A right colon pouch with a novel efferent channel concept: long-term results of the Turin pouch.

PURPOSE: To report stoma stenosis rates and efferent channel (EC) complications at long term follow-up for Turin pouch (TP). METHODS: This is a retrospective analysis of the prospectively maintained database of patients who underwent TP between March 2006 and May 2018. The TP is a U-shaped right colon pouch. The EC was conceived by the tubularization of 5 cm of the colon wall with the use of a stapler and sutured to the skin (EC-cutaneostomy). The ureters are sutured separately to the last 10 cm of ileum before the ileocecal valve. In literature, catheterization problems have been described on average in 20.3% of patients and stoma stenosis in 19.5% of the patients with flap valve systems. RESULTS: Thirty-eight consecutive patients underwent a TP procedure. The median age was 55 years (IQR: 52-60). Median operative time was 201 min (IQR: 170-210), median reconstructive time was 61 min (IQR: 55-65) and the blood loss was 244 ml (IQR: 150-300) and 4 patients (10.5%) needed blood transfusions. The median follow-up was 52 months (IQR: 37-92). Complete 24h continence was achieved in 34 (89%) patients. Seven (18.4%) patients reported difficulties in EC catheterization and 4 (10.5%) patients had stoma stenosis. This study is limited by the relatively small number of patients. CONCLUSION: In relation to similar systems, the TP seems to offer comparatively good functional results but EC and stoma complications were lower than other pouch variants in literature.

Non-mast cell histamine levels in rat tissues after histidine loading.

The i.p. administration of L-histidine in doses of 500 and 1000 mg/kg, caused prolonged high levels of histidine but did not influence the levels of histamine in the non-mast cell tissues such as the stomach, lungs and liver in the rat. After polymyxin B or 48/80 treatments as well as in anaphylaxis, the levels of histamine in the lungs and liver were greatly reduced but histidine administration failed to alter noticeably the concentrations of histamine in these organs. Similarly, the low contents of histamine in the stomach of 48/50-treated or polymyxin B-treated rats remained unchanged in the presence of excess histidine. Histidine loadings however produced a marked increase in histidine decarboxylase activity of the glandular stomach and a simultaneous elevation in the serum histamine concentrations. Results suggest that the increased level of serum histamine is the consequence of the increased activity of histidine decarboxylase in the tissues and a rapid elimination of the newly formed histamine into the blood. This led us to consider that the flux rather than the formation of histamine might be regulatory for the actual concentration of the non-mast cell histamine, especially in stomach tissue.

Pharmacology of GYKI-41 099 (chlorpropanol, Tobanum) a new potent beta-adrenergic antagonist.

The compound GYKI-41 099, as a beta-adrenergic antagonist, is 3-8 times more potent than propranolol in vitro and in vivo. Its antiarrhythmic effectiveness surpasses that of propranolol and pindolol inhibiting the ouabain arrhythmia in dogs and cats. GYKI-41 900 has a negligible cardiodepressant activity; it is not cardioselective. The compound shows a rapid and long lasting effect. There was a prolonged elimination of the radioactivity after the injection of 14C-41 099 to rats and dogs. The half life of the unlabeled substance in humans was more than 10 hours.