Effects of water ingestion on autonomic activity and gastric motility in patients with celiac disease.

The pathogenesis of celiac disease is associated with an autoimmune process. The disease causes chronic inflammation of the small intestinal mucosa, which may affect the brain-gut axis. The activation of visceral receptors (gastrointestinal mechanoreceptor and osmoreceptor) in response to stomach distension caused by water ingestion has not been studied before. Our results showed reduced responsiveness of the autonomic nervous system to water ingestion in patients with celiac disease, which may lead to disturbances of gastric myoelectrical activity and depends on baseline autonomic activity. Water intake can induce gastric distension and motility response, without changes in gastrointestinal hormones. It can also increase the activity of the autonomic nervous system. On the other hand, inflammation in celiac disease (CeD) can alter visceral perception (increase sensitization), leading to autonomic dysfunction. We aimed to investigate the effect of water ingestion on autonomic activity measured as heart rate variability (HRV) and gastric myoelectrical activity measured by electrogastrography (EGG) in patients with CeD. The study included 53 patients with CeD and 50 healthy controls: mean (SD) age, 43.4 (14.8) years and 44.1 (9.2) years, respectively. Electrocardiography with HRV analysis and simultaneous 4-channel EGG was performed before and after the water load test (WLT) ingestion 500-ml water over 5 minutes. We found that compared with controls, at fasting, patients with CeD showed a reduced percentage of normogastria (P=0.045) and an average percentage of slow wave coupling (P<0.01) with increased dominant power (DP) (P<0.001). Moreover, water ingestion in CeD patients reduced the percentage of gastric arrhythmia (P<0.01) and increased the percentage of normogastria (P<0.01) and DP (P<0.01). Finally, in the CeD group, water ingestion increased HRV indices: low frequency by 116.9% (P<0.001), high frequency by 125.3% (P<0.01), but they did not reach the values of the control group. Patients with CeD showed a smaller increase in parasympathetic autonomic activity after the WLT than controls. Altered autonomic responsiveness may contribute to the disturbances of gastric myoelectrical activity and depends on baseline autonomic activity.

Phagocytosis of latex beads by a human monocytic Mono Mac 6 cell line and effects of low-frequency electromagnetic field interaction.

Some studies have shown that electromagnetic fields (EMFs) may impact immune response cells and their functions. The first stage of the defense from pathogens is innate immunity encompassing phagocytosis and phagocytosis-related intracellular effects. Our work aimed to determine the influence of a low-frequency electromagnetic field (7 Hz, 30 mTrms) on the phagocytosis process of latex beads (LBs), the production of reactive oxygen species (ROS), and viability changes in a human monocytic Mono Mac 6 (MM6) cell line as an experimental model of the phagocytosing cells in in vitro cell culture conditions. For these purposes, cells were firstly activated with infectious agents such as lipopolysaccharide (LPS), Staphylococcal enterotoxin B (SEB), or the proliferatory agent phytohaemagglutinin (PHA), and then a phagocytosis test was performed. Cell viability and range of phagocytosis of latex beads by MM6 cells were measured by flow cytometry, and the level of ROS was evaluated with the use of a cytochrome C reduction test. The obtained results revealed that applied EMF exposure mainly increased the necrosis parameter of cell death when they were pre-stimulated with SEB as an infectious factor and subsequently phagocytosed LBs (P=0.001). Prestimulation with other agents like LPS or PHA preceding phagocytosis resulted in no statistically significant changes in cell death parameters. The level of ROS depended on the used stimulatory agent, phagocytosis, and/or EMF exposure. The obtained effects for EMF exposure indicated only a slight decrease in the ROS level for cells phagocytosing latex beads and being treated with SEB or PHA, while the opposite effect was observed for LPS pre-stimulated cells (data not statistically significant). The results concerning the viability of phagocytosing cells, the effectiveness of the phagocytosis process, and the level of radical forms might result from applied EMF parameters like signal waveform, frequency, flux density, and especially single EMF exposure.

The effect of visceral reception activation (water load test) on autonomic activity and gastric myoelectric activity in gastrointestinal malignancies.

OBJECTIVES: The aim of this study was to analyze the effect of water load test (WLT) on heart rate variability (HRV), blood pressure variability (BPV), hemodynamic parameters and gastric myoelectric activity in gastrointestinal (GI) cancer patients. BACKGROUND: WLT activates gastrointestinal mechanoreception and osmoreception, and hence, can indirectly modulate autonomic activity. METHODS: Eighty patients (mean age 61.2 years) were enrolled, along with the group of healthy controls. HRV, BPV and electrogastrography (EGG) were recorded at rest (in a fasted state) and after water uptake at 100 ml/min. RESULTS: WLT contributed to an increase in the percentages of normogastria time, from 37.3 % to 50.0 % (p=0.02) and from 42.3 % to 47.7 % (p=0.01), respectively in colon and rectal cancer. Cancer patients presented lower values of HRV indices determined on linear analysis at rest and after WLT. CONCLUSIONS: A slight predominance of the sympathetic component was observed in response to WLT, which was reflected by changes in hemodynamic parameters. The response to WLT is a consequence of GI mechanoreception and osmoreception activation and resultant pressure reaction. This effect was disrupted by the neoplastic process within the GI tract, especially in gastric and colon malignancies, but not in rectal cancer (Tab. 2, Fig. 12, Ref. 40). Text in PDF www.elis.sk Keywords: autonomic nervous system, gastric myoelectric activity, water uptake, heart rate variability, blood pressure variability, gastrointestinal cancer.

Urinary neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, uromodulin, and cystatin C concentrations in an experimental rat model of ascending acute kidney injury induced by pyelonephritis.

Recent evidence suggests that neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), cystatin C (CysC), uromodulin (UMOD), and some interleukins (IL-6 and IL-18) can be considered as diagnostic markers of acute kidney injury (AKI). The aim of this study was to verify the applicability of four urinary (u) markers, namely uNGAL, uKIM-1, uCysC, and uUMOD, for the diagnosis of ascending AKI induced by bacterial pyelonephritis. The study included 30 female rats that were divided into three groups (n = 10 each) and were inoculated transurethrally with various doses of Escherichia coli to induce isolated pyelonephritis (group 1, 105 CFU/ml), pyelonephritis-induced AKI (group 2, 107 CFU/ml), or AKI and urosepsis (group 3, 109 CFU/ml). The inoculate contained a highly virulent E. coli strain isolated from a patient with pyelonephritis. Urine samples were obtained prior to the inoculation and 7, 14, and 21 days thereafter. The concentrations of all assessed proteins were determined in the urine samples by ELISA. All the study groups showed elevated concentrations of uNGAL and uCysC at all study time points. The concentrations of uKIM-1 in group 1 were the same as that at the baseline, whereas it was elevated in groups 2 and 3 at all study time points. The concentrations of uUMOD in groups 1 and 2 tended to decrease with the time from inoculation, whereas it rapidly increased in group 3 at 21 days postinfection. uKIM-1 seems to be the only marker of ascending AKI associated with urinary tract infection. Elevated concentrations of uNGAL, uCysC, and uUMOD were found in both AKI and isolated pyelonephritis. Thus, it can be concluded that none of these markers can be used as a single diagnostic marker of ascending AKI, as it may produce false-negative results, leading to incorrect diagnosis, lack of adequate treatment, and increased mortality risk.

Abscisic acid-mediated phytochrome B signaling promotes primary root growth in Arabidopsis.

Plant photomorphogenic responses have been studied mostly using the shoots, the core part of plant architecture that perceives light for photosynthesis and influences the overall processes of growth and development. While the roots are also known to respond to aboveground light through multiple routes of light signal transduction, root photomorphogenesis has been less highlighted until recently. A long-standing, critical question was how the underground roots are capable of sensing aerial light and how the root-sensed light signals trigger root photomorphogenesis. When the roots are directly exposed to light, reactive oxygen species (ROS) are rapidly produced to promote primary root elongation, which helps the roots to escape from the abnormal growth conditions. However, severe or long-term exposure of the roots to light causes ROS burst, which impose oxidative damages, leading to a reduction of root growth. We have recently found that phytochrome B (phyB) promotes abscisic acid (ABA) biosynthesis in the shoots and the shoot-derived ABA signals mediate ROS detoxification in the roots, lessening the detrimental effects of light on root growth. On the basis of these observations we propose that the phyB-mediated ABA signaling contributes to the shoot-root synchronization that is essential for optimal growth and performance in plants.

Changes in viability of rat adipose-derived stem cells isolated from abdominal/perinuclear adipose tissue stimulated with pulsed electromagnetic field.

Previous experiments demonstrated that low-frequency electromagnetic field (LF-EMF) may activate cellular death pathways in proliferating cells. Therefore, we hypothesized that LF-EMF may also influence viability of highly proliferating undifferentiated adipose-derived stem cells. Obesity is classified as a civilization disease; its etiopathogenesis is presumed to include both genetic predisposition and influence of modified environmental factors, such as unbalanced diet with excess calories and/or too low physical activity. Obesity may lead to a number of metabolic disorders, including type 2 diabetes mellitus, cardiovascular diseases (associated with atherosclerosis) related to primary hypertension and ischemic heart disease, myocardial infarction and other complications. The aim of this study was to verify if LF-EMF alters viability parameters of adipose-derived stem cells (ADSCs) isolated from rats, cultured in vitro and exposed to pulsed electromagnetic field (PEMF; 7 Hz, 30 mT). ADSCs were obtained from healthy rats and animals with experimentally-induced obesity, both males and females, pups and adults. The animals were fed with chow with either low (LF diet) or high fat content (HF diet) for 21 days. Then, ADSCs were isolated from extracted adipose tissue and used to establish cell cultures. ADSCs from the first passage were exposed to PEMF three times, 4 hours per exposure, at 24-h intervals (experimentally developed protocol of PEMF stimulation). 24 hours after the last exposure to PEMF, viability parameters of ADSCs were analyzed by flow cytometry (FCM). The study demonstrated that LF diet exerted a protective effect on PEMF-exposed ADSCs, especially in the case of male and female pups. In turn, the proportion of early apoptotic cells in PEMF-treated ADSC cultures from adult female rats maintained on HF diet turned out to be significantly higher than in other experimental groups.

Interstitial cells of Cajal - systematic review.

This paper reviews the distribution of interstitial cells of Cajal (ICC) in the human gastro-intestinal (GI) tract, based on ultrastructural and immunohistochemical evidence. The distribution and morphology of ICC at each level of the normal GI tracts is addressed from the perspective of their functional significance. Alterations of ICC reported in as well as in GI stromal tumours are reviewed, with emphasis on the place of ICC in the pathophysiology of disease.

Self-efficacy, quality of life, and weight loss in overweight/obese endometrial cancer survivors (SUCCEED): a randomized controlled trial.

OBJECTIVE: More patient-centered programming is essential for endometrial cancer (EC) survivors needing to lose weight to reduce cardiovascular disease risk (CVD). The purpose of this study was to improve self-efficacy (SE) and quality of life (QOL) using a lifestyle intervention program designed for weight loss. METHODS: Overweight and obese early-stage EC survivors, n = 75, were randomized into two groups: 1) Survivors of Uterine Cancer Empowered by Exercise and Healthy Diet (SUCCEED), a six-month lifestyle intervention or 2) a usual care group (UC). Participants completed the Weight Efficacy Lifestyle Questionnaire (WEL) to assess SE and the Functional Assessment of Cancer Therapy-General (FACT-G) to measure QOL, and their body mass index (BMI) was calculated at baseline, 3, 6, and 12 months. Mixed, repeated-measures ANCOVA models with baseline covariates were employed using SPSS 20.0. RESULTS: Positive effects in every WEL domain, including the total score, were statistically significant in the SUCCEED group versus the UC group. A linear regression model demonstrated that, if BMI decreased by 1 unit, the total WEL score increased by 4.49 points. Significant negative correlations were found in the total WEL score and a change in BMI of R = -0.356 (p = 0.006). Between-group differences in the FACT-G were significant from baseline in the fatigue domain at three months (p = .008) and in the physical domain at six months (p = .048). No other significant differences were found. CONCLUSION: Overall, this study shows promise for targeted interventions to help improve SE, thus improving BMI.

Type of desmin expression in cardiomyocytes - a good marker of heart failure development in idiopathic dilated cardiomyopathy.

AIM: The aim of this study was to determine whether remodelling of the desmin (DES) cytoskeleton affects myocardial function and whether it could be a useful marker of disease progression in patients with idiopathic dilated cardiomyopathy (IDCM). MATERIAL AND METHODS: Endomyocardial biopsy was performed in 195 IDCM patients, and five to six specimens were collected from the left ventricle. DES expression was evaluated using tissue immunostaining and Western blotting. The study population was assigned to four groups according to DES expression type: I, normal DES staining at Z-lines giving a regular pattern of cross-striation (n = 57); IIA, increased DES staining with a regular pattern of cross-striation (n = 40); IIB, increased DES staining with an irregular pattern of cross-striation and/or the presence of aggregates (n = 56); and III, decreased/lack of DES staining (n = 42). Fibrosis, cardiomyocyte hypertrophy and ultrastructure were assessed for the four types of DES expression. RESULTS: The pathological types of DES expression (IIB or III) were associated with pathological changes in mitochondria and the contractile apparatus. Cardiomyocyte diameter and level of fibrosis were both significantly affected. DES expression type correlated with NYHA class, left ventricular end-diastolic diameter, left ventricular ejection fraction and the level of N-terminal pro-brain natriuretic protein. CONCLUSION: The type of immunohistochemical DES expression correlated with the level of myocardial injury at the cellular and organ levels. This correlation was similar to that observed between DES expression and the well-established biochemical, echocardiographic and clinical parameters of heart failure (HF). DES expression type could be used as an important diagnostic feature of HF development.

Functional, histological structure and mastocytes alterations in rat urinary bladders following acute and [corrected] chronic cyclophosphamide treatment.

Neurogenic inflammation is linked to urinary bladder overactivity development. Cyclophosphamide (CYP) damages all mucosal defence lines of urinary bladder and induces cystitis with overactivity. The aim of this study was to estimate the effect of CYP on rat urinary bladder function, histological structure and mastocytes numbers following acute and chronic CYP treatment. Fourty two female rats were divided into four groups: I (control), II (acute cystitis), III (chronic cystitis), IV (sham group). Acute and chronic cystitis were induced by CYP in single dose and four doses (1(st), 3(rd), 5(th), 7(th) day), respectively. In group I-III the cystometric evaluation was performed. Sections of the bladder were stained with HE and toluidine blue for the detection of mastocytes. The severity of inflammation was examined according to mucosal abrasion, haemorrhage, leukocyte infiltration and oedema. Acute and chronic CYP treatment caused inflammatory macroscopic and microscopic changes (mucosal abrasion, haemorrhage, oedema) and increased infiltration of inflammatory cells in urinary bladder. Acute treatment induced the infiltration of mastocytes within bladder wall contrary to chronic one decrement. Acute treatment caused more severe mucosal abrasion, whereas chronic one revealed more developed haemorrhage changes. Additionally, cystometric evaluation revealed urinary bladder overactivity development in both types of cystitis. Basal pressure and detrusor overactivity index after acute treatment increased considerably in comparison with the increase obtained after chronic one. Our results proved that acute model of CYP-induced cystitis in rats is more credible for further evaluation of neurogenic inflammation response in pathogenesis of overactive bladder as compared to chronic one.

Physiological and morphological effects of long-term vagal stimulation in diet induced obesity in rats.

Some previous studies have shown suppressive effect of the vagal nerve stimulation (VNS) on long - term feeding regulation in rats. We assessed body weight, interstitial cells of Cajal (ICC), myenteric plexus neurons, mast cells in the stomach, duodenum and colon and c-Fos expression in nodose vagal ganglia in the rats with VNS. Male Wistar rats were implanted with microchip (MC) and kept during the whole study (100 days) on high calorie diet. Left vagal nerve was stimulated by electrical pulses (10ms, 200mV, 0.05Hz) generated by MC. After finishing the experiments tissue samples (stomach, duodenum, colon and nodosal vagal ganglia) were taken. Mast cells were toluidine blue stained and counted in mucosa, muscularis externa and serosa. For immunostaining, antibodies for ICC (CD117), myenteric plexus neurons (PGP9.5) and c-Fos were used. Positive cells were assessed by image analysis. Chronic microchip vagal stimulation significantly decreased epididymal fat pad weight, meal size with effect on decreased weight gain in VNS rat. VNS significantly increased mast cells number in all examined parts of the gastrointestinal wall, mainly in the muscularis. There were no significant differences in ICC and myenteric plexus neurons between VNS and control. Expression of c-Fos in nodosal ganglia was higher in VNS group. The effects observed during long-term VNS concern predominantly mast cells. These data support the theory that VNS can increase vagal afferent satiety signals leading to reduced food intake and body weight gain and mast cells are involved in this process.

Magnetically induced vagus nerve stimulation and feeding behavior in rats.

Vagus nerve (VN) contribute to the bidirectional communication between the gastrointestinal tract and the central nervous system. Stimulation of the VN by a magnetically-driven solenoid with parameters similar to those during food-induced stomach distension has been thought to mimic short-term signaling of satiety and suppress food intake. In this study, the determination of optimal parameters of vagal neuro-modulation to achieve decreased food intake with a resulting reduction in body mass of rats is explored as therapy to treat obesity. The experimental design consisted of three groups of obese adult male Wistar rats: Group 1: VEMF - with solenoid's electrodes placed on the left VN in the magnetic field exposure (MFE); Group 2: EMF - without solenoid's electrodes on the VN in MFE; Group 3: CON - without solenoid's electrodes on the VN outside the MFE. This study suggests that the rats with solenoid's electrodes placed on the left VN significantly decreased their food intake, weight gain and serum leptin concentrations when compared to that of the CON group. PP levels were found to be higher in the VEMF group when compared to the controls groups. It was found that the most effective parameters of vagal stimulation on eating behavior were 3631, 7861, 14523 A(2) x h/m(2). The magnetic field by unknown mechanisms also influences feeding behavior. This study suggests that vago-vagal reflexes are involved in the feeding homeostasis and that neuromodulation might be an effective method for managing obesity. Further studies are required to confirm these effects in humans.

Effect of parity on gestational age at delivery in multiple gestation pregnancies.

OBJECTIVE: To estimate the effect of parity on gestational age (GA) at birth in multifetal pregnancies. STUDY DESIGN: Birth data from the public-access Matched Multiple Birth File produced by the National Center for Health Statistics from 1995 to 2000 were analyzed following IRB approval. GA, parity and demographic data were analyzed with parametric and nonparametric tests, including regression analysis, using SPSS. RESULT: Data from women with twin (n=316,983), triplet (n=11,981), and quadruplet (n=766) pregnancies were analyzed. A significantly higher proportion of nulliparous versus parous women were Caucasian (twins: 82 versus 77%; triplets: 91 versus 87%) and had more than 15 years of education (twins: 39 versus 24%; triplets: 55 versus 39%; quadruplets: 53 versus 35%). Mean GA was 5.6 days longer for twins, 5.4 days longer for triplets and 6.8 days longer for quadruplets born to parous versus nulliparous women. Caucasian and African-American parous women pregnant with twins or triplets delivered their babies at a later GA than their nulliparous counterparts at each level of education. GA at delivery increased as a function of age of the mother in nulliparous and parous women of twins or triplets, and at every age level, parous women delivered their babies at a later GA. A higher proportion of nulliparous women delivered before 24 weeks (twins: 2.9 versus 1.2%; triplets: 5.9 versus 2.5%; quadruplets: 8.3 versus 2.6%). The percentage of twins born at or after 32 weeks was 84.9% for nullipara and 90.1% for parous women; for triplets, corresponding figures were 61.4 and 69.6%; and for quadruplets the figures were 33.2 and 44.2%. The percentage of births at or after 36 weeks for nulliparous and parous women pregnant with twins was 54.8 and 63.2%, respectively. The majority of the gain in GA was observed between women who had no previous births and those who had one previous birth. In regression analysis, the effect of parity remained after controlling for demographic and risk factors known to affect GA. CONCLUSION: GA at delivery is significantly increased in parous women carrying a multifetal gestation after controlling for other factors that affect GA at birth.

The vagal afferents discharge and myoelectrical activity in the gastric hyperalgesia model in rats.

A long term exposure of the gastric mucosa to inflammatory factors is suspected to alter the normal stomach motility. The consequence of it is an abnormal sensomotor response to food causing dyspeptic symptoms. Our study aimed to investigate the vagal afferents activity and the gastro-duodenal slow wave response to the mild gastric mucosa inflammation in rats. The gastric mucosal inflammation was induced by addition iodoacetamide to drinking water for 5 days. The gastro-duodenal slow wave, vagal nerve recordings and the gastric mucosa examination were performed on 6th day. The iodoacetamide irritated gastric mucosa presented the minimal inflammatory infiltration with mast cells. The vagal afferent activity was significantly increased after iodoacetamide treatment from 0.3 +/- 0.1 to 1.9 +/- 0.58 Hz, (p<0.05). The gastric slow wave accurate frequencies extracted from the fast Fourier transform spectra accelerated from 0.08 +/- 0.01 to 0.1 +/- 0.02 Hz (p<0.05). The duodenal frequencies remained unchanged (from 0.64 +/- 0.02 to 0.59 +/- 0.1 Hz). These results suggest that mild gastric mucosa irritation sensitizes vagal afferents and alters gastric but not duodenal pacemaker activity which may contribute to dyspeptic sensations.

Baixa estatura por insensibilidade ao hormônio de crescimento / Short stature caused by growth hormone insensitivity

Objetivo: crianças portadoras de baixa estatura apresentam um grande número de opções diagnósticas. Muitas vezes não se consegue estabelecer o diagnóstico preciso...

Introduction: Tasks for diagnosing short stature in children has been challenged by a broad array of pathways. Precise diagnosis has been often unconspicuous...

Effect of long-term vagal stimulation on food intake and body weight during diet induced obesity in rats.

Regulation of food intake and body weight is accomplished by several mechanisms. CNS receives information from periphery and modifies food intake mainly by vagal nerves that provide the major neuroanatomical link between gastrointestinal sites stimulated during food intake and CNS sites that control feeding behavior and metabolism. Gastric mechanoreceptors and jejunal chemoreceptors activated by food or vagal nerve stimulation (VNS), which mimic the physiological input, suppress feeding within short-term regulation. Our research was aimed on determination the role of electrical VNS in long-term control of food intake and body weight in diet induced obesity fed rats. Food intake, body weight and epididymal fat pad were assessed in male Wistar rats divided into three groups (controls vs. VNS). Rats were implanted with microchip and kept during the whole study (100 days) on diet induced obesity. Vagal nerve was stimulated by electrical rectangular pulses duration 10 ms, amplitude 200 mV, frequency 0.05 Hz generated by microchip. In control group surgery produced no significant changes in meal size and body weight gain as compared to intact group. In contrast, significantly decreased epididymal fat pad weight, decreased meal size with effect on decreased weight gain was observed in VNS rats. Data support theory that VNS can increase vagal afferent signal conduct to CNS and mimics the satiety signals leading to reduce food intake and body weight gain.

Vacuum and forceps training in residency: experience and self-reported competency.

OBJECTIVE: Determine chief residents' experience with vacuum and forceps deliveries and self-perceived competencies with the procedures. STUDY DESIGN: Study 1: A written questionnaire was mailed to all fourth year residents in US RRC approved Ob/Gyn programs. Study 2: The study was replicated using a web-based survey the following year. Data were analyzed with chi (2) and Wilcoxon Signed Rank tests using SPSS. RESULTS: Surveys were received from 238 residents (20%) in Study 1 and 269 residents in Study 2 (23%, representing 50% of all residency programs). In both studies, residents reported performing significantly less forceps than vacuum deliveries. Virtually all residents wanted to learn to perform both deliveries, indicated attendings were willing to teach both, and felt competent to perform vacuum deliveries (Study 1, 94.5%; Study 2, 98.5%); only half felt competent to perform forceps deliveries (Study 1, 57.6%; Study 2, 55.0%). The majority of residents who felt competent to perform forceps deliveries reported that they would predominately use forceps or both methods of deliveries in their practice (Study 1, 75.8%; Study 2, 64.6%). The majority of residents who reported that they did not feel competent to perform forceps deliveries reported that they would predominately use vacuum deliveries in their practice (Study 1, 86.1%; Study 2, 84.2%). CONCLUSION: Current training results in a substantial portion of residents graduating who do not feel competent to perform forceps deliveries. Perceived competency affected future operative delivery plans.

Melatonin and serotonin effects on gastrointestinal motility.

The gastrointestinal tract represents the most important extra pineal source of melatonin. Presence of melatonin (M) suggests that this hormone is somehow involved in digestive pathophysiology. Release of GI melatonin from serotonin-rich enterochromaffin EC cells of the GI mucosa suggest close antagonistic relationship with serotonin (S) and seem to be related to periodicity of food intake. Food deprivation resulted in an increase of tissue and plasma concentrations of M. Its also act as an autocrine and paracrine hormone affecting not only epithelium and immune system but also smooth muscle of the digestive tract. Low doses M improve gastrointestinal transit and affect MMC. M reinforce MMCs cyclic pattern but inhibits spiking bowel activity. Pharmacological doses of M delay gastric emptying via mechanisms that involve CCK2 and 5HT3 receptors. M released in response to lipid infusion exerts a modulatory influence that decreases the inhibitory effects of the ileal brake on gastric emptying. On isolated bowel S induces dose dependent increase in tone and reduction in amplitude of contraction which is affected by M. M reduced the tone but not amplitude or frequency of contraction. M is a promising therapeutic agent for IBS with activities independent of its effects on sleep, anxiety or depression. Since of its unique properties M could be considered for prevention or treatment of colorectal cancer, ulcerative colitis, gastric ulcers and irritable bowel syndrome.

Practice parameter: diagnostic assessment of the child with status epilepticus (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society.

OBJECTIVE: To review evidence on the assessment of the child with status epilepticus (SE). METHODS: Relevant literature were reviewed, abstracted, and classified. When data were missing, a minimum diagnostic yield was calculated. Recommendations were based on a four-tiered scheme of evidence classification. RESULTS: Laboratory studies (Na(++) or other electrolytes, Ca(++), glucose) were abnormal in approximately 6% and are generally ordered as routine practice. When blood or spinal fluid cultures were done on these children, blood cultures were abnormal in at least 2.5% and a CNS infection was found in at least 12.8%. When antiepileptic drug (AED) levels were ordered in known epileptic children already taking AEDs, the levels were low in 32%. A total of 3.6% of children had evidence of ingestion. When studies for inborn errors of metabolism were done, an abnormality was found in 4.2%. Epileptiform abnormalities occurred in 43% of EEGs of children with SE and helped determine the nature and location of precipitating electroconvulsive events (8% generalized, 16% focal, and 19% both). Abnormalities on neuroimaging studies that may explain the etiology of SE were found in at least 8% of children. RECOMMENDATIONS: Although common clinical practice is that blood cultures and lumbar puncture are obtained if there is a clinical suspicion of a systemic or CNS infection, there are insufficient data to support or refute recommendations as to whether blood cultures or lumbar puncture should be done on a routine basis in children in whom there is no clinical suspicion of a systemic or CNS infection (Level U). AED levels should be considered when a child with treated epilepsy develops SE (Level B). Toxicology studies and metabolic studies for inborn errors of metabolism may be considered in children with SE when there are clinical indicators for concern or when the initial evaluation reveals no etiology (Level C). An EEG may be considered in a child with SE as it may be helpful in determining whether there are focal or generalized epileptiform abnormalities that may guide further testing for the etiology of SE, when there is a suspicion of pseudostatus epilepticus (nonepileptic SE), or nonconvulsive SE, and may guide treatment (Level C). Neuroimaging may be considered after the child with SE has been stabilized if there are clinical indications or if the etiology is unknown (Level C). There is insufficient evidence to support or refute routine neuroimaging in a child presenting with SE (Level U).

Peripheral mechanisms of intestinal dysmotility in rats with salsolinol induced experimental Parkinson's disease.

Gastrointestinal dysmotility in Parkinson's disease (PD) has been attributed in part to peripheral neurotoxine action. Our purpose was the evaluation of the salsolinol effect on intramuscular interstitial cells of Cajal (ICC), duodenal myoelectrical activity (DMA) and vagal afferent activity (VAA) in rats with experimental PD. Twenty rats were divided into 2 equal groups. Experimental PD was produced in one group by 3 weeks of the intraperitoneal salsolinol injections (50 mg/kg/day), whereas the 2-nd group served as control. DMA and VAA were recorded in both groups during fasting and stepwise--gastric distension (GD) of 10 ml. Subsequently fragments of duodenum were removed and intramuscular ICC were assessed as c-Kit antigen percentage in the duodenal muscular zone. Analyses of the fasting DMA and VAA recordings didn't reveal differences between the compared groups. During GD increase of DMA dominant frequency (p=0.04) and VAA frequency (p<0.01) was observed in the controls whereas in the salsolinol group both parameters remained unchanged. Image analysis of duodenum revealed decreased c-Kit expression in the salsolinol-injected animals (p=0.05). The results of our study may suggest the direct effect of salsolinol on both ICC and neuronal pathways of gastro-duodenal reflexes.