AND MlTOCHONDRIAL RESPIRATORY ACTIVITY. P Portincasal, M Testini2, S Scacco3, G Picciooi2, F Mineral, G LissidiniZ, F Papa3,L Loiotild, GM Bonomd, G Pelascianol. ISectionof Iotemal Medicine,Dept of Internaland Public Medicine; 2 Sectionof GeneralSurgery, Vascular Surgery and Clinical Oocology, Dept of Applications in Surgery of Innovative T&nolo&: 3Sectiooof Medical Biochemistv. Deot of Biology and Biochemisev, University Medical School,Policlimco, Ban, ITALY. -. Universiti di Bai Policlimco Background: Tix leakageof largebowel anastomosisremainsthe most senoos postoperetwe complicationin gestro&=stioel surgery. We have previously shorn that surgically-induced hypona resultedin aderangementofbiochemical ma&xx which wzv more evidentin CO than IL. Aim: To study if smoothmuscle cootmctility of IL & CO in vitro is influencedby surgical pnxedores andto which cxteot readrotor, activities in smoath musclemito&aulria are involved. Methods: 60 male New Zealandrabbits w&e operated;segmentsofIL and CO were resectedfrom eachanimal andan end-to-endanestomosiscoostrocted. A representativesubsetof segmentsfrom IL (n=l4) andCO (n=14) at time 0 wss usedas control. Anastomosiscontabdngsegmentswere resected postoperativelyet day 2.7, and 14.At eachtime point, 20 segmentsadjacentto the enestomosisof both IL &CO were used for teosiometric(socmtaoeous& acethylcholine,A&induced remonse) andbiacbemicel@orified smoothmoscle ;ditochondria,pymv& + melate es substrates) &dies. Results:At baseline,spooteoeousPhasicactivity W&Esseoin 71% and 14%of IL and CO tissues, respectively w.0063); thesensitivity of the choline@ receptor (i.e. molar concentmtion producing 50% of the maximal effect to Ach, EC50) wes I .3&0.45 oM and I .X0.33 oM m IL and CO, rescativeb (P-N?.). Postooerntively,soootaoeouscontractility wes obsmred in 20% oflL tissuesAd eb&ot in all CO &es. IL.&h &uitivity ticreesed si&icaotly on day 2 andslightly decreasedthereafter.In the CO the sensitivity decreasedprogressively starting at day 7 and deoremeduntil dev 14.The resoiratorv ceoecitv ofmithocoodria &nn the rsected CO decreased booml83+8 to 3&S mnol o,enlmi&, pmi (day 0 andday 2, resp.P
102 MUST ULCERATIVE IEJUNITIS BE ALWAYS CONSIDBRBD A CRYPTIC LYMPHOMA ? Camli A, Biasin MR., Gmppo M, Vnua E*, Loperfdo S, Monica F, Okolicsanyi L. Sewizio di Gestmentemlogia, OspedaIeRegionaledi Ttiso; *Aoatomia Patologicae Laboratorio di Biologia Molecolare,Ospedeledi Mootebellooa( TV), It&a Osp Treviso Background andaim. Ulcemtive Jejooitis ( UJ ) is arare, O&II fataldisorder, that producesmultiple non-maliemmtsmellbowel oloemtioos.Recentevidences,mainly basedon immonobistocbemicel andmole&x studies,suggestthet almost all oasesofUJ are cry&. BntempethyAssociated T-cell Lvmohomes (EATL) (I). Moreover, at present,only few casesofUJ havebeen studiedwith these &&ds. We have rec&ly observed e &gically proved fatal ~88~of WI and performed eo immonohistochemiceland molecular analysisof the pathologicsamplesavailablein order to investigatethepnsmce of e clyptic EATL. Methods. Fixed duodenojejonelbiopsy sampleson pentEn sections were enelyxd to find out the phenotypeeodmolecular ebnormalitiesof intmepitbelialT-cell population The materielwes immoootioed with CD3 endCD8 monoclonal antibodiesusing an immeo~xidesz tecbniqoe.After DNA extitioo fmm paraffin blocks, amplification of tbe TCR-gammachain genewa carried out in five scparetePCR reactions.Both techniqueswere alsoperformed on biospy samplesobtained fmm oncamplicetedcoeliac disease, which served es control. Results. By zoeaoaofimmonosteining with antibodiesto CD3 end CDB, more thao 70% of IEL expressedboth CD3 andCD8 and were considerednormal. Sbnilsrly no clonel reammgemeotwee found on molecularstudy. Cooclusions.Iotbis study we did wt find an ebermntpheootypeanda clooelity of the intraepitbelielT-cell population, espreviously described It seemstherefore that fatalcases of UJ may present witboot any sign of act& evolutionto lymphoma. (1) Cellier C et al , Lancet 2000;356:203-08.
lNTESTINAI. ABSORPTION IN PATIENTS WITH SHORT BOWEL SYNDROME (SBS) P.Messe.renti,l M.Zaoardi, *A.De Fmocesco, *GM&i, l D.Boggio, D.PeoIetto,R.Pagni, l A.Pabno Clinical Chemistry Laboratory, Nutritional Unit and*DPT of Dietetics end Clinical Nutrition. S.Giovami Battiste Hospital, Turin S.Giovami Bettiste Aim of the study was to evaluatethe mtestinelabsorptionand the sodrom (Ne) and potassium(K) excretion in patients @ts) with SBS, according to the residual lenght of short bowel andcolon (Data as mean +/- SD; t-test for statistics). Fitly four pts (MZ4/3OF), age: 54,6+/-28 yn were nuolled. Surgery wes performed >3 months before the study. Pts were classified according to the residual lenght of the short bowel (SBL) endofthe colon as shown in the table: SBL 50.IM) cm Pts (n) SBL<50cm Pts(n)Colon 100% Gl 5 G4 8 Colon < 100% G6 I Dietary intakeswere: protein G2 13 G5 22 Colon 0% G3 5 81+/-25 gid; fat 66+/-18 gid; carbohydrate (CHO): ZlO+/-84 gid; kcel/& 1719+/-636 (no significant differencesamong thegroups). Nitrogeo i.N), fat and kcal were measuredon 24-h samplesof 3-d stools; CHO were calculated.Percentof dietary nutrients absorption wes calculated es difference betweenintakes end the averageof the 3-d stool collectioos. The paceot of absorption, in the different groups, wes: N: 71+/-23 (Gl), 57+/-I8 (GZ), Zl+/-I6 (G3). 4O+/-16 (G4), 5l+/-22 (G5), 26 (G6); fat: 69+/-20 (Gl), 64+/-23 (GZ), 29+/-25 (G3), 47+/-I8 (G4), 53+/-I9 (G5), I8 (G6); CHO: 96+/-l (Gl), 84+/-I4 (G2), 38+/-0.4 (G3), 57+/-4l(G4), 63+/-30 (GS); kcal: 88+/-2 (Gl), 75+/-l I CGZI.28+1-3(G3). 35+//-28(G4). 54+/-19 (G5). Studeot’st test shows a sititicant difference @< 0.001) betweenGl YSG3, G2 vs G3‘for’% N, % fas % CHO, % kc&while no simifioant differences were found belweeo Gl YSG2, G4 vs G5 for the came pemmetn~.Na e&etions were(mBq/d): 55+/-33 (Gl), 50+//-46(GZ), 87+/-48 (G3), 55+/-49 (G4). 51+/-41 (GS), 202 (G6); K excretions were: 25+,-g (Gl); 30+/-26 (G2); 2l+,-IO (Q); 54+/-35 (G4); 33+/-25 (G5); 36 (G5) (no sigoificent differences) The presenceof the colon, but not its lenght,significantly improves the intestinalabsorption in pts with a SBL of 50-150 cm. Absorption is significantly reducedin pts with e SBL 60 cm; however the Ieogthof tbe colon in thesepts doesnot iotlueoce theabsorption. Na excretion wes higher but not significantly differeot in the groups without colon (G3 and G6), while K excretion was not different among the groups.
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101 Endoscopicappearanceofjejooel mucosein celiac disease:role of sobmucosalfibrosis SStaibaoo,E.Mezza,L.Iosabato, F.Lebanca,R.Romano,R.Cavallem, L.&sic, G.De Rosa, G.Mazzacca And C.Ciecci PathologyUnit and GastmmtestinalUnit Federico II University ofNapoli relatore C.Ciacci FedericoII Napoli Background: eodoscopicapp-ce of small intestineof untreatedceliec patientsceo very from normal to variableloss of duodenalfolds, s&lopping of folds, micnmodulcs or mosaic pattem of the mocose.No dataare available aboutclinical and histologicalcorrelates of duodenalappearance in untreated end treatedceliac patients. Aim of the study was to retrospectively evaluate eodoscopicmarkers of celiec disease,histology andclinical presentationin celiec diseasepatientsin unfreetedandhpetedconditions.Metbods:date from clinical records (symptoms, labontorv.recorded videoeodosMmv.histolow) andendoscoovmarkers of celiec disease(loss of folds, s&lioppiog, gram&u or mozc ouoo~&em) of 15’&eated celiac peheots beiom and after I year of alutcn-tixe diet were collected in a comooterizeddatabase(SPSS 10.0).Momholonic and &rphom&c evaluationofjejonel biopsiesW&Edoneby acompote&ed image &y& system. Presenceof submocosalfibrosis was evaluatedby measuringcollagenstainedwith Sirius red F3B (Gorr-BDH ChemicalsLtd. Poole. U.K). The imeee muccssine &xitbms used aotom&ally catacted fibmsis uaidg tbresholdig andmoGh;logic filt&io~. Fibmtic areas were aotometicellvauantified in absolute(:2) and relative (%I values (Leica Ouantimet500 IW hmge An&&, Leica, Cambridge,‘U.K eom&ing a 200 k &miom &). A p&sting databasefor normal controls W&Eused for compmisonsP.esolts:endoscopicmarkers of celiec dxesse do not comlate with oreseoceendaeveritv of snnotoms. In two cases endoswoic markers of diseasewere presentin &mptomatic petieots&ith fo&ete recovny of intestioel‘mocosa Fibrosis areasdisclosed two clusters ofceliac oetieots(low and hi&) and WBSsreseot in 23 % of untreatedand 10% of treatedpatients.Sobmo~oselfibisis is bon&&e relatedto loss of duodenal folds. Conclusions: thereis no conelation with presenceof coy ccl&c diseeeemarker and presence and severity of symptoms.Celiecdiseaseendoscopicmarkers may not diseppeu with recovery of intestinalmocosafollowing gloteo withdrawal. Tbe role of fibmsis in determiningmacroscopic qpennce of duodenallesionsneedsto be clarified. The image analysis-basedevaluation constitutesa reproducible,objective and reliable method,which could conhlbute to the cunent nebulousdeftition afmucasel fibrosis
103 ANASTOMOSIS IN RABBIT ILEUM (IL) AND COLON (CO) AFFECTS SMOOTH MUSCLE CONTRACTILITY AND MlTOCHONDRIAL RESPIRATORY ACTIVITY. P Portincasal, M Testini2, S Scacco3, G Picciooi2, F Mineral, G LissidiniZ, F Papa3,L Loiotild, GM Bonomd, G Pelascianol. ISectionof Iotemal Medicine,Dept of Internaland Public Medicine; 2 Sectionof GeneralSurgery, Vascular Surgery and Clinical Oocology, Dept of Applications in Surgery of Innovative T&nolo&: 3Sectiooof Medical Biochemistv. Deot of Biology and Biochemisev, University Medical School,Policlimco, Ban, ITALY. -. Universiti di Bai Policlimco Background: Tix leakageof largebowel anastomosisremainsthe most senoos postoperetwe complicationin gestro&=stioel surgery. We have previously shorn that surgically-induced hypona resultedin aderangementofbiochemical ma&xx which wzv more evidentin CO than IL. Aim: To study if smoothmuscle cootmctility of IL & CO in vitro is influencedby surgical pnxedores andto which cxteot readrotor, activities in smoath musclemito&aulria are involved. Methods: 60 male New Zealandrabbits w&e operated;segmentsofIL and CO were resectedfrom eachanimal andan end-to-endanestomosiscoostrocted. A representativesubsetof segmentsfrom IL (n=l4) andCO (n=14) at time 0 wss usedas control. Anastomosiscontabdngsegmentswere resected postoperativelyet day 2.7, and 14.At eachtime point, 20 segmentsadjacentto the enestomosisof both IL &CO were used for teosiometric(socmtaoeous& acethylcholine,A&induced remonse) andbiacbemicel@orified smoothmoscle ;ditochondria,pymv& + melate es substrates) &dies. Results:At baseline,spooteoeousPhasicactivity W&Esseoin 71% and 14%of IL and CO tissues, respectively w.0063); thesensitivity of the choline@ receptor (i.e. molar concentmtion producing 50% of the maximal effect to Ach, EC50) wes I .3&0.45 oM and I .X0.33 oM m IL and CO, rescativeb (P-N?.). Postooerntively,soootaoeouscontractility wes obsmred in 20% oflL tissuesAd eb&ot in all CO &es. IL.&h &uitivity ticreesed si&icaotly on day 2 andslightly decreasedthereafter.In the CO the sensitivity decreasedprogressively starting at day 7 and deoremeduntil dev 14.The resoiratorv ceoecitv ofmithocoodria &nn the rsected CO decreased booml83+8 to 3&S mnol o,enlmi&, pmi (day 0 andday 2, resp.P
102 MUST ULCERATIVE IEJUNITIS BE ALWAYS CONSIDBRBD A CRYPTIC LYMPHOMA ? Camli A, Biasin MR., Gmppo M, Vnua E*, Loperfdo S, Monica F, Okolicsanyi L. Sewizio di Gestmentemlogia, OspedaIeRegionaledi Ttiso; *Aoatomia Patologicae Laboratorio di Biologia Molecolare,Ospedeledi Mootebellooa( TV), It&a Osp Treviso Background andaim. Ulcemtive Jejooitis ( UJ ) is arare, O&II fataldisorder, that producesmultiple non-maliemmtsmellbowel oloemtioos.Recentevidences,mainly basedon immonobistocbemicel andmole&x studies,suggestthet almost all oasesofUJ are cry&. BntempethyAssociated T-cell Lvmohomes (EATL) (I). Moreover, at present,only few casesofUJ havebeen studiedwith these &&ds. We have rec&ly observed e &gically proved fatal ~88~of WI and performed eo immonohistochemiceland molecular analysisof the pathologicsamplesavailablein order to investigatethepnsmce of e clyptic EATL. Methods. Fixed duodenojejonelbiopsy sampleson pentEn sections were enelyxd to find out the phenotypeeodmolecular ebnormalitiesof intmepitbelialT-cell population The materielwes immoootioed with CD3 endCD8 monoclonal antibodiesusing an immeo~xidesz tecbniqoe.After DNA extitioo fmm paraffin blocks, amplification of tbe TCR-gammachain genewa carried out in five scparetePCR reactions.Both techniqueswere alsoperformed on biospy samplesobtained fmm oncamplicetedcoeliac disease, which served es control. Results. By zoeaoaofimmonosteining with antibodiesto CD3 end CDB, more thao 70% of IEL expressedboth CD3 andCD8 and were considerednormal. Sbnilsrly no clonel reammgemeotwee found on molecularstudy. Cooclusions.Iotbis study we did wt find an ebermntpheootypeanda clooelity of the intraepitbelielT-cell population, espreviously described It seemstherefore that fatalcases of UJ may present witboot any sign of act& evolutionto lymphoma. (1) Cellier C et al , Lancet 2000;356:203-08.
lNTESTINAI. ABSORPTION IN PATIENTS WITH SHORT BOWEL SYNDROME (SBS) P.Messe.renti,l M.Zaoardi, *A.De Fmocesco, *GM&i, l D.Boggio, D.PeoIetto,R.Pagni, l A.Pabno Clinical Chemistry Laboratory, Nutritional Unit and*DPT of Dietetics end Clinical Nutrition. S.Giovami Battiste Hospital, Turin S.Giovami Bettiste Aim of the study was to evaluatethe mtestinelabsorptionand the sodrom (Ne) and potassium(K) excretion in patients @ts) with SBS, according to the residual lenght of short bowel andcolon (Data as mean +/- SD; t-test for statistics). Fitly four pts (MZ4/3OF), age: 54,6+/-28 yn were nuolled. Surgery wes performed >3 months before the study. Pts were classified according to the residual lenght of the short bowel (SBL) endofthe colon as shown in the table: SBL 50.IM) cm Pts (n) SBL<50cm Pts(n)Colon 100% Gl 5 G4 8 Colon < 100% G6 I Dietary intakeswere: protein G2 13 G5 22 Colon 0% G3 5 81+/-25 gid; fat 66+/-18 gid; carbohydrate (CHO): ZlO+/-84 gid; kcel/& 1719+/-636 (no significant differencesamong thegroups). Nitrogeo i.N), fat and kcal were measuredon 24-h samplesof 3-d stools; CHO were calculated.Percentof dietary nutrients absorption wes calculated es difference betweenintakes end the averageof the 3-d stool collectioos. The paceot of absorption, in the different groups, wes: N: 71+/-23 (Gl), 57+/-I8 (GZ), Zl+/-I6 (G3). 4O+/-16 (G4), 5l+/-22 (G5), 26 (G6); fat: 69+/-20 (Gl), 64+/-23 (GZ), 29+/-25 (G3), 47+/-I8 (G4), 53+/-I9 (G5), I8 (G6); CHO: 96+/-l (Gl), 84+/-I4 (G2), 38+/-0.4 (G3), 57+/-4l(G4), 63+/-30 (GS); kcal: 88+/-2 (Gl), 75+/-l I CGZI.28+1-3(G3). 35+//-28(G4). 54+/-19 (G5). Studeot’st test shows a sititicant difference @< 0.001) betweenGl YSG3, G2 vs G3‘for’% N, % fas % CHO, % kc&while no simifioant differences were found belweeo Gl YSG2, G4 vs G5 for the came pemmetn~.Na e&etions were(mBq/d): 55+/-33 (Gl), 50+//-46(GZ), 87+/-48 (G3), 55+/-49 (G4). 51+/-41 (GS), 202 (G6); K excretions were: 25+,-g (Gl); 30+/-26 (G2); 2l+,-IO (Q); 54+/-35 (G4); 33+/-25 (G5); 36 (G5) (no sigoificent differences) The presenceof the colon, but not its lenght,significantly improves the intestinalabsorption in pts with a SBL of 50-150 cm. Absorption is significantly reducedin pts with e SBL 60 cm; however the Ieogthof tbe colon in thesepts doesnot iotlueoce theabsorption. Na excretion wes higher but not significantly differeot in the groups without colon (G3 and G6), while K excretion was not different among the groups.
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