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PubMed2004

Causes of idiopathic constipation in Thai patients: associations between the causes and constipation symptoms as defined in the Rome II criteria.

UNLABELLED: The authors investigated 103 consecutive Thai patients (29M, 74F age 50 +/- 20) with chronic idiopathic constipation (symptom duration; median 5 yr, range 0.25-45 yr) as defined by Rome II criteria using colonic transit test, anorectal manometry, and balloon expulsion tests. Constipation symptoms were evaluated by a questionnaire. RESULTS: There were 30, 14, 11, and 48 patients who fulfilled the criteria of anorectal dysfunction, colonic inertia, anorectal dysfunction plus colonic inertia, and the normal transit constipation, respectively. The proportion of female gender in the normal transit constipation group (F:M=37:11) was significantly greater than the anorectal dysfunction group (16.14, p<0.05%). Patients with colonic inertia and colonic inertia plus anorectal dysfunction had a higher prevalence of infrequent bowel movement compaired to anorectal dysfunction and normal transit constipation (p<0.001). The prevalence of straining, hard stool, incomplete evacuation, sense of anal obstruction, and use of manual maneuver to facilitate defecation, were not different among the constipation subgroups (p>0.05). CONCLUSIONS: Prevalence of pathophysiologic conditions associated with idiopathic constipation in Thai patients are similar to Western countries. 29%, 13%, and 11% of Thai patients with idiopathic constipation were associated with anorectal dysfunction, colonic inertia, and anorectal dysfunction plus colonic inertia, respectively. Among the 6 constipation symptoms defined by Rome II criteria, only infrequent bowel movements was associated with delayed colonic transit.

Adult↗
PubMed1991

Hypertension and atherosclerosis. Cause and effect, or two effects with one unknown cause?

Hypertension is associated with an increased risk of clinical cardiovascular complications due to atherosclerosis. However, attempts to reduce that risk with antihypertensive treatment have not always been successful. Therefore, it may be significant to discuss antihypertensive treatment in view of the cellular pathogenesis of atherosclerosis. Endothelial and smooth muscle cells are found in both normal and atherosclerotic arterial tissue, but cellular characteristics appear to be affected during atherogenesis. Lymphocytes and monocytes are found primarily in the atherosclerotic lesion and may be of critical importance for both cell proliferation and lipid accumulation. In the present review, processes involved in the regulation of functional properties of the various cell populations in the atherosclerotic lesions are discussed. The significance of the smooth muscle population as a quantitatively dominating cell constituent in both the atherosclerotic lesion and in the resistance vessels of hypertensives is emphasized. Two different mechanisms possibly involved in the increase of size of the smooth muscle population are discussed. Proliferation of a stem cell population or of differentiated medial smooth muscle cells might be involved. In addition, generalized, possibly genetically determined changes in cellular reactivity to adrenergic stimuli and growth factors may be implicated. If so, hypertension and atherosclerosis might perhaps be regarded as two independent expressions of the same cellular defect. This would have implications in attempts to prevent coronary heart disease by antihypertensive drugs.

Animals↗