Determinants of ileoanal pouch function
Article Abstract:
Restorative proctocolectomy is a procedure in which the rectum and colon are removed, and the remaining distal segment of the intestine (the ileum) is formed into a pouch (ileal reservoir), and joined to the anus (pouch-anal anastomosis). Increasing operative sophistication on the part of surgeons has improved the morbidity associated with this procedure, but there is still great variability in the clinical results, and the outcome is considered poor in about 10 percent of patients undergoing the procedure. Part of this variability may result from the completely subjective nature of the evaluation applied to ileoanal pouch function. Four characteristics are given varying weights (depending on the evaluator) in determining how well the pouch functions: spontaneity of defecation, ability to defer defecation, continence, and stool frequency. In most procedures performed, patients report stool frequency of four to six per 24 hours, an ability to defer defecation for at least 15 minutes, complete continence, and spontaneous defecation. A variety of anatomical differences in pouch construction have been shown to have effects on the functioning of the pouch; surgical methodology is becoming more standardized, and the degree of different patient outcomes is decreasing. In spite of this increasing homogeneity, the response of patients with morphologically and physiologically identical pouches may differ dramatically. An inability to document all the variables that may affect patient response to a pouch is likely to blame for much of this apparent variability. Given the current state of knowledge, the construction of an adequately large pouch in a patient with a fully functional anal sphincter yields the best prognosis for satisfactory outcome. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Gut
Subject: Health
ISSN: 0017-5749
Year: 1991
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Comparison of three species of fish consumed as part of a Western diet: effects on platelet fatty acids and function, hemostasis, and production of thromboxane
Article Abstract:
Studies have suggested that diets that contain certain fish and shellfish decrease the risk of cardiovascular disease (CVD). The protective effects are thought to derive from beneficial effects on blood fat levels by the fatty acids contained in fish. Diets containing these n-3 fatty acids may also diminish the occurrence of clot formation in arteries, probably by altering levels of thromboxane A2 (TXA2) and prostacyclins I3 and I2, hormones which alter the activity of platelets (blood cells important for clotting) and blood vessel constriction. Most studies of the impact of fish in the diet have studied fatty fish. The effects of moderate amounts of two fatty fish, Chinook salmon and sablefish (black cod), and Dover sole on platelet function were studied in 23 men. Each subject consumed one type of fish for 18 days and was then shifted, after a rest, to a second and then to the third type of fish. Daily intake of monounsaturated and polyunsaturated fatty acids was similar among the sole, salmon, and sablefish diets, while the salmon and sablefish diets caused approximately a twofold increase in consumption of n-3 fatty acids. Similarly, the proportion of n-3 fatty acids increased in platelets from subjects fed salmon or sablefish. Bleeding time, a measure of clotting efficiency, increased significantly in response to fish intake, particularly salmon. Sablefish and salmon consumption significantly lowered TXB2 production and altered platelet function. The study indicates that moderate consumption of salmon or sablefish can modestly benefit platelet function. Further study is needed to understand all the factors contributing to this change. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Clinical Nutrition
Subject: Health
ISSN: 0002-9165
Year: 1991
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Uncovering thymus function
Article Abstract:
The field of immunology has undergone tremendous technical and experimental advances and these encompass the specialized area of thymus functions. While the immunological function of the thymus involving T and B functions is now taken for granted, T cells have further been classified into subdivisions subject to their immunity functions. In the last two decades, research has broken new ground by exploring the molecular foundation of the relation between T cells and their ions as well as other cells. Critical issues in the clinical application of this research need to be addressed.
Publication Name: Perspectives in Biology and Medicine
Subject: Health
ISSN: 0031-5982
Year: 1996
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