SummaryThe transit times of food residues through the gastrointestinal tract have been studied by administering food mixed with a small amount of barium sulphate. Observations were made on 88 normal subjects, 75 patients with the irritable colon syndrome, and 43 patients with diverticulosis. The transit times were found to be substantially shorter in the patients with diverticula than in normal subjects and to follow closely the transit shown by patients with the irritable colon syndrome. This finding is put forward as evidence supporting the hypothesis that incoordinated colonic activity is the basic abnormality in diverticulosis.We wish to express our gratitude to all the patients and normal subjects who volunteered to take part in this study, the Beer, E. (1904). Amer. 7. med. Sci., 128, 135. Burnett, F. L. (1923). Amer. 7. Roentgenol., 10, 599. Cole, L. G. (1914). Ainer. Y. med. Sci., 148, 92. Edwards, H. C. (1939 It has been generally accepted that diverticulosis of the colon is a common condition in Western countries, especially in the older age groups (Barborka, 1958; Reichman and Watkins, 1962). However, up to the present time the frequcncy of diverticulosis has been calculated from radiological studies carried out on patients or from post-mortem examinations in hospital, and consequently the results apply only to selected sections of the population. Spriggs and Marxer (1925) examined 1,000 consecutive barium enemas and found diverticula in 10%. Rankin and Brown (1930) Until some years ago diverticula were more common in men than in women (Spriggs and Marxer, 1925;Ochsner and Bargen, 1935); recently, however, it appears that a change in sex ratio is taking place and a female preponderance is now commonly observed (Ford, 1953;Brown and Toomey, 1960). Table I shows the sex ratio in diverticulosis and diverticulitis reported by various authors. In a recent study on the prognosis of diverticulosis and diverticulitis (Manousos and Truelove, 1967) it was found that whereas below the age of 60 diverticula were equally common in men and women, above that age the condition was much more common in women. It was also shown that the number of patients admitted to hospital with diverticulosis, diverticulitis, and the complications of diverticular disease is increasing, and this probably indicates a true increase in the prevalence of the disease as a whole.In view of the lack of accurate information on the frequency of diverticulosis in the population at large the present study was made. f Consultant Radiologist, United Oxford Hospitals, Oxford. Methods and SubjectsThe radiological appearances of the colon of 109 subjects without gastrointestinal symptoms were studied. The majority of the subjects were healthv volunteers who were either members of the staff of the Radcliffe Infirmary or visitors to inpatients. A minority of the subjects were patients in a geriatric unit (Cowley Road Hospital, Oxford) who were volunteers and who were completely free from gastrointestinal symptoms.
Background A clear-cut need exists for safe and effective alternatives to the use of isotretinoin in severe acne. Lack of data regarding the specifics of isotretinoin’s mechanism of action has hampered progress in this area. Recently the protein neutrophil gelatinase-associated lipocalin (NGAL) has been identified as a mediator of the apoptotic effect of isotretinoin on sebocytes. The goal of this paper is to further establish the clinical relevance of NGAL and to elucidate the factors that induce NGAL expression in sebocytes. Methods/Results Methods were developed to isolate and quantify skin surface levels of NGAL from normal subjects and acne patients undergoing treatment with isotretinoin. Acne patients were found to have higher skin levels of NGAL compared to normal subjects. Studies in SEB-1 sebocytes indicate that NGAL expression is increased in response to P. acnes and IL-1β. In patients, isotretinoin increases NGAL levels by 2.4-fold on the skin surface and this increase precedes decreases in sebum and P. acnes counts. Conclusions These data support the hypothesis that NGAL is an important mediator of the early effects of isotretinoin on the sebaceous glands and provide insights into the mechanisms that regulate NGAL expression in the skin.
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