Free cortisol and accuracy of total cortisol measurements in the diagnosis of adrenal insufficiency in brain-dead patients.

Background: After brain death, adrenal insufficiency (AI) is very common and may be one of the mechanisms that contributes to hemodynamic instability and loss of potential organ donors. However, when diagnosed by total cortisol measurement, critically ill patients may be overdiagnosed as having AI. The aims of this study were to assess the prevalence of AI when diagnosed using free cortisol measurement and the accuracy of total cortisol measurement to diagnose AI in brain-dead patients.

Hydrocortisone supplementation enhances hemodynamic stability in brain-dead patients.

Background: Hemodynamic instability is frequent in brain-dead patients and may result, in part, from absolute or relative adrenal insufficiency. Corticosteroid supplementation is widely used to restore hemodynamic stability in septic shock and to reduce the time of shock resolution. The authors verified that supplementation with hydrocortisone may enhance hemodynamic stability in brain-dead patients.

[Medium-term results of grade 3 and 4 cystocele repair by porcine xenograft matrix (pelvicol)].

Objective: To evaluate the medium-term results of grade 3 and 4 (Baden-Walker classification) cystocele repair by transvaginal porcine xenograft matrix (Pelvicol).

Materials: Between February 2002 and October 2005, fifty patients with grade 3 or 4 cystocele were treated by Pelvicol matrix. The preoperative grade of prolapse and symptoms (urinary and pelvic heaviness) were recorded and a sexuality questionnaire was completed retrospectively (BISF-W questionnaire).

Toxin B of Clostridium difficile activates human VIP submucosal neurons, in part via an IL-1beta-dependent pathway.

This study investigated whether toxin B of Clostridium difficile can activate human submucosal neurons and the involved pathways. Isolated segments of human colon were placed in organ culture for 3 h in the presence of toxin B or IL-1beta. Whole mounts of internal submucosal plexus were stained with antibodies against c-Fos, neuron-specific enolase (NSE), vasoactive intestinal polypeptide (VIP), and substance P (SP).

Changes in chemical coding of myenteric neurones in ulcerative colitis.

Background: Morphological and functional changes in the enteric nervous system (ENS) have been reported in inflammatory bowel diseases but it is still uncertain whether neurochemical coding of myenteric neurones is altered in ulcerative colitis (UC).

Aims: In this study we investigated transmitter co-localisation in myenteric neurones of normal colon and the colon of patients with UC.

Methods: Choline acetyltransferase (ChAT), neurone specific enolase (NSE), vasoactive intestinal peptide (VIP), and substance P (SP) were detected by immunohistochemical methods in whole mounts of colonic myenteric plexus of UC patients (n=10) and controls (n=8).