مهدی صرافی

In many patients with ulcerative colitis,control of the disease is possible through medical methods, but in some cases,surgery is indicated.So far,no comprehensive study on the consequences of surgery in children with ulcerative colitis has been published in Iran. present study was conducted for the same purpose.

All children with ulcerative colitis admitted in Mofid Children Hospital with indication for surgery for ten years were included in the study.Information on demographic characteristics,surgical indications, duration of medical treatment,type of surgical procedure,complications of surgery, were evaluated.

21patients who underwent surgery during these years were included in the study. The mean age of patients was 11.12 ± 5.65 years. 42.9% were male. In terms of surgical indications, anemia in 100%, Intestinal bleeding in 33.3%, FTT in 14.3%, recurrent defecation in 9.5% and severe colic abdominal pain in14.3%.In terms of early surgical complications,intestinal perforation in4.8%, peritonitis 4.8%,wound infection23.8%, pelvic abscesses14.3%, deep vein thrombosis4.8%,intestinal obstruction9.5%, Pouchitis 9.5% and anal fissure 4.8% were reported.23.8% of patients underwent redo laparotomy for improvement surgical complications.The mean follow-up period of patients in terms of surgical outcomes was 6.79 ± 4.24years. During this period, improvement in gastrointestinal function was reported in 100% of patients. Long-term complications of surgery include , delayed fistulas were reported in 23.8% of cases. Fecal incontinence was reported at 4.8%. Long-term complication-free survival at 5 and 10 years after surgery was estimated to be 92.3% and 56.4%, respectively.

Surgical treatment in children with ulcerative colitis,candidate for surgery,accompanies with favorable outcomes and correctable short and long-term complications.

Introduction and

Omeprazole is a gastric parietal cells proton pump inhibitor that is also active against H. pylori in vitro. This study was designed to examine the neutralization of H. pylori cytotoxicity on Vero cells by omeprazole micronized in strains isolated from gastritis, ulcer, cancer and Barrett's ulcer, to determine whether omeprazole can inhibit vacuolation of the Vero cells induced by cytotoxin of H. pylori or by urease. The effect of omeprazole on motility of H. pylori was assessed using concentrations lower than MIC.

The antimicrobial activity of omeprazole micronized was studied by determining the MICs for 15 H. pylori strains. Water extract of the bacteria (concentrated culture supernatant) and different concentrations of omeprazole were added to Vero cells in culture. Also extracted urease from H. pylori strains with urea (10 mM) and omeprazole were added to Vero cells in culture. The inhibitory effect of omeprazole on motility of H. pylori was tested in semi-solid medium.

MIC of omeprazole micronized was 20 µ|g/ml. Omeprazole could inhibit induced vacuolation by the water extract of H. pylori strains in Vero cells. It could also inhibit vacuolation induced by urease. Inhibition of vacuolation strains was assessed microscopically and by the neutral red method. It was also found that omeprazole inhibits the motility of H. pylori strains at concentrations lower than MIC.

The results of this study suggest that omeprazole micronized could neutralize the vacuolation effect of H. pylori cytotoxin on Vero cells probably by targeting v-type ATPase. The bacterial motility was also inhibited by low concentrations of omeprazole. The results of this study considers omeprazole micronized as an effective drug which targets important virulence factors of H. pylori including vacuolating cytotoxin, urease, and motility.