SUMMARYBackground: Preliminary trials of probiotics in preventing recurrent chronic pouchitis have been encouraging. Aim: To investigate the efficacy of Lactobacillus GG supplementation as primary therapy for ileal pouch inflammation, and its effect on the microbial flora. Methods: Twenty patients, with a previous history of pouchitis and endoscopic inflammation, were recruited for a prospective, randomized, double-blind, placebocontrolled trial of Lactobacillus GG supplementation (10 LGG, 10 placebo) in two gelatine capsules [(0.5-1) · 10 10 colony-forming units/capsule] b.d. for 3 months. Quantitative bacterial culture of fresh faecal samples and biopsies taken from the pouch and afferent limb was performed before and after supplementation.

An increasing body of evidence suggests that insulin-like growth factors (IGFs) are important in the development of some tumors. In the present study, we investigated the gene expression of IGF-I, IGF-II, and their receptors in different adrenal tumors and hyperplasias. Four adrenocortical carcinomas, 15 adenomas, 4 pheochromocytomas, 5 nodular hyperplasias, and hyperplastic adrenals from 2 patients with pituitary Cushing's disease were analyzed and compared to normal adrenals. Northern blots, dot blots, and reverse transcription polymerase chain reaction analyses were used for mRNA detection, and immunohistochemistry was used for IGF-II peptide localization. The IGF-I mRNA content was low in normal, hyperplastic, and neoplastic adrenals. IGF-II mRNA levels were more than 10-fold higher in hormonally active adrenocortical carcinomas than in normal adult adrenals, and increased IGF-II-like immunoreactivity was detectable in these carcinomas. A moderate elevation of the IGF-II mRNA content was also noted in one nonfunctioning carcinoma. The IGF-II mRNA content was high in pheochromocytomas, as reported previously. Furthermore, Cushing's and Conn's adenomas expressed IGF-II mRNA levels similar to those in the normal adrenal. In nodular adrenocortical hyperplasia, we found variable IGF-II mRNA content (40-400% of normal adrenal expression). All of the normal adrenal and tumor tissues studied contained both the type I and type II IGF receptor mRNAs. The findings in the present study show that both IGF-I and IGF-II and their receptor mRNAs are expressed in various adrenocortical tumors. Moreover, the high IGF-II expression in functional adrenocortical carcinomas suggests that the IGFs may be involved in the auto/paracrine regulation of certain adrenocortical tumors.

The incidence and characteristics of reservoir inflammation after restorative proctocolectomy for ulcerative colitis were studied in a series of 179 patients. The median follow up time was 27 months (range 6-80). Pouchitis occurred in 36 patients (20%)

A correlation existed between the prevalence and titre of pANCAs and extent and disease activity of pouchitis. Chronic pouchitis may continuously stimulate the immunological process, keeping pANCAs at detectable levels. A strong correlation between AS, iritis and pouchitis suggests a common link in their pathogenesis.