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Pediatr Surg Int. 2002 Sep;18(5-6):349-53. Epub 2002 May 23.
Acetylcholinesterase distribution and refractory constipation - a new criterion for diagnosis and management.

Kobayashi H, Li Z, Yamataka A, Lane GJ, Yokota H, Watanabe A, Miyano T.

Department of Paediatric Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. kobed.juntendo.ac.jp

To describe manifestations of acetylcholinesterase (AchE) activity in the bowel of patients presenting with refractory constipation and correlate them with outcome, rectal biopsy specimens (RBS) from 165 patients who presented with refractory constipation between 1988 and 1999 were examined. Age at biopsy ranged from 4 days to 17 years; 45 subjects were excluded because they satisfied diagnostic criteria for Hirschsprung's disease, intestinal neuronal dysplasia, or hypoganglionosis. Thirty-five autopsy subjects were used as controls. All RBS were compared and AchE activity was assessed in the lamina propria (LP), muscularis mucosae (MM), and around the submucosal vessels (V). Variations in AchE distribution were classified as grade I (no AchE-positive nerve fibers in the LP or MM), grade II (some positive fibers in the LP or MM), grade III (moderate positive fibers in the LP or MM), grade IV (many positive fibers in the LP, MM, or V), or grade V (fibrillar, foamy, or amorphous staining for AchE). All grade I (11/120) and V (12/120) subjects achieved normal bowel control with laxatives alone and all grade II subjects (58/120) did with laxatives and enemas. Grade III subjects (34/120) required addition of cisapride. All grade IV subjects (5/120) were unresponsive to conservative management and 4/5 were found to have a megarectum, which was treated surgically. AchE distribution correlated well with eventual outcome and requirement for surgery. AchE distribution could also be used to classify bowel motility disorders, and we suggest the term AchE-positive disease be used to describe them.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12415353&dopt=Abstract

Pediatr Surg Int. 2002 Sep;18(5-6):368-70. Epub 2002 Mar 27.
Lateral sphincteromyotomy in patients with outlet obstruction after surgery for Hirschsprung's disease and short-segment disease.

Vorm HN, Jensen SI, Qvist N.

Surgical Department A, Odense University Hospital, 5000 Odense C, Denmark.

The results of lateral sphincteromyotomy (LSM) including the external sphincter in patients with severe outlet obstruction (OO) and constipation refractory to medical treatment after surgery for Hirschsprung's disease (HD) or with short-segment disease were evaluated. The parents filled out a detailed questionnaire on the child's bowel habits prior to surgery and at follow-up 2-26 months after surgery. The postoperative questionnaire included a 10-grade visual analog scale (VAS) indicating the general effect of LSM on the child's bowel habits: grade 1 represented no change at all and 10 represented an excellent result with normal bowel habits. 15 (65%) of the 23 patients had a VAS score of 7 or more, and 7 were reported to have normal bowel habits. Patients with a previous Soave operation did better compared to patients with short-segment disease (SSD). In 2 patients (Soave's operation) with scores of 1 and 2, respectively, a sigmoidostomy was performed 4 and 6 months after the LSM. High-dose laxatives and/or enemas have been used in the 5 patients with scores of 3-5. One patient developed a perianal abscess and one experienced minor soiling. LSM including the whole sphincter complex thus gave significant symptomatic relief in two-thirds of the patients. However, the long-term results are still pending.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12415357&dopt=Abstract

Behav Res Ther. 2003 May;41(5):619-27.
Somatoform dissociation in eating-disordered patients.

Waller G, Babbs M, Wright F, Potterton C, Meyer C, Leung N.

Department of Psychiatry, St. George's Hospital Medical School, University of London, Cranmer Terrace, SW17 0RE, London, UK. g.walleghms.ac.uk

This study investigated the role of somatoform dissociation in eating disorders and pathological eating behaviour, relative to the established association of eating pathology with psychological dissociation. The participants were 131 women with DSM-IV diagnoses of anorexic or bulimic disorders and 75 women who had no such disorder. Each woman completed measures of psychological and somatoform dissociation, as well as a measure of bulimic attitudes. The current presence or absence of specific bulimic behaviours was identified during the clinical interview. Levels of both forms of dissociation were higher in the women who had diagnoses of disorders with a bulimic component (bulimia nervosa; anorexia nervosa of the binge/purge subtype) than in the non-clinical or restrictive anorexic women. Somatoform dissociation showed particularly strong links with the presence of bulimic behavioural features (excessive exercise, laxative abuse, diet pill abuse, diuretic abuse) and with bulimic attitudes. The formulation and treatment of cases where there are bulimic features is likely to be enhanced by the assessment of somatoform dissociation.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12711268&dopt=Abstract

The average human scalp is covered by approximatey 100,000 hair follicles. Each hair undergoes hair cycle and normally 50-100 hairs randomly fall out a day, which is unnoticeable because lost hair is replaced by as many new hairs springing up daily. Hair loss results from the fall out of hair from the hair follicle. Alopecia or excessive, premature hair loss is the condition caused by many factors. Loss of hair itself does not pose critical health problems because biological role of human hair is relatively marginal. Hair on our scalp protects the head from mechanical shock, heat loss, and exposure to UV-light. The eyelashes and eyebrowes protect the eyes, and hair in the ear canal or the nasal passages help filter out particles and pathogens, thus protecting our internal organs. However, hair does play important social role: it is one of the major determinants of our appearance and identity in daily life. Fullness of hair also implicates or manifests physical integrity and youthfulness of the person. Losing hair could have more than just emotional impacts on individuals. The hair is a unique organ that goes through a characteristic cycle consisting of an immature phase, a growing phase called anagen, a transitional phase between the growing phase and the resting phase called catagen, and finally a resting phase called telogen in which the hair stops growing, waiting to fall out. 85-90% of hairs on our body are in anagen phase or growing phase, which lasts anywhere from two to five years. This phase is followed by a short regression phase, or catagen, which lasts 2-3 weeks. Approximately 1% of hair follicles are in catagen. Approximately 10-15% of hair follicles are in the resting phase, the telogen, which lasts about 3-5 months. Hair follicles typically goes through 10-20 asynchronous cycles during the lifetime. Persistent loss of more than 150 hairs would consist a state of hair loss, or alopecia, albeit it could be temporary.

DHEA is a natural hormone, and it is produced in our body by the adrenal glands. DHEA has been suggested to provide numerous potential benefits. DHEA (or dehydroepiandrosterone) is converted into androgens (male hormones) or estrogens (female hormones) in the cells. Our bodies produce decreasing amount of DHEA as we get older. various health benefits: To deter aging, improve sexual function/erectile dysfunction, treat cognitive decline, enhance athletic performance, facilitate weight loss, improve strength, prevent osteoporosis, enhance immunomodulation for rheumatic conditions, and treat depression.

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