Quantification of subclasses of human colonic myenteric neurons by immunoreactivity to Hu, choline acetyltransferase and nitric oxide synthase.

An accurate method to count human enteric neurons is essential to develop a comprehensive account of the classes of nerve cells responsible for gut function and dysfunction. The majority of cells in the enteric nervous system utilize acetyl choline, or nitric oxide, or a combination of these, as neurotransmitters. Antisera raised against the RNA-binding protein Hu, were used to identify nerve cell bodies in whole mounts of the myenteric plexus of human colon, and then were utilized to analyse cells immunoreactive for combinations of choline acetyltransferase and nitric oxide synthase. Antisera to Hu provided a reliable means to count apparently all enteric nerve cell bodies, revealing 10% more cell bodies than labelling with neuron specific enolase, and no labelling of glial cells as revealed by S100. ChAT+/NOS- neurons accounted for 48% (+/-3%) of myenteric neurons and ChAT-/NOS+ neurons accounted for 43% (+/-2.5%). ChAT+/NOS+ neurons comprised 4% (+/-0.5) of the total number of neurons, and a novel class of small ChAT-/NOS- neurons, making up 5% (+/-0.9%) of all cells, was described for the first time.

The relationship of obesity to the complications of diverticular disease.

OBJECTIVE: Diverticular disease is common in our community. Most patients remain asymptomatic and the development of diverticular complications is rare. A common clinical observation is that patients presenting with complications of diverticular disease are obese. The aim of this study was to examine the relationship of obesity to the complications of diverticular disease. METHODS: The study was based on a retrospective case note review conducted at the Flinders Medical Centre between 1/7/1998 and 30/6/2003. Patients were identified using ICD codes and their body mass index (BMI) calculated. Controls were taken randomly from the colonoscopy database at The Flinders Medical Centre. Patients were divided into four groups, those admitted with diverticular perforation or abscess, recurrent diverticulitis, a single episode of diverticulitis and a control group of patients with uncomplicated diverticulosis. The mean BMI for each group was calculated. Statistical analysis was performed by one way anova test with significance set at P < 0.05. RESULTS: Sixty-one patients were studied, including 16 patients with perforated diverticular disease, 11 randomly selected with recurrent diverticulitis, 16 patients with a single episode of diverticulitis and 18 controls. The control group had a significantly lower BMI than patients presenting with perforation (P = 0.001) or recurrent diverticulitis (P = 0.002). There was no significant difference between the control group and patients with a single episode of diverticulitis (P = 1.0). CONCLUSION: The study showed that patients with perforations and recurrent diverticulitis are significantly more obese than those who remain asymptomatic or have one episode. The aetiological relationship between obesity and diverticular complications remain unclear.