AIM: To evaluate differences in distribution, density and staining intensity of enterochromaffin cells (EC) and serotonin cells (SC) in the colonic mucosa of patients with colonic inertia (CI), idiopathic diarrhoea (ID) and a control group. METHODS: Three groups were studied: 19 patients' colons after subtotal colectomy for CI, and 17 patients' biopsies for diarrhoea (>3 bowel movements/day) with histological findings of normal mucosa (excluding microscopic, eosinophillic and collagenous colitis). The third group included 15 patients who underwent colonoscopy and biopsy for indications other than constipation, inflammatory bowel disease, diarrhoea or neoplasm (control group). Specimen blocks were obtained in each case from the right and left colon. Immunohistochemical staining for EC and SC were done on 4 micro m sections from Hollandes fixed, paraffin embedded tissues with primary rabbit antibody against chromagranin A or serotonin, and biotynylated secondary antibody and enzyme labelled streptavidin. RESULTS: The number of EC in the mucosa of the left colon in patients with CI (16.8 +/- 10.2) and ID (19.9 +/- 9.7) were significantly higher than they were on the right side (CI: 9.4 +/- 6.0, ID: 12.1 +/- 5.3). However, there were no significant differences between the left and right sides in the control group (L: 10.3 +/- 5.3; R: 13.4 +/- 7.6). Although the quantity of EC in the left colon in both patients with CI (P < 0.05) and ID (P < 0.01) were significantly higher than in the controls, there was no significant difference between CI and ID. In both the right and left colon, the percentage of EC with low positive density was significantly higher (P < 0.01) while those cells with moderate or low staining intensity were significantly lower in patients with CI than in either patients with ID or control group. In patients with CI, the quantity of SC in the mucosa of the left colon (12.1 +/- 6.4) was higher than in the right (CI: 7.9 +/- 3.6; control 4.6 +/- 3.3; ID 4.6 +/- 2.9) (P = 0.0057). In contrast there was no significant difference in SC in either the ID or control groups. The quantity of SC in both sides of the colon was significantly higher both in patients with CI as compared to the control group (P < 0.01) and patients with CI vs. patients with ID (L = P < 0.01; R = P < 0.05). There was a significantly positive correlation between the numbers of EC and SC in patients with CI (L: r = 0.5425, P < 0.05; R: r = 0.745, P < 0.01). CONCLUSION: In patients with CI, EC increases possibly due to an increase in SC. Conversely, in patients with ID, the EC increase results from peptides other than SC. Our results suggest that different aetiological factors contribute to ID and CI.
Background: Head and neck cancer (HNC) patients experience treatment-related complications that may interfere with health related quality of life. Swallowing and neck disability, impaired neck movements and eating or swallowing contribute to decrements in functional status of an individual. The aim of this paper is to assess swallowing and neck dysfunction in HNC patients post radiotherapy (RT)/chemoradiotherapy (CXRT). Materials and Methods:The purpose of this study was to assess neck dysfunction and functional status post RT/CXRT in HNC patients. Data was collected on forty nine out-patients after a course of RT / CXRT for cancers of Head and Neck using GUSS (Gugging Swallowing Screen), NDI (Neck Disability Index) and Neck Range of Motion (ROM). Results and Conclusion:Forty nine out-patients were included in the study with mean age of 58.35 ± 13.34 years (21-80). Forty three (89%) were men. Majority (59.2%) were in the advanced stage (III & IV) of HNC. Flexion (51%), extension (79.6%), left (57.1%) and right (61.2%) rotation had decreased Active Range of Motion (AROM). Lateral Flexion and extension; flexion and NDI; and extension and flexion had a significant positive correlation (p< 0.001). Mean GUSS score was 14.65 ± 2.05 (9-19) and mean NDI score was 10.59 ± 7.96(0-30). Majority of the patients had mild swallowing {37(75.5%)} and mild neck {23(46.9%)} disability.
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