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Ann Ital Chir. 1989 Sep-Oct;60(5):393-7; discussion 397-8.
[Digestive endocrinology, today]

[Article in Italian]

Carlei F, Simi M.

The authors discuss the changing role of gastrointestinal endocrinology during the last twenty years starting from the early sixties when techniques such as radioimmunoassay and immunocytochemistry allowed major advances of our knowledge on this field. Using these techniques several regulatory peptides have been identified and the concept of the diffuse neuroendocrine system as a morphofunctional apparatus regulating the majority of physiological activities, was postulated. Therefore gut endocrinology was enclosed as a part of neuroendocrinology and similarly the importance of peptidergic substances in neural physiology was recognized. Nevertheless, the usefulness of gut endocrinology in the clinical management of gastrointestinal diseases, following an emphatic start, is now restricted to gastrointestinal neuroendocrine tumours. In these pathological conditions some regulatory peptides have been shown to be responsible for the associated symptoms and can be useful markers in the diagnosis and follow-up. However, recent advances in gut endocrinology make us think to new possibilities of clinical applications of gut hormones, at least in the understanding of the pathophysiology of some diseases (i.e. constipation, incontinence, short-bowel syndrome, etc.). Moreover, new events are now occurring in gut endocrinology since major improvements in molecular biology and genetic engineering can now allow us to sequence and clone DNA strands encoding several regulatory peptides and their precursors. Similarly membrane receptors and intracellular messengers have been characterized elucidating the complex metabolic pathways of neuroendocrine cells. Using advanced molecular biology techniques we can obtain today large amount of different regulatory peptides highly purified that can be employed in the diagnosis and therapy of several diseases.(ABSTRACT TRUNCATED AT 250 WORDS)

Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2634&dopt=Abstract constipation laxative

Gastroenterol Clin Biol. 1989 Mar;13(3):245-9.
[Sigmoid motility stimulated by luminal distention. Changes in the motility response in constipation by the slowing down of left colonic transit]

[Article in French]

Chevalier T, Arhan P, Bouchoucha M, Faverdin C, Devroede G, Mignon M, Bonfils S, Pellerin D.

Service de Gastroenterologie et Laboratorie d'Exploration Fonctionnelle Digestive, CHU Bichat, Paris.

The aim of our study was to develop a new technique of sigmoid manometry using standardized luminal distensions and to compare patterns of colonic motility following distension in normal subjects and in constipated patients. Eight subjects without colonic disturbances and 8 constipated patients with delayed transit time of the left colon as shown by radiopaque markers were investigated. Sigmoid motor activity was recorded by measuring pressure in a distending latex balloon placed at 25 cm from the anus. Inflations were maintained during 250 s and separated by 60 s recovery periods of deflation. Volumes of air (V) were increased until the patient reported abdominal pain (VMT). For each distension level, the resistance to distension of the bowel wall evaluated by the baseline adaptative pressure (P) and the contractile activity (A) quantified by planimetry of the active contractile activity (A) quantified by planimetry of the active contraction waves superimposed to P were assessed. In normal subjects, VMT was 147 +/- 9 ml. P increased linearly with V (p less than 0.03) up to 4,336 +/- 876 Pa. A increased with V until VMT/2 reached the maximum of 389 +/- 72 Pa*; for higher volumes A decreased significantly with to 166 +/- 46 Pa for VMT. Reference to controls, the constipated patients had a decreased VMT (61 +/- 4 ml). P increase at VMT (5,084 +/- 753 Pa) and A maximal value (387 +/- 176 Pa) were not different.(ABSTRACT TRUNCATED AT 250 WORDS)

Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2731676&dopt=Abstract constipation laxative colon cleansing

Lab Invest. 1989 Jun;60(6):847-51.
Morphometric study of colonic biopsies: a new method of estimating inflammatory diseases.

Salzmann JL, Peltier-Koch F, Bloch F, Petite JP, Camilleri JP.

Laboratoire d'Anatomie-Pathologique, Hopital Broussais, Paris, France.

In this study, colonic biopsy specimens from 87 subjects (37 men and 50 women; mean age 51 +/- 14 years) were investigated by a new method of quantitation morphometric analysis. Subjects were classified in 3 groups: I, control group (25 cases); II, constipation and/or abdominal pain (36 cases); III, diarrhea (26 cases). All biopsy specimens were considered normal by both colonoscopic and microscopic observations. Morphometric analysis was performed with a specialized automated image processor. Complete analysis of 1 biopsy specimen required about 10 minutes. Glandular area showed no difference in the ascending, transverse, and descending colonic sites in the three groups. By contrast, the rectal glandular area was significantly larger than those from the 3 colonic sites in all groups (p less than 0.001). The mean cellular density in the control group was 172.7 +/- 24 nuclei/unit area of lamina propria at all biopsy sites. The cellular densities of groups II and III were significantly increased in the ascending colon as compared with the group I subjects (195.1 +/- 22.8, p less than 0.01 and 198.2 +/- 24.7 p less than 0.001, respectively). The cellular density in group III was significantly increased in the other sites as compared with group I (p less than 0.01). Morphometric analysis does provide a definition of the normal range of the lamina propria cellularity and can identify mild abnormalities in patients in whose both colonoscopy and conventional histologic interpretation have been considered as normal by experienced endoscopists and pathologists. A statistical increase in cellular density in groups of patients with clinical symptoms should be regarded as consistent with the concept of microscopic colitis and detectable by mor

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