[Desmoid tumors in an adolescent girl with familial adenomatous polyposis]. / Tumeurs desmoïdes dans le cadre d'une polypose adénomateuse familiale chez une adolescente.

Desmoid tumors (DT) are rare and nonmetastasizing fibroblastic neoplasms, characterized by local invasiveness. They occur sporadically or arise in the context of familial adenomatous polyposis (FAP; 5-10% of cases). Most cases develop sporadically in young adults, but some cases also occur in children. We report the case of an adolescent girl with FAP and DT, and we discuss the therapeutic strategies. An adolescent girl with FAP underwent surgery at the age of 14 years with total proctocolectomy. She had a neo-mutation in the APC gene at codon 1068, which is not usually associated with DT. Three years later, she had painful defecations. Imaging showed two abdominal DT. After a multidisciplinary team meeting, the patient was refused for surgery, and medical treatment with antihormonal agents and nonsteroidal anti-inflammatory drugs was started. Imaging 18 months later showed DT stabilization, but the patient had difficulties to control chronic pains, which required morphine treatment, hypnotic sessions, and transcutaneous electric nerve stimulation. This case highlights the importance of DT screening in patients with FAP, mainly after surgery, regardless of their age and genetic mutation. Progress remains to be made in determining DT risk factors and in developing treatment. DT are still difficult to cure because of their potential for local invasion and local recurrence, and need to be managed by a multidisciplinary team.

Copper-indomethacinate associated with zwitterionic phospholipids prevents enteropathy in rats: effect on inducible NO synthase.

Intestinal toxicity exerted by indomethacin was compared to that induced by copper-indomethacinate, free or associated to zwitterionic phospholipids. A single high dose of indomethacin (15 or 20 mg/kg), copper-indomethacinate (15 or 20 mg/kg), or copper-indomethacinate liposomes or nanocapsules (15 mg/kg) was orally administered. Then 24 hr later jejunoileal tissue was taken for macroscopic observation, ex vivo nitrite production, and determination of myeloperoxydase and iNOS activities. Antiinflammatory activity of the drugs was investigated using the carrageenan-induced paw edema model. Indomethacin induced penetrating ulcerations of the intestine that were maximal at hour 24. Copper-indomethacinate induced significantly less ulceration than indomethacin with no significant difference in MPO and iNOS activities. The injurious action of indomethacin on the small intestine was further reduced when copper-indomethacinate was administered as the phospholipid-associated state while similar anti-inflammatory action was observed on rat paw edema. The antiulcerogen effect of copper-indomethacinate seems to be linked to its free radical scavenging effect without any modification of nitric oxide release.

Digestion and absorption rates of [3H]-oleic acid and [14C]-triolein do not differ in rats fed heated (-) and (+) gossypol cottonseed and soybean flours.

This study was conducted to compare in vivo the acute effects of heated (+) and (-) gossypol cottonseed flours with those of soybean flour on lipid digestion and absorption in growing rats. Rats were fed by gastric intubation mixed [3H]-oleic acid and [14C]-triolein with heated flours or without flour (control). Lipid digestion and absorption were determined for 6 h after meal intubation. Both radioactivities recovered in gastrointestinal tract were significantly higher in rats fed (+) gossypol cottonseed flour than in all other groups. The majority of both recovered radioactivities was found in stomach contents, then in stomach wall and finally in intestinal wall. The distribution of both radioactivities at different gastrointestinal levels was similar. In stomach contents and wall, [14C]-radioactivity was primarily in triacylglycerols, but was also recovered in free fatty acids and diacylglycerols. In intestinal wall (mucosa + tunica) [3H]-radioactivity was found at greatest levels in free fatty acids, then in triacylglycerols and diacylglycerols. Greatest [14C]-radioactivity was found in triacylglycerols, then in free fatty acids, in diacylglycerols and last in phospholipids in rats fed the three flours. Therefore no quantitative differences in lipid digestion and absorption were observed among the rats fed the three flours. In conclusion, both cottonseed flours slowed lipid digestion and absorption compared with soybean flour and this delay was greater in the rats fed (+) gossypol cottonseed flour than in those fed (-) gossypol cottonseed flour. However, this inhibiting effect was probably too low to induce physiologically important effects on lipid digestion or absorption.

In vitro rat pancreatic digestive enzyme activities and raw and heated glandless cottonseed and soybean flours.

Higher nitrogen and lipid digestibilities have been obtained with diets containing cottonseed flour rather than soybean flour. To explain these results, in vitro studies were carried out to compare the effects of raw and heated glandless (without gossypol) cottonseed flours versus soybean flours on pancreatic digestive enzyme activities. These effects were compared with those obtained without addition of flour in standard assays. Apparent lipase (lipase colipase dependent) and potential lipase (lipase with saturating amounts of colipase), colipase, phospholipase A2, amylase, trypsin and chymotrypsin activities were measured on specific substrates. Phospholipase A2 and amylase activities were enhanced, while chymotrypsin activity was diminished with both raw and heated flours. Compared with raw and heated soybean flours, raw and heated cottonseed flours promoted higher potential lipase, chymotrypsin, trypsin and lipase activities. Heat treatment of cottonseed flour enhanced apparent lipase, colipase, chymotrypsin, trypsin activities and diminished potential lipase, phospholipase A2 and amylase activities. When soybean flour was heated, apparent lipase, phospholipase A2, chymotrypsin, trypsin and amylase activities were raised while those of potential lipase were decreased. Our findings show that in vitro raw or heated cottonseed flours affect less digestive enzymes than raw or heated soybean flours, apparent lipase activity excepted. Moreover, only chymotrypsin activities were seriously lowered with both flours, especially with raw soybean flour. Hypotheses are suggested to account for the differences in alterations.

Effect of refeeding diets containing cottonseed flour with traces of gossypol on rat liver and testis.

The aim of the present work was to show that cottonseed flour introduced into rehabilitation diets is not nutritionally harmful. The cottonseed flour obtained from glandless seeds contains traces of gossypol. As gossypol is known to have pathological hepatic and testicular actions, the effects on hepatic variables and on the histological appearance of liver and testis of diets containing cottonseed flour were compared with those without cottonseed flour. Seventy growing male Wistar rats were divided into two groups. The control group (C) received a balanced diet (200 g casein + 3 g methionine/kg) for 78 d and the experimental group was fed on a low-protein diet (20 g casein + 3 g methionine/kg) for 29 d. After the period of protein deprivation, the depleted rats were divided into four groups and each group was refed with a different diet, for 49 d: a balanced diet (200 g casein + 3 g methionine/kg; rC), maize-soya-bean flour-milk (60:30:5, by wt; MSM), maize-cottonseed flour-milk (60:30:5, by wt; MCM) or rice-cottonseed flour-milk (60:30:5, by wt; RCM). Each diet was supplemented with a vitamin mixture (10 g/kg) and a salt mixture (40 g/kg). In the liver, protein, total lipid, fatty acid composition and nucleic acid contents were determined after 29 d of protein deprivation and after 2, 14, 29, 49 d of refeeding. The refeeding of rats with either diet MSM or RCM promoted a higher growth than that with diet MCM or diet rC. In all groups, a progressive decrease in relative liver weights with age was observed. The highest values were obtained with diets rC and MSM. After 49 d of refeeding, the lowest values for lipid, DNA and protein:RNA and the highest values for RNA and RNA:DNA were obtained with the cottonseed diets (MCM and RCM). Rats fed on the cottonseed-flour diets for a 49 d period after severe protein malnutrition showed no change in size or shape of their hepatocytes compared with those obtained with the control casein diet, and all stages of spermatogenesis occurred normally and spermatozoa were accurately formed. Therefore, our findings show that a low level of gossypol administrated during 49 d, even to an organism weakened by protein malnutrition, does not affect hepatic variables and the histological appearance of liver and testis.

[Nutritional utilization of cottonseed flour, compared to soya flour, by growing rats with protein malnutrition]. / Utilisation nutritionnelle de la farine de coton, comparée à celle du soja, par des rats en croissance ayant subi une malnutrition protéique.

The aim of this study was to compare the nutritional value of three diets with rats submitted to protein malnutrition. After one month on a low protein diet (2% casein), the rats were refed with corn-soya-milk (60%/30%/5%, W/W/W) and rice-cotton-milk (60%/30%/5%) diets. This produced a higher growth rate than either the corn-cotton milk (60%/30%/5%) diets or a control diet containing 20% casein. The caloric intake/100 g body weight was about the same with the four rehabilitation diets. The highest apparent nitrogen digestive utilization coefficients (C. U. D.) values were obtained with the control diet, lower values with the rice-cotton-milk diet, then the corn-cotton-milk diet and lowest with the corn-soya-milk diet. Results of lipid C. U. D. were in the same order. The highest nitrogen balances were obtained with the control diet, then the corn-soya-milk diet, the rice-cotton-milk diet and lowest values with the corn-cotton-milk diet. Our data prove that the cotton flour mixed with rice may perfectly replace soya flour associated with corn in a nutritional rehabilitation diet.