Short-Term Vegetarian Diet Reduces Oxidative Stress and Increases Antioxidant Defense in Healthy Volunteers

1106

AMERICAN GASTROENTEROLOGICAL ASSOCIATION

GASTROENTEROLOGY Vol. 129, No. 3

5 Backwash Ileitis Is Not Associated With an Increased Risk of Neoplasia in Ulcerative Colitis Henry L. Haskell, Charles Andrews, Sarathchar I. Reddy, Klea Dendrinos, Francis A. Farraye, Arthur F. Stucchi, James Becker, and Robert D. Odze Introduction: Some patients with chronic ulcerative colitis (CUC) develop inflammatory changes of the distal ileum thought to be related to backwash of colonic contents, termed “backwash ileitis” (BI). One previous study showed a high association between BI and carcinoma in CUC (GASTROENTROLOGY 2001;120:841– 847). However, in that study, strict pathologic criteria for BI were not utilized. The purpose of this study was to evaluate the risk of dysplasia and/or carcinoma in patients with CUC who have BI. Methods: Ileo-colonic resection specimens from 175 consecutive patients with CUC were evaluated for a wide variety of inflammatory changes in the distal ileum and colon, including the presence and grade of dysplasia and carcinoma. The pathologic features in the colon were compared between patients with BI versus those without BI. Follow-up information was obtained (mean, 32.8 months) to ensure the absence of features of Crohn’s disease. Results: Overall, 35 patients showed inflammatory changes of the distal ileum (M/F ratio, 16/19; mean age, 42 years). Ileal changes included villous atrophy and crypt regeneration without increased inflammation (n ⫽ 3), increased neutrophilic and mononuclear inflammation in the lamina propria (n ⫽ 6), patchy cryptitis, and crypt abscesses (n ⫽ 22), and focal superficial surface erosions (n ⫽ 4), some with pyloric metaplasia (n ⫽ 2/4). Except for a higher prevalence rate of pancolitis in patients with BI (94% pancolitis vs. 45% pancolitis, P ⬍ .001), there were no significant differences in the pathologic features in the colon between patients with or without BI. In general, the severity of ileal inflammatory changes paralleled the severity of colonic activity, except for 4 confirmed CUC patients, who had either subtotal or left-sided colitis in addition to inflammatory changes in the ileum. None of the patients with BI had dysplasia, although 2 had carcinoma (6%), in contrast to 14/140 (10%) control patients who had either low (N ⫽ 6) or high-grade dysplasia (N ⫽ 5), or carcinoma (N ⫽ 3), as their most severe neoplastic lesion. These differences were not statistically significant (P ⬎ .05). Conclusion: Ileal inflammatory changes in CUC are not uncommon (prevalence rate; 20%) and, in most cases, are consistent with a “backwash” etiology. The prevalence of dysplasia and/or carcinoma is not increased in CUC patients with BI.

6 Short-Term Vegetarian Diet Reduces Oxidative Stress and Increases Antioxidant Defense in Healthy Volunteers Henryk Witmanowski, Karl H. Herzig, Juliusz Przyslawski, Lidia Wadolowska, Jacek Piatek, and Jaroslaw M. Walkowiak Background: There is a considerable body of evidence that a vegetarian lifestyle is associated with a lower risk of diseases. Vegetarian diet has a beneficial effect on some cardiovascular risk factors and reduces coronary heart disease. It has been documented in a cross-sectional study (Szeto et al. 2004) that vegetarians have better antioxidant status and less pronounced oxidative stress than omnivores. However, there are no prospective studies in this respect. In the present study, we assessed prospectively the influence of 2 different vegetarian diets consumed by healthy volunteers on oxidative stress and antioxidant status. Materials and Methods: Twenty-one healthy omnivores (15 females and 6 males) aged 21 to 35 years were included in the study. Volunteers consumed lacto-ovovegetarian (n ⫽ 9) or vegan (n ⫽ 12) diet for 1 month. In all subjects serum malonylodialdehyde (MDA) concentrations and total antioxidant serum capacity (total antioxidant status [TAS]) were assessed before and after 1-month period of the diet. Results: All values are expressed as mean ⫾ SEM (Table 1). Statistically significant decrease of MDA concentrations was stated in both subgroups (lacto-ovovegetarian, P ⬍ .008 and vegan P ⬍ .05). Similarly, TAS values increased both in lacto-ovovegetarian (P ⬍ .05) and vegan (P ⬍ .003) subgroups. No correlation nor between TAS and MDA concentrations before and after nutritional intervention period neither between the changes of studied parameters within the period of the study was stated. Conclusions: Both lacto-ovovegetarian and vegan short-term diets decreased oxidative stress and improved antioxidant defense in healthy volunteers. 7 Contrast Enhanced Endoscopic Ultrasound With Low Mechanical Index, a New Technique-Preliminary Report Andre Ignee, Holger Frey, Gundrun Schuessler and Christoph F. Dietrich Introduction: Recent advances in technology have supported the development of new endoscopic systems making it possible to apply contrast enhanced low MI techniques with wide band harmonic imaging by endoscopic ultrasound at a preliminary stage. We report on the first use of real-time, contrastenhanced, endoscopic ultrasound with low mechanical index technique in 6 patients. Methods: Endoscopic ultrasound was performed using an electronic echoendoscope HITACHI/Pentax EG-3830UT and adapted dynamic Contrast Harmonic Wideband Pulsed Inversion Software with low mechanical index (MI, 0.09 – 0.25) before and from up to 180 seconds after injection of BR1 4.8 mL. Results: Adequate visualization of the arterial and portal venous phase was sufficient in all patients. The pancreas and liver were studied thereafter. In contrast to the mentioned vessels enhancement of the liver was sufficient only in 4 patients. In the remaining 2 patients

Table 1. MDA Concentrations and TAS Values in Both Groups MDA (␮M/L)

TAS (mmol/L)

Group

Before

After

Before

After

Lacto-ovovegetarians Vegans

9.28 ⫾ 0.48 6.08 ⫾ 0.62

4.05 ⫾ 0.13 3.97 ⫾ 0.19

0.786 ⫾ 0.019 0.755 ⫾ 0.034

1.017 ⫾ 0.069 1.086 ⫾ 0.057