Gastrointestinal Tract Disturbances Research Articles

Effects of Yifukang Oral Liquid on Chemotherapy- and Radiotherapy-Induced Toxic and Side Effects of Myelosuppression, Leucopenia and Gastrointestinal Tract Disturbances

Purpose: To investigate the effects of Yifukang oral liquid (YFKOL) on chemotherapy- and radiotherapy-induced myelosuppression, leucopenia and gastrointestinal tract disturbances. Methods: The effects of YFKOL on myelosuppression, leucopenia and gastrointestinal tract disturbances were assessed by cyclophosphamide- and Co60-induced leucopenia in mice, copper sulfate-induced emesis in pigeons, ethanol-induced gastric mucosal lesions in rats, gastric emptying and intestinal propulsion in mice. Results: In cyclophosphamide- and Co60-induced leucopenia assays, the mean white blood cell count (82.6 and 90.1 × 10 9 /L; 7.3 and 8.2 × 10 9 /L, respectively) and thighbone marrow granulocytes (66.1 % and 67.4 %; 60.8 and 66.5 %, respectively) were significantly (p < 0.05) increased after treatment with YFKOL (15 and 30 mL/kg), compared with the respective control (68.2 and 4.7 × 10 9 /L; 58.2 and 53.1 %). In emesis, gastric mucosal lesions, gastric emptying and intestinal propulsion assays, the mean frequency of emesis (30.8 and 22.3 times, respectively) and ulcer index (39.6 and 26.5, respectively) significantly (p < 0.05) decreased, and the mean gastric emptying (25.0 and 24.0 %) and intestinal propulsion (81.9 and 82.8 %) were significantly (p < 0.05) promoted after treatment with YFKOL (10 and 20 mL/kg), compared with the respective control (54.7 times, 62.8, 42.0 and 68.9 %). Conclusion: YFKOL may suppress chemotherapy- and radiotherapy-induced myelosuppression, leucopenia and gastrointestinal tract disturbances. Keywords: Yifukang oral liquid, Gastrointestinal tract disturbances, Leucopenia, Myelosuppression, Tumor, Chemotherapy, Radiotherapy

Emu oil offers protection in Crohn's disease model in rats.

BackgroundEmu oil is a product of animal origin used for the treatment of inflammation, burns etc. as a part of aboriginal medicine in Australia. Crohn’s disease is a common inflammatory manifestation in humans and other animal species relating to the ulceration and digestive disturbances in upper gastro-intestinal tract. Aloe vera is commonly used substance from plant sources for inflammation, wound healing and various other properties. Given the difference in the source of the substances all the while playing a similar therapeutic role in different parts of the world, the present investigation was undertaken to evaluate the protective effect of aloe vera and emu oil alone and in combination; in comparison to sulfasalazine (Allopathic drug) as an alternative for the treatment of Crohn’s disease.MethodsWistar albino rats were divided into six groups with two sub-groups of six animals each. After pre-treating the animals with sulfasalazine, aloe vera, emu oil and their combination for five consecutive days, the animals were sub-cutaneously administered indomethacin on 4th and 5th day and each sub-group was sacrificed on day 6 and 9. After sacrifice, serum and intestine of these animals was collected. Intestine length from duodenum till caecum was measured for estimating relative organ weight and disease activity index. Part of intestine was preserved in formalin for histopathology while the rest was used for analysis of oxidative parameters and myeloperoxidase. Serum collected was used for measuring alkaline phosphatase and cholesterol.ResultsAssessment of the parameters in treatment groups indicated that the combination of aloe vera and emu oil resulted in better protection by suppressing the oxidative (P < 0.05) and histomorphological changes indicating a enhanced effect of these two agents which was found to be better than sulfasalazine.ConclusionThe combination of emu oil and aloe vera exhibited enhanced effect resulting in significant protection from indomethacin induced ulceration. This might be due to the different mechanism of anti-inflammatory effects (Salicylic acid in aloe vera and n3, n6 fatty acids acting as pseudosubstrates to cyclooxygenase enzyme) of components of the animal and plant products tested.

Listeriosis After Transient Infectious or Mechanical Disturbance of the Gastrointestinal Tract

In rare instances, Listeria monocytogenes bacteremia and central nervous system infection appear to have followed either infectious or mechanical disturbances of the gastrointestinal tract. We report a patient who developed postoperative colitis due to Clostridium difficile that in turn was complicated by bacteremia due to L. monocytogenes. To our knowledge, this is the first report of this association. In addition, we summarize other published instances in which invasive listeriosis closely followed gastrointestinal tract disturbances by other infectious agents or endoscopic instrumentation.

Prevalence of Helicobacter pylori infection among β-thalassemia major children with recurrent abdominal pain at Suez Canal University Hospital

Background Recurrent abdominal pain (RAP) is a common pediatric problem and it is also one the several gastrointestinal tract disturbances frequently seen in β-thalassemia major (β-TM) patients. Helicobacter pylori is known to be an etiological agent of chronic gastritis and peptic ulcer diseases, but its correlation with RAP is still under debate. Aim The aim of the study was to determine the prevalence of H. pylori infection among β-TM children with RAP. Patients and methods This study was cross-sectional in design. We recruited 48 β-TM cases (24 β-TM children who presented with RAP and 24 β-TM children who did not present with RAP), aged 5-18 years, and 48 age-matched and sex-matched controls (24 children who presented with RAP without any other apparent manifestations of disease and 24 healthy children who did not present with RAP). Children who presented with RAP fulfilled Apley's criteria for the diagnosis of RAP. All patients and controls had undergone serum H. pylori IgG evaluation by ELISA. Results The seroprevalence of H. pylori in β-TM patients who presented with RAP was more common than in controls who presented with RAP [14/24 (58.3%) vs. 7/24 (29.2%); P = 0.04]. Also, there was a statistically significantly higher seroprevalence of H. pylori among the total number of β-TM children than among the total number of control children [24/48 (50%) vs. 12/48 (25%)]. The mean duration of splenectomy was statistically significantly higher in total β-TM children who were H. pylori IgG positive than among total β-TM children who were H. pylori IgG negative. There was no significant difference between total H. pylori IgG-positive β-TM children and age, sex, duration of blood transfusion, duration of iron chelating agent, criteria of abdominal pain, and serum ferritin level. Conclusion There was a higher prevalence of H. pylori IgG in β-TM children with RAP than among control children with RAP, as well as among total β-TM children than among total control children. H. pylori IgG was detected more frequently in thalassemic patients with a longer duration of splenectomy.

Coordination of Silver Sulfadiazine with Glutathione in Aqueous Medium

Silver sulfadiazine (Ag-SD) was introduced as an antibacterial agent for topical treatment of burns and healing of wounds. But when sliver is ingested it caused severe complication like gastro-intestinal tract damages and disturbances, convulsions and shock, which may lead to death. Glutathione, containing sulfhydryl group, has strong affinity for silver and may interact with silver. In the present study, Ellman’s method was used to investigate spectophotometrically the effects of silver sulfadiazine on glutathione under various conditions in aqueous medium. It was found that the interaction of silver with glutathione causes depletion of glutathione in aqueous medium. This effect was more pronounced with increasing concentration of silver and with extended time of incubation. The maximum decline in glutathione was also observed at physiological pH (~7.6) and temperature (37°C). This decrease in glutathione level in aqueous medium may be due to conjugation of silver with glutathione (Ag-GS conjugate). From this finding, we can conclude that glutathione has significant role in the detoxification of silver, which further suggests the use of glutathione supplement in the management of silver-related toxicity.

Osteogenic effect of locally applied Pentoxyfilline gel: in vitro and in vivo evaluations

The aim of this study was to formulate Pentoxyfylline drug (PTX) as a local bioadhesive Carbopol (Cbp) based gels for the aid of bone induction around an endosseus oral implant. The local delivery of the drug will probably avoid most of the problems associated with its systemic use including; disturbances in gastrointestinal tract and the central nervous system. Two concentrations of 1% and 3% Cbp containing 1% PTX were prepared. The gels were investigated for their physicochemical properties. Cbp based gels were found to be translucent with good homogeneity, uniform distribution of the drug and absence of any lumps. The pH of the gels was within neutrality, 7.1, which is considered to be acceptable to avoid the risk of any possible irritation in the oral cavity. The Cbp gels exhibited satisfactory bioadhesive properties and a pseudo-plastic rheological behavior. Cumulative drug released from the gels showed a controlled-release for more than 24 hours with the order of 3% >1% and the drug was released by diffusion mechanism from both gels. Statistical analysis revealed non-significant difference in drug content, rheological property and release rate of the stored gels for six months compared to the fresh ones. In vivo experimental results in rabbits have shown significant difference in bone depth induction of 3% and 1% Cbp gels with the formation of strong organized bone over the control group. Local administration of Pentoxifylline could be regarded as a valid approach in the management of osseointegration.

MILK FORMULAS 3 AND 4 IN FEEDING OF CHILDREN IN THE IZHEVSK ORPHANAGE

Aim: to assess efficacy of studied milk formulas in nutrition of infants living under conditions of orphanages. Patients and methods : 70 inmates of a certain orphanage aged 1,4–3,6 years old were divided into 2 groups. Children of the observation group (n =25) were fed with 150 ml of «Children milk with prebiotics» twice a day. Comparative group (n =25) received 150 ml of cow milk twice a day. The studied population was characterized by constantly changing number of patients, this difficulty led to decrease of duration of feeding with «Children milk with prebiotics» from 1 month to 24 days. Efficacy control of nutrition at the beginning and in 24 days of feeding with this milk formula was assessed according to anthropometric indexes, laboratory data and symptoms of functional gastro-intestinal disorders. Results: it was shown that including of studied formulas enriched with vitamins, microelements and containing lower percentage of proteins into the children diet instead of cow milk contributes to accelerated growth and development of infants, arresting of symptoms of functional digestive disturbances, improvement of the results of the red blood and faeces analyses. Conclusions : nutrition of orphan children with diseases of central nervous system and a number of other disorders, among them functional disturbances of gastro-intestinal tract, it is necessary to include the afore-mentioned milk formulas, which are indicated to such children also with medicinal aim.

Reasons for medical consultation among members of the Indian Scientific Expeditions to Antarctica

The article attempts to analyze the disease burden in a healthy, pre-screened population subjected to prolonged residence in the hostile environment of Antarctica. This retrospective epidemiological study was conducted utilizing data from medical consultation room on board the Indian Antarctic expedition vessels and at Indian Antarctic station, Maitri from seven Indian Scientific Expeditions to Antarctica (ISEA). The study group (n=327) consisted of 325 men and two women. The total number of medical room consultations was 1989. Maximum consultations were for injuries (27.25%); 14.68% were musculoskeletal and 10.31% were bruises and lacerations. Disturbances of gastrointestinal tract (19.66%) were the second most common disorders. Psychological disturbances accounted for 2.66% consultations. Cold injuries constituted 2.01% consultations and photophthalmia accounted for 1.06% consultations.

The effect of Nigella sativa on the diabetic liver in male albino rats with a special focus on the role of hepatic oval cells

Introduction Aging is believed to affect the structure and function of the enteric nervous system in the gastrointestinal tract. Aim of the work This work was designed to study the histological changes that might occur in the myenteric plexus of rat gastric fundus during aging. Materials and methods: Thirty male albino rats were used in this study and divided equally into three groups: group A (which included 4-month-old rats), group B (which included 18-monthold rats), and group C (which included 24-month-old rats). All the animals were anesthetized, and their stomachs were dissected out and processed for light and electron microscope examination. Also, immunohistochemical staining was carried out for the detection of protein gene product (PGP 9.5) and Bcl-2 proteins. The area% of myenteric ganglia was also determined. The results were analyzed statistically. Results: With age, in group B (early senile), there was obvious neuronal loss and few gaps in the myenteric plexus, with a significant decrease in the number of PGP-positive neurons and moderate immunoreactions for the Bcl-2 protein. Glial cells had cytoplasmic vacuoles and nerve cells had peripheral condensation of heterochromatin in their nuclei. The myenteric plexus of the rats of group C (late senile) showed nerve cell bodies with apoptotic nuclei and cytoplasmic vacuolations. Many large cavities and eosinophillic cellular infiltration were observed within the neuropil. There was a marked apparent decrease in PGP 9.5-positive neurons and minimal immunoreactions for the Bcl-2 protein. Also, the area of myenteric ganglia increased with advancing age. Conclusion: In the current study, it was found that the myenteric plexus of the gastric fundus showed histological and immunohistochemical changes during aging, which may potentially be an explanation for the gastrointestinal tract disturbance in elderly individuals.

ENTEROSORBENTS AS A PART OF COMPLEX THERAPY OF ATOPIC DERMATITIS

Atopic dermatitis (AD) is one of the most common allergic diseases in children which is assuming ever greater medical and social importance. Risk factors of AD include gastro-intestinal tract disturbances, especially intestinal dysbiosis, which is revealed in 89–94,1% of children with atopic dermatitis. Both correlation of the dysbiosis and AD manifestations severity and increase of underlying disease treatment efficacy as a result of target influence on intestinal microflora confirm that. For many decades guidelines of atopic dermatitis treatment in children along with elimination diet, antihistamine drugs and topic medicines include enterosorbents. The most effective drugs are those ones, consisting of prebiotics and sorbents. The wide experience of prebiotic drug with sorbent action (Lactofiltrum) in complex therapy of atopic dermatitis in children is reviewed in this article.

Bisphosphonates and the Risk of Atrial Fibrillation in Elderly Women with Osteoporosis

Evaluation of: Rhee CW, Lee J, Oh S, Choi NK, Park BJ. Use of bisphosphonate and risk of atrial fibrillation in elderly women with osteoporosis. Osteoporos. Int. DOI: 10.1007/s00198-011-1608-z (2011) (Epub ahead of print). Osteoporosis is a growing problem in the aging population. It affects postmenopausal women, as well as elderly subjects of both sexes, often with dysfunction of the cardiovascular system or with an increased risk of circulation disorders. It has been found that the mortality rate of subjects with osteoporosis is comparable with that in patients suffering from diseases such as obturative pulmonary disease and myocardial ischemia. Bisphosphonates are the first-line drugs used in the therapy of osteoporosis. However, their administration is associated with a risk of adverse symptoms, which are likely to occur as gastrointestinal tract disturbances, muscular-osseous pains, mandible necrosis and atypical fractures. Recently, an increased risk of atrial fibrillation during bisphosphonate treatment in females has been reported, but the results of some studies are rather controversial. The new paper by Rhee et al., published in Osteoporosis International, presents data from a large cohort study and shows opposite, protective effects of bisphosphonate against atrial fibrillation. It is important for both clinicians and their patients to know whether bisphosphonates increase the risk of cardiac arrhythmia.

Anti-Inflammatory and Immunomodulatory Effects of Paeonia Lactiflora Pall., a Traditional Chinese Herbal Medicine

In China, Korea, and Japan, a decoction of the dried root without bark of Paeonia lactiflora Pall. has been used in the treatment of rheumatoid arthritis, systemic lupus erythematosus, hepatitis, dysmenorrhea, muscle cramping and spasms, and fever for more than 1200 years. A water/ethanol extract of the root is now known as total glucosides of peony (TGP), which contains more than 15 components. Paeoniflorin is the most abundant ingredient and accounts for the pharmacological effects observed with TGP in both in vitro and in vivo studies. The analgesic effect of TGP was confirmed in various animal models of pain, which may be mediated partly by adenosine A1 receptor. The direct anti-inflammatory effects of TGP were observed in animal models of both acute and subacute inflammation, by inhibiting the production of prostaglandin E2, leukotriene B4, and nitric oxide, and by suppressing the increase of intracellular calcium ion concentration. TGP was also reported to have protective effects of cells against oxidative stress. In vitro, dual effects of TGP were noted on the proliferation of lymphocytes, differentiation of Th/Ts lymphocytes, and the production of proinflammatory cytokines and antibodies. In vivo, TGP inhibited the delayed-type hypersensitivity in immuno-activated mice, and enhanced the delayed-type hypersensitivity in immuno-suppressed mice. In adjuvant arthritis rats, paeoniflorin exerted immunosuppressive effects. The beneficial effects of TGP in treating rheumatoid arthritis were verified by randomized controlled trials. The adverse events of TGP were mainly gastrointestinal tract disturbances, mostly mild diarrhea.

Particle beam radiotherapy with a surgical spacer placement for advanced abdominal leiomyosarcoma results in a significant clinical benefit

Leiomysarcoma is a rare malignant tumor originating from smoothmuscle cells. Because of the limited number of cases, the naturalhistory and optimal treatment have not been clarified. In particular,prognosis of leiomyosarcoma originating from large vessels includingthe inferior vena cava (IVC) and aorta is extremely poor. Recent datasupport an aggressive surgical resection combined with adjuvantchemotherapy as the best treatment option for a leiomyosarcoma fromthe IVC [1,2]. However, the long-term outcome of curative resectionsfor leiomyosarcoma from large vessels has been disappointing. The5-year survival rates obtained with absolute curative resections wereobserved to range from 34.8% to 53.3% [1,2]. Hines et al. [2]suggested that radiation therapy after a surgical resection may prolongsurvival. It should be noted, however, that an absolute curativeresection was performed in all of their cases and the effectiveness ofchemotherapy and radiotherapy were assessed in the framework ofadjuvant therapy. There is no report about the treatment of anunresectable leiomyosarcoma and the overall survival rate.Particle beam radiotherapy is a new mode of radiotherapy that hasan inherent advantage over photon radiotherapy. Particle beams, suchas proton and carbon ion beams, show an increase in energy depositionwith penetration depth up to a sharp maximum at the end of their rangeto form the so-called Bragg peak. It thus permits delivery of higherdoses of radiation to the tumor, which may lead to profoundlyimproved tumor eradication. Recent results from major centers haveshown the therapeutic superiority of particle radiotherapy for variouskinds of malignant tumors [3,4]. However, the application of particlebeam radiotherapy for abdominal malignant tumors is restrictedbecause most of them come in contact with the intestine that cannottolerate the radical dose of particle beams. Several studies haveinvestigated the risk factors related to late gastrointestinal tractdisturbance after radiotherapy. Ishikawa et al. [5] assessed that thedosimetric parameter was a very important factor in the occurrence ofgastrointestinal bleeding after particle radiotherapy. Gastrointestinaldisturbances, such as ulcer formation and colitis, generally occurwithin several months after the completion of particle radiotherapy.However, the irradiated volume of a marginal tumor is normallylimited to make it lower than the maximum dose in order to prevent anytoxicity to the nearby gastrointestinal tract. To overcome thislimitation, we developed a novel two-step treatment with a surgicalspacer placement and subsequent proton beam radiotherapy andachieved a significant clinical benefit for three patients.

Colonic perforation after short-term use of nonsteroidal antiinflammatory drugs: report of two cases

Nonsteroidal antiinflammatory drugs are widely used for acute and chronic pain, but they may have serious side effects such as impairment of renal function, asthma, erosions of the mucosa in the gastrointestinal tract, colonic and intestinal strictures, and gastrointestinal tract bleeding. Although the upper gastrointestinal tract disturbances caused by nonsteroidal antiinflammatory drugs are well known, their side effects in the lower gastrointestinal tract are not clearly defined. There are a limited number of articles and case reports about the latter in the literature. We report two cases of colonic perforation due to short-term use of nonsteroidal antiinflammatory drugs in this study. Colonic perforation should be considered as one of the possible diagnoses in patients with acute abdominal pain and nonsteroidal antiinflammatory drug use should be considered as a possible cause of colonic perforation if other possibilities are excluded.

Interactive Multimedia Can Be Used Effectively in Food Safety Education

Unsafe food practices can lead to foodborne illnesses that can cause gastrointestinal tract disturbances including diarrhea and vomiting. These conditions are critical for pregnant women, infants, and young children because dehydration, loss of electrolytes, and malabsorption of many macro- and micronutrients can subsequently occur. Foodborne illnesses could cause infants to lose weight at this critical juncture of their lives when they should be growing. Therefore, food safety education should be included as a part of nutrition counseling for these populations.

New Insights in the Etiology and Pathophysiology of Irritable Bowel Syndrome: Contribution of Neonatal Stress Models

Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders, characterized by abdominal pain and disturbed defecation that cannot be explained by structural abnormalities. Although IBS symptoms (visceral pain, increased gut permeability, motility alterations) are clearly established, the etiology of this pathology is loosely understood. Nevertheless, clinical studies have reported that some early abuse (physical and psychological) is often associated with IBS development. Thus, loss and separation in the family during childhood may contribute to the IBS development. The recent development of animal models has pointed out the importance of early traumatic experiences in favoring the occurrence of IBS in adult life. Among these different models, neonatal maternal deprivation (NMD), neonatal colonic irritation (inflammatory stimuli), and neonatal colonic pain (rectal distension) have been described to mimic some cardinal features of IBS. The purpose of this review is 3-fold. First, to present the different neonatal stress models. Second, to review the literature on the influence of these early traumatic experiences on the gastrointestinal tract disturbances observed in adult life. Finally, we will also present the mediators and mechanisms involved in gut dysfunction triggered by NMD and probably in IBS.

Mycophenolate mofetil in diffuse cutaneous systemic sclerosis--a retrospective analysis

We have assessed indications, duration and tolerability of treatment with mycophenolate mofetil (MMF) in patients with diffuse cutaneous systemic sclerosis (dcSSc), and compared clinical outcome with a control cohort treated with other immunosuppressive drugs. The clinical records of 109 patients treated with MMF and 63 control subjects receiving other immunosuppressive drugs were reviewed. Data covering a 5-yr period from commencement of treatment or until last assessment date were collected. MMF and control groups were well-matched in terms of basic demographic and clinical parameters. Treatment with MMF was very well tolerated. Of all patients, 12% experienced adverse reactions with gastrointestinal (GI) tract disturbances and infections being most frequent. MMF was discontinued due to disease stabilization in 9%, side effects in 8% and no effect on the disease activity in 14% of the patients. There was a significantly lower frequency of clinically significant pulmonary fibrosis in the MMF-treated cohort (P = 0.037) and significantly better 5-yr survival from disease onset and from commencement of treatment (P = 0.027 and P = 0.012, respectively). There was no significant difference between the two groups in terms of modified Rodnan skin score and forced vital capacity (FVC) change. MMF is very well tolerated and appears to be at least as effective as the other current therapies for dcSSc. Our results provide support for further evaluation of MMF in a prospective trial.

PVN1: A Phase 2 Study of Pegylated Interferon-α2a in Polycythemia Vera (PV) by the “PV-Nord” Group. Preliminary Report of Efficacy and Safety.

Background: Interferon-α (IFN) can control erythrocytosis in about 75% of PV patients and may even induce cytogenetic remission while avoiding the leukemogenic potential of myelosuppressive drugs. However, 20–25% of patients discontinue therapy due to side effects. Pegylated-IFN (peg-IFN) α2b, usually better tolerated than standard IFN, has shown similar efficacy but no advantage in terms of tolerance in PV (ASH 2004, abstracts 1517 & 1518). The use of peg-IFN-α2a has not been reported in PV to our knowledge. The French “PV-Nord” group performed an open label phase II study of peg-IFN-α2a (Pegasys®, Roche Laboratories) in PV patients.Study design: Inclusion criteria were: PV diagnosed according to PVSG criteria, aged 18 to 65, previously untreated, or only phlebotomized, or with cytoreductive treatment for less than 2 years. Complete response (CR) was defined by Ht lower than 45% in male and 42% in female without phlebotomy for more than 3 months, absence of splenomegaly and normal WBC and platelet counts. Partial response was defined by Ht as above but persistent splenomegaly or elevated platelet count, or > 50% decrease in phlebotomies. Failure was defined by persistent phlebotomies to maintain Ht in the target range. Primary objective was determination of response rate; secondary objectives were evaluation of toxicity and evolution of molecular markers (i.e. detection of JAK2 mutation and PRV-1 expression) on peg-IFN.Results: Between September 04 and August 05, the 37 initially planned patients were included. 20 of them had a follow-up greater than 6 months and were evaluable for response: M/F ratio 7/13, median age 49 years (range 22–65). Median time from diagnosis to inclusion in the 20 patients was 6 months (range 1–65). 14 patients (70%) were either untreated or only phlebotomized before inclusion and 6 (30%) had previously received hydroxyurea. 25% of patients had a history of thrombosis. Median Ht was 56% in males (range 46–66) and 45% in females (range 40–60). Median WBC and platelet counts were 8.109/l (range 3–23) and 571.109/l (range 120–1478), respectively. 30% of patients had splenomegaly. After 3 months, all patients were responders, with 15 CR (75%) and 5 PR (25%). At 6 months, 95% of patients were responders with 16 CR (80%) and 3 PR (15%) (persistent splenomegaly in 2, elevated platelets in 1). Only grade 1 and 2 toxicities were reported. Most frequent toxicities were fatigue (n=6), muscle and joint pain (n=6) and disturbances of gastro-intestinal tract (n=3). Fever and depression (grade1 for both) were observed in 3 and 2 patients respectively. Only one patient discontinued treatment due to repeated grade 2 thrombocytopenia.Conclusion: This is the first report of a phase II trial using peg-IFN-α2a in PV. The 95% response rate after 6 months of treatment and only 5% treatment withdrawal due to side effects suggest that peg-IFN-α2a is at least as effective and as well tolerated as both standard IFN and peg-IFN-α2b in PV. Updated results will be presented.

Chronic symptoms after subtotal or partial oesophagectomy: diagnosis and treatment

In the great majority of patients, subtotal or partial oesophagectomy is performed because of malignancy, for which wide local excision and additional lymphadenectomy are indicated. Except in patients with early lesions, the vagal nerves have to be sacrificed bilaterally, which can induce a great variety of functional abnormalities. The continuity of the gastrointestinal tract is preferably restored by using a whole-stomach interposition or gastric tube. The oesophago-gastric anastomosis is critically vascularized and carries a significant risk of benign fibrotic stricturing, especially when it is located in the neck. Acid or biliary reflux may result in persistent oesophagitis and the development of Barrett's metaplasia in the remnant oesophagus. The reservoir capacity of the gastric tube is limited, whereas the emptying rate can vary considerably, leading to complaints of either gastric retention or intestinal dumping. It is not clear whether or not gastric drainage procedures are beneficial. Recurrent nerve damage with vocal cord paralysis may result in aspiration and recurrent pulmonary infection. The permanent threat of recurrent disease combined with the substantial physical impact of an extensive surgical procedure inducing a wide range of functional disturbances of the gastrointestinal tract has a great influence on quality of life, at least temporarily. The late complications of anastomotic stricturing and the functional consequences of bilateral vagotomy, gastric tubulization and gastric pull-up will be reviewed. Moreover, the general and specific changes in quality of life will be addressed.

Peculiarities of blood rheology in patients with chronic generalized periodontitis combined with gastrointestinal tract disturbances

The aim of investigation is to study blood rheological properties in patients with chronic generalised periodontitis combined with gastrointestinal tract disturbances. 205 patients have been examined including those with erosive ulcerous involvement of gastroduodenal area — 51, with stomach ulcer and duodenal ulcer — 62, with chronic colitis — 39, with nonspecific ulcer colitis — 53. Blood viscosity properties, indices of erythrocyte aggregation and deformability, rate of oxygen delivery to tissues have been evaluated by rotary viscometer АBR-2 (Russia). It has been revealed that blood rheological properties in patients with chronic generalised periodontitis combined with gastrointestinal tract disturbances had been disturbed, that was accompanied with the blood viscosity rise, erythrocyte aggregation increase and with the decrease of deformability and rate of oxygen delivery to tissues. The degree of violations in blood rheology indices was mostly expressed under chronic and plural erosions of gastroduodenal area, duodenal ulcer and severe course of chronic nonspecific ulcer colitis.