Efficacy of combination of biofeedback therapy and pelvic floor muscle training in dyssynergic defecation.

BACKGROUND: It is now known that with appropriate exercises, the functions of the muscles in the body ameliorate and increase in strength. We applied pelvic floor muscle relaxation training and exercises that strengthen the abdominal and pelvic muscles in combination with biofeedback therapy (BFT) to patients with dyssynergic defecation (DD). METHODS: Patients who met the criteria for DD and had no underlying organic cause were included in this study. The electromyography (EMG) technique was used for BFT therapy. Patients had received at least six sessions of BFT. BFT was considered successful in patients when the DD pattern in anorectal manometry (ARM) disappeared and/or adequate anal relaxation was obtained following BFT and in patients who had full clinical recovery. RESULTS: Data of 104 patients (58 females [55.8%] and 46 males [44.2%]) was evaluated. Abdominal and rectal symptoms disappeared in 71 (68.26%) patients. Of the patients who achieved symptomatic improvement, 58 (55.76%) saw a disappearance of the dyssynergic defecation pattern. When the differences between anal sphincter pressures before and after treatment were compared in patients who responded to BFT and those who did not, no significant differences were observed, but significant changes were found in anal squeezing pressures. It was found that those who had high squeezing pressures before BFT, those who increased their squeezing pressures after BFT, and those who decreased their resting pressure responded better to BFT. CONCLUSIONS: In this study, BFT was found to be more effective in those with a high squeezing pressure and those that increased squeezing pressure after BFT. These findings will influence the treatment of patients with dyssynergic defecation who do not respond to treatment. A combination of abdominal and pelvic floor muscle exercises and BFT increases patient response.

The Effect of the iNOS Inhibitor S-Methylisothiourea and Hyperbaric Oxygen Treatment on Radiation Colitis in Rats.

INTRODUCTION: External radiotherapy is one of the main treatment modalities for a variety of malignancies. However, the lower gastrointestinal tract is sensitive to the ionizing radiation. Hyperbaric oxygen treatment (HOT) has been suggested as a viable treatment for refractory radiation colitis, but the effect of S-Methylisothiourea (SMT) in the radiation colitis have not reported. To investigate the effect of SMT, HOT and the combination of both in an acute radiation-induced enterocolitis model. METHODS: Sixty Sprague-Dawley rats were divided randomly into five equal groups. A single dose of gamma irradiation (25 Gy) was administered through the colorectal region to anesthetized rats. In the control group, we applied 2 ml of saline solution intraperitoneally for five days. In the HOT group, 100-per-cent oxygen at 2.5 atm pressure was applied for five days. In the SMT group, 10 mg/kg/day of SMT was applied intraperitoneally for five days. In the HOT+SMT group, HOT and SMT were both applied in the same dosages as in the preceding two groups. At the end of five days, the rats were sacrificed and colon samples were collected for histological grading. Blood samples were collected to test for : tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), IL-1ß, transforming growth factor-ß (TGF-ß) and intercellular adhesion molecule-1 (ICAM-1) mRNA. RESULTS: The TNF-α, IL-1ß, IL-10 and TGF-ß levels were reduced by SMT, HOT and HOT+SMT applications (p < 0.05). However ICAM-1 mRNA levels were not significantly lower (p:0.19). The microscopic scores differed significantly between the SMT, HOT and HOT+SMT groups and the control group. There was significant improvement histologically, especially in the HOT+SMT group. When we compared the weight of the rats before and after the study, weight loss was significantly lower in the SMT, HOT and HOT+SMT groups compared with the control group (p < 0.05). CONCLUSION: HOT and SMT together were significantly more effective in preventing weight loss and in reducing inflammation and the severity of colitis histology when compared with HOT and SMT separately.

The protective effects of omega-3 fatty acid against toluene-induced neurotoxicity in prefrontal cortex of rats.

OBJECTIVE: Toluene is used as an organic solvent, and it has neurotoxic effects. Omega-3 is an essential fatty acid required for brain development. The aim of this study was to investigate the protective effects of omega-3 fatty acid against toluene-induced neurotoxicity in prefrontal cortex of rats. MATERIALS AND METHODS: A total of 21 male Wistar rats were divided into three groups with seven rats in each group. Rats in group I were the controls. Toluene was intraperitoneally injected into the rats of group II with a dose of 0.5 ml/kg. Rats in group III received omega-3 fatty acid with a dose of 0.4 g/kg/day while exposed to toluene. After 14 days, all the rats were killed by decapitation. Enzymatic activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) and the level of malondialdehyde (MDA) were spectrophotometrically studied in the prefrontal cortex of rats. RESULTS: Enzymatic activities of SOD and GSH-Px were decreased, and MDA levels were significantly increased in rats treated with toluene compared with the controls. However, the increased SOD and decreased GSH-Px enzymatic activities and MDA levels were detected in the rats administered with omega-3 fatty acid while exposed to toluene. CONCLUSION: The results of this experimental study indicate that omega-3 fatty acid treatment can prevent toluene-induced neuronal damage in the prefrontal cortex of rats.

The effects of Brassica oleraceae var capitata on epidermal glutathione and lipid peroxides in DMBA-initiated-TPA-promoted mice.

BACKGROUND: The objective of the present study was to determine if modulation of GSH-dependent antioxidant protective system by Brassica oleraceae var capitata might inhibit the molecular mechanism of skin tumor promotion. MATERIALS AND METHODS: In a two stages skin carcinogenesis model, the protocol used included a single topical application of 200 nmol of the initiator 7,12-dimethyl-benz(a) anthracene (DMBA) to the backs of mice, followed 1 week later by promotion with 10 nmol of 12-O-tetradecanoyl-phorbol-13 acetate (TPA) twice weekly for 30 weeks. In addition to this regimen, 0.1 g/L brassica extract was added water week prior to the initiating dose of DMBA in the treatment group. Tissue glutathione (GSH) contents and levels of lipid peroxidation products (measured as thiobarbituric-acid (TBA)-reactive substances) were quantitated in the skin tumors generated by the initiation-promotion protocol. RESULTS: It was observed that the tumor incidence and tumor multiplicity in the treatment group was highly significantly low compared to the first group of mice (p < 0.001 and p < 0.001, respectively). In the treatment group, GSH content in the papillomas was higher than in the non-involved skin surrounding the papillomas. CONCLUSIONS: We suggest that the anticarcinogenicity of Brassica may be linked to its ability to facilitate or enhance the activity of the natural GSH-dependent antioxidant protective system of the epidermal cells during the later stages of skin tumor promotion.