Comparison of long-term outcome of sacral nerve stimulation for constipation and faecal incontinence with focus on explantation rate, additional visits, and patient satisfaction.

BACKGROUND: The aim of the present study was to compare sacral nerve stimulation (SNS) for constipation (SNS-C) with SNS for idiopathic faecal incontinence (SNS-IFI) regarding explantation rate, additional visits, and improvement of patient satisfaction 5 years after implantation. METHODS: From our prospective database (launched in 2009), we extracted all SNS-C patients 5 years post-implantation, and the SNS-IFI patients implanted just before and just after each SNS-C patient. We retrospectively evaluated the explantation rate, number of additional visits, and patient satisfaction using a visual analogue scale (VAS). We hypothesized that compared with those in the SNS-IFI group: (1) the explantation rate would be higher in SNS-C patients, (2) the number of additional visits would be higher in SNS-C patients, and (3) in patients with an active implant at 5 years, the improvement in VAS would be the same. RESULTS: We included 40 SNS-C patients and 80 SNS-IFI patients. In the SNS-C group 7/40 (17.5%), patients were explanted, compared to 10/80 (12.5%) patients in the SNS-IFI group (p = 0.56). The mean number of additional visits in the SNS-C group was 3.5 (95% CI 2.8-4.1)) and 3.0 (95% CI 2.6-3.6)) in the SNS-IFI group (p = 0.38). Additional visits due to loss of efficacy were significantly higher in the SNS-C patients (p = 0.03). The reduction in VAS score (delta VAS) at 5 years was 37.1 (95% CI 20.9-53.3) in the SNS-C group, and 46.0 (95% CI 37.9-54.0) in the SNS-IFI group (p = 0.27). CONCLUSIONS: No significant difference was found regarding explantation rate, number of additional visits, or improvement of VAS at 5 years after SNS implantation between SNS-C patients and SNS-IFI patients.

The iodocyanopindolol and SM-11044 binding protein belongs to the TM9SF multispanning membrane protein superfamily.

SM-11044 is the only beta-adrenergic agonist that inhibits guinea pig eosinophil chemotaxis and induces relaxation of depolarized rat colon tonus. We have previously reported the purification of a 34 kDa photoaffinity-labeled SM-11044 binding protein (SMBP) from rat colon that may mediate the biological effects of the ligand and that differs from all known monoamine receptors (Sugasawa et al., J. Biol. Chem. 272 (1997) 21244). The present report describes partial amino acid sequence of rat SMBP and molecular cloning of corresponding human SMBP (hSMBP) cDNA. This cDNA encodes a 588 amino acid residue polypeptide comprising a signal peptide, a long hydrophilic amino-terminal region, and a highly hydrophobic C-terminal portion organized into nine putative transmembrane domains. The sequence and structure of hSMBP shows homology to members of a new transmembrane protein 9 superfamily (TM9SF). Comparison of hSMBP with related protein sequences from yeast, plant and human revealed two subgroups within TM9SF. The members of these groups differ in length and have characteristic amino acid sequence motifs in their amino-terminal portion. Northern blot analysis revealed two major SMBP mRNAs, at 3.4 and 3.8 kb, that were present in all the human tissues examined. Western blot experiments detected SMBP as a 70 kDa protein that may be further cleaved into an active 34 kDa N-terminal polypeptide. Stable Chinese Hamster Ovary cell transfectants expressing hSMBP cDNA displayed specific binding of [(125)I]iodocyanopindolol that was displaced by SM-11044 in a dose-dependent manner. Thus, SMBP is the first member of TM9SF with functional ligand binding properties, suggesting that some of these integral membrane proteins may function as channels, small molecule transporters or receptors.

An anion channel from transverse tubular membranes incorporated into planar bilayers.

Transverse tubular (TT) vesicles from rabbit skeletal muscle were incorporated into planar lipid bilayers to characterize the chloride channel. The single channel conductance of the channel was 40 pS in choline-Cl solution (cis, 300 mM/100 mM, trans). The gating rate of the channel does not depend on membrane voltage. The channel was blocked by stilbene derivatives (DIDS and SITS), which are known as inhibitors of voltage-dependent Cl- channels of the Torpedo electric organ, from both sides of the membrane. An inhibitor of voltage-dependent Cl- channels of skeletal muscles, 9-anthracene carboxylic acid (9-AC) inhibited the channel from the cis side of the membranes, which corresponded to the cytoplasmic space. Ethacrynic acid (EA), which is reported to inhibit Cl- conductance of the kidney and trachea, decreased the open probability of the TT Cl- channel concentration dependently. Indanyloxyacetic acid (IAA), which is also reported to be an inhibitor of kidney and trachea Cl- channels, decreased the single channel current without affecting open probability of the TT Cl- channel.

Characterization of a Cl(-)-channel from rabbit transverse tubules in the planar lipid bilayer system.

A Cl(-)-channel of the transverse tubule(TT) was incorporated into artificial planar lipid bilayers and its properties were investigated. The channel was found to have the following properties. (1) The single-channel conductance is 40 pS in choline-Cl solution. (2) The rate of gating of the channel does not depend on the membrane voltage. (3) The channel is blocked by stilbene derivatives (DIDS and SITS), which are known as inhibitors of voltage-dependent Cl(-)-channels of the Torpedo electric organ, from both sides of the membrane. (4) An inhibitor of voltage-dependent Cl(-)-channels of skeletal muscle, 9-anthracene carboxylic acid(9-AC), inhibits Cl(-)-current from the cis-side to which the TT vesicles were added.