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Sample records for large bowel mucosa

  1. Increased density of tolerogenic dendritic cells in the small bowel mucosa of celiac patients

    OpenAIRE

    Vorobjova, Tamara; Uibo, Oivi; Heilman, Kaire; Uibo, Raivo

    2015-01-01

    AIM: To investigate the densities of dendritic cells (DCs) and FOXP3+ regulatory T cells (Tregs) and their interrelations in the small bowel mucosa in untreated celiac disease (CD) patients with and without type 1 diabetes (T1D).

  2. The presence of oncofoetal antigens in large bowel carcinoma.

    Science.gov (United States)

    Ma, J; De Boer, W G; Nayman, J

    1982-02-01

    This paper is an immunohistological study of the occurrence of the oncofoetal antigens, (carcinoembryonic antigen (CEA), small intestine mucin antigen (SIMA), and normal large bowel mucin antigen (LIMA) in 60 surgically resected colons: 10 non-malignant specimens and 50 colorectal carcinomas. SIMA is a new oncofoetal antigen found in mucinous carcinoma of the large bowel. In the adult it is normally present only in the duodenum and jejunum. Of the 50 carcinoma specimens, 13 were mucinous, 17 non-mucinous and 20 mixed mucinous and non-mucinous. LIMA was the only antigen detected in the mucosa of non-malignant specimens. In mucinous carcinomas only SIMA was present, whilst in the non-mucinous specimens CEA was always found and to a lesser extent LIMA. The same relationship was observed in mixed tumours: SIMA in mucinous and CEA-LIMA in the non-mucinous parts. In the mucosa adjacent to the cancer in all 50 cases there was evidence of an increase or decrease in LIMA. In 42 cases (84%) both oncofoetal antigens (CEA and SIMA) could also be detected in this transitional or perineoplastic epithelium at varying distances from the tumour. These results provide evidence to suggest that the majority of large bowel carcinomas occur in areas of metaplastic change. PMID:6280663

  3. ORAL MUCOSA LESIONS AND ORAL SYMPTOMS IN INFLAMMATORY BOWEL DISEASE PATIENTS

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    Nuno LARANJEIRA

    2015-06-01

    Full Text Available Background Inflammatory Bowel Disease is known for its extra intestinal manifestations, the oral cavity is no exception. Objectives The aim of this study was to evaluate the association between Inflammatory Bowel Disease and oral mucosa lesions and symptoms, and complementary to evaluate their possible relation with oral hygiene, smoking habits, drug therapy, duration and activity of the disease. Methods Patients were selected from the Gastroenterology Clinic of a Portuguese tertiary referral hospital. This sample consisted of 113 patients previously diagnosed with ulcerative colitis or Crohn’s disease along with a control group of 58 healthy individuals that were accompanying the study group patients to their appointments. Clinical interviews and clinical examinations were performed for data collection. Results The patients in the study group were more affected by oral symptoms (P=0.011, and showed a trend towards a higher incidence of oral mucosal lesions, even though statistical significance was not reached (8.8% versus 3.4% in the control group; P=0.159. Patients in active phase were the most affected. No differences were detected between Crohn’s disease and ulcerative colitis, or concerning smoking habits. The corticosteroid and immunosuppressant therapy seemed to increase the incidence of oral symptoms (P=0.052. The oral mucosa lesions increased and the oral symptoms decreased over the course of the disease, however without statistical significance. Conclusion Oral mucosa’s lesions and oral symptoms were positively associated with Inflammatory Bowel Disease, mainly during disease activity periods and conceivably, associated with corticosteroid and immunosuppressant therapy.

  4. Misoprostol in the intestinal lumen protects against radiation injury of the mucosa of the small bowel

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    Delaney, J.P.; Bonsack, M.E.; Felemovicius, I. (Univ. of Minnesota Medical School, Minneapolis, MN (United States))

    1994-03-01

    Systemically administered misoprostol, a PGE analog, has been shown to be an intestinal radioprotector. The purpose of this study was to determine if administration of misoprostol into the intestinal lumen can also reduce the severity of acute radiation enteritis. The rat small bowel was operatively exteriorized and segmented by means of suture ties. The remainder of the intestine and the rat were shielded in a lead box. Misoprostol was introduced into the lumen in various doses. After 30 min exposure to misoprostol, the isolated, exteriorized, segmented bowel was subjected to 11 Gy X irradiation. Five days later the animals were sacrificed and the intestines harvested for evaluation. Surviving crypt numbers per circumference and mucosal height were the criteria used for quantification of damage. Mucosa exposed to misoprostol at the time of radiation delivery showed significantly increased crypt numbers and mucosal height compared to adjacent saline-filled intestine. 24 refs., 2 figs., 2 tabs.

  5. Misoprostol in the intestinal lumen protects against radiation injury of the mucosa of the small bowel

    International Nuclear Information System (INIS)

    Systemically administered misoprostol, a PGE analog, has been shown to be an intestinal radioprotector. The purpose of this study was to determine if administration of misoprostol into the intestinal lumen can also reduce the severity of acute radiation enteritis. The rat small bowel was operatively exteriorized and segmented by means of suture ties. The remainder of the intestine and the rat were shielded in a lead box. Misoprostol was introduced into the lumen in various doses. After 30 min exposure to misoprostol, the isolated, exteriorized, segmented bowel was subjected to 11 Gy X irradiation. Five days later the animals were sacrificed and the intestines harvested for evaluation. Surviving crypt numbers per circumference and mucosal height were the criteria used for quantification of damage. Mucosa exposed to misoprostol at the time of radiation delivery showed significantly increased crypt numbers and mucosal height compared to adjacent saline-filled intestine. 24 refs., 2 figs., 2 tabs

  6. Large bowel obstruction secondary to adhesive bands

    OpenAIRE

    El-Masry, Nabil S.; Geevarghese, Ruben

    2015-01-01

    Large bowel obstruction (LBO) is most commonly due to malignancy, volvulus, hernia, diverticular disease and inflammatory bowel disease. LBO due to adhesions is unusual. A literature review was conducted which revealed that only a few such cases have been reported. We report two cases of LBO secondary to adhesions in patients, one with and one without a past abdominal surgical history. We highlight that while rare, the aetiology of LBO secondary to adhesions must be considered in the differen...

  7. Vasoactive intestinal peptide and somatostatin in the plasma and sigmoid mucosa in irritable bowel syndrome

    International Nuclear Information System (INIS)

    To investigate the possible role and clinical significance of vasoactive intestinal peptide (VIP) and somatostatin(SS) in the irritable bowel syndrome (IBS), the VIP and SS in the plasma and sigmoid mucosa were measured by radioimmunoassay in the control group and the IBS group. The VIP concentration in the plasma and sigmoid mucosa of the IBS patients with constipation was significantly higher than that of the control group (P<0.01), while that of the IBS patients with diarrhea was significantly lower than that of the control group (P<0.05). The SS concentration in two sites was significantly elevated in IBS patients of both types and was significantly higher in IBS with constipation than in IBS with diarrhea (P<0.05). Conclusion: The VIP and SS in IBS are abnormal, which might play a role in the pathogenesis of IBS. The plasma and mucosa concenration of VIP and SS in two kinds of IBS patients are significantly different, which indicates that there might be different pathophysiological basis involved in the pathogenesis of the two kinds of IBS patients. (authors)

  8. Large bowel obstruction secondary to adhesive bands.

    Science.gov (United States)

    El-Masry, Nabil S; Geevarghese, Ruben

    2015-01-01

    Large bowel obstruction (LBO) is most commonly due to malignancy, volvulus, hernia, diverticular disease and inflammatory bowel disease. LBO due to adhesions is unusual. A literature review was conducted which revealed that only a few such cases have been reported. We report two cases of LBO secondary to adhesions in patients, one with and one without a past abdominal surgical history. We highlight that while rare, the aetiology of LBO secondary to adhesions must be considered in the differential diagnosis in patients presenting with obstructive symptoms. PMID:25650387

  9. Histological abnormalities of the small bowel mucosa in cirrhosis and portal hypertension

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    Jamilé Wakim-Fleming, Nizar N Zein, Ana Bennett, Rocio Lopez, Janice Santisi, William D Carey

    2008-11-01

    Full Text Available AIM: To study the small bowel (SB mucosa on biopsy in cirrhotic patients with portal hypertension and in non-cirrhotic controls and grade findings according to the Marsh criteria.METHODS: We prospectively enrolled 51 consecutive patients undergoing an upper endoscopy for their routine medical care. Twenty five patients with cirrhosis and portal hypertension were compared to 26 controls. We obtained coeliac serology and multiple upper small bowel biopsies on all 51 patients. A GI pathologist interpreted biopsies and graded findings according to the Marsh criteria. We assessed equivalence in Marsh grade between cirrhotic and non-cirrhotic controls using the Mann-Whitney test for equivalence.RESULTS: Gender, ethnicity and age were similar between both groups. Marsh grades were equivalent between the groups. Grade of 0 was present in 96% and grade of 1 was present in 4% of both groups and there was no villus atrophy or decrease in villus/crypt ratio in patients with portal hypertension.CONCLUSION: This study provides evidence for the lack of villus atrophy in patients with cirrhosis and portal hypertension, and supports the continuous reliance on the Marsh criteria when the diagnosis of coeliac disease is to be made in the presence of cirrhosis.

  10. ORAL MUCOSA LESIONS AND ORAL SYMPTOMS IN INFLAMMATORY BOWEL DISEASE PATIENTS / Lesões das mucosas orais e sintomatologia oral em doentes com Doença Inflamatória Intestinal

    Scientific Electronic Library Online (English)

    Nuno, LARANJEIRA; Jorge, FONSECA; Tânia, MEIRA; João, FREITAS; Sara, VALIDO; Jorge, LEITÃO.

    2015-06-01

    Full Text Available Contexto A doença inflamatória intestinal é conhecida por suas manifestações extraintestinais, a cavidade oral não é exceção. Objetivos O objetivo deste estudo foi o de avaliar a associação da doença inflamatória intestinal com lesões da mucosa oral e sintomatologia oral, e complementarmente, avali [...] ar a sua possível relação com a higiene oral, tabagismo, terapêutica farmacológica, duração e atividade da doença. Métodos Os pacientes foram selecionados no serviço de Gastroenterologia de um hospital de referência terciária Português (Hospital Garcia de Horta). Esta amostra foi composta por 113 pacientes previamente diagnosticados com colite ulcerosa ou doença de Crohn, juntamente com um grupo controle de 58 indivíduos saudáveis que acompanhavam os pacientes do grupo nas suas consultas de controle. Entrevistas clínicas e exames clínicos foram realizados para a coleta de dados. Resultados Os pacientes do grupo de estudo foram mais afetados por sintomas orais (P=0,011), e houve também uma tendência para uma maior incidência de lesões da mucosa oral, embora a significância estatística não tenha sido alcançada (8,8% versus 3,4% no grupo de controle; P=0,159). Pacientes em fase ativa foram os mais afetados. Não foram detetadas diferenças entre a doença de Crohn e a colite ulcerosa, ou relativas a hábitos tabágicos. O tratamento com corticosteroides e imunossupressores pareceu aumentar a incidência de sintomas orais (P=0,052). Os dados são ainda compatíveis com aumento das lesões da mucosa oral e diminuição dos sintomas ao longo do curso da doença, no entanto, sem significância estatística. Conclusão As lesões de mucosa oral e sintomas orais foram associados positivamente com a doença inflamatória intestinal, principalmente durante os períodos de atividade da doença e possivelmente, associado a terapêutica com corticosteroides e imunossupressores. Abstract in english Background Inflammatory Bowel Disease is known for its extra intestinal manifestations, the oral cavity is no exception. Objectives The aim of this study was to evaluate the association between Inflammatory Bowel Disease and oral mucosa lesions and symptoms, and complementary to evaluate their poss [...] ible relation with oral hygiene, smoking habits, drug therapy, duration and activity of the disease. Methods Patients were selected from the Gastroenterology Clinic of a Portuguese tertiary referral hospital. This sample consisted of 113 patients previously diagnosed with ulcerative colitis or Crohn’s disease along with a control group of 58 healthy individuals that were accompanying the study group patients to their appointments. Clinical interviews and clinical examinations were performed for data collection. Results The patients in the study group were more affected by oral symptoms (P=0.011), and showed a trend towards a higher incidence of oral mucosal lesions, even though statistical significance was not reached (8.8% versus 3.4% in the control group; P=0.159). Patients in active phase were the most affected. No differences were detected between Crohn’s disease and ulcerative colitis, or concerning smoking habits. The corticosteroid and immunosuppressant therapy seemed to increase the incidence of oral symptoms (P=0.052). The oral mucosa lesions increased and the oral symptoms decreased over the course of the disease, however without statistical significance. Conclusion Oral mucosa’s lesions and oral symptoms were positively associated with Inflammatory Bowel Disease, mainly during disease activity periods and conceivably, associated with corticosteroid and immunosuppressant therapy.

  11. Reduced expression of aquaporins in human intestinal mucosa in early stage inflammatory bowel disease

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    Ricanek P

    2015-01-01

    Full Text Available Petr Ricanek,1,2 Lisa K Lunde,3 Stephan A Frye,1 Mari Støen,1 Ståle Nygård,4 Jens P Morth,5,6 Andreas Rydning,2 Morten H Vatn,7,8 Mahmood Amiry-Moghaddam,3 Tone Tønjum,1,9 1Department of Microbiology, Oslo University Hospital, Rikshospitalet, Oslo, 2Department of Gastroenterology, Akershus University Hospital, Lørenskog and Campus Ahus, Institute of Clinical Medicine, University of Oslo, Lørenskog, 3Department of Anatomy, Institute of Basic Medical Sciences, University of Oslo, 4Bioinformatics Core Facility, Institute for Medical Informatics, Oslo University Hospital and University of Oslo, 5Centre for Molecular Medicine, Nordic EMBL Partnership, University of Oslo, 6Institute for Experimental Research, Oslo University Hospital (Ullevaal, Oslo, 7EpiGen Institute, Campus Ahus, Institute of Clinical Medicine, University of Oslo, Lørenskog, 8Section of Gastroenterology, Oslo University Hospital, Rikshospitalet, Oslo, 9Department of Microbiology, University of Oslo, Oslo, Norway Objectives: The aim of this study was to investigate the relationship between aquaporin (AQP water channel expression and the pathological features of early untreated inflammatory bowel disease (IBD in humans. Methods: Patients suspected to have IBD on the basis of predefined symptoms, including abdominal pain, diarrhea, and/or blood in stool for more than 10 days, were examined at the local hospital. Colonoscopy with biopsies was performed and blood samples were taken. Patients who did not meet the diagnostic criteria for IBD and who displayed no evidence of infection or other pathology in the gut were included as symptomatic non-IBD controls. AQP1, 3, 4, 5, 7, 8, and 9 messenger RNA (mRNA levels were quantified in biopsies from the distal ileum and colon by quantitative real-time polymerase chain reaction. Protein expression of selected AQPs was assessed by confocal microscopy. Through multiple alignments of the deduced amino acid sequences, the putative three-dimensional structures of AQP1, 3, 7, and 8 were modeled. Results: AQP1, 3, 7, and 8 mRNAs were detected in all parts of the intestinal mucosa. Notably, AQP1 and AQP3 mRNA levels were reduced in the ileum of patients with Crohn's disease, and AQP7 and AQP8 mRNA levels were reduced in the ileum and the colon of patients with ulcerative colitis. Immunofluorescence confocal microscopy showed localization of AQP3, 7, and 8 at the mucosal epithelium, whereas the expression of AQP1 was mainly confined to the endothelial cells and erythrocytes. The reduction in the level of AQP3, 7, and 8 mRNA was confirmed by immunofluorescence, which also indicated a reduction of apical immunolabeling for AQP8 in the colonic surface epithelium and crypts of the IBD samples. This could indicate loss of epithelial polarity in IBD, leading to disrupted barrier function. Conclusion: AQPs 1 and 8 and the aquaglyceroporins AQPs 3 and 7 are the AQPs predominantly expressed in the lower intestinal tract of humans. Their expression is significantly reduced in patients with IBD, and they are differentially expressed in specific bowel segments in patients with Crohn's disease and ulcerative colitis. The data present a link between gut inflammation and water/solute homeostasis, suggesting that AQPs may play a significant role in IBD pathophysiology. Keywords: inflammatory bowel disease, Crohn's disease, ulcerative colitis, aquaporins, aquaglyceroporins

  12. Mejoría mucosa endoscópica en pacientes con enfermedad inflamatoria intestinal / Endoscopic mucosal improvememt in patients with inflammatory bowel disease

    Scientific Electronic Library Online (English)

    Guillermo, Veitia; Beatriz, Pernalete; María Alejandra, La Cruz; María Josefina, Rodríguez; Lisbeth, Cachima; José, Soto; Ivanova, Esquerre; Juan, Manuitt; Guillermo, Pérez.

    2014-03-01

    Full Text Available La curación mucosa endoscópica en enfermedad inflamatoria intestinal se asocia con remisión clínica sostenida, reducción de hospitalizaciones y cirugía, pero lograrlo es difícil, según la literatura. Por ello evaluamos la mejoría mucosa endoscópica en nuestros pacientes. Objetivo: Evaluar la mejoría [...] mucosa endoscópica en pacientes con enfermedad inflamatoria intestinal. Métodos: estudio multicéntrico, descriptivo, transversal. Incluyó 24 pacientes entre 17 y 73 años. Para evaluar respuesta a tratamiento se realizó colonoscopia, utilizando clasificaciones endoscópicas de Mayo para colitis ulcerosa, Score simplificado para enfermedad de Crohn y Rutgeerts para recurrencia post operatoria, considerando curación endoscópica grado 0 en todas las escalas y mejoría cuando disminuyó un grado en relación al estudio previo. Resultados: colitis ulcerosa: 12 pacientes, 10 recibían aminosalicilatos y 2 terapia biológica. De ellos, 3 tuvieron curación endoscópica y 8 mejoría. De estos, 6 recibían aminosalicilatos y 2 Infliximab. Hubo 1 paciente con aminosalicilatos sin mejoría. Enfermedad de Crohn: 12 pacientes, 7 con aminosalicilatos, 2 con biológicos, 2 con biológicos e inmunomoduladores y 1 con biológicos y aminosalicilatos. De ellos, 4 tuvieron mejoría, 6 mantuvieron igual afectación y 2 curación con aminosalicilatos. Conclusiones: Se observó un alto porcentaje (70,8%) de curación y mejoría endoscópica, asociado a adherencia y optimización del tratamiento. Abstract in english Introduction: endoscopic mucosal healing in inflammatory bowel disease has been associated with sustained clinical remission and hospitalizations and surgery reduction, but it has been difficult to achieve, according to the literature. So, we decided to assess improvement in endoscopic mucosal in ou [...] r inflammatory bowel disease patients. Purpose: endoscopic mucosal assess improvement in patients with inflammatory bowel disease. Methods: multicenter, descriptive and transversal. We included 24 patients with IBD between 17-73 years. Control colonoscopy was performed to evaluate the response to treatment using endoscopic Mayo Score for ulcerative colitis, Simplified Score for Crohn’s disease and postoperative recurrence was evaluated with Rutgeerts Index endoscopic healing was considered when the patient had grade 0 at all scales and improvement when they had one point less in the endoscopy scale in decreased relation to the previous study. Results: ulcerative colitis: 12 patients, 10 received aminosalicylates and 2 biological therapy. The group receiving aminosalicylates, 3 had endoscopic healing, there was endoscopic improvement in 8 of which 6 are aminosalicylates and 2 Infliximab. There was one patient with no improvement aminosalicylates. Crohn’s Disease: 12 patients, 7 with aminosalicylates, 2 biological therapy alone, 2 with biological and immunomodulatory and 1 with biological and aminosalicylates. Of which 4 had endoscopic improvement, 12 stayed the same degree of involvement and 2 with aminosalicylates was endoscopic healing. Conclusions: There was a high percentage (70.8%) of healing and endoscopic improvement associated with adherence and treatment optimization.

  13. The Bowel Microbiota and Inflammatory Bowel Diseases

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    Gerald W. Tannock

    2010-01-01

    Full Text Available The human bowel contains a large and biodiverse bacterial community known as the microbiota or microbiome. It seems likely that the microbiota, fractions of the microbiota, or specific species comprising the microbiota provide the antigenic fuel that drives the chronic immune inflammation of the bowel mucosa that is characteristic of Crohn's disease and ulcerative colitis. At least twenty years of microbiological research have been expended on analysis of the composition of the bowel microbiota of inflammatory bowel disease patients in comparison to that of control subjects. Despite extensive speculations about the aetiological role of dysbiosis in inflammatory bowel diseases, knowledge that can be easily translated into effective remedies for patients has not eventuated. The causes of this failure may be due to poorly defined and executed bacteriological studies, as well as the overwhelming complexity of a biome that contains hundreds of bacterial species and trillions of bacterial cells.

  14. Colon cancer and large bowel function in Denmark and Finland

    DEFF Research Database (Denmark)

    Cummings, J H; Branch, W J; Bjerrum, L; Paerregaard, A; Helms, P; Burton, R

    1982-01-01

    Stool weight and transit time through the gut were measured in 4 groups of 30 men, aged 50-59 years, randomly selected from populations in urban (Copenhagen) and rural (Them) Denmark and urban (Helsinki) and rural (Parikkala) Finland. These populations exhibited a 3-4 fold difference in risk for large bowel cancer. Mean transit time (37 +/- 1 hours, Copenhagen; 43 +/- 1 hours, Helsinki; 40 +/- 1 hours, Them; 37 +/- 1 hours, Parikkala) was not significantly different among populations, but averag...

  15. Hormone Therapy in Relation to Survival from Large Bowel Cancer

    OpenAIRE

    Newcomb, Polly A.; Chia, Victoria M.; Hampton, John M; Doria-Rose, V. Paul; Dietz, Amy Trentham

    2008-01-01

    Epidemiologic studies of hormone therapy (HT) and colorectal cancer incidence consistently show an inverse association; however, few studies considered prediagnostic use of HT on mortality among colorectal cancer patients. We evaluated the relationship of HT and survival among a population-based cohort of women with large bowel cancer. Cases (n=1297) were newly diagnosed with invasive cancer of the colon or rectum, aged 40-74 years at diagnosis, who were identified by Wisconsin’s statewide re...

  16. Radiological diagnosis of large-bowel obstruction: nonneoplastic etiology.

    Science.gov (United States)

    Hayakawa, Katsumi; Tanikake, Masato; Yoshida, Shoko; Urata, Yoji; Inada, Yuki; Narumi, Yoshifumi; Yamamoto, Eiji; Morimoto, Taisuke

    2012-08-01

    Large-bowel obstruction (LBO) is a relatively common abdominal emergency. Computed tomography (CT) diagnosis of LBO is often easy, but it is essential to clarify LBO etiology and to decide how to treat it. Therefore, it is important for the radiologist to become familiar with the imaging findings of LBO, including plain radiography and CT, to determine its various causes, as well as the many diseases mimicking LBO. In this article, we show the characteristics of radiological findings of plain radiograph, barium study, and CT and their correlations with pathologic findings. LBO etiology comprises two main categories: neoplastic and nonneoplastic disease. However, the primary causes of LBO are neoplastic etiologies, and nonneoplastic causes are relatively uncommon and unfamiliar to many radiologists in clinical practice. Therefore, in this review, we present nonneoplastic etiology of LBO and diseases simulating LBO and provide critical information concerning the causes of LBO and viability of the involved bowel loops. PMID:22744438

  17. Large bowel obstruction due to sesame seed bezoar: a case report

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    Shaw Aidan G; Peacock Oliver; Lund Jonathan N; Tierney Gillian M; Larvin Mike; Speake William

    2007-01-01

    Abstract We report a case of a 79 year old man with a known benign anastomotic stricture presenting with large bowel obstruction. At laparotomy the obstruction was found to be caused by a large sesame seed bezoar. Seed bezoars are well known to cause impaction in the rectum but have never been previously reported to cause large bowel obstruction. We recommend that patients with known large bowel strictures should be advised not to eat seeds as this could ultimately lead to obstruction, ischae...

  18. Large Intraluminal Ileal Hematoma Presenting as Small Bowel Obstruction in a Child

    International Nuclear Information System (INIS)

    Intraluminal small bowel hematoma has been rarely reported in children, as a rare cause of small bowel obstruction. We present a case of an intraluminal ileal hematoma presenting as small bowel obstruction in a child. Computed Tomography (CT) indicated a large intraluminal hyperdense lesion in the distal ileum as the cause of small bowel obstruction. Abdominal ultrasonography (US) showed an echogenic mass-like lesion with multiple septa in the distal ileum. Small bowel obstruction due to a complicated cystic mass was provisionally diagnosed. Histopathologic examination of the resected mass suggested a submucosal ileal hematoma. Although intraluminal small bowel hematoma is rare in children, it can present as an intraluminal cystic mass and should be considered as a rare cause of small bowel obstruction. The US and CT findings of submucosal ileal hematoma could be useful for the diagnosis of such cases in the future

  19. Radiological diagnosis of large-bowel obstruction: neoplastic etiology.

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    Hayakawa, Katsumi; Tanikake, Masato; Yoshida, Shoko; Urata, Yoji; Yamamoto, Eiji; Morimoto, Taisuke

    2013-01-01

    Large-bowel obstruction (LBO) is a relatively common abdominal emergency. The CT exam has become the most important imaging modality for the diagnosis of LBO, following abdominal ultrasound and plain radiography. The recent multi-detector CT (MD-CT) is able to clarify the etiology of LBO and to help in deciding how to treat LBO. Therefore, it is important for the radiologists to become familiar with the imaging findings of LBO, including plain radiograph and CT, due to various causes. In this article, we have shown the characteristics of the radiological findings including plain radiograph, barium study, and CT as well as their correlations with pathologic findings of LBO. The etiology of LBO is usually divided into neoplastic diseases and nonneoplastic diseases. However, the most common cause is the neoplastic etiology. Now, we can afford the critical information concerning the level of obstruction, its cause, the viability of the involved bowel loops, and a decision-making regarding the therapy for patients with LBO, using MD-CT high technology. PMID:23109230

  20. Reduction in diversity of the colonic mucosa associated bacterial microflora in patients with active inflammatory bowel disease

    OpenAIRE

    Ott, S.J.; Musfeldt, M; Wenderoth, D F; Hampe, J; Brant, O; Fölsch, U.R.; Timmis, K.N.; Schreiber, S.

    2004-01-01

    Background and aims: The intestinal bacterial microflora plays an important role in the aetiology of inflammatory bowel disease (IBD). As most of the colonic bacteria cannot be identified by culture techniques, genomic technology can be used for analysis of the composition of the microflora.

  1. Evaluation of large intestinal mucosa regeneration in ulcerative colitis using linear measurements

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    ?olai Matilda

    2005-01-01

    Full Text Available Ulcerative colitis is a chronic inflammatory condition characterized by three phases: active, regression and remission phase. The active phase is followed by atrophy of the large intestinal mucosa. Although its evaluation is sometimes difficult, quantification of ceratin mucosal parameters can be used as an accessory method. The aim of the study was to determine the parameters of linear micrometry in order to estimate the regeneration of the large intestinal mucosa in ulcerative colitis, and to evaluate the efficiency of this method in everyday work. The measurements were performed on routine bioptic samples after qualitative histologic analysis and determination of the type and stage of the disease. The measurements were carried out to determine: the number of crypts per unit length, the height of crypt epithelium, diameter of crypts, their lumen and interstices; also, the quotient between the diameters of crypts and interstices was calculated. The analysis of the measured parameters points to presence and degree of regeneration and/or atrophy of mucosa, particularly by following the parameters of crypt epithelium. Linear measurements can be used in estimation of regeneration and atrophy of large intestinal mucosa. .

  2. Clinical applications of small bowel capsule endoscopy.

    Science.gov (United States)

    Kopylov, Uri; Seidman, Ernest G

    2013-01-01

    Video capsule endoscopy has revolutionized our ability to visualize the entire small bowel mucosa. This modality is established as a valuable tool for the diagnosis of obscure gastrointestinal bleeding, Crohn's disease, small bowel tumors, and other conditions involving the small bowel mucosa. This review includes an overview of the current and potential future clinical applications of small bowel video endoscopy. PMID:23983481

  3. Prognostic significance of CEA immunoreactivity patterns in large bowel carcinoma tissue.

    OpenAIRE

    Wiggers, T; Arends, J.W.; Verstijnen, C.; Moerkerk, P. M.; Bosman, F.T.

    1986-01-01

    In order to determine the clinical value of CEA detection in large bowel cancer tissue the patterns rather than the intensity of immunoreactivity of CEA reactive antibodies were analyzed in 312 large bowel cancer patients especially in relation to patient survival. CEA immunoreactivity appeared to be distinguishable into a predominantly apical/cytoplasmic and a predominantly membranous pattern. Twenty-four (7.7%) tumours were found to be CEA negative or only focally positive. Two hundred and ...

  4. The impact of helical computed tomography on the diagnosis of unsuspected inflammatory bowel disease in the large bowel

    Energy Technology Data Exchange (ETDEWEB)

    Markose, G.; Freeman, A.H. [Department of Radiology, Addenbrooke' s NHS Trust, Cambridge (United Kingdom); Ng, C.S. [Department of Radiology, Addenbrooke' s NHS Trust and the University of Cambridge, Cambridge (United Kingdom)

    2003-01-01

    Inflammatory bowel diseases (IBD) are diagnoses that can be easily overlooked clinically. The aim of this study was to investigate if CT is able to make a contribution to the identification of previously unsuspected cases of IBD. We retrospectively identified cases in which the possibility of an IBD was raised in CT reports (over a 4-year period), by utilising a keyword search of the radiology database. Cases with a previously known or suspected IBD were rigorously excluded by review of case notes, and endoscopic, radiological, histological and microbiological findings. The CT images of the identified cases were reviewed by a blinded observer to document the extent of bowel wall thickening, the location of lesion(s), and presence of peri-colic fat abnormality, ascites and/or collections. The observer also attempted to corroborate the presence, and to identify the type, of IBD based on the CT appearances alone. Thirty-five cases (out of approximately 19,000 body CTs performed) of clinically unsuspected IBD were identified, of which 27 underwent further investigation. An IBD was confirmed in 48% (13 of 27): Crohn's disease (n=6), ulcerative colitis (n=2), pseudomembranous colitis (n=3) and other (n=2), of which 70% (9 of 13) were correctly typed by the reviewer. Inflammatory bowel disease was not substantiated in the remainder (14 of 27), although 7 of these had other bowel pathologies: diverticular disease (n=4); and carcinoma (n=3). Prospectively determining the presence, and furthermore type, of IBD on CT is challenging largely because of the considerable overlap in the appearances of the individual IBDs and indeed of normality. Nevertheless, CT is able to identify clinically unsuspected cases and radiologists should be alert to this treatable and not infrequently elusive diagnosis. (orig.)

  5. FOLLOW UP IN LARGE BOWEL RESECTIONS: WERNICKE-KORSAKOFF’S SYNDROME

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    M. Lo Gatto

    2012-01-01

    Full Text Available Introduction. The main complication of large bowel resection is the malabsorption syndrome, a rare form of which is the syndrome of Wernicke-Korsakoff. Patients and Methods. B.E. following gastro-entero anastomosis develops Syndrome Wernicke-Korsakoff characterized by progressive state of disorientation, fixity of gaze, dysphoria. Results. Syndrome Wernicke-Korsacoff is linked to a deficiency of thiamin (also known as vitamin B1. Conclusions. In the follow up of patients who underwent a large bowel resection will be important to carry out systematic blood tests that can detect any frameworks-megaloblastic anemia macrocytosis deficiency vit. B12, iron deficiency, hypomagnesaemia, hypocalcemia, ipodisprotidemy. In the follow up of patients who underwent a large bowel resection will be important to carry out systematic blood tests that can detect any frameworks-megaloblastic anemia macrocytosis deficiency vit. B12, iron deficiency, hypomagnesaemia, hypocalcemia,ipodisprotidemy.

  6. Intramural and subserosal echogenic foci on US in large-bowel intussusceptions: prognostic indicator for reducibility?

    International Nuclear Information System (INIS)

    In large-bowel intussusceptions, several US signs are known to indicate a lower likelihood of reducibility by enema. US can demonstrate echogenic dots or lines (foci) in the bowel wall, which might indicate an ischemic bowel. To determine the presence of echogenic intramural and subserosal foci in large-bowel intussusceptions and to evaluate the degree of correlation with reducibility. Between 2001 and 2008, 74 consecutive US examinations were retrospectively evaluated by two pediatric radiologists for intramural and subserosal echogenic foci, or trapped gas, in the intussusception. The degree of correlation between the sonographic findings and reducibility was evaluated. Of 73 intussusceptions examined by US, 56 (76%) were reducible and 17 (23%) were not reducible. Out of 10 intussusceptions with intramural gas, 11 with subserosal gas, and 14 with intramural and subserosal gas, 8 (80%), 6 (56%), 9 (64%), respectively, were not reducible. The presence of intramural gas or subserosal gas or both predicted a lower chance of reduction, but with regard to the effect of these findings together, intramural gas was the only significant predictor. Having intramural gas in large-bowel intussusception significantly decreases the chance of reduction. (orig.)

  7. Gallstone ileus of the sigmoid colon: an extremely rare cause of large bowel obstruction detected by multiplanar CT.

    Science.gov (United States)

    Carlsson, Tarryn; Gandhi, Sanjay

    2015-01-01

    Gallstone ileus of the sigmoid colon is an important, though extremely rare, cause of large bowel obstruction. The gallstone often enters the large bowel through a fistula formation between the gallbladder and colon, and impacts at a point of narrowing, causing large bowel obstruction. We describe the case of an 80-year-old woman who presented with features of bowel obstruction. Multiplanar abdominal CT demonstrated a cholecystocolonic fistula in exquisite detail. The scan also showed obstruction of the colon due to a large gallstone impacted just proximal to a stricture in the sigmoid. Owing to inflammatory adhesions and a stricture from extensive diverticular disease, the gallstone could not be retrieved. This frail and elderly woman was treated with a loop colostomy to relieve bowel obstruction. The patient made an uneventful recovery. PMID:26682834

  8. Clinical applications of small bowel capsule endoscopy

    Directory of Open Access Journals (Sweden)

    Kopylov U

    2013-07-01

    Full Text Available Uri Kopylov, Ernest G Seidman Division of Gastroenterology, McGill University Health Center, Montreal, Quebec, Canada Abstract: Video capsule endoscopy has revolutionized our ability to visualize the entire small bowel mucosa. This modality is established as a valuable tool for the diagnosis of obscure gastrointestinal bleeding, Crohn's disease, small bowel tumors, and other conditions involving the small bowel mucosa. This review includes an overview of the current and potential future clinical applications of small bowel video endoscopy. Keywords: small bowel video capsule endoscopy, obscure gastrointestinal bleeding, Crohn’s disease, small bowel tumors, patency capsule

  9. Bleeding from multifocal heterotopic gastric mucosa in the colon controlled by an H2 antagonist.

    OpenAIRE

    Murray, F. E.; Lombard, M.; Dervan, P.; FitzGerald, R. J.; Crowe, J.

    1988-01-01

    The sixth documented case of heterotopic gastric mucosa in the large bowel proximal to the rectum is described in a two year old girl with a neural tube defect and recurrent rectal bleeding. Unusual in itself, this case is unique in that the rectal bleeding has been controlled with an H2 receptor antagonist.

  10. Expression of toll-like receptors 2 and 4 and CD14 in human intestina mucosa from patiens with inflammatory bowel disease (IBD).

    Czech Academy of Sciences Publication Activity Database

    Frolová, Lenka; Drastich, P.; Rossmann, Pavel; Tlaskalová, Helena

    Vienna : Basic Science in Allergology, 2006, s. 253-253. [Congress of the European Academy of Allergology and Clinical Immunology /25./. Vienna (AT), 10.06.2006-14.06.2006] R&D Projects: GA ?R GD310/03/H147 Institutional research plan: CEZ:AV0Z50200510 Keywords : Toll-like receptors * intestinal mucosa * cd14 Subject RIV: EE - Microbiology, Virology

  11. Blood-based Biomarkers at Large Bowel Endoscopy and Prediction of Future Malignancies

    DEFF Research Database (Denmark)

    Kring, Thomas S; Piper, Thomas B

    2015-01-01

    Soluble cancer-related protein biomarker levels may be increased in subjects without findings at large bowel endoscopy performed due to symptoms associated with colorectal cancer. The present study focused on a possible association between increased biomarker levels in such subjects and subsequent development of malignant diseases. In a major study of 4,990 subjects undergoing large bowel endoscopy, 691 were without pathology and comorbidity. Plasma levels of TIMP-1, CEA, CA19-9, and YKL-40 were determined in samples collected just before endoscopy and compared with subsequent development of a malignant disease within a period of 7-8 years. The upper 90% limits of the reference levels of every single protein were used to differentiate between normal and increased levels. The levels were separated into three groups: 0, none of the biomarkers increased; 1, one biomarker increased; 2, two or more biomarkers increased. A total of 43 subjects developed a primary malignant disease in the observation period. Univariatly, increase of all four biomarkers was significantly associated with subsequent development of a malignant disease. A multivariate analysis showed that increased biomarker levels were associated with subsequent development of a malignant disease (P = 0.002). The cumulative risk of developing malignant disease within the first 5 years after endoscopy was group 0, 3.3%; group 1, 5.8%; group 2, 7.8%. It is concluded that increased levels of plasma TIMP-1, CEA, CA19-9, and serum YKL-40 at large bowel endoscopy without findings may be associated with an increased risk of developing a subsequent malignant disease.

  12. The bacterial colonization of the large bowel of pre-term low birth weight neonates.

    OpenAIRE

    Stark, P L; Lee, A

    1982-01-01

    The bacterial colonization of the large bowel of 11 pre-term, low birth weight neonates who were nourished by expressed breast milk was examined by culturing serial faecal samples and compared to that observed in eight breast-fed and seven formula-fed full-term neonates. Pre-term neonates were colonized by high counts of facultatively anaerobic bacteria from the first days of life while bifidobacteria colonized only six babies during the first week and appeared in only one baby before day 5. ...

  13. Excision of a large abdominal wall lipoma improved bowel passage in a Proteus syndrome patient

    Directory of Open Access Journals (Sweden)

    Yoshifumi Nakayama, Shinichi Kusuda, Naoki Nagata, Koji Yamaguchi

    2009-07-01

    Full Text Available Proteus syndrome is an extremely rare congenital disorder that produces multifocal overgrowth of tissue. This report presents a surgical case of a large lipoma in the abdominal wall of a patient with Proteus syndrome. She was diagnosed with Proteus syndrome based on certain diagnostic criteria. The neoplasm increased in size gradually, producing hemihypertrophy of her left lower extremity and trunk, and spread to her retroperitoneum and her left abdominal wall. She experienced gradually progressive constipation, nausea, vomiting, and abdominal pain. Computed tomography (CT of the abdomen demonstrated a large mass in the subcutaneous adipose tissue of the left lower abdominal wall which measured 12 cm × 8 cm x 6 cm in diameter and encased the left colon. This mass in the abdominal wall was excised. The weight of the excised mass was 1550 g. The histopathological diagnosis of this mass was lipoma. After surgery, the encasement of the left colon was improved, and the patient was able to move her bowels twice per day. The excision of the large lipoma in the abdominal wall contributed to the improved bowel passage in this patient with Proteus syndrome.

  14. Clinical applications of small bowel capsule endoscopy

    OpenAIRE

    Kopylov U; Seidman EG

    2013-01-01

    Uri Kopylov, Ernest G Seidman Division of Gastroenterology, McGill University Health Center, Montreal, Quebec, Canada Abstract: Video capsule endoscopy has revolutionized our ability to visualize the entire small bowel mucosa. This modality is established as a valuable tool for the diagnosis of obscure gastrointestinal bleeding, Crohn's disease, small bowel tumors, and other conditions involving the small bowel mucosa. This review includes an overview of the current and potential future c...

  15. Ileal Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma with a Large-Cell Component That Regressed Spontaneously

    OpenAIRE

    Makino, Yohsuke; SUZUKI, HIDEKAZU; Nishizawa, Toshihiro; Kameyama, Kaori; Hisamatsu, Tadakazu; Imaeda, Hiroyuki; Mukai, Makio; Hibi, Toshifumi

    2010-01-01

    Reported herein is a case of mucosa-associated lymphoid tissue (MALT) lymphoma of the terminal ileum with a large-cell component, which regressed spontaneously. To the best of our knowledge, only five cases of spontaneously regressing MALT lymphoma have been reported in the English-language literature, and all of these cases were low-grade lymphomas. Spontaneous regression of a MALT lymphoma with a high-grade component is very rare. The present case suggests that MALT lymphoma cells have a re...

  16. Short-term duodenal seal oil administration normalised n-6 to n-3 fatty acid ratio in rectal mucosa and ameliorated bodily pain in patients with inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Lind Ragna

    2006-03-01

    Full Text Available Abstract Background A high dietary intake of n-6 compared to n-3 fatty acids (FAs may promote the production of pro-inflammatory eicosanoids and cytokines. In two recent studies, short-term (10-day duodenal administration of n-3 polyunsaturated fatty acid rich seal oil ameliorated joint pain in patients with inflammatory bowel disease (IBD. Using unpublished data from these two studies we here investigated whether normalisation of the n-6 to n-3 FA ratio in blood and tissues by seal oil administration was associated with improved health related quality of life (HRQOL as assessed by the generic short-form 36 (SF-36 questionnaire. Results In the first pilot study, baseline n-6 to n-3 FA ratio in rectal mucosal biopsies from 10 patients with IBD (9 of those had joint pain was significantly increased compared with that in 10 control patients without IBD or joint pain. Following seal oil administration, the n-6 to n-3 FA ratio of the IBD-patients was significantly lowered to the level seen in untreated controls. In the subsequent, randomized controlled study (n = 19, seal oil administration reduced the n-6 to n-3 FA ratio in blood similarly and also the SF-36 assessed bodily pain, while n-6 FA rich soy oil administration had no such effect. Conclusion In these two separate studies, short-term duodenal administration of seal oil normalised the n-6 to n-3 FA ratio in rectal mucosa and improved the bodily pain dimension of HRQOL of patients with IBD-related joint pain. The possibility of a causal relationship between n-6 to n-3 FA ratio in rectal mucosa and bodily pain in IBD-patients warrants further investigations.

  17. Management of acute large bowel obstruction due to colorectal cancer: Diversion colostomy versus stent placement

    Directory of Open Access Journals (Sweden)

    C. Fotiadis

    2007-03-01

    Full Text Available Background and Aim: Colonic stenting is a novel and privileged therapeutic option for malignant obstructions of the large bowel, especially as a bridging procedure to elective surgery. The aim of this retrospective study was to compare the efficacy of the traditional surgical approach with stent placement in the management of obstructing colorectal tumours. Patients and Methods: Thirty-three patients with malignant colonic obstruction were retrospectively studied. Of them, 17 underwent a diversion colostomy (group I, while 16 were treated with SEMS (group II. Early outcome, late outcome and duration of hospitalisation were evaluated. For statistical analysis chi-square and Student.s t-test were used (statistical significance level P<0.05. Results: One death in each group occurred within the first 3 days following colonic decompression. One case of pulmonary embolism (group I and one case of asymptomatic colonic perforation (group II were the only early morbid situations complicating decompressing interventions. Elective surgery was finally performed on 10 patients in group I and in 9 patients in group II. One case of early local recurrence after tumor resection was observed in the stenting group. The cumulated mortality rate was estimated at 6.9% and 9.1 % and cumulated morbidity rate at 20.7% and 9.1% for the two groups respectively. The mean time of hospitalization was significantly longer in the colostomy group. Conclusions: SEMS are effective for the temporary treatment of malignant occlusions of the large bowel and particularly advantageous not only because of their technical simplicity but also good tolerance and quality of life which they offer epecially in cases of locally or distally extended disease.

  18. Intestinal perfusion of dietary levels of aluminium: association with the mucosa.

    OpenAIRE

    Powell, J. J.; Ainley, C C; R. Evans; Thompson, R P

    1994-01-01

    An aluminium (93 microM) sulphate solution freshly adjusted to pH 7.0 was perfused through the rat small bowel to mimic the reported physiological conditions that follow dietary aluminium ingestion. One third of this aluminium was taken up from the perfusate, but > 90% of this was then recovered from the intestinal mucus/mucosa and most (> 70%) from the distal third of the small bowel. The fresh perfusate was shown by ultrafiltration to contain largely particulate/colloidal aluminium-hydroxid...

  19. Cistadenoma mucinoso del apéndice cecal como causa de gangrena intestinal / Appendiceal mucocele causing large bowel gangrene

    Scientific Electronic Library Online (English)

    Humberto, Osnaya M; Tahitiana Abelina, Zaragoza S; Marco Antonio, Mondragón C.

    2013-02-01

    Full Text Available Introducción: Los tumores del Apéndice Cecal corresponden al 0,5% de las neoplasias gastrointestinales y se encuentran entre el 0,8% y el 1% de las apendicectomías. El término Mucocele Apendicular (AM), se refiere a un grupo de lesiones localizados a nivel del ciego cuyo rango de incidencia está ent [...] re el 0,2% y el 0,3% de todas las apendicectomías, y entre el 8-10% de todos los tumores apendiculares. Las presentaciones clínicas más frecuentes son: cuadro clínico de apendicitis aguda, como hallazgo incidental como en el caso de esta paciente, o como masa abdominal en fosa ilíaca derecha. Caso clínico: Se presenta un caso de Cistade-noma Mucinoso Apendicular (CAM) encontrado como hallazgo incidental en un abdomen agudo quirúrgico con la particularidad de presentarse con una necrosis intestinal. Abstract in english Introduction: Appendiceal mucocele are lesions located in the cecum, which are found in 0.2 to 0.3% of appendectomies and correspond to 8-10% of all appendiceal tumors. Clinical case: We report a 83 years old female consulting for abdominal pain lasting 24 hours. On physical examination, signs of pe [...] ritoneal irritation were found. The patient was operated, finding an appendiceal tumor that was coiled up in the mesentery with large bowel gangrene. An intestinal resection, terminal ileostomy, appendectomy and surgical lavage were performed. The pathological study of the surgical piece reported a mucinous cystadenoma.

  20. Cistadenoma mucinoso del apéndice cecal como causa de gangrena intestinal Appendiceal mucocele causing large bowel gangrene

    Directory of Open Access Journals (Sweden)

    Humberto Osnaya M

    2013-02-01

    Full Text Available Introducción: Los tumores del Apéndice Cecal corresponden al 0,5% de las neoplasias gastrointestinales y se encuentran entre el 0,8% y el 1% de las apendicectomías. El término Mucocele Apendicular (AM, se refiere a un grupo de lesiones localizados a nivel del ciego cuyo rango de incidencia está entre el 0,2% y el 0,3% de todas las apendicectomías, y entre el 8-10% de todos los tumores apendiculares. Las presentaciones clínicas más frecuentes son: cuadro clínico de apendicitis aguda, como hallazgo incidental como en el caso de esta paciente, o como masa abdominal en fosa ilíaca derecha. Caso clínico: Se presenta un caso de Cistade-noma Mucinoso Apendicular (CAM encontrado como hallazgo incidental en un abdomen agudo quirúrgico con la particularidad de presentarse con una necrosis intestinal.Introduction: Appendiceal mucocele are lesions located in the cecum, which are found in 0.2 to 0.3% of appendectomies and correspond to 8-10% of all appendiceal tumors. Clinical case: We report a 83 years old female consulting for abdominal pain lasting 24 hours. On physical examination, signs of peritoneal irritation were found. The patient was operated, finding an appendiceal tumor that was coiled up in the mesentery with large bowel gangrene. An intestinal resection, terminal ileostomy, appendectomy and surgical lavage were performed. The pathological study of the surgical piece reported a mucinous cystadenoma.

  1. Capsule endoscopy and imaging tests in the elective investigation of small bowel disease

    International Nuclear Information System (INIS)

    Capsule endoscopy enables high-resolution depiction of small bowel mucosa and has been shown, by several studies, to have a high diagnostic yield in a variety of small bowel diseases. In this review, we critically assess the contributions of capsule endoscopy and imaging tests in common small bowel disorders. Radiological tests that only assess the small bowel mucosa will be less useful in the era of capsule endoscopy

  2. The expression of HSP60 and HSP10 in large bowel carcinomas with lymph node metastase

    International Nuclear Information System (INIS)

    The involvement of Heat Shock Proteins (HSP) in cancer development and progression is a widely debated topic. The objective of the present study was to evaluate the presence and expression of HSP60 and HSP10 in a series of large bowel carcinomas and locoregional lymph nodes with and without metastases. 82 Astler and Coller's stage C2 colorectal cancers, of which 48 well-differentiated and 34 poorly-differentiated, were selected along with 661 lymph nodes, including 372 with metastases and 289 with reactive hyperplasia only, from the same tumours. Primitive tumours and both metastatic and reactive lymph nodes were studied; specifically, three different compartments of the lymph nodes, secondary follicle, paracortex and medullary sinus, were also analysed. An immunohistochemical research for HSP60 and HSP10 was performed and the semiquantitative results were analysed by statistical analysis to determine the correlation between HSPs expression and 1) tumour grading; 2) degree of inflammation; 3) number of lymph nodes involved; 4) lymph node compartment hyperplasia. Moreover, western blotting was performed on a smaller group of samples to confirm the immunohistochemical results. Our data show that the expression of HSP60, in both primary tumour and lymph node metastasis, is correlated with the tumoral grade, while the HSP10 expression is not. Nevertheless, the levels of HSP10 are commonly higher than the levels of HSP60. In addition, statistical analyses do not show any correlation between the degree of inflammation and the immunopositivity for both HSP60 and HSP10. Moreover, we find a significant correlation between the presence of lymph node metastases and the positivity for both HSP60 and HSP10. In particular, metastatic lymph nodes show a higher percentage of cells positive for both HSP60 and HSP10 in the secondary follicles, and for HSP10 in the medullary sinuses, when compared with hyperplastic lymph nodes. HSP60 and HSP10 may have diagnostic and prognostic significance in the management of this tumour and their overexpression in tumoral cells may be functionally related to tumoral progression. We hypothesise that their expression in follicular and medullary cells of lymph nodes may be induced by formation of metastases. Further studies based on these observations could lead to a better understanding of the HSPs involvement in colorectal cancer progression, as well as other neoplasms

  3. The Interaction of Large Bowel Microflora with the Colonic Mucus Barrier

    OpenAIRE

    Pearson, Jeffrey P; Brownlee, Iain A.

    2010-01-01

    The colonic mucus barrier is the first line of defence that the underlying mucosa has against the wide range of potentially damaging agents of microbial, endogenous, and dietary origin that occur within the colonic lumen. The functional component of mucus is the secreted, polymeric glycoprotein mucin. The mucus barrier can either act as an energy source or a support medium for growth to the intestinal microflora. The mucus barrier appears to effectively partition the vast number of microbial ...

  4. Role of capsule endoscopy in inflammatory bowel disease

    OpenAIRE

    Kopylov, Uri; Seidman, Ernest G.

    2014-01-01

    Videocapsule endoscopy (VCE) has revolutionized our ability to visualize the small bowel mucosa. This modality is a valuable tool for the diagnosis of obscure small bowel Crohn’s disease (CD), and can also be used for monitoring of disease activity in patients with established small-bowel CD, detection of complications such as obscure bleeding and neoplasms, evaluation of response to anti-inflammatory treatment and postoperative recurrence following small bowel resection. VCE could also be an...

  5. Increased fasting serum levels of growth hormone and gastrin in patients with gastric and large bowel cancer

    OpenAIRE

    Triantafillidis J.K.; Govosdis V.; Konstandellou Evangelia; Cheracakis P.; Barbatzas C.; Tzourmakliotis D.; Sklavaina Maria

    2007-01-01

    SUMMARY Background: Growth hormone (GH), Insulin-like growth factor-I (somatomedine, IGF-I) and gastrin seem to play a significant role in cell proliferation in mamalian and rat cells. The role of these factors in the etiology of gastric and large bowel cancer has not been completely elucitated. The aim of this study was to concurrently estimate the levels of GH, IGF-I and gastrin in a group of patients with gastric and colorectal cancer and to compare the results with those of a group of nor...

  6. Increased fasting serum levels of growth hormone and gastrin in patients with gastric and large bowel cancer

    Directory of Open Access Journals (Sweden)

    Triantafillidis J.K.

    2007-03-01

    Full Text Available SUMMARY Background: Growth hormone (GH, Insulin-like growth factor-I (somatomedine, IGF-I and gastrin seem to play a significant role in cell proliferation in mamalian and rat cells. The role of these factors in the etiology of gastric and large bowel cancer has not been completely elucitated. The aim of this study was to concurrently estimate the levels of GH, IGF-I and gastrin in a group of patients with gastric and colorectal cancer and to compare the results with those of a group of normal controls. Patients and Methods: In 33 consequtive patients with gastric (16 patients and large bowel (17 patients cancer, the serum levels of GH, IGF-I and gastrin were measured by radioimmunoassay. Fiftyfour normal people served as controls. Results: Significantly higher levels of serum GH (3.16?3.12 ng/ml in gastric cancer patients vs 3.01?2.91 ng/ml in colorectal cancer patients vs 0.69?1.60 ng/ml in normal controls, adjusted P<0.001 and gastrin (98.2?87.9 pg/ml in gastric cancer patients vs 95.3?85.4 pg/ml in colorectal cancer patients, vs 47.5?32.4 pg/ml in normal controls, adjusted P<0.035 and <0.05 respectively were found in both groups of patients compared with normal controls. The levels of IGF-I in patients with gastric and colorectal cancer patients and normal controls did not differ significantly (Gastric cancer 98.2 pg/ml?87.9 vs 95.3?85.4 vs 47.5?32.4 respectively (adjusted P=0.070. Conclusion: It is concluded that in patients with gastric and colorectal cancer a significant increase of serum GH and gastrin can be found. This increase is likely to play a role in gastric and colorectal carcinogenesis. Key words: Growth hormone, Somatomedine, IGF-I, Gastrin, Gastric cancer, Large bowel cancer

  7. Digestion of complex carbohydrates and large bowel fermentation in rats fed on raw and cooked peas (Pisum sativum).

    Science.gov (United States)

    Goodlad, J S; Mathers, J C

    1992-05-01

    Rats were fed on four semi-purified diets in which raw or cooked peas (Pisum sativum var. Sentinel) provided 250 or 500 g/kg diet. Pressure-cooking of peas followed by rapid freezing and freeze-drying increased the proportion of starch resistant to alpha-amylase (EC 3.2.1.1) without previous treatment with dimethyl sulphoxide. There were only minor effects of cooking on the digestibilities of non-starch polysaccharides and their constituent sugars. With the higher dietary pea concentration there were marked increases in the flow of organic matter to, and fermentation in, the large bowel. These increases were associated with significant increases in colonic tissue and contents weights, and in colonic transit time. Both cooking and dietary pea inclusion rate altered the pattern of volatile fatty acids in caecal contents and in portal blood. PMID:1622985

  8. Colorectal carcinomas with microsatellite instability display a different pattern of target gene mutations according to large bowel site of origin

    International Nuclear Information System (INIS)

    Only a few studies have addressed the molecular pathways specifically involved in carcinogenesis of the distal colon and rectum. We aimed to identify potential differences among genetic alterations in distal colon and rectal carcinomas as compared to cancers arising elsewhere in the large bowel. Constitutional and tumor DNA from a test series of 37 patients with rectal and 25 patients with sigmoid carcinomas, previously analyzed for microsatellite instability (MSI), was studied for BAX, IGF2R, TGFBR2, MSH3, and MSH6 microsatellite sequence alterations, BRAF and KRAS mutations, and MLH1 promoter methylation. The findings were then compared with those of an independent validation series consisting of 36 MSI-H carcinomas with origin from each of the large bowel regions. Immunohistochemical and germline mutation analyses of the mismatch repair system were performed when appropriate. In the test series, IGFR2 and BAX mutations were present in one and two out of the six distal MSI-H carcinomas, respectively, and no mutations were detected in TGFBR2, MSH3, and MSH6. We confirmed these findings in the validation series, with TGFBR2 and MSH3 microsatellite mutations occurring less frequently in MSI-H rectal and sigmoid carcinomas than in MSI-H colon carcinomas elsewhere (P = 0.00005 and P = 0.0000005, respectively, when considering all MSI-carcinomas of both series). No MLH1 promoter methylation was observed in the MSI-H rectal and sigmoid carcinomas of both series, as compared to 53% found in MSI-H carcinomas from other locations (P = 0.004). KRAS and BRAF mutational frequencies were 19% and 43% in proximal carcinomas and 25% and 17% in rectal/sigmoid carcinomas, respectively. The mechanism and the pattern of genetic changes driving MSI-H carcinogenesis in distal colon and rectum appears to differ from that occurring elsewhere in the colon and further investigation is warranted both in patients with sporadic or hereditary disease

  9. Leiomiossarcoma do intestino grosso: relato de um caso Large bowel leiomyosarcoma: a case report

    Directory of Open Access Journals (Sweden)

    Simone Gonçalves Lopes

    2001-04-01

    Full Text Available Os autores relatam um caso de leiomiossarcoma de cólon ascendente acometendo um paciente do sexo masculino, de 49 anos de idade. O paciente iniciou o quadro com anemia e massa abdominal, e a evolução dos sintomas até o diagnóstico final foi de nove meses. Na radiografia simples do abdome havia presença de coleção aérea localizada no hipocôndrio direito, fora da topografia de alças; no clister opaco com duplo contraste foi demonstrado deslocamento inferior da flexura hepática e divertículos. A ultra-sonografia abdominal mostrou lesão expansiva heterogênea, com gás no seu interior, de localização sub-hepática. A tomografia computadorizada do abdome revelou massa escavada com nível líquido, sub-hepática, que não se impregnou pelo meio de contraste. Foi realizada hemicolectomia direita com ileocoloanastomose, e o diagnóstico histopatológico foi de leiomiossarcoma de cólon ascendente.The authors report a case of a 49-year-old male patient with leiomyosarcoma of the ascending colon. The patient presented with anemia and an abdominal mass, and the symptoms progressed until a final diagnosis was made nine months later. A plain abdominal x-ray showed the presence of gas outside the bowel, in the right hypochondrium. The double contrast barium enema showed a sublevel displacement of the hepatic flexure and diverticula. An abdominal ultrasound revealed a heterogeneous expansive lesion below the liver containing gas, and a computed tomography of the abdomen revealed an excavated mass below the liver containing liquid, that was not filled in by contrast medium. The patient was submitted to a right hemicolectomy with ileocoloanastomosis and the histopathological analysis of the excised material revealed a leiomyosarcoma of the ascending colon.

  10. Pregnancy and inflammatory bowel disease.

    OpenAIRE

    Zeldis, J. B.

    1989-01-01

    Conclusions about the relationship between the pathophysiology and treatment of inflammatory bowel disease and the physiology and management of pregnancy are based on the results of several large physician surveys and retrospective chart reviews. Patients with active disease fare worse than those with inactive disease. There is little evidence that pregnancy affects the course of inflammatory bowel disease or that inactive inflammatory bowel disease affects the course of pregnancy. Judicious ...

  11. Complementary and alternative medicine use and cost in functional bowel disorders: A six month prospective study in a large HMO

    OpenAIRE

    Drossman Douglas A; Turner Marsha J; Feld Andrew D; Levy Rona L; Palsson Olafur S; van Tilburg Miranda AL; Whitehead William E

    2008-01-01

    Abstract Background Functional Bowel Disorders (FBD) are chronic disorders that are difficult to treat and manage. Many patients and doctors are dissatisfied with the level of improvement in symptoms that can be achieved with standard medical care which may lead them to seek alternatives for care. There are currently no data on the types of Complementary and Alternative Medicine (CAM) used for FBDs other than Irritable Bowel Syndrome (IBS), or on the economic costs of CAM treatments. The aim ...

  12. MRI for chronic inflammatory bowel disease; MRT chronisch entzuendlicher Darmerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Hansmann, H.J.; Hess, T.; Hahmann, M.; Erb, G.; Richter, G.M.; Duex, M. [Heidelberg Univ. (Germany). Abt. Roentgendiagnostik; Elsing, C. [Heidelberg Univ. (Germany). Abt. IV - Gastroenterologie

    2001-01-01

    Chronic inflammatory bowel disease is diagnosed and monitored by the combination of colonoscopy and small bowel enteroklysis. Magnetic resonance imaging has become the gold standard for the imaging of perirectal and pelvic fistulas. With the advent of ultrafast MRI small and large bowel imaging has become highly attractive and is being advocated more and more in the diagnostic work up of inflammatory bowel disease. Imaging protocols include fast T{sub 1}-weighted gradient echo and T{sub 2}-weighted TSE sequences and oral or rectal bowel distension. Furthermore, dedicated imaging protocols are based on breath-hold imaging under pharmacological bowel paralysis and gastrointestinal MR contrast agents (Hydro-MRI). High diagnostic accuracy can be achieved in Crohn's disease with special reference to the pattern of disease, depth of inflammation, mesenteric reaction, sinus tract depiction and formation of abscess. In ulcerative colitis, the mucosa-related inflammation causes significantly less bowel wall thickening compared to Crohn's disease. Therefore with MRI, the extent of inflammatory changes is always underestimated compared to colonoscopy. According to our experience in more than 200 patients as well as the results in other centers, Hydro-MRI possesses the potential to replace enteroklysis in the diagnosis of chronic inflammatory bowel disease and most of the follow-up colonoscopies in Crohn's disease. Further technical improvements in 3D imaging will allow interactive postprocessing of the MR data. (orig.) [German] Zusammenfassung: Die Standardverfahren in der Diagnostik und der Verlaufskontrolle chronisch entzuendlicher Darmerkrankungen, speziell des Morbus Crohn und der Colitis ulcerosa, sind die Koloskopie und das Enteroklysma. Die MRT hat sich dazu ihren festen Platz in der Diagnostik perirektaler Fisteln erobert. Mit schnellen, T{sub 1}-gewichteten Gradienten-Echo-Sequenzen und T{sub 2}-gewichteten Turbo-Spin-Echo-Sequenzen koennen auch Duenn- und Dickdarm nach oraler oder rektaler Fuellung zuverlaessig dargestellt werden. Die Hydro-MRT als spezielles MR-Untersuchungsprotokoll mit Bildakquisition in Atemstillstand unter medikamentoeser Darmhypotonie und Verwendung intestinaler MR-Kontrastmittel erlaubt die Abbildung intestinaler und extraintestinaler pathologischer Veraenderungen beim M. Crohn. Hierzu rechnen einerseits entzuendliche Darmwandverdickung und Stenosen, andererseits Fisteln, entzuendliche Konglomerate und Abszesse. Bei der Colitis ulcerosa ist im Gegensatz zum Morbus Crohn in der Hydro-MRT eine deutlich geringere entzuendliche Wandverdickung typisch. Ferner ist bei der Colitis ulcerosa die Ausdehnung der Befunde in der MRT regelmaessig geringer als in der Endoskopie. Die Hydro-MRT kann nach unseren eigenen Erfahrungen an mehr als 200 Patienten und den Ergebnissen anderer Zentren das Enteroklysma in der Diagnostik chronisch entzuendlicher Darmerkrankungen und die Mehrzahl von Wiederholungsendoskopien beim Morbus Crohn ersetzen. Weiterentwicklungen der Technik erlauben interaktive multiplanare Nachverarbeitungen der MR-Datensaetze. (orig.)

  13. Citrus auraptene exerts dose-dependent chemopreventive activity in rat large bowel tumorigenesis: the inhibition correlates with suppression of cell proliferation and lipid peroxidation and with induction of phase II drug-metabolizing enzymes.

    Science.gov (United States)

    Tanaka, T; Kawabata, K; Kakumoto, M; Hara, A; Murakami, A; Kuki, W; Takahashi, Y; Yonei, H; Maeda, M; Ota, T; Odashima, S; Yamane, T; Koshimizu, K; Ohigashi, H

    1998-06-15

    In our previous short-term experiment, Citrus auraptene inhibited the development of azoxymethane (AOM)-induced aberrant crypt foci, which are precursor lesions for colorectal carcinoma. In the present study, the possible inhibitory effect of dietary administration of auraptene was investigated using an animal colon carcinogenesis model with a colon carcinogen AOM. Male F344 rats were given s.c. injections of AOM (15 mg/kg body weight) once a week for 3 weeks to induce colon neoplasms. They also received diets containing 100 or 500 ppm auraptene for 4 weeks in groups of "initiation" feeding, starting 1 week before the first dosing of AOM. The diets containing auraptene were also given to rats for 38 weeks in groups of "postinitiation" feeding. At the termination of the study (38 weeks), dietary administration of auraptene caused dose-dependent inhibition in AOM-induced large bowel carcinogenesis. Auraptene feeding during the initiation phase reduced the incidence of colon adenocarcinoma by 49% at 100 ppm (P = 0.099) and 65% at 500 ppm (P = 0.0075). Auraptene administration during the postinitiation phase inhibited the incidence of colon adenocarcinoma by 58% at 100 ppm (P = 0.021) and 65% at 500 ppm (P = 0.0075). Also, the multiplicity of colon carcinoma was significantly reduced by initiation feeding at a dose level of 500 ppm (P auraptene suppressed the expression of cell proliferation biomarkers (ornithine decarboxylase activity and polyamine content) in the colonic mucosa and reduced the production of aldehydic lipid peroxidation [malondialdehyde and 4-hydroxy-2(E)-nonenal]. In addition, auraptene increased the activities of Phase II drug-metabolizing enzymes (glutathione S-transferase and quinone reductase) in the liver and colon. These findings suggest that the inhibitory effects of auraptene on AOM-induced colon tumorigenesis at the initiation level might be associated, in part, with increased activity of Phase II enzymes, and those at the postinitiation stage might be related to suppression of cell proliferation and lipid peroxidation in the colonic mucosa. PMID:9635577

  14. Psychosocial risk markers for new onset irritable bowel syndrome – Results of a large prospective population-based study

    OpenAIRE

    Nicholl, B.I.; Halder, S.L.; Macfarlane, G.J.; Thompson, D.G.; O’Brien, S.; Musleh, M.; McBeth, J.

    2008-01-01

    Irritable bowel syndrome (IBS) affects up to 22% of the general population. Its aetiology remains unclear. Previously reported cross-sectional associations with psychological distress and depression are not fully understood. We hypothesised that psychosocial factors, particularly those associated with somatisation, would act as risk markers for the onset of IBS. We conducted a community-based prospective study of subjects, aged 25–65 years, randomly selected from the registers of three primar...

  15. Bowel Obstruction: Sonographic Evaluation.

    Science.gov (United States)

    Hollerweger, A; Wüstner, M; Dirks, K

    2015-06-01

    Learning objectives: Sonographic examination concept in the case of suspicion of bowel obstruction. Recognition of the sonographic criteria of a bowel obstruction. Ability to detect the level of a bowel obstruction. Sonographic detection of typical causes of bowel obstruction. Detection of sonographic signs of complicated bowel obstruction. Ability to sonographically define important differential diagnoses. Further diagnostic procedures in unclear situations. PMID:25905814

  16. Hemorragia maciça do intestino grosso: o que está ao nosso alcance? Massive large bowel bleeding: what is within our reach?

    Directory of Open Access Journals (Sweden)

    Júlio César M Santos Jr.

    2010-06-01

    Full Text Available A forma de avaliar e lidar com a hemorragia aguda digestiva baixa tem sido modificado com os recentes desenvolvimentos de novas técnicas e aparelhos. O nosso objetivo, por esse manuscrito, é demonstrar com simplicidade uma forma de condução dos pacientes com hemorragia digestiva baixa aguda, sobretudo para os sangramentos que parecem mais graves, principalmente quando nos faltam os recursos das avançadas tecnologias atuais. Doenças localizadas no intestino grosso respondem por ¼ dos casos de hemorragias digestivas que são motivos para admissão hospitalar e têm como principais agentes etiológicos os divertículos, na moléstia diverticular, e as alterações vasculares, nas angiodisplasias. Na grande maioria das vezes o sangramento que pode parecer abundante cessa espontaneamente. Os distúrbios circulatórios graves não são comuns e os sinais mais frequentes são a queda do valor da hemoglobina observada na metade dos pacientes, e algumas alterações hemodinâmicas como a variação pressórica postural que pode ser vista em até 30% dos casos; a síncope em 10% e alguma forma de colapso circulatório, em 9%. Contudo, a faixa etária em que ocorre, as condições da senilidade, as doenças eventualmente associadas e a falta de recursos materiais e humanos para lidar com esse tipo de problema são os motivos que mais causam preocupação. A abordagem clínica simples com uma história bem elaborada; o exame físico com atenção e objetividade, a inclusão do exame proctológico, a obrigatória disponibilidade de aparelho para a coloscopia e os conhecimentos básicos sobre o evento formam o conjunto necessário e, na maioria das vezes, suficiente para o correto desempenho profissional na elaboração dos cuidados que devem ser dados a esses pacientes.The evaluation and management of the acute lower digestive hemorrhage has been modified with the recent development of new techniques and devices. The aim of this manuscript was to demonstrate with simplicity how to treat the patients with acute lower intestinal hemorrhage. Diseases of the large bowel account for the ¼ of the cases of digestive hemorrhages on the hospital admission and have as main etiological agents the diverticula, in the diverticular disease, and small vascular malformation, in the angiodysplasias. Sometime, it can be seen as a life-threatening condition, however, most of the times, the hemorrhage stops spontaneously. The serious circulatory disturbances are not common; the most frequent signs are the decrease in hemoglobin occurring on about one half of patients and some form of circulatory disturbance as orthostatic changes in 30%; as syncope in 10% and as cardiovascular collapse in 9%. However, the age group, the conditions of the senility, the eventually associated diseases and the lack of material and human resources to handle with that kind of problem are the reasons for concern. The simple clinical approach with a well elaborated history; the physical examination released with attention and objectivity, the inclusion of the proctologic exam, the obligatory readiness for an endoscope for colonoscopy, the basic knowledge on the event are necessary and, in most of the times, enough for the good professional acting in the elaboration of the cares that it should be given to those patient ones.

  17. RNA–Stable-Isotope Probing Shows Utilization of Carbon from Inulin by Specific Bacterial Populations in the Rat Large Bowel

    OpenAIRE

    Tannock, Gerald W; Lawley, Blair; Munro, Karen; Sims, Ian M; Lee, Julian; Butts, Christine A.; Roy, Nicole

    2014-01-01

    Knowledge of the trophisms that underpin bowel microbiota composition is required in order to understand its complex phylogeny and function. Stable-isotope (13C)-labeled inulin was added to the diet of rats on a single occasion in order to detect utilization of inulin-derived substrates by particular members of the cecal microbiota. Cecal digesta from Fibruline-inulin-fed rats was collected prior to (0 h) and at 6, 12, 18 and 24 h following provision of the [13C]inulin diet. RNA was extracted...

  18. Understanding Bowel Preparation

    Science.gov (United States)

    Understanding Bowel Preparation What bowel preparation steps are involved before the colonoscopy? Your doctor will prescribe the ... side effects of the prep selected for you. Understanding Bowel Preparation Before Colonoscopy It is extremely important ...

  19. beta-Catenin-accumulated crypts in the colonic mucosa of juvenile ApcMin/+ mice.

    Science.gov (United States)

    Hata, Kazuya; Tanaka, Takuji; Kohno, Hiroyuki; Suzuki, Rikako; Qiang, Sheng Hong; Yamada, Yasuhiro; Oyama, Takeshi; Kuno, Toshiya; Hirose, Yoshinobu; Hara, Akira; Mori, Hideki

    2006-07-28

    Although Apc(Min/+) mice are widely used for an animal model of human familial adenomatous polyposis (FAP), a majority of intestinal polyps locate in the small intestine. We recently reported that numerous beta-catenin-accumulated crypts (BCAC), which are reliable precursor lesions for colonic adenocarcinoma, develop in the large bowel of aged Apc(Min/+) mice. In this study, we determined the presence and location of BCAC in the large intestine of juvenile Apc(Min/+) mice (3 and 5 weeks of age). Surprisingly, BCAC were noted in the colon of even Apc(Min/+) mice of both ages, and mainly located in the distal and middle segments of the colon. Also, a few microadenomas were detected in Apc(Min/+) mice of 5-week old. Our results may indicate need of further investigation of the colorectal mucosa of Apc(Min/+) mice for examining colorectal carcinogenesis using Apc(Min/+) mice. PMID:16168560

  20. Inflammatory bowel disease: Pathogenesis

    OpenAIRE

    Zhang, Yi-Zhen; Li, Yong-yu

    2014-01-01

    Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, is characterized by chronic relapsing intestinal inflammation. It has been a worldwide health-care problem with a continually increasing incidence. It is thought that IBD results from an aberrant and continuing immune response to the microbes in the gut, catalyzed by the genetic susceptibility of the individual. Although the etiology of IBD remains largely unknown, it involves a complex interaction between the...

  1. Video Capsule Endoscopy of the Small Bowel for Monitoring of Crohn's Disease.

    Science.gov (United States)

    Kopylov, Uri; Ben-Horin, Shomron; Seidman, Ernest G; Eliakim, Rami

    2015-11-01

    Video capsule endoscopy has revolutionized our ability to visualize the small bowel mucosa. This modality is a valuable tool for the diagnosis of suspected small bowel Crohn's disease, and it is increasingly used for the monitoring of disease activity in patients with established small bowel Crohn's. The purpose of the current article was to review the literature pertaining to the utilization of capsule endoscopy in established Crohn's disease, for monitoring of mucosal healing, postoperative recurrence, disease classification, and other indications. PMID:26193349

  2. Bowel Retraining: Strategies for Establishing Bowel Control

    Science.gov (United States)

    ... Overview Biofeedback Bowel Retraining Dietary Fiber Fruit Juice Hirschsprung's Disease Laxatives Stool Form Guide Tips on Finding a ... Overview Biofeedback Bowel Retraining Dietary Fiber Fruit Juice Hirschsprung's Disease Laxatives Stool Form Guide Tips on Finding a ...

  3. Complementary and alternative medicine use and cost in functional bowel disorders: A six month prospective study in a large HMO

    Directory of Open Access Journals (Sweden)

    Drossman Douglas A

    2008-07-01

    Full Text Available Abstract Background Functional Bowel Disorders (FBD are chronic disorders that are difficult to treat and manage. Many patients and doctors are dissatisfied with the level of improvement in symptoms that can be achieved with standard medical care which may lead them to seek alternatives for care. There are currently no data on the types of Complementary and Alternative Medicine (CAM used for FBDs other than Irritable Bowel Syndrome (IBS, or on the economic costs of CAM treatments. The aim of this study is to determine prevalence, types and costs of CAM in IBS, functional diarrhea, functional constipation, and functional abdominal pain. Methods 1012 Patients with FBD were recruited through a health care maintenance organization and followed for 6 months. Questionnaires were used to ascertain: Utilization and expenditures on CAM, symptom severity (IBS-SS, quality of life (IBS-QoL, psychological distress (BSI and perceived treatment effectiveness. Costs for conventional medical care were extracted from administrative claims. Results CAM was used by 35% of patients, at a median yearly cost of $200. The most common CAM types were ginger, massage therapy and yoga. CAM use was associated with female gender, higher education, and anxiety. Satisfaction with physician care and perceived effectiveness of prescription medication were not associated with CAM use. Physician referral to a CAM provider was uncommon but the majority of patients receiving this recommendation followed their physician's advice. Conclusion CAM is used by one-third of FBD patients. CAM use does not seem to be driven by dissatisfaction with conventional care. Physicians should discuss CAM use and effectiveness with their patients and refer patients if appropriate.

  4. Review article : the potential role of nitric oxide in chronic inflammatory bowel disorders

    DEFF Research Database (Denmark)

    Perner, A; Rask-Madsen, J

    1999-01-01

    The aetiology of the chronic inflammatory bowel diseases-ulcerative colitis and Crohn's disease-as well as 'microscopic colitis'-both collagenous (COC) and lymphocytic colitis (LC)-remains unknown. Autoimmune mechanisms, cytokine polymorphism, commensal bacteria, infectious agents and vascular impairment have all been proposed as playing important roles in the pathogenesis of this spectrum of diseases. A variety of proinflammatory mediators, including tumour necrosis factor alpha, interleukin-1beta, interferon gamma, leukotriene B4 and platelet activating factor, promote the adherence of phagocytes to the venular endothelium and extravasation of these cells into the colonic mucosa. In addition to large amounts of nitric oxide (NO), injurious peroxynitrite may be formed in the epithelium by the inducible nitric oxide synthase (iNOS), which is considered to elicit cytotoxicity by the generation of superoxide with reduced L-arginine availability. In active ulcerative colitis, and to a lesser extent in Crohn's disease, a greatly increased production of NO has been demonstrated by indirect and direct measurements. Surprisingly, even higher rates of production have been observed in COC-a condition which is never associated with injurious inflammation. The latter observation favours the notion that NO promotes mucosal integrity. Further evidence for a protective role of NO in chronic inflammatory bowel disorders is provided by the observation of increased susceptibility to the induction of experi mental colitis in 'knock-out' mice deficient in iNOS. Selective inhibitors of iNOS activity, as well as topical L-arginine, may therefore prove beneficial in inflammatory bowel disease by reducing the production of superoxide by iNOS, while only the former option may be expected to reduce diarrhoea in chronic inflammatory bowel disorders. Clearly, further experimental work needs to be done before testing topical L-arginine in human inflammatory bowel disease.

  5. Review article: the potential role of nitric oxide in chronic inflammatory bowel disorders.

    DEFF Research Database (Denmark)

    Perner, Anders; Rask-Madsen, J

    1999-01-01

    The aetiology of the chronic inflammatory bowel diseases-ulcerative colitis and Crohn's disease-as well as 'microscopic colitis'-both collagenous (COC) and lymphocytic colitis (LC)-remains unknown. Autoimmune mechanisms, cytokine polymorphism, commensal bacteria, infectious agents and vascular impairment have all been proposed as playing important roles in the pathogenesis of this spectrum of diseases. A variety of proinflammatory mediators, including tumour necrosis factor alpha, interleukin-1beta, interferon gamma, leukotriene B4 and platelet activating factor, promote the adherence of phagocytes to the venular endothelium and extravasation of these cells into the colonic mucosa. In addition to large amounts of nitric oxide (NO), injurious peroxynitrite may be formed in the epithelium by the inducible nitric oxide synthase (iNOS), which is considered to elicit cytotoxicity by the generation of superoxide with reduced L-arginine availability. In active ulcerative colitis, and to a lesser extent in Crohn's disease, a greatly increased production of NO has been demonstrated by indirect and direct measurements. Surprisingly, even higher rates of production have been observed in COC-a condition which is never associated with injurious inflammation. The latter observation favours the notion that NO promotes mucosal integrity. Further evidence for a protective role of NO in chronic inflammatory bowel disorders is provided by the observation of increased susceptibility to the induction of experi mental colitis in 'knock-out' mice deficient in iNOS. Selective inhibitors of iNOS activity, as well as topical L-arginine, may therefore prove beneficial in inflammatory bowel disease by reducing the production of superoxide by iNOS, while only the former option may be expected to reduce diarrhoea in chronic inflammatory bowel disorders. Clearly, further experimental work needs to be done before testing topical L-arginine in human inflammatory bowel disease.

  6. Comparison of two cathartic preparations, peg-electrolytes solution and sodium phosphate salts, as means for large bowel preparation for colonoscopy

    Directory of Open Access Journals (Sweden)

    N. Antonakopoulos, I. Kyrlagkitsis, V. Xourgias, D.G. Karamanolis

    2007-03-01

    Full Text Available SUMMARY The ideal bowel preparation for colonoscopy must combine the characteristics of effectiveness with the least side effects. We compared the relatively novel cathartic preparation of sodium phosphate salts (Fleet Phospho-sodaR with the widely used PEG-electrolytes solution (Klean-prepR. Fiftytwo consecutive patients referred for colonoscopy were randomised to receive either sodium phospate salts or PEG electrolytes. The evaluation of the two preparations was based on two separate questionnaires, one completed by the endoscopist who ignored the kind of bowel preparation used and the other by the patient. Bowel preparation with sodium phospate salts was more effective in bowel cleansing and better tolerated than PEG-electrolytes solution in terms of difficulty in intake and swallowing, fatigue, the presence of colicky abdominal pain, flatulence, vomiting and perianal irritation (p<0,05. Key words: cathartic preparation, PEG-electrolytes, sodium phosphate salts

  7. Expression of CD4+ T cell cytokine genes in the colorectal mucosa of inflammatory colorectal polyps in miniature dachshunds.

    Science.gov (United States)

    Ohta, Hiroshi; Takada, Kanae; Torisu, Shidow; Yuki, Masashi; Tamura, Yu; Yokoyama, Nozomu; Osuga, Tatsuyuki; Lim, Sue Yee; Murakami, Masahiro; Sasaki, Noboru; Nakamura, Kensuke; Yamasaki, Masahiro; Takiguchi, Mitsuyoshi

    2013-10-01

    Inflammatory colorectal polyps (ICRPs) in miniature dachshunds are recently recognized as a major cause of large bowel diarrhea in this dog breed in Japan. ICRPs are characterized by the formation of multiple small polyps and a space-occupying large polyp in the colorectal area, and are thought to be a novel form of inflammatory bowel disease (IBD). In humans, specific cytokine patterns attributed to T helper (Th)1, Th17 and regulatory T cells have important roles in the pathogenesis of IBD. Thus, the aim of the present study was to assess the gene expression of cytokines of T cell subsets in the colorectal mucosa from dogs with ICRPs. Colorectal mucosal specimens from 10 dogs with ICRPs and 14 control dogs were used in this study. Interferon (IFN)-?, interleukin (IL)-4, IL-17A and IL-10 mRNA expression was assessed using quantitative real-time PCR. IL-17A mRNA expression was significantly increased in large polyps compared to small polyps and controls. IFN-? and IL-10 mRNA expression in large polyps were significantly higher than in controls. There was no significant difference in IL-4 mRNA expression among the three groups. IL-17A is thought to play important roles in the pathogenesis of ICRPs. IL-10 up-regulation could oppose the proinflammatory function of IL-17A. PMID:23953369

  8. Histological and histochemical evaluation of human oral mucosa constructs developed by tissue engineering

    OpenAIRE

    Sánchez-Quevedo, M.C.; Alaminos, M.; Capitan, L.M.; Moreu, G.; Garzon, I.; Crespo, P.V.; CAMPOS, A.

    2007-01-01

    Reconstruction of large oral mucosa defects is often challenging, since the shortage of healthy oral mucosa to replace the excised tissues is very common. In this context, tissue engineering techniques may provide a source of autologous tissues available for transplant in these patients. In this work, we developed a new model of artificial oral mucosa generated by tissue engineering using a fibrin-agarose scaffold. For that purpose, we generated primary cultures of human oral mucosa ...

  9. Role of capsule endoscopy in inflammatory bowel disease.

    Science.gov (United States)

    Kopylov, Uri; Seidman, Ernest G

    2014-02-01

    Videocapsule endoscopy (VCE) has revolutionized our ability to visualize the small bowel mucosa. This modality is a valuable tool for the diagnosis of obscure small bowel Crohn's disease (CD), and can also be used for monitoring of disease activity in patients with established small-bowel CD, detection of complications such as obscure bleeding and neoplasms, evaluation of response to anti-inflammatory treatment and postoperative recurrence following small bowel resection. VCE could also be an important tool in the management of patients with unclassified inflammatory bowel disease, potentially resulting in reclassification of these patients as having CD. Reports on postoperative monitoring and evaluation of patients with ileal pouch-anal anastomosis who have developed pouchitis have recenty been published. Monitoring of colonic inflammatory activity in patients with ulcerative colitis using the recently developed colonic capsule has also been reported. Capsule endoscopy is associated with an excellent safety profile. Although retention risk is increased in patients with small bowel CD, this risk can be significanty decreased by a routine utilization of a dissolvable patency capsule preceding the ingestion of the diagnostic capsule. This paper contains an overview of the current and future clinical applications of capsule endoscopy in inflammatory bowel disease. PMID:24574792

  10. Mucolytic bacteria with increased prevalence in IBD mucosa augment in vitro utilization of mucin by other bacteria

    OpenAIRE

    Png, C.W.; Linden, S.K.; Gilshenan, K.S.; Zoetendal, E.G.; McSweeney, C S; Sly, L. I.; McGuckin, M A; Florin, T.H.

    2010-01-01

    OBJECTIVES: Mucosa-associated bacteria are increased in inflammatory bowel disease (IBD), which suggests the possibility of an increased source of digestible endogenous mucus substrate. We hypothesized that mucolytic bacteria are increased in IBD, providing increased substrate to sustain nonmucolytic mucosa-associated bacteria. METHODS: Mucolytic bacteria were characterized by the ability to degrade human secretory mucin (MUC2) in pure and mixed anaerobic cultures. Real-time PCR was used t...

  11. Detection of a fluorescent-labeled avidin-nucleic acid nanoassembly by confocal laser endomicroscopy in the microvasculature of chronically inflamed intestinal mucosa

    Directory of Open Access Journals (Sweden)

    Buda A

    2015-01-01

    Full Text Available Andrea Buda,1,* Sonia Facchin,1,* Elisa Dassie,2 Elisabetta Casarin,3 Mark A Jepson,4 Helmut Neumann,5 Giorgia Hatem,1 Stefano Realdon,6 Renata D’Incà,1 Giacomo Carlo Sturniolo,1 Margherita Morpurgo3 1Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, 2Department of Molecular Medicine, University of Padova, Padova, Italy; 3Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy; 4School of Biochemistry and Wolfson Bioimaging Facility, University of Bristol, Bristol, UK; 5Ludwig Demlig Endoscopic Center of Excellence, ESGE Endoscopy Training Center, University of Erlangen-Nuremberg, Erlangen, Germany; 6Veneto Institute of Oncology IOV-IRCCS, Padova, Italy *These authors contributed equally to this work Abstract: Inflammatory bowel diseases are chronic gastrointestinal pathologies causing great discomfort in both children and adults. The pathogenesis of inflammatory bowel diseases is not yet fully understood and their diagnosis and treatment are often challenging. Nanoparticle-based strategies have been tested in local drug delivery to the inflamed colon. Here, we have investigated the use of the novel avidin-nucleic acid nanoassembly (ANANAS platform as a potential diagnostic carrier in an experimental model of inflammatory bowel diseases. Fluorescent-labeled ANANAS nanoparticles were administered to mice with chemically induced chronic inflammation of the large intestine. Localization of mucosal nanoparticles was assessed in vivo by dual-band confocal laser endomicroscopy. This technique enables characterization of the mucosal microvasculature and crypt architecture at subcellular resolution. Intravascular nanoparticle distribution was observed in the inflamed mucosa but not in healthy controls, demonstrating the utility of the combination of ANANAS and confocal laser endomicroscopy for highlighting intestinal inflammatory conditions. The specific localization of ANANAS in inflamed tissues supports the potential of this platform as a targeted carrier for bioactive moieties in the treatment of inflammatory bowel disease. Keywords: confocal laser endomicroscopy, inflammatory bowel disease, diagnostics, dextran sodium sulfate, avidin-nucleic acid nanoassembly, fluorescent nanoparticles, ulcerative colitis

  12. Short bowel syndrome

    International Nuclear Information System (INIS)

    This thesis describes some aspects of short bowel syndrome. When approximately 1 m or less small bowel is retained after extensive resection, a condition called short bowel syndrome is present. Since the advent of parenteral nutrition, the prognosis of patients with a very short bowel has dramatically improved. Patients with 40 to 100 cm remaining jejunum and/or ileum can generally be maintained with oral nutrition due to increased absorption of the small bowel remnant as result of intestinal adaptation. This study reports clinical, biochemical and nutritional aspects of short bowel patients on oral or parenteral nutrition, emphasizing data on absorption of various nutrients and on bone metabolism. Furthermore, some technical apsects concerning long-term parenteral nutrition are discussed. (Auth.)

  13. Host-microbiota interactions in inflammatory bowel disease

    OpenAIRE

    Elson, Charles O; Cong, Yingzi

    2012-01-01

    The interaction of the host with its abundant intestinal microbiota is complex and engages most of the cells in the intestinal mucosa. The inflammatory bowel diseases appear to be disorders of the host immune response to the microbiota. This is supported by data from induced gene mutations in mice and more recently by the identification of gene variants in humans that result in IBD or IBD susceptibility. These genetic studies have provided insights into the cells and molecular pathways involv...

  14. Why is damage limited to the mucosa in ulcerative colitis but transmural in Crohn’s disease?

    Directory of Open Access Journals (Sweden)

    Xiaofa Qin

    2013-01-01

    Full Text Available It has been a big puzzle as why the inflammation of ulcerative colitis (UC is limited to the mucosa, while in Crohn’s disease (CD the inflammation is transmural and can be seen in all layers of the gut. Here, I give a tentative explanation extended from the unified hypothesis I proposed on the etiology of inflammatory bowel disease. This hypothesis suggested that both UC and CD are caused by weakening of the gut barrier due to damage of the protective mucus layer and the underlying tissue by the poorly inactivated digestive proteases resulting from a reduction of gut bacteria by dietary chemicals like saccharin and sucralose. However, the large amounts of bacteria in the colon make the recruitment of neutrophils and formation of crypt abscess the main manifestation of UC, while the infiltration of antigens and dietary particles in the small and large intestine mainly cause the recruitment of macrophages and formation of granulomas as the main manifestations in CD. The fast reacting and short life span of neutrophils make the fight and damage limited to the surface of the mucosa. In contrast, the long life span and constant movement of macrophages may bring the harmful agents deep into the tissue. Therefore, the pathogenesis of UC may be more like bacterial pneumonia, while CD may be more like pneumoconiosis or tuberculosis of the lung.

  15. Hemorragia maciça do intestino grosso: o que está ao nosso alcance? / Massive large bowel bleeding: what is within our reach?

    Scientific Electronic Library Online (English)

    Júlio César M, Santos Jr..

    2010-06-01

    Full Text Available A forma de avaliar e lidar com a hemorragia aguda digestiva baixa tem sido modificado com os recentes desenvolvimentos de novas técnicas e aparelhos. O nosso objetivo, por esse manuscrito, é demonstrar com simplicidade uma forma de condução dos pacientes com hemorragia digestiva baixa aguda, sobretu [...] do para os sangramentos que parecem mais graves, principalmente quando nos faltam os recursos das avançadas tecnologias atuais. Doenças localizadas no intestino grosso respondem por ¼ dos casos de hemorragias digestivas que são motivos para admissão hospitalar e têm como principais agentes etiológicos os divertículos, na moléstia diverticular, e as alterações vasculares, nas angiodisplasias. Na grande maioria das vezes o sangramento que pode parecer abundante cessa espontaneamente. Os distúrbios circulatórios graves não são comuns e os sinais mais frequentes são a queda do valor da hemoglobina observada na metade dos pacientes, e algumas alterações hemodinâmicas como a variação pressórica postural que pode ser vista em até 30% dos casos; a síncope em 10% e alguma forma de colapso circulatório, em 9%. Contudo, a faixa etária em que ocorre, as condições da senilidade, as doenças eventualmente associadas e a falta de recursos materiais e humanos para lidar com esse tipo de problema são os motivos que mais causam preocupação. A abordagem clínica simples com uma história bem elaborada; o exame físico com atenção e objetividade, a inclusão do exame proctológico, a obrigatória disponibilidade de aparelho para a coloscopia e os conhecimentos básicos sobre o evento formam o conjunto necessário e, na maioria das vezes, suficiente para o correto desempenho profissional na elaboração dos cuidados que devem ser dados a esses pacientes. Abstract in english The evaluation and management of the acute lower digestive hemorrhage has been modified with the recent development of new techniques and devices. The aim of this manuscript was to demonstrate with simplicity how to treat the patients with acute lower intestinal hemorrhage. Diseases of the large bow [...] el account for the ¼ of the cases of digestive hemorrhages on the hospital admission and have as main etiological agents the diverticula, in the diverticular disease, and small vascular malformation, in the angiodysplasias. Sometime, it can be seen as a life-threatening condition, however, most of the times, the hemorrhage stops spontaneously. The serious circulatory disturbances are not common; the most frequent signs are the decrease in hemoglobin occurring on about one half of patients and some form of circulatory disturbance as orthostatic changes in 30%; as syncope in 10% and as cardiovascular collapse in 9%. However, the age group, the conditions of the senility, the eventually associated diseases and the lack of material and human resources to handle with that kind of problem are the reasons for concern. The simple clinical approach with a well elaborated history; the physical examination released with attention and objectivity, the inclusion of the proctologic exam, the obligatory readiness for an endoscope for colonoscopy, the basic knowledge on the event are necessary and, in most of the times, enough for the good professional acting in the elaboration of the cares that it should be given to those patient ones.

  16. Solid Organ Transplantation in Patients with Inflammatory Bowel Diseases (IBD): Analysis of Transplantation Outcome and IBD Activity in a Large Single Center Cohort

    Science.gov (United States)

    Schnitzler, Fabian; Friedrich, Matthias; Stallhofer, Johannes; Schönermarck, Ulf; Fischereder, Michael; Habicht, Antje; Karbalai, Nazanin; Wolf, Christiane; Angelberger, Marianne; Olszak, Torsten; Beigel, Florian; Tillack, Cornelia; Göke, Burkhard; Zachoval, Reinhart; Denk, Gerald; Guba, Markus; Rust, Christian; Grüner, Norbert; Brand, Stephan

    2015-01-01

    Background Currently, limited data of the outcome of inflammatory bowel disease (IBD) in patients after solid organ transplantation (SOT) are available. We aimed to analyze effects of SOT on the IBD course in a large IBD patient cohort. Methods Clinical data from 1537 IBD patients were analyzed for patients who underwent SOT (n = 31) between July 2002 and May 2014. Sub-analyses included SOT outcome parameters, IBD activity before and after SOT, and efficacy of IBD treatment. Results 4.74% of patients with ulcerative colitis (UC) and 0.84% of patients with Crohn’s disease (CD) underwent SOT (p = 2.69 x 10?6, UC vs. CD). 77.4% of patients with SOT underwent liver transplantation (LTx) with tacrolimus-based immunosuppressive therapy after SOT. All LTx were due to primary sclerosing cholangitis (PSC) or PSC overlap syndromes. Six patients (19.4%) required renal transplantation and one patient (3.2%) heart transplantation. A survival rate of 83.9% after a median follow-up period of 103 months was observed. Before SOT, 65.0% of patients were in clinical remission and 5 patients received immunosuppressive therapy (16.1%). After SOT, 61.0% of patients were in remission (p = 1.00 vs. before SOT) and 29.0% required IBD-specific immunosuppressive or anti-TNF therapy (p = 0.54 vs. before SOT). 42.9% of patients with worsening of IBD after SOT were at higher risk of needing steroid therapy for increased IBD activity (p = 0.03; relative risk (RR): 10.29; 95% CI 1.26–84.06). Four patients (13.0%) needed anti-TNF therapy after SOT (response rate 75%). Conclusions SOT was more common in UC patients due to the higher prevalence of PSC-related liver cirrhosis in UC. Despite mainly tacrolimus-based immunosuppressive regimens, outcome of SOT and IBD was excellent in this cohort. In this SOT cohort, concomitant immunosuppressive therapy due to IBD was well tolerated. PMID:26288187

  17. Oral manifestations of patients with inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Flora Zervou

    2007-03-01

    Full Text Available Background: Crohn?s disease (CD is considered to be a disease involving the whole gastrointestinal tract, while ulcerative colitis (UC is a disease exclusively located in the large bowel. The aim of this study was to examine whether patients with either CD or UC are at increased risk for developing oral manifestations. Patients-Methods: A wide spectrum of oral lesions was carefully sought by the same oral dentist in a consecutive series of 30 patients with inflammatory bowel disease (IBD (15 with CD and 15 with UC. Forty-seven healthy individuals (matched for age and sex, attendants of our dental clinic served as controls. Results: 93% of UC and 87% of the CD group had at least one lesion compared to 55% of the control group (P<0.005. Significantly more patients with CD had mandibula lymphadenopathy (P<0.0001, ulcers (P=0.011, angular cheilitis (P<0.0001, hair tongue (P=0.011, periodontitis (P=0.011, gingival bleeding (P<0.0001, gingivitis (P=0.002, cobblestone appearance of the mucosa (P=0.002, polypoid tags (P=0.002, buccal trauma (P<0.0001 and lip swelling (P=0.002 as compared to healthy controls. Ulcerative colitis patients had in a significantly higher proportion of involvement of salivary glands (P<0.0001, as well as lymphadenopathy (P=0.002, buccal trauma (P<0.0001 and angular cheilitis (P<0.0001, compared to healthy controls. Significantly more patients with CD or UC had concurrently 3 or more oral manifestations as compared to normal controls (P<0.0001. On multivariate analysis, age and IBD were the only factors significantly related to the existence of oral lesions (OR 1.07, 95% CI: 1.02 ? 1.13, P=0.009. No correlation between activity and duration of disease, sex and smoking habit, with the presence of oral manifestations, was noticed. No significant differences between patients and controls in the incidence of other lesions, including leukoplakia, and aphthouslike ulcers were found. No cases of pyostomatitis vegetans in either patients with IBD or controls were found. Conclusion: Although the number of patients included in the study is small we can conclude that oral manifestations in patients with IBD (especially in those with CD, is a frequent and underestimated event that needs further clinical validation. Key words: Inflammatory bowel disease, Crohn's disease, Ulcerative colitis, Oral manifestations

  18. Confocal Laser Endomicroscopy in the Study of Colonic Mucosa in IBD Patients: A Review

    OpenAIRE

    Salvatori, Francesca; Siciliano, Saverio; Maione, Francesco; Esposito, Dario; Masone, Stefania; Persico, Marcello; De Palma, Giovanni D.

    2012-01-01

    Confocal laser endomicroscopy (CLE) is one of several novel methods that provide real-time, high-resolution imaging at a micronscale via endoscopes. CLE and related technologies are often termed “virtual biopsy” as they simulate the images seen in traditional histology. Recently, the use of CLE was reported in the study of colonic mucosa in patients with inflammatory bowel diseases and in particular in patients affected by ulcerative colitis. CLE has the potential to have an important role in...

  19. Bleeding peptic ulcer caused by ectopic gastric mucosa in a duplicated segment of jejunum

    Energy Technology Data Exchange (ETDEWEB)

    Newmark, H.; Ching, G.; Halls, J.; Levy, I.J.

    1981-02-01

    The authors present a case in which a patient suffered a bleeding jejunal ulcer caused by heterotopic gastric mucosa in a congenital duplication of a segment of jejunum. This is the first case diagnosed preoperatively by two different radiographic means. These lesions were shown by both pertechnetate flow and barium small bowel studies. The rarity of these entities and the modalities used for diagnosis are described.

  20. Prevalence of Bowel Incontinence

    Science.gov (United States)

    ... We Are Contact Us Donate Prevalence of Bowel Incontinence What is Incontinence? “Incontinence” is the word used to describe loss ... to treat and manage the condition Prevelance of Incontinence Unless asked specifically about it, individuals often are ...

  1. Small bowel resection - discharge

    Science.gov (United States)

    ... small bowel). You may also have had an ileostomy . ... taken out. You may have problems with your ileostomy . ... protect it if needed. If you have an ileostomy, follow care instructions from your provider.

  2. Irritable Bowel Syndrome

    Science.gov (United States)

    ... foods are linked to other digestive conditions like lactose intolerance or celiac disease , though, so it's important to ... While Eating Out Ulcers Gastroesophageal Reflux Disease (GERD) Lactose Intolerance Constipation Inflammatory Bowel Disease Contact Us Print Additional ...

  3. Small bowel tissue smear

    Science.gov (United States)

    Small bowel tissue smear is a lab test that checks for disease in a sample of tissue from the small intestine. ... 142. Giannella RA. Infectious enteritis and proctocolitis and bacterial food poisoning. In: Feldman M, Friedman LS, Brandt ...

  4. Irritable Bowel Syndrome

    Science.gov (United States)

    ... Exercising regularly is a good way to relieve stress. It also helps the bowel function better and improves overall health. Meditation, yoga, and massage may also help. Return to top More information ...

  5. Intraluminal injection of short chain fatty acids diminishes intestinal mucosa injury in experimental ischemia-reperfusion

    Directory of Open Access Journals (Sweden)

    Aguilar-Nascimento José Eduardo de

    2006-01-01

    Full Text Available PURPOSE: Investigated the effect of intraluminal short-chain fatty acids (SCFA on the intestinal mucosa in the presence of ischemia-reperfusion injury (IRI. METHODS: Six blind sacs of the small bowel (3at the jejunum and 3 at the ileum were created in ten Wistar rats. The lateral sacs of both bowel regions were subjected to IRI (15/15 minutes while the medial sacs were let free to receive blood supply. In the lateral sacs, it was injected either a solution containing SCFA (butyrate, propionate and acetate or pure saline at the bowel lumen. No fluid was injected in the medial sacs. RESULTS: Both at the jejunum and at the ileum the score of the mucosal injury was higher in saline than in control sacs. SCFA treated sacs showed lesser score at the ileum (p=0.03 but were not significantly different at the jejunum (p=0.83 when compared with saline sacs. It was found a significant greater number of neutrophils (p < 0.01 in the sacs treated with saline than in the other two sacs in both regions. CONCLUSION: SCFA protect the distal small bowel mucosa and diminishes infiltration of neutrophils to the gut lamina propria in IRI.

  6. Molecular evidence that the hepatitis C virus replicates in the oral mucosa.

    OpenAIRE

    Gandolfo, Sergio; PENTENERO, MONICA

    2002-01-01

    BACKGROUND/AIMS: Patients infected with the hepatitis C virus (HCV) often have extrahepatic manifestations, which significantly contribute to HCV-related morbidity, but whose pathogenesis is largely unknown. Our aim was to evaluate the HCV replication in oral mucosa of chronic hepatitis C patients. METHODS: We collected oral mucosa specimens from 17 anti-HCV-positive and four anti-HCV-negative patients. Fifteen had oral lichen (12 anti-HCV-positive). Total mucosa RNA was extracted and analyze...

  7. Bowel vaginoplasty in children

    Directory of Open Access Journals (Sweden)

    Sarin Yogesh

    2006-01-01

    Full Text Available OBJECTIVES: To describe our experience with bowel vaginoplasty done in children. MATERIALS AND METHODS: This is a retrospective study of eight children aged 10 months to 8 years, who underwent bowel vaginoplasty over a period of 5 years (2000-2005. The indications of bowel vaginoplasty included anorectovestibular fistula (ARVF associated with Mayer-Rokitansky-Kuster-Hauser (MRKH syndrome (n=6 and cloaca (n=2. The bowel segment used for vaginoplasty included colon (n=3, ileum (n=2 and duplicated rectum (n=1. In two patients of ARVF associated with uterovaginal agenesis, the distal- most part of ARVF was transected at the level of peritoneal reflection and left as neovagina, whereas the proximal bowel was pulled through at the proposed neo-anal site. All the patients were advised daily home dilatation of the neo vaginal orifice with Hegar?s dilators, for a period of six weeks. RESULTS: Bowel vaginoplasty was done in eight patients. None had any significant per-operative complication. Two patients had abdominal wound dehiscence, requiring secondary suturing. Two patients had mucosal prolapse of the neovagina, which required trimming. One patient died two months after discharge, because of meningitis. Out of the eight patients, seven are in regular follow-up. Six patients have neovagina, cosmetically acceptable to the parents; all have been radiologically proven to have adequate length. One patient had unacceptable perineal appearance with nipple-like vaginal orifice and scarred perineal wound, that merits a revision. None of the patients had vaginal stenosis and excessive mucus discharge, during follow-up visits. Although post surgical results are acceptable to the parents cosmetically, the sexual and psychological outcome is yet to be assessed. Conclusions: Bowel vaginoplasty is a safe and acceptable procedure to treat the pediatric patients of uterovaginal agenesis and cloaca.

  8. Bowel obstruction: Differential diagnosis and clinical management

    International Nuclear Information System (INIS)

    This book presents a practical guide to the diagnosis and management of obstruction, both mechanical and organic, of the large and small bowel. Obstruction is a common problem for surgeons, and this text emphasizes differential diagnosis and the use of all radiologic modalities. It presents the surgical and medical considerations involved with gallstones, bezoars, parasites, tumors, inflammation, trauma, intussusception, more

  9. Immunomodulatory effect of ghrelin in the intestinal mucosa.

    Science.gov (United States)

    Eissa, N; Ghia, J E

    2015-11-01

    The gastrointestinal tract is the largest endocrine organ in the body and it produces a wide array of hormones and neuropeptides. Ghrelin, a 28-amino acid hormone produced mainly by the X/A-like endocrine cells in the gastric mucosa, has widespread tissue distribution and diverse physiological functions such as hormonal, orexigenic, metabolic, cardiovascular, neurological and immunological activities. Recent research has implicated ghrelin in gastrointestinal pathological conditions and immune system regulation, but its contribution is controversial. Although ghrelin levels are elevated in clinical active inflammatory bowel diseases, confirmation of its exact role using experimental models remains unclear. This review discusses the conflicting effects of ghrelin on intestinal inflammation, through the different possible immune and intracellular mechanisms and highlights new findings. PMID:26503163

  10. Neuroregulation of Human Nasal Mucosa

    OpenAIRE

    James N. BARANIUK; Merck, Samantha J.

    2009-01-01

    Multiple subsets of nociceptive, parasympathetic, and sympathetic nerves innervate human nasal mucosa. These play carefully coordinated roles in regulating glandular, vascular, and other processes. These functions are vital for cleaning and humidifying ambient air before it is inhaled into the lungs. The recent identification of distinct classes of nociceptive nerves with unique patterns of transient receptor potential sensory receptor ion channel proteins may account for the polymodal, chemo...

  11. Small bowel biopsy.

    OpenAIRE

    Collins, A.L.; Brookfield, D. S.; Hyde, I; Rolles, C. J.

    1985-01-01

    We describe our technique of small bowel biopsy, which has been used on 190 occasions over a four year period. In 77%, the examination was completed within 10 minutes, and fluoroscopy times were less than 10 seconds in 75% of the cases. The technique is easily taught, and it has made the examination a minor procedure.

  12. Computed Tomography Angiography of the Small Bowel and Mesentery.

    Science.gov (United States)

    Raman, Siva P; Fishman, Elliot K

    2016-01-01

    Multidetector computed tomography (MDCT) has largely supplanted other available radiologic modalities in the evaluation of a wide variety of different vascular and inflammatory abnormalities of the small bowel, with computed tomography angiography (CTA) playing a major role in the diagnostic efficacy of MDCT for these diseases. Improvements in CTA imaging have proved particularly valuable in the evaluation of small bowel vascular and inflammatory disorders, diagnoses in which arterial phase images might be able to offer greater information than standard venous phase imaging. This article details the MDCT imaging findings of several small bowel vascular and inflammatory disorders. PMID:26654393

  13. Inflammatory pathways of importance for management of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Pedersen, Jannie; Coskun, Mehmet

    2014-01-01

    Inflammatory bowel disease (IBD) is a group of chronic disorders of the gastrointestinal tract comprising Crohn's disease (CD) and ulcerative colitis (UC). Their etiologies are unknown, but they are characterised by an imbalanced production of pro-inflammatory mediators, e.g., tumor necrosis factor (TNF)-?, as well as increased recruitment of leukocytes to the site of inflammation. Advantages in understanding the role of the inflammatory pathways in IBD and an inadequate response to conventional therapy in a large portion of patients, has over the last two decades lead to new therapies which includes the TNF inhibitors (TNFi), designed to target and neutralise the effect of TNF-?. TNFi have shown to be efficient in treating moderate to severe CD and UC. However, convenient alternative therapeutics targeting other immune pathways are needed for patients with IBD refractory to conventional therapy including TNFi. Indeed, several therapeutics are currently under development, and have shown success in clinical trials. These include antibodies targeting and neutralising interleukin-12/23, small pharmacologic Janus kinase inhibitors designed to block intracellular signaling of several pro-inflammatory cytokines, antibodies targeting integrins, and small anti-adhesion molecules that block adhesion between leukocytes and the intestinal vascular endothelium, reducing their infiltration into the inflamed mucosa. In this review we have elucidated the major signaling pathways of clinical importance for IBD therapy and highlighted the new promising therapies available. As stated in this paper several new treatment options are under development for the treatment of CD and UC, however, no drug fits all patients. Hence, optimisations of treatment regimens are warranted for the benefit of the patients either through biomarker establishment or other rationales to maximise the effect of the broad range of mode-of-actions of the present and future drugs in IBD.

  14. Bowel disease after radiotherapy.

    OpenAIRE

    Schofield, P F; Holden, D.; Carr, N. D.

    1983-01-01

    The clinical presentation, operative findings and outcome in 40 patients who required surgery for bowel disease after radiotherapy are presented. The type of presentation varied according to the time after radiotherapy. In the first month, many patients had a proctitis but none required surgery. Five patients were operated on within one month, 2 for radiation-induced acute ileitis and 3 for exacerbations of pre-existing disease (diverticular disease 2, ulcerative colitis 1). The commonest tim...

  15. Neurogenic bowel dysfunction score

    DEFF Research Database (Denmark)

    Krogh, Klaus; Christensen, Peter; Sabroe, S; Laurberg, S

    2005-01-01

    STUDY DESIGN: Cross-sectional questionnaire study. OBJECTIVES: To develop and validate a symptom-based score for neurogenic bowel dysfunction (NBD): NBD score. SETTING: University Hospital of Aarhus, Denmark. METHODS: A questionnaire including questions about background parameters (n=8), faecal incontinence (n=10), constipation (n=10), obstructed defecation (n=8), and impact on quality of life (QOL) (n=3) was sent to 589 Danish spinal cord injured (SCI) patients. The reproducibility and validity...

  16. Foreign Body in Jugal Mucosa

    Science.gov (United States)

    Serrano, Thiago Luís Infanger; Pauna, Henrique Furlan; Hazboun, Igor Moreira; Dal Rio, Ana Cristina; Correa, Maria Elvira Pizzigatti; Nicola, Ester Maria Danielli

    2015-01-01

    Introduction?Foreign body in the oral cavity may be asymptomatic for long time and only sometimes it can lead to a typical granulomatous foreign body reaction. Some patients may complain of oral pain and present signs of inflammation with purulent discharge. A granuloma is a distinct, compact microscopic structure composed of epithelioid-shaped macrophages typically surrounded by a rim of lymphocytes and filled with fibroblasts and collagen. Nowadays, the increase of cosmetic invasive procedures such as injection of prosthetic materials in lips and cheeks may lead to unusual forms of inflammatory granulomas. Objectives?Describe an unusual presentation of a foreign body reaction in the buccal mucosa due to previous injection of cosmetic agent. Resumed Report?A 74-year-old woman was referred to the Department of Otorhinolaryngology, Head and Neck Surgery to investigate the presence of multiple painless, bilateral nodules in the buccal mucosa, with progressive growth observed during the previous 2 months. The histologic results showed a foreign body inflammatory reaction. Conclusion?Oral granulomatosis lesions represent a challenging diagnosis for clinicians and a biopsy may be necessary. Patients may feel ashamed to report previous aesthetic procedures, and the clinicians must have a proactive approach. PMID:26491486

  17. Short bowel syndrome.

    LENUS (Irish Health Repository)

    Donohoe, Claire L

    2012-02-01

    The short bowel syndrome (SBS) is a state of malabsorption following intestinal resection where there is less than 200 cm of intestinal length. The management of short bowel syndrome can be challenging and is best managed by a specialised multidisciplinary team. A good understanding of the pathophysiological consequences of resection of different portions of the small intestine is necessary to anticipate and prevent, where possible, consequences of SBS. Nutrient absorption and fluid and electrolyte management in the initial stages are critical to stabilisation of the patient and to facilitate the process of adaptation. Pharmacological adjuncts to promote adaptation are in the early stages of development. Primary restoration of bowel continuity, if possible, is the principle mode of surgical treatment. Surgical procedures to increase the surface area of the small intestine or improve its function may be of benefit in experienced hands, particularly in the paediatric population. Intestinal transplant is indicated at present for patients who have failed to tolerate long-term parenteral nutrition but with increasing experience, there may be a potentially expanded role for its use in the future.

  18. A three-dimensional coculture of enterocytes, monocytes and dendritic cells to model inflamed intestinal mucosa in vitro.

    Science.gov (United States)

    Leonard, Fransisca; Collnot, Eva-Maria; Lehr, Claus-Michael

    2010-12-01

    While epithelial cell culture models (e.g., Caco-2 cell line) are widely used to assess the absorption of drug molecules across healthy intestinal mucosa, there are no suitable in vitro models of the intestinal barrier in the state of inflammation. Thus development of novel drugs and formulations for the treatment of inflammatory bowel disease is largely bound to animal models. We here report on the development of a complex in vitro model of the inflamed intestinal mucosa, starting with the selection of suitable enterocyte cell line and proinflammatory stimulus and progressing to the setup and characterization of a three-dimensional coculture of human intestinal epithelial cells and immunocompetent macrophages and dendritic cells. In the 3D setup, controlled inflammation can be induced allowing the mimicking of pathophysiological changes occurring in vivo in the inflamed intestine. Different combinations of proinflammatory stimuli (lipopolysaccharides from Escherichia coli and Salmonella typhimurium, interleukin-1?, interferon-?) and intestinal epithelial cell lines (Caco-2, HT-29, T84) were evaluated, and only Caco-2 cells were responsive to stimulation, with interleukin-1? being the strongest stimulator. Caco-2 cells responded to the proinflammatory stimulus with a moderate upregulation of proinflammatory markers and a slight, but significant, decrease (20%) of transepithelial electrical resistance (TEER) indicating changes in the epithelial barrier properties. Setting up the coculture model, macrophages and dendritic cells derived from periphery blood monocytes were embedded in a collagen layer on a Transwell filter insert and Caco-2 cells were seeded atop. Even in the presence of immunocompetent cells Caco-2 cells formed a tight monolayer. Addition of IL-1? increased inflammatory cytokine response more strongly compared to Caco-2 single culture and stimulated immunocompetent cells proved to be highly active in sampling apically applied nanoparticles. Thus the 3D coculture provides additional complexity and information compared to the stimulated single cell model. The coculture system may serve as a valuable tool for developing drugs and formulations for the treatment of inflammatory bowel diseases, as well as for studying the interaction of xenobiotics and nanoparticles with the intestinal epithelial barrier in the state of inflammation. PMID:20809575

  19. Human inflammatory bowel disease does not associate with Lawsonia intracellularis infection

    OpenAIRE

    Giese Thomas; Köninger Jörg S; Wendt Michael; Kümmel Klaus; Di Mola Fabio; Michalski Christoph W; Giese Nathalia A; Friess Helmut

    2006-01-01

    Abstract Background There is increasing evidence that bacterial infection of the intestinal mucosa may contribute to the pathogenesis of inflammatory bowel diseases (IBD). In pigs, an obligate intracellular bacterium, Lawsonia intracellularis (LI), was shown to cause proliferative enteropathy (PE) of which some forms display histological and clinical similarities to human IBD. Since LI-similar Desulfovibrio spp. may infect human cells, we hypothesized that LI might be associated with the deve...

  20. Clinical and Experimental Studies on Inflammatory Bowel Disease with special emphasis on Collagenous Colitis

    OpenAIRE

    Wagner, Michael

    2010-01-01

    This thesis describes studies in patients with inflammatory bowel disease (IBD) and collagenous colitis (CC). We investigated mucosal eosinophil and neutrophil granulocytes and T-cells involved in the inflammatory processes and aimed at determining whether these processes are reflected in the faecal (F) contents of specific proteins secreted by cells in the intestinal mucosa. Thus, we measured eosinophil cationic protein (ECP) and eosinophil protein X (EPX) and the neutrophil derived myeloper...

  1. Confocal Laser Endomicroscopy in the Study of Colonic Mucosa in IBD Patients: A Review.

    Science.gov (United States)

    Salvatori, Francesca; Siciliano, Saverio; Maione, Francesco; Esposito, Dario; Masone, Stefania; Persico, Marcello; De Palma, Giovanni D

    2012-01-01

    Confocal laser endomicroscopy (CLE) is one of several novel methods that provide real-time, high-resolution imaging at a micronscale via endoscopes. CLE and related technologies are often termed "virtual biopsy" as they simulate the images seen in traditional histology. Recently, the use of CLE was reported in the study of colonic mucosa in patients with inflammatory bowel diseases and in particular in patients affected by ulcerative colitis. CLE has the potential to have an important role in management of IBD patients as it can be used to assess the grading of colitis and in detection of microscopic colitis in endoscopically silent segments. Moreover, CLE can be used in surveillance programs especially in high-risk patients. This report aims to evaluate the current data on the application of confocal endomicroscopy in clinical gastroenterology and particularly in the study of colonic mucosa in UC patients. PMID:22474440

  2. Familial risk of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Trier Møller, Frederik; Andersen, Vibeke; Jess, Tine; Wohlfart, Jan

    2014-01-01

    Background The inflammatory bowel diseases (IBD) – ulcerative colitis (UC) and Crohn’s disease (CD) - are caused by complex gene-environment interactions. This study provides updated familial aggregation patterns in a large population-based Danish IBD cohort. Methods: Our cohort study was based on the entire Danish population during 1977-2011 (n=8,295,773). Through a unique personal identification number assigned to each Danish citizen, sex, date and location of birth, identity of parents, and i...

  3. Diseases of the small bowel in chronic diarrhea: diagnosis and treatment

    OpenAIRE

    Simadibrata, M.

    2002-01-01

    The incidence of chronic diarrhea in Asia is between 0.8-1.0%. The diseases and abnormalities according to the location, which can cause chronic diarrhea, are divided into three locations: the small bowel, the large bowel and extraintestinal. The small bowel diseases include infectious and non-infectious diseases. The infectious diseases are bacterial infections, parasitic infections etc. The non-infectious diseases include of Crohn’s disease, Celiac sprue, NSAID enteropathy, lactose intolera...

  4. Physiologic effects of bowel preparation

    DEFF Research Database (Denmark)

    Holte, Kathrine; Nielsen, Kristine Grubbe

    2004-01-01

    PURPOSE: Despite the universal use of bowel preparation before colonoscopy and colorectal surgery, the physiologic effects have not been described in a standardized setting. This study was designed to investigate the physiologic effects of bowel preparation. METHODS: In a prospective study, 12 healthy volunteers (median age, 63 years) underwent bowel preparation with bisacodyl and sodium phosphate. Fluid and food intake were standardized according to weight, providing adequate calorie and oral fluid intake. Before and after bowel preparation, weight, exercise capacity, orthostatic tolerance, plasma and extracellular volume, balance function, and biochemical parameters were measured. RESULTS: Bowel preparation led to a significant decrease in exercise capacity (median, 9 percent) and weight (median, 1.2 kg). Plasma osmolality was significantly increased from 287 to 290 mmol kg(-1), as well as increased phosphate and urea concentrations, whereas calcium and potassium concentrations decreased significantly afterbowel preparation. No differences in plasma or extracellular volumes were seen. Orthostatic tolerance and balance function did not change after bowel preparation. CONCLUSIONS: Bowel preparation has significant adverse physiologic effects, which may be attributed to dehydration. The majority of these findings is small and may not be of clinical relevance in otherwise healthy patients undergoing bowel preparation and following recommendations for oral fluid intake.

  5. Functional bowel disease

    DEFF Research Database (Denmark)

    Rumessen, J J; Gudmand-Høyer, E

    1988-01-01

    Twenty-five patients with functional bowel disease were given fructose, sorbitol, fructose-sorbitol mixtures, and sucrose. The occurrence of malabsorption was evaluated by means of hydrogen breath tests and the gastrointestinal symptoms, if any, were recorded. One patient could not be evaluated because of lack of H2 production. Based on a cut-off level of 10 ppm rise of H2 concentration, malabsorption was apparent in 13 patients, in 7 of which the calculated absorption capacities were below 15 g...

  6. Primary malignant small bowel tumor

    International Nuclear Information System (INIS)

    Small bowel tumors are rarely detected unless there is intestinal obstruction or bleeding. In the seven years 1982-1988, at Kosin Medical Center, 25 primary malignant small bowel tumors were studied radiographically with barium and / or computed tomography (CT). CT revealed gastrointestinal abnormalities in 20 patients. In ten, lesion were identified by upper G-I series, in 15 by small bowel series, and in addition, in 3 by colon enema. The most common malignant small bowel tumor was adenocarcinoma (N=15) and was next common lymphoma (N=7). On barium study, primary adenocarcinoma appeared as an irregular stricture (66.7%) and polypoid mass with intussusception was most prominent finding in lymphoma. Leiomyosarcoma appeared as an exophytic mass with excavation or ulceration. CT was found to be accurate in detecting wall thickening, complications and other associated findings. In conclusion, barium study was useful in the diagnosis of primary malignant small bowel tumor and CT was more accurate in detecting secondary findings

  7. Urethral fistula following circumcision: salvaged by buccal mucosa graft urethroplasty

    OpenAIRE

    Sinha, Rahul Janak; Dalela, Divakar; Sankhwar, S. N.; Singh, Vishwajeet

    2009-01-01

    Fistula following circumcision and at times accompanied by disfigurement of the glans penis is a common problem in our country, where a large number of circumcision is performed by untrained professionals. These complications may have profound negative psychological impact on the growing child. Herein, we report the successful closure of such fistula using buccal mucosa, which occurred following circumcision (for phimosis) in a 15 year old boy. This resulted in the disfigurement of the glans ...

  8. Common polymorphisms in the microsomal epoxide hydrolase and N-acetyltransferase 2 genes in association with inflammatory bowel disease in the Danish population

    DEFF Research Database (Denmark)

    Ernst, Anja; Andersen, Vibeke

    2011-01-01

    Chronic inflammatory bowel disease (IBD) is characterized by recurrent inflammation of the intestinal mucosa. Reactive molecules play a central role in altering the intestinal permeability, which may induce or sustain an immune response. Changes in detoxification of substances that causes epithelial damage may confer susceptibility to IBD. Hence, polymorphic enzymes involved in the detoxification processes may be risk factors of IBD.

  9. Integrating-Sphere Measurements for Determining Optical Properties of Tissue-Engineered Oral Mucosa

    Science.gov (United States)

    Ionescu, A. M.; Cardona, J. C.; Garzón, I.; Oliveira, A. C.; Ghinea, R.; Alaminos, M.; Pérez, M. M.

    2015-02-01

    Surgical procedures carried out in the oral and maxillofacial region can result in large tissue defects. Accounting for the shortage of oral mucosa to replace the excised tissues, different models of an organotypic substitute of the oral mucosa generated by tissue engineering have recently been proposed. In this work, the propagation of light radiation through artificial human oral mucosa substitutes based on fibrin-agarose scaffolds (fibrin, fibrin-0.1% agarose, fibrin-0.2%agarose) is investigated, and their optical properties are determined using the inverse adding-doubling (IAD) method based on integrating-sphere measurements. Similar values for the absorption and scattering coefficients between the fibrin and fibrin-0.1% agarose bioengineered tissues and the native oral mucosa were found. These results suggest the adequacy of these biomaterials for potential clinical use in human oral mucosa applications. These optical properties represent useful references and data for applications requiring the knowledge of the light transport through this type of tissues, applications used in clinical practice. It also provides a new method of information analysis for the quality control of the development of the artificial nanostructured oral mucosa substitutes and its comparison with native oral mucosa tissues.

  10. Altered gastric emptying in patients with irritable bowel syndrome

    International Nuclear Information System (INIS)

    Irritable bowel syndrome is the most frequent functional disorder of the digestive system. Patients with irritable bowel syndrome have motor disorders not only in the colon, but also in other parts of the digestive tract such as the oesophagus and small intestine; however, it is not known whether the stomach is also involved. We used a radiolabelled mixed solid-liquid meal (technetium-99m for the solid component, indium-111 for the liquid component) to study gastric emptying of solids (GES), liquids (GEL) and indigestible solids (GER) in 50 patients diagnosed as having irritable bowel syndrome (30 with predominant constipation and 20 with predominant diarrhoea). GER was measured by counting the number of indigestible solids remaining in the stomach 4 h after they were swallowed. In patients with irritable bowel syndrome, GES and GEL were slower than in control subjects (P<0.05). GER was normal in all patients except for two women. Thirty-two patients (64%) showed delayed GES, 29 (58%) delayed GEL, and 2 (4%) delayed GER. Among patients with irritable bowel syndrome, GES was slower in those with predominant constipation than in those with predominant diarrhoea (P<0.05); GEL and GER were similar in both groups. Gastroparesis was found in a large proportion of patients with irritable bowel syndrome, suggesting the presence of a more generalised motor disorder of the gut. (orig.)

  11. Altered gastric emptying in patients with irritable bowel syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Caballero-Plasencia, A.M.; Valenzuela-Barranco, M. [Department of Medicine, School of Medicine, University of Granada (Spain); Herrerias-Gutierrez, J.M. [Division of Gastroenterology, University Hospital ``Virgen de la Macarena``, Sevilla (Spain); Esteban-Carretero, J.M. [Central Service of Investigation in Health Sciences, University of Cadiz, Cadiz (Spain)

    1999-04-29

    Irritable bowel syndrome is the most frequent functional disorder of the digestive system. Patients with irritable bowel syndrome have motor disorders not only in the colon, but also in other parts of the digestive tract such as the oesophagus and small intestine; however, it is not known whether the stomach is also involved. We used a radiolabelled mixed solid-liquid meal (technetium-99m for the solid component, indium-111 for the liquid component) to study gastric emptying of solids (GES), liquids (GEL) and indigestible solids (GER) in 50 patients diagnosed as having irritable bowel syndrome (30 with predominant constipation and 20 with predominant diarrhoea). GER was measured by counting the number of indigestible solids remaining in the stomach 4 h after they were swallowed. In patients with irritable bowel syndrome, GES and GEL were slower than in control subjects (P<0.05). GER was normal in all patients except for two women. Thirty-two patients (64%) showed delayed GES, 29 (58%) delayed GEL, and 2 (4%) delayed GER. Among patients with irritable bowel syndrome, GES was slower in those with predominant constipation than in those with predominant diarrhoea (P<0.05); GEL and GER were similar in both groups. Gastroparesis was found in a large proportion of patients with irritable bowel syndrome, suggesting the presence of a more generalised motor disorder of the gut. (orig.) With 1 fig., 3 tabs., 48 refs.

  12. The Neuromodulation of the Intestinal Immune System and Its Relevance in Inflammatory Bowel Disease

    Science.gov (United States)

    Di Giovangiulio, Martina; Verheijden, Simon; Bosmans, Goele; Stakenborg, Nathalie; Boeckxstaens, Guy E.; Matteoli, Gianluca

    2015-01-01

    One of the main tasks of the immune system is to discriminate and appropriately react to “danger” or “non-danger” signals. This is crucial in the gastrointestinal tract, where the immune system is confronted with a myriad of food antigens and symbiotic microflora that are in constant contact with the mucosa, in addition to any potential pathogens. This large number of antigens and commensal microflora, which are essential for providing vital nutrients, must be tolerated by the intestinal immune system to prevent aberrant inflammation. Hence, the balance between immune activation versus tolerance should be tightly regulated to maintain intestinal homeostasis and to prevent immune activation indiscriminately against all luminal antigens. Loss of this delicate equilibrium can lead to chronic activation of the intestinal immune response resulting in intestinal disorders, such as inflammatory bowel diseases (IBD). In order to maintain homeostasis, the immune system has evolved diverse regulatory strategies including additional non-immunological actors able to control the immune response. Accumulating evidence strongly indicates a bidirectional link between the two systems in which the brain modulates the immune response via the detection of circulating cytokines and via direct afferent input from sensory fibers and from enteric neurons. In the current review, we will highlight the most recent findings regarding the cross-talk between the nervous system and the mucosal immune system and will discuss the potential use of these neuronal circuits and neuromediators as novel therapeutic tools to reestablish immune tolerance and treat intestinal chronic inflammation. PMID:26635804

  13. Up-regulation and Pre-activation of TRAF3 and TRAF5 in Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    Jun Shen, Yu-qi Qiao, Zhi-hua Ran, Tian-rong Wang

    2013-01-01

    Full Text Available Objective: TRAF3 and TRAF5 share a common ancestral gene, and interact as essential components of signaling pathways in immunity. TRAF3 and TRAF5 are overexpressed in the colon of rat/mouse models with colitis. However, the expressions of TRAF3 and TRAF5 in patients with inflammatory bowel disease have not been elucidated. The aim of the present study is to explore the potential roles of TRAF3 and TRAF5 in patients with inflammatory bowel disease.Methods: Plasma levels of TRAF3 and TRAF5 proteins were detected by Enzyme-linked Immunosorbent Assay (ELISA. Colonic expression of TRAF3 and TRAF5 proteins was detected by western blot analysis. Quantitative Real-time PCR (qRT-PCR was applied for gene expression. Inflamed intestinal mucosa and non-inflamed intestinal mucosa in patients with inflammatory bowel disease and normal mucosa was analyzed from healthy controls.Results: The plasma levels of TRAF3 and TRAF5 were significantly higher both in patients with Crohn's disease and ulcerative colitis than in healthy controls. Only soluble TRAF5 showed a weak correlation with endoscopic disease activity index (Baron score in patients with ulcerative colitis (spearman's r=0.358, P=0.022. Gene expressions of TRAF3 and TRAF5 in peripheral blood mononuclear cells were significantly higher both in patients with Crohn's disease and ulcerative colitis than in healthy controls (all P<0.0001. Gene and protein expressions of TRAF3 and TRAF5 were significantly higher in inflamed colonic mucosa of patients with Crohn's disease and ulcerative colitis than in non-inflamed colonic mucosa and normal mucosa of healthy controls (all P<0.0001. Furthermore, gene and protein expressions of TRAF3 and TRAF5 were also significantly higher in non-inflamed colonic mucosa of patients with Crohn's disease and ulcerative colitis than in normal mucosa of healthy controls.Conclusions: TRAF3 and TRAF5 are overexpressed in inflammatory bowel disease. Although the endoscopic appearance can be normal, TRAF3 and TRAF5 pre-activation can be detected in non-inflamed colonic segments.

  14. Laser Treatment of Oral Mucosa Tattoo

    OpenAIRE

    Gojkov-Vukelic, Mirjana; Hadzic, Sanja; Pasic, Enes

    2011-01-01

    The most common oral solitary pigmented lesion is the dental amalgam tattoo. It occurs as a result of colouring of the tissue by alien pigment which was administered intra or subepidermaly either intentionally or accidentally. The most common material used for the colouring of the oral mucosa is amalgam from amalgam fillings and metal particles from prosthetic restorations which are absorbed accidentally. The oral mucosa tattoos are most often found in the area of the marginal gingiva or the ...

  15. CT assessment of anastomotic bowel leak

    Energy Technology Data Exchange (ETDEWEB)

    Power, N. [Department of Radiology, Sunnybrook Hospital, Toronto, Ontario M4N 3M5 (Canada); Atri, M. [Department of Radiology, Sunnybrook Hospital, Toronto, Ontario M4N 3M5 (Canada)]. E-mail: mostafa.atri@sw.ca; Ryan, S. [Department of Radiology, Sunnybrook Hospital, Toronto, Ontario M4N 3M5 (Canada); Haddad, R. [Department of Surgery, Sunnybrook Hospital, Toronto, Ontario M4N 3M5 (Canada); Smith, A. [Department of Surgery, Sunnybrook Hospital, Toronto, Ontario M4N 3M5 (Canada)

    2007-01-15

    Aim: To evaluate the predictors of clinically important gastrointestinal anastomotic leaks using multidetector computed tomography (CT). Subjects and methods: Ninety-nine patients, 73 with clinical suspicion of anastomotic bowel leak and 26 non-bowel surgery controls underwent CT to investigate postoperative sepsis. Fifty patients had undergone large bowel and 23 small bowel anastomoses. The time interval from surgery was 3-30 days (mean 10 {+-} 5.9 SD) for the anastomotic group and 3-40 days (mean 14 {+-} 11 SD) for the control group (p = 0.3). Two radiologists blinded to the final results reviewed the CT examinations in consensus and recorded the presence of peri-anastomotic air, fluid or combination of the two; distant loculated fluid or combination of fluid and air; free air or fluid; and intestinal contrast leak. Final diagnosis of clinically important anastomotic leak (CIAL) was confirmed at surgery or by chart review of predetermined clinical and laboratory criteria. Results: The prevalence of CIAL in the group undergoing CT was 31.5% (23/73). The CT examinations with documented leak were performed 5-28 (mean; 11.4 {+-} 6 SD) days after surgery. Nine patients required repeat operation, 10 percutaneous abscess drainage, two percutaneous drainage followed by surgery, and two prolonged antibiotic treatment and total parenteral nutrition (TPN). Of the CT features examined, only peri-anastomotic loculated fluid containing air was more frequently seen in the CIAL group as opposed to the no leak group (p = 0.04). There was no intestinal contrast leakage in this cohort. Free air was present up to 9 days and loculated air up to 26 days without CIAL. Conclusion: Most postoperative CT features overlap between patients with and without CIAL. The only feature seen statistically more frequently with CIAL is peri-anastomotic loculated fluid containing air.

  16. CT assessment of anastomotic bowel leak

    International Nuclear Information System (INIS)

    Aim: To evaluate the predictors of clinically important gastrointestinal anastomotic leaks using multidetector computed tomography (CT). Subjects and methods: Ninety-nine patients, 73 with clinical suspicion of anastomotic bowel leak and 26 non-bowel surgery controls underwent CT to investigate postoperative sepsis. Fifty patients had undergone large bowel and 23 small bowel anastomoses. The time interval from surgery was 3-30 days (mean 10 ± 5.9 SD) for the anastomotic group and 3-40 days (mean 14 ± 11 SD) for the control group (p = 0.3). Two radiologists blinded to the final results reviewed the CT examinations in consensus and recorded the presence of peri-anastomotic air, fluid or combination of the two; distant loculated fluid or combination of fluid and air; free air or fluid; and intestinal contrast leak. Final diagnosis of clinically important anastomotic leak (CIAL) was confirmed at surgery or by chart review of predetermined clinical and laboratory criteria. Results: The prevalence of CIAL in the group undergoing CT was 31.5% (23/73). The CT examinations with documented leak were performed 5-28 (mean; 11.4 ± 6 SD) days after surgery. Nine patients required repeat operation, 10 percutaneous abscess drainage, two percutaneous drainage followed by surgery, and two prolonged antibiotic treatment and total parenteral nutrition (TPN). Of the CT features examined, only peri-anastomotic loculated fluid containing air was more frequently seen in the CIAL group as opposed to the no leak group (p = 0.04). There was no intestinal contrast leakage in this cohort. Free air was present up to 9 days and loculated air up to 26 days without CIAL. Conclusion: Most postoperative CT features overlap between patients with and without CIAL. The only feature seen statistically more frequently with CIAL is peri-anastomotic loculated fluid containing air

  17. CT findings of bowel and mesenteric injury

    International Nuclear Information System (INIS)

    To evaluate the role of CT in the diagnosis of bowel and mesenteric injury we studied the CT findings and its usefulness in patients of abdominal trauma. CT scans of 27 patients who were confirmed to have bowel and/or mesenteric injury due to abdominal trauma were analyzed retrospectively. Of these 27 patients 15 had bowel injury only and 12 had both bowel and mesenteric injury. CT findings analysed were bowel wall thickening, presence or absence of highly attenuated bowel wall, sentinel clot, mesenteric infiltration, peritoneal fluid collection and free intraabdominal air in cases with bowel injury only and with both bowel and mesenteric injury respectively. Ten patients had other accompanying abdominal injuries, such as liver, spleen, pancreas, kidney, bladder injuries, intraperitoneal abscess or retroperitoneal hemorrhage. Findings observed were bowel wall thickening in 23 cases (85%), peritoneal fluid collection in 21 (78%), highly attenuated bowel wall in 19 (70%), mesenteric infiltration in 17 (63%), free intraperitoneal air in 10 (37%) and sentinel clot in 7 (26%). Pneumoperioneum were observed in 10 of 24 patients (41,7%) having bowel perforation. Two cases did not show any CT findings suggesting bowel and/or mesenteric injury. There was no significant difference in the prevalence of the CT findings between the patient group with bowel injury only and the patient group with both bowel and meseneric injury. CT scan is a useful tool in evaluating the degree and extent of bowel and/or mesenteric injury as well as in planning the patient's management

  18. Clinical, endoscopical and morphological efficacy of mesalazine in patients with irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Dorofeyev AE

    2011-06-01

    Full Text Available Andrey E Dorofeyev1, Elena A Kiriyan2, Inna V Vasilenko1, Olga A Rassokhina1, Andrey F Elin11National Medical University, Donetsk, Ukraine; 2Gastroenterological Center of Poltava Hospital Clinic, Poltava, UkraineObjectives: The aim of this study was to analyze the clinical efficacy and cytomorphologic changes of colon mucosa following the treatment of patients suffering from irritable bowel syndrome (IBS with mesalazine (5-aminosalicylic acid [5-ASA].Methods: In this controlled, randomized, blind clinical trial, a total of 360 patients with varying subtypes of IBS were randomly treated with 500 mg of mesalazine qid or by standard therapy without mesalazine for a period of 28 days. Pre- and post-treatment pain intensity, pain duration, meteorism, stool abnormalities and endoscopic parameters were monitored, and biopsies or brush biopsies were examined histologically.Results: Treatment of IBS patients with mesalazine significantly reduced intensity and duration of pain in all subtypes of IBS, except for duration of pain in the subtype “undifferentiated”, where the difference was not significant. In addition, in patients with diarrhea type and undifferentiated type of IBS, mesalazine also significantly reduced the abnormal stool pattern. In comparison to the control group, administration of mesalazine reduced the incidence of endoscopic and cytomorphologic changes of the bowel mucosa, including changes in colon mucus, mucus production, cytologic or histologic parameters, epithelial cell degeneration, appearance of leukocytes and macrophages and cell infiltrations.Conclusion: Mesalazine was effective in reducing several symptoms characteristic of IBS. It significantly reduced pain intensity and duration and improved cytohistologic parameters of the bowel mucosa.Keywords: 5-amino salicylic acid, 5-ASA, abdominal pain, irritable bowel syndrome, IBS, meteorism, stool abnormalities

  19. Magnetic resonance imaging of the bowel. Today and tomorrow; Magnetresonanztomografie des Darms. Altbewaehrtes und Innovatives

    Energy Technology Data Exchange (ETDEWEB)

    Kinner, S.; Hahnemann, M.L.; Forsting, M.; Lauenstein, T.C. [Univ. Hospital Essen (Germany). Dept. of Diagnostic and Interventional Radiology and Neuroradiology

    2015-03-15

    Magnetic resonance imaging of the small bowel has been feasible for more than 15 years. This review is meant to give an overview of typical techniques, sequences and indications. Furthermore, newly evaluated promising techniques are presented, which have an impact on the advance of MR imaging of the small and large bowel.

  20. Living with Bowel Control Problems

    Science.gov (United States)

    ... you lose bowel control often, use a fecal deodorant—a pill that you chew or swallow to ... moisture-barrier cream. Use a cream that contains ingredients such as dimethicone—a type of silicone—that ...

  1. The Role of HSP70 Heat Shock Proteins in the Pathogenesis and Treatment of Inflammatory Bowel Diseases.

    Science.gov (United States)

    Samborski, Pawe?; Grzymis?awski, Marian

    2015-01-01

    Heat shock proteins (HSPs) represent an important element in the body's defense against various damaging factors. The probably also play an important role in the pathogenesis and treatment of several diseases, including autoimmune pathology and neoplasms. Recently, several investigators have focused their attention on the involvement of the HSP70 protein family in the morbid process of inflammatory bowel diseases (IBD). The HSP70 family of is represented by two distinct forms of protein, the HSP72 protein (also known as the HSP70.1 protein), the expression of which is clearly increased in conditions of stress; and the HSP73 (or HSC73) protein, which manifests stable expression. HSP70 proteins are present in the colorectal epithelium. In patients with inflammatory bowel diseases, their expression in significantly increased during the active stage of the disease. In experimental studies, overexpression of HSP70 was found to prevent the development of inflammatory process in the large intestinal mucosa provoked by various damaging factors. In physiological conditions, various mechanisms are considered to be responsible for an increased expression of HSP70. One of them involves lymphocyte activity and the production of cytokines (mainly IL-2). Another suggested mechanism involves the presence of bacteria in the large intestine, including both physiological flora (Lactobacillus GG, Bacteroides fragilis) and pathogenic bacteria (Salmonella, Escherichia coli). HSP70 expression is probably also increased by physical activity. There is also a potential for pharmacological stimulation of HSP70 expression, linked (for example) to geranylgeranylacetone, polaprezinc and mesalazine. Thus, augmentation of HSP70 expression may become a new element in IBD therapy. PMID:26467144

  2. Expression of integrin alphavbeta6 in the intestinal epithelial cells of patients with inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Bai-Sui Feng

    2009-09-01

    Full Text Available Background and aims: The prevalence of inflammatory bowel disease (IBD is about 0.05% in industrialized countries. The pathogenesis of IBD remains to be further understood. The present study aims to elucidate the expression of integrin ?v?6 in the intestinal mucosa of patients with IBD. Materials and Methods: Colonic biopsy was obtained from a group of IBD patients. The expression of ?v?6 in the intestinal mucosa was detected by Western blotting. Human colonic epithelial cell line T84 cells were stimulated by microbial antigen flagellin. The expression of ?v?6 in T84 cells was evaluated by quantitative RT-PCR and Western blotting. Results: The levels of ?v?6 in the intestinal mucosa were much lower than it in normal control subjects. The serum levels of myeloperoxidase (MPO were higher in IBD patients that were negatively correlated with the levels of ?v?6 in the intestinal mucosa. The expression of ?v?6 was detectable in T84 cells at naïve status that could be upregulated by exposure to microbial antigen flagellin. Pretreatment with MPO dramatically suppressed the expression of ?v?6 in T84 cells. Conclusions: We conclude that the expression of ?v?6 was suppressed in IBD intestinal mucosa, which could be resulted from the high levels of MPO.

  3. Does stress induce bowel dysfunction?

    OpenAIRE

    Chang, Yu-Ming; El-Zaatari, Mohamad; John Y. Kao

    2014-01-01

    Psychological stress is known to induce somatic symptoms. Classically, many gut physiological responses to stress are mediated by the hypothalamus-pituitary-adrenal axis. There is, however, a growing body of evidence of stress-induced corticotrophin-releasing factor (CRF) release causing bowel dysfunction through multiple pathways, either through the HPA axis, the autonomic nervous systems, or directly on the bowel itself. In addition, recent findings of CRF influencing the composition of gut...

  4. Úlcera eosinófila de la mucosa oral / Eosinophilic ulcer of oral mucosa

    Scientific Electronic Library Online (English)

    A.C., Bencini; C.A., Bencini; V., Strada; M., Florencia Soldavini; G.M., Bruno; M.F., Cordeu; M.A., Cotignola.

    2009-08-01

    Full Text Available La Úlcera Eosinófila de la Mucosa Oral, es una entidad poco frecuente, pobremente descrita en la literatura mundial. Se define como una lesión benigna autolimitada que si bien puede presentarse en distintas áreas de la cavidad bucal, presenta una marcada predilección por la mucosa ventral de la leng [...] ua. Clínicamente, se presenta como una lesión ulcerada de bordes indurados y sobreelevados. Los hallazgos histopatológicos son característicos y consisten en un infiltrado mixto rico en eosinófilos, acompañado de una población de grandes células mononucleadas. Recientes artículos basados en estudios inmunohistoquimicos, permiten afirmar la presencia de grandes linfocitos atípicos CD30+ y por lo tanto, incluir esta lesión en el espectro de las entidades simuladoras de desordenes linfoproliferativos. A pesar de esto, el mecanismo etiopatogenico permanece oscuro y el trauma local juega un rol todavía no dilucidado; aunque se halla presente en la mayoría de las publicaciones, explicando el fenómeno como un mecanismo reactivo. La importancia de esta lesión, radica en su diagnostico diferencial por su semejanza clínica al carcinoma espinocelular, histoplasmosis, chancro sifilítico, Úlcera tuberculosa, carcinoma epidermoide y otras. En nuestro trabajo se revisa la literatura y se discuten la características clínicas, histopatológicas y alternativas terapéuticas, a partir del artículo de un caso clínico en una paciente joven, que luego de la biopsia escisión como método para el diagnostico de certeza, se produce una recidiva de la lesión; lo que orientó el tratamiento hacia la cirugía combinada con corticoterapia local intralesional, logrando su remisión. Abstract in english Eosinophilic Ulcer of the Oral Mucosa, an entity, poorly deciphers in world-wide literature. It is defined as a self-limited, benign injury that although it can appear in different areas of the buccal cavity it presents a noticeable predilection via the ventral mucosa of the tongue. Clinically, one [...] looks like an ulcer with hard and risen edges. The histo-pathological findings are typical and consist of a rich infiltrated mix of eosinophils, as well as a population of large mononuclear cells. Recent reports based on immunohistochemical studies allow us to confirm the presence of large atypical lymphocytes CD30+ and therefore include this lesion injury in the spectrum of lympho proliferative disorder simulators. Despite this the etiopathogenic mechanism remains unknown and local trauma still plays an unexplained roll; although the majority of publications have explained the phenomena as a reactive mechanism. The importance of this injury is established by its differential diagnostic because of its clinical similarity to Spinocellular Carcinoma, Histoplasmosis, syphilitic chancre, Ulcer Tuberculosis, Epidermoid Carcinoma and others. In our work the literature is reviewed and clinical characteristics, histo-pathologies and alternative therapies are discussed. We use the case of a young patient who has a biopsy in an effort to diagnose with certainty has a relapse of the lesion which directs the treatment towards combined surgery and local intra lesion cortico therapy which led to successful remission.

  5. Úlcera eosinófila de la mucosa oral Eosinophilic ulcer of oral mucosa

    Directory of Open Access Journals (Sweden)

    A.C. Bencini

    2009-08-01

    Full Text Available La Úlcera Eosinófila de la Mucosa Oral, es una entidad poco frecuente, pobremente descrita en la literatura mundial. Se define como una lesión benigna autolimitada que si bien puede presentarse en distintas áreas de la cavidad bucal, presenta una marcada predilección por la mucosa ventral de la lengua. Clínicamente, se presenta como una lesión ulcerada de bordes indurados y sobreelevados. Los hallazgos histopatológicos son característicos y consisten en un infiltrado mixto rico en eosinófilos, acompañado de una población de grandes células mononucleadas. Recientes artículos basados en estudios inmunohistoquimicos, permiten afirmar la presencia de grandes linfocitos atípicos CD30+ y por lo tanto, incluir esta lesión en el espectro de las entidades simuladoras de desordenes linfoproliferativos. A pesar de esto, el mecanismo etiopatogenico permanece oscuro y el trauma local juega un rol todavía no dilucidado; aunque se halla presente en la mayoría de las publicaciones, explicando el fenómeno como un mecanismo reactivo. La importancia de esta lesión, radica en su diagnostico diferencial por su semejanza clínica al carcinoma espinocelular, histoplasmosis, chancro sifilítico, Úlcera tuberculosa, carcinoma epidermoide y otras. En nuestro trabajo se revisa la literatura y se discuten la características clínicas, histopatológicas y alternativas terapéuticas, a partir del artículo de un caso clínico en una paciente joven, que luego de la biopsia escisión como método para el diagnostico de certeza, se produce una recidiva de la lesión; lo que orientó el tratamiento hacia la cirugía combinada con corticoterapia local intralesional, logrando su remisión.Eosinophilic Ulcer of the Oral Mucosa, an entity, poorly deciphers in world-wide literature. It is defined as a self-limited, benign injury that although it can appear in different areas of the buccal cavity it presents a noticeable predilection via the ventral mucosa of the tongue. Clinically, one looks like an ulcer with hard and risen edges. The histo-pathological findings are typical and consist of a rich infiltrated mix of eosinophils, as well as a population of large mononuclear cells. Recent reports based on immunohistochemical studies allow us to confirm the presence of large atypical lymphocytes CD30+ and therefore include this lesion injury in the spectrum of lympho proliferative disorder simulators. Despite this the etiopathogenic mechanism remains unknown and local trauma still plays an unexplained roll; although the majority of publications have explained the phenomena as a reactive mechanism. The importance of this injury is established by its differential diagnostic because of its clinical similarity to Spinocellular Carcinoma, Histoplasmosis, syphilitic chancre, Ulcer Tuberculosis, Epidermoid Carcinoma and others. In our work the literature is reviewed and clinical characteristics, histo-pathologies and alternative therapies are discussed. We use the case of a young patient who has a biopsy in an effort to diagnose with certainty has a relapse of the lesion which directs the treatment towards combined surgery and local intra lesion cortico therapy which led to successful remission.

  6. Role of Antimicrobial Peptides in Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    Stefan Vordenbäumen

    2011-11-01

    Full Text Available Inflammatory bowel diseases (IBD are characterized by a chronic relapsing inflammation of the gastrointestinal mucosa. The etiology and pathogenesis of these disorders such as Crohn’s disease and ulcerative colitis are incompletely understood. Recently, antimicrobial peptides, which are expressed by leukocytes and epithelia, have been implicated in the pathogenesis of IBD. Antimicrobial peptides are pivotal for intestinal defense, shaping the composition of the luminal flora and contributing thereby to the maintenance of intestinal homeostasis. Apart from their antimicrobial activity affecting commensal bacteria, immunomodulatory properties of antimicrobial peptides have been identified, which link innate and adaptive immune response. There is increasing evidence that alterations in mucosal levels of these peptides contribute to IBD pathogenensis.

  7. Probiotics in Inflammatory Bowel Diseases and Associated Conditions

    Directory of Open Access Journals (Sweden)

    David R. Mack

    2011-02-01

    Full Text Available A complex set of interactions between the human genes encoding innate protective functions and immune defenses and the environment of the intestinal mucosa with its microbiota is currently considered key to the pathogenesis of the chronic inflammatory bowel diseases (IBD. Probiotics offer a method to potentially alter the intestinal microbiome exogenously or may provide an option to deliver microbial metabolic products to alter the chronicity of intestinal mucosal inflammation characterizing IBD. At present, there is little evidence for the benefit of currently used probiotic microbes in Crohn’s disease or associated conditions affecting extra-intestinal organs. However, clinical practice guidelines are now including a probiotic as an option for recurrent and relapsing antibiotic sensitive pouchitis and the use of probiotics in mild ulcerative colitis is provocative and suggests potential for benefit in select patients but concerns remain about proof from trials.

  8. Small bowel tumors

    Directory of Open Access Journals (Sweden)

    Xynopoulos D.

    2007-03-01

    Full Text Available SUMMARY Small intestinal neoplasms are uncommonly encountered in clinical practice. Small intestinal neoplasms may occur sporadically, or in association with genetic diseases such as familial adenomatous polyposis coli or Peutz-Jeghers syndrome, or in association with chronic intestinal inflammatory disorders such as Crohn?s disease or celiac sprue. Benign small intestinal tumors such as leiomyoma, lipoma, hamartoma or desmoid tumor, are usually asymptomatic but may present with intussception. Primary malignancies of the small intestine, including adenocarcinoma, leiomyosarcoma, carcinoid, and lymphoma, may present with intestinal obstruction, jaundice, bleeding, or pain. Extraintestinal neoplasms may involve the intestine via contiguous spread or peritoneal metastasis. Hematogenous metastases to the intestine from an extraintestinal primary are unusual and are most typical of melanoma. Because the small intestine is relatively inaccessible to routine endoscopy, diagnosis of small intestinal neoplasms is often delayed for months after onset of symptoms. When the diagnosis is suspected, enteroclysis is the most useful imaging study. Small bowel endoscopy (enteroscopy is increasingly widely available and may permit earlier, non-operative diagnosis.

  9. Experience with an alternative contrast medium in oral small bowel imaging

    International Nuclear Information System (INIS)

    Purpose: The image quality of oral small bowel imaging is often poor on account of the small bowel enema. A new contrast medium should increase the image quality due to better compliance of patient because of the better taste of substance. The loading of patient with radiation or time should not increase. Methods and patients: We investigated prospectively 40 patients, randomized in two groups of 20 patients each. Two different substances were used as contrast medium: barium-methylcellulose and Barium-Mucofalk trademark, respectively. The quality of the double contrast, profile of the mucosa, duration of radiation, duration of examination, dose-area product, and taste of the substance were judged for significance. Results: The taste of the new contrast medium was judged to be better: twice as often as ''good'' and five times less often as ''bad'', the difference was not significant due to the small number of patients. There is no significant difference in the other criterias. Conclusion: Mucofalk trademark is an alternative contrast medium for oral small bowel radiology in cases of difficult placement of the tube for enema. The quality of double contrast and visualization of the profile of mucosa are the same while the taste is better. (orig.)

  10. If I Had - Bowel Control Issues

    Medline Plus

    Full Text Available ... that doctors give to patients who have problems controlling the bowel, and typically controlling gas is less of a problem than controlling the stool or the bowel movement. This is ...

  11. Irritable Bowel Syndrome and Complementary Health Practices

    Science.gov (United States)

    ... al. Acupuncture for treatment of irritable bowel syndrome. Cochrane Database of Systematic Reviews . 2012;(5):CD005111. Accessed ... antidepressants for the treatment of irritable bowel syndrome. Cochrane Database of Systematic Reviews . 2011;(8):CD003460. Accessed ...

  12. Biologic targeting in the treatment of inflammatory bowel diseases

    Directory of Open Access Journals (Sweden)

    Matteo Bosani

    2009-02-01

    Full Text Available Matteo Bosani, Sandro Ardizzone, Gabriele Bianchi PorroChair of Gastroenterology, “L. Sacco” University Hospital, Milan, ItalyAbstract: The etiology of inflammatory bowel disease (IBD has not yet been clarified and immunosuppressive agents which nonspecifically reduce inflammation and immunity have been used in the conventional therapies for IBD. Evidence indicates that a dysregulation of mucosal immunity in the gut of IBD causes an overproduction of inflammatory cytokines and trafficking of effector leukocytes into the bowel, thus leading to an uncontrolled intestinal inflammation. Under normal situations, the intestinal mucosa is in a state of “controlled” inflammation regulated by a delicate balance of proinflammatory (tumor necrosis factor [TNF-?], interferon-gamma [IFN-?], interleukin-1 [IL-1], IL-6, IL-12 and anti-inflammatory cytokines IL-4, IL-10, IL-11. The mucosal immune system is the central effector of intestinal inflammation and injury, with cytokines playing a central role in modulating inflammation. Cytokines may therefore be a logical target for inflammatory bowel disease therapy using specific cytokine inhibitors. Biotechnology agents targeted against TNF, leukocyte adhesion, Th1 polarization, T cell activation, nuclear factor-kappaB (NF-?B, and other miscellaneous therapies are being evaluated as potential therapies for the treatment of inflammatory bowel disease. In this context, infliximab and adalimumab are currently the only biologic agents approved in Europe for the treatment of inflammatory Crohn’s disease. Other anti-TNF biologic agents have emerged, including CDP571, certolizumab pegol, etanercept, onercept. However, ongoing research continues to generate new biologic agents targeted at specific pathogenic mechanism involved in the inflammatory process. Lymphocyte-endothelial interactions mediated by adhesion molecules are important in leukocyte migration and recruitment to sites of inflammation, and selective blockade of these adhesion molecules is a novel and promising strategy to treat Crohn’s disease. Therapeutics agents to inhibit leukocyte trafficking include natalizumab (approved for use in Crohn’s disease in USA, MLN-02, and ISIS 2302. Other agents being investigated for the treatment of Crohn’s disease include inhibitors of T cell activation, proinflammatory cytokine receptors, Th1 polarization, growth hormone, and growth factors. Agents being investigated for treatment of ulcerative colitis include many of those mentioned above. Controlled clinical trials are currently being conducted, exploring the safety and efficacy of old and new biologic agents, and the search certainly will open new and exciting perspective on the development of therapies for inflammatory bowel disease. A review is made of the main areas of research exploring the mechanisms associated with the pathogenesis of IBD, providing advances in the agents currently in use, and identifying a host of new therapeutic biologic targets.Keywords: Crohn’s disease, ulcerative colitis, biological therapy

  13. Why is damage limited to the mucosa in ulcerative colitis but transmural in Crohn’s disease?

    OpenAIRE

    Xiaofa Qin

    2013-01-01

    It has been a big puzzle as why the inflammation of ulcerative colitis (UC) is limited to the mucosa, while in Crohn’s disease (CD) the inflammation is transmural and can be seen in all layers of the gut. Here, I give a tentative explanation extended from the unified hypothesis I proposed on the etiology of inflammatory bowel disease. This hypothesis suggested that both UC and CD are caused by weakening of the gut barrier due to damage of the protective mucus layer and the underlying t...

  14. Why is damage limited to the mucosa in ulcerative colitis but transmural in Crohn’s disease?

    OpenAIRE

    Qin, Xiaofa

    2013-01-01

    It has been a big puzzle as why the inflammation of ulcerative colitis (UC) is limited to the mucosa, while in Crohn’s disease (CD) the inflammation is transmural and can be seen in all layers of the gut. Here, I give a tentative explanation extended from the unified hypothesis I proposed on the etiology of inflammatory bowel disease. This hypothesis suggested that both UC and CD are caused by weakening of the gut barrier due to damage of the protective mucus layer and the underlying tissue b...

  15. Intestinal anisakiasis as a rare cause of small bowel obstruction.

    Science.gov (United States)

    Kojima, Gotaro; Usuki, Shinichiro; Mizokami, Ken; Tanabe, Marianne; Machi, Junji

    2013-09-01

    Anisakiasis, a parasitic infection by larvae of the nematode Anisakis found in raw or undercooked saltwater fish, mostly involves stomach but rarely small intestine. We report a rare case of a 61-year-old man who presented with abdominal pain and developed small bowel obstruction caused by intestinal anisakiasis. Abdominal computed tomography revealed segmental edema of the intestinal wall with proximal dilatation. The patient underwent urgent laparotomy because strangulated small bowel obstruction was suspected. A localized portion of the intestine around jejunoileal junction was found to be erythematous, edematous, and hardened, which was resected. The resected specimen showed a linear whitish worm, Anisakis simplex, penetrating into the intestinal mucosa. It is often clinically challenging to consider intestinal anisakiasis in the differential diagnosis because of its nonspecific abdominal symptoms and findings. Although gastrointestinal anisakiasis is still rare in the United States, the incidence is expected to rise given the growing popularity of Japanese cuisine such as sushi or sashimi. Anisakiasis should be considered as one of the differential diagnoses in patients with nonspecific abdominal symptoms after consumption of raw or undercooked fish. PMID:23786678

  16. Differential patterns of histone acetylation in inflammatory bowel diseases

    Directory of Open Access Journals (Sweden)

    Adcock Ian M

    2011-01-01

    Full Text Available Abstract Post-translational modifications of histones, particularly acetylation, are associated with the regulation of inflammatory gene expression. We used two animal models of inflammation of the bowel and biopsy samples from patients with Crohn's disease (CD to study the expression of acetylated histones (H 3 and 4 in inflamed mucosa. Acetylation of histone H4 was significantly elevated in the inflamed mucosa in the trinitrobenzene sulfonic acid model of colitis particularly on lysine residues (K 8 and 12 in contrast to non-inflamed tissue. In addition, acetylated H4 was localised to inflamed tissue and to Peyer's patches (PP in dextran sulfate sodium (DSS-treated rat models. Within the PP, H3 acetylation was detected in the mantle zone whereas H4 acetylation was seen in both the periphery and the germinal centre. Finally, acetylation of H4 was significantly upregulated in inflamed biopsies and PP from patients with CD. Enhanced acetylation of H4K5 and K16 was seen in the PP. These results demonstrate that histone acetylation is associated with inflammation and may provide a novel therapeutic target for mucosal inflammation.

  17. A retrospective study of 5-year outcomes of radiotherapy for gastric mucosa-associated lymphoid tissue lymphoma refractory to Helicobacter pylori eradication therapy

    International Nuclear Information System (INIS)

    The favorable response rate of radiotherapy for localized gastric mucosa-associated lymphoid tissue lymphoma refractory to Helicobacter pylori eradication has been demonstrated. However, there are limited data available on the long-term outcomes. The aim of this retrospective study was to evaluate the long-term outcomes of radiotherapy for localized gastric mucosa-associated lymphoid tissue lymphoma refractory to Helicobacter pylori eradication. Thirty-four consecutive patients with localized gastric mucosa-associated lymphoid tissue lymphoma that were refractory to eradication were treated with radiotherapy (a total dose of 30 Gy). The response and adverse events of radiotherapy were retrospectively analyzed as short-term outcomes, and recurrence-free, overall and disease-specific survival rates were calculated as long-term outcomes. Thirty-three (97.1%) patients achieved complete remission and radiotherapy was well tolerated. One patient underwent emergency gastrectomy due to severe hematemesis. Of the 34 patients during the median follow-up period of 7.5 (1.2-13.0) years, one patient had local recurrence after 8.8 years, one patient underwent surgery for bowel obstruction secondary to small bowel metastasis after 5.1 years and one patient had pulmonary metastasis after 10.9 years. Pathologically, all three recurrences revealed mucosa-associated lymphoid tissue lymphoma without any transformation to high-grade lymphoma. None died of gastric mucosa-associated lymphoid tissue lymphoma. The 5-year recurrence-free survival rate was 97.0%. The 5-year overall survival rates and disease-specific survival rates were 97.0 and 100%, respectively. Radiotherapy in patients with localized gastric mucosa-associated lymphoid tissue lymphoma refractory to Helicobacter pylori eradication can achieve excellent overall survival. However, long-term surveillance is necessary to identify late recurrences. (author)

  18. Genetics of Inflammatory Bowel Diseases.

    Science.gov (United States)

    McGovern, Dermot P B; Kugathasan, Subra; Cho, Judy H

    2015-10-01

    In this review, we provide an update on genome-wide association studies (GWAS) in inflammatory bowel disease (IBD). In addition, we summarize progress in defining the functional consequences of associated alleles for coding and noncoding genetic variation. In the small minority of loci where major association signals correspond to nonsynonymous variation, we summarize studies defining their functional effects and implications for therapeutic targeting. Importantly, the large majority of GWAS-associated loci involve noncoding variation, many of which modulate levels of gene expression. Recent expression quantitative trait loci (eQTL) studies have established that the expression of most human genes is regulated by noncoding genetic variations. Significant advances in defining the epigenetic landscape have demonstrated that IBD GWAS signals are highly enriched within cell-specific active enhancer marks. Studies in European ancestry populations have dominated the landscape of IBD genetics studies, but increasingly, studies in Asian and African-American populations are being reported. Common variation accounts for only a modest fraction of the predicted heritability and the role of rare genetic variation of higher effects (ie, odds ratios markedly deviating from 1) is increasingly being identified through sequencing efforts. These sequencing studies have been particularly productive in more severe very early onset cases. A major challenge in IBD genetics will be harnessing the vast array of genetic discovery for clinical utility through emerging precision medical initiatives. In this article, we discuss the rapidly evolving area of direct-to-consumer genetic testing and the current utility of clinical exome sequencing, especially in very early onset, severe IBD cases. We summarize recent progress in the pharmacogenetics of IBD with respect to partitioning patient responses to anti-TNF and thiopurine therapies. Highly collaborative studies across research centers and across subspecialties and disciplines will be required to fully realize the promise of genetic discovery in IBD. PMID:26255561

  19. Caracterização anatômica e citométrica em biribazeiro (Rollinia mucosa [Jacq.]) / Anatomical and cytometric characterization in biribazeiro (Rollinia mucosa [Jacq.])

    Scientific Electronic Library Online (English)

    Joyce Dória Rodrigues, Soares; Gabrielen de Maria Gomes, Dias; Filipe Almendagna, Rodrigues; Moacir, Pasqual; Edvan Alves, Chagas.

    Full Text Available O biribazeiro (Rollinia mucosa [Jacq.]) é uma frutífera nativa da América Central e América do Sul que se destaca das demais espécies do gênero por apresentar frutos grandes e comestíveis. Tendo em vista que pouco se conhece a respeito da anatomia da planta, tipo de reserva da semente, como também s [...] obre o conteúdo de DNA de espécies da família anonáceas, este trabalho teve por objetivos caracterizar histoquimicamente as sementes e anatomicamente as plântulas, e determinar o conteúdo de DNA de biribazeiro. As plântulas foram obtidas de sementes coletadas na região Amazônica pela Embrapa Roraima e enviadas à Universidade Federal de Lavras. Os frutos foram despolpados, e suas sementes foram previamente lavadas e semeadas em bandejas de 48 células, contendo como substrato pó de serragem, permanecendo em câmara de germinação a 30ºC por 90 dias. Nas plantas obtidas, procedeu-se à análise histoquímica, à caracterização anatômica e à determinação do conteúdo de DNA. As principais conclusões deste trabalho foram que: (1) as sementes da Rollinia mucosa apresentam reserva principal lipídica; (2) as secções transversais da lâmina foliar indicam organização dorsiventral, do tipo hipoestomática com estômatos paracíticos e tricomas em ambas as faces da folha; (3) as folhas de biribazeiro apresentam, em média, 4,77 pg de DNA. Abstract in english The biribazeiro (Rollinia mucosa [Jacq.]) is a native fruit of Central America and South America that stands out from the other species of the genus because it has large and edible fruits. Considering that little is known about the anatomy of the plant, the type of reserve of the seed, as well as li [...] ttle is known about the DNA content of species of Annonaceae family, this study aimed to characterize seeds histochemically and seedlings anatomically, and determine DNA content of biribazeiro (Rollinia mucosa [Jacq.]). The seedlings were obtained from seeds collected in the Amazon region by Embrapa Roraima and then, sent to UFLA, Federal University of Lavras, Minas Gerais State. The pulp of the fruits were extracted and the seeds were previously washed and sown in trays of 48 cells containing sawdust as substrate, remaining in a germination chamber at 30ºC for 90 days. A histochemical analysis, anatomical characterization and determination of DNA content of the plants obtained were made. The main conclusions of this research were: (1) the seeds of Biribazeiro (Rollinia mucosa) present mainly lipid reserve, (2) The cross-sections of the leaf blade indicate dorsiventral organization, hypostomatic with paracitic stomata and trichomes on both sides of the sheet (3) the leaves of biribazeiro have on average 4.77 pg of DNA.

  20. Epithelial restitution and wound healing in inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Andreas Sturm, Axel U Dignass

    2008-01-01

    Full Text Available Inflammatory bowel disease is characterized by a chronic inflammation of the intestinal mucosa. The mucosal epithelium of the alimentary tract constitutes a key element of the mucosal barrier to a broad spectrum of deleterious substances present within the intestinal lumen including bacterial microorganisms, various dietary factors, gastrointestinal secretory products and drugs. In addition, this mucosal barrier can be disturbed in the course of various intestinal disorders including inflammatory bowel diseases. Fortunately, the integrity of the gastrointestinal surface epithelium is rapidly reestablished even after extensive destruction. Rapid resealing of the epithelial barrier following injuries is accomplished by a process termed epithelial restitution, followed by more delayed mechanisms of epithelial wound healing including increased epithelial cell proliferation and epithelial cell differentiation. Restitution of the intestinal surface epithelium is modulated by a range of highly divergent factors among them a broad spectrum of structurally distinct regulatory peptides, variously described as growth factors or cytokines. Several regulatory peptide factors act from the basolateral site of the epithelial surface and enhance epithelial cell restitution through TGF-?-dependent pathways. In contrast, members of the trefoil factor family (TFF peptides appear to stimulate epithelial restitution in conjunction with mucin glycoproteins through a TGF-?-independent mechanism from the apical site of the intestinal epithelium. In addition, a number of other peptide molecules like extracellular matrix factors and blood clotting factors and also non-peptide molecules including phospholipids, short-chain fatty acids (SCFA, adenine nucleotides, trace elements and pharmacological agents modulate intestinal epithelial repair mechanisms. Repeated damage and injury of the intestinal surface are key features of various intestinal disorders including inflammatory bowel diseases and require constant repair of the epithelium. Enhancement of intestinal repair mechanisms by regulatory peptides or other modulatory factors may provide future approaches for the treatment of diseases that are characterized by injuries of the epithelial surface.

  1. Scintigraphic diagnosis of inflammatory small bowel stenoses in Crohn's disease using 111In-labelled leucocytes

    International Nuclear Information System (INIS)

    17 patients with known small bowel involvement in Crohn's disease (clinically active, n=14; clinically inactive, n=3) were examined within 8 days via barium enemas of the small bowel (Pansdorf's method or enteroclysma) and by 111In-oxin labelled leucocytes. From 19 radiologically diagnosed small bowel stenoses 14 were classified as inflammatory and 5 as non-inflammatory. The leucocyte scan also showed 14 inflammatory stenoses. The not inflamed stenoses could not be diagnosed scintigraphically. The barium enemas of the small bowel and the leukocyte scans both correctly diagnosed the acute inflamed segments. The inability to show non-inflamed segments (n=5) and to localise small bowel stenoses exactly is disadvantageous in the scan. The advantage of the leucocyte scan is a non invasive examination without specific bowel preparation and the possibility to diagnose additionally inflamed large bowel segments (n=4), fistulas and abscesses (n=2). The leucocyte scan offers a useful expansion of the diagnostic tools in small bowel diseases, especially in radiological problems in patients with Crohn's disease. (orig.)

  2. CT enteroclysis in small bowel Crohn's disease

    International Nuclear Information System (INIS)

    The diagnostic evaluation of small bowel Crohn's disease has changed dramatically over the last decade. The introduction of wireless capsule endoscopy, double balloon endoscopy and the introduction of newer therapeutic agents have changed the role of imaging in the small bowel. Additionally, advances in multidetector CT technology have further changed how radiologic investigations are utilized in the diagnosis and management of small bowel Crohn's disease. This article describes how we perform CT enteroclysis in the investigation of small bowel Crohn's disease and discusses the role of CT enteroclysis in the current management of small bowel Crohn's disease.

  3. Short Bowel Syndrome: clinical management

    OpenAIRE

    Loris Pironi; Mariacristina Guidetti; Elisabetta Lanzoni; Caterina Pazzeschi; Catia Corsini

    2013-01-01

    The management of a case of intestinal failure due to Short Bowel Syndrome (SBS) is described. Patients’ care needs an expert multidisciplinary approach. Published data have demonstrated that the lack of a specialist staff is a risk factor for patients’ death. The creation of networks linking non-specialist doctors with dedicated centers is recommended.

  4. Fetal bowel anomalies - US and MR assessment

    Energy Technology Data Exchange (ETDEWEB)

    Rubesova, Erika [Stanford University, Department of Radiology, Lucile Packard Children' s Hospital, Stanford, CA (United States)

    2012-01-15

    The technical quality of prenatal US and fetal MRI has significantly improved during the last decade and allows an accurate diagnosis of bowel pathology prenatally. Accurate diagnosis of bowel pathology in utero is important for parental counseling and postnatal management. It is essential to recognize the US presentation of bowel pathology in the fetus in order to refer the patient for further evaluation or follow-up. Fetal MRI has been shown to offer some advantages over US for specific bowel abnormalities. In this paper, we review the normal appearance of the fetal bowel on US and MRI as well as the typical presentations of bowel pathologies. We discuss more specifically the importance of recognizing on fetal MRI the abnormalities of size and T1-weighted signal of the meconium-filled distal bowel. (orig.)

  5. Investigation of bowels adjacent to the uterus using MRI. For relief of bowel complications following intracavitary brachytherapy for cervical cancer

    International Nuclear Information System (INIS)

    Intracavitary brachytherapy occasionally causes bowel injuries other than rectum. To relieve these adverse events, we investigated the relationships between uterine bodies and surrounding bowels using MRI. A hundred and ten of serial 252 pelvic MRI of women, excluding the following, were reviewed. The excluded items were large intrapelvic extrauterine masses over 3.5 cm in greater diameter, large uterine corpus masses over 2 cm, three or more uterine corpus masses, past history of hysterectomy or rectocolonic resection, and massive ascites. We investigated the fundus-bowel distance (FBD), site of the nearest bowel to the uterine body, flexion type and deviation of uterus, uterine wall thickness, subcutaneous fat thickness and age. FBD ranged from 8 to 42 mm (20.2±8.2 mm). In 66 cases (60%), FBD was 20 mm or less. The sites of the nearest bowel were 67 sigmoid colons, 27 rectums, 8 small intestines, and 7 descending colons. Eighty-three uteri (75.5%) were anteflexion and 27 uteri (24.5%) were retroflexion. Of the anteflexion group, 78.3% were adjacent to the sigmoid colon, and 92.6% of the retroflexion group were adjacent to rectum. Right-deviation uteri represented 33 cases (30%); mid-position 33, (30%); and left-deviation uteri, 44 (40%). Uterine wall thickness was 5 to 33 mm (17.8±5.2). Subcutaneous fat thickness was 10 to 47 mm (20.2±9.3). The age of patients ranged from 21 to 83 years (39.9±14.4). FBD showed statistical good correlation to uterine wall thickness and subcutaneous fat thickness. In anteflexion group, correlation of uterine wall thickness with FBD was significant. In retroflexion group, however, it was not significant. The site of bowels, flexion type, and deviation type did not correlate with FBD. FBD, uterine wall thickness and subcutaneous fat thickness showed regression of quadric curves with age; these peaked at ages 50.4, 46.0 and 46.2, respectively. It is presumed that predictive factors of bowel complication are thin uterine wall, young and aged, thin patients and retroflexion uterus. Uterine deviation does not shorten FBD. To relieve a radiation injury to bowels adjacent to the uterine fundus, the isodose curve must be decrease the irradiation dose of the tandem tip. At this time we conformed so as to recommend refering to MRI, CT and ultrasonography to detect the uterine wall thickness and the involved area of primary carcinoma. Retroflexion uterus as should be reformed to anteflexion by hard tandem applicator. Laterally-deviated uteruses should be adjusted such that they lie within the central shielding zone of the external beam. (author)

  6. Weight loss and morphometric study of intestinal mucosa in rats after massive intestinal resection: influence of a glutamine-enriched diet Perda de peso e estudo morfométrico da mucosa intestinal de ratos submetidos à ressecção subtotal de intestino delgado: influência do uso de dieta com glutamina

    Directory of Open Access Journals (Sweden)

    Sidney Resende Ribeiro

    2004-01-01

    Full Text Available Short-bowel syndrome is responsible for significant metabolic alterations that compromise nutritional status. Glutamine is considered an essential nutrient for enterocytes, so beneficial effects from supplementation of the diet with glutamine are hypothesized. PURPOSE: In this study, the effect of a diet enriched with glutamine was evaluated in rats undergoing extensive small bowel resection, with analysis of postoperative weight loss and intestinal morphometrics of villi height, crypt depth, and thickness of the duodenal and remnant jejunal mucosa. METHODS: Three groups of male Wistar rats were established receiving the following diets: with glutamine, without glutamine, and the standard diet of laboratory ration. All animals underwent an extensive small bowel resection, including the ileocecal valve, leaving a remnant jejunum of only 25 cm from the pylorus that was anastomosed lateral-laterally to the ascendant colon. The animals were weighed at the beginning and end of the experiment (20th postoperative day. Then they were killed and the remnant intestine was removed. Fragments of duodenal and jejunal mucosa were collected from the remnant intestine and submitted to histopathologic exam. The morphometric study of the intestinal mucosa was accomplished using a digital system (KS 300 connected to an optic microscope. Morphometrics included villi height, crypt depth, and the total thickness of intestinal mucosa. RESULTS: The weight loss comparison among the 3 groups showed no significant loss difference. The morphometric studies showed significantly taller duodenal villi in the glutamine group in comparison to the without glutamine group, but not different from the standard diet group. The measurements obtained comparing the 3 groups for villi height, crypt depth, and thickness of the remnant jejunum mucosa were greater in the glutamine-enriched diet group than for the without-glutamine diet group, though not significantly different from with standard-diet group. CONCLUSIONS: In rats with experimentally produced short-bowel syndrome, glutamine-enrichment of an isonitrogenous test diet was associated with an improved adaptation response by the intestinal mucosa but not reduced weight loss. However, the adaptation response in the group receiving the glutamine-enriched diet was not improved over that for the group fed regular chow.A síndrome do intestino curto é responsável por alterações metabólicas que comprometem o estado nutricional do paciente. A glutamina é nutriente essencial para os enterócitos. OBJETIVOS: Estudou-se o efeito da administração de dieta com glutamina, em ratos submetidos à ressecção subtotal do intestino delgado, avaliando a perda de peso pós-operatória e a morfometria da mucosa intestinal. MÉTODOS: Foram constituídos três grupos de ratos Wistar machos recebendo as seguintes dietas: com glutamina (grupo EG, sem glutamina (grupo EsG, e a dieta padrão do laboratório (grupo ER. A ressecção intestinal foi realizada em todos os animais incluindo-se a válvula íleo-cecal, com remanescente jejunal de apenas 25cm a partir do piloro, anastomosado látero-lateralmente ao cólon ascendente. A diferença entre o peso inicial real e ao final do experimento no 20º dia pós-operatório foi registrada antes do sacrifício. Fragmentos de mucosa do duodeno e jejuno foram colhidos e corados com hematoxilina-eosina. Realizou-se o estudo morfométrico da mucosa intestinal, por meio de sistema digital associado ao microscópio ótico. Mediu-se a altura das vilosidades, a profundidade das criptas e a extensão total da mucosa intestinal. RESULTADOS: A perda de peso entre os três grupos não diferiu estatisticamente. A análise da morfometria da mucosa intestinal mostrou diferença significativa: 1 animais do grupo Enterectomia com Glutamina (EG apresentaram vilosidade duodenal significativamente maior que o grupo EsG (p< 0,05, mas não diferiram do grupo que recebeu dieta padrão do laboratório (ER; 2 nas medidas da vilosidade jejunal, cripta jejunal e mucosa jejunal, o grup

  7. Bowel resection in Nigerian children

    Directory of Open Access Journals (Sweden)

    Abdur-Rahman L

    2009-01-01

    Full Text Available Background : Although bowel resections are commonly done for congenital malformations in children in developed countries, they usually follow neglected and preventable acquired diseases of the intestine in developing countries. Objectives : To determine the indications and outcome of bowel resections in children of a developing country in a university teaching hospital. Materials and Methods: Data of the patients operated (from birth to 15 years was retrospectively collected over eight years (January 1999 to December 2006. The biodata of children included the following: Indications for operation, type of operations, duration of admission, and outcome of treatment including complications. Patients with Hirschsprung?s disease were excluded from the study because bowel resection forms part of their definitive surgical management. Results : There were 70 patients (38 boys and 32 girls. The age ranged between four hours to 15 years (median, five months. There were 16 (22.9% neonates, 26 (37.1% infants, and 28 (40% grown children. The indications were congenital anomalies in the 16 neonates. Also, 23 (88.5% infants had intussusception, 2 (7.7% had midgut vovulusm and 1 (3.8% had congenital small intestine band. Among the grown children, typhoid ileal perforation (TIP was seen in 14 (50.0%, intussusception in 5 (17.9%, and other causes in nine patients. Overall, intussusception was the most common indication for bowel resection, followed by TIP. A total of 24 patients developed 33 complications. Complications included wound infection in 47.8% and anastomotic leak in 42.8%. The duration of admission ranged between 4-35 days (median, 15 days. The overall mortality was 17.1% -; which was highest among neonates (56.3%, followed by the infants (26.9% -. Conclusion : Bowel resections are mainly done for intussusception and complications of TIP at our centre. Late presentation, preexisting malnutrition, and nonavailability of parenteral nutrition contributed to unacceptable morbidity and mortality.

  8. Multidetector CT of bowel obstruction: value of post-processing

    International Nuclear Information System (INIS)

    The value of imaging in patients with suspicion of bowel obstruction is dependent on the ability to answer questions relevant to the clinical management of patients. Is there mechanical obstruction? Is it a small bowel obstruction (SBO) or a large bowel obstruction (LBO)? What is the transition point? What is the cause of the obstruction? What is the severity of the obstruction? The results of studies published more than 10 years ago using axial and single-slice helical CT gave rise to findings based on axial slices that enables CT to answer these different questions. With the recent advent of multislice CT, large numbers of thin sections can be generated with short image intervals, which is well suited to postprocessing. Postprocessing techniques include standard reformatting methods such as sagittal, coronal and oblique reformatting, curved reformatting, maximum and minimum-intensity projection, variable thickness viewing, and volume and surface rendering. This pictorial review illustrates the added value of postprocessing for answering different questions concerning patients with suspicion of bowel obstruction. (orig.)

  9. Bacteria, genetics and irritable bowel syndrome.

    LENUS (Irish Health Repository)

    Craig, Orla F

    2010-06-01

    EVALUATION OF: Villani AC, Lemire M, Thabane M et al. Genetic risk factors for post-infectious irritable bowel syndrome following a waterborne outbreak of gastroenteritis. Gastroenterology 138, 1502-1513 (2010). While the pathogenesis of irritable bowel syndrome (IBS) remains to be fully defined, two clinical observations - the occurrence, de novo, of IBS following bacterial gastroenteritis and the history, commonly obtained from IBS patients, of other instances of the syndrome within their families - have instigated investigations, in IBS, of the potential roles, on the one hand, of the gut microbiota and the host response and, on the other hand, of genetic factors. The study reviewed here relates to both of these factors by studying genetic predisposition to postinfective IBS in a large population of individuals who were exposed to a multimicrobial enteric infection, which resulted in a severe outbreak of gastroenteritis and was followed by the development of IBS in over a third. In this detailed study, the investigators identified a number of genes that were linked significantly to the development of postinfectious-IBS in the Toll-like receptor 9, IL-6 and cadherin 1 regions. These genes play important roles in bacterial recognition, the inflammatory response and epithelial integrity, respectively, and provide considerable support for the hypothesis that links IBS onset to disturbances in the microbiota and the host response.

  10. Inflammatory bowel disease: clinical aspects and treatments

    Directory of Open Access Journals (Sweden)

    Fakhoury M

    2014-06-01

    Full Text Available Marc Fakhoury,1 Rebecca Negrulj,2 Armin Mooranian,2 Hani Al-Salami2 1Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering and Artificial Cells and Organs Research Center, Faculty of Medicine, McGill University, Montreal, QC, Canada; 2Biotechnology and Drug Development Research Laboratory, Curtin Health Innovation Research Institute, Biosciences Research Precinct, School of Pharmacy, Curtin University, Perth, WA, Australia Abstract: Inflammatory bowel disease (IBD is defined as a chronic intestinal inflammation that results from host-microbial interactions in a genetically susceptible individual. IBDs are a group of autoimmune diseases that are characterized by inflammation of both the small and large intestine, in which elements of the digestive system are attacked by the body's own immune system. This inflammatory condition encompasses two major forms, known as Crohn's disease and ulcerative colitis. Patients affected by these diseases experience abdominal symptoms, including diarrhea, abdominal pain, bloody stools, and vomiting. Moreover, defects in intestinal epithelial barrier function have been observed in a number of patients affected by IBD. In this review, we first describe the types and symptoms of IBD and investigate the role that the epithelial barrier plays in the pathophysiology of IBD as well as the major cytokines involved. We then discuss steps used to diagnose this disease and the treatment options available, and finally provide an overview of the recent research that aims to develop new therapies for such chronic disorders. Keywords: inflammatory bowel disease, Crohn's disease, ulcerative colitis, cytokines

  11. Ethical Considerations for Clinical Trials in Inflammatory Bowel Disease

    OpenAIRE

    David T. Rubin; Becker, Samuel; Siegler, Mark

    2014-01-01

    Although advancements in the field of inflammatory bowel disease (IBD) include effective therapies for many patients with Crohn’s disease and ulcerative colitis, there remains a large unmet need, and there is a large number of investigational agents in the pipeline. Drug development through clinical trials is critical to understanding the safety and efficacy of new therapies in the affected human population, and the need for ethical trial design is of the utmost importance. This paper explore...

  12. Small bowel intubation using guide wire: use in decompression of small bowel obstruction

    International Nuclear Information System (INIS)

    Small bowel intubation is a useful method in the non-operative decompression of small bowel obstruction and enteral hyperalimentation in malnourished patients. We have tried small bowel intubation with Ventrol tube guided by small bowel enteroclysis guide wire (Bilbao-Dotter wire) in 12 patients. Ten cases were successfully intubated. In 11 cases of bowel obstruction, 9 cases were intubated and 8 cases were effectively drained. One malnourished patient was improved in nutritional state after enteral hyperalimentation through the intubated tube. We believe this method is an easy and time-saving method in the small bowel decompression

  13. ESTUDO DA MUCOSA ENTERAL DE RESERVATÓRIOS EM "J" EM CÃES

    Scientific Electronic Library Online (English)

    SANDRA PEDROSO DE, MORAES; AMAURY JOSÉ TEIXEIRA, NIGRO; JOSÉ ALFREDO DOS, REIS NETO; FLÁVIO ANTONIO, QUILICI; MIRALVA APARECIDA DE JESUS, SILVA.

    1998-07-01

    Full Text Available A proctocolectomia total com reservatório enteral é a principal técnica utilizada para o tratamento operatório de algumas doenças do intestino grosso. Com o objetivo de estudar as características da mucosa enteral de reservatórios em J, foram operados 36 cães. Após a ressecção de 5 cm do jejunum cau [...] dalis, para estudo-controle, os cães foram separados em dois grupos (GI e GII). No GI, foi realizada anastomose êntero-enteral término-terminal; no GII, foi feito um reservatório na forma de "J" no segmento cranialis, que foi anastomosado ao segmento caudalis da mesma forma que no GI. Aos 21, 42 e 63 dias de pós-operatório, foi realizada eutanásia de 6 cães de cada grupo para estudos macroscópico e microscópico, incluindo-se contagens celulares e medidas da lâmina própria da mucosa enteral. Os resultados revelaram, aos 21 dias, edema e enantema, à macroscopia, e necrose à microscopia, em freqüências semelhantes nos dois grupos. Aos 42 e 63 dias, essas alterações diminuiram ou desapareceram no GI e persistiram no GII. Somente neste último foram observadas úlceras à macroscopia aos 21 dias (2 cães) e 42 dias (1 cão). Não houve diferença significante à presença de abscesso, à microscopia, nos dois grupos. Na contagem celular, já aos 21 dias houve aumento da densidade volumétrica de neutrófilos, macrófagos, eosinófilos, plasmócitos e linfócitos nos dois grupos. Todas as células, exceto eosinófilos, apresentavam-se com densidade volumétrica significantemente maior no GII, aos 63 dias. O diâmetro transversal da lâmina própria, excluindo a altura dos vilos, apresentou-se significantemente maior no GII aos 63 dias de pós-operatório. Concluiu-se que a mucosa enteral de reservatórios em J, em cães, apresenta modificações do padrão de normalidade macroscópica e microscópica, entre as quais o aumento da densidade volumétrica de células inflamatórias. Abstract in english Total proctocolectomy with enteral reservoir is, at present, the best technique used for the surgical treatment of some large intestine diseases involving the whole colon. In order to study the characteristics of the "J" reservoir enteral mucosa, thirty-six dogs underwent surgery. After resection of [...] 5cm of the jejunum caudalis the animals were divided into two equal groups (GI and GII) for study-control. In GI, an entero-enteral end-to-end anastomosis was performed; in GII, a "J" reservoir was performed in the cranialis segment of the jejunum and this pouch was anastomosed end-to-end to the jejunun caudalis (similar to GI). On the 21st, 42nd and 63rd postoperative days, six animals of each group were sacrificed for macro and microscopic studies, including cellular counting and the measuring of the enteral mucosa lamina propria. On the 21st day, both groups showed oedema and erythema on macroscopic examination, and necrosis under microscopy in similar numbers. On the 42nd and 63rd days, these alterations decreased or disappeared in GI and persisted in GII. Only in the latter group, on macroscopy, ulcers were observed on the 21st day (2 dogs) and on the 42nd day (1 dog). In both groups there was no significant difference as to the incidence of abscess under microscopy. On the 21st day there was an increase of the volumetric density of neutrophils polymorph, macrophages, eosinophils, plasma cells and lymphocites in both groups. All the cells, except the eosinophils, showed a significant enlargement of the volumetric density in GII on the 63rd day. The transversal diameter of lamina propria, except for the villi height, was significantly larger in GII on the 63rd postoperative day. It was concluded that the enteral mucosa of the "J" reservoir in dogs shows alterations of the normal pattern of macroscopy and microscopy, including the volumetric density enlargement of the inflammatory cells.

  14. Benign Papules and Nodules of Oral Mucosa

    Directory of Open Access Journals (Sweden)

    Mehmet Salih Gürel

    2012-12-01

    Full Text Available This article reviews some of the more common benign oral papules and nodules of oral mucosa with emphasis on their etiology, epidemiology, clinical presentation, histopathology, and treatment. These lesions include mucocele, traumatic fibroma, epulis, pyogenic granuloma, oral papilloma, oral warts, lymphangioma, hemangioma, lipoma, oral nevi and some soft tissue benign tumors. These benign lesions must be separated clinically and histologically from precancerous and malign neoplastic lesions. Accurate clinico-pathological diagnosis is mandatory to insure appropriate therapy.

  15. Efeitos da injeção de solução bicarbonatada de ácido acetilsalicílico em mucosa colorretal de coelhos, com vistas a aplicação no preparo pré-operatório do cólon / Local effects of rectal washout with acetylsalicylic acid solution on the colonic mucosa of rabbits

    Scientific Electronic Library Online (English)

    Enrico Salomão, Ioriatti; Maria A. M., Rodrigues; Juliana Menezes, Siqueira; Rogério Saad, Hossne.

    2007-12-01

    Full Text Available INTRODUÇÃO: A recidiva local no câncer colorretal tem como principal causa o implante de células tumorais nas anastomoses. 11-15 Dessa maneira, lavagem química do lúmen intestinal é preconizada para evitar tanto o implante quanto à recidiva local. 11-28 Em estudos prévios constatamos que a solução b [...] icarbonatada de ácido acetilsalicílico tem efeitos citolíticos e anti-tumorais in-vitro.31 OBJETIVOS: Avaliar a toxicidade da solução de aspirina na mucosa colônica de coelhos com o objetivo de usá-la no preparo intestinal de portadores de câncer colorretal. MATERIAIS E MÉTODOS: Foram utilizados 20 coelhos. Um clampe vascular foi colocado acima do cólon sigmóide. Os animais foram submetidos a um enema com 50 ml da solução de aspirina ou soro fisiológico de acordo com o grupo. Os animais foram sacrificados ao término do procedimento ou tardiamente de acordo com o grupo. RESULTADOS: A solução de aspirina não altera a mucosa colônica de coelhos. CONCLUSÃO: O uso da solução bicarbonatada de ácido acetilsalicílico no preparo intestinal de portadores de câncer colorretal é clinicamente possível. Abstract in english BACKGROUND: The implantation of viable exfoliated intraluminal tumour cells is the major cause of local recurrence in colorectal cancer. 11-28 Therefore, the bowel lumen wash with a tumoricidal agent has been recommended. 11-28 In previous study we observe that acetylsalicylic acid solution cause ne [...] oplastic cell death in vitro.31 PURPOSE: Assess the local effect of acetylsalicylic acid solution on the colonic mucosa of rabbits, in order to use this agent in the bowel lumen wash. METHODS: 20 rabbits were used. A vascular clamp was placed on the distal colon, followed by the instillation per rectum of 50 ml of acetylsalicylic acid solution or saline solution, according to the group. The euthanasia was performed immediately or later according to the group. RESULTS: The acetylsalicylic acid solution doesn't cause any injury on the colonic mucosa of rabbits. Conclusion: The use of acetylsalicylic acid solution in the bowel lumen wash seems clinically feasible.

  16. Innate mucosal-associated invariant T (MAIT) cells are activated in inflammatory bowel diseases.

    Science.gov (United States)

    Serriari, N-E; Eoche, M; Lamotte, L; Lion, J; Fumery, M; Marcelo, P; Chatelain, D; Barre, A; Nguyen-Khac, E; Lantz, O; Dupas, J-L; Treiner, E

    2014-05-01

    Inflammatory bowel diseases are characterized by a deregulated immune response targeting the gut bacterial flora. Mucosal-associated invariant T (MAIT) cells are major histocompatibility complex (MHC) class Ib-restricted innate-like lymphocytes with anti-bacterial functions. They display an effector/memory phenotype and are found in large numbers in the blood, mucosae and liver. They have also been implicated in inflammatory diseases such as multiple sclerosis. Therefore, we aimed to analyse the possible involvement of MAIT cells in Crohn's disease (CD) and ulcerative colitis (UC). To this end, a phenotypical and functional analysis of MAIT cells isolated from the blood of healthy subjects, CD and UC patients was undertaken. MAIT cells were also quantified in ileal biopsies of CD patients. The frequency of blood MAIT cells was specifically reduced in IBD patients compared with healthy donors, whereas it was dramatically greater in the inflamed versus healthy tissue. MAIT cells were activated as they expressed significantly more the Ki67 antigen, and this was accompanied by phenotypical changes such as increased expression of natural killer (NK)G2D and B and T lymphocyte attenuator (BTLA). Finally, in-vitro-activated MAIT cells from CD and UC patients secreted significantly more interleukin (IL)-17, together with a decreased interferon (IFN)-? in CD but an increased IL-22 in UC. These data show that MAIT cells are activated in IBD, which results in an increased recruitment towards the inflamed tissues, an altered phenotype and a switch in the pattern of cytokine secretion. This is the first demonstration that MAIT cells are immune players in IBD, whose precise functions in this context need to be addressed. PMID:24450998

  17. Candidiasis de la mucosa bucal: Revisión bibliográfica

    Scientific Electronic Library Online (English)

    Judy, Rodríguez Ortega; Josefa, Miranda Tarragó; Haydée, Morejón Lugones; Julio C, Santana Garay.

    2002-08-01

    Full Text Available Se presenta una revisión de la literatura actualizada de una de las enfermedades más frecuentes de la mucosa bucal y la afección micótica más común en esta localización: la candidiasis de la mucosa bucal. Se detallan los factores predisponentes generales y locales que favorecen la aparición de esta [...] alteración patológica como son los tratamientos prolongados con antibióticos, la diabetes, la anemia, la radioterapia y quimioterapia antineoplásicas, las drogas inmunosupresoras y el SIDA, entre otros. Se exponen las diferentes clasificaciones clínicas, según el criterio de distintos autores y el cuadro clínico de la enfermedad. Finalmente se presentan alternativas terapéuticas tanto en el campo de la medicina convencional como en el de la medicina tradicional y natural. Abstract in english This paper presents an updated literature review of one of the most frequent diseases in the oral mucosa and the most common mycotic affection in this site, i.e, oral mucosal candidiasis. The general and local predisposing factors that favor the occurrence of this pathological disorder such as exten [...] ded antibiotic treatments, diabetes, anemia, anti-neoplastic radiotherapy and chemotherapy, immunosuppresive drugs, AIDS, among others. Different clinical classifications, according to several authors´ criteria and the clinical picture of the disease, are stated. Finally, therapeutical options in the fields of conventional medicine and traditional and natural medicine are presented.

  18. Candidiasis de la mucosa bucal: Revisión bibliográfica

    Directory of Open Access Journals (Sweden)

    Judy Rodríguez Ortega

    2002-08-01

    Full Text Available Se presenta una revisión de la literatura actualizada de una de las enfermedades más frecuentes de la mucosa bucal y la afección micótica más común en esta localización: la candidiasis de la mucosa bucal. Se detallan los factores predisponentes generales y locales que favorecen la aparición de esta alteración patológica como son los tratamientos prolongados con antibióticos, la diabetes, la anemia, la radioterapia y quimioterapia antineoplásicas, las drogas inmunosupresoras y el SIDA, entre otros. Se exponen las diferentes clasificaciones clínicas, según el criterio de distintos autores y el cuadro clínico de la enfermedad. Finalmente se presentan alternativas terapéuticas tanto en el campo de la medicina convencional como en el de la medicina tradicional y natural.This paper presents an updated literature review of one of the most frequent diseases in the oral mucosa and the most common mycotic affection in this site, i.e, oral mucosal candidiasis. The general and local predisposing factors that favor the occurrence of this pathological disorder such as extended antibiotic treatments, diabetes, anemia, anti-neoplastic radiotherapy and chemotherapy, immunosuppresive drugs, AIDS, among others. Different clinical classifications, according to several authors´ criteria and the clinical picture of the disease, are stated. Finally, therapeutical options in the fields of conventional medicine and traditional and natural medicine are presented.

  19. Pleiotropic effects of bombesin and neurotensin on intestinal mucosa: Not just trefoil peptides

    Directory of Open Access Journals (Sweden)

    Stelios F Assimakopoulos, Chrisoula D Scopa, Vassiliki N Nikolopoulou, Constantine E Vagianos

    2008-06-01

    Full Text Available Bombesin and neurotensin are neuropeptides which exert a wide spectrum of biological actions on gastrointestinal tissues influencing intestinal growth and adaptation, intestinal motility, blood flow, secretion, nutrient absorption and immune response. Based mainly on their well-established potent enterotrophic effect, numerous experimental studies investigated their potential positive effect on the atrophic or injured intestinal mucosa. These peptides proved to be effective mucosa-healing factors, but the potential molecular and cellular mechanisms for this action remained unresolved. In a recently published study (World J Gastroenterol 2008; 14(8: 1222-1230, it was shown that their protective effect on the intestine in experimentally induced inflammatory bowel disease was related to anti-inflammatory, antioxidant and antiapoptotic actions. These results are in close agreement with our previous studies on jaundiced and hepatectomized rats that showed a regulatory effect of bombesin and neurotensin on critical cellular processes such as enterocyte’ proliferation and death, oxidative stress and redox equilibrium, tight junctions’ formation and function, and inflammatory response. The pleiotropic effects of bombesin and neurotensin on diverse types of intestinal injury may justify their consideration for clinical trials.

  20. Preoperative bowel preparation in children: Polyethylene glycol versus normal saline

    Directory of Open Access Journals (Sweden)

    Ashok Kumar

    2013-01-01

    Full Text Available Background: Colorectal surgeries frequently require bowel preparation. In children, (is this standard of care?: this method is mostly followed this is usually performed using normal saline, which is very cumbersome and causes unnecessary discomfort. This study compared polyethylene glycol (PEG with normal saline for preoperative bowel preparation in children. Patients and Methods: Thirty patients, admitted in the Department of Paediatric Surgery, Rajindra Hospital, Patiala, for colonic and colorectal surgical procedures, were divided into two groups, I (PEG and II (NS, randomly for bowel preparation with PEG and normal saline, respectively. Results: It was found that there was no significant difference in the quality of preparation (P > 0.05, but PEG use was found to be easier, more comfortable and acceptable for the patients, their relatives and the hospital staff. Overall, complications are significantly lesser for PEG preparation (P < 0.05. There was no significant difference in the overall cost. Conclusion: Thus, it can be inferred that PEG may be a safe, cost-effective and acceptable option for large bowel preparation.

  1. Weight loss and morphometric study of intestinal mucosa in rats after massive intestinal resection: influence of a glutamine-enriched diet / Perda de peso e estudo morfométrico da mucosa intestinal de ratos submetidos à ressecção subtotal de intestino delgado: influência do uso de dieta com glutamina

    Scientific Electronic Library Online (English)

    Sidney Resende, Ribeiro; Paulo Engler, Pinto Júnior; Ariney Costa de, Miranda; Sansom Henrique, Bromberg; Fábio Pinatel, Lopasso; Kiyoshi, Irya.

    Full Text Available A síndrome do intestino curto é responsável por alterações metabólicas que comprometem o estado nutricional do paciente. A glutamina é nutriente essencial para os enterócitos. OBJETIVOS: Estudou-se o efeito da administração de dieta com glutamina, em ratos submetidos à ressecção subtotal do intestin [...] o delgado, avaliando a perda de peso pós-operatória e a morfometria da mucosa intestinal. MÉTODOS: Foram constituídos três grupos de ratos Wistar machos recebendo as seguintes dietas: com glutamina (grupo EG), sem glutamina (grupo EsG), e a dieta padrão do laboratório (grupo ER). A ressecção intestinal foi realizada em todos os animais incluindo-se a válvula íleo-cecal, com remanescente jejunal de apenas 25cm a partir do piloro, anastomosado látero-lateralmente ao cólon ascendente. A diferença entre o peso inicial real e ao final do experimento no 20º dia pós-operatório foi registrada antes do sacrifício. Fragmentos de mucosa do duodeno e jejuno foram colhidos e corados com hematoxilina-eosina. Realizou-se o estudo morfométrico da mucosa intestinal, por meio de sistema digital associado ao microscópio ótico. Mediu-se a altura das vilosidades, a profundidade das criptas e a extensão total da mucosa intestinal. RESULTADOS: A perda de peso entre os três grupos não diferiu estatisticamente. A análise da morfometria da mucosa intestinal mostrou diferença significativa: 1) animais do grupo Enterectomia com Glutamina (EG) apresentaram vilosidade duodenal significativamente maior que o grupo EsG (p Abstract in english Short-bowel syndrome is responsible for significant metabolic alterations that compromise nutritional status. Glutamine is considered an essential nutrient for enterocytes, so beneficial effects from supplementation of the diet with glutamine are hypothesized. PURPOSE: In this study, the effect of a [...] diet enriched with glutamine was evaluated in rats undergoing extensive small bowel resection, with analysis of postoperative weight loss and intestinal morphometrics of villi height, crypt depth, and thickness of the duodenal and remnant jejunal mucosa. METHODS: Three groups of male Wistar rats were established receiving the following diets: with glutamine, without glutamine, and the standard diet of laboratory ration. All animals underwent an extensive small bowel resection, including the ileocecal valve, leaving a remnant jejunum of only 25 cm from the pylorus that was anastomosed lateral-laterally to the ascendant colon. The animals were weighed at the beginning and end of the experiment (20th postoperative day). Then they were killed and the remnant intestine was removed. Fragments of duodenal and jejunal mucosa were collected from the remnant intestine and submitted to histopathologic exam. The morphometric study of the intestinal mucosa was accomplished using a digital system (KS 300) connected to an optic microscope. Morphometrics included villi height, crypt depth, and the total thickness of intestinal mucosa. RESULTS: The weight loss comparison among the 3 groups showed no significant loss difference. The morphometric studies showed significantly taller duodenal villi in the glutamine group in comparison to the without glutamine group, but not different from the standard diet group. The measurements obtained comparing the 3 groups for villi height, crypt depth, and thickness of the remnant jejunum mucosa were greater in the glutamine-enriched diet group than for the without-glutamine diet group, though not significantly different from with standard-diet group. CONCLUSIONS: In rats with experimentally produced short-bowel syndrome, glutamine-enrichment of an isonitrogenous test diet was associated with an improved adaptation response by the intestinal mucosa but not reduced weight loss. However, the adaptation response in the group receiving the glutamine-enriched diet was not improved over that for the group fed regular chow.

  2. Biomarkers of Inflammatory Bowel Disease

    OpenAIRE

    Yi Fengming; Wu Jianbing

    2014-01-01

    Inflammatory bowel disease (IBD) is a chronic disease mostly involved with intestine with unknown etiology. Diagnosis, evaluation of severity, and prognosis are still present as challenges for physicians. An ideal biomarker with the characters such as simple, easy to perform, noninvasive or microinvasive, cheap, rapid, and reproducible is helpful for patients and clinicians. Currently biomarkers applied in clinic include CRP, ESR, pANCA, ASCA, and fecal calprotectin. However, they are far fro...

  3. Short bowel syndrome in adults

    DEFF Research Database (Denmark)

    Matarese, Laura E; Jeppesen, Palle B; O'Keefe, Stephen J D

    2014-01-01

    Short bowel syndrome (SBS) is a heterogeneous disorder with broad variation in disease severity arising from different types of intestinal resection. The spectrum of malabsorption ranges from intestinal insufficiency to intestinal failure. Individualized patient strategies involving modifications of dietary macro- and micronutrients, fluid, and pharmacologic options are required to maximize health and quality-of-life outcomes and to minimize complications and SBS-associated mortality. Intestinal...

  4. Inflammatory bowel disease and osteoporosis

    DEFF Research Database (Denmark)

    Andreassen, Hans Steen; Rungby, J; Dahlerup, Jens Frederik; Mosekilde, L

    1997-01-01

    The relation between inflammatory bowel disease (IBD) and osteoporosis has received increasing attention during the past decade. The prevalence of low bone mass in patients with IBD has been reported to be more than 50%. The development of a quick non-invasive method to diagnose osteoporosis (dual-energy X-ray absorptiometry) provides a practical tool to identify the patient who needs special attention. The aetiology of the bone disease in patients with IBD has still not been elucidated, but cor...

  5. Adhesive bowel obstruction? Not always

    OpenAIRE

    Mittapalli D; Sebastian B; Leung E; Barnes N; Senapati P S P

    2011-01-01

    A 58-year-old man presented acutely with features of post-surgical adhesive small bowel obstruction. Following an unsuccessful trial of conservative management, computed tomography (CT) of the abdomen was performed. This revealed a mass in the ileocaecal region, for which he underwent a subsequent right hemicolectomy. Histology revealed diffuse B-cell Non-Hodgkin?s lymphoma of the terminal ileum. Confounding obstructive lesion of the intestine in patients with a history of previous lap...

  6. An unusual white blood cell scan in a child with inflammatory bowel disease: a case report.

    Science.gov (United States)

    Porn, U; Howman-Giles, R; O'Loughlin, E; Uren, R; Chaitow, J

    2000-10-01

    Technetium-99m-labeled leukocyte (WBC) imaging is a valuable screening method for inflammatory bowel disease, especially in children, because of its high rate of sensitivity, low cost, and ease of preparation. A 14-year-old girl is described who had juvenile arthritis and iritis complicated by inflammatory bowel disease. She was examined for recurrent abdominal pain. A Tc-99m stannous colloid WBC scan was performed, and tracer accumulation was seen in the small bowel in the region of the distal ileum on the initial 1-hour image. Delayed imaging at 3 hours also revealed tracer accumulation in the cecum and ascending colon, which was not seen on the early image. A biopsy of the colon during endoscopy showed no evidence of active inflammation in the colon. The small bowel was not seen. Computed tomography revealed changes suggestive of inflammatory bowel disease in the distal ileum. The appearance on the WBC study was most likely a result of inflammatory bowel disease involving the distal ileum, with transit of luminal activity into the large bowel. PMID:11043720

  7. Neurostimulation for neurogenic bowel dysfunction

    DEFF Research Database (Denmark)

    WorsØe, J; Rasmussen, Mikkel Mylius

    2013-01-01

    Background. Loss of normal bowel function caused by nerve injury, neurological disease or congenital defects of the nervous system is termed neurogenic bowel dysfunction (NBD). It usually includes combinations of fecal incontinence, constipation, abdominal pain and bloating. When standard treatment of NBD fails surgical procedures are often needed. Neurostimulation has also been investigated, but no consensus exists about efficacy or clinical use. Methods. A systematic literature search of NBD treated by sacral anterior root stimulation (SARS), sacral nerve stimulation (SNS), peripheral nerve stimulation, magnetic stimulation, and nerve re-routing was made in Pubmed, Embase, Scopus, and the Cochrane Library. Results. SARS improves bowel function in some patients with complete spinal cord injury (SCI). Nerve re-routing is claimed to facilitate defecation through mechanical stimulation of dermatomes in patients with complete or incomplete SCI or myelomeningocele. SNS can reduce NBD in selected patients with a variety of incomplete neurological lesions. Peripheral stimulation using electrical stimulation or magnetic stimulation may represent non-invasive alternatives. Conclusion. Numerous methods of neurostimulation to treat NBD have been investigated in pilot studies or retrospective studies. Therefore, larger controlled trials with well-defined inclusion criteria and endpoints are recommended before widespread clinical use of neurostimulation against NBD.

  8. Internal hernia and small bowel obstruction following open ileoanal pouch formation: A case report

    Directory of Open Access Journals (Sweden)

    H.S. Nair

    2015-01-01

    Conclusion: The case presented highlights the difficulty in making the diagnosis, and the pictures clearly indicate an unusual hernia passing directly behind the stomach and involving a large section of the small bowel. The lead up history of several admissions with sub acute small bowel obstruction suggested the underlying problem was adhesional but quite clearly there was a well defined internal hernia. Without timely surgery she would have been at high risk of losing her pouch.

  9. Studies of the immunoglobulin-producing cells of the human intestine: the defunctioned bowel.

    OpenAIRE

    Wijesinha, S S; Steer, H. W.

    1982-01-01

    An indirect immunoperoxidase method was used to visualise immunoglobulin-containing cells in the large intestinal mucosa of 10 children who had defunctioning colostomies. Intestine deprived of its usual exposure to intraluminal antigens contained less immunocytes per unit area than intestinal mucosa subjected to normal stimulation by dietary and microbial antigens. These findings substantiate in man the conclusion based on observations made on animals that continued mucosal exposure to antige...

  10. From bowel to kidneys

    DEFF Research Database (Denmark)

    Christensen, Erik Ilsø; Nielsen, Rikke; Birn, Henrik

    2013-01-01

    Cubilin is a large endocytic receptor serving such diverse functions as the intestinal absorption of the intrinsic factor-B(12) complex and the renal proximal tubule reabsorption of filtered proteins including albumin, transferrin, vitamin D-binding protein and other important plasma carriers. Cubilin is a structurally unique, peripheral membrane protein, which depends on the membrane protein amnionless (AMN) for correct apical translocation. In addition, AMN appears important for efficient inte...

  11. Anorexia nervosa complicating inflammatory bowel disease.

    OpenAIRE

    Mallett, P; Murch, S

    1990-01-01

    Two cases of inflammatory bowel disease, occurring in adolescence and complicated by anorexia nervosa, are presented. The management of the bowel disease with corticosteroids appeared to precipitate the eating disorder in one case whereas covert withdrawal of steroid treatment led to life threatening complications of inflammatory bowel disease in the other. The difficulties of managing two serious conditions, each ideally treated in a specialist centre, are discussed and the dangers of treati...

  12. Diet and risk of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Andersen, Vibeke; Olsen, Anja; Carbonnel, Franck; Tjønneland, Anne; Vogel, Ulla Birgitte

    2012-01-01

    Background: A better understanding of the environmental factors leading to inflammatory bowel disease should help to prevent occurrence of the disease and its relapses. Aim: To review current knowledge on dietary risk factors for inflammatory bowel disease. Methods: The PubMed, Medline and Cochrane Library were searched for studies on diet and risk of inflammatory bowel disease. Results: Established non-diet risk factors include family predisposition, smoking, appendectomy, and antibiotics. Retr...

  13. Diet and risk of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Andersen, Vibeke; Olsen, Anja; Carbonnel, Franck; Tjønneland, Anne; Vogel, Ulla Birgitte

    2012-01-01

    BACKGROUND: A better understanding of the environmental factors leading to inflammatory bowel disease should help to prevent occurrence of the disease and its relapses. AIM: To review current knowledge on dietary risk factors for inflammatory bowel disease. METHODS: The PubMed, Medline and Cochrane Library were searched for studies on diet and risk of inflammatory bowel disease. RESULTS: Established non-diet risk factors include family predisposition, smoking, appendectomy, and antibiotics. Retr...

  14. Updates on treatment of irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Christopher W Hammerle, Christina M Surawicz

    2008-05-01

    Full Text Available Irritable bowel syndrome (IBS is a highly prevalent gastrointestinal disorder characterized by abdominal pain and discomfort in association with altered bowel habits. It is estimated to affect 10%-15% of the Western population, and has a large impact on quality of life and (indirect healthcare costs. IBS is a multifactorial disorder involving dysregulation within the brain-gut axis, and it is frequently associated with gastrointestinal motor and sensory dysfunction, enteric and central nervous system irregularities, neuroimmune dysregulation, and post-infectious inflammation. As with other functional medical disorders, the treatment for IBS can be challenging. Conventional therapy for those with moderate to severe symptoms is largely unsatisfactory, and the development of new and effective drugs is made difficult by the complex pathogenesis, variety of symptoms, and lack of objective clinical findings that are the hallmark of this disorder. Fortunately, research advances over the past several decades have provided insight into potential mechanisms responsible for the pathogenesis of IBS, and have led to the development of several promising pharmaceutical agents. In recent years there has been much publicity over several of these new IBS medications (alosetron and tegaserod because of their reported association with ischemic colitis and cardiovascular disease. While these agents remain available for use under restricted prescribing programs, this highlights the need for continued development of safe and effective medication for IBS. This article provides a physiologically-based overview of recently developed and frequently employed pharmaceutical agents used to treat IBS, and discusses some non-pharmaceutical options that may be beneficial in this disorder.

  15. Mucosal bacterial microflora and mucus layer thickness in adolescents with inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Krzysztof Fyderek, Magdalena Strus, Kinga Kowalska-Duplaga, Tomasz Gosiewski, Andrzej W?drychowicz, Urszula Jedynak-W?sowicz, Ma?gorzata S?adek, Stanis?aw Pieczarkowski, Pawe? Adamski, Piotr Kochan, Piotr B Heczko

    2009-11-01

    Full Text Available AIM: To assess the mucosa-associated bacterial microflora and mucus layer in adolescents with inflammatory bowel disease (IBD.METHODS: Sixty-one adolescents (mean age 15 years, SD ± 4.13 were included in the study. Intestinal biopsies from inflamed and non-inflamed mucosa of IBD patients and from controls with functional abdominal pain were cultured under aerobic and anaerobic conditions. The number of microbes belonging to the same group was calculated per weight of collected tissue. The mucus thickness in frozen samples was measured under a fluorescent microscope.RESULTS: The ratios of different bacterial groups in inflamed and non-inflamed mucosa of IBD patients and controls were specific for particular diseases. Streptococcus spp. were predominant in the inflamed mucosa of Crohn’s disease (CD patients (80% of all bacteria, and Lactobacillus spp. were predominant in ulcerative colitis patients (90%. The differences were statistically significant (P = 0.01-0.001. Lower number of bifidobacteria was observed in the whole IBD group. A relation was also found between clinical and endoscopic severity and decreased numbers of Lactobacillus and, to a lesser extent, of Streptococcus in biopsies from CD patients. The mucus layer in the inflamed sites was significantly thinner as compared to controls (P = 0.0033 and to non-inflamed areas in IBD patients (P = 0.031.CONCLUSION: The significantly thinner mucosa of IBD patients showed a predominance of some aerobes specific for particular diseases, their numbers decreased in relation to higher clinical and endoscopic activity of the disease.

  16. CT findings in acute small bowel diverticulitis

    International Nuclear Information System (INIS)

    Small bowel diverticulitis is a rare cause of an acute abdomen. Originating from acquired diverticula of the jejunum, less often of the ileum, or Meckel diverticulum, the symptoms are non-specific, simulating other acute inflammatory disorders, such as appendicitis, cholecystitis or colonic diverticulitis. The diagnosis of small bowel diverticulitis is solely based on radiologic findings, with computed tomography (CT) regarded as the method of choice. In recent years, a number of case reports have described the spectrum of the CT features in acute small bowel diverticulitis and its dependence on the severity of the inflammatory process. Typical findings are an inflamed diverticulum, inflammatory mesenteric infiltration, extraluminal gas collection and mural edema of adjacent small bowel loops with resultant separation of bowel loops. An enterolith is rarely found in an inflamed diverticulum. Complications include abscesses, fistulae, small bowel obstruction and free perforation with peritonitis. Small bowel diverticulitis can be a diagnostic problem if it involves the terminal ileum or Meckel's diverticulum. For preoperative confirmation of the presumed diagnosis of small bowel diverticulitis on CT, an enteroclysis for acquired diverticula or a technetium scan for Meckel's diverticulum should be performed. We present the CT findings in three patients of acute small bowel diverticulitis, two affecting the jejunum and one a Meckel's diverticulum. (orig.)

  17. Inactivation of corticosteroids in intestinal mucosa by 11 beta-hydroxysteroid: NADP oxidoreductase (EC 1.1.1.146)

    International Nuclear Information System (INIS)

    Activity of the enzyme 11 beta-hydroxysteroid:NADP oxidoreductase (EC 1.1.1.146) in human intestinal mucosa was determined by incubating scraped mucosa with 3H-cortisone and 14C-cortisol; these steroids were then extracted, separated chromatographically, and the radioactivity assayed to determine simultaneously both reductase and dehydrogenase activities. This was the only significant metabolic alteration which the substrate underwent. Only two cases had slight (5 and 13%) reductase activity. In 35 patients, 16 male and 19 female, including seven cases of Crohn's disease, three ulcerative colitis, five diverticulitis, two undergoing surgery for repair of injuries and 18 for carcinoma of colon or rectum, cortisol was converted to cortisone in 15 min with a wide range of values distributed uniformly up to 85% dehydrogenation, with a mean of 42%. When tissue homogenates were fortified with coenzymes, excess NADPH lowered dehydrogenase activity 81%; excess NADP increased dehydrogenase activity 2-fold in three cases. It is possible that a value is characteristic of an individual but perhaps more likely enzyme activity varies with metabolic events involving changes in the coenzyme levels in mucosa, and a random sampling might be expected to yield such a distribution of values. In any event, where activity is high most of the cortisol is inactivated within minutes. It is suggested that synthetic corticoids which escape such metabolic alteration might, except during pregnancy, prove superior in the treatment of conditions such as inflammatory bowel disease

  18. Inactivation of corticosteroids in intestinal mucosa by 11 beta-hydroxysteroid: NADP oxidoreductase (EC 1. 1. 1. 146)

    Energy Technology Data Exchange (ETDEWEB)

    Burton, A.F.; Anderson, F.H.

    1983-10-01

    Activity of the enzyme 11 beta-hydroxysteroid:NADP oxidoreductase (EC 1.1.1.146) in human intestinal mucosa was determined by incubating scraped mucosa with /sup 3/H-cortisone and /sup 14/C-cortisol; these steroids were then extracted, separated chromatographically, and the radioactivity assayed to determine simultaneously both reductase and dehydrogenase activities. This was the only significant metabolic alteration which the substrate underwent. Only two cases had slight (5 and 13%) reductase activity. In 35 patients, 16 male and 19 female, including seven cases of Crohn's disease, three ulcerative colitis, five diverticulitis, two undergoing surgery for repair of injuries and 18 for carcinoma of colon or rectum, cortisol was converted to cortisone in 15 min with a wide range of values distributed uniformly up to 85% dehydrogenation, with a mean of 42%. When tissue homogenates were fortified with coenzymes, excess NADPH lowered dehydrogenase activity 81%; excess NADP increased dehydrogenase activity 2-fold in three cases. It is possible that a value is characteristic of an individual but perhaps more likely enzyme activity varies with metabolic events involving changes in the coenzyme levels in mucosa, and a random sampling might be expected to yield such a distribution of values. In any event, where activity is high most of the cortisol is inactivated within minutes. It is suggested that synthetic corticoids which escape such metabolic alteration might, except during pregnancy, prove superior in the treatment of conditions such as inflammatory bowel disease.

  19. Harvesting oral mucosa for one-stage anterior urethroplasty

    OpenAIRE

    Kulkarni, Sanjay Balwant; Barbagli, Guido; Sansalone, Salvatore; Joshi, Pankaj Mangalkumar

    2014-01-01

    Oral mucosa has been the most popular substitute material for urethral reconstructive surgery because it is easy to harvest, is easy to access, has a concealed donor site scar, and obviates most of the problems associated with other grafts. However, the success of using oral mucosa for urethral surgery is mainly attributed to the biological properties of this tissue. Herein, the surgical steps of harvesting oral mucosa from the inner cheek are presented with an emphasis on tips and tricks to ...

  20. Intestino Corto Short bowel syndrome

    Directory of Open Access Journals (Sweden)

    María Matilde Socarrás Suárez

    2004-06-01

    Full Text Available El intestino corto está asociado a pérdida o disfunción del intestino delgado por resección del mismo, que causa diarreas, tránsito intestinal acelerado, malabsorción intestinal, y eventualmente la pérdida de peso y el desgaste muscular. El objetivo de este trabajo fue actualizar el conocimiento acerca de este síndrome. Se realiza una revisión del tema de intestino corto donde se refiere a su definición, causas fundamentales frecuentes e infrecuentes en el niño y en el adulto, cómo se adapta el intestino a la resección de diferentes extensiones, las funciones del íleon terminal. Se hacen una valoración clínica inicial, con el interrogatorio médico, revisión minuciosa de la historia clínica para cuantificar la capacidad de absorción. Se habla de los síntomas y signos de deficiencia nutricional. Se explican las estrategias del tratamiento, que tienen 3 etapas de evolución clínica. Se concluye que se indica la dietoterapia adecuada según el estado nutricional del paciente y la resección intestinal realizada, evitando las complicaciones para lograr una calidad máxima de vidaShort bowel is associated with loss or dysfunction of the small bowel due to its resection, which causes diarrheas, accelerated intestinal transit, intestinal malabsorption and, eventually, weight loss ansd muscular waste. The objective of this paper was to update knowledge about this syndrome. A review of the short intestine topic is made, making reference to its definition, common and uncommon main cuases in the child and adult, how the bowel adapts itslef to resection of different extensions, and the functions of the terminal ileum. An initial clinical assessment is made with the medical questionnaire and a detailed review of the medical history to quantify the absorption capacity. The symptoms and signs of nutritional deficiency are dealt with. The strategies of the treatment consisting of 3 stages of clinical evolution are explained. It is concluded that the adequate diet therapy is indicated according to the nutritional state of the patient and the performed intestinal resections, preventing complications to achieve a maximum quality of life

  1. Honey and Apoptosis in Human Gastric Mucosa

    Directory of Open Access Journals (Sweden)

    Alireza Ostadrahimi

    2012-07-01

    Full Text Available Background: Gastric cancer is the fourth most common malignancy in the world. Honey is acomplex mixture of special biological active constituents. Honey possesses antioxidant and antitumorproperties. Nutritional studies have indicated that consumption of honey modulates therisk of developing gastric cancer. On the other hand, apoptosis has been reported to play a decisiverole in precancerous changes. Our chief study was conducted to assess the relationship betweenconsumption of honey and apoptosis in human gastric mucosa.Method: This cross-sectional study was conducted on 98 subjects over 18 years old, referred totwo hospitals in Tabriz, Iran. Subjects were undergone an upper gastrointestinal endoscopy, 62subjects were finally enrolled. Honey consumption was assessed by a Food Frequency Questionnaire(FFQ and apoptosis was detected by TUNEL technique. We tested polynomial curve tofind the best fit between honey consumption and apoptosis.Results: A positive relation between honey consumption and apoptosis was found (P=0.024.Our results indicated that the final and the best fit curve was: apoptosis = 1.714+1.648(honeyamount - 0.533(honey amount2 +1.833×10-5(honey amount7.Conclusion: Honey consumption had positive effects on gastric cancer by inducing apoptosis ingastric mucosa.

  2. Small bowel obstruction caused by dried apple

    OpenAIRE

    Ooi, Sally; Hong, Khiem

    2015-01-01

    •Small bowel obstruction in a virgin abdomen can be caused by food bezoar such as rehydrated fruits.•Dried apple has a potential to reabsorb fluid and expand up to 35% of its initial size within 72 h.•The most common site of small bowel obstruction is proximal to ileocecal valve.

  3. Epidemiology and inflammatory bowel diseases

    Directory of Open Access Journals (Sweden)

    Ahmed Mahmoud El-Tawil

    2013-01-01

    Full Text Available The role of alcohol in causing or aggravating the pathogenesis of inflammatory bowel disease is unclear. For finding a conclusive answer for this valuable question we conducted this review. Only two studies were identified that successfully fulfilled our inclusive criteria. Usual consumption of alcohol reduced the risk compared with less frequent use (odds ratio = 0.57, 95%CI: 0.37-0.86. Light alcoholic drinking has protective effects against development of ulcerative colitis. But this inverse association disappeared when smoking was included.

  4. Adhesive bowel obstruction? Not always

    Science.gov (United States)

    Mittapalli, D; Sebastian, B J; Leung, E; Barnes, N; Senapati, P S P

    2011-01-01

    A 58-year-old man presented acutely with features of post-surgical adhesive small bowel obstruction. Following an unsuccessful trial of conservative management, computed tomography (CT) of the abdomen was performed. This revealed a mass in the ileocaecal region, for which he underwent a subsequent right hemicolectomy. Histology revealed diffuse B-cell Non-Hodgkin’s lymphoma of the terminal ileum. Confounding obstructive lesion of the intestine in patients with a history of previous laparotomy is extremely uncommon. Early high resolution imaging may predict diagnosis and consolidate clinical management plans. PMID:21633584

  5. Adhesive bowel obstruction? Not always

    Directory of Open Access Journals (Sweden)

    Mittapalli D

    2011-01-01

    Full Text Available A 58-year-old man presented acutely with features of post-surgical adhesive small bowel obstruction. Following an unsuccessful trial of conservative management, computed tomography (CT of the abdomen was performed. This revealed a mass in the ileocaecal region, for which he underwent a subsequent right hemicolectomy. Histology revealed diffuse B-cell Non-Hodgkin?s lymphoma of the terminal ileum. Confounding obstructive lesion of the intestine in patients with a history of previous laparotomy is extremely uncommon. Early high resolution imaging may predict diagnosis and consolidate clinical management plans.

  6. Computed tomography of the whole bowel in patients suspected of Crohn's disease. Preliminary report - assessment of examination technique and image quality

    International Nuclear Information System (INIS)

    Evaluation of the usefulness of new technique - computed tomography (CT) of the whole bowel in patients with Crohn's disease and correlation of obtained images with other modalities (MR of the bowel, enteroclysis, barium enema, colonoscopy) and operation results. CT examination was performed in 20 patients suspected of having Crohn's disease, which was confirmed in 16 cases. CT was performed after filling small bowel with fluid administered by catheter placed in duodenum (in 10 patients) or orally (in 10 patients), distension of large bowel with air and intravenous injection of contrast material. Distension of small bowel was assessed in both groups by two radiologists. In 7 patients immediately after CT examination MR of the bowel was performed with contrast enhanced T1-weighted images. Distension of small bowel was better in patients examined after administration of fluid directly to duodenum, although the difference was not statistically significant. In 16 CT studies performed in patients with confirmed Crohn's disease all narrowed bowel segments (n = 25) were diagnosed and extraintestinal abnormalities were visualized (thickening of the mesenteries, enlarged lymph nodes, perirectal changes, abscess, fistula). In 7 patients examined by MR 2 of 10 narrowing (20%) were not diagnosed. CT of the whole bowel is promising method in diagnosis of patients with Crohn's disease. The best views of the small bowel were obtained with the use of CT enteroclysis. (author)

  7. Histamine, mast cells, and the enteric nervous system in the irritable bowel syndrome, enteritis, and food allergies

    OpenAIRE

    Wood, J D

    2006-01-01

    There is altered expression of histamine H1 and H2 receptor subtypes in mucosal biopsies from the terminal ileum and large intestine of patients with symptoms of food allergy and/or irritable bowel syndrome

  8. Diclofenac sodium and Imipenem action on rat intestinal mucosa: a biomechanical and histological study Ação do Diclofenaco de sódio e Imipenem na mucosa intestinal do rato: estudo biomecânico e histológico

    Directory of Open Access Journals (Sweden)

    Irio Gonçalves Junior

    2012-02-01

    Full Text Available PURPOSE: To study diclofenac sodium induced histological and mechanical alterations and their prevention with Imipenem in rat intestine. METHODS: Male Wistar rats (n=240 were randomly assigned to four experimental groups: GI: n=60 treated with 0.9% saline IM; GII: n=60 treated with 6mg/kg body weight diclofenac sodium IM for four days; GIII: n=60 treated with 30mg/kg body weight Imipenem IM for four days, and GIV n=60 treated with diclofenac sodium plus Imipenem at the above doses IM for 4 days. Each group was further divided into 4 subgroups of 15 rats each and sacrificed at 4, 7, 14, and 21 days of follow-up, respectively. Abdominal cavity macroscopy and histology, and small bowel breaking strength were analyzed at each sacrifice moment. RESULTS: There were no histological or mechanical alterations in normal control rats throughout the study. Ulcerated lesions in intestinal mucosa were observed and breaking strength decreased in all diclofenac sodium treated rats. Ulcerated lesions in intestinal mucosa were prevented by Imipenem in all rats. CONCLUSION: Diclofenac sodium induced ulcerated lesions in rat intestinal mucosa can be prevented by Imipenem treatment.OBJETIVO: Avaliar as alterações histológicas e biomecânicas do diclofenaco de sódio na mucosa intestinal do rato e a associação com o uso de Imipenem. MÉTODOS: Foram estudados 240 ratos Wistar distribuídos aleatoriamente em quatro grupos experimentais: GI: 60 ratos tratados com injeção IM de soro fisiológico 0,9%; GII: 60 ratos tratados com injeção IM de diclofenaco de sódio na dose de 6mg/kg de peso por 4 dias; GIII: 60 ratos tratados com injeção IM de Imipenem na dose de 30 mg/kg de peso por 4 dias; GIV: 60 ratos tratados com injeção IM de soro fisiológico e diclofenaco de sódio nas doses acima. Em cada grupo os animais foram posteriormente divididos em 4 momentos de 15 animais em cada um para sacrifício, respectivamente, no 4º, 7º, 14º e 21º dias após o início do tratamento. As alterações da cavidade abdominal, assim como as características histológicas e de força de ruptura do intestino delgado foram analisadas em cada momento, em cada grupo. RESULTADOS: Não foram encontradas alterações histológicas e biomecânicas nos animais do Grupo I nesse estudo. Lesões ulceradas na mucosa do intestino delgado foram observadas nos animais tratados com diclofenaco de sódio, assim como diminuição da força de ruptura. As lesões ulceradas encontradas foram prevenidas pelo uso de Imipenem. CONCLUSÃO: O diclofenaco de sódio induz lesões ulceradas na mucosa intestinal do rato que podem ser prevenidas pelo uso de Imipenem.

  9. Diclofenac sodium and Imipenem action on rat intestinal mucosa: a biomechanical and histological study / Ação do Diclofenaco de sódio e Imipenem na mucosa intestinal do rato: estudo biomecânico e histológico

    Scientific Electronic Library Online (English)

    Irio, Gonçalves Junior; Luiz Eduardo, Naresse; Maria Aparecida Marchesan, Rodrigues; Shoiti, Kobayasi.

    2012-02-01

    Full Text Available OBJETIVO: Avaliar as alterações histológicas e biomecânicas do diclofenaco de sódio na mucosa intestinal do rato e a associação com o uso de Imipenem. MÉTODOS: Foram estudados 240 ratos Wistar distribuídos aleatoriamente em quatro grupos experimentais: GI: 60 ratos tratados com injeção IM de soro fi [...] siológico 0,9%; GII: 60 ratos tratados com injeção IM de diclofenaco de sódio na dose de 6mg/kg de peso por 4 dias; GIII: 60 ratos tratados com injeção IM de Imipenem na dose de 30 mg/kg de peso por 4 dias; GIV: 60 ratos tratados com injeção IM de soro fisiológico e diclofenaco de sódio nas doses acima. Em cada grupo os animais foram posteriormente divididos em 4 momentos de 15 animais em cada um para sacrifício, respectivamente, no 4º, 7º, 14º e 21º dias após o início do tratamento. As alterações da cavidade abdominal, assim como as características histológicas e de força de ruptura do intestino delgado foram analisadas em cada momento, em cada grupo. RESULTADOS: Não foram encontradas alterações histológicas e biomecânicas nos animais do Grupo I nesse estudo. Lesões ulceradas na mucosa do intestino delgado foram observadas nos animais tratados com diclofenaco de sódio, assim como diminuição da força de ruptura. As lesões ulceradas encontradas foram prevenidas pelo uso de Imipenem. CONCLUSÃO: O diclofenaco de sódio induz lesões ulceradas na mucosa intestinal do rato que podem ser prevenidas pelo uso de Imipenem. Abstract in english PURPOSE: To study diclofenac sodium induced histological and mechanical alterations and their prevention with Imipenem in rat intestine. METHODS: Male Wistar rats (n=240) were randomly assigned to four experimental groups: GI: n=60 treated with 0.9% saline IM; GII: n=60 treated with 6mg/kg body weig [...] ht diclofenac sodium IM for four days; GIII: n=60 treated with 30mg/kg body weight Imipenem IM for four days, and GIV n=60 treated with diclofenac sodium plus Imipenem at the above doses IM for 4 days. Each group was further divided into 4 subgroups of 15 rats each and sacrificed at 4, 7, 14, and 21 days of follow-up, respectively. Abdominal cavity macroscopy and histology, and small bowel breaking strength were analyzed at each sacrifice moment. RESULTS: There were no histological or mechanical alterations in normal control rats throughout the study. Ulcerated lesions in intestinal mucosa were observed and breaking strength decreased in all diclofenac sodium treated rats. Ulcerated lesions in intestinal mucosa were prevented by Imipenem in all rats. CONCLUSION: Diclofenac sodium induced ulcerated lesions in rat intestinal mucosa can be prevented by Imipenem treatment.

  10. Quantitative analysis of bowel gas by plain abdominal radiograph combined with computer image processing

    International Nuclear Information System (INIS)

    Objective: To establish a method for quantitative analysis of bowel gas by plain abdominal radiograph and computer graphics. Methods: Plain abdominal radiographs in supine position from 25 patients with irritable bowel syndrome (IBS) and 20 health controls were studied. A gastroenterologist and a radiologist independently conducted the following procedure on each radiograph. After the outline of bowel gas was traced by axe pen, the radiograph was digitized by a digital camera and transmitted to the computer with Histogram software. The total gas area was determined as the pixel value on images. The ratio of the bowel gas quantity to the pixel value in the region surrounded by a horizontal line tangential to the superior pubic symphysis margin, a horizontal line tangential to the tenth dorsal vertebra inferior margin, and the lateral line tangential to the right and left anteriosuperior iliac crest, was defined as the gas volume score (GVS). To examine the sequential reproducibility, a second plain abdominal radiograph was performed in 5 normal controls 1 week later, and the GVS were compared. Results: Bowel gas was easily identified on the plain abdominal radiograph. Both large and small intestine located in the selected region. Both observers could finish one radiographic measurement in less than 10 mins. The correlation coefficient between the two observers was 0.986. There was no statistical difference on GVS between the two sequential radiographs in 5 health controls. Conclusion: Quantification of bowel gas based on plain abdominal radiograph and computer is simple, rapid, and reliable

  11. Clostridium difficile Carriage Rate in Outpatients with Inflammatory Bowel Diseases

    Directory of Open Access Journals (Sweden)

    Mohammad Hosain Salari

    2013-10-01

    Full Text Available Abstract Background and objective: Closteridium difficile is a gram positive, anaerobic and spore-forming bacillus. Inflammatory bowel disease or IBD includes Crohn's disease and ulcerative colitis. Inflammation of the intestinal mucosa in these patients can be as a risk factor for colonization of Clostridium difficile. The purpose of this study was to analysis of Clostridium difficile carriage in the IBD outpatients. Materials and methods: Stool specimens were obtained from 50 outpatients with IBD. Stools were cultured on selective media under anaerobic conditions. Filtered extract of bacteria was exposed to HeLa cell culture for analysis of toxin production after identification of Clostridium difficile isolates. Results: The results showed that 3 IBD patients (6% had stool cultures positive for Clostridium difficile. Stool cultures were negative in all patients with Crohn's disease. All 3 patients had ulcerative colitis. Only one isolate was positive for toxin production. Conclusion: The ulcerated colitis than Crohn's patients had higher carriage. In general IBD outpatients carriage rates for Clostridium difficile was low.

  12. From intestinal stem cells to inflammatory bowel diseases

    Directory of Open Access Journals (Sweden)

    Michael Gersemann

    2011-01-01

    Full Text Available The pathogenesis of both entities of inflammatory bowel disease (IBD, namely Crohn’s disease (CD and ulcerative colitis (UC, is still complex and under investigation. The importance of the microbial flora in developing IBD is beyond debate. In the last few years, the focus has changed from adaptive towards innate immunity. Crohn’s ileitis is associated with a deficiency of the antimicrobial shield, as shown by a reduced expression and secretion of the Paneth cell defensin HD5 and HD6, which is related to a Paneth cell differentiation defect mediated by a diminished expression of the Wnt transcription factor TCF4. In UC, the protective mucus layer, acting as a physical and chemical barrier between the gut epithelium and the luminal microbes, is thinner and in part denuded as compared to controls. This could be caused by a missing induction of the goblet cell differentiation factors Hath1 and KLF4 leading to immature goblet cells. This defective Paneth and goblet cell differentiation in Crohn’s ileitis and UC may enable the luminal microbes to invade the mucosa and trigger the inflammation. The exact molecular mechanisms behind ileal CD and also UC must be further clarified, but these observations could give rise to new therapeutic strategies based on a stimulation of the protective innate immune system.

  13. New strategies for treatment of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Nielsen, Ole Haagen

    2014-01-01

    The etiology of inflammatory bowel disease (IBD), of which ulcerative colitis (UC) and Crohn's disease (CD) are the two most prevailing entities, is unknown. However, IBD is characterized by an imbalanced synthesis of pro-inflammatory mediators of the inflamed intestine, and for more than a decade tumor necrosis factor-(TNF) ? has been a major target for monoclonal antibody therapy. However, TNF inhibitors are not useful for one third of all patients (i.e. "primary failures"), and further one third lose effect over time ("secondary failures"). Therefore, other strategies have in later years been developed including monoclonal antibodies targeting the interleukin (IL)-6 family of receptors (the p40 subunit of IL-12/IL-23) as well as monoclonal antibodies inhibiting adhesion molecules (the ?4?7 heterodimers), which direct leukocytes to the intestinal mucosa. Recently, small molecules, which are inhibitors of Janus kinases (JAKs), hold promise with a tolerable safety profile and efficacy in UC, and the field of nanomedicine is emerging with siRNAs loaded into polyactide nanoparticles that may silence gene transcripts at sites of intestinal inflammation. Thus, drug development for IBD holds great promise, and patients as well as their treating physicians can be hopeful for the future.

  14. New treatment strategies for treatment of inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Ole HaagenNielsen

    2014-03-01

    Full Text Available The etiology of inflammatory bowel disease (IBD, of which ulcerative colitis (UC and Crohn’s disease (CD are the two most prevailing entities, is unknown. However, IBD is characterized by an imbalanced synthesis of pro-inflammatory mediators of the inflamed intestine, and for more than a decade tumour necrosis factor- (TNF ? has been a major target for monoclonal antibody therapy. However, TNF inhibitors are not useful for one third of all patients (i.e. “primary failures”, and further one third lose effect over time (“secondary failures”. Therefore other strategies have in later years been developed including monoclonal antibodies targeting the interleukin (IL-6 family of receptors (the p40 subunit of IL-12/IL-23 as well as monoclonal antibodies inhibiting adhesion molecules (the ?4?7 heterodimers, which direct leukocytes to the intestinal mucosa. Recently small molecules, which are inhibitors of Janus kinases (JAKs, hold promise with a tolerable safety profile and efficacy in UC, and the field of nanomedicine is emerging with siRNAs loaded into polyactide nanoparticles that may silence gene transcripts at sites of intestinal inflammation.Thus, drug development for IBD holds great promise, and patients as well as their treating physicians can be hopeful for the future.

  15. Physiological basis for novel drug therapies used to treat the inflammatory bowel diseases I. Pathophysiological basis and prospects for probiotic therapy in inflammatory bowel disease.

    LENUS (Irish Health Repository)

    Shanahan, Fergus

    2012-02-03

    Mechanisms underlying the conditioning influence of the intestinal flora on mucosal homeostasis, including development and function of immune responses, are attracting increasing scientific scrutiny. The intestinal flora is a positive asset to host defense, but some of its components may, in genetically susceptible hosts, become a risk factor for development of inflammatory bowel disease (IBD). It follows that strategies to enhance assets or offset microbial liabilities represent a therapeutic option; therein lies the rationale for manipulation of the flora in IBD. In addition, the diversity of regulatory signalling among the flora and host epithelum, lymphoid tissue, and neuromuscular apparatus is an untapped reservoir from which novel therapeutics may be mined. Moreover, the capacity to engineer food-grade or commensal bacteria to deliver therapeutic molecules to the intestinal mucosa promises to extend the scope of microbial manipulation for the benefit of mankind.

  16. Efecto del Tisuacryl sobre la mucosa oral

    Directory of Open Access Journals (Sweden)

    Gastón García-Simons

    2006-01-01

    Full Text Available Los ensayos estipulados para el registro de los equipos médico, biomateriales y materiales implantables están regidos por un conjunto de normas que regulan cuáles deben efectuarse. En dependencia del tipo de aplicaci ón que se pretende dar al material en estudio o el tiempo del contacto con el organismo, así será el rigor que se exija para la evaluación. Con el objetivo de ampliar a la zona de la boca las aplicaciones del adhesivo tisular compuesto por cianoacrilato de n-butilo, de fabricación nacional, Tisuacryl, se efectuó la evaluaci ón de la irritación que provoca el producto a la mucosa oral. Estos productos están constituidos entre otras cosas por monómeros de cianoacrilato de nbutilo, que polimerizan con facilidad por contacto con sustratos orgánicos e inorgánicos por lo que exigen un tratamiento especial para aplicar la metodología seleccionada sin invalidar el resultado de las evaluaciones. En los experimentos que se desarrollaron se pudo aplicar directamente la norma internacional vigente con la utilización de un circulo plástico para delimitar la zona de aplicación del adhesivo. En la evaluación macroscópica se encontró una irritación ligera según la puntuación obtenida y en la histológica se observó una irritación promedio de 3,4, lo que le confiere al producto una irritación mínima, aceptable para el uso en mucosa. No obstante los resultados, es recomendable ampliar el estudio incorporando ensayos que no recoge la norma vigente, tales como la evaluación del comportamiento del adhesivo frente a las enzimas bucales antes de su aplicación oral, pues se conoce que tales productos son degradados por dichas enzimas en un corto período. Esto permitiría obtener una informaci ón más completa acerca de la toxicidad del adhesivo.

  17. Intestino Corto / Short bowel syndrome

    Scientific Electronic Library Online (English)

    María Matilde, Socarrás Suárez; Miriam, Bolet Astoviza; Martha, Larrea Fabra.

    2004-06-01

    Full Text Available El intestino corto está asociado a pérdida o disfunción del intestino delgado por resección del mismo, que causa diarreas, tránsito intestinal acelerado, malabsorción intestinal, y eventualmente la pérdida de peso y el desgaste muscular. El objetivo de este trabajo fue actualizar el conocimiento ace [...] rca de este síndrome. Se realiza una revisión del tema de intestino corto donde se refiere a su definición, causas fundamentales frecuentes e infrecuentes en el niño y en el adulto, cómo se adapta el intestino a la resección de diferentes extensiones, las funciones del íleon terminal. Se hacen una valoración clínica inicial, con el interrogatorio médico, revisión minuciosa de la historia clínica para cuantificar la capacidad de absorción. Se habla de los síntomas y signos de deficiencia nutricional. Se explican las estrategias del tratamiento, que tienen 3 etapas de evolución clínica. Se concluye que se indica la dietoterapia adecuada según el estado nutricional del paciente y la resección intestinal realizada, evitando las complicaciones para lograr una calidad máxima de vida Abstract in english Short bowel is associated with loss or dysfunction of the small bowel due to its resection, which causes diarrheas, accelerated intestinal transit, intestinal malabsorption and, eventually, weight loss ansd muscular waste. The objective of this paper was to update knowledge about this syndrome. A re [...] view of the short intestine topic is made, making reference to its definition, common and uncommon main cuases in the child and adult, how the bowel adapts itslef to resection of different extensions, and the functions of the terminal ileum. An initial clinical assessment is made with the medical questionnaire and a detailed review of the medical history to quantify the absorption capacity. The symptoms and signs of nutritional deficiency are dealt with. The strategies of the treatment consisting of 3 stages of clinical evolution are explained. It is concluded that the adequate diet therapy is indicated according to the nutritional state of the patient and the performed intestinal resections, preventing complications to achieve a maximum quality of life

  18. Inmunología de la mucosa oral: Revisión Immunology of oral mucosa: A review

    Directory of Open Access Journals (Sweden)

    Zulema J. Casariego

    2012-10-01

    Full Text Available Durante los últimos 50 años numerosas publicaciones han tratado de explicar los cambios inmunológicos en relación con exclusivas o determinadas enfermedades. El objetivo de esta presentación es realizar una revisión sobre lo publicado hasta el momento sobre la respuesta del sistema inmune innato y adaptativo en relación con la mucosa oral, un panorama sobre el rol o roles de las células inmunes, citoquinas, receptores, factores de crecimiento y otros productos secretorios y el los distintos elementos inmunológicos que actúan sobre la mucosa oral asociados con los estados de salud, inflamación, stress crónico, desregulación inmune, longevidad tolerancia inmune e inmunosenescencia.During the last 50 years several papers have been put forward to explain induce immunological changes in relationship with exclusive or determinated oral diseases. The objective of this presentation is to make a rewie about what is published at the moment about of innated and adaptative immune response, in relationship with oral mucosa, and an overwie of the role (s of immune cells, cytoquines, receptors, grow factors, and other secretory products associated with health, inflammation, chronic stress, Immune dysregulation aging, inmuno tolerance and inmunosenescence.

  19. Inmunología de la mucosa oral: Revisión / Immunology of oral mucosa: A review

    Scientific Electronic Library Online (English)

    Zulema J., Casariego.

    2012-10-01

    Full Text Available Durante los últimos 50 años numerosas publicaciones han tratado de explicar los cambios inmunológicos en relación con exclusivas o determinadas enfermedades. El objetivo de esta presentación es realizar una revisión sobre lo publicado hasta el momento sobre la respuesta del sistema inmune innato y a [...] daptativo en relación con la mucosa oral, un panorama sobre el rol o roles de las células inmunes, citoquinas, receptores, factores de crecimiento y otros productos secretorios y el los distintos elementos inmunológicos que actúan sobre la mucosa oral asociados con los estados de salud, inflamación, stress crónico, desregulación inmune, longevidad tolerancia inmune e inmunosenescencia. Abstract in english During the last 50 years several papers have been put forward to explain induce immunological changes in relationship with exclusive or determinated oral diseases. The objective of this presentation is to make a rewie about what is published at the moment about of innated and adaptative immune respo [...] nse, in relationship with oral mucosa, and an overwie of the role (s) of immune cells, cytoquines, receptors, grow factors, and other secretory products associated with health, inflammation, chronic stress, Immune dysregulation aging, inmuno tolerance and inmunosenescence.

  20. Small-bowel permeability in collagenous colitis

    DEFF Research Database (Denmark)

    Wildt, Signe; Madsen, Jan L

    2006-01-01

    Collagenous colitis (CC) is a chronic inflammatory bowel disease that affects the colon. However, some patients with CC present with accompanying pathologic small-bowel manifestations such as coeliac disease, defects in bile acid absorption and histopathologic changes in small-intestinal biopsies, indicating that CC is a pan-intestinal disease. In small-intestinal disease, the intestinal barrier function may be impaired, and the permeability of the small intestine altered. The purpose of this research was to study small-bowel function in patients with CC as expressed by intestinal permeability.

  1. A Strange Case of Left Bowel Ischemia after Right Hernioplasty

    Science.gov (United States)

    Geraci, Girolamo; Pisello, Franco; Modica, Giuseppe; Li Volsi, Francesco; Cajozzo, Massimo; Sciumè, Carmelo

    2010-01-01

    We report the first observed case of a young man who suffered of large and unsuspected left bowel ischemia following an elective right open hernioplasty. A 54-year-old man had a 2-year history of right inguinal reducible mass and was admitted to hospital for an elective day case open inguinal hernioplasty for a direct right inguinal hernia. Apart from mild hypertension controlled with ACE inhibitor, he was medically fit and well. The patient was submitted to open tension-free mesh repair with polypropylene preshaped mesh with local infiltration anesthesia and additive sedation with midazolam. The local anesthesia and surgery were uneventful and he was discharged home on the same day as per day case protocol. He was readmitted about 12 h after discharge with a history of central and left lower abdominal pain with palpable mass, and distension and fever (38°C). After imaging and laboratory studies the patient was submitted to explorative surgery with the suspicion of left colonic ischemia. After intraoperative confirmation we performed standard left hemicolectomy. The postoperative course was uneventful; the patient was discharged in good general condition on the 7th postoperative day. Actually, the patient is in follow-up, with normal coagulation and hemochromocytometric pattern, asymptomatic for hypercholesterolemia and atrial flutter/fibrillation. Complications relating to bowel during open techniques of hernia repair are limited to two situations: the freeing of an incarcerated or strangulated segment of bowel and inadvertent laceration of large bowel in the presence of a sliding hernia. Following this strange case of colonic ischemia, a boolean Medline search (terms: hernia, complication, repair, groin, herniorrhaphy, hernioplasty, all major MESH subjects without language restriction) revealed no previous similar cases reported. However, to our knowledge, there is another trouble hypothesis: not causality but casualty. In conclusion, to our knowledge this is the first reported case of large left bowel ischemia following right open hernioplasty. We can conclude that the presence of a dolichocolon is an added risk factor for this rare and uneventful complication, but further investigations and case reports are necessary to estabilish the real causality. PMID:21103221

  2. Probiotics and irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Cong Dai

    2013-01-01

    Full Text Available Irritable bowel syndrome (IBS is common gastrointestinal problems. It is characterized by abdominal pain or discomfort, and is associated with changes in stool frequency and/or consistency. The etiopathogenesis of IBS may be multifactorial, as is the pathophysiology, which is attributed to alterations in gastrointestinal motility, visceral hypersensitivity, intestinal microbiota, gut epithelium and immune function, dysfunction of the brain-gut axis or certain psychosocial factors. Current therapeutic strategies are often unsatisfactory. There is now increasing evidence linking alterations in the gastrointestinal microbiota and IBS. Probiotics are living organisms which, when ingested in certain numbers, exert health benefits beyond inherent basic nutrition. Probiotics have numerous positive effects in the gastrointestinal tract. Recently, many studies have suggested that probiotics are effective in the treatment of IBS. The mechanisms of probiotics in IBS are very complex. The purpose of this review is to summarize the evidence and mechanisms for the use of probiotics in the treatment of IBS.

  3. Disturbances in small bowel motility.

    LENUS (Irish Health Repository)

    Quigley, E M

    2012-02-03

    Recently, the small intestine has become the focus of investigation as a potential site of dysmotility in the irritable bowel syndrome (IBS). A number of motor abnormalities have been defined in some studies, and include \\'clustered\\' contractions, exaggerated post-prandial motor response and disturbances in intestinal transit. The significance of these findings remains unclear. The interpretation of available studies is complicated by differences in subject selection, the direct influence of certain symptoms, such as diarrhoea and constipation, and the interference of compounding factors, such as stress and psychopathology. Dysmotility could also reflect autonomic dysfunction, disturbed CNS control and the response to heightened visceral sensation or central perception. While motor abnormalities may not explain all symptoms in IBS, sensorimotor interactions may be important in symptom pathogenesis and deserve further study.

  4. Bowel injuries secondary to induced abortion: a dilemma

    International Nuclear Information System (INIS)

    To study the pattern of bowel injuries incurred by induced abortion, and the morbidity and mortality associated with them. All patients with bowel injuries due to induced abortion. Detailed data of all the patients was collected and analyzed. A total of 22 patients, mostly young with an average age of 26.86 years, presented with bowel injuries following induced abortion. Severe hemorrhage occurred in 8(36.4%) patients while 11(50%) had ileal perforation; 9(40.9%) underwent primary repair and 2(9.1%) ileostomy formation. Two (9.1%) patients with jejunal perforation had primary repair, whereas two with both jejunal and ileal perforations underwent resections with anastomosis in one and ileostomy in another. Seven (31.8%) with large gut involvement had colostomy formation. Septicemia and wound infection occurred in 7(31.8%) patients each, faecal fistula and abdominal wound dehiscence in 3(13.6%), and pelvic abscess in 1(4.6%) patient. The total mortality in this series was 6(27.3%) patients. Iatrogenic injuries during induced abortion, most commonly caused by quacks, can be minimized substantially if the procedure is performed by qualified medical personnel in proper health care facilities. There is a need for radical overhauling of the mind set in our society together with legislation. (author)

  5. Crystal structure of the mucosa-associated lymphoid tissue lymphoma translocation 1 (MALT1) paracaspase region

    OpenAIRE

    Yu, Jong W.; Jeffrey, Philip D.; Ha, Jun Yong; Yang, Xiaolu; Shi, Yigong

    2011-01-01

    The mucosa-associated lymphoid tissue lymphoma translocation 1 (MALT1) paracaspase, a key component of the Carma1/Bcl10/MALT1 signalosome, is critical for NF-?B signaling in multiple contexts. MALT1 is thought to function as a scaffold and protease to promote signaling; however, the biochemical and structural basis of paracaspase action remains largely unknown. Here we report the 1.75-? resolution crystal structure of the MALT1 paracaspase region, which contains the paracaspase domain and an ...

  6. Changes of smooth muscle contractile filaments in small bowel atresia

    Directory of Open Access Journals (Sweden)

    Udo Rolle

    2012-01-01

    Full Text Available AIM: To investigate morphological changes of intestinal smooth muscle contractile fibres in small bowel atresia patients. METHODS: Resected small bowel specimens from small bowel atresia patients (n = 12 were divided into three sections (proximal, atretic and distal. Standard histology hematoxylin-eosin staining and enzyme immunohistochemistry was performed to visualize smooth muscle contractile markers ?-smooth muscle actin (SMA and desmin using conventional paraffin sections of the proximal and distal bowel. Small bowel from age-matched patients (n = 2 undergoing Meckel’s diverticulum resection served as controls. RESULTS: The smooth muscle coat in the proximal bowel of small bowel atresia patients was thickened compared with control tissue, but the distal bowel was unchanged. Expression of smooth muscle contractile fibres SMA and desmin within the proximal bowel was slightly reduced compared with the distal bowel and control tissue. There were no major differences in the architecture of the smooth muscle within the proximal bowel and the distal bowel. The proximal and distal bowel in small bowel atresia patients revealed only minimal differences regarding smooth muscle morphology and the presence of smooth muscle contractile filament markers. CONCLUSION: Changes in smooth muscle contractile filaments do not appear to play a major role in postoperative motility disorders in small bowel atresia.

  7. Effect of paclitaxel (TAXOL) alone and in combination with radiation on the gastrointestinal mucosa

    International Nuclear Information System (INIS)

    Paclitaxel is a potentially useful drug for augmenting the cytotoxic action of radiotherapy because it has independent cytotoxic activity against certain cancers and blocks cells in the radiosensitive mitotic phase of the cell cycle. However, all rapidly proliferating tissues, both normal and neoplastic, may be affected by this therapeutic strategy. The aim of this study was to define the in vivo response of rapidly dividing cells of the small bowel mucosa in mice to paclitaxel given alone and in combination with radiation. Paclitaxel blocked jejunal crypt cells in mitosis and induced apoptosis in a dose-dependent manner. Fractionating the paclitaxel dose over 1-4 days did not result in any greater accumulation of mitotically blocked cells than did a single dose. Mitosis peaked 2-4 h after paclitaxel and returned to near normal by 24 h. Apoptosis lagged several hours behind mitosis and peaked about 6 h later than mitosis. Despite these kinetic perturbations, there was little or no enhancement of radiation effect when single doses were delivered 2-4 h after paclitaxel administration. The maximum sensitizer enhancement ratio of 1.07 observed after a single paclitaxel dose of 40 mg/kg is consistent with independent crypt cell killing. Conversely, when radiation was given 24 h after paclitaxel, a significant protective effect of the drug (SER 0.89-0.92), most probably due to a regenerative overshoot induced by paclitaxel, was observed. Stem cells of the jejunal mucosa determining radiation response were not radiosensitized by paclitaxel with the drug concentrations and dose deliver schedules used, although additive cytotoxicity was observed with the highest drug dose. A radioprotective effect was observed when radiation was given 24 h after paclitaxel administration. 33 refs., 4 figs., 3 tabs

  8. Bowel dysfunction after rectal cancer treatment

    DEFF Research Database (Denmark)

    Chen, Tina Yen-Ting; Emmertsen, Katrine J; Laurberg, Søren

    2014-01-01

    To investigate how bowel dysfunction after sphincter-preserving rectal cancer treatment, known as low anterior resection syndrome (LARS), is perceived by rectal cancer specialists, in relation to the patient's experience.

  9. Magnetic resonance imaging of the small bowel

    International Nuclear Information System (INIS)

    Magnetic Resonance Imaging of the Small Bowel (MR Enterography, or MRE) is becoming increasingly popular as the first imaging modality for the diagnosis and follow-up of small bowel diseases. The inherent advantages of MRI, including excellent soft tissue contrast, multiplanar capability and lack of ionising radiation are well known. In addition, the use of luminal contrast agents in MRE has the added advantage of demonstrating the lumen and the wall directly, something not possible to achieve with conventional small bowel barium follow-through imaging. This review will highlight recent technical advances to this low cost, simple technique which is easily achievable in all hospitals. It will also review normal and abnormal radiological findings and highlight the value of this technique to both the clinician and patient alike in the investigation of small bowel disease.

  10. Neurogenic mechanisms in bladder and bowel ageing

    OpenAIRE

    Ranson, Richard N.; Saffrey, M.Jill

    2015-01-01

    The prevalence of both urinary and faecal incontinence, and also chronic constipation, increases with ageing and these conditions have a major impact on the quality of life of the elderly. Management of bladder and bowel dysfunction in the elderly is currently far from ideal and also carries a significant financial burden. Understanding how these changes occur is thus a major priority in biogerontology. The functions of the bladder and terminal bowel are regulated by complex neuronal networks...

  11. Mechanical bowel preparation for elective colorectal surgery

    DEFF Research Database (Denmark)

    Guenaga, Katia K F G; Matos, Delcio; Wille-Jørgensen, Peer

    2009-01-01

    BACKGROUND: The presence of bowel contents during surgery has been related to anastomotic leakage, but the belief that mechanical bowel preparation (MBP) is an efficient agent against leakage and infectious complications is based on observational data and expert opinions only. OBJECTIVES: To determine the security and effectiveness of MBP on morbidity and mortality in colorectal surgery. SEARCH STRATEGY: Publications describing trials of MBP before elective colorectal surgery were sought through...

  12. Biopsychosocial Model of Irritable Bowel Syndrome

    OpenAIRE

    Tanaka, Yukari; Kanazawa, Motoyori; Fukudo, Shin; Drossman, Douglas A.

    2011-01-01

    Irritable bowel syndrome (IBS) is a common chronic disorder seen in gastroenterology and primary care practice. It is characterized by recurrent abdominal pain or discomfort associated with disturbed bowel function. It is a heterogeneous disorder with varying treatments, and in this regard physicians sometimes struggle with finding the optimal approach to management of patients with IBS. This disorder induces high health care costs and variably reduces health-related quality of life. IBS is i...

  13. [Contemporary dietotherapy of the irritable bowel syndrome].

    Science.gov (United States)

    Pilipenko, V I; Burliaeva, E A; Isakov, V A

    2013-01-01

    Irritable bowel syndrome (IBS) is the most prevalent functional disease of the gastrointestinal tract. This highly prevalent condition is best diagnosed by assessing the constellation of symptoms with which patients present to their physicians. Because some critics have previously questioned whether irritable bowel syndrome and other functional gastrointestinal disorders truly exist because they do not have defining structural features, the Rome Foundation fostered the use of symptom-based criteria for universal use. In most cases treatment is reduced to symptomatic therapy because a lot of unknown in pathogenesis by irritable bowel syndrome. Irritable bowel syndrome leads to decrease of quality of life of the patients and could be one of the reasons of patients' disability. Food is believed by patients promotes symptoms and the diet or avoiding specific food can reduce symptoms. Possible role of different food and microbiota in the pathophysiology of irritable bowel syndrome, as well as the data from randomized, controlled clinical trials dedicated to the effects of diet in irritable bowel syndrome are summarized and discussed in this review. The efficacy of the diet, enriched by fiber, prebiotics, probiotics, peppermint oil, curcumin and vitamin B6 in irritable bowel syndrome patients was shown in numerous studies. In some studies restriction in consumption of fermented carbohydrates, coffee and alcohol, as well as diet with elimination IgG-sensed food was also shown to be effective in irritable bowel syndrome. Food intolerances, defined as non-toxic non-immune adverse reactions to food, include reactions to bioactive chemicals in foods and metabolic reactions to poorly absorbed dietary carbohydrates. New dietary approaches like polyunsaturated fatty acids intake correction and the low tryptophan intake are discussed. PMID:23808281

  14. Cutaneous manifestations of inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Al Roujayee Abdulaziz

    2007-01-01

    Full Text Available Inflammatory bowel disease (IBD has many extraintestinal manifestations, and skin lesions are one of the most frequently described extraintestinal findings. Reports indicate an incidence of cutaneous manifestations ranging from 2 to 34%, Cutaneous manifestations are usually related to the activity of the bowel disease but may have an independent course. In this review we aim to address the various cutaneous manifestations associated with IBD, their impact on the disease course, and the treatment options available.

  15. Mechanical bowel preparation for elective colorectal surgery

    DEFF Research Database (Denmark)

    Güenaga, Katia F; Matos, Delcio

    2011-01-01

    The presence of bowel contents during colorectal surgery has been related to anastomotic leakage, but the belief that mechanical bowel preparation (MBP) is an efficient agent against leakage and infectious complications is based on observational data and expert opinions only.An enema before the rectal surgery to clean the rectum and facilitate the manipulation for the mechanical anastomosis is used for many surgeons. This is analysed separately

  16. Irritable Bowel Syndrome, Gut Microbiota and Probiotics

    OpenAIRE

    Lee, Beom Jae; Bak, Young-Tae

    2011-01-01

    Irritable bowel syndrome (IBS) is a complex disorder characterized by abdominal symptoms including chronic abdominal pain or discomfort and altered bowel habits. The etiology of IBS is multifactorial, as abnormal gut motility, visceral hypersensitivity, disturbed neural function of the brain-gut axis and an abnormal autonomic nervous system are all implicated in disease progression. Based on recent experimental and clinical studies, it has been suggested that additional etiological factors in...

  17. Microstructure imaging of human rectal mucosa using multiphoton microscopy

    International Nuclear Information System (INIS)

    Multiphoton microscopy (MPM) has high resolution and sensitivity. In this study, MPM was used to image microstructure of human rectal mucosa. The morphology and distribution of the main components in mucosa layer, absorptive cells and goblet cells in the epithelium, abundant intestinal glands in the lamina propria and smooth muscle fibers in the muscularis mucosa were clearly monitored. The variations of these components were tightly relevant to the pathology in gastrointestine system, especially early rectal cancer. The obtained images will be helpful for the diagnosis of early colorectal cancer.

  18. Halophilic archaea in the human intestinal mucosa.

    Science.gov (United States)

    Oxley, Andrew P A; Lanfranconi, Mariana P; Würdemann, Dieco; Ott, Stephan; Schreiber, Stefan; McGenity, Terry J; Timmis, Kenneth N; Nogales, Balbina

    2010-09-01

    The human gastrointestinal tract microbiota, despite its key roles in health and disease, remains a diverse, variable and poorly understood entity. Current surveys reveal a multitude of undefined bacterial taxa and a low diversity of methanogenic archaea. In an analysis of the microbiota in colonic mucosal biopsies from patients with inflammatory bowel disease we found 16S rDNA sequences representing a phylogenetically rich diversity of halophilic archaea from the Halobacteriaceae (haloarchaea), including novel phylotypes. As the human colon is not considered a salty environment and haloarchaea are described as extreme halophiles, we evaluated and further discarded the possibility that these sequences originated from pre-colonoscopy saline lavage solutions. Furthermore, aerobic enrichment cultures prepared from a patient biopsy at low salinity (2.5% NaCl) yielded haloarchaeal sequence types. Microscopic observation after fluorescence in situ hybridization provided evidence of the presence of viable archaeal cells in these cultures. These results prove the survival of haloarchaea in the digestive system and suggest that they may be members of the mucosal microbiota, even if present in low numbers in comparison with methanogenic archaea. Investigation of a potential physiological basis of this association may lead to new insights into gastrointestinal health and disease. PMID:20438582

  19. Electrochemical measurements of serotonin (5-HT) release from the guinea pig mucosa using continuous amperometry with a boron-doped diamond microelectrode

    Science.gov (United States)

    Zhao, Hong; Bian, Xiaochun; Galligan, James J.; Swain, Greg M.

    2009-01-01

    Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder characterized by chronic abdominal discomfort, including pain, bloating and changes in bowel habits. The exact cause of IBS is not entirely understood. Recent studies have shown that IBS may be associated with altered serotonin (5-hydroxytryptamine, 5-HT) levels within the GI tract. About 90% of 5-HT in the human body is produced and stored in enterochromaffin (EC) cells that reside in the mucosal layer of the intestine. Measurements of serotonin availability locally in the mucosa can provide insight on the functionality of these cells and potentially the pathophysiology of the disease. In this study, we used continuous amperometry with a diamond microelectrode to record serotonin levels in vitro in the ileum mucosa as an oxidation current. The boron-doped diamond (BDD) microelectrode is quite practical for these measurements because if its low background signal, low sensitivity to solution pH changes, and excellent resistance to fouling by adsorbed serotonin oxidation reaction products. In fact, the measurements are only possible because of the unique properties of diamond. We present electrochemical data that demonstrate the diamond microelectrode’s utility for assessment of enterochromaffin cell function. Confirmation that the oxidation current was associated with indogenous serotonin release came from pharmacological studies. We are hopeful that these types of in vitro electrochemical measurements will lead to a better understanding of the pathophysiology of IBS. PMID:20209031

  20. Acute small bowel obstruction caused by endometriosis: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Antonella De Ceglie, Claudio Bilardi, Sabrina Blanchi, Massimo Picasso, Marcello Di Muzio, Alberto Trimarchi, Massimo Conio

    2008-06-01

    Full Text Available Gastrointestinal involvement of endometriosis has been found in 3%-37% of menstruating women and exclusive localization on the ileum is very rare (1%-7%. Endometriosis of the distal ileum is an infrequent cause of intestinal obstruction, ranging from 7% to 23% of all cases with intestinal involvement. We report a case in which endometrial infiltration of the small bowel caused acute obstruction requiring emergency surgery, in a woman whose symptoms were not related to menses. Histology of the resected specimen showed that endometriosis was mainly prevalent in the muscularis propria and submucosa and that the mucosa was not ulcerated but had inflammation and glandular alteration. Endometrial lymph node involvement, with a cystic glandular pattern was also detected.

  1. Contrast enema depiction of small-bowel volvulus in complicated neonatal bowel obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Navarro, Oscar M.; Daneman, Alan; Miller, Stephen F. [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada)

    2004-12-01

    About one-half of patients with meconium ileus (MI) present with a complication such as volvulus, atresia, meconium peritonitis or giant cystic meconium peritonitis. The treatment of these complications requires surgery. However, the preoperative diagnosis of complicated MI is difficult. We describe two neonates with complicated small-bowel obstruction, one with MI related to cystic fibrosis and the other not related to cystic fibrosis. In both, contrast enema depicted a spiral appearance of the distal small bowel, which at surgery proved to be the result of volvulus associated with antenatal bowel perforation. This appearance of the small bowel on contrast enema in this clinical setting has not been previously described. The recognition of this spiral appearance of the distal small bowel suggests the need for surgery. (orig.)

  2. Habitual biting of oral mucosa: A conservative treatment approach

    Directory of Open Access Journals (Sweden)

    Sarabjot Kaur Bhatia

    2013-01-01

    Full Text Available Chronic biting of oral mucosa is an innocuous self inflicted injury, commonly seen in children suffering from developmental and psychological problems and has rarely been reported in normal unaffected individuals. The management strategies vary from counseling, prescription of sedatives to different prosthetic shields. The paper highlights the efficacy of a simple approach using soft mouth guard in the management of self inflicted lesions due to habitual biting of oral mucosa in two normal healthy children.

  3. Duodenal mucosa and extracellular cyclic nucleotide pattern in coeliac disease.

    OpenAIRE

    Peracchi, M; Bamonti-Catena, F; Faggioli, P; Molteni, N; Bardella, M.T.; Bareggi, B; Bianchi, P A

    1993-01-01

    This study measured the values of cyclic nucleotides and adenylate and guanylate cyclase activities in duodenal mucosa homogenates to verify if they played a part in coeliac disease. Nine controls, 13 patients who did not receive treatment and nine patients who received treatment were studied. Cyclase activity assays were performed under basal conditions and in the presence of gliadin derived peptides. Duodenal mucosa cyclic nucleotide values and adenylate cyclase activity were significantly ...

  4. Oral mucosa lesions in hypereosinophilic syndrome - an update.

    OpenAIRE

    Ionescu, Marius,; Murata, Hideyuki; Janin, Anne

    2008-01-01

    Hypereosinophilic syndrome (HES) is a rare disorder characterized by persistent and marked eosinophilia. Some HES forms have a poor prognosis, either because of end-organ damage (particularly endomyocardial fibrosis), or because of associated myeloid leukemia or malignant T-cell lymphoma. Oral mucosa ulcerations can be early clinical signs in severe forms. They are discrete, round or oval, sometimes confluent ulcers or erosions, located on non-keratinized, unattached oral mucosa. In the last ...

  5. Inflammatory bowel disease in pregnancy

    Directory of Open Access Journals (Sweden)

    Dawn B Beaulieu

    2011-01-01

    Full Text Available Crohn’s disease and ulcerative colitis affect women in their child-bearing years. Family planning has come to be a common discussion between the gastroenterologist and the inflammatory bowel disease (IBD patient. Disease control prior to desired conception and throughout pregnancy is the most important thing to keep in mind when caring for the IBD patient. Continued medical management during pregnancy is crucial in optimizing outcomes. Studies indicate that quiescent disease prior to conception infer the best pregnancy outcomes, similar to those in the general population. Active disease prior to and during pregnancy, can lead to complications such as pre-term labor, low birth weight, and small for gestational age infants. Although there are no definitive long term effects of pregnancy on IBD, there are some limited studies that suggest that it may alter the disease course. Understanding the literature and its limitations is important in the modern era of IBD care. Educating the patient and taking a team approach with the obstetrician will help achieve successful outcomes for mother and baby.

  6. A Strange Case of Left Bowel Ischemia after Right Hernioplasty

    OpenAIRE

    Geraci, Girolamo; Pisello, Franco; Modica, Giuseppe; Li Volsi, Francesco; Cajozzo, Massimo; Sciumè, Carmelo

    2010-01-01

    We report the first observed case of a young man who suffered of large and unsuspected left bowel ischemia following an elective right open hernioplasty. A 54-year-old man had a 2-year history of right inguinal reducible mass and was admitted to hospital for an elective day case open inguinal hernioplasty for a direct right inguinal hernia. Apart from mild hypertension controlled with ACE inhibitor, he was medically fit and well. The patient was submitted to open tension-free mesh repair with...

  7. Heterotaxy syndromes and abnormal bowel rotation

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley [Stanford University, Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Koppolu, Raji; Sylvester, Karl [Lucile Packard Children' s Hospital at Stanford, Department of Surgery, Stanford, CA (United States); Murphy, Daniel [Lucile Packard Children' s Hospital at Stanford, Department of Cardiology, Stanford, CA (United States)

    2014-05-15

    Bowel rotation abnormalities in heterotaxy are common. As more children survive cardiac surgery, the management of gastrointestinal abnormalities has become controversial. To evaluate imaging of malrotation in heterotaxy with surgical correlation and provide an algorithm for management. Imaging reports of heterotaxic children with upper gastrointestinal (UGI) and/or small bowel follow-through (SBFT) were reviewed. Subsequently, fluoroscopic images were re-reviewed in conjunction with CT/MR studies. The original reports and re-reviewed images were compared and correlated with surgical findings. Nineteen of 34 children with heterotaxy underwent UGI, 13/19 also had SBFT. In 15/19 reports, bowel rotation was called abnormal: 11 malrotation, 4 non-rotation, no cases of volvulus. Re-review, including CT (10/19) and MR (2/19), designated 17/19 (90%) as abnormal, 10 malrotation (abnormal bowel arrangement, narrow or uncertain length of mesentery) and 7 non-rotation (small bowel and colon on opposite sides plus low cecum with probable broad mesentery). The most useful CT/MR findings were absence of retroperitoneal duodenum in most abnormal cases and location of bowel, especially cecum. Abnormal orientation of mesenteric vessels suggested malrotation but was not universal. Nine children had elective bowel surgery; non-rotation was found in 4/9 and malrotation was found in 5/9, with discrepancies (non-rotation at surgery, malrotation on imaging) with 4 original interpretations and 1 re-review. We recommend routine, early UGI and SBFT studies once other, urgent clinical concerns have been stabilized, with elective laparoscopic surgery in abnormal or equivocal cases. Cross-sectional imaging, usually obtained for other reasons, can contribute diagnostically. Attempting to assess mesenteric width is important in differentiating non-rotation from malrotation and more accurately identifies appropriate surgical candidates. (orig.)

  8. MOLECULAR MARKERS OF MUCOSA HARBORING GASTRIC ADENOMAS

    Scientific Electronic Library Online (English)

    Adriana Vaz, SAFATLE-RIBEIRO; Kátia Adriana Tessima, FRANCO; Carlos Eduardo Pereira, CORBETT; Kiyoshi, IRIYA; Bruno, ZILBERSTEIN; Ulysses, RIBEIRO Jr..

    2013-04-01

    Full Text Available Contexto Adenoma gástrico é uma lesão precursora do adenocarcinoma. Objetivo Melhor caracterizar os adenomas de acordo com a imunoexpressão de mucinas e avaliar a imunoexpressão de p53, p16ink4a, BCL-2, cyclin D, Ki-67, nos adenomas e na mucosa gástrica adjacente. Métodos Quarenta espécimes gás [...] tricos provenientes de 20 pacientes portadores de adenomas foram classificados como do tipo intestinal (MUC2 – mucina presente nas células caliciformes) ou gástrico (MUC5AC – mucinas de padrão foveolar). Realizou-se imunoistoquímica para p53, p16ink4a, BCL-2, cyclin D e Ki-67 pelo método do complexo da estreptavidina-biotina. Resultados Doze (60%) pacientes eram homens e a média de idade foi de 67,9 ± 12,9 anos. Os adenomas foram classificados como do tipo intestinal em 13 (65%) pacientes e do tipo gástrico em 7 (35%). Displasia (neoplasia intraepitelial) de baixo grau estava presente em 13 (65%), displasia de alto grau em 3 (15%), e adenocarcinoma no pólipo adenomatoso em 4 (20%) pacientes. Observou-se immunoexpressão do p53 em 6/20 (30%) adenomas, e em 2/6 (33,3%) dos tumores sincrônicos. Houve associação entre imunoexpressão do p53 e adenoma/tumor tipo intestinal, P = 0.04. Não houve associação entre imunoexpressão do p16ink4a, Bcl-2, ciclina D e Ki-67 e as características clinicopatológicas dos adenomas. Conclusão Imunoistoquímica pode ser utilizada para caracterizar os subtipos de adenoma e talvez indicar o caminho de carcinogênese. Abstract in english Context Gastric adenoma is a precursor lesion of the adenocarcinoma. Objective To characterize gastric adenomas according to the mucin immunoexpression and to evaluate the immunoexpression of p53, p16ink4a, BCL-2, cyclin D, Ki-67, in the adenoma and in the gastric mucosa harboring adenoma. Meth [...] ods Forty gastric specimens from 20 patients were classified as intestinal (MUC2 - goblet cell mucin) or foveolar (MUC5AC - gastric-foveolar mucin) adenomas. Immunohistochemistry was performed using streptavidin-biotin-complex method. Results Twelve (60%) patients were men. The mean age was 67.9 ± 12.9 years-old. Intestinal adenomas were detected in 13 (65%) patients and gastric type in 7 (35%). Low-grade dysplasia was present in 13 (65%) of the adenomas, high-grade in 3 (15%), and adenocarcinoma within the polyp in 4 (20%). Six (30%) patients had synchronous adenocarcinoma. p53 immunoexpression was observed in 6/20 (30%) of adenomas, and in 2/6 (33.3%) of synchronous tumors. There was an association between p53 immunoexpression and intestinal type of adenoma/tumor, P = 0.04. There was no association between p16ink4a, Bcl-2, cyclin D and Ki-67 and adenoma clinicopathological characteristics. Conclusion Immunohistochemistry may be useful to classify the adenomas subtypes and may define the pathway of adenoma to carcinoma sequence.

  9. Lymphoepithelial Cyst in Jugal Mucosa / Quiste Linfoepitelial en la Mucosa Yugal

    Scientific Electronic Library Online (English)

    Marceli Moço, Silva; Alvimar Lima de, Castro; Ana Maria Pires, Soubhia; Marcelo Macedo, Crivelini.

    2011-04-01

    Full Text Available Un quiste linfoepitelial bucal es raro, con pocos casos reportados en la literatura. El objetivo de este artículo es describir un caso clínico, centrándose en los aspectos clínicos y diagnósticos, tratamiento y pronóstico. La lesión tuvo un año de evolución, y se había desarrollado como un nódulo fi [...] broso en la mucosa yugal de un paciente de 71 años de edad con leucoderma. Teniendo en cuenta la hiperplasia fibrosa inflamatoria, fibroma y mucocele como diagnósticos diferenciales, se llevó a cabo una biopsia por escisión. Una cavidad quística limitada por epitelio pseudoestratificado sin proyecciones en el tejido conjuntivo, con tejido linfoide en el interior fue identificado microscópicamente. No se observaron eventos adversos postoperatorios, y el seguimiento clínico al año confirmó el pronóstico favorable de este tipo de lesión. Abstract in english Mouth lymphoepithelial cyst is rare, with few cases reported in literature. The aim of this article is to describe a clinical case, focusing on clinical and diagnostic aspects, treatment and prognosis. The lesion was one year old and had developed as a fibrous nodule in the jugal mucosa of a 71-year [...] -old leucoderma patient. Considering focal inflammatory fibrous hyperplasia, fibroma and mucocele as differential diagnosis, excisional biopsy was carried out. A cystic cavity limited by pseudostratified epithelium without projections into the conjunctive tissue, with lymphoid tissue within, was microscopically identified. Without postoperative adverse events, the one-year clinical followup confirmed the favorable prognosis of this kind of lesion.

  10. A comparison of linaclotide and lubiprostone dosing regimens on ion transport responses in human colonic mucosa.

    Science.gov (United States)

    Kang, Sang Bum; Marchelletta, Ronald R; Penrose, Harrison; Docherty, Michael J; McCole, Declan F

    2015-03-01

    Linaclotide, a synthetic guanylyl cyclase C (GC-C) agonist, and the prostone analog, Lubiprostone, are approved to manage chronic idiopathic constipation and constipation-predominant irritable bowel syndrome. Lubiprostone also protects intestinal mucosal barrier function in ischemia. GC-C signaling regulates local fluid balance and other components of intestinal mucosal homeostasis including epithelial barrier function. The aim of this study was to compare if select dosing regimens differentially affect linaclotide and lubiprostone modulation of ion transport and barrier properties of normal human colonic mucosa. Normal sigmoid colon biopsies from healthy subjects were mounted in Ussing chambers. Tissues were treated with linaclotide, lubiprostone, or vehicle to determine effects on short-circuit current (I sc). Subsequent I sc responses to the cAMP agonist, forskolin, and the calcium agonist, carbachol, were also measured to assess if either drug caused desensitization. Barrier properties were assessed by measuring transepithelial electrical resistance. I sc responses to linaclotide and lubiprostone were significantly higher than vehicle control when administered bilaterally or to the mucosal side only. Single versus cumulative concentrations of linaclotide showed differences in efficacy while cumulative but not single dosing caused desensitization to forskolin. Lubiprostone reduced forskolin responses under all conditions. Linaclotide and lubiprostone exerted a positive effect on TER that was dependent on the dosing regimen. Linaclotide and lubiprostone increase ion transport responses across normal human colon but linaclotide displays increased sensitivity to the dosing regimen used. These findings may have implications for dosing protocols of these agents in patients with constipation. PMID:26038704

  11. Intraluminal injection of short chain fatty acids diminishes intestinal mucosa injury in experimental ischemia-reperfusion / A injeção intraluminal de ácidos graxos de cadeia curta diminui a lesão da mucosa intestinal produzida por isquemia e reperfusão experimental

    Scientific Electronic Library Online (English)

    José Eduardo de, Aguilar-Nascimento; Alberto Bicudo, Salomão; Rubens Jardim, Nochi Jr.; Mariana, Nascimento; José de Souza, Neves.

    2006-02-01

    Full Text Available OBJETIVO: Investigou-se o efeito de ácidos graxos de cadeia curta (SCFA) na mucosa intestinal na presença de lesão por isquemia e reperfusão (IRI). MÉTODOS: Foram criados seis sacos fechados no intestino delgado (três no jejuno e três no íleo) em 10 ratos Wistar. Ao sacos laterais de ambas as regiõe [...] s intestinais foram submetidos a IRI (15/15 minutos) enquanto que o saco medial não sofreu interrupção do suprimento sanguíneo. Nos sacos laterais ambas as regiões injetou-se SCFA ou solução fisiológica na luz intestinal. Nos sacos mediais não se injetou nenhuma solução. RESULTADOS: Tanto no jejuno quanto no íleo o escore de injuria da mucosa intestinal foi mais alto nos sacos tratados com solução salina do que nos controles. Os sacos que receberam SCFA apresentaram menor escore inflamatório no íleo (p=0.03) porém sem diferença no jejuno (p=0.083) quando comparados com os sacos injetados com solução salina. Observou-se um significante maior acumulo de neutrófilos nos sacos tratados com solução salina (p Abstract in english PURPOSE: Investigated the effect of intraluminal short-chain fatty acids (SCFA) on the intestinal mucosa in the presence of ischemia-reperfusion injury (IRI). METHODS: Six blind sacs of the small bowel (3at the jejunum and 3 at the ileum) were created in ten Wistar rats. The lateral sacs of both bow [...] el regions were subjected to IRI (15/15 minutes) while the medial sacs were let free to receive blood supply. In the lateral sacs, it was injected either a solution containing SCFA (butyrate, propionate and acetate) or pure saline at the bowel lumen. No fluid was injected in the medial sacs. RESULTS: Both at the jejunum and at the ileum the score of the mucosal injury was higher in saline than in control sacs. SCFA treated sacs showed lesser score at the ileum (p=0.03) but were not significantly different at the jejunum (p=0.83) when compared with saline sacs. It was found a significant greater number of neutrophils (p

  12. Sclerosing encapsulating peritonitis (abdominal cocoon) associated with liver cirrhosis and diffuse large B-cell lymphoma: autopsy case.

    Science.gov (United States)

    Yamada, Sohsuke; Tanimoto, Akihide; Matsuki, Yasumasa; Hisada, Yuji; Sasaguri, Yasuyuki

    2009-09-01

    A case of sclerosing encapsulating peritonitis (SEP) associated with liver cirrhosis (LC) and complicated by diffuse large B-cell lymphoma (DLBCL) is reported herein. A 49-year-old Japanese man had undergone peritoneo-venous shunt against refractory ascites due to hepatitis C virus-positive uncompensated LC for 2 years. After he received a diagnosis of DLBCL of the left neck lymph node 3 months before his death, palliative care was given because of his poor general condition. He developed severe abdominal distention and pain over 1 week and was found to have marked ascites and whole bowel lumped together on abdominal CT. At autopsy, the peritoneum was covered with a thick white membrane and the bowel could not be distinguished, which was macroscopically characterized by a cocoon-like appearance. Histology indicated a proliferation of diffusely thickened or hyalinized fibrocollagenous tissue in the entire peritoneum with a slight chronic inflammatory infiltrate and without remarkable change of mucosa. A diagnosis of SEP, also known as abdominal cocoon, was established based on these features. Additionally, in the abdominal cavity, a large amount of serous ascites and multiple peritoneal nodules or masses involved by DLBCL were recognized. To the authors' knowledge this is the first case report of SEP associated with LC and complicated by the invasion of DLBCL in the abdominal cavity. PMID:19712139

  13. Reação liquenoide à carbamazepina em mucosa bucal: relato de caso / Lichenoid reaction to carbamazepine in the oral mucosa: case report

    Scientific Electronic Library Online (English)

    Gabriela, Artico; Ingrid S, Bruno; Juliana, Seo; Silvio K, Hirota; Renata, Acay; Dante A, Migliari.

    2011-08-01

    Full Text Available As reações liquenoides por drogas são mais comuns na pele, mas também podem ocorrer na mucosa bucal. Estas lesões são de difícil diagnóstico por causa de sua semelhança clínica com às do líquen plano oral idiopático. O presente artigo relata um caso de reação liquenoide em mucosa bucal, associado ao [...] uso de carbamazepina, no qual o processo de diagnóstico é enfatizado Abstract in english Lichenoid drug reactions are more commom in skin, but they may also occur in the oral mucosa. It is difficult to diagnose these lesions due to their clinical similarity to the idiopathic oral lichen planus lesions. The present article reports a case of lichenoid reaction in oral mucosa associated to [...] the use of carbamazepine, emphasizing the diagnostic process

  14. Diet and risk of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Andersen, Vibeke; Olsen, Anja

    2012-01-01

    Background: A better understanding of the environmental factors leading to inflammatory bowel disease should help to prevent occurrence of the disease and its relapses. Aim: To review current knowledge on dietary risk factors for inflammatory bowel disease. Methods: The PubMed, Medline and Cochrane Library were searched for studies on diet and risk of inflammatory bowel disease. Results: Established non-diet risk factors include family predisposition, smoking, appendectomy, and antibiotics. Retrospective case–control studies are encumbered with methodological problems. Prospective studies on European cohorts, mainly including middle-aged adults, suggest that a diet high in protein from meat and fish is associated with a higher risk of inflammatory bowel disease. Intake of the n-6 polyunsaturated fatty acid linoleic acid may confer risk of ulcerative colitis, whereas n-3 polyunsaturated fatty acids may be protective. No effect was found of intake of dietary fibres, sugar, macronutrients, total energy, vitamin C, D, E, Carotene, or Retinol (vitamin A) on risk of ulcerative colitis. No prospective data was found on risk related to intake of fruits, vegetables or food microparticles (titanium dioxide and aluminium silicate). Conclusions: A diet high in protein, particular animal protein, may be associated with increased risk of inflammatory bowel disease and relapses. N-6 polyunsaturated fatty acids may predispose to ulcerative colitis whilst n-3 polyunsaturated fatty acid may protect. These results should be confirmed in other countries and in younger subjects before dietary counselling is recommended in high risk subjects.

  15. Volvulus and bowel obstruction in ATR-X syndrome-clinical report and review of literature.

    Science.gov (United States)

    Horesh, Nir; Pery, Ron; Amiel, Imri; Shwaartz, Chaya; Speter, Chen; Guranda, Larisa; Gutman, Mordechai; Hoffman, Aviad

    2015-11-01

    Alpha thalassemia-mental retardation, X-linked (ATR-X) syndrome is a rare genetic disorder with a variety of clinical manifestations. Gastrointestinal symptoms described in this syndrome include difficulties in feeding, regurgitation and vomiting which may lead to aspiration pneumonia, abdominal pain, distention, and constipation. We present a 19-year-old male diagnosed with ATR-X syndrome, who suffered from recurrent colonic volvulus that ultimately led to bowel necrosis with severe septic shock requiring emergent surgical intervention. During 1 year, the patient was readmitted four times due to poor oral intake, dehydration and abdominal distention. Investigation revealed partial small bowel volvulus which resolved with non-operative treatment. Small and large bowel volvulus are uncommon and life-threatening gastrointestinal manifestations of ATR-X patients, which may contribute to the common phenomenon of prolonged food refusal in these patients. © 2015 Wiley Periodicals, Inc. PMID:26174613

  16. Small bowel obstruction secondary to migration of a fragment of lithobezoar: a case report.

    LENUS (Irish Health Repository)

    Medani, Mekki

    2009-01-01

    INTRODUCTION: Small bowel obstruction is a common world-wide condition that has a range of etiological factors. The management is largely dependent on the cause of the obstruction. Small bowel obstruction caused by foreign body ingestion is rare; many items have been reported as responsible, but there are no reports implicating polyurethane foam. CASE PRESENTATION: We report the case of a 44-year-old Irish male who presented following ingestion of polyurethane foam. He was asymptomatic on presentation but developed a small bowel obstruction shortly thereafter. CONCLUSION: Patients presenting following ingestion of polyurethane foam should be scheduled for elective laparotomy, gastrotomy, and retrieval of the cast on the next available theatre list - given that they are suitable for surgery.

  17. Biofeedback & Bowel Disorders: Teaching Yourself to Live without the Problem

    Science.gov (United States)

    ... Overview Biofeedback Bowel Retraining Dietary Fiber Fruit Juice Hirschsprung's Disease Laxatives Stool Form Guide Tips on Finding a ... Overview Biofeedback Bowel Retraining Dietary Fiber Fruit Juice Hirschsprung's Disease Laxatives Stool Form Guide Tips on Finding a ...

  18. X-ray studies of arteriovenous malformation of the small bowel

    International Nuclear Information System (INIS)

    Differential diagnosis of intestinal bleeding includes arteriovenous malformation. A patient with chronic anemia due to intestinal blood loss had negative studies of the small and large bowel. Angiography demonstrated arteriovenous malformation. Histologic examination of the resected intestine verified the diagnosis. (orig.)

  19. [Migraine and irritable bowel syndrome].

    Science.gov (United States)

    Mulak, Agata; Paradowski, Leszek

    2005-01-01

    The association between migraine and functional gastrointestinal disorders has been confirmed by many clinical observations and epidemiological studies. In most patients during the attacks of migraine, apart from various neurological and vascular symptoms, gastrointestinal disturbances occur including nausea, vomiting, abdominal pain or diarrhea. Functional gastrointestinal disorders, such as irritable bowel syndrome (IBS), are reported in migraine patients in periods between the attacks as well. On the other hand 23-53% of IBS patients have frequent headaches. Migraine and IBS often coexist with fibromyalgia and other chronic pain syndromes and functional disorders. Migraine and IBS affect approximately 10-20% of the general population, usually young adults. Both diseases are more prevalent in women, perhaps due to the role of estrogen in their pathogenesis. Looking for the common pathogenetic mechanisms of IBS and migraine the role of the brain-gut axis, neuroimmune and neuroendocrine interactions are being considered. The influence of stress on symptom occurrence and severity seems to be associated with hyperactivity of the hypothalamic-pituitary-adrenal axis. The enteric nervous system as a source of numerous neurotransmitters and visceral reflexes is a plausible common pathogenic link between IBS and migraine. In particular serotonin being the main neurotransmitter of the gastrointestinal tract plays a relevant role in the pathogenesis of IBS as well as migraine. Nowadays, agonists and antagonists of serotoninergic receptors are the most efficacious drugs for IBS and migraine therapy. Some side effects of triptans, 5-HT(1B/D) agonists, used in migraine treatment may be connected with the influence of triptans on the gastrointestinal functions. A better understanding of the relationship between migraine and IBS may result in more effective treatment of both diseases. PMID:16419571

  20. Mucosal healing effect of mesalazine granules in naproxen-induced small bowel enteropathy

    Directory of Open Access Journals (Sweden)

    István Rácz

    2013-01-01

    Full Text Available AIM: To investigate the effect of mesalazine granules on small intestinal injury induced by naproxen using capsule endoscopy (CE. METHODS: This was a single center, non-randomized, open-label, uncontrolled pilot study, using the PillCam SB CE system with RAPID 5 software. The Lewis Index Score (LIS for small bowel injury was investigated to evaluate the severity of mucosal injury. Arthropathy patients with at least one month history of daily naproxen use of 1000 mg and proton pump inhibitor co-therapy were screened. Patients with a minimum LIS of 135 were eligible to enter the 4-wk treatment phase of the study. During this treatment period, 3 × 1000 mg/d mesalazine granules were added to ongoing therapies of 1000 mg/d naproxen and 20 mg/d omeprazole. At the end of the 4-wk combined treatment period, a second small bowel CE was performed to re-evaluate the enteropathy according to the LIS results. The primary objective of this study was to assess the mucosal changes after 4 wk of mesalazine treatment. RESULTS: A total of 18 patients (16 females, ranging in age from 46 to 78 years (mean age 60.3 years were screened, all had been taking 1000 mg/d naproxen for at least one month. Eight patients were excluded from the mesalazine therapeutic phase of the study for the following reasons: the screening CE showed normal small bowel mucosa or only insignificant damages (LIS < 135 in five patients, the screening esophagogastroduodenoscopy revealed gastric ulcer in one patient, capsule technical failure and incomplete CE due to poor small bowel cleanliness in two patients. Ten patients (9 female, mean age 56.2 years whose initial LIS reached mild and moderate-to-severe enteropathy grades (between 135 and 790 and ? 790 entered the 4-wk therapeutic phase and a repeat CE was performed. When comparing the change in LIS from baseline to end of treatment in all patients, a marked decrease was seen (mean LIS: 1236.4 ± 821.9 vs 925.2 ± 543.4, P = 0.271. Moreover, a significant difference between pre- and post-treatment mean total LIS was detected in 7 patients who had moderate-to-severe enteropathy gradings at the inclusion CE (mean LIS: 1615 ± 672 vs 1064 ± 424, P = 0.033. CONCLUSION: According to the small bowel CE evaluation mesalazine granules significantly attenuated mucosal injuries in patients with moderate-to-severe enteropathies induced by naproxen.

  1. Relationship of small bowel motility to ileoanal reservoir function.

    OpenAIRE

    Groom, J S; Kamm, M A; Nicholls, R. J.

    1994-01-01

    Some patients with an ileoanal reservoir have a high defecation frequency, despite a good anatomical result and the absence of pouchitis. This study aimed to determine whether variation in function is related to a difference in small bowel motility proximal to the reservoir and if small bowel motility is propagated into the reservoir. Ambulatory small bowel and reservoir motility was studied for 24 hours in five patients with good function (median bowel frequency 4 per day, range 3-6) and sev...

  2. Microbial Sensing by the Intestinal Epithelium in the Pathogenesis of Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    Gerhard Rogler

    2010-01-01

    Full Text Available Recent years have raised evidence that the intestinal microbiota plays a crucial role in the pathogenesis of chronic inflammatory bowels diseases. This evidence comes from several observations. First, animals raised under germ-free conditions do not develop intestinal inflammation in several different model systems. Second, antibiotics are able to modulate the course of experimental colitis. Third, genetic polymorphisms in a variety of genes of the innate immune system have been associated with chronic intestinal inflammatory diseases. Dysfunction of these molecules results in an inappropriate response to bacterial and antigenic stimulation of the innate immune system in the gastrointestinal tract. Variants of pattern recognition receptors such as NOD2 or TLRs by which commensal and pathogenic bacteria can be detected have been shown to be involved in the pathogenesis of IBD. But not only pathways of microbial detection but also intracellular ways of bacterial processing such as autophagosome function are associated with the risk to develop Crohn's disease. Thus, the “environment concept” and the “genetic concept” of inflammatory bowel disease pathophysiology are converging via the intestinal microbiota and the recognition mechanisms for an invasion of members of the microbiota into the mucosa.

  3. A case of Polyarteritis Nodosa Mimicking Pyelonephritis and was Misdiagnosed as Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    Ebubekir ?ENATE?

    2013-03-01

    Full Text Available Polyarteritis nodosa (PAN is characterized by necrotizing inflammation of small- or medium-sized muscular arteries. Atypic clinical presentation leads to delay in diagnosis. For this reason, it can cause severe morbidity and mortality. Here, we described a case which presented first with fever and left costovertebral angle tenderness, and was misdiagnosed as pyelonephritis. The patient did not benefit from intravenous antibiotherapy that was prescribed in the outpatient clinic and then hospitalized for left lower abdominal pain. No source of fever was found despite detailed physical examination and laboratory investigation. An abdominal ultrasonography showed hyperechogenity of the left kidney. An abdominal computed tomography was performed for left lower abdominal pain suggesting inflammatory bowel disease findings. Colonoscopy showed an ulcero-vegetating and nodular mass surrounding the whole sigmoid colon mucosa and suggesting a malignant tumour. A conventional angiography of the mesenteric artery showed total occlusion of the inferior mesenteric artery. He developed acute abdominal pain and, left hemicolectomy was performed for colonic perforation. Histopathological findings consistent with PAN were detected in the pathological examination of the resected bowel, and the patient was diagnosed with PAN. After initiation of corticosteroid and cyclophosphamide therapy, the clinical status of the patient was improved dramatically with disappearence of fever and relief of abdominal pain. Turk J Phys Med Rehab 2013;59:79-82.

  4. Manifestaciones reumatológicas de la enfermedad inflamatoria intestinal Rheumatologic manifestations of inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Octavio Germán Muñoz Maya

    2006-01-01

    Full Text Available La enfermedad inflamatoria intestinal (EII se caracteriza por la activación inapropiada del sistema inmune de la mucosa intestinal y sus dos formas de presentación son: la colitis ulcerativa y la enfermedad de Crohn. Las manifestaciones extraintestinales se presentan hasta en el 36% de los pacientes y pueden comprometer cualquier órgano o sistema. La disfunción inmune se caracteriza por el desequilibrio entre los mediadores proinflamatorios y los antinflamatorios y se expresa como una enfermedad sistémica. Las manifestaciones reumatológicas asociadas a la EII son de tres tipos: la artritis periférica, la espondiloartropatía y una tercera categoría que incluye lesiones dérmicas, oftálmicas y del metabolismo óseo, entre otras. El manejo de estas manifestaciones se basa en la terapia sistémica para el control de la actividad inflamatoria local utilizando esteroides, derivados de la 5-ASA, inmunomoduladores y, en los últimos años, terapia anti-TNF. The main feature of inflammatory bowel disease (IBD is the continuous activation of the mucosa-associated immune system; the disease has two major forms of presentation: ulcerative colitis and Crohn´s disease. The extraintestinal manifestations are present in 36% of patients, and any organ can be affected. There is an imbalance between proinflammatory and antinflammatory cytokines leading to a systemic disease. The rheumatologic manifestations of the IBD are: Peripheral arthritis, spondyloarthropathy and a third category that includes dermic and ocular lesions as well as metabolic bone disease. Control of the extraintestinal manifestations is based on systemic therapy with steroids, 5-ASA derivatives and biological anti-TNF therapy.

  5. Colonoscopy surveillance for dysplasia and colorectal cancer in patients with inflammatory bowel disease

    DEFF Research Database (Denmark)

    Aalykke, Claus; Jensen, Michael Dam

    2015-01-01

    The risk of colorectal cancer (CRC) and dysplasia in patients with inflammatory bowel disease (IBD) has been highly debated as risk estimates from different studies vary greatly. The present national Danish guideline on colonoscopy surveillance for dysplasia and colorectal cancer in patients with IBD is based on a thorough review of existing literature with particular focus on recent studies from Denmark revealing a lower risk of CRC than previously assumed. The overall risk of CRC in the Danish IBD population does not appear to be different from that of the background population; however, in some subgroups of patients the risk is increased. These subgroups of patients, who should be offered colonoscopy surveillance, include patients with ulcerative colitis having extensive disease and a long disease duration (10-13 years); early age at onset (less than 19 years of age) of ulcerative colitis; and patients with ulcerative colitis as well as Crohn's disease with a concomitant diagnosis of primary sclerosing cholangitis. A colonoscopy surveillance program is recommended in these subgroups with intervals ranging from every 3-6 months to every 5 years, using chromoendoscopy with targeted biopsies of the lesion and adjacent mucosa, instead of conventional colonoscopy with random biopsies. Preferably, the colonoscopy should be performed during clinical remission. If a lesion is detected the endoscopical resectability together with the pathology of the lesion and the adjacent mucosa determine how the lesion should be treated.

  6. Clinical significance of cytomegalovirus infection in patients with inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Elena Garrido

    2013-01-01

    Full Text Available Cytomegalovirus (CMV infection is common in humans. The virus then enters a “latency phase” and can reactivate to different stimuli such as immunosuppression. The clinical significance of CMV infection in inflammatory bowel disease is different in Crohn’s disease (CD and ulcerative colitis (UC. CMV does not interfere in the clinical course of CD. However, CMV reactivation is frequent in severe or steroid-resistant UC. It is not known whether the virus exacerbates the disease or simply appears as a bystander of a severe disease. Different methods are used to diagnose CMV colitis. Diagnosis is classically based on histopathological identification of viral-infected cells or CMV antigens in biopsied tissues using haematoxylin-eosin or immunohistochemistry, other tests on blood or tissue samples are currently being investigated. Polymerase chain reaction performed in colonic mucosa has a high sensitivity and a positive result could be associated with a worse prognosis disease; further studies are needed to determine the most appropriate strategy with positive CMV-DNA in colonic mucosa. Specific endoscopic features have not been described in active UC and CMV infection. CMV colitis is usually treated with ganciclovir for several weeks, there are different opinions about whether or not to stop immunosuppressive therapy. Other antiviral drugs may be used. Multicenter controlled studies would needed to determine which subgroup of UC patients would benefit from early antiviral treatment.

  7. Small Bowel Obstruction due to Intestinal Xanthomatosis

    Science.gov (United States)

    Barrera-Herrera, L. E.; Arias, F.; Rodríguez-Urrego, P. A.; Palau-Lázaro, M. A.

    2015-01-01

    Vast majority of bowel obstruction is due to postoperative adhesions, malignancy, intestinal inflammatory disease, and hernias; however, knowledge of other uncommon causes is critical to establish a prompt treatment and decrease mortality. Xanthomatosis is produced by accumulation of cholesterol-rich foamy macrophages. Intestinal xanthomatosis is an uncommon nonneoplastic lesion that may cause small bowel obstruction and several cases have been reported in the English literature as obstruction in the jejunum. We report a case of small intestinal xanthomatosis occurring in a 51-year-old female who presented with one day of copious vomiting and intermittent abdominal pain. Radiologic images revealed jejunal loop thickening and inflammatory changes suggestive of foreign body obstruction, diagnostic laparoscopy found two strictures at the jejunum, and a pathologic examination confirmed a segmental small bowel xanthomatosis. This case illustrates that obstruction even without predisposing factors such as hyperlipidemia or lymphoproliferative disorders. PMID:26167322

  8. Toll-like receptors -2, -4 and CD14 in human intestinal mucosa from patients with inflammatory Bowel Disease (IBD).

    Czech Academy of Sciences Publication Activity Database

    Frolová, Lenka; Drastich, P.; Klimešová, Klára; Rossmann, Pavel; Tlaskalová, Helena

    Prague : Verlag, 2006, s. 80-80. [Meeting of the European Mucosal Immunology Group /5./. Prague (CZ), 05.10.2006-07.10.2006] R&D Projects: GA ?R GD310/03/H147 Institutional research plan: CEZ:AV0Z50200510 Keywords : crohns disease * ulcerative colitis * toll-like receptors Subject RIV: EE - Microbiology, Virology

  9. Aumento de gengiva queratinizada em mucosa peri-implantar / Increased keratinized gigiva in peri-implant mucosa

    Scientific Electronic Library Online (English)

    Juliano Milanezi de, Almeida; Vivian Noronha, Novaes; Paula Lazilha, Faleiros; Valmir Campos, Macarimi; Álvaro Francisco, Bosco; Letícia Helena, Theodoro; Valdir Gouveia, Garcia.

    2012-10-01

    Full Text Available INTRODUÇÃO: Estudos recentes são direcionados a explorar a relação da faixa da mucosa queratinizada com a saúde dos tecidos peri-implantares. Quando esta faixa não é suficiente, uma cirurgia para o aumento de mucosa queratinizada pode ser indicada, pois tem sido relatado que a presença ou a reconstr [...] ução de tecido queratinizado ao redor de implantes pode facilitar os procedimentos restauradores, promover a estética e ainda permitir a manutenção de uma higienização oral rotineira sem irritação ou desconforto ao paciente. Dentre os procedimentos cirúrgicos disponíveis, a técnica do enxerto gengival livre é consagrada na literatura periodontal para aumento da faixa de mucosa queratinizada. OBJETIVO: Este estudo relata um caso clínico em que foi realizada cirurgia de enxerto gengival livre com objetivo de aumentar a faixa da mucosa queratinizada na região de implantes previamente instalados na maxila, para suporte de prótese tipo protocolo. RELATO DO CASO: Foi realizada a cirurgia de enxerto gengival livre na região anterior da maxila, obtido do palato, na qual haviam sido instalados implantes osseointegrados para suporte de prótese tipo protocolo e a mucosa peri-implantar apresentava-se sem tecido queratinizado e inflamada. Após dois meses de reparação da cirurgia mucogengival, foi possível observar que o enxerto gengival livre favoreceu a saúde peri-implantar e os procedimentos protéticos de moldagem. CONCLUSÃO: Diante dos resultados clínicos, pode-se concluir que o enxerto gengival livre é uma técnica previsível e de fácil realização para aumento da faixa de mucosa queratinizada em mucosa peri-implantar de prótese protocolo. Abstract in english INTRODUCTION: Recent studies have evaluated the relationship between the width of keratinized mucosa and peri-implant tissue health. Insufficiently wide keratinized tissue can be increased surgically, for example by free gingival grafting. The presence or reconstruction of keratinized tissue around [...] the implant can facilitate restorative procedures, promote aesthetics and allow the maintenance of an oral hygiene routine without irritation or discomfort to the patient. OBJECTIVE: To describe a patient who underwent free gingival graft surgery to increase the width of keratinized tissue in the region of previously implants to support a type of prosthetic protocol. CASE REPORT: A patient who had received dental implants to support a type of prosthetic protocol presented with inflamed peri?implant mucosa, but with no keratinized tissue. Free gingival tissue was obtained from the palate and grafted into the anterior maxilla. Sixty days after muco-gingival surgery, we observed that the free gingival graft favored peri-implant health and prosthetic casting. CONCLUSION: The free gingival graft technique is both easy to perform and effective in increasing the width of keratinized mucosa following implantation.

  10. Cell therapy in experimental model of inflammatory bowel disease / Terapia celular em modelo experimental de doença inflamatória intestinal

    Scientific Electronic Library Online (English)

    Mônica Yonashiro, Marcelino; Natália Langenfeld, Fuoco; Ana Elise Valencise, Quaglio; Renata Aparecida de Camargo, Bittencourt; Bruna Cambraia, Garms; Thaís Helena da Motta, Conceição; Luiz Claudio Di, Stasi; João Tadeu, Ribeiro-Paes.

    2015-03-01

    Full Text Available A Doença Inflamatória Intestinal (DII), consistindo principalmente da doença de Crohn e retocolite ulcerativa, é uma condição inflamatória da mucosa que pode acometer qualquer segmento do trato gastrointestinal. Apesar das terapias existentes resultarem na melhora dos sintomas e da qualidade de vida [...] dos pacientes, não há nenhum tratamento curativo. O tratamento cirúrgico envolve procedimentos complexos associados a altas taxas de morbimortalidade. Neste contexto, a terapia celular com células-tronco desponta como opção de tratamento potencialmente promissora. Em função destes aspectos, pretendeu-se, no presente estudo, verificar a eficácia do transplante de células-tronco derivadas do tecido adiposo (ASC) em ratos com inflamação intestinal induzida por ácido trinitrobenzenosulfonico (TNBS). As ASCs foram obtidas por dissociação mecânica do tecido adiposo da região inguinal de ratos e processadas para cultivo. Os animais foram avaliados, considerando-se os aspectos clínicos e bioquímicos, além de análises macroscópica, microscópica e histológica. No modelo de inflamação intestinal induzida por TNBS, a infusão de ASCs reduziu significativamente a presença de aderências entre o cólon e órgãos adjacentes, bem como diminuiu a atividade da mieloperoxidase (MPO), um marcador da infiltração de neutrófilos na mucosa lesada. Os resultados obtidos permitem concluir que a terapia celular com ASCs pode promover e/ou acelerar o processo de regeneração da mucosa intestinal inflamada. Abstract in english Inflammatory bowel disease, which mainly involves Crohn's disease and ulcerative rectocolitis, is an inflammatory condition of the mucosa that can afflict any segment of the gastrointestinal tract. Despite the fact that the existing therapies result in improvement in patient's symptomatology and qua [...] lity of life, there is no curative treatment. Surgical treatment involves complex procedures associated with high morbidity and mortality rates. In this context, cell therapy with stem cells has emerged as a treatment with broad potential applicability. In this study, we intended to verify the efficacy of transplantation of adipose tissue-derived stem cells in rats with intestinal inflammation induced by trinitrobenzenesulfonic acid. The cell population was isolated from the adipose tissue of inguinal region of rats and processed for culture by mechanical dissociation. The animals were evaluated with respect to clinical and biochemical aspects, as well as by macroscopic, microscopic and histological analyses. In the experimental model of bowel inflammation by 2,4,6-trinitrobenzenesulfonic acid, the infusion of adipose tissue significantly reduced the presence of adhesions in the colon and adjacent organs and decreased the activity of myeloperoxidase, a marker of neutrophil infiltration in the injured mucosa. The results suggest that cell therapy with adipose tissue can promote and/or accelerate the regeneration of damaged intestinal mucosa. It is concluded that the presence of adhesions and the determination of myeloperoxidase activity provide indications that adipose tissue can promote and/or accelerate the regeneration of inflammatory bowel mucosa.

  11. Spontaneous perforation of rectum with evisceration of small bowel small bowel simulating intussusception

    Directory of Open Access Journals (Sweden)

    Sandeep Bhat

    2010-12-01

    Full Text Available Context: Spontaneous perforation of rectum is a rare event; however evisceration of the small bowel through the perforated site without predisposing factors is extremely rare, complex and worth reporting. Case report: A 14 years old presented to us apparently as a case of intussception. The operative findings revealed it to be a case of spontaneous perforation of rectum with evisceration of the small bowel through the perforation. Conclusion: Sudden increase in the intra-abdominal pressure leads to the perforation in the chronically deranged rectal wall and pushes the small bowel loops into the pelvis and through the perforated rectum to appear transanally.

  12. Multidetector CT findings of bowel Transection in blunt abdominal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Hyun Suk; Woo, Ji Young; Hong, Hye Suk; Park, Mee Hyun; Yang, Ik; Lee, Yul; Jung, Ah Young; Hwang, Ji Young [Dept. of Radiology, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of); Ha, Hong Il [Dept. of Radiology, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)

    2013-08-15

    Though a number of CT findings of bowel and mesenteric injuries in blunt abdominal trauma are described in literature, no studies on the specific CT signs of a transected bowel have been published. In the present study we describe the incidence and new CT signs of bowel transection in blunt abdominal trauma. We investigated the incidence of bowel transection in 513 patients admitted for blunt abdominal trauma who underwent multidetector CT (MDCT). The MDCT findings of 8 patients with a surgically proven complete bowel transection were assessed retrospectively. We report novel CT signs that are unique for transection, such as complete cutoff sign (transection of bowel loop), Janus sign (abnormal dual bowel wall enhancement, both increased and decreased), and fecal spillage. The incidence of bowel transection in blunt abdominal trauma was 1.56%. In eight cases of bowel transection, percentage of CT signs unique for bowel transection were as follows: complete cutoff in 8 (100%), Janus sign in 6 (100%, excluding duodenal injury), and fecal spillage in 2 (25%). The combination of complete cutoff and Janus sign were highly specific findings in patients with bowel transection. Complete cut off and Janus sign are the unique CT findings to help detect bowel transection in blunt abdominal trauma and recognition of these findings enables an accurate and prompt diagnosis for emergency laparotomy leading to reduced mortality and morbidity.

  13. Small Bowel Ischemia in a Sickle Cell Patient

    OpenAIRE

    Abadin, Shabirhusain S.; Salazar, Mario R.; Zhu, Richard Y.; Mark M. Connolly; Francis J. Podbielski

    2009-01-01

    We report a case of small bowel ischemia secondary to sickle cell disease. Acute bowel ischemia is an uncommon presentation of patients with sickle cell disease. Historically, only a handful of cases have been reported. We also provide a summary of the literature relevant to sickle cell patients with acute bowel ischemia.

  14. Studies of the small bowel surface by scanning electron microscopy in infants with persistent diarrhea

    Directory of Open Access Journals (Sweden)

    U. Fagundes-Neto

    2000-12-01

    Full Text Available We describe the ultrastructural abnormalities of the small bowel surface in 16 infants with persistent diarrhea. The age range of the patients was 2 to 10 months, mean 4.8 months. All patients had diarrhea lasting 14 or more days. Bacterial overgrowth of the colonic microflora in the jejunal secretion, at concentrations above 10(4 colonies/ml, was present in 11 (68.7% patients. The stool culture was positive for an enteropathogenic agent in 8 (50.0% patients: for EPEC O111 in 2, EPEC O119 in 1, EAEC in 1, and Shigella flexneri in 1; mixed infections due to EPEC O111 and EAEC in 1 patient, EPEC O119 and EAEC in 1 and EPEC O55, EPEC O111, EAEC and Shigella sonnei in 1. Morphological abnormalities in the small bowel mucosa were observed in all 16 patients, varying in intensity from moderate 9 (56.3% to severe 7 (43.7%. The scanning electron microscopic study of small bowel biopsies from these subjects showed several surface abnormalities. At low magnification (100X most of the villi showed mild to moderate stunting, but on several occasions there was subtotal villus atrophy. At higher magnification (7,500X photomicrographs showed derangement of the enterocytes; on several occasions the cell borders were not clearly defined and very often microvilli were decreased in number and height; in some areas there was a total disappearance of the microvilli. In half of the patients a mucus-fibrinoid pseudomembrane was seen partially coating the enterocytes, a finding that provides additional information on the pathophysiology of persistent diarrhea.

  15. Case report: Congenital short bowel syndrome

    Directory of Open Access Journals (Sweden)

    Palle Lalitha

    2010-01-01

    Full Text Available Congenital short bowel syndrome (SBS is a relatively rare condition as compared to acquired SBS. It is associated with significant mortality and morbidity. Infants usually present with failure to thrive, recurrent vomiting, and diarrhea. It is important to suspect and diagnose this condition promptly, as early initiation of parenteral nutrition or surgery, if necessary, may result in a favorable outcome. We discuss a case of an infant aged 26 days, who presented with failure to thrive, recurrent vomiting, and weight loss. A contrast study of the gastrointestinal tract revealed a short small bowel, with malrotation. The infant was started on parenteral nutrition, but succumbed shortly thereafter to severe disseminated sepsis.

  16. Patient compliance and suboptimal bowel preparation with split-dose bowel regimen in average-risk screening colonoscopy

    Science.gov (United States)

    Menees, Stacy B.; Kim, H. Myra; Wren, Patricia; Zikmund-Fisher, Brian J.; Elta, Grace H.; Foster, Stephanie; Korsnes, Sheryl; Graustein, Brittany; Schoenfeld, Philip

    2014-01-01

    Background Although split-dose bowel regimen is recommended in colon cancer screening and surveillance guidelines, implementation in clinical practice has seemingly lagged because of concerns of patient compliance. Objectives To assess patient compliance with the split-dose bowel regimen and assess patient- and preparation process–related factors associated with compliance and bowel preparation adequacy. Design Prospective survey cohort. Setting Tertiary care setting. Patients Average-risk patients undergoing colonoscopy for colorectal cancer screening between August 2011 and January 2013. Main Outcome Measurements Split-dose bowel regimen patient-reported compliance and bowel preparation adequacy with the Boston Bowel Preparation Scale score. Results Surveys and Boston Bowel Preparation Scale score data were completed in 462 participants; 15.4% were noncompliant with the split-dose bowel regimen, and suboptimal bowel preparation (score < 5) was reported in 16% of all procedures. White (P = .009) and married (P = .01) subjects were least likely to be noncompliant, whereas Hispanic subjects and those who reported incomes of US$75,000 or less were most likely to be noncompliant (P = .004). Participants who were noncompliant with split-dosing were less likely to follow the other laxative instructions and more likely to have their colonoscopy appointment before 10:30 am. Compliance differed by bowel preparation type (P = .003, ?2 test), with those who used MiraLAX showing the highest compliance, followed by polyethylene glycol electrolyte solution and other bowel preparations. Noncompliance with split-dose bowel preparation (odds ratio 6.7; 95% confidence interval, 3.2–14.2) was the strongest predictor of suboptimal bowel preparation. Limitations Patient self-report, performed at tertiary care center. Conclusions Overall, 1 in 7 patients do not comply with a split-dose bowel regimen. Ensuring compliance with the split-dose bowel regimen will reduce the risk of a suboptimal bowel preparation. (Gastrointest Endosc 2014;79:811-20.) PMID:24631492

  17. CT enteroclysis in small bowel Crohn's disease

    Energy Technology Data Exchange (ETDEWEB)

    Kohli, Marc D. [Department of Radiology, Indiana University School of Medicine, Indianapolis, IN (United States); Maglinte, Dean D.T. [Department of Radiology, Indiana University School of Medicine, Indianapolis, IN (United States)], E-mail: dmaglint@iupui.edu

    2009-03-15

    The diagnostic evaluation of small bowel Crohn's disease has changed dramatically over the last decade. The introduction of wireless capsule endoscopy, double balloon endoscopy and the introduction of newer therapeutic agents have changed the role of imaging in the small bowel. Additionally, advances in multidetector CT technology have further changed how radiologic investigations are utilized in the diagnosis and management of small bowel Crohn's disease. This article describes how we perform CT enteroclysis in the investigation of small bowel Crohn's disease and discusses the role of CT enteroclysis in the current management of small bowel Crohn's disease.

  18. Harvesting oral mucosa for one-stage anterior urethroplasty.

    Science.gov (United States)

    Kulkarni, Sanjay Balwant; Barbagli, Guido; Sansalone, Salvatore; Joshi, Pankaj Mangalkumar

    2014-01-01

    Oral mucosa has been the most popular substitute material for urethral reconstructive surgery because it is easy to harvest, is easy to access, has a concealed donor site scar, and obviates most of the problems associated with other grafts. However, the success of using oral mucosa for urethral surgery is mainly attributed to the biological properties of this tissue. Herein, the surgical steps of harvesting oral mucosa from the inner cheek are presented with an emphasis on tips and tricks to render the process easier and more reproducible and to prevent intra and post-operative complications. The following steps are emphasized: Nasal intubation, ovoid shape graft, delicate harvesting leaving the muscle intact, donor site closure and removal of submucosal tissue. PMID:24497698

  19. Are Probiotics or Prebiotics useful in pediatric irritable bowel syndrome or inflammatory bowel disease?

    OpenAIRE

    StefanoGuandalini

    2014-01-01

    Treatment options for irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are notoriously either inadequate (IBS) or loaded with potentially serious side effects and risks (IBD). In recent years a growing interest for effective and safer alternatives has focused on the potential role of probiotics and their metabolic substrates, prebiotics. It is in fact conceivable that the microbiome might be targeted by providing the metabolic fuel needed for the growth and expansion of ben...

  20. Are Probiotics or Prebiotics Useful in Pediatric Irritable Bowel Syndrome or Inflammatory Bowel Disease?

    OpenAIRE

    Guandalini, Stefano

    2014-01-01

    Treatment options for irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are notoriously either inadequate (IBS) or loaded with potentially serious side effects and risks (IBD). In recent years, a growing interest in effective and safer alternatives has focused on the potential role of probiotics and their metabolic substrates, prebiotics. It is in fact conceivable that the microbiome might be targeted by providing the metabolic fuel needed for the growth and expansion of ben...

  1. Inflammatory bowel diseases: principles of nutritional therapy

    OpenAIRE

    Campos Fábio Guilherme; Waitzberg Dan L.; Teixeira Magaly Gemio; Mucerino Donato Roberto; Habr-Gama Angelita; Kiss Desidério R.

    2002-01-01

    Inflammatory Bowel Diseases - ulcerative colitis and Crohn's disease- are chronic gastrointestinal inflammatory diseases of unknown etiology. Decreased oral intake, malabsorption, accelerated nutrient losses, increased requirements, and drug-nutrient interactions cause nutritional and functional deficiencies that require proper correction by nutritional therapy. The goals of the different forms of nutritional therapy are to correct nutritional disturbances and to modulate inflammatory respons...

  2. The kidneys in inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Katsanos K.

    2007-03-01

    Full Text Available Extraintestinal manifestations and complications are common in patients with inflammatory bowel disease (IBD and may involve almost any organ or system. Renal or urinary complications occur in 4-23% of patients often in those with severe long-standing disease. The most common manifestations are kidney stones, enterovesical fistulas and ureteral obstruction. Genital involvement is uncommon in IBD. Patients with IBD have a risk of nephrolithiasis 10-100 times greater than that for the general hospital population. Glomerulonephritis (GN in IBD has been reported in at least 27 patients; of these 7 had CD, 17 had UC and 3 were indeterminate.Histology changes range from minimal change nephropathy to rapidly progressive crescentic GN which may be accompanied by active tubulointerstitial nephritis. Tubulointerstitial abnormalities are not uncommon in autopsy studies of IBD patients. Granulomatous interstitial nephritis, interstitial nephritis with hyperoxalouria and renal tubular acidosis have also been reported. Inflammatory bowel disease is an uncommon cause of secondary amyloidosis. Complications from medical therapy are relatively rare in the majority of drugs used to treat IBD. There is little or no nephrotoxicity with many drugs used including corticosteroids, azathioprine or 6-mercaptopurine, metronidazole and low dose methotrexate. The drugs with significant potential renal toxicity are the aminosalicylates (sulfasalazine, mesalamine, 5-ASA, olsalazine and cyclosporine. Surgical complications following bowel surgery include ureteral injury, urinary vetention and sexual dysfunction. Key words: renal, urinary, genital, drugs, therapy, inflammatory bowel disease, Crohn?s, ulcerative colitis, glomerular, tubular, interstitial, kidneys.

  3. [Gender differences and inflammatory bowel disease].

    Science.gov (United States)

    Hausmann, J; Blumenstein, I

    2015-08-01

    This review focuses on the gender and sex dimorphic disease profile and treatment reality of patients suffering from inflammatory bowel diseases (IBD). It provides an overview of gender-specific differences in the disease course, medical and surgical therapy as well as psychosocial aspects of IBD. PMID:26284324

  4. Analysis of bowel perforation in necrotizing enterocolitis

    International Nuclear Information System (INIS)

    The most severe complication of necrotizing enterocolitis (NEC) is bowel perforation. Identification of neonates at high risk for perforation and optimization of radiologic imaging to identify bowel perforation are necessary to reduce the high mortality rate associated with this catastrophic event. One hundred 55 cases of NEC were seen at our institution during a 5.5 year period. Nineteen (12%) progressed to perforation. A review of surgical findings, autopsy results and radiographs from these patients shows only 63% had radiographic evidence of free air in the peritoneal cavity at the time of perforation. Twenty-one percent had radiographic evidence of ascites but no pneumoperitoneum, and 16 percent had neither free air nor ascites. Thus purely radiographic criteria for bowel perforation in NEC are imprecise, and paracentesis is mandatory in NEC patients with ascites or clinical findings indicative of peritonitis. Timing of radiographic studies and site of bowel involvement are also important. Seventy-nine percent of perforations occurred by 30 h from confirmation of diagnosis (by clinical or radiographic criteria). Surgery or autopsy revealed involvement of the ileo-cecal region in 89% of cases with the actual site of perforation occurring in this area in 58% of patients. (orig.)

  5. Microbiota biodiversity in inflammatory bowel disease

    OpenAIRE

    Comito, Donatella; Cascio, Antonio; Romano, Claudio

    2014-01-01

    Gut microbiota plays a significant role in human health and energy balance, and provides protection against disease states. An altered balance between microbiota and its host (dysbiosis) would appear to contribute to the development of Inflammatory Bowel Disease (IBD), Crohn’s Disease (CD) and Ulcerative Colitis (UC). CD and UC are chronic inflammatory diseases of the gastrointestinal tes.

  6. If I Had - Bowel Control Issues

    Medline Plus

    Full Text Available ... Emory University. As Director of the Emory Continence Center, Dr. Galloway's clinical research covers a broad range of continence issues. We asked Dr. Galloway what he would do if he had a family member with bowel control issues. Dr. Galloway: Well, fecal incontinence is the ...

  7. Oral contrast agents for small bowel MRI: comparison of different additives to optimize bowel distension

    International Nuclear Information System (INIS)

    The purpose of this study was to compare two osmotic carbohydrate sugar alcohols (mannitol 2.5% and sorbitol 2.5%, 2.0%, and 1.5% watery solutions) in combination with 0.2% locust bean gum (LBG) for small bowel distension for MR imaging. Small bowel distension was quantified on coronal 2D TrueFISP images by measuring the diameters of 16 small bowel loops in each of 12 healthy subjects (age range 31-55 years). Additionally, the grade of small bowel distension was rated qualitatively. Patient acceptance concerning nausea, vomiting, flatulence, and diarrhea was noted for each solution, and all results were compared by a Wilcoxon test or t test, respectively. The ingestion of water combined with LBG and either 2.5% mannitol or 2.0% sorbitol showed the best distension of the small bowel. The lowest side effect rate was observed following ingestion of sorbitol in a concentration of 2.0 and 1.5%. Based on these data, we recommend a combination of LBG and 2% sorbitol use for optimal bowel distension and minimal side effects resulting in enhanced patient acceptance. (orig.)

  8. Alphamimetic effects at the nasal mucosa in the MR tomogram

    International Nuclear Information System (INIS)

    The effect of xylometazolin spray (OTRIVEN) on the nasal mucosa was tested on persons with and without clinical signs of rhinitis and sinusitis. MRI is an excellent means to show the decongestive effect. The reaction is chiefly seen at the inferior and middle nasal concha and becomes manifest in a few minutes. No significant effect is noticeable at the maxillary sinus mucosa and infiltrated ethmoidal sinus. Generally, it is possible to show and examine the pharmacological effects that change the size and the liquid consistency of organs. (orig.)

  9. Inflammatory bowel disease in pediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Charron, M. [Children`s Hospital of Pittsburgh, Pittsburgh (United States). Dept. of Radiology

    1997-12-01

    Optimal management of chronic idiopathic inflammatory bowel disease requires determination of disease localization and intensity. Scintigraphy with the use of {sup 99m}Tc - HMPAO- White Bloods Cells ({sup 99m}Tc - HMPAO-WBC) is a relatively new noninvasive nuclear medicine procedure. They have evaluated more than 230 children and have found a high correspondence between the disease distribution shown by the {sup 99m}Tc - HMPAO- WBC scan and that shown by endoscopic, radiologic, or surgical methods. Additionally the {sup 99m}Tc - HMPAO-WBC scan has the ability of identifying extra intestinal site of inflammation, such as appendicitis and others. The {sup 99m}Tc - HMPAO-WBC scan is reliable in differentiating Crohn`s disease from ulcerative colitis. Some patients because of unequivocal demonstrable small bowel uptake are reclassified from ulcerative colitis to Crohn`s disease. The medication regimen is frequently altered because of the intensity of uptake displayed by the {sup 99m}Tc - HMPAO-WBC scan. It is a practical and safe study even in an acutely ill patient who may not tolerate endoscopic or radiological study. At their institution, the {sup 99m}Tc - HMPAO-WBC scan is now part of the initial evaluation, and follow-up of patients with inflammatory bowel disease. In conclusion the {sup 99m}Tc - HMPAO-WBC is excellent for the detection, localization and characterization of inflammatory bowel disease in children. Compared with the other methods of investigation this study requires no bowel preparation, is noninvasive and has excellent diagnostic accuracy.

  10. [Irritable Bowel Syndrome treatment: a multidisciplinary approach].

    Science.gov (United States)

    Shani-Zur, Dana; Wolkomir, Keren

    2015-01-01

    Irritable Bowel Syndrome affects 9-23% of the general population. This diagnosis contributes to more frequent doctor visits and multiple consultations by patients. The current approach to treating IBS is symptomatic and consists of a regimen of first line pharmacological treatment options; the use of anti-depressant drugs is also common. The efficiency of complementary medicine in the treatment of IBS has been studied in the last few years. Qualitative multidisciplinary approach studies, using personalized medicines with complementary therapies are needed. We present the case of a 39-year-old woman with a diagnosis of IBS since 2009, who complained about gastrointestinal symptoms since the age of 13 and severe episodes of spasmodic stomach aches in the last year self-ranked as 10, on a 0-10 scale; 3-4 episodes a month, which last for 5 days, accompanied by severe flatulence and bloating. In addition, she has constipation (one bowel movement every 10 days), alternating with multiple diarrheic bowel movements (6 times a day). Using a multidisciplinary approach, including medicinal care, Chinese medicine, reflexology and naturopathy resulted in significant improvement in symptoms and quality of life, as well as gradual reduction of drugs, approved by her physician. Stomach ache self-ranked now as 1, on a 0-10 scale; and flatulence and bloating self-ranked as mild. Bowel movement frequency increased and is now every other day. She no longer has diarrheic and/or multiple bowel movements. This case report emphasizes the importance of integrative treatment in IBS and its benefit in improving patients' quality of life. PMID:25796677

  11. Effect of Paclitaxel (Taxol) alone and in combination with radiation on the gastrointestinal mucosa

    International Nuclear Information System (INIS)

    Purpose: Paclitaxel is a potentially useful drug for augmenting the cytotoxic action of radiotherapy because it has independent cytotoxic activity against certain cancers and blocks cells in the radiosensitive mitotic phase of the cell cycle. However, all rapidly proliferating tissues, both normal and neoplastic, may be affected by this therapeutic strategy. The aim of this study was to define the in vivo response of rapidly dividing cells of the small bowel mucosa to paclitaxel given alone and in combination with radiation. Methods and Materials: Mice were given single IV doses of 10 or 40 mg/kg paclitaxel or four doses of 10 mg/kg paclitaxel at 6, 12, or 24 h intervals. The kinetics of mitotic arrest and apoptosis in jejunal crypts of mice at 1-24 h after treatment were defined histologically. An in vivo stem cell microcolony assay was used to assess the radiosensitizing potential of paclitaxel when radiation was delivered at the peak of mitosis and at 24 h after drug treatment. Results: Paclitaxel blocked jejunal crypt cells in mitosis and induced apoptosis in a dose-dependent manner. Fractionating the paclitaxel dose over 1-4 days did not result in any greater accumulation of mitotically blocked cells than did a single dose. Mitosis peaked 2-4 h after paclitaxel and returned to near normal by 24 h. Apoptosis lagged several hours behind mitosis and peaked about 6 h later than mitosis. Despite these kinetic perturbations, there was little or no enhancement of radiation effect when single doses were delivered 2-4 h after paclitaxel administration. The maximum sensitizer enhancement ratio of 1.07 observed after a single paclitaxel dose of 40 mg/kg is consistent with independent crypt cell killing. Conversely, when radiation was given 24 h after paclitaxel, a significant protective effect of the drug (SER 0.89-0.92), most probably due to a regenerative overshoot induced by paclitaxel, was observed. Conclusion: Stem cells of the jejunal mucosa determining radiation response were not radiosensitized by paclitaxel with the drug concentrations and dose delivery schedules used, although additive cytotoxicity was observed with the highest drug dose. A radioprotective effect was observed when radiation was given 24 h after paclitaxel administration

  12. Small bowel cleansing does not improve quality of wireless capsule endoscopy

    DEFF Research Database (Denmark)

    Wilkens, Rune; Langholz, Ebbe

    ABSTRACT: Background Wireless capsule endoscopy (WCE) is the most important tool for investigating obscure gastrointestinal bleeding in the small bowel and is superior to cross sectional imaging in detecting early and subtle inflammation of the small intestine in Crohn's Disease (CD). [1] With increasing demand of early diagnosis, WCE becomes more important. However, a drawback is the limited visualization of the mucosa in patients with poor cleansing quality. The aim of our study was to determine the benefit of preparation with Picoprep prior to examination with WCE and evaluate two different methods for cleansing quality. Methods This prospective cluster trial examined all patients from two Danish centres, who underwent WCE with PillCam SB based on either known or suspected small bowel CD or obscure bleeding from August 2013 to July 2014. Our local ethics committee waived the necessity of informed consent. Both Centres used the same instructions for preparation; the day before examination, normal breakfast and lunch was allowed until 2 pm, hereafter patients were instructed to go on a liquid diet. Only water was allowed the last two hours before the procedure. Site A, in addition to Site B, instructed patients to ingest one sachet of Picoprep powder, at 9 pm the day before examination, followed by 1.5 litres of liquid diet, as per standard of care at Site A. Patients were matched between centres based on indication, sex and age. Cleansing quality was assessed by two different methods described by Park et al. 2010 [2] with a 3 grade subjective assessment every 5 minutes and Weyenberg et al. 2011 [3] with a computer assessment of cleansing using the colour bar in the capsule reading software. Mean overall score between groups were compared using students ttest. Results We enrolled 135 consecutive patients allowing matching of 92 patients with a mean age of 45 years (16-83), 67 % women. CD was the indication in 69.6 %. Both scoring systems correlated well (rho = 0.80). Using both scoring systems, cleansing qualitydecreased significantly throughout the small bowel when comparing each third individually, p < 0.01. There were no overall difference in quality between groups. Conclusions Small bowel cleansing prior to WCE does not improve mucosal visualization of the small bowel in patients with suspected CD or obscure bleeding. References: [1] Mustafa BF, Samaan M, Langmead L, Khasraw M, (2013), Small bowel video capsule endoscopy: an overview, Expert review of gastroenterology & hepatology, 323-329 [2] Park SC, Keum B, Hyun JJ et al., (2010), A novel cleansing score system for capsule endoscopy, World Journal of Gastroenterology, 875-880 [3] Van Weynberg SJB, De Leest HTJI, Mulder CJJ, (2011), Description of a novel grading system to assess the quality of bowel preparation in video capsule endoscopy., Endoscopy, 406-411

  13. Irritable Bowel Syndrome in Children

    Science.gov (United States)

    ... large enough amounts. But more research is needed. Probiotics can be found in dietary supplements, such as capsules, tablets, and powders, and in some foods, such as yogurt. A health care provider can give information about ...

  14. Combined alpha-methylacyl coenzyme A racemase/p53 analysis to identify dysplasia in inflammatory bowel disease.

    Science.gov (United States)

    Marx, Andreas; Wandrey, Timo; Simon, Philipp; Wewer, Agatha; Grob, Tobias; Reichelt, Uta; Minner, Sarah; Simon, Ronald; Spehlmann, Martina; Tigges, Wolfgang; Soehendra, Nib; Seitz, Uwe; Seewald, Stefan; Izbicki, Jakob R; Yekebas, Emre; Kaifi, Jussuf T; Mirlacher, Martina; Terracciano, Luigi; Fleischmann, Achim; Raedler, Andreas; Sauter, Guido

    2009-02-01

    Identification of dysplasia in inflammatory bowel disease represents a major challenge for both clinicians and pathologists. Clear diagnosis of dysplasia in inflammatory bowel disease is sometimes not possible with biopsies remaining "indefinite for dysplasia." Recent studies have identified molecular alterations in colitis-associated cancers, including increased protein levels of alpha-methylacyl coenzyme A racemase, p53, p16 and bcl-2. In order to analyze the potential diagnostic use of these parameters in biopsies from inflammatory bowel disease, a tissue microarray was manufactured from colons of 54 patients with inflammatory bowel disease composed of 622 samples with normal mucosa, 78 samples with inflammatory activity, 6 samples with low-grade dysplasia, 12 samples with high-grade dysplasia, and 66 samples with carcinoma. In addition, 69 colonoscopic biopsies from 36 patients with inflammatory bowel disease (28 low-grade dysplasia, 8 high-grade dysplasia, and 33 indefinite for dysplasia) were included in this study. Immunohistochemistry for alpha-methylacyl coenzyme A racemase, p53, p16 and bcl-2 was performed on both tissue microarray and biopsies. p53 and alpha-methylacyl coenzyme A racemase showed the most discriminating results, being positive in most cancers (77.3% and 80.3%) and dysplasias (94.4% and 94.4%) but only rarely in nonneoplastic epithelium (1.6% and 9.4%; P < .001). Through combining the best discriminators, p53 and alpha-methylacyl coenzyme A racemase, a stronger distinction between neoplastic tissues was possible. Of all neoplastic lesions, 75.8% showed a coexpression of alpha-methylacyl coenzyme A racemase and p53, whereas this was found in only 4 of 700 nonneoplastic samples (0.6%). alpha-methylacyl coenzyme A racemase/p53 coexpression was also found in 10 of 33 indefinite for dysplasia biopsies (30.3 %), suggesting a possible neoplastic transformation in these cases. Progression to dysplasia or carcinoma was observed in 3 of 10 p53/alpha-methylacyl coenzyme A racemase-positive, indefinite-for-dysplasia cases, including 1 of 7 cases without and 2 of 3 cases with p53 mutation. It is concluded that combined alpha-methylacyl coenzyme A racemase/p53 analysis may represent a helpful tool to confirm dysplasia in inflammatory bowel disease. PMID:18835622

  15. Effects of psychological stress on small intestinal motility and bacteria and mucosa in mice

    OpenAIRE

    Wang, Shao-Xuan; Wu, Wan-Chun

    2005-01-01

    AIM: To investigate the effects of psychological stress on small intestinal motility and bacteria and mucosa in mice, and to explore the relationship between small intestinal dysfunction and small intestinal motility and bacteria and mucosa under psychological stress.

  16. Helicobacter pylori in the gastric mucosa of dead children Helicobacter pylori en la mucosa gástrica de cadáveres de niños

    Directory of Open Access Journals (Sweden)

    John Jairo Duque Alzate

    1999-03-01

    Full Text Available 23 children under the age of 12 years who died violently without receiving any treatment, had their gastric mucosa studied by means of he Warthin-Starry stain and immunohistochemistry in search for Helicobacter pylori. It was found that 60.9% (14 cases were positive; of them 64,3% belonged to a low social class and 35,7% to the middle one. Of the positive cases, 9 had acute gastritis, 1 had chronic gastritis and only 4 had normal gastric mucosa. A clear association between Helicobacter pylory and changes in gastritis was observed. En 23 niños menores de 12 años que murieron en forma violenta sin haber recibido tratamiento, se estudiaron para Helicobacter pylori las mucosas gástricas con las coloraciones de hematoxilina eosina, Warthin Starry e inmunohistoquímica. Se encontró que 14 casos (60,9% fueron positivos para esta bacteria, de los cuales 9 (64,3% pertenecían a un estrato social bajo y 5 (35,7% a uno medio. De los casos positivos para H. pylori, 9 tenían gastritis aguda, 1 gastritis crónica y sólo en 4 la mucosa gástrica era normal. Se observó una clara asociación entre H. pylori y cambios de gastritis.

  17. Diseases of the small bowel in chronic diarrhea: diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    M. Simadibrata

    2002-09-01

    Full Text Available The incidence of chronic diarrhea in Asia is between 0.8-1.0%. The diseases and abnormalities according to the location, which can cause chronic diarrhea, are divided into three locations: the small bowel, the large bowel and extraintestinal. The small bowel diseases include infectious and non-infectious diseases. The infectious diseases are bacterial infections, parasitic infections etc. The non-infectious diseases include of Crohn’s disease, Celiac sprue, NSAID enteropathy, lactose intolerance, benign tumor, carcinoid tumor, carcinoma, post surgery complications, laxative etc. The approaches to diagnosis include good anamnesis, careful physical examination, supporting laboratory tests, more specialized supporting examinations including X-ray of the colon, esophagogastroduodenum follow-through, enteroclysis, ileo-colonoscopy and endoscopy on the upper portion of the digestive tract including the small intestine with biopsy for histopathology examinations. The treatment for chronic diarrhea is divided into supportive and causal therapy. (Med J Indones 2002; 11: 179-89 Keywords: small bowel, chronic diarrhea, approaches to diagnosis, treatment

  18. Review article: the incidence and prevalence of colorectal cancer in inflammatory bowel disease.

    DEFF Research Database (Denmark)

    Munkholm, P

    2003-01-01

    Although colorectal cancer (CRC), complicating ulcerative colitis and Crohn's disease, only accounts for 1-2% of all cases of CRC in the general population, it is considered a serious complication of the disease and accounts for approximately 15% of all deaths in inflammatory bowel disease (IBD) patients. The magnitude of the risk was found to differ, even in population-based studies. Recent figures suggest that the risk of colon cancer for people with IBD increases by 0.5-1.0% yearly, 8-10 years after diagnosis. The magnitude of CRC risk increases with early age at IBD diagnosis, longer duration of symptoms, and extent of the disease, with pancolitis having a more severe inflammation burden and risk of the dysplasia-carcinoma cascade. Considering the chronic nature of the disease, it is remarkable that there is such a low incidence of CRC in some of the population-based studies, and possible explanations have to be investigated. One possible cancer-protective factor could be treatment with 5-aminosalicylic acid preparations (5-ASAs). Adenocarcinoma of the small bowel is extremely rare, compared with adenocarcinoma of the large bowel. Although only few small bowel cancers have been reported in Crohn's disease, the number was significantly increased in relation to the expected number.

  19. Neurogenic mechanisms in bladder and bowel ageing.

    Science.gov (United States)

    Ranson, Richard N; Saffrey, M Jill

    2015-04-01

    The prevalence of both urinary and faecal incontinence, and also chronic constipation, increases with ageing and these conditions have a major impact on the quality of life of the elderly. Management of bladder and bowel dysfunction in the elderly is currently far from ideal and also carries a significant financial burden. Understanding how these changes occur is thus a major priority in biogerontology. The functions of the bladder and terminal bowel are regulated by complex neuronal networks. In particular neurons of the spinal cord and peripheral ganglia play a key role in regulating micturition and defaecation reflexes as well as promoting continence. In this review we discuss the evidence for ageing-induced neuronal dysfunction that might predispose to neurogenic forms of incontinence in the elderly. PMID:25666896

  20. Irritable bowel syndrome: alternative therapeutic management

    Directory of Open Access Journals (Sweden)

    A. Forbes .

    2007-03-01

    Full Text Available SUMMARY Irritable bowel syndrome is common, ill-understood and often difficult to treat. Conventional pharmacological approaches have not yet provided adequate solutions, and understandably patients have looked outside orthodox medicine to find relief. There is a paucity of verifiable data in respect of the alternative and complementary therapies that have been embarked upon, but worthwhile studies have been performed, and it is possible to draw some conclusions based on scientific grounds. Dietary manipulation and exclusion diets can help but value from any dietary addition has yet to be confirmed. Hypnotherapy and psychotherapy (whether individual or group are valuable in selected patients. Relaxation therapy and biofeedback techniques are probably helpful but reliable data are still awaited. Cognitive behavioural therapy is useful for some patients, but acupuncture does not seem to be effective. Key Words: Irritable bowel syndrome, Acupuncture, Hypnotherapy, Alternative therapy, Complementary therapy

  1. Enfermedad de la mucosa oral: Penfigoide de las membranas mucosas Oral mucosal disease: Mucouse membrane pemphigoid

    Directory of Open Access Journals (Sweden)

    N. Discepoli

    2009-04-01

    Full Text Available Los trastornos vesículobullosos subepiteliales representan desordenes autoinmunitarios que cogen origen de reacciones dirigidas hacia componentes de los hemidesmosomas o bien de las Zonas de la Membrana Basal (ZMB de los epitelios escamosos estratificados. A estos trastornos ha sido conferidoel término de enfermedades ampollosa subepiteliales inmunomediadas (EASIM y el penfigoide de las membranas mucosas (PMM es el más frecuente. Todas las enfermedades subepiteliales vesiculobullosas se presentan como lesiones ampollosas y descamativas, y el diagnostico debe de ser confirmado por una biopsia junta a tinción inmunológica. No hay un único tratamiento capaz de controlar todas las enfermedades subepiteliales vesiculoampollosas; las diferencias inmunológicas entre las EASIM proporciona diferencias en las respuestas al tratamiento. Hoy en día el tratamiento inmunorregulador es usado para controlar la lesión oral de PMM.Subepithelial vesiculobullous conditions are chronic autoimmune disorders that arise from reactions directed against components of the hemidesmosomes or basement membrane zones (BMZ of stratified squamous epithelium to which the term immune-mediated subepithelial blistering diseases (IMSEBD has been given. Mucous membrane pemphigoid (MMP is the most common, but variants do exist. All subepithelial vesiculobullous disorders present as blisters and erosions, and diagnosis must be confirmed by biopsy examination with immunostaining, sometimes supplemented by other investigations. No single treatment reliably controls all subepithelial vesiculobullous disorders; the immunological differences within IMSEBD may account for differences in responses to treatment. Currently, as well as improving oral hygiene, immunomodulatory treatment is used to control the oral lesions of MMP, but it is not known if its specific subsets reliably respond to different agents.

  2. Understanding inflammatory bowel disease via immunogenetics.

    Science.gov (United States)

    de Lange, Katrina M; Barrett, Jeffrey C

    2015-11-01

    The major inflammatory bowel diseases, Crohn's disease and ulcerative colitis, are both debilitating disorders of the gastrointestinal tract, characterized by a dysregulated immune response to unknown environmental triggers. Both disorders have an important and overlapping genetic component, and much progress has been made in the last 20 years at elucidating some of the specific factors contributing to disease pathogenesis. Here we review our growing understanding of the immunogenetics of inflammatory bowel disease, from the twin studies that first implicated a role for the genome in disease susceptibility to the latest genome-wide association studies that have identified hundreds of associated loci. We consider the insight this offers into the biological mechanisms of the inflammatory bowel diseases, such as autophagy, barrier defence and T-cell differentiation signalling. We reflect on these findings in the context of other immune-related disorders, both common and rare. These observations include links both obvious, such as to pediatric colitis, and more surprising, such as to leprosy. As a changing picture of the underlying genetic architecture emerges, we turn to future directions for the study of complex human diseases such as these, including the use of next generation sequencing technologies for the identification of rarer risk alleles, and potential approaches for narrowing down associated loci to casual variants. We consider the implications of this work for translation into clinical practice, for example via early therapeutic hypotheses arising from our improved understanding of the biology of inflammatory bowel disease. Finally, we present potential opportunities to better understand environmental risk factors, such as the human microbiota in the context of immunogenetics. PMID:26257098

  3. Genetic Studies in Inflammatory Bowel Disease

    OpenAIRE

    Linde, K

    2006-01-01

    Inflammatory bowel disease (IBD) is an idiopathic chronic gastrointestinal disease with genetic susceptibility playing an important role 1. This is further explored in this thesis. The initiative for this thesis started within the departments of Gastroenterology and Hepatology, and Internal Medicine of the Erasmus MC University Medical Centre Rotterdam (UMCR). The primary research goal was to explore aspects of the genetic aetiology of IBD by searching for mutations in inflamma...

  4. Familial risk of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Trier Møller, Frederik; Andersen, Vibeke; Wohlfarht, Jan; Jess, Tine

    2015-01-01

    OBJECTIVES: Estimates of familial risk of inflammatory bowel diseases (IBDs), Crohn's disease (CD), and ulcerative colitis (UC) are needed for counseling of patients and could be used to target future prevention. We aimed to provide comprehensive population-based estimates of familial risk of IBD. METHODS: The study encompassed the entire Danish population during 1977-2011 (N=8,295,773; 200 million person-years). From national registries, we obtained information on diagnosis date of IBD (N=45,78...

  5. Irritable Bowel Syndrome: Yoga as Remedial Therapy

    OpenAIRE

    Kavuri, Vijaya; Raghuram, Nagarathna; Malamud, Ariel; Selvan, Senthamil R.

    2015-01-01

    Irritable bowel syndrome (IBS) is a group of symptoms manifesting as a functional gastrointestinal (GI) disorder in which patients experience abdominal pain, discomfort, and bloating that is often relieved with defecation. IBS is often associated with a host of secondary comorbidities such as anxiety, depression, headaches, and fatigue. In this review, we examined the basic principles of Pancha Kosha (five sheaths of human existence) concept from an Indian scripture Taittiriya Upanishad and t...

  6. Quality Improvement in Inflammatory Bowel Disease

    OpenAIRE

    Melmed, Gil Y; SIEGEL, COREY A.

    2013-01-01

    Chronic illnesses such as inflammatory bowel disease (IBD) present a unique opportunity to define and improve the quality of care. Processes of care can be complex, and outcomes of care may vary across different healthcare delivery settings. Patients with IBD are managed over long periods of time and often by the same physician within a single care delivery system. Both patients with Crohn’s disease and ulcerative colitis have variable courses of disease progression that require changes in th...

  7. The evolving epidemiology of inflammatory bowel disease.

    LENUS (Irish Health Repository)

    Shanahan, Fergus

    2009-07-01

    Epidemiologic studies in inflammatory bowel disease (IBD) include assessments of disease burden and evolving patterns of disease presentation. Although it is hoped that sound epidemiologic studies provide aetiological clues, traditional risk factor-based epidemiology has provided limited insights into either Crohn\\'s disease or ulcerative colitis etiopathogenesis. In this update, we will summarize how the changing epidemiology of IBD associated with modernization can be reconciled with current concepts of disease mechanisms and will discuss studies of clinically significant comorbidity in IBD.

  8. Diagnostics in inflammatory bowel disease: Ultrasound

    OpenAIRE

    Deike Strobel; Ruediger S Goertz; Thomas Bernatik

    2011-01-01

    Diagnosis of chronic inflammatory bowel diseases (IBD) is based on a combination of clinical symptoms, laboratory tests and imaging data. Imaging of the morphological characteristics of IBD includes the assessment of mucosal alterations, transmural involvement and extraintestinal manifestations. No single imaging technique serves as a diagnostic gold standard to encompass all disease manifestations. Ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) allow cross-sectional...

  9. Bowel injury associated with pelvic radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Francois, Agnes [Institut de Radioprotection et de Surete Nucleaire/Institut Gustave-Roussy, UPRES EA 2710, Radiosensibilite des Tumeurs et des Tissus Sains, PR1, 39, rue Camille Desmoulins, 94 800 Villejuif Cedex (France)]. E-mail: Francois@igr.fr; Milliat, Fabien [Institut de Radioprotection et de Surete Nucleaire/Institut Gustave-Roussy, UPRES EA 2710, Radiosensibilite des Tumeurs et des Tissus Sains, PR1, 39, rue Camille Desmoulins, 94 800 Villejuif Cedex (France); Vozenin-Brotons, Marie-Catherine [Institut de Radioprotection et de Surete Nucleaire/Institut Gustave-Roussy, UPRES EA 2710, Radiosensibilite des Tumeurs et des Tissus Sains, PR1, 39, rue Camille Desmoulins, 94 800 Villejuif Cedex (France)

    2005-02-01

    Radiation therapists have to deal with the difficulty to give an efficient radiation dose to the tumor without generating unacceptable normal tissue injury. Acute reactions are experienced in most of the patients and are characterized by diarrhea resulting from intestinal mucosal injury. In some cases, intestinal wall fibrosis may develop, with hazard of occlusion syndrome. The only therapeutic recourse consists of surgical resection of the injured bowel.

  10. Clostridium difficile and pediatric inflammatory bowel disease

    DEFF Research Database (Denmark)

    Martinelli, Massimo; Strisciuglio, Caterina; Veres, Gabor; Paerregaard, Anders; Pavic, Ana M; Aloi, Marina; Martín-de-Carpi, Javier; Levine, Arie; Turner, Dan; Del Pezzo, Mariassunta; Staiano, Annamaria; Miele, Erasmo

    2014-01-01

    BACKGROUND: Clostridium difficile infection is associated with pediatric inflammatory bowel disease (IBD) in several ways. We sought to investigate C. difficile infection in pediatric patients with IBD in comparison with a group of children with celiac disease and to evaluate IBD disease course of C. difficile infected patients. METHODS: In this prospective, comparative, multicenter study, 211 pediatric patients with IBD were enrolled from October 2010 to October 2011 and tested for the presence...

  11. Inflammatory Bowel Disease (IBD) and the Liver

    OpenAIRE

    A. B. Adamopoulos

    2007-01-01

    Hepatobiliary Diseases (HBDs) accompanies in a 5-10% of patients with Inflammatory Bowel Diseases (IBD). They are either extra-intestinal manifestations or drug side effects. The main extra-intestinal manifestation is Primary Sclerosing Cholangitis (PSC), which as an entity, includes the former ?pericholangitis?, now called small duct Primary Sclerosing Cholangitis. It mainly affects young males with ulcerative colitis. It is a chronic cholestatic disease with a broad spectr...

  12. Irritable bowel syndrome: alternative therapeutic management

    OpenAIRE

    Forbes, A

    2007-01-01

    SUMMARY Irritable bowel syndrome is common, ill-understood and often difficult to treat. Conventional pharmacological approaches have not yet provided adequate solutions, and understandably patients have looked outside orthodox medicine to find relief. There is a paucity of verifiable data in respect of the alternative and complementary therapies that have been embarked upon, but worthwhile studies have been performed, and it is possible to draw some conclusions based on scientific grounds. D...

  13. Denovo Post Renal Transplantation Inflammatory Bowel Disease

    OpenAIRE

    Halim M; Al-Otaibi T; Elsisi A; El-Sayed A; Nair P; Said T; Balaha M; Nampoory MRN

    2008-01-01

    Post-renal transplant de-novo inflammatory bowel disease (IBD) may develop despite the presence of mycophenolate mofetil (MMF), a drug used for treatment of IBD, in the immunosuppressive regimen. A 39-year-old man received live unrelated renal transplant, and was started postoperatively on prednisolone, MMF, and tacrolimus, which was changed to sirolimus when he developed diabetes mellitus two months post-transplant. Nine months post-transplant, the patient developed recurrent attacks of bloo...

  14. Use of thiopurines in inflammatory bowel disease

    OpenAIRE

    Pascal Frei; Luc Biedermann; Ole Haagen Nielsen; Gerhard Rogler

    2013-01-01

    The use of thiopurines as immunosuppression for the treatment of refractory or chronic active inflammatory bowel disease is established for both Crohn's disease and ulcerative colitis. Nevertheless, many questions remain concerning the optimal treatment regimens of azathioprine, 6-mercaptopurine and thioguanine. We will briefly summarize dose recommendations, indications for thiopurine therapy and side effects which are relevant in clinical practice. We discuss some currently debated topics, ...

  15. Irritable bowel syndrome and its psychological management

    Directory of Open Access Journals (Sweden)

    Ravikesh Tripathi

    2015-01-01

    Full Text Available Irritable Bowel Syndrome (IBS is a chronic and disabling gastrointestinal problem that affects psychosocial functioning as well as the quality of life. This case study reports the utility of cognitive behavior therapy as a psychological intervention procedure in a chronic case of IBS. The use of psychological intervention was found to result in a reduction of anxiety; amelioration of the symptoms associated with IBS and improved functioning.

  16. Gas Embolic Stroke Secondary to Bowel Infarction.

    Science.gov (United States)

    Parikh, Dhruv; Leyon, Joe Joseph; Chavda, Swarupsinh

    2016-01-01

    A 69-year-old gentleman with metastatic esophageal adenocarcinoma presented with acute abdominal pain to the emergency medicine department and subsequently developed an acute left hemiplegia while in the resuscitation unit. An unenhanced computed tomography (CT) scan of the head showed right frontal cerebral gas emboli while an unenhanced CT scan of the abdomen and pelvis showed extensive portal venous gas and pneumatosis intestinalis, presumed secondary to bowel infarction. PMID:26599977

  17. Systems Biology Approaches for Inflammatory Bowel Disease

    DEFF Research Database (Denmark)

    Moco, Sofia; Candela, Marco; Chuang, Emil; Draper, Colleen; Cominetti, Ornella; Montoliu, Ivan; Barron, Denis; Kussmann, Martin; Brigidi, Patrizia; Gionchetti, Paolo; Martin, Francois-Pierre J.

    2014-01-01

    Although the prevalence of main idiopathic forms of inflammatory bowel disease (IBD) has risen considerably over the last decades, their clinical features do not allow accurate prediction of prognosis, likelihood of disease progression, or response to specific therapy. Through a better understanding of the molecular pathways involved in IBD and the promise of more targeted therapies, the personalized approach to the management of IBD shows potential. To achieve this, there remains a significant ...

  18. Transplante de intestino delgado / Small bowel transplantation

    Scientific Electronic Library Online (English)

    Rafael Antonio Arruda, Pécora; André Ibrahim, David; André Dong, Lee; Flávio Henrique, Galvão; Ruy Jorge, Cruz-Junior; Luiz Augusto Carneiro, D' Albuquerque.

    2013-09-01

    Full Text Available INTRODUÇÃO: O transplante de intestino delgado, em razão de sua complexidade, apresentou evolução mais lenta que os demais órgãos sólidos. Diversos avanços permitiram sua aplicação clínica. OBJETIVO: Revisão da evolução do transplante de intestino delgado e seu estado atual. MÉTODO: levantamento bib [...] liográfico nas bases de dados MEDLINE e ScIELO. Os termos usados como descritores foram: intestinal failure, intestinal transplant, small bowel transplant, multivisceral transplant. Foram analisados dados sobre evolução histórica, centros, indicações, tipos de enxertos, seleção e captação de órgãos, manejo pós-operatório, complicações e resultados. CONCLUSÃO: Apesar de desenvolvimento mais lento, o transplante intestinal é hoje a terapia para pacientes portadores de falência intestinal irreversível que apresentam complicações da nutrição parenteral. Envolve algumas modalidades: intestino delgado isolado, fígado-intestino, multivisceral e multivisceral modificado. Atualmente a sobrevida é semelhante aos demais órgãos sólidos. A maioria dos pacientes fica livre da nutrição parenteral. Abstract in english BACKGROUND: Small bowel transplantation evolution, because of its complexity, was slower than other solid organs. Several advances have enabled its clinical application. AIM: To review intestinal transplantation evolution and its current status. METHOD: Search in MEDLINE and ScIELO literature. The t [...] erms used as descriptors were: intestinal failure, intestinal transplantation, small bowel transplantation, multivisceral transplantation. Were analyzed data on historical evolution, centers experience, indications, types of grafts, selection and organ procurement, postoperative management, complications and results. CONCLUSION: Despite a slower evolution, intestinal transplantation is currently the standard therapy for patients with intestinal failure and life-threatening parenteral nutrition complications. It involves some modalities: small bowel transplantation, liver-intestinal transplantation, multivisceral transplantation and modified multivisceral transplantation. Currently, survival rate is similar to other solid organs. Most of the patients become free of parenteral nutrition.

  19. Effective in vivo and ex vivo gene transfer to intestinal mucosa by VSV-G-pseudotyped lentiviral vectors

    Directory of Open Access Journals (Sweden)

    Kasahara Noriyuki

    2010-05-01

    Full Text Available Abstract Background Gene transfer to the gastrointestinal (GI mucosa is a therapeutic strategy which could prove particularly advantageous for treatment of various hereditary and acquired intestinal disorders, including inflammatory bowel disease (IBD, GI infections, and cancer. Methods We evaluated vesicular stomatitis virus glycoprotein envelope (VSV-G-pseudotyped lentiviral vectors (LV for efficacy of gene transfer to both murine rectosigmoid colon in vivo and human colon explants ex vivo. LV encoding beta-galactosidase (LV-?-Gal or firefly-luciferase (LV-fLuc reporter genes were administered by intrarectal instillation in mice, or applied topically for ex vivo transduction of human colorectal explant tissues from normal individuals. Macroscopic and histological evaluations were performed to assess any tissue damage or inflammation. Transduction efficiency and systemic biodistribution were evaluated by real-time quantitative PCR. LV-fLuc expression was evaluated by ex vivo bioluminescence imaging. LV-?-Gal expression and identity of transduced cell types were examined by histochemical and immunofluorescence staining. Results Imaging studies showed positive fLuc signals in murine distal colon; ?-Gal-positive cells were found in both murine and human intestinal tissue. In the murine model, ?-Gal-positive epithelial and lamina propria cells were found to express cytokeratin, CD45, and CD4. LV-transduced ?-Gal-positive cells were also seen in human colorectal explants, consisting mainly of CD45, CD4, and CD11c-positive cells confined to the LP. Conclusions We have demonstrated the feasibility of LV-mediated gene transfer into colonic mucosa. We also identified differential patterns of mucosal gene transfer dependent on whether murine or human tissue was used. Within the limitations of the study, the LV did not appear to induce mucosal damage and were not distributed beyond the distal colon.

  20. Asma leve persistente: Estudio histopatológico de mucosa bronquial y nasal

    Scientific Electronic Library Online (English)

    Trina, Martin; Marissa, Campos; Lisseloth, Garrido; Guillermo, Isturiz.

    2002-04-01

    Full Text Available Asma y rinitis son patologías inflamatorias relacionadas con severidad y respuesta terapéutica variable. El objetivo del presente estudio es determinar las características histopatológicas a nivel de mucosa bronquial y nasal de pacientes con asma leve persistente, y establecer si existe similitud en [...] tre ambas, lo que permitiría considerar nuevas estrategias diagnósticas y terapéuticas oportunas para mejorar la morbilidad. Se estudiaron 10 pacientes con asma leve persistente, no fumadores, sin uso de corticoesteroides. Durante cuatro semanas previas al estudio se les practicó espirometría simple, pruebas de alergia, biopsia de mucosa bronquial y nasal, además de lavado bronquial. Todos los pacientes tuvieron un volumen espirado en el 1º segundo (VEF1s) mayor al 65 % del valor predictivo, con una segunda respuesta al broncodilatador ž 12 %. La prueba de alergia documentó atopia en 3 pacientes de 7 que realizaron la prueba. Se observaron cambios inflamatorios similares en ambas mucosas, engrosamiento variable de la membrana basal sin diferencias estadísticamente significativas (P = 0,07); la célula reactiva común en todas las muestras de biopsia y lavado fue el eosinófilo asociado a severo infiltrado linfoplasmohistiocitario; además se observaron cristales de Charcot Leyden tanto a nivel tisular como en lavado bronquial. Conclusión: Se encontraron cambios inflamatorios similares en ambas mucosas. Pacientes con comportamiento clínico funcional leve presentan cambios inflamatorios activos y severos durante todo el tracto respiratorio. Abstract in english Asthma and rinitis are inflammatory pathologies related with variable severity and therapeutic response. The objective of the present study is to assess and compare the histopathological changes in nasal and bronchial mucosa of patients with mild persistent asthma and to settle down if similarity ex [...] ists among both, what would allow to consider new strategies diagnoses and therapeutic opportunities to improve the morbidity. Ten patients were studied with mild persistent asthma, no smokers, withdraw of corticosteroids for at least 4 weeks before the start, without respiratory tract infection 4 previous weeks to the study. They were practiced simple spirometry, allergy tests by means of micropuncture, biopsy of bronchial and nasal mucosa, with bronchial lavage. All the patients obtained a 1 second forced expiratory volume (FEV1) greater than 65 % of the predictive value with the broncodilator second response greater or similar to 12 %. The allergy test documents atopia in 3 of 7 patients whom were tested. Similar inflammatory changes were observed in both nasal an bronchial mucosa, variable thickness of the basal membrane without statistically significant differences (P= 0,07); the common reactive cell in all the biopsy samples and bronchial lavage was the eosinophil associated to severe infiltrated linfoplasmocitary, Charcot Leyden crystals were present at the bronchial lavage and at both mucosas. Conclusion: Similar inflammatory changes were found at the nasal and bronchial mucosa. Patients with mild functional clinical behavior present active and severe inflammatory changes at the upper and lower respiratory tract.

  1. The radiolesions of the small bowel

    International Nuclear Information System (INIS)

    The irradiation of the pelvic abdominal cancers extends beyond the centre of the tumour and may induce actinic digestive lesions. The bowel and more rarely the small bowel -which is the subject-matter of our study- are concerned by those radiolesions that are favoured by therapeutic overdose, post-operative adhesions fastening the bows, radio-surgical or chemicostatic associations, and lastly by vascular or nutritive deficiencies. One may distinguish between two kinds of lesions, depending on the lapse of time before their coming out and on the symptoms. The early or acute types are characterized by a radio-mucitis and give an exsudative enteropathy with anorexia, vomiting, diarrhoea and loss of weight, of which the diagnosis is easy because it occurs during the irradiation and lessens at the end of the treatment. The late radiolesions of the small bowel are characterized by sclerosis and chronic endarteritis and, after a longlasting period of latency, give varied symptoms: disordered intestinal transit which sometimes is irreversible, perforation, fistula, syndrome of malabsorption, giving often rise to be mistaken for a recurrence of the cancer. The treatment varies whether the lesion is segmental or diffuse. In the first case, the failure of the medical means accounts for the surgical cutting away or the internal derivation; in the second case, the digestive mutilation which would result from an enlargement of the lesion commands to be more cautious and to call for the methods of parenteral feeding and digestive setting to rest

  2. Bowel damage after radiation therapy of carcinoma of the cervix

    International Nuclear Information System (INIS)

    Radiation damage to bowel is increasing in frequency in patients treated for invasive carcinoma of the cervix (as is the cure rate). Symptoms of bowel damage can occur many years after the therapy and may be confused with recurrent cancer or development of a primary bowel cancer. The care of patients presents a difficult challenge to physicians, but every effort must be made to provide proper care for these women who many times have been cured of their cervical cancer. (U.S.)

  3. Capsule Endoscopy in the Small Bowel Crohn’s Disease

    OpenAIRE

    Federico Argüelles-Arias; Juan Rodríguez-Oballe; Calixto Duarte-Chang; Luisa Castro-Laria; Josefa María García-Montes; Ángel Caunedo-Álvarez; Juan Manuel Herrerías-Gutiérrez

    2014-01-01

    CD is a chronic inflammatory disorder associated to mucosal and transmural inflammation of the bowel wall. It is well known that CD can affect the entire gastrointestinal. Therefore, ileocolonoscopy and biopsies of the terminal ileum as well as of each colonic segment to look for microscopic evidence of CD are the first-line procedures to establish the diagnosis. However, it has been observed that up to 30% of the patients have only small bowel involvement. Evaluation of the small bowel has b...

  4. Intussusception of the bowel in adults: A review

    OpenAIRE

    Athanasios Marinis, Anneza Yiallourou, Lazaros Samanides, Nikolaos Dafnios, Georgios Anastasopoulos, Ioannis Vassiliou, Theodosios Theodosopoulos

    2009-01-01

    Intussusception of the bowel is defined as the telescoping of a proximal segment of the gastrointestinal tract within the lumen of the adjacent segment. This condition is frequent in children and presents with the classic triad of cramping abdominal pain, bloody diarrhea and a palpable tender mass. However, bowel intussusception in adults is considered a rare condition, accounting for 5% of all cases of intussusceptions and almost 1%-5% of bowel obstruction. Eight to twenty percent of cases a...

  5. Intestinal microbiota in pathophysiology and management of irritable bowel syndrome

    OpenAIRE

    Lee, Kang Nyeong; Lee, Oh Young

    2014-01-01

    Irritable bowel syndrome (IBS) is a functional bowel disorder without any structural or metabolic abnormalities that sufficiently explain the symptoms, which include abdominal pain and discomfort, and bowel habit changes such as diarrhea and constipation. Its pathogenesis is multifactorial: visceral hypersensitivity, dysmotility, psychosocial factors, genetic or environmental factors, dysregulation of the brain-gut axis, and altered intestinal microbiota have all been proposed as possible cau...

  6. Mechanical bowel preparation in elective open colon surgery

    OpenAIRE

    Fa-Si-Oen, Patrick Regnier

    2006-01-01

    Mechanical bowel preparation is a long standing practice in elective open colon surgery dating from the 1970's. It has always been believed to reduce the rate of postoperative complications in the form of anastomotic leakage and wound infection. In this thesis we broadly and thoroughly examine the various aspects and the value of mechanical bowel preparation in elective open colon surgery. - Mechanical bowel preparation in elective open colon surgery does not reduce the rate of anastomo...

  7. Growth factors as treatment for inflammatory bowel disease: A concise review of the evidence toward their potential clinical utility

    Directory of Open Access Journals (Sweden)

    Barahona-Garrido Josue

    2009-01-01

    Full Text Available In the process of inflammation and repair of the intestinal mucosa in inflammatory bowel disease (IBD, there occurs a complex and an unknown interplay of innate and adaptive immune mechanisms. This interaction of factors may explain why IBD is characterized by a relapsing and remitting clinical course. Different components of innate immunity, hormones and interleukins in IBD have been suggested to be impaired. The growth hormone, epidermal growth factor, keratinocyte growth factor and colony-stimulating factors have emerged as potential tools for the modulation of intestinal inflammation and repair. Despite promising results of initial studies, the evidence that justify treatment of patients in clinical practice is not enough as some of the trials are nonrandomized or included a small number of patients. In this concise review, we provide a summary of the most recent and relevant evidence regarding the potential therapeutic effects of growth factors in IBD.

  8. Small bowel obstruction caused by secondary tumors.

    Science.gov (United States)

    Idelevich, Efraim; Kashtan, Hanoch; Mavor, Eli; Brenner, Baruch

    2006-07-01

    Small bowel obstruction in an oncology patient is a common and serious medical problem which is associated with diagnostic as well as therapeutic dilemmas. While the condition is most commonly caused by postoperative adhesions and peritoneal carcinomatosis, other causes have been reported [Cormier WJ, Gaffey TA, Welch JM, et al. Linitis plastica caused by metastatic lobular carcinoma of the breast. Mayo Clinical Proceedings 1980;55:747-53; Clavien P-A, Laffer U, Torhos J, et al. Gastrointestinal metastases as first clinical manifestation of the dissemination of a breast cancer. European Journal of Surgical Oncology 1990;16:121-6; Bender GN, Maglinte DD, McLarney JH, et al. Malignant melanoma: patterns of metastasis to the small bowel, reliability of imaging studies, and clinical relevance. American Journal of Gastroenterology 2001;96:2392-400; Gatsoulis N, Roukounakis N, Kafetzis I, et al. Small bowel intussusception due to metastatic malignant melanoma. A case report. Technical Coloproctology 2004;8:141-3; Hung GY, Chiou T, Hsieh YL, et al. Intestinal metastasis causing intussusception in a patient treated for osteosarcoma with history of multiple metastases: a case report. Japanese Journal of Clinical Oncology 2001;31(4):165-7; Chen TF, Eardley I, Doyle PT, Bullock KN. Rectal obstruction secondary to carcinoma of the prostate treated by transanal resection of the prostate. British Journal of Urology 1992;70(6):643-7; Kamal HS, Farah RE, Hamzi HA, et al. Unusual presentation of rectal adenocarcinoma. Roman Journal of Gastroenterology 2003;12(1):47-50; Hofflander R, Beckes D, Kapre S, et al. A case of jejunal intussusception with gastrointestinal bleeding caused by metastatic testicular germ cell cancer. Digestive Surgery 1999;16(5):439-40]. One of these, reported thus far in only very few patients, is obstruction caused by secondary tumors, i.e. metastases from other organs to the small bowel wall. As cancer patients live longer with improved therapy, physicians are more likely to cope with rare phenomena of neoplasms, such as small bowel obstruction caused by secondary tumors. We hereby present a review of the relevant medical literature. The goal of this article is to define current knowledge on this phenomenon, with emphasis on its epidemiology and clinical characteristics, and to increase the awareness of the clinician treating cancer patients of such possibility. PMID:16905310

  9. Multislice CT enteroclysis in the diagnosis of bowel endometriosis

    Energy Technology Data Exchange (ETDEWEB)

    Biscaldi, Ennio; Rollandi, Gian A. [' ' Duchesse of Galliera' ' -Hospital, Genoa (Italy). Dept. of Radiology; Ferrero, Simone; Ragni, Nicola; Remorgida, Valentino [San Martino Hospital and Genoa Univ. (Italy). Dept. of Obstretics and Gynaecology; Fulcheri, Ezio [San Martino Hospital and Genoa Univ. (Italy). Unit of Anatomy and Histopathology

    2007-01-15

    This prospective study aims to evaluate the efficacy of multislice computed tomography combined with colon distension by water enteroclysis (MSCTe) in determining the presence and depth of bowel endometriotic lesions. Ninety-eight women with symptoms suggestive of colorectal endometriosis underwent MSCTe; locations, number of nodule/s, size of the nodule/s and depth of bowel wall infiltration were determined. Independently from the findings of MSCTe, all women underwent laparoscopy. MSCTe findings were compared with surgical and histological results. Abnormal findings suggestive of bowel endometriotic nodules were detected by MSCTe in 75 of the 76 patients with bowel endometriosis. MSCTe identified 110 (94.8%) of the 116 bowel endometriotic nodules removed at surgery; 6 nodules missed at MSCTe were located on the rectum. MSCTe correctly determined the degree of infiltration of the bowel wall in all of the 34 serosal bowel nodules identified at MSCTe. In six nodules reaching the submucosa, the depth of infiltration was underestimated by MSCTe. MSCTe had a sensitivity of 98.7%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 95.7% in identifying women with bowel endometriosis. MSCTe is effective in determining the presence and depth of bowel endometriotic lesions. (orig.)

  10. Multi-detector CT (MDCT in bowel and mesenteric injury

    Directory of Open Access Journals (Sweden)

    Vajjalla Ravikumar

    2013-04-01

    Full Text Available Objectives: To evaluate multi-detector CT (MDCT findings in bowel and mesenteric injury due to blunt abdominal trauma.Method: Retrospective evaluation of MDCT scan reports of patients admitted in Hamad Medical Corporation, Doha, Qatar with bowel and mesenteric injury during the period of January 2005 to April 2008.Results: MDCT, without using oral contrast, clearly demonstrated various specific and less specific findings of bowel and mesenteric injury.Conclusion: Multi-detector CT is an excellent diagnostic modality in bowel and mesenteric injury. Routine administration of oral contrast agent is not mandatory for initial evaluation of these patients.

  11. Omphalocele minor associated with complete absence of the large bowel.

    LENUS (Irish Health Repository)

    Ferede, Atakelet

    2012-02-01

    Colonic atresia, unlike small intestine atresia, is a rare congenital malformation. Congenital absence of the entire colon is exceptionally rare. Moreover, an association of omphalocele and complete absence of the colon has not yet been reported in the literature. We present an infant born with such combination of congenital anomalies.

  12. Cholecystectomy and adenomatous polyps of the large bowel.

    OpenAIRE

    Llamas, K J; Torlach, L G; Ward, M.; Bain, C

    1986-01-01

    Seventy two patients (39 women) with colonic adenomas were compared with 72 adenoma free controls (39 women) to investigate the possible association between previous cholecystectomy and the subsequent development of adenomas. Data were gathered retrospectively from medical records. Overall there was no significant association between colonic adenomas and previous cholecystectomy. When women are considered separately, however, eight cases and no controls had undergone cholecystectomy (odds rat...

  13. Solitary fibrous tumor of small bowel mesentery with postoperative bowel obstruction: a case report and review of literature

    Science.gov (United States)

    Zhang, Guo-Jing; Li, Ruo-Tong; Zhou, Yang; Huang, Fei; Zhao, Zhi-Cheng; Li, Wei-Dong; Fu, Wei-Hua

    2015-01-01

    Solitary fibrous tumor (SFT) which is an extremely rare clinical entity has been reported infrequently. Most commonly it is distinguished into pleural and extrapleural forms, with same morphological resemblance. There has been many literatures reported regarding extrapleural form of SFT but few cases of SFT originating from small bowel mesentery have been reported till now. We here report one case of SFT of small bowel mesentery with some eventful postoperative bowel obstruction and literature review. PMID:26617912

  14. An immunoglobulin G-4 related sclerosing disease of the small bowel: CT and small bowel series findings

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Young Hwan; Hwang, Dae Hyun; Min, Seon Jeong [Dept. of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong (Korea, Republic of); Woo, Ji Young; Kim, Jeong Won; Hong, Hye Sook; Yang, Ik; Lee, Yul [Hallym University Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of)

    2013-10-15

    Immunoglobulin G4 (IgG4)-related sclerosing disease is rare and is known to involve various organs. We present a case of histologically proven IgG4-related sclerosing disease of the small bowel with imaging findings on computed tomography (CT) and small bowel series. CT showed irregular wall thickening, loss of mural stratification and aneurysmal dilatation of the distal ileum. Small bowel series showed aneurysmal dilatations, interloop adhesion with traction and abrupt angulation.

  15. Estrategias quirúrgicas en el intestino corto / Surgical strategies in short bowel syndrome

    Scientific Electronic Library Online (English)

    J., Bueno.

    2007-05-01

    Full Text Available El tratamiento del síndrome de intestino corto ha de ser realizado por un equipo multidisciplinar que incluye entre otras especialidades a gastroenterólogos, cirujanos y nutricionistas. El objetivo final del tratamiento quirúrgico es posibilitar que el intestino alcance el fenómeno de adaptación y a [...] sí destetar al paciente de la nutrición parenteral. Los factores anatómicos que influyen en la adaptación son muy importantes a la hora de elegir la mejor opción quirúrgica. El tipo de intervención vendrá definido entre otros por la edad, la longitud y funcionalidad del intestino remanente, la existencia de dilatación intestinal, la presencia de sobrecrecimiento bacteriano, y la presencia o ausencia de complicaciones relacionadas con la nutrición parenteral. Entre los principios básicos del manejo quirúrgico están el cierre precoz de estomas si están presentes, así como la corrección de estenosis; a ser posible con estricturoplastias y si es necesario remodelaje o plicatura intestinal. Las intervenciones para disminuir el tiempo de tránsito como la creación de válvulas, interposición de segmentos antiperistálticos o interposición de colon tienen poca aceptación. Las técnicas más aceptadas son las técnicas de alargamiento intestinal, las cuales solo se pueden aplicar sobre intestinos dilatados. Aunque se tiene más experiencia con la técnica de Bianchi, los resultados a corto plazo de la enteroplastia transversal seriada (STEP) son prometedores. El STEP es más sencillo, e incluso se puede aplicar en intestinos previamente alargados con la técnica de Bianchi. Abstract in english Management of short bowel syndrome has to be undertaken by a multidisciplinary team including gastroenterology, surgery, and nutrition, among other specialties. The final therapeutic goal is favoring intestinal adaptation by the bowel so that the patient may be weaned from parenteral nutrition. Anat [...] omical factors influencing on adaptation are very important for deciding the best surgical option. The type of procedure will defined by age, length and functionality of the remnant bowel, the existence of intestinal dilation, the presence of bacterial overgrowth, and the presence or absence of parenteral nutrition-related complications, among others. Early closure of the stomas, if present, and correction of stenoses, if possible with stricturoplasties and with remodeling or intestinal plicature if needed, are among the basic principles of surgical management. Interventions aimed at decreasing the transit time such as the creation of valves, interposition of anti-peristaltic segments or large bowel are poorly accepted. The most accepted techniques are those elongating the bowel that may be applied only on dilated bowels. Although experience is greater with Bianchi's technique, short-term outcomes of serial transversal enteroplasty (STEP) are promising. STEP is simpler and may be applied even to previously elongated bowels by the Bianchi's technique.

  16. Estrategias quirúrgicas en el intestino corto Surgical strategies in short bowel syndrome

    Directory of Open Access Journals (Sweden)

    J. Bueno

    2007-05-01

    Full Text Available El tratamiento del síndrome de intestino corto ha de ser realizado por un equipo multidisciplinar que incluye entre otras especialidades a gastroenterólogos, cirujanos y nutricionistas. El objetivo final del tratamiento quirúrgico es posibilitar que el intestino alcance el fenómeno de adaptación y así destetar al paciente de la nutrición parenteral. Los factores anatómicos que influyen en la adaptación son muy importantes a la hora de elegir la mejor opción quirúrgica. El tipo de intervención vendrá definido entre otros por la edad, la longitud y funcionalidad del intestino remanente, la existencia de dilatación intestinal, la presencia de sobrecrecimiento bacteriano, y la presencia o ausencia de complicaciones relacionadas con la nutrición parenteral. Entre los principios básicos del manejo quirúrgico están el cierre precoz de estomas si están presentes, así como la corrección de estenosis; a ser posible con estricturoplastias y si es necesario remodelaje o plicatura intestinal. Las intervenciones para disminuir el tiempo de tránsito como la creación de válvulas, interposición de segmentos antiperistálticos o interposición de colon tienen poca aceptación. Las técnicas más aceptadas son las técnicas de alargamiento intestinal, las cuales solo se pueden aplicar sobre intestinos dilatados. Aunque se tiene más experiencia con la técnica de Bianchi, los resultados a corto plazo de la enteroplastia transversal seriada (STEP son prometedores. El STEP es más sencillo, e incluso se puede aplicar en intestinos previamente alargados con la técnica de Bianchi.Management of short bowel syndrome has to be undertaken by a multidisciplinary team including gastroenterology, surgery, and nutrition, among other specialties. The final therapeutic goal is favoring intestinal adaptation by the bowel so that the patient may be weaned from parenteral nutrition. Anatomical factors influencing on adaptation are very important for deciding the best surgical option. The type of procedure will defined by age, length and functionality of the remnant bowel, the existence of intestinal dilation, the presence of bacterial overgrowth, and the presence or absence of parenteral nutrition-related complications, among others. Early closure of the stomas, if present, and correction of stenoses, if possible with stricturoplasties and with remodeling or intestinal plicature if needed, are among the basic principles of surgical management. Interventions aimed at decreasing the transit time such as the creation of valves, interposition of anti-peristaltic segments or large bowel are poorly accepted. The most accepted techniques are those elongating the bowel that may be applied only on dilated bowels. Although experience is greater with Bianchi's technique, short-term outcomes of serial transversal enteroplasty (STEP are promising. STEP is simpler and may be applied even to previously elongated bowels by the Bianchi's technique.

  17. Carcinogenesis of gallbladder mucosa with occult pancreatobiliary reflux

    International Nuclear Information System (INIS)

    Characteristics of gallbladder cancer (GC) with occult pancreatobiliary reflux (OPBR) were retrospectively examined with images by US (ultrasonography), endoscopic US (EUS), ERCP (endoscopic retrograde cholangiopancreatography) and multi-row CT, and with pathological specimens of the mucosa to consider its carcinogenesis. Subjects were 51-77 years old, 7 female patients with GC in whom OPBR was suggested mainly by mucosal hypertrophy in those images. Pathological observation was performed on specimens stained by HE and Ki-67 (for detecting cell proliferation). Imaging and pathological findings of the mucosa in the present GC were found analogous to known characteristics of GC with abnormal pancreatbiliary confluence, suggesting a similar carcinogenetic process to each other, where biliary phospholipids (PL) were degraded to toxic lyso-PL and free fatty acids. The subject with OPBR could thus be classified in the high risk group. More cases in number were thought necessary to define the surgical treatment, its timing and procedure in GC. (R.T.)

  18. Cryosectioning Method for Microdissection of Murine Colonic Mucosa

    Science.gov (United States)

    Farkas, Attila E.; Gerner-Smidt, Christian; Lili, Loukia; Nusrat, Asma; Capaldo, Christopher T.

    2015-01-01

    The colonic mucosal tissue provides a vital barrier to luminal antigens. This barrier is composed of a monolayer of simple columnar epithelial cells. The colonic epithelium is dynamically turned over and epithelial cells are generated in the stem cell containing crypts of Lieberkühn. Progenitor cells produced in the crypt-bases migrate toward the luminal surface, undergoing a process of cellular differentiation before being shed into the gut lumen. In order to study these processes at the molecular level, we have developed a simple method for the microdissection of two spatially distinct regions of the colonic mucosa; the proliferative crypt zone, and the differentiated surface epithelial cells. Our objective is to isolate specific crypt and surface epithelial cell populations from mouse colonic mucosa for the isolation of RNA and protein. PMID:26274554

  19. Adherence of enteroaggregative Escherichia coli to the ileal and colonic mucosa: an in vitro study utilizing the scanning electron microscopy / Aderência da Escherichia coli enteroagregativa a mucosas ileal e colônica: estudo in vitro utilizando microscopia eletrônica de varredura

    Scientific Electronic Library Online (English)

    Jacy Alves Braga de, Andrade; Edna, Freymüller; Ulysses, Fagundes-Neto.

    2011-09-01

    Full Text Available CONTEXTO: Cepas de Escherichia coli enteroagregativa têm sido associadas à diarreia persistente em vários países em desenvolvimento. Procedimentos in vivo com modelos animais, cultura de órgão in vitro com fragmentos intestinais e ensaios in vitro com linhas celulares têm sido utilizados para estuda [...] r essas bactérias e a sua patogenicidade. OBJETIVO: A presente investigação experimental avaliou as interações patogênicas de três cepas de Escherichia coli enteroagregativa, usando cultura de órgão in vitro, para mostrar a aderência a diferentes regiões do intestino: íleo e cólons e demonstrar possíveis mecanismos que poderiam ter participação na perpetuação do processo diarréico. MÉTODOS: Este estudo usou fragmentos de íleo terminal e cólon que foram retirados de pacientes pediátricos submetidos a cirurgias intestinais e de pacientes adultos que foram submetidos a colonoscopias. Cada cepa foi testada com três fragmentos intestinais para cada região. O tecido foi fixado para análise sob microscopia eletrônica de varredura. RESULTADOS: Estas bactérias colonizaram mucosa ileal e colônica na configuração típica de pilhas de tijolos. Em ambas as regiões, as bactérias foram vistas sobre grande quantidade de muco e, às vezes, sobre o epitélio intacto. Em algumas áreas, há evidência de provável achatamento de vilosidades. Foi possível ver sobre a superfície intestinal, estruturas fimbriais bacterianas que poderiam estar relacionadas ao processo de adesão. CONCLUSÕES: Para causar diarreia, cepas de Escherichia coli enteroagregativa aderem à mucosa intestinal e criam um biofilme de muco sobre a superfície do intestino delgado, o que poderia justificar as anormalidades digestivo-absortivas e, por conseguinte, prolongar a diarreia. Abstract in english CONTEXT: Enteroaggregative Escherichia coli strains have been associated with persistent diarrhea in several developing countries. In vivo procedures with animal models, in vitro assays with cellular lines and in vitro organ culture with intestinal fragments have been utilized to study these bacteri [...] a and their pathogenicity. OBJECTIVE: The present experimental research assessed the pathogenic interactions of three enteroaggregative Escherichia coli strains, using the in vitro organ culture, in order to show the adherence to different regions of both, the ileal and the colonic mucosa and demonstrate possible mechanisms that could have the participation in the prolongation of diarrheiogenic process. METHODS: This study used intestinal fragments from terminal ileum and colon that were excised from pediatric patients undergoing intestinal surgeries and from adult patients that underwent to colonoscopic procedures. Each strain was tested with three intestinal fragments for each region. Tissue was fixed for scanning electron microscopic analysis. RESULTS: These bacteria colonized ileal and colonic mucosa in the typical stacked-brick configuration in the ileum and colon. In both regions, the strains were seen over a great amount of mucus and sometimes over the intact epithelium. In some regions, there is a probable evidence of effacement of the microvilli. It was possible to see adhered to the intestinal surface, bacteria fimbrial structures that could be responsible for the adherence process. CONCLUSION: In order to cause diarrhea, enteroaggregative Escherichia coli strains adhere to the intestinal mucosa, create a mucoid biofilm on the small bowel surface that could justify the digestive-absorptive abnormalities and consequently, prolonging the diarrhea.

  20. Candida albicans forms biofilms on the vaginal mucosa

    OpenAIRE

    Harriott, M. M.; Lilly, E.A.; Rodriguez, T. E.; Fidel, P L; Noverr, M. C.

    2010-01-01

    Current understanding of resistance and susceptibility to vulvovaginal candidiasis challenges existing paradigms of host defence against fungal infection. While abiotic biofilm formation has a clearly established role during systemic Candida infections, it is not known whether C. albicans forms biofilms on the vaginal mucosa and the possible role of biofilms in disease. In vivo and ex vivo murine vaginitis models were employed to examine biofilm formation by scanning electron and confocal mic...

  1. Isolation of Lymphocytes from Mouse Genital Tract Mucosa

    OpenAIRE

    Jiang, Janina; Kelly, Kathleen A.

    2012-01-01

    Mucosal surfaces, including in the gastrointestinal, urogenital, and respiratory tracts, provide portals of entry for pathogens, such as viruses and bacteria 1. Mucosae are also inductive sites in the host to generate immunity against pathogens, such as the Peyers patches in the intestinal tract and the nasal-associated lymphoreticular tissue in the respiratory tract. This unique feature brings mucosal immunity as a crucial player of the host defense system. Many studies have been focused on ...

  2. Nasal mucosa in workers exposed to formaldehyde: a pilot study.

    OpenAIRE

    Boysen, M.; Zadig, E; Digernes, V; Abeler, V; Reith, A.

    1990-01-01

    This study evaluates the histological changes, especially the presence of possible precancerous lesions, in the nasal mucosa of workers exposed to formaldehyde. Nasal biopsies of 37 workers occupationally exposed to formaldehyde for more than five years and 37 age matched referents showed a higher degree of metaplastic alterations in the former group. In addition, three cases of epithelial dysplasia were observed among the exposed. These results indicate that formaldehyde may be potentially c...

  3. Early or pre-coeliac mucosa: development of gluten enteropathy.

    OpenAIRE

    Egan-Mitchell, B.; Fottrell, P F; McNicholl, B

    1981-01-01

    Duodenal mucosa showed normal morphology, interepithelial lymphocytes, alkaline phosphatase, and sucrase in a girl with growth retardation and iron deficiency, but normal absorption of lactose and xylose after two years of abnormal stools. Mucosal lactase was low. Fourteen months later mucosal damage consistent with coeliac disease was evident, and gluten intolerance was subsequently confirmed by gluten challenge. It is probable that, in some children, the mucosal lesion occurs very gradually...

  4. Intestinal mucosa development in broiler chickens fed natural growth promoters

    OpenAIRE

    ERL Pelicano; PA Souza; HBA de Souza; DF Figueiredo; MM Boiago; SR Carvalho; VF Bordon

    2005-01-01

    This study evaluated the use of probiotics and prebiotics on the histological and morphological indexes of the intestinal mucosa of broilers at 21 days of age. Thirty-six birds were randomly distributed in a 3 x 3 factorial arrangement, considering 3 probiotics and prebiotics sources in the diet. There were 9 treatments with 4 repetitions. Diet treatments were: 1 - Control (without growth promoters); 2 - Bacillus subtilis-based probiotic (Pro 1); 3 - Probiotic (Pool) based on Lactobacillus ac...

  5. Endothelial cells in the oral mucosa of Bufo marinus.

    OpenAIRE

    Loo, S. K.; Yeo, B C; Kovac, H

    1980-01-01

    The oral mucosa of the cane toad (Bufo marinus) is lined by a pseudostratified columnar ciliated epithelium containing an intraepithelial network of capillaries, which penetrates it to the bases of the distal layer of cells. The capillaries are lined by fenestrated endothelium lying on a complete basal lamina. A connective tissue sheath, approximately 1 micrometer thick, surrounds the capillaries and separates them from the surrounding epithelial cells. Endothelial cells resemble those in lym...

  6. Bacteroides fragilis toxin 2 damages human colonic mucosa in vitro

    OpenAIRE

    M. Riegler(Institute for Theoretical Physics, Vienna University of Technology, Wiedner Hauptstr. 8–10/136, A-1040 Vienna, Austria); Lotz, M.; Sears, C; Pothoulakis, C; Castagliuolo, I.; Wang, C; Sedivy, R.; Sogukoglu, T; Cosentini, E; Bischof, G; Feil, W; Teleky, B; Hamilton, G.; Lamont, J; Wenzl, E

    1999-01-01

    BACKGROUND—Strains of Bacteroides fragilis producing a 20 kDa protein toxin (B fragilis toxin (BFT) or fragilysin) are associated with diarrhoea in animals and humans. Although in vitro results indicate that BFT damages intestinal epithelial cells in culture, the effects of BFT on native human colon are not known. ?AIMS—To examine the electrophysiological and morphological effects of purified BFT-2 on human colonic mucosa in vitro. ?METHODS—For resistance (R) measur...

  7. NEW CONCEPTS OF NEURAL REGULATION IN HUMAN NASAL MUCOSA

    OpenAIRE

    James N. BARANIUK; Merck, Samantha J.

    2009-01-01

    Nasal mucosa is innervated by multiple subsets of nociceptive, parasympathetic and sympathetic nerves. These play carefully coordinated roles in regulating glandular, vascular and other processes. These functions are vital for cleaning and humidifying ambient air before it is inhaled into the lungs. The recent recognition of distinct classes of nociceptive nerves with unique patterns of sensory receptors that include seven transmembrane G-protein coupled receptors, new families of transient r...

  8. The microvascular architecture of the glandular mucosa of rat stomach.

    OpenAIRE

    Gannon, B.; Browning, J; O'Brien, P.

    1982-01-01

    The circulatory pattern in the gastric mucosa of the rat and relationships of mucosal capillaries to gastric gland cells were investigated. Techniques used included the vascular corrosion cast/scanning electron microscope method, scanning electron microscopy of acid-digested tissues, conventional transmission electron microscopy and in vivo light microscopy. Arterial break-up into capillaries invariably occurs around the base of the gastric glands. The mucosal capillaries are fenestrated and ...

  9. Viewpoints on Acid-Induced Inflammatory Mediators in Esophageal Mucosa

    OpenAIRE

    Harnett, Karen M; Rieder, Florian; Behar, Jose; Biancani, Piero

    2010-01-01

    We have focused on understanding the onset of gastroesophageal reflux disease by examining the mucosal response to the presence of acid in the esophageal lumen. Upon exposure to HCl, inflammation of the esophagus begins with activation of the transient receptor potential channel vanilloid subfamily member-1 (TRPV1) in the mucosa, and production of IL-8, substance P (SP), calcitonin gene related peptide (CGRP) and platelet activating factor (PAF). Production of SP and CGRP, but not PAF, is abo...

  10. Morphological changes of gastric mucosa depending on functional dyspepsia syndrome

    Directory of Open Access Journals (Sweden)

    Svintsitskyy A.

    2014-06-01

    Full Text Available Background. Chronic gastritis process of cell renewal in the mucosa is disturbed, leading to rapid movement of the generative cell zone without full differentiation into mature specialized area accommodation epithelial cells. The result of this process is the inability to fully function gastric glands. Crucial in the diagnosis of gastritis given the nature of the morphological changes of the gastric mucosa and preferential localization of these changes. Objective. To assess histological changes of gastric mucosa in patients with clinically different types of functional dyspepsia. Methods. Adult patients (18-65 years with confirmed diagnosis of functional dyspepsia were eligible to participate. Biopsy specimens were taken from stomach due to the Houston-updated gastric biopsy sampling protocol for the next histological examination. One expert gastrointestinal pathologist assessed all tissue samples. Atrophy was assessed due to Operative Link for Gastritis Assessment (OLGA staging system. Results. 75 patients were recruited, 42 of which had epigastric pain (I group and 33 – postprandial distress syndrome (II group due to Rome III criteria (2006. Antral and corpus atrophy were detected at the same frequency in both groups (p>0.05, however the stage of atrophy didn’t exceed I in all cases. Complete antral metaplasia was revealed in 11 (26.2% patients of the I group and 11 (33.3% patients of the II one. Incomplete antral metaplasia was seen in 2 (4.7% patients of the I group and 2 (6.1% patients of the II one. No cases of corpus metaplasia or dysplasia were found. Conclusion. Our study didn’t reveal statistically significant correlation between stage of gastritis, atrophic or metaplastic changes and clinical symptoms of functional dyspepsia. Citation: Svintsitskyy A, Korendovych I, Kuryk O, Solovyova G. [Morphological changes of gastric mucosa depending on functional dyspepsia syndrome]. Morphologia. 2014;8(2:50-5. Ukrainian.

  11. Drug Development for the Irritable Bowel Syndrome: Current Challenges and Future Perspectives

    OpenAIRE

    FabrizioDe Ponti

    2013-01-01

    Medications are frequently used for the treatment of patients with the irritable bowel syndrome (IBS), although their actual benefit is often debated. In fact, the recent progress in our understanding of the pathophysiology of IBS, accompanied by a large number of preclinical and clinical studies of new drugs, has not been matched by a significant improvement of the armamentarium of medications available to treat IBS. The aim of this review is to outline the current challenges in drug develop...

  12. Association between tumor necrosis factor-? antagonists and risk of cancer in patients with inflammatory bowel disease

    DEFF Research Database (Denmark)

    Nyboe Andersen, Nynne; Pasternak, Björn; Basit, Saima; Andersson, Mikael; Svanström, Henrik; Caspersen, Sarah; Munkholm, Pia; Hviid, Anders; Jess, Tine

    2014-01-01

    IMPORTANCE: A Cochrane review and network meta-analysis concluded that there is need for more research on adverse effects, including cancer, after treatment with tumor necrosis factor ? (TNF-?) antagonists and that national registries and large databases would provide relevant sources of data to evaluate these effects. OBJECTIVE: To investigate whether patients with inflammatory bowel disease (IBD) exposed to TNF-? antagonists were at increased risk of developing cancer. DESIGN, SETTING, AND PAR...

  13. Effectiveness of anti-tumour necrosis factor-? therapy in Danish patients with inflammatory bowel diseases

    DEFF Research Database (Denmark)

    Bank, Steffen; Andersen, Paal Skytt; Burisch, Johan; Pedersen, Natalia; Roug, Stine; Galsgaard, Julie; Turino, Stine Ydegaard; Brodersen, Jacob Broder; Rashid, Shaista; Avlund, Sara; Olesen, Thomas; Green, Anders; Hoffmann, Hans Jürgen; Thomsen, Marianne Kragh; Thomsen, Vibeke Østergaard; Nexø, Bjørn Andersen; Vogel, Ulla; Andersen, Vibeke

    2015-01-01

    INTRODUCTION: The objective of this study was to evaluate the outcome of anti-tumour necrosis factor-? (anti-TNF) treatment in a large cohort of patients with inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC) in clinical practice and to establish a cohort for future studies of genetic markers associated with treatment response. METHODS: A national, clinically based cohort of previously naïve anti-TNF treated patients from 18 medical departments was est...

  14. Effect of smoking on inflammatory bowel disease: Is it disease or organ specific?

    OpenAIRE

    Karban, A.; Eliakim, R.

    2007-01-01

    Smoking is an important environmental factor in inflammatory bowel disease (IBD) with differing effects in ulcerative colitis (UC) and Crohn’s disease (CD). Never smoking and formerly smoking increase the risk of UC, whereas smoking exacerbates the course of CD. The potential mechanisms involved in this dual relationship are yet unknown. A reasonable assumption is that smoking has different effects on the small and large intestine. This assumption is based on animal and human studies that sho...

  15. What is the best strategy for successful bowel preparation under special conditions?

    OpenAIRE

    Lim, Yun Jeong; Hong, Su Jin

    2014-01-01

    Adequate bowel preparation is important for successful colonoscopic examination. Several effective colonic cleansing agents are available and routinely prescribed, but each carries its own limitations and benefits from particular dosing regimens. The most frequently prescribed colonic cleansing agent, the polyethylene glycol (PEG) cathartic solution, suffers from low patient compliance in general, due to its unpalatable taste and smell coupled with the large ingested volumes required. However...

  16. Effect of leukocyte apheresis on oxidative stress and fibrosis in inflammatory bowel diseases

    OpenAIRE

    POLI, Giuseppe; Rizzetto, Mario; BIASI, Fiorella

    2008-01-01

    Inflammatory bowel diseases (IBD) are characterized by recurrent inflammatory injury and repair with consequent gross structural damage of the intestine, that involves the cross-talk of different cell types through the production of large variety of pro-inflammatory and pro-fibrogenic cytokines. TGF-beta1 maintains the intestinal epithelial cell homeostasis, but its dysregulation has been observed in IBD and colon carcinoma. Another consistent feature of chronic inflammation, is an overproduc...

  17. Hospital Admissions, Biological Therapy, and Surgery in Familial and Sporadic Cases of Inflammatory Bowel Disease

    DEFF Research Database (Denmark)

    Trier Moller, Frederik; Andersen, Vibeke; Andersson, Mikael; Jess, Tine

    2015-01-01

    BACKGROUND: Easily accessible predictors of disease course in inflammatory bowel disease (IBD) are scarce, and it remains largely unknown whether a family history of IBD predicts the course of Crohn's disease (CD) and ulcerative colitis (UC). We aimed to compare the course of disease in familial and sporadic cases of IBD in a nationwide cohort study. METHODS: From national registries, covering a population of 8,295,773 individuals, we obtained information on date and year of diagnosis of IBD cas...

  18. Treatment of irritable bowel syndrome with probiotics. An etiopathogenic approach at last?

    Science.gov (United States)

    Bixquert Jiménez, M

    2009-08-01

    Irritable bowel syndrome (IBS) is the most common functional digestive disorder, and may affect 11-20% of the adult population in industrialized countries. In accordance with Rome III criteria (2006) IBS involves abdominal pain and bowel habit disturbance, which are not explained by structural or biochemical abnormalities. Several hypotheses attempt to account for the pathophysiology of IBS, but the etiology still remains uncertain or obscure, perhaps multifactorial. Abnormalities in colonic microflora have recently been suggested in such patients, as has abnormal small-intestine bacterial overgrowth (SIBO), or in particular a significant reduction in the amount of intraluminal Bifidobacteria or Lactobacilli, with consequences like the production of colonic gas, and motility or sensitivity disturbances of the intestinal tract. The disorder is difficult to treat, and the wide spectrum of non-drug and drug treatments shows our ignorance about the cause of the condition. Newer drugs, both pro- and anti-serotonin, have failed to show long-term efficacy or have been withdrawn due to concerns about harmful effects. Recent research has provided increasing support for the idea that disturbances of intestinal microbiota occur in patients with IBS, and that such abnormalities may contribute to IBS symptoms. Studies in Scandinavian countries in the last ten years emphasize the role of probiotics in the modulation of intestinal microbiota, and as a consequence in the regulation of the motility and hypersensitivity of the digestive tract. Although results between studies are difficult to compare because of differences in study design, probiotic dose, strain, and duration of therapy, some studies show symptom improvement. Lactobacilli are found among the normal bacterial flora of the gastrointestinal tract, and Lactobacillus plantarum (Lp) is one of the species frequently isolated from the human mucosa, which is capable of surviving the low pH of the stomach and duodenum, resisting the effect of bile acids in the upper small intestine when ingested, and temporarily colonizing the gastrointestinal tract by binding to the intestinal and colonic mucosa. Concurrent with colonization by Lp there is a decrease in bacterial groups with gas-producing ability, such as Veillonella spp. and Clostridia spp. Evidence has now accumulated to suggest the efficacy of certain probiotics like Lp299v, which may be capable of bringing about a significant reduction in pain, abdominal distension and flatulence, while increasing health-related quality of life in IBS. PMID:19785495

  19. A Biologia molecular das doenças inflamatórias intestinais Molecular biology of inflammatory bowel diseases

    Directory of Open Access Journals (Sweden)

    Mauro Pinho

    2008-03-01

    Full Text Available Com elevada prevalência, a Doença de Crohn e a retocolite ulcerativa apresentam mecanismos fisiopatológicos os quais permanecem como um grande desafio apesar de muitas décadas de pesados investimentos em pesquisa. Entretanto, o desenvolvimento de técnicas de análise da biologia molecular tem proporcionado a identificação de um grande número de moléculas relacionadas a estas doenças as quais poderão representar um importante auxílio na compreensão de seus complexos aspectos. Existem fortes evidências hoje, de que as doenças inflamatórias intestinais (DII são o resultado de um desequilíbrio entre a flora bacteriana comensal e o aparato imunológico da mucosa intestinal. Um dos achados mais consistentes neste sentido refere-se à elevada incidencia de mutações do gene NOD2/CARD15 em pacientes portadores de Doença de Crohn, além da comprovação de sua correlação fenotípica com esta doença. Além desta proteína, diversas outras moléculas apresentam-se alteradas nas DIIs, envolvendo diversos aspectos como imunidade inata, resposta inflamatória e função de barreira mucosa. A observação das variações de expressão destas moléculas correlacionadas à evolução clínica e respostas terapêuticas irá contribuir para que possamos em um futuro obter resposta a históricos questionamentos sobre estas complexas doenças.Despite its high prevalence and many years of basic and clinical research, pathophysiology of Crohn's disease and ulcerative colitis remains a great challenge. The recent advances in molecular biology techniques have provided identification of a great number of molecules related to these diseases that may help in a near future to understand its still obscure aspects. Many evidences have recently demonstrated that inflammatory bowel diseases (IBD result from an imbalance between bowel commensal bacterial flora and the immunological mucosal apparatus. The very consistent finding that mutations in NOD2/CARD15 gene occur in a high percentage of Crohn's disease patients and its phenotype correlation have boosted further research to identify other IBD-related molecules. Indeed, many other variations in gene expression have been demonstrated to be related to pathophysiology of IBD including different aspects such as inate immunity, inflammatory response and mucosal barrier disfunction. The observation of the correlation between these gene expression variation, disease behaviour and response to therapeutics may contribute in a near future to understand most questions regarding these complex diseases.

  20. A Biologia molecular das doenças inflamatórias intestinais / Molecular biology of inflammatory bowel diseases

    Scientific Electronic Library Online (English)

    Mauro, Pinho.

    2008-03-01

    Full Text Available Com elevada prevalência, a Doença de Crohn e a retocolite ulcerativa apresentam mecanismos fisiopatológicos os quais permanecem como um grande desafio apesar de muitas décadas de pesados investimentos em pesquisa. Entretanto, o desenvolvimento de técnicas de análise da biologia molecular tem proporc [...] ionado a identificação de um grande número de moléculas relacionadas a estas doenças as quais poderão representar um importante auxílio na compreensão de seus complexos aspectos. Existem fortes evidências hoje, de que as doenças inflamatórias intestinais (DII) são o resultado de um desequilíbrio entre a flora bacteriana comensal e o aparato imunológico da mucosa intestinal. Um dos achados mais consistentes neste sentido refere-se à elevada incidencia de mutações do gene NOD2/CARD15 em pacientes portadores de Doença de Crohn, além da comprovação de sua correlação fenotípica com esta doença. Além desta proteína, diversas outras moléculas apresentam-se alteradas nas DIIs, envolvendo diversos aspectos como imunidade inata, resposta inflamatória e função de barreira mucosa. A observação das variações de expressão destas moléculas correlacionadas à evolução clínica e respostas terapêuticas irá contribuir para que possamos em um futuro obter resposta a históricos questionamentos sobre estas complexas doenças. Abstract in english Despite its high prevalence and many years of basic and clinical research, pathophysiology of Crohn's disease and ulcerative colitis remains a great challenge. The recent advances in molecular biology techniques have provided identification of a great number of molecules related to these diseases th [...] at may help in a near future to understand its still obscure aspects. Many evidences have recently demonstrated that inflammatory bowel diseases (IBD) result from an imbalance between bowel commensal bacterial flora and the immunological mucosal apparatus. The very consistent finding that mutations in NOD2/CARD15 gene occur in a high percentage of Crohn's disease patients and its phenotype correlation have boosted further research to identify other IBD-related molecules. Indeed, many other variations in gene expression have been demonstrated to be related to pathophysiology of IBD including different aspects such as inate immunity, inflammatory response and mucosal barrier disfunction. The observation of the correlation between these gene expression variation, disease behaviour and response to therapeutics may contribute in a near future to understand most questions regarding these complex diseases.

  1. Usefulness of Ultrasonography for Diagnosis of Small Bowel Tumors

    Science.gov (United States)

    Fujita, Minoru; Manabe, Noriaki; Honda, Keisuke; Murao, Takahisa; Osawa, Motoyasu; Kawai, Ryosuke; Akiyama, Takashi; Shiotani, Akiko; Haruma, Ken; Hata, Jiro

    2015-01-01

    Abstract Ultrasonography is a standard, noninvasive modality used to evaluate patients with gastrointestinal diseases. This study assessed the usefulness of ultrasonography in the detection of small bowel tumors. This study enrolled 558 consecutive patients (295 males, 263 females; mean age 71.1 years) who underwent ultrasonography before capsule endoscopy and/or balloon-assisted endoscopy. Ultrasonographic detection of small bowel tumors was compared with detection by capsule endoscopy and/or balloon-assisted endoscopy. In addition, factors affecting small bowel tumor detection by ultrasonography and clinical characteristics of patients with small bowel tumors undetected by ultrasonography were evaluated. Ninety-seven tumors (52 benign, 45 malignant) detected by capsule endoscopy and/or balloon-assisted endoscopy were retrospectively analyzed. The sensitivity and specificity of ultrasonography in the detection of small bowel tumors were 50.5% (47/93) and 100% (465/465), respectively. If we restricted patients to those with a tumor >20?mm in size, its detection ratio would become higher (91.7%): the ratio of submucosal tumor >20?mm in size was 85.7% (6/7) and that of partial and circumferential ulcerative tumors >20?mm in size was 96.9% (31/32), respectively. Small bowel tumors detected by ultrasonography (mean 33.2?mm) were significantly larger than those undetected by ultrasonography (mean 8.7?mm). The percentage of small bowel tumors located in the ileum detected by ultrasonography (70.6%) was significantly higher than those undetected by ultrasonography (29.4%). Of the 46 small bowel tumors undetected by ultrasonography, 42 (91.3%) were benign tumors with good clinical prognosis. Ultrasonography is a useful modality for detecting larger small bowel tumors and ulcerative lesions. Ultrasonography should be considered a first-line modality for patients suspected of having small bowel tumors, because most small bowel tumors undetected by ultrasonography were benign tumors with good clinical prognosis. PMID:26448000

  2. The frequency of microscopic and focal active colitis in patients with irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Akyuz Umit

    2011-08-01

    Full Text Available Abstract Background Irritable bowel syndrome (IBS is a chronic functional bowel disorder. The frequency of microscopic colitis and focal active colitis in the colonic mucosa has been investigated in IBS patients. Methods Between June 2007 and September 2010, 378 patients (between 16 and 84 years were recruited prospectively. Of these 378 patients, 226 patients were diagnosed with IBS using the Rome III criteria. 152 control patients were also enrolled who were undergoing colonoscopy for colorectal cancer screening or investigation of anemia. Histopathological abnormalities identified during colonoscopy were compared between the IBS and control groups. Results The average age of the IBS group was 46.13 ± 14.16 years and and the average age of the control group was 57.01 ± 13.07 years. The prevalence of microscopic colitis (MC in the diarrhea predominant and the mixed subgroup of IBS patients was 4.32% (7/162 whereas in all IBS patients, the prevalence was 3.09% (7/226. MC was not found in the 152 control cases, (p = 0.045. Lymphocytic colitis was seen in 7 IBS patients, with 1 case in the mixed group and 6 cases in the diarrhea group and there was a significant difference in the frequency of lymphocytic colitis between the IBS subgroups (p Conclusion Microscopic colitis was more often found in the diarrhea predominant/mixed subgroups of IBS patients and in patients who were older women. In patients who are older woman with non-constipated IBS, it may be reasonable to perform a biopsy to screen for microscopic colitis. Focal active colitis was significantly increased in patients with IBS compared to controls.

  3. Comparative study of pathological findings and trace elements profiles of gastric mucosa in benign gastric disease

    Energy Technology Data Exchange (ETDEWEB)

    Tsunoda, N.; Ito, M.; Sakurai, S.; Yukawa, M [Digestive Disease Center, Nippon Medical Univ., Tokyo (Japan)

    1998-07-01

    The purpose of this study is to clarify how trace elements in gastric mucosa, reflex bile acid and inflammation of gastric mucosa relate to environment of Helicobacter Pylori. Subjects were 33 patients who had colonic endoscopic examination. 11 gastric ulcer and 14 duodenal ulcer patients were chosen as subjects of the study. The control group had 8 members who had no localized lesions. Trace elements were measured by PIXE analysis which use Pd as internal standard. Cu and Zn, especially Zn, were found in large amount in gastric body and antrum. Zn value for the antrum was higher than that for the gastric body. Especially, the values of Zn for antrum showed significant differences between grade I, II and III of inflammatory cell infiltration. In gastric ulcer group, the value of Cu indicated high at gastric body and low at antrum. On the other hand, the values of Zn were low at both gastric body and antrum. Particularly, development of atrophy in antrum requires less than one in gastric body; therefore, trace elements decreased in gastric ulcer group. (author)

  4. Presence of highly oncogenic human papillomavirus in the oral mucosa of asymptomatic men

    Scientific Electronic Library Online (English)

    Ana Paula, Machado; Flávia Gatto de, Almeida; Camila Mareti, Bonin; Thiago Theodoro Martins, Prata; Leandro Sobrinho, Ávilla; Cacilda Tezelli Junqueira, Padovani; Alda Maria Teixeira, Ferreira; Carlos Eurico dos Santos, Fernandes; Inês Aparecida, Tozetti.

    2014-06-01

    Full Text Available OBJECTIVES: The aim of this study was to identify highly oncogenic forms of human papillomavirus in the oral mucosa of asymptomatic men. METHODS: In this study, we analyzed samples of exfoliated cells from the oral cavity of 559 asymptomatic men. DNA-human papillomavirus was detected using the [...] consensus primers PGMY09/11; viral genotyping was performed using type-specific PCR and restriction fragment length polymorphism. RESULTS: DNA-human papillomavirus was detected in 1.3% of the study participants and of those 42.8% were infected by more than one type of virus. Viral types included HPV6, 11, 89 (low oncogenic risk), and HPV52, 53 (high oncogenic risk). Increased vulnerability to human papillomavirus infection was observed in individuals aged over 26 years, among those who reported oral sex practices, and in those who have had more than 16 sexual partners since first engaging in sexual intercourse. CONCLUSIONS: There was a low prevalence of human papillomavirus detection in the oral mucosa of asymptomatic men. Highly oncogenic human papillomavirus types and infection by more than one viral type was observed. Oral sex practices and a large number of sexual partners may increase the risk of acquiring human papillomavirus infection.

  5. Leishmaniose mucosa: considerações epidemiológicas e de tratamento Mucosal leishmaniasis: epidemiological and treatment considerations Leishmaniasis mucosa: consideraciones epidemiológicas y de tratamiento

    Directory of Open Access Journals (Sweden)

    Letícia Ziggiotti de Oliveira

    2011-06-01

    Full Text Available Na região Sul do Brasil, a leishmaniose tegumentar americana predomina no Estado do Paraná, especialmente ao Norte e Oeste, onde um dos circuitos de produção da doença é localizado. Estima-se que 3 a 5% dos casos de leishmaniose cutânea desenvolvam lesão mucosa, e que cerca de 1% destas podem evoluir para óbito. De longa data, as drogas de escolha para tratamento da doença são os compostos antimoniais sob a forma de sais pentavalentes. O objetivo deste estudo foi descrever características epidemiológicas e de tratamento dos pacientes com leishmaniose mucosa, diagnosticados no período de 2001 a 2007, em municípios localizados na área de abrangência da 13ª Regional de Saúde, com sede no município de Cianorte, no Paraná. As informações foram coletadas do prontuário ambulatorial e das fichas de investigação epidemiológicas do Sistema de Notificação e Informação de Agravos. No período estudado, foram notificados 505 casos de leishmaniose tegumentar americana, 30 deles (6% na forma mucosa. Foram incluídos no estudo pacientes com diagnóstico de leishmaniose mucosa, que apresentavam exames complementares realizados antes e durante o tratamento. Os resultados evidenciaram a necessidade de acompanhamento cuidadoso dos doentes nas equipes de saúde, dado a possível evolução e presença de efeitos medicamentosos indesejáveis nos pacientes afetados pela condição. In South Brazil, American tegumentary leishmaniasis is predominant at Paraná, specially on the North and West areas, where it is localized one of the disease’s production circuits. It is believed that 3 to 5% of the cases evolve to the mucosal form, and that 1% of these can evolve to death. There is a long time that first choice drugs to treat this disease are the antimony compounds as pentavalent salts. The purpose of this study was to describe epidemiological and treatment characteristics of patients with mucosal leishmaniasis, who were diagnosed during the period from 2001 to 2007 in cities located on the coverage area of the 13 Heath Regional, which is situated in Cianorte, Paraná. The data were collected at the outpatient medical records and the System of Notifications and Information of Diseases epidemiological investigation records. During the mentioned period, 505 cases of American tegumentary leishmaniasis were notified, 30 of them (6% as the mucosal form. In this study, the patients included were those with diagnosis of mucosal leishmaniasis that had complementary exams performed before and during the treatment. The results showed the need of patients’ careful monitoring by health teams, due to the possible evolution of the disease and the presence of unwanted drug effects. En la región Sur de Brasil, la leishmaniasis tegumentaria americana predomina en el estado de Paraná, principalmente al Norte y Oeste del país, donde está localizado uno de los circuitos de producción de la enfermedad. Se estima que de 3 a 5% de los casos de leishmaniasis cutánea desenvuelvan lesión mucosa, y que cerca de 1% de ellas puedan acabar en muerte. Por mucho tiempo, las drogas escogidas para tratar la enfermedad son los compuestos antimoniales bajo la forma de sales pentavalentes. El objetivo de este estudio fue describir características epidemiológicas y de tratamiento de los pacientes con leishmaniasis mucosa, diagnosticados en el periodo de 2001 a 2007, en municipios localizados en el área de estudio de la 13ª Regional de la Salud, localizada en el municipio de Cianorte, Paraná. Las informaciones fueron colectadas del registro médico y de los papeles de investigación epidemiológicos del SINAN (Sistema de Notificación e Información de Agravios. En el periodo estudiado, fueron notificados 505 casos de leishmaniasis tegumentaria americana, 30 de los cuales (6% en forma mucosa. Fueron incluidos en el estudio pacientes diagnosticados con leishmaniasis mucosa, que poseían exámenes complementares realizados antes y durante el tratamiento. Los resultados evidenciaron la necesidad de cuidadosamente acompaña

  6. Tatuagem extensa por amálgama em mucosa gêngivo-alveolar Extensive amalgam tattoo on the alveolar-gingival mucosa

    OpenAIRE

    Vivian C Galletta; Gabriela Artico; Aluana M. C Dal Vechio; Celso A Lemos Jr; Dante A Migliari

    2011-01-01

    Tatuagens por amálgama são lesões pigmentadas, exógenas, de frequente ocorrência na mucosa bucal, que resultam da introdução acidental de partículas de amálgama nos tecidos moles. O diagnóstico da tatuagem por amálgama é simples, geralmente, baseado em achados clínicos, complementado pela história recente ou pregressa de remoção de restauração por amálgama. Radiografias intraorais podem ser úteis na detecção de radiopacidade, associadas à partícula de amálgama. Nos casos em que as tatuagens p...

  7. Telemedicine in inflammatory bowel disease: opportunities and approaches.

    Science.gov (United States)

    Aguas Peris, Mariam; Del Hoyo, Javier; Bebia, Paloma; Faubel, Raquel; Barrios, Alejandra; Bastida, Guillermo; Valdivieso, Bernardo; Nos, Pilar

    2015-02-01

    This review article summarizes the evidence about telemedicine applications (e.g., telemonitoring, teleconsulting, and tele-education) in the management of patients with inflammatory bowel disease (IBD), and we aim to give an overview of the acceptance and impact of these interventions on health outcomes. Based on the literature search on "inflammatory bowel disease," "Crohn's disease" and "ulcerative colitis" in combination with "e-health," "telemedicine," and "telemanagement," we selected 58 titles and abstracts published up to June 2014 and searched in PubMed, EMBASE, MEDLINE, Cochrane Database, Web of Science and Conference Proceedings. Titles and abstracts were screened for a set of inclusion criteria: e-health intervention, IBD as the main disease, and a primary study performed. Finally, 16 were included for full reading, data extraction, and critical appraisal of the evaluation. Most studies use telemonitoring (home telemanagement system or web portal) and telecare (real-time telephone and image) as telemedicine applications and assessed the feasibility and acceptance of these systems, adherence to treatment, quality of life, and patient knowledge, particularly in patients with ulcerative colitis. Furthermore, some of these studies evaluated the patients' empowerment, health care costs, and safety of telemonitoring in IBD. In conclusion, the health outcomes of telemedicine applications in IBD suggest that these could be implemented in clinical practice because they are safe and feasible applications that are well accepted by the patient and improve adherence, quality of life, and disease knowledge. Further studies with large sample sizes and complex diseases are needed to confirm these results. PMID:25437818

  8. Mecanoreceptores da mucosa palatina de avestruz (Struthio camelus): estudo ao microscópio de luz / Mechanoreceptors of the palatine mucosa of ostrich (Struthio camelus): light microscope study

    Scientific Electronic Library Online (English)

    Juliana P., Guimarães; Renata B., Mari; Maria Angélica, Miglino; Francisco J., Hernandez-Blasquez; Ii-sei, Watanabe.

    2007-12-01

    Full Text Available Foram estudados corpúsculos de Herbst da mucosa palatina de avestruz em nível de microscopia de luz. Os corpúsculos compõem-se de uma cápsula externa, cápsula interna e axônio central. A cápsula externa apresentou numerosas lamelas, enquanto que a cápsula interna mostrou estrutura de folhas compacta [...] s. Os corpúsculos apresentaram formato ovalado ou circular e circundado por espessos feixes de fibras colágenas. Cada lamela estava composta de uma densa rede de fibras espessas. Os axônios terminais estavam situados ao longo do eixo, terminando em um bulbo terminal. As fibras da cápsula externa, coradas por Picrosirius e examinadas no microscópio óptico sob luz polarizada, revelou a presença de fibras colágenas do tipo I em verde e na região periférica observou-se grande quantidade de fibras colágenas do tipo III. Os corpúsculos apresentaram-se envoltos por células planas e envoltos por fibras colágenas. Abstract in english Herbst corpuscles of the palatine mucosa of ostrich were studied by light microscopy. The corpuscles are composed of an outer core, inner core and central nerve terminal. The outer core presents numerous lamellae, while the inner core shows compact structure of cytoplasm sheets. The corpuscles are e [...] longate or oval in shape and are surrounded by bundles of collagen fibers. Each lamella is composed of a dense network of thick fibrils. The terminal axons are located along the axis and form a bulb terminal. The fibers of external core stained by Picrosirius and examined by polarized light microscopy revealed to be green in color like type I collagen fibers, and at the periphery is a large amount of collagen type III. The corpuscles are surrounded by flat cells and dense collagen fibers at the periphery.

  9. Mecanoreceptores da mucosa palatina de avestruz (Struthio camelus: estudo ao microscópio de luz Mechanoreceptors of the palatine mucosa of ostrich (Struthio camelus: light microscope study

    Directory of Open Access Journals (Sweden)

    Juliana P. Guimarães

    2007-12-01

    Full Text Available Foram estudados corpúsculos de Herbst da mucosa palatina de avestruz em nível de microscopia de luz. Os corpúsculos compõem-se de uma cápsula externa, cápsula interna e axônio central. A cápsula externa apresentou numerosas lamelas, enquanto que a cápsula interna mostrou estrutura de folhas compactas. Os corpúsculos apresentaram formato ovalado ou circular e circundado por espessos feixes de fibras colágenas. Cada lamela estava composta de uma densa rede de fibras espessas. Os axônios terminais estavam situados ao longo do eixo, terminando em um bulbo terminal. As fibras da cápsula externa, coradas por Picrosirius e examinadas no microscópio óptico sob luz polarizada, revelou a presença de fibras colágenas do tipo I em verde e na região periférica observou-se grande quantidade de fibras colágenas do tipo III. Os corpúsculos apresentaram-se envoltos por células planas e envoltos por fibras colágenas.Herbst corpuscles of the palatine mucosa of ostrich were studied by light microscopy. The corpuscles are composed of an outer core, inner core and central nerve terminal. The outer core presents numerous lamellae, while the inner core shows compact structure of cytoplasm sheets. The corpuscles are elongate or oval in shape and are surrounded by bundles of collagen fibers. Each lamella is composed of a dense network of thick fibrils. The terminal axons are located along the axis and form a bulb terminal. The fibers of external core stained by Picrosirius and examined by polarized light microscopy revealed to be green in color like type I collagen fibers, and at the periphery is a large amount of collagen type III. The corpuscles are surrounded by flat cells and dense collagen fibers at the periphery.

  10. Pulmonary involvement in inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Ayd?n Y?lmaz, Nilgün Y?lmaz Demirci, Derya Ho?gün, Enver Üner, Yurdanur Erdo?an, Atila Gökçek, Atalay Ça?lar

    2010-10-01

    Full Text Available AIM: To determine the relationship of pulmonary abnormalities and bowel disease activity in inflammatory bowel disease (IBD.METHODS: Thirty ulcerative colitis (UC and nine Crohn’s disease patients, and 20 control subjects were enrolled in this prospective study. Detailed clinical information was obtained. Extent and activity of the bowel disease were established endoscopically. Each patient underwent pulmonary function tests and high-resolution computed tomography (HRCT. Blood samples for measurement of C-reactive protein (CRP, erythrocyte sedimentation rate (ESR, angiotensin converting enzyme and total IgE were delivered by the patients.RESULTS: Ten (25.6% patients had respiratory symptoms. A pulmonary function abnormality was present in 22 of 39 patients. Among all patients, the most prevalent abnormalities in lung functions were a decrease in forced expiratory volume in 1 s (FEV1, FEV1/forced vital capacity (FVC, forced expiratory flow (FEF 25%-75%, transfer coefficient for carbon monoxide (DLCO, DLCO/alveolar volume. Increased respiratory symptoms score was associated with high endoscopic activity index in UC patients. Endoscopic and clinical activities in UC patients were correlated with FEV1, FEV1/FVC, and FEF 25%-75%. Smoking status, duration of disease and medication were not correlated with pulmonary physiological test results, HRCT abnormalities, clinical/endoscopic disease activity, CRP, ESR or total IgE level or body mass index.CONCLUSION: It is important that respiratory manifestations are recognized and treated early in IBD. Otherwise, they can lead to destructive and irreversible changes in the airway wall.

  11. The heart in inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Tsianos E.V.

    2007-03-01

    Full Text Available SUMMARY Cardiovascular involvement in inflammatory bowel disease (IBD has been occasionally reported, mainly in the form of case reports. Endocardium derangement in IBD involves endocarditis and subendocardial abscess. Endocarditis may occur as a result of septicemia or due to the prolonged use of total parental nutrition (TPN catheters or/and immunosuppression. The cause of endocarditis may be bacterial or fungal and require surgery in several cases. Prophylaxis for endocarditis in selected IBD patients is discussed. Myocarditis or perimyocarditis in IBD is reported as an autoimmune phenomenon during bowel disease excacerbations or as a side-effect of 5-aminosalicylic acid (5-ASA formulations. Ulcerative colitis (UC patients seem to be at a higher risk for this complication compared to Crohn?s disease (CD patients. Myocardial infarctions, selenium deficiency during TPN, the role of prolonged steroid use and the association with giant cell myocarditis are topics which need further analysis. Pericardium involvement seems to be the most frequent type of cardiovascular complication in IBD caused by drugs (5-ASA, azathioprine, cyclosporine, pericardio-colonic fistulas or unknown causes (idiopathic and it may occasionally be the disease presenting symptom. Coronary artery status and other factors for cardiovascular risk, such as smoking, hyperlipidemia and exercise are also discussed. Electrocardiogram and ultrasonographic changes are not so uncommon and cardiogenic sudden death in IBD is reviewed. Intracavitary coagulation abnormalities, amyloidosis, heart failure and aortitis syndrome are topics included and discussed in this review. A list of tables contributes to a more systemic overview of this current knowledge. Key Words: heart, inflammatory bowel disease, ulcerative colitis, Crohn?s diseas

  12. Trasplante de mucosa oral en la reconstrucción de las vías lagrimales Oral mucosa transplants in restoration of lacrimal canaliculi

    Directory of Open Access Journals (Sweden)

    Bernardo Canto Vidal

    2000-06-01

    Full Text Available Se realizaron 143 intervenciones de las vías lagrimales, mediante la técnica quirúrgica de trasplante de mucosa oral con 55 injertos libres y 88 tubulares, a partir del año 1995. Para ello se tuvo en cuenta el examen clínico y radiológico y el tipo de afectación. Con la utilización de las técnicas de injerto libre o tubular de la mucosa se puede restablecer la fisiología lagrimal en los pacientes con mutilaciones por traumatismos o presencia de tumores con disminución del riesgo quirúrgico; además se recomienda por novedosa, práctica y por los buenos resultados obtenidos.143 interventions of lacrimal canaliculi were carried out, throgh surgical technique of oral mucosa transplant (55 free grafts and 88 tutular ones since 1995, bearing in min radiological and clinical examination and type of invelvement. Using technique of free or tubular graft, it is possible restore lacrimal physiology in patients with mutilations from trauma or prevence of tumors thus decreasing surgical risk; this tachnique is recommended by its novelty, usefulness . and by good results obtained.

  13. Inflammatory bowel disease activity assessed by fecal calprotectin and lactoferrin: correlation with laboratory parameters, clinical, endoscopic and histological indexes

    Directory of Open Access Journals (Sweden)

    Rossini Lucio

    2009-10-01

    Full Text Available Abstract Background Research has shown that fecal biomarkers are useful to assess the activity of inflammatory bowel disease (IBD. The aim of the study is: to evaluate the efficacy of the fecal lactoferrin and calprotectin as indicators of inflammatory activity. Findings A total of 78 patients presenting inflammatory bowel disease were evaluated. Blood tests, the Crohn's Disease Activity Index (CDAI, Mayo Disease Activity Index (MDAI, and Crohn's Disease Endoscopic Index of Severity (CDEIS were used for the clinical and endoscopic evaluation. Two tests were performed on the fecal samples, to check the levels of calprotectin and lactoferrin. The performance of these fecal markers for detection of inflammation with reference to endoscopic and histological inflammatory activity was assessed and calculated sensitivity, specificity, accuracy. A total of 52 patient's samples whose histological evaluations showed inflammation, 49 were lactoferrin-positive, and 40 were calprotectin-positive (p = 0.000. Lactoferrin and calprotectin findings correlated with C-reactive protein in both the CD and UC groups (p = 0.006; p = 0.000, with CDAI values (p = 0.043; 0.010, CDEIS values in DC cases (p = 0,000; 0.000, and with MDAI values in UC cases (p = 0.000. Conclusion Fecal lactoferrin and calprotectin are highly sensitive and specific markers for detecting intestinal inflammation. Levels of fecal calprotectin have a proportional correlation to the degree of inflammation of the intestinal mucosa.

  14. A pedunculated polyp-shaped small-bowel lymphangioma causing gastrointestinal bleeding and treated by double-balloon enteroscopy

    Directory of Open Access Journals (Sweden)

    Akihiko Kida

    2012-01-01

    Full Text Available We report a rare case of a small-bowel lymphangioma causing massive gastrointestinal (GI bleeding that we successfully diagnosed and treated using double-balloon enteroscopy (DBE. An 81-year-old woman suffering from repeated GI bleeding of unknown origin underwent a capsule endoscopy at a previous hospital. She was suspected of having bleeding from the jejunum, and was referred to our department for diagnosis and treatment. An oral DBE revealed a 20 mm × 10 mm, regularly surfaced, white to yellowish, elongated, pedunculated jejunal polyp with small erosions at 10 cm distal to the ligament of Treiz. Since no other source of bleeding was identified by endoscopy in the deep jejunum, an endoscopic polypectomy (EP was performed for this lesion. A subsequent histopathological examination of the resected polyp showed clusters of lymphatic vessels with marked cystic dilatation in the submucosa and the deep layer of the lamina propria mucosae. These characteristics are consistent with the typical features of small-bowel lymphangioma with erosions. Although clipping hemostasis was performed during EP, re-bleeding occurred. Finally, a complete hemostasis was achieved by performing an additional argon plasma coagulation.

  15. FoxP3(+)CD4(+)CD25(+) T cells with regulatory properties can be cultured from colonic mucosa of patients with Crohn's disease.

    DEFF Research Database (Denmark)

    RØmer, Johanne Lade

    2005-01-01

    Summary CD4(+)CD25(+) regulatory T cells (T(regs)) are involved in the maintenance of peripheral tolerance and ensure a balanced immune response competent of fighting pathogens and at the same time recognizing commensals as harmless. This feature is lost in Crohn's disease (CD). The forkhead/winged helix transcription factor FoxP3 is a master gene for T(reg) function and defects in the FoxP3 gene lead to a clinical picture similar to inflammatory bowel disease (IBD). Murine colitis can be cured by adoptive transfer of T(regs) and ex vivo-generated gut-specific T(regs) represent an attractive option for therapy in CD. Thus, defective T(regs) could contribute to the development of CD. We cultured biopsies of colonic mucosa in the presence of high concentrations of interleukin (IL)-2 and IL-4 to overcome the anergic nature of naturally occurring CD4(+)CD25(+) T(regs) in the mucosa. We investigated the expression of FoxP3 and regulatory potential of gut-derived CD4(+)CD25(+) T cells cultured from patients with CDand healthy individuals. The FoxP3 expression was analysed by reverse transcriptase polymerase chain reaction (RT-PCR), and the suppressive effect of FoxP3(+)CD4(+)CD25(+) T cells on proliferation and cytokine production of autologous CD4(+) T cells was assessed by flow cytometry. Cultured gut-derived T cells with CD4(+)CD25(+) phenotype expressed FoxP3 and were able as the freshly isolated T(regs) from peripheral blood to suppress proliferation and cytokine production of autologous CD4(+) T cells. Thus, we demonstrate that FoxP3(+)CD4(+)CD25(+) T cells with regulatory properties can be propagated in vitro from inflamed mucosa of CD patients, which may be of interest in adoptive immunotherapy.

  16. Total Orthotopic Small Bowel Transplantation In Swine Under FK 506

    OpenAIRE

    Alessiani, M.; Spada, M.; Vischi, S.; M. Maestri; Dionigi, P; Arbustini, E.; Grossi, P; Ippoliti, G.B.; Regazzi, M.; De Ponti, F.; Moratti, R; Noli, S.; Zonta, A; Todo, S; STARZL, T. E.

    1994-01-01

    Previous experimental studies in rodents and in dogs have established the efficacy of FK 506 in controlling the immunologic events following small bowel or multivisceral transplantation.1–5 To complete the assessment of FK 506 in experimental small bowel transplantation, we present here our experience with the frequently used swine model.

  17. Blunt abdominal trauma with transanal small bowel evisceration

    Directory of Open Access Journals (Sweden)

    Noushif Medappil

    2013-01-01

    Full Text Available Small bowel evisceration through the anus can occur spontaneously or post traumatically. Traumatic transanal small bowel evisceration results from iatrogenic injuries, suction injuries, and blunt abdominal trauma (BAT. We report a 48-year-old female who presented with evisceration of small intestinal loops through the anus following BAT and discuss the etiologies and mechanisms of injury of this rare presentation.

  18. Small bowel angiodysplasia and novel disease associations: a cohort study.

    LENUS (Irish Health Repository)

    Holleran, Grainne

    2013-04-01

    Gastrointestinal angiodysplasias recurrently bleed, accounting for 3-5% of obscure gastrointestinal bleeding. The advent of small bowel capsule endoscopy (SBCE) has led to an increased recognition of small bowel angiodysplasias (SBAs) but little is known about their etiology. Previous small cohorts and case reports suggest an equal gender incidence and associations with cardiovascular disease, renal impairment, and coagulopathies.

  19. Bowel preparation regimens for colon capsule endoscopy: a review

    OpenAIRE

    Singhal, Shashideep; Nigar, Sofia; Paleti, Vani; Lane, Devin; Duddempudi, Sushil

    2014-01-01

    Colon capsule endoscopy (CCE) is being actively evaluated as an emerging complementary or alternative procedure for evaluation of the colon. The yield of CCE is significantly dependent on the quality of bowel preparation. In addition to achieving a stool-free colon the bowel preparation protocols need to decrease bubble effect and aid propulsion of the capsule.

  20. Is bowel preparation for excretory urography necessary?

    International Nuclear Information System (INIS)

    Objective: The objective of this study was to compare the three methods of preparation for excretory urography with regards to image clarity: bowel preparation, together with dietary restriction, dietary restriction alone and no preparation at all. Study Design: Randomized control trail. Place and Duration of Study: Department of Radiology, Military Hospital, Rawalpindi, which is a tertiary care hospital. The duration of study was 6 months from Aug 2009 to Feb 2010. Material and Methods: This was a randomized control trial of 588 patients undergoing excretory urography at a tertiary care hospital. Both male and female consecutive ambulatory patients older than 15 years referred for excretory urography were included in the study. The 588 patients were randomly distributed into three separate groups. Group 1 received standard bowel preparation consisting of tablet bisacodyl in a dose of 30 mg. The patients were instructed to fast for 4 hours before starting the laxative and do drink the laxative drug in the afternoon the day before the examination. Group 2 was instructed to only fast for 12 hours before the examination and the group 3 received no preparation at all. All the three groups were advised not to take breakfast and underwent the same examination procedure and then image clarity was assessed. The images were shown to a single consultant who was blind about the group of the patient and bowel preparatory technique which he or she underwent. Images were regarded clear when pelvicalyceal system, ureters and urinary bladder were demonstrated beyond any doubt. Same contrast agent (urografin) was used in all the three groups in a dose according to body weight (1 mg/kg) to exclude its effects on image clarity. Results: Assessment of image clarity was done between group 1 and 2, group 1 and 3 and group 2 and 3. The image clarity in patients of group 1 patients was found to be 94.3% and images were unclear in 5.7%. The image clarity in patients of group 2 was found to be 95.4% and the images were unclear in 4.3%. The image clarity in patients of group 3 was found to be 95.1% and images were unclear in 4.9%. Conclusion: Bowel preparation before excretory urography does not effect the image clarity and should be abandoned. (author)

  1. Trefoil factors in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Aamann, Luise; Vestergaard, Else Marie

    2014-01-01

    Inflammatory bowel disease (IBD), which comprises ulcerative colitis and Crohn's disease, is characterized by inflammation of the gastrointestinal tract. The trefoil factors 1, 2, and 3 (TFF1-3) are a family of peptides that play important roles in the protection and repair of epithelial surfaces, including the gastrointestinal tract. TFFs may be involved in IBD pathogenesis and are a potential treatment option. In the present review, we describe the TFF family and their potential role in IBD by summarizing the current knowledge of their expression, possible function and pharmacological role in IBD.

  2. Therapeutic drug monitoring in inflammatory bowel disease.

    Science.gov (United States)

    Kopylov, Uri; Ben-Horin, Shomron; Seidman, Ernest

    2014-01-01

    Tumor necrosis factor (TNF)-? inhibitors and thiopurines are among the most important classes of medications utilized in the clinical management of Crohn's disease and ulcerative colitis. A significant proportion of patients loses response to these agents or develops adverse effects during the course of the treatment. Monitoring of drug levels and anti-drug antibodies (for TNF-? inhibitors) and metabolite levels (for thiopurines) can provide valuable insight into the possible etiology of unfavorable outcomes and allow for an appropriate management strategy for these patients. This review summarizes the current knowledge on the clinical implications of therapeutic drug monitoring in inflammatory bowel disease patients treated with TNF-? inhibitors and thiopurines. PMID:25331715

  3. Bowel imaging - a reevaluation. Pt. 1. Conventional techniques and ultrasonography

    International Nuclear Information System (INIS)

    For decades fluoroscopy was the only adequate imaging modality in the diagnostic evaluation of the bowel. In the 1980 s new techniques such as MRI, CT and flexible fiber-optic endoscopy were introduced into the daily routine and revolutionized bowel imaging. Wireless capsule endoscopy (WCE) is the latest technical innovation for visualizing the bowel. Today a broad range of different imaging methods is available. This article provides a review of state-of-the-art bowel imaging and is divided into two parts. The first part addresses conventional X-ray techniques and ultrasonography and the second part discusses bowel imaging with computed tomography (CT) and magnetic resonance imaging (MRI). The goal of this article is to present the imaging techniques and to discuss them in the context of competitive methods. (orig.)

  4. Targeted Therapies for Inflammatory Bowel Disease and Colorectal Cancer: An Increasing Need for Microbiota-Intestine Mutualism

    Directory of Open Access Journals (Sweden)

    Tomasello Giovanni

    2015-06-01

    Full Text Available The involvement of intestinal microbiota and dysbiosis in the pathogenesis of inflammatory bowel disease (IBD and colorectal cancer (CRC is a well-established fact to be taken into real consideration when developing tartgeted therapies. This review aimed to depict what advances in our understanding of the role of intestinal flora in the pathogenesis of IBD and CRC is shaping up the therapeutic protocols of their management. It was demonstrated that there is a circadian regulation of colocytes gene expression in response to microbiota. In addition, dysbiosis leading to a decrease in microbiome biodiversity was also described in IBD patients whereby thick layers of adherent mucosa associated bacteria exist both in ulcerative colitis (UC and Crohn's disease (CD. Probiotics based approaches using lactobacilli and Bibidobacteria improved clinical symptoms of IBD's through the GALT immune modulation. In addition, fecal microbiota transplantation (FMT has also been used for IBD treatment. It consists of transferring gastrointestinal microbiota from a healthy donor to an IBD patient by duodenal infusion of liquid stool suspension to establish microbial homeostasis. The passage of bacteria in the injured mucosal zone triggers chronic inflammation and eventually CRC development by creating a carcinogenic environment. Actually, high level of Fusobacterium nucleatun and other bacteria are prevalent in CRC patients, thus suggesting a potential role of these organisms in the initiation and progression processes due to the production of genotoxic metabolites causing a direct damage to DNA integrity. Moreover, regular probiotics intake was shown to actively prevent the whole process. In conclusion, the mutualistic relationship between microbiota and colonic mucosa proved useful in depicting some of the dynamics of the initiation and development of IBD and CRC. Therapies oriented towards establishing equilibrium of intestinal microbiota may represent the key strategy to switch off chronic inflammatory processes hitting colonic mucosa, thus preventing the onset of CRC.

  5. Estudo epidemiológico do HPV na mucosa oral por meio de PCR / Epidemiological study of HPV in oral mucosa through PCR

    Scientific Electronic Library Online (English)

    Willys, Tristão; Rodrigo Metzker Pereira, Ribeiro; Camila Andrea de, Oliveira; Julio Cesar, Betiol; Jussara de Sousa Ribeiro, Bettini.

    2012-08-01

    Full Text Available Pertencente à família Papillomaviridae, o papilomavírus humano (HPV) é formado por um capsídeo e uma única fita dupla de DNA. Sua infecção ocorre principalmente por forma sexual, apresentando grande tropismo por células cutâneas e mucosas. OBJETIVO: Avaliar a presença do HPV em mucosa oral de pacien [...] tes assintomáticos e em paralelo correlacionar os hábitos sociais comportamentais com a presença viral. MATERIAL E MÉTODO: Estudo de coorte contemporânea com corte transversal. O diagnóstico da presença viral foi realizado por PCR, utilizando os primers gerais MY09/11 em 125 amostras de mucosa oral, submetidas à extração de DNA e PCR para a pesquisa do gene da beta-globina para avaliação da qualidade do DNA extraído. Em paralelo, foi realizado um estudo de questões comportamentais dos pacientes. RESULTADOS: Todas as amostras apresentaram o diagnóstico positivo para o gene da betaglobina. O HPV foi diagnosticado em 23,2% das amostras analisadas. CONCLUSÃO: O vírus esteve presente em 29 dos 125 pacientes, sem que estes apresentassem qualquer manifestação clinicopatológica relacionada com o HPV. Quanto ao comportamento social dos pacientes, concluiu-se que a prática de sexo oral está correlacionada de forma estatisticamente significante com a presença viral, além de o HPV ter sido estatisticamente mais prevalente em pacientes do sexo feminino. Abstract in english The Human Papillomavirus (HPV) belongs to the Papillomaviridae family and has a capsid and a single DNA strand. Its infection occurs mainly through sexual intercourse, having an important tropism for skin and mucosal cells. AIM: To evaluate the HPV presence in normal oral mucosa of asymptomatic subj [...] ects and; in parallel, to correlate social behavioral habits with the virus. MATERIALS AND METHODS: Contemporary cohort cross-sectional study. The HPV was found by PCR, using general primers MY09/11 in 125 oral mucosa samples submitted to DNA extraction and PCR to search for the beta-globin gene in order to assess the quality of the extracted DNA. In parallel, we carried out a study of behavioral issues associated with the patients. RESULTS: All the samples had a positive diagnosis of the beta-hemoglobin gene. HPV was diagnosed in 23.2% of the samples analyzed. CONCLUSION: The virus was present in 29 of the 125 patients, without them having any clinical-pathological manifestation associated with the HPV. As to the social behavior of the patients, we concluded that oral sex is statistically correlated to the virus, and besides the HPV has been statistically more present in female patients.

  6. Factors influencing quality of bowel preparation for colonoscopy

    Directory of Open Access Journals (Sweden)

    Ronald V Romero

    2013-01-01

    Full Text Available Recent technological advances in colonoscopy have led to improvements in both image enhancement and procedural performance. However, the utility of these technological advancements remain dependent on the quality of bowel preparation during colonoscopy. Poor bowel preparation has been shown to be associated with lower quality indicators of colonoscopy performance, such as reduced cecal intubation rates, increased patient discomfort and lower adenoma detection. The most popular bowel preparation regimes currently used are based on either Polyethylene glycol-electrolyte, a non-absorbable solution, or aqueous sodium phosphate, a low-volume hyperosmotic solution. Statements from various international societies and several reviews have suggested that the efficacy of bowel preparation regimes based on both purgatives are similar, although patients’ compliance with these regimes may differ somewhat. Many studies have now shown that factors other than the type of bowel preparation regime used, can influence the quality of bowel preparation among adult patients undergoing colonoscopy. These factors can be broadly categorized as either patient-related or procedure-related. Studies from both Asia and the West have identified patient-related factors such as an increased age, male gender, presence of co-morbidity and socio-economic status of patients to be associated with poor bowel preparation among adults undergoing routine out-patient colonoscopy. Additionally, procedure-related factors such as adherence to bowel preparation instructions, timing of bowel purgative administration and appointment waiting times for colonoscopy are recognized to influence the quality of colon cleansing. Knowledge of these factors should aid clinicians in modifying bowel preparation regimes accordingly, such that the quality of colonoscopy performance and delivery of service to patients can be optimised.

  7. MRI of the small bowel: can sufficient bowel distension be achieved with small volumes of oral contrast?

    International Nuclear Information System (INIS)

    Sufficient luminal distension is mandatory for small bowel imaging. However, patients often are unable to ingest volumes of currently applied oral contrast compounds. The aim of this study was to evaluate if administration of low doses of an oral contrast agent with high-osmolarity leads to sufficient and diagnostic bowel distension. Six healthy volunteers ingested at different occasions 150, 300 and 450 ml of a commercially available oral contrast agent (Banana Smoothie Readi-Cat, E-Z-EM; 194 mOsmol/l). Two-dimensional TrueFISP data sets were acquired in 5-min intervals up to 45 min after contrast ingestion. Small bowel distension was quantified using a visual five-grade ranking (5 very good distension, 1 = collapsed bowel). Results were statistically compared using a Wilcoxon-Rank test. Ingestion of 450 ml and 300 ml resulted in a significantly better distension than 150 ml. The all-over average distension value for 450 ml amounted to 3.4 (300 ml: 3.0, 150 ml: 2.3) and diagnostic bowel distension could be found throughout the small intestine. Even 45 min after ingestion of 450 ml the jejunum and ileum could be reliably analyzed. Small bowel imaging with low doses of contrast leads to diagnostic distension values in healthy subjects when a high-osmolarity substance is applied. These findings may help to further refine small bowel MRI techniques, but need to be confirmed in patients with small bowel disorders. (orig.)

  8. Imaging differentiation of phytobezoar and small-bowel faeces: CT characteristics with quantitative analysis in patients with small- bowel obstruction

    International Nuclear Information System (INIS)

    The objective is to use multidetector computed tomography (MDCT) to differentiate phytobezoar impaction and small-bowel faeces in patients with small-bowel obstruction (SBO). We retrospectively reviewed 91 consecutive SBO patients with surgically proven phytobezoars (n = 31) or adhesion with small-bowel faeces (n = 60). Two readers blinded to the diagnosis recorded the following MDCT features: degree of obstruction, transition point, mesenteric fatty stranding, intraperitoneal fluid, air-fluid level, pneumatosis intestinalis, and portal venous gas. MDCT measurements of the food debris length, attenuation, luminal diameter, and wall thickness of the obstructed bowel were also compared. A higher grade of obstruction with an absence of mesenteric fatty stranding and intraperitoneal fluid was more commonly seen in the phytobezoar group than in the small-bowel faeces group (p < 0.01). The food debris length (phytobezoar, 5.7 ± 2.8 cm; small-bowel feces, 20.3 ± 7.9 cm, p < 0.01) and mean attenuation (phytobezoar, -59.6 ± 43.3 Hounsfield units (HU); small-bowel faeces, 8.5 ± 7.7 HU, p <0.01) were significantly different between the two groups. The ROC curve showed that food debris length <9.5 cm and mean attenuation value < -11.75 HU predicted phytobezoar impaction. MDCT features with measurements of the food debris length and mean attenuation assist the differentiation of phytobezoar impaction and small-bowel faeces. (orig.)

  9. Imaging differentiation of phytobezoar and small-bowel faeces: CT characteristics with quantitative analysis in patients with small- bowel obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Ya-Cheng; Liu, Chang-Hsien; Hsu, Hsian-He; Yu, Chih-Yung [Tri-Service General Hospital, National Defense Medical Center, Department of Radiology, Taipei (China); Wang, Hong-Hau [Tri-Service General Hospital, National Defense Medical Center, Department of Radiology, Taipei (China); Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Department of Radiology, Taipei (China); Fan, Hsiu-Lung [Tri-Service General Hospital, National Defense Medical Center, Division of General Surgery, Department of Surgery, Taipei (China); Chen, Ran-Chou [Taipei City Hospital, Department of Radiology, Taipei (China); National Yang-Ming Univeristy, Department of Biochemical Imaging and Radiological Sciences, Taipei (China); Chang, Wei-Chou [Tri-Service General Hospital, National Defense Medical Center, Department of Radiology, Taipei (China); National Yang-Ming Univeristy, Department of Biochemical Imaging and Radiological Sciences, Taipei (China)

    2015-04-01

    The objective is to use multidetector computed tomography (MDCT) to differentiate phytobezoar impaction and small-bowel faeces in patients with small-bowel obstruction (SBO). We retrospectively reviewed 91 consecutive SBO patients with surgically proven phytobezoars (n = 31) or adhesion with small-bowel faeces (n = 60). Two readers blinded to the diagnosis recorded the following MDCT features: degree of obstruction, transition point, mesenteric fatty stranding, intraperitoneal fluid, air-fluid level, pneumatosis intestinalis, and portal venous gas. MDCT measurements of the food debris length, attenuation, luminal diameter, and wall thickness of the obstructed bowel were also compared. A higher grade of obstruction with an absence of mesenteric fatty stranding and intraperitoneal fluid was more commonly seen in the phytobezoar group than in the small-bowel faeces group (p < 0.01). The food debris length (phytobezoar, 5.7 ± 2.8 cm; small-bowel feces, 20.3 ± 7.9 cm, p < 0.01) and mean attenuation (phytobezoar, -59.6 ± 43.3 Hounsfield units (HU); small-bowel faeces, 8.5 ± 7.7 HU, p <0.01) were significantly different between the two groups. The ROC curve showed that food debris length <9.5 cm and mean attenuation value < -11.75 HU predicted phytobezoar impaction. MDCT features with measurements of the food debris length and mean attenuation assist the differentiation of phytobezoar impaction and small-bowel faeces. (orig.)

  10. MRI of the small bowel: can sufficient bowel distension be achieved with small volumes of oral contrast?

    Energy Technology Data Exchange (ETDEWEB)

    Kinner, Sonja; Kuehle, Christiane A.; Ladd, Susanne C.; Barkhausen, Joerg [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Herbig, Sebastian [University Hospital Essen, Institute of Pharmacy and Pharmaceutical Services, Essen (Germany); Haag, Sebastian [University Hospital Essen, Department of Hepatology and Gastroenterology, Essen (Germany); Lauenstein, Thomas C. [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Emory University Hospital, Department of Radiology, Atlanta, GA (United States)

    2008-11-15

    Sufficient luminal distension is mandatory for small bowel imaging. However, patients often are unable to ingest volumes of currently applied oral contrast compounds. The aim of this study was to evaluate if administration of low doses of an oral contrast agent with high-osmolarity leads to sufficient and diagnostic bowel distension. Six healthy volunteers ingested at different occasions 150, 300 and 450 ml of a commercially available oral contrast agent (Banana Smoothie Readi-Cat, E-Z-EM; 194 mOsmol/l). Two-dimensional TrueFISP data sets were acquired in 5-min intervals up to 45 min after contrast ingestion. Small bowel distension was quantified using a visual five-grade ranking (5 = very good distension, 1 = collapsed bowel). Results were statistically compared using a Wilcoxon-Rank test. Ingestion of 450 ml and 300 ml resulted in a significantly better distension than 150 ml. The all-over average distension value for 450 ml amounted to 3.4 (300 ml: 3.0, 150 ml: 2.3) and diagnostic bowel distension could be found throughout the small intestine. Even 45 min after ingestion of 450 ml the jejunum and ileum could be reliably analyzed. Small bowel imaging with low doses of contrast leads to diagnostic distension values in healthy subjects when a high-osmolarity substance is applied. These findings may help to further refine small bowel MRI techniques, but need to be confirmed in patients with small bowel disorders. (orig.)

  11. Current and emerging drugs for the treatment of inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Triantafillidis JK

    2011-04-01

    Full Text Available John K Triantafillidis, Emmanuel Merikas, Filippos GeorgopoulosDepartment of Gastroenterology, Center for Inflammatory Bowel Disease, “Saint Panteleimon” General Hospital, Nicea, GreeceAbstract: During the last decade a large number of biological agents against tumor necrosis factor-? (TNF-?, as well as many biochemical substances and molecules specifically for the medical treatment of patients with inflammatory bowel disease (IBD, have been developed. This enormous progress was a consequence of the significant advances in biotechnology along with the increased knowledge of the underlying pathophysiological mechanisms involved in the pathogenesis of IBD. However, conventional therapies remain the cornerstone of treatment for most patients. During recent years conventional and biologic IBD therapies have been optimized. Newer mesalazine formulations with a reduced pill size and only one dose per day demonstrate similar efficacy to older formulations. New corticosteroids retain the efficacy of older corticosteroids while exhibiting a higher safety profile. The role of antibiotics and probiotics has been further clarified. Significant progress in understanding thiopurine metabolism has improved the effective dose along with adjunctive therapies. Quite a large number of substances and therapies, including biologic agents other than TNF-? inhibitors, unfractionated or low-molecular-weight heparin, omega-3 polyunsaturated fatty acids, microbes and microbial products, leukocytapheresis, and other substances under investigation, could offer important benefits to our patients. In this paper we review the established and emerging therapeutic strategies in patients with Crohn’s disease and ulcerative colitis.Keywords: inflammatory bowel disease, ulcerative colitis, Crohn’s disease, treatment, biologic agents, immunosuppressives, mesalazine, antibiotics

  12. Psychosocial determinants of irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Teodora Surdea-Blaga

    2012-01-01

    Full Text Available From a pure motor disorder of the bowel, in the past few years, irritable bowel syndrome (IBS has become a multifactorial disease that implies visceral hypersensitivity, alterations at the level of nervous and humoral communications between the enteric nervous system and the central nervous system, alteration of the gut microflora, an increased intestinal permeability and minimum intestinal inflammation. Psychological and social factors can interfere with the communication between the central and enteric nervous systems, and there is proof that they are involved in the onset of IBS and influence the response to treatment and outcome. There is evidence that abuse history and stressful life events are involved in the onset of functional gastrointestinal disorders. In order to explain clustering of IBS in families, genetic factors and social learning mechanisms have been proposed. The psychological features, such as anxiety, depression as well as the comorbid psychiatric disorders, health beliefs and coping of patients with IBS are discussed in relation to the symptoms and outcome.

  13. Inflammatory Bowel Disease: Therapy for Active Disease

    Directory of Open Access Journals (Sweden)

    Konstantina D. Paraskeva

    2007-04-01

    Full Text Available The optimal therapy for active inflammatory bowel disease (IBD is individualized according to the severity and the location of the disease and furthermore, the particular needs of each patient. For ulcerative colitis (UC, topical therapy can be useful in distal disease and the higher the dose of 5 ASA the better the response. In Crohn?s disease (CD, budesonide is a promising treatment for mild to moderate ileitis and rightsided colitis. The anti-tumor necrosis factor-a (TNF-a antibody infliximab is an effective therapy for moderate to severe inflammatory and fistulizing Crohn?s disease. Recent studies have shown that infliximab is also effective in the treatment of moderate to severe UC. For both UC and CD, corticosteroids still remain the mainstay of treatment in active disease. The therapeutic goals in inflammatory bowel disease (IBD include induction of remission in patients with active disease and maintenance of remission in those with quiescent disease. Furthermore, therapy should prevent disease complications. This review is focused on the standard therapeutic options for inducing remission in patients with active IBD.

  14. Zinc absorption in inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Valberg, L.S.; Flanagan, P.R.; Kertesz, A.; Bondy, D.C.

    1986-07-01

    Zinc absorption was measured in 29 patients with inflammatory bowel disease and a wide spectrum of disease activity to determine its relationship to disease activity, general nutritional state, and zinc status. Patients with severe disease requiring either supplementary oral or parenteral nutrition were excluded. The mean 65ZnCl2 absorption, in the patients, determined using a 65Zn and 51Cr stool-counting test, 45 +/- 17% (SD), was significantly lower than the values, 54 +/- 16%, in 30 healthy controls, P less than 0.05. Low 65ZnCl2 absorption was related to undernutrition, but not to disease activity in the absence of undernutrition or to zinc status estimated by leukocyte zinc measurements. Mean plasma zinc or leukocyte zinc concentrations in patients did not differ significantly from controls, and only two patients with moderate disease had leukocyte zinc values below the 5th percentile of normal. In another group of nine patients with inflammatory bowel disease of mild-to-moderate severity and minimal nutritional impairment, 65Zn absorption from an extrinsically labeled turkey test meal was 31 +/- 10% compared to 33 +/- 7% in 17 healthy controls, P greater than 0.1. Thus, impairment in 65ZnCl2 absorption in the patients selected for this study was only evident in undernourished persons with moderate or severe disease activity, but biochemical evidence of zinc deficiency was uncommon, and clinical features of zinc depletion were not encountered.

  15. Inflammatory Bowel Disease in Children and Adolescents.

    Science.gov (United States)

    Rosen, Michael J; Dhawan, Ashish; Saeed, Shehzad A

    2015-11-01

    The inflammatory bowel diseases (IBDs), including ulcerative colitis and Crohn disease, are chronic inflammatory disorders of the gastrointestinal tract most often diagnosed in adolescence and young adulthood, with a rising incidence in pediatric populations. These disorders are common enough in children that most pediatricians and other pediatric clinicians will encounter children with IBD in their general practice. Inflammatory bowel disease is caused by a dysregulated mucosal immune response to the intestinal microflora in genetically predisposed hosts. Although children can present with the classic symptoms of weight loss, abdominal pain, and bloody diarrhea, many present with nonclassic symptoms of isolated poor growth, anemia, or other extraintestinal manifestations. Once IBD is diagnosed, the goals of therapy consist of eliminating symptoms, normalizing quality of life, restoring growth, and preventing complications while minimizing the adverse effects of medications. Unique considerations when treating children and adolescents with IBD include attention to the effects of the disease on growth and development, bone health, and psychosocial functioning. The purpose of this review is to provide a contemporary overview of the epidemiologic features, pathogenesis, diagnosis, and management of IBD in children and adolescents. PMID:26414706

  16. Sleep disturbances and inflammatory bowel disease.

    Science.gov (United States)

    Ali, Tauseef; Orr, William C

    2014-11-01

    With an estimated 70 million Americans suffering, sleep disorders have become a global issue, and discovering their causes and consequences are the focus of many clinical research studies. Sleep is now also considered to be an important environmental and behavioral factor associated with the process of inflammation and the immune system. Increased sleepiness is considered part of the acute phase of response to tissue injury, and sleep loss activates inflammatory cytokines such as interleukin (IL)-1 and tumor necrosis factor (TNF)-?. Clinical studies in many immune-mediated diseases, such as systemic lupus erythematosus, rheumatoid arthritis, and ankylosing spondylitis, have revealed an association of sleep disturbances with disease activity. Recent research suggests that individuals with sleep abnormalities are also at greater risk of serious adverse health, economic consequences, and most importantly increased all-cause mortality. The importance of sleep in inflammatory bowel disease has recently gained attention with some published studies demonstrating the association of sleep disturbances with disease activity, subclinical inflammation, and risk of disease relapse. A comprehensive review of sleep physiology and its association with the immune system is provided here. Experimental and clinical studies exploring this relationship in inflammatory bowel disease are reviewed, and the clinical implications of this relationship and future directions for research are also discussed. PMID:25025716

  17. Zinc absorption in inflammatory bowel disease

    International Nuclear Information System (INIS)

    Zinc absorption was measured in 29 patients with inflammatory bowel disease and a wide spectrum of disease activity to determine its relationship to disease activity, general nutritional state, and zinc status. Patients with severe disease requiring either supplementary oral or parenteral nutrition were excluded. The mean 65ZnCl2 absorption, in the patients, determined using a 65Zn and 51Cr stool-counting test, 45 +/- 17% (SD), was significantly lower than the values, 54 +/- 16%, in 30 healthy controls, P less than 0.05. Low 65ZnCl2 absorption was related to undernutrition, but not to disease activity in the absence of undernutrition or to zinc status estimated by leukocyte zinc measurements. Mean plasma zinc or leukocyte zinc concentrations in patients did not differ significantly from controls, and only two patients with moderate disease had leukocyte zinc values below the 5th percentile of normal. In another group of nine patients with inflammatory bowel disease of mild-to-moderate severity and minimal nutritional impairment, 65Zn absorption from an extrinsically labeled turkey test meal was 31 +/- 10% compared to 33 +/- 7% in 17 healthy controls, P greater than 0.1. Thus, impairment in 65ZnCl2 absorption in the patients selected for this study was only evident in undernourished persons with moderate or severe disease activity, but biochemical evidence of zinc deficiency was uncommon, and clinical features of zinc depletion were not encountered

  18. Irritable bowel syndrome: Diagnosis and pathogenesis

    Directory of Open Access Journals (Sweden)

    Magdy El-Salhy

    2012-01-01

    Full Text Available Irritable bowel syndrome (IBS is a common gastrointestinal (GI disorder that considerably reduces the quality of life. It further represents an economic burden on society due to the high consumption of healthcare resources and the non-productivity of IBS patients. The diagnosis of IBS is based on symptom assessment and the Rome III criteria. A combination of the Rome III criteria, a physical examination, blood tests, gastroscopy and colonoscopy with biopsies is believed to be necessary for diagnosis. Duodenal chromogranin A cell density is a promising biomarker for the diagnosis of IBS. The pathogenesis of IBS seems to be multifactorial, with the following factors playing a central role in the pathogenesis of IBS: heritability and genetics, dietary/intestinal microbiota, low-grade inflammation, and disturbances in the neuroendocrine system (NES of the gut. One hypothesis proposes that the cause of IBS is an altered NES, which would cause abnormal GI motility, secretions and sensation. All of these abnormalities are characteristic of IBS. Alterations in the NES could be the result of one or more of the following: genetic factors, dietary intake, intestinal flora, or low-grade inflammation. Post-infectious IBS (PI-IBS and inflammatory bowel disease-associated IBS (IBD-IBS represent a considerable subset of IBS cases. Patients with PI- and IBD-IBS exhibit low-grade mucosal inflammation, as well as abnormalities in the NES of the gut.

  19. Cytoprotective effects of disodium cromoglycate on rat stomach mucosa.

    OpenAIRE

    Goossens, J.; Van Reempts, J.; Van Wauwe, J. P.

    1987-01-01

    The cytoprotective effects of the anti-asthmatic drug, disodium cromoglycate (DSCG), on gastric mucosal necrosis induced by ethanol in rats were studied. Subcutaneous, but not oral, DSCG prevented the formation of gastric lesions and this effect was dose-dependent between 1.25 and 40 mg kg-1, with an ED50 value of 6.8 mg kg-1. Maximal cytoprotection occurred 15-30 min after DSCG treatment. Histological examination revealed that DSCG effectively protected the gastric mucosa against ethanol-ind...

  20. Nasal mucosa in workers exposed to formaldehyde: a pilot study.

    Science.gov (United States)

    Boysen, M; Zadig, E; Digernes, V; Abeler, V; Reith, A

    1990-01-01

    This study evaluates the histological changes, especially the presence of possible precancerous lesions, in the nasal mucosa of workers exposed to formaldehyde. Nasal biopsies of 37 workers occupationally exposed to formaldehyde for more than five years and 37 age matched referents showed a higher degree of metaplastic alterations in the former group. In addition, three cases of epithelial dysplasia were observed among the exposed. These results indicate that formaldehyde may be potentially carcinogenic to man. Combination of this finding with the inconclusive epidemiological studies suggests that formaldehyde is a weak carcinogen and that occupational exposure to formaldehyde alone is insufficient to induce nasal cancer. Images PMID:2310715

  1. Collagenase inhibition in colonic mucosa by proteinase inhibitors.

    OpenAIRE

    Lewin, M. R.; Chowcat, N. L.; Jayaraj, A P; Boulos, P. B.

    1986-01-01

    The effect of proteinase inhibitors on collagenase activity in rabbit colonic mucosa, both in vitro and in vivo, has been measured by a tissue culture method. Aprotinin, when applied to colonic explants at doses of 20 and 40 KIU, significantly reduced the lytic activity by 97.3% and 99.1% respectively (P less than 0.001). At doses of 100, 200 and 400 KIUs, lysis was completely abolished. Rectal biopsies taken from rabbits at 4, 24, 48 and 72 h following either intramuscular, oral or rectal ad...

  2. Small-bowel MRI in children and young adults with Crohn disease: retrospective head-to-head comparison of contrast-enhanced and diffusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Neubauer, Henning; Evangelista, Laura; Wirth, Clemens; Beer, Meinrad [University Hospital Wuerzburg, Institute of Radiology, Department of Paediatric Radiology, Wuerzburg (Germany); Pabst, Thomas; Machann, Wolfram; Koestler, Herbert; Hahn, Dietbert [University Hospital Wuerzburg, Institute of Radiology, Wuerzburg (Germany); Dick, Anke [University Hospital Wuerzburg, Department of Paediatrics, Wuerzburg (Germany)

    2013-01-15

    Small-bowel MRI based on contrast-enhanced T1-weighted sequences has been challenged by diffusion-weighted imaging (DWI) for detection of inflammatory bowel lesions and complications in patients with Crohn disease. To evaluate free-breathing DWI, as compared to contrast-enhanced MRI, in children, adolescents and young adults with Crohn disease. This retrospective study included 33 children and young adults with Crohn disease ages 17 {+-} 3 years (mean {+-} standard deviation) and 27 matched controls who underwent small-bowel MRI with contrast-enhanced T1-weighted sequences and DWI at 1.5 T. The detectability of Crohn manifestations was determined. Concurrent colonoscopy as reference was available in two-thirds of the children with Crohn disease. DWI and contrast-enhanced MRI correctly identified 32 and 31 patients, respectively. All 22 small-bowel lesions and all Crohn complications were detected. False-positive findings (two on DWI, one on contrast-enhanced MRI), compared to colonoscopy, were a result of large-bowel lumen collapse. Inflammatory wall thickening was comparable on DWI and contrast-enhanced MRI. DWI was superior to contrast-enhanced MRI for detection of lesions in 27% of the assessed bowel segments and equal to contrast-enhanced MRI in 71% of segments. DWI facilitates fast, accurate and comprehensive workup in Crohn disease without the need for intravenous administration of contrast medium. Contrast-enhanced MRI is superior in terms of spatial resolution and multiplanar acquisition. (orig.)

  3. Advances in the Endoscopic Assessment of Inflammatory Bowel Diseases: Cooperation between Endoscopic and Pathologic Evaluations.

    Science.gov (United States)

    Cheon, Jae Hee

    2015-05-01

    Endoscopic assessment has a crucial role in the management of inflammatory bowel disease (IBD). It is particularly useful for the assessment of IBD disease extension, severity, and neoplasia surveillance. Recent advances in endoscopic imaging techniques have been revolutionized over the past decades, progressing from conventional white light endoscopy to novel endoscopic techniques using molecular probes or electronic filter technologies. These new technologies allow for visualization of the mucosa in detail and monitor for inflammation/dysplasia at the cellular or sub-cellular level. These techniques may enable us to alter the IBD surveillance paradigm from four quadrant random biopsy to targeted biopsy and diagnosis. High definition endoscopy and dye-based chromoendoscopy can improve the detection rate of dysplasia and evaluate inflammatory changes with better visualization. Dye-less chromoendoscopy, including narrow band imaging, iScan, and autofluorescence imaging can also enhance surveillance in comparison to white light endoscopy with optical or electronic filter technologies. Moreover, confocal laser endomicroscopy or endocytoscopy have can achieve real-time histology evaluation in vivo and have greater accuracy in comparison with histology. These new technologies could be combined with standard endoscopy or further histologic confirmation in patients with IBD. This review offers an evidence-based overview of new endoscopic techniques in patients with IBD. PMID:26018512

  4. Intestinal small bowel lymphomas - diagnosis and treatment; Primaer intestinale Lymphome - Diagnosestellung mittels CT und Therapie

    Energy Technology Data Exchange (ETDEWEB)

    Goessmann, H.; Reith, H.B. [Klinikum fuer Visceral-, Thorax und Gefaesschirurgie, Klinikum Konstanz (Germany); Goerlitz, T.; Beck, A. [Inst. fuer Roentgendiagnostik und Nuklearmedizin, Klinikum Konstanz (Germany)

    2006-07-01

    Primary intestinal lymphomas are most common in the stomach. The mucosa associated lymphatic tissue (MALT)-lymphoma which is closely associated with helicobacter pylori is very well known. In most cases, these malignancies are from B-cells origin. Another possible point of manifestation, although not well known, is the small bowel. Both tumors have enormous capabilities to enlarge in the abdominal cave. This is responding to their often asymptomatic manifestation. The symptoms, if they occur, are widespread and unspecific. Ileus, diarrhae, abdominal pain or bleeding will be observed, in rare cases also perforation or gastrointestinal or cutaneous fistulas. Diagnostic imaging often demonstrates a tumour of massive size by then, which is echopoor in the abdominal ultrasound. Our report concerns two cases of small intestine lymphomas, which were diagnosed by CT-scanning and treated in our clinic in only a short period of time. The first case was a low malignant jejunal lymphoma which was almost asymptomatic, whereas the second case had an ileus, due to compression of the intestine because of a high malignant lymphoma of the ileocecal region. (orig.)

  5. Human inflammatory bowel disease does not associate with Lawsonia intracellularis infection

    Directory of Open Access Journals (Sweden)

    Giese Thomas

    2006-09-01

    Full Text Available Abstract Background There is increasing evidence that bacterial infection of the intestinal mucosa may contribute to the pathogenesis of inflammatory bowel diseases (IBD. In pigs, an obligate intracellular bacterium, Lawsonia intracellularis (LI, was shown to cause proliferative enteropathy (PE of which some forms display histological and clinical similarities to human IBD. Since LI-similar Desulfovibrio spp. may infect human cells, we hypothesized that LI might be associated with the development of human IBD. Results In human intestinal tissue samples, PCR using LLG, 50SL27, LSA and strictly LI-specific 16SII primers, yielded either no amplicons or products with weak homology to human genomic sequences. Sequencing of these amplicons revealed no specificity for LI. However, amplification of DNA with less specific 16SI primers resulted in products bearing homology to certain Streptococcus species. These 16SI-amplified products were present in healthy and diseased specimens, without obvious prevalence. Conclusion LI is not associated with the pathogenesis of UC or CD. Whether an immunologic response to commensal bacteria such as streptococci may contribute to the chronic inflammatory condition in IBD, remained to be determined.

  6. Neuroendocrine tumors of the small bowels are on the rise: Early aspects and management

    Directory of Open Access Journals (Sweden)

    Hans Scherübl

    2010-10-01

    Full Text Available Neuroendocrine tumors of the small bowel are on the rise. In the US they have increased by 300%-500% in the last 35 years. At the same time their prognosis is much improved. Today, most neuroendocrine tumors (NETs of the duodenum are detected “incidentally” and therefore recognized at an early stage. Duodenal NETs which are well differentiated, not larger than 10 mm and limited to the mucosa/submucosa can be endoscopically resected. The management of duodenal NETs ranging between 10 and 20 mm needs an interdisciplinary discussion. Endoscopic ultrasound is the method of choice to determine tumor size and depth of infiltration. Surgery is recommended for well-differentiated duodenal NET tumors greater than 20 mm, for localized sporadic gastrinomas (of any size and for localized poorly differentiated NE cancers. Surgery is recommended for any ileal NET. Advanced ileal NETs with a carcinoid syndrome are treated with long-acting somatostatin analogs. This treatment significantly improves (progression-free survival in patients with metastatic NETs of the ileum. For optimal NET management, tumor biology, type, localization and stage of the neoplasm, as well as the patient’s individual circumstances have to be taken into account.

  7. MEP1A allele for meprin A metalloprotease is a susceptibility gene for inflammatory bowel disease.

    Science.gov (United States)

    Banerjee, S; Oneda, B; Yap, L M; Jewell, D P; Matters, G L; Fitzpatrick, L R; Seibold, F; Sterchi, E E; Ahmad, T; Lottaz, D; Bond, J S

    2009-05-01

    The MEP1A gene, located on human chromosome 6p (mouse chromosome 17) in a susceptibility region for inflammatory bowel disease (IBD), encodes the alpha-subunit of metalloproteinase meprin A, which is expressed in the intestinal epithelium. This study shows a genetic association of MEP1A with IBD in a cohort of ulcerative colitis (UC) patients. There were four single-nucleotide polymorphisms in the coding region (P=0.0012-0.04), and one in the 3'-untranslated region (P=2 x 10(-7)) that displayed associations with UC. Moreover, meprin-alpha mRNA was decreased in inflamed mucosa of IBD patients. Meprin-alpha knockout mice exhibited a more severe intestinal injury and inflammation than their wild-type counterparts following oral administration of dextran sulfate sodium. Collectively, the data implicate MEP1A as a UC susceptibility gene and indicate that decreased meprin-alpha expression is associated with intestinal inflammation in IBD patients and in a mouse experimental model of IBD. PMID:19262505

  8. Leishmaniose mucosa fatal em criança Fatal mucosal leishmaniasis in a child

    OpenAIRE

    Daniela Velozo; Andréa Cabral; Maria Custódia Machado Ribeiro; Jorgeth de Oliveira Carneiro da Motta; Izelda Maria Carvalho Costa; Raimunda Nonata Ribeiro Sampaio

    2006-01-01

    A leishmaniose tegumentar americana, doença endêmica e crescente no Brasil, pode manifestar-se por úlceras na pele e lesões nas mucosas nasal, oral e faringiana. O antimônio pentavalente é a droga de primeira escolha no tratamento, com resposta menos favorável nas formas mucosas. Destaca-se a dificuldade para diagnosticar e tratar um caso de leishmaniose mucosa em criança de cinco anos que teve exames parasitológicos, imunológicos e reação em cadeia da polimerase negativos. Somente após vária...

  9. Volume-based Feature Analysis of Mucosa for Automatic Initial Polyp Detection in Virtual Colonoscopy

    OpenAIRE

    Wang, Su; Zhu, Hongbin; Lu, Hongbing; LIANG, ZHENGRONG

    2008-01-01

    In this paper, we present a volume-based mucosa-based polyp candidate determination scheme for automatic polyp detection in computed colonography. Different from most of the existing computer-aided detection (CAD) methods where mucosa layer is a one-layer surface, a thick mucosa of 3-5 voxels wide fully reflecting partial volume effect is intentionally extracted, which excludes the direct applications of the traditional geometrical features. In order to address this dilemma, fast marching-bas...

  10. Techniques to preserve keratinized peri-implant mucosa in CT-guided oral implant surgery

    OpenAIRE

    Bernhard Pommer

    2012-01-01

    Guided implant dentistry using computed tomographic (CT) scans, virtual planning software and mucosa-supported surgical templates is an upcoming technology with the potential for more predictable and less invasive implant placement. While generally associated with a flapless approach, soft tissue punching and removal may not be indicated if available width of keratinized mucosa is limited prior to implant surgery. Two techniques to preserve keratinized peri-implant mucosa (Punch Reposition Te...

  11. Oxidative stress disturbs energy metabolism of mitochondria in ethanol-induced gastric mucosa injury

    OpenAIRE

    Jin-Shui Pan, Shao-Zhen He, Hong-Zhi Xu, Xiao-Juan Zhan, Xiao-Ning Yang, Hong-Min Xiao, Hua-Xiu Shi, Jian-Lin Ren

    2008-01-01

    AIM: To study the role of mitochondrial energy disorder in the pathogenesis of ethanol-induced gastric mucosa injury.METHODS: Wistar rats were used in this study. A gastric mucosal injury model was established by giving the rats alcohol. Gross and microscopic appearance of gastric mucosa and ultrastructure of mitochondria were evaluated. Malondiadehyde (MDA) in gastric mucosa was measured with thiobarbituric acid. Expression of ATP synthase (ATPase) subunits 6 and 8 in mitochondrial DNA (mtDN...

  12. [The morphologic changes of gastric mucosa before and after the surgical operations].

    Science.gov (United States)

    Rustamov, E A

    2012-01-01

    The article outlines the morphologic evaluation of the gastric mucosa in 159 patients with different types of pyloroduodenal ulcers. The comparative characteristics of the gastric mucosa of 80 patients before and after the gastric resection. The complete restoration of the mucosa within the year after the selective proximal vagotomy was registered. The gastric resection leads to the chronic gastritis with dystrophic changes and intestinal or pseudopyloric metaplasia. PMID:22810340

  13. Intussusception of the bowel in adults: A review

    Directory of Open Access Journals (Sweden)

    Athanasios Marinis, Anneza Yiallourou, Lazaros Samanides, Nikolaos Dafnios, Georgios Anastasopoulos, Ioannis Vassiliou, Theodosios Theodosopoulos

    2009-01-01

    Full Text Available Intussusception of the bowel is defined as the telescoping of a proximal segment of the gastrointestinal tract within the lumen of the adjacent segment. This condition is frequent in children and presents with the classic triad of cramping abdominal pain, bloody diarrhea and a palpable tender mass. However, bowel intussusception in adults is considered a rare condition, accounting for 5% of all cases of intussusceptions and almost 1%-5% of bowel obstruction. Eight to twenty percent of cases are idiopathic, without a lead point lesion. Secondary intussusception is caused by organic lesions, such as inflammatory bowel disease, postoperative adhesions, Meckel’s diverticulum, benign and malignant lesions, metastatic neoplasms or even iatrogenically, due to the presence of intestinal tubes, jejunostomy feeding tubes or after gastric surgery. Computed tomography is the most sensitive diagnostic modality and can distinguish between intussusceptions with and without a lead point. Surgery is the definitive treatment of adult intussusceptions. Formal bowel resection with oncological principles is followed for every case where a malignancy is suspected. Reduction of the intussuscepted bowel is considered safe for benign lesions in order to limit the extent of resection or to avoid the short bowel syndrome in certain circumstances.

  14. The epidemiology of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Burisch, Johan; Munkholm, Pia

    2015-01-01

    BACKGROUND AND AIMS: The inflammatory bowel diseases (IBD), Crohn's disease (CD) and ulcerative colitis (UC), are chronic relapsing disorders of unknown aetiology. The aim of this review is to present the latest epidemiology data on occurrence, disease course, risk for surgery, as well as mortality and cancer risks. MATERIAL AND METHODS: Gold standard epidemiology data on the disease course and prognosis of patients with inflammatory bowel disease (IBD) are based on unselected population-based cohort studies. RESULTS: The incidence of ulcerative colitis (UC) and Crohn's disease (CD) has increased overall in Europe from 6.0 per 100,000 person-years in UC and 1.0 per 100,000 person-years in CD in 1962 to 9.8 per 100,000 person-years and 6.3 per 100,000 person-years in 2010, respectively. The highest incidence of IBD is found on the Faroe Islands. Overall, surgery rates have been declining over the last decades, partly due to aggressive medical therapy. Among IBD patients, mortality risk is increased by up to 50% in CD when compared to the background population, but this is not the case for UC. In CD, 25 - 50% deaths are disease-specific deaths, e.g. malnutrition, postoperative complications and intestinal cancer. In UC, disease-specific causes of deaths include colorectal cancer (CRC), and surgical and postoperative complications. The risk of CRC and small bowel cancer is increased two- to eightfold among IBD patients. Various subgroups carry increased risk of malignancy, e.g. those with persistent inflammation, long-standing disease, extensive disease, young age at diagnosis, family history of CRC and co-existing primary sclerosing cholangitis. The risk of extra-intestinal cancers, including lymphoproliferative disorders (LD) and intra- and extrahepatic cholangio carcinoma, is significantly higher among IBD patients. CONCLUSION: In recent years, self-management and patient empowerment, combined with evolving eHealth solutions, has utilized epidemiological knowledge on disease patterns and has been improving compliance and the timing of adjusting therapies, thus optimizing efficacy by individualizing medication in the community setting.

  15. Comparative endoscopic evaluation of normal and ulcerated gastric mucosae in Thoroughbred foals

    Science.gov (United States)

    OKAI, Kazuhiko; TAHARAGUCHI, Sadao; ORITA, Yasuhiro; YOKOTA, Hiroshi; TANIYAMA, Hiroyuki

    2015-01-01

    To contribute to early diagnosis and treatment of gastric ulcer of foals, we examined the gastric mucosa of healthy and affected foals using an endoscope. In healthy foals, the characteristic changes in the development of the squamous mucosa were seen mainly in the squamous mucosa, and maturation of the squamous mucosa in the greater curvature (GC-S) occurred more slowly than that of the squamous mucosa in the lesser curvature (LC-S). Epithelial desquamation in the LC-S and GC-S was observed between 6 and 90 days but was not observed in the LC-S at about 60 days, whereas it was observed in the GC-S until 90 days old. These findings suggest that there is a difference in the development of the gastric mucosa by region and that desquamation continues over a term longer than studies have reported in the past. In the affected foals, the minimum age at which gastric ulcer was observed was 4 days old. Gastric ulcers formed predominantly in the squamous mucosa (LC-S and GC-S) of foals with an immature mucosa before the weaning period, and the peak incidence occurred between 61 and 90 days old. The differences in the ulceration sites were considered to depend on the difference in the development (maturation) stage of the squamous mucosa. The grading score of the gastric ulcer increased with the growth of the affected foals. The gastric ulcer might be enhanced greatly by stress in the weaning period. PMID:25648790

  16. Candida albicans forms biofilms on the vaginal mucosa.

    Science.gov (United States)

    Harriott, M M; Lilly, E A; Rodriguez, T E; Fidel, P L; Noverr, M C

    2010-12-01

    Current understanding of resistance and susceptibility to vulvovaginal candidiasis challenges existing paradigms of host defence against fungal infection. While abiotic biofilm formation has a clearly established role during systemic Candida infections, it is not known whether C. albicans forms biofilms on the vaginal mucosa and the possible role of biofilms in disease. In vivo and ex vivo murine vaginitis models were employed to examine biofilm formation by scanning electron and confocal microscopy. C. albicans strains included 3153A (lab strain), DAY185 (parental control strain), and mutants defective in morphogenesis and/or biofilm formation in vitro (efg1/efg1 and bcr1/bcr1). Both 3153A and DAY815 formed biofilms on the vaginal mucosa in vivo and ex vivo as indicated by high fungal burden and microscopic analysis demonstrating typical biofilm architecture and presence of extracellular matrix (ECM) co-localized with the presence of fungi. In contrast, efg1/efg1 and bcr1/bcr1 mutant strains exhibited weak or no biofilm formation/ECM production in both models compared to wild-type strains and complemented mutants despite comparable colonization levels. These data show for the first time that C. albicans forms biofilms in vivo on vaginal epithelium, and that in vivo biotic biofilm formation requires regulators of biofilm formation (BCR1) and morphogenesis (EFG1). PMID:20705667

  17. Normal small bowel wall characteristics on MR enterography

    Energy Technology Data Exchange (ETDEWEB)

    Cronin, Carmel G., E-mail: carmelcronin2000@hotmail.co [Department of Radiology, University College Hospital, Galway (Ireland); Delappe, Eithne; Lohan, Derek G.; Roche, Clare; Murphy, Joseph M. [Department of Radiology, University College Hospital, Galway (Ireland)

    2010-08-15

    Purpose: To assess the normal small bowel parameters, namely bowel diameter, bowel wall thickness, number of folds (valvulae connivientes) per 2.5 cm (in.), fold thickness and interfold distance per small bowel segment (duodenum, jejunum, proximal ileum, distal ileum and terminal ileum) on MR enterography. Materials and methods: Between September 2003 and January 2008, 280 MR enterography examinations were performed for investigation of known or suspected small bowel pathology. 120 of these examinations were normal. Sixty-five (m = 29, f = 36, mean age = 34 years, range = 17-73 years) of 120 examinations without a prior small bowel diagnosis, with no prior or subsequent abnormal radiology or endoscopy examinations, no prior small bowel surgery and with a minimum 3 years follow-up demonstrating normality were retrospectively evaluated for the described small bowel parameters. Results: We found the mean diameter of the duodenum to be 24.8 mm (S.D. = 4.5 mm), jejunum to be 24.5 mm (S.D. = 4.2 mm), proximal ileum to be 19.5 mm (S.D. = 3.6 mm), distal ileum to be 18.9 mm (S.D. = 4.2 mm) and terminal ileum to be 18.7 mm (S.D. = 3.6 mm). The number of folds per 2.5 cm varied from 4.6 in the jejunum to 1.5 in the terminal ileum. The fold thickness varied from 2.1 mm in the duodenum to 1.8 mm in the terminal ileum. The small bowel parameters gradually decreased in size from the duodenum to the smallest measurements which were in the terminal ileum. The bowel wall is similar in size throughout the small bowel measuring 1.5 {+-} 0.5 mm. Conclusion: These results provide the mean, range of normality and standard deviation of the small bowel parameters per segment on the current population on MR enterography. From our experience, knowledge of these parameters is extremely helpful and essential in the everyday assessment of MR enterography studies.

  18. Effect of different periods of hyperbaric oxygen on ischemia-reperfusion injury of rat small bowel / Efeitos de diferentes períodos de oxigenação hiperbárica na lesão de isquemia e reperfusão de intestino delgado de ratos

    Scientific Electronic Library Online (English)

    Paulo Roberto, Bertoletto; José Carlos, Chaves; Anna Tereza Negrini, Fagundes; Ricardo Santos, Simões; Celina Tizuko Fujiyama, Oshima; Manuel de Jesus, Simões; Djalma José, Fagundes.

    2008-02-01

    Full Text Available OBJETIVO: Determinar se a oxigenação hiperbárica (OHB) protege a mucosa do intestino delgado de ratos após isquemia e reperfusão. MÉTODOS: 32 ratos machos foram submetidos a clampeamento da artéria e da veia mesentéricas superiores durante 60 minutos (isquemia) seguido de 60 minutos de reperfusão. A [...] pós estes procedimentos os animais fora separados em quatro grupos, a saber: grupo I (GI) isquemia e reperfusão (IR); grupo II (GII) submetido a OHB concomitante a isquemia, Grupo III (GIII) submetido a OHB durante a reperfusão e, grupo IV (GIV) submetido a OHB durante o período de isquemia e de reperfusão. A OHB foi realizada em câmara acrílica (2.0 ATA). Após anestesia, fragmentos do intestino delgado (íleo) foram fixados e processados para inclusão em parafina sendo os cortes corados pelo HE. As lâminas foram avaliadas quanto a presença de lesões histopatológicas da mucosa e avaliado a espessura da mucosa. RESULTADOS: A lesão histopatológica da mucosa foi significativamente inferior quando a OHB foi administrada na isquemia (12.6 ± 0.6) em comparação com o IR (21.3 ± 1.8). A OHB não foi efetiva quando aplicada durante a reperfusão (23.1 ± 2.1), ou durante a isquemia e reperfusão (18.7 ± 1.9). A espessura da mucosa foi preservada pela OHB na isquemia (327,50 ± 30.23 µm) em comparação com o IR (172.79 ± 5.95 µm). Nos períodos de reperfusão (162.50 ± 6.05 µm) e a isquemia (296.49 ± 20.01 µm) a mucosa apresentou lesão estrutural. CONCLUSÃO: A oxigenação hiperbárica protege a mucosa intestinal quando realizada durante o período de isquemia. Abstract in english PURPOSE: To determine whether hyperbaric oxygen (HBO) could effectively protect the small intestine mucosa against an ischemic insult, according to different periods of application. METHODS: The gut of 32 male rats was subjected to 60-min ischemia (clamping the mesenteric artery and vein); After the [...] y were further reperfused upon clamp opening during 60 min. Animal groups were as follows. GII = placed on HBO during the ischemia period; GIII = placed on HBO during reperfusion; GIV = treated with HBO throughout the ischemia-reperfusion period. Some animals (GI) did not receive HBO treatment at all and served as reference of ischemia-reperfusion injury (IR). HBO was carried out in a cylindrical acrylic chamber (2.0 ATA). Samples of small bowel were prepared for H.E staining for histological evaluations. RESULTS: The histological injury of mucosa was significantly less when HBO was administered during the ischemia period (17.6 ± 0.6) as compared with the IR (21.3 ± 1.8). HBO was not effective when applied during reperfusion (23.1 ± 2.1) or during the ischemia plus reperfusion period (18.7 ± 1.9). The thickness of the mucosa was preserved by HBO in ischemia (327.50 ± 30.23 µm) in comparison with the IR (172.79 ± 5.95 µm). In the periods of reperfusion (162.50 ± 6.05 µm) and ischemia plus reperfusion (296.49 ± 20.01 µm) the mucosa revealed a structural injury. CONCLUSION: Hyperbaric oxygen affects the ischemic insult of small bowel, being the favorable effect obtained when hyperbaric oxygen was administered early in the ischemic period.

  19. Interobserver agreement on the diagnosis of bowel ischemia. Assessment using dynamic computed tomography of small bowel obstruction

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the accuracy and interobserver variability of dynamic computed tomography (CT) for diagnosis of small bowel obstruction. A total of 115 patients with a CT diagnosis of small bowel obstruction were included. Two radiologists and two residents performed blinded, independent, retrospective reviews of CT studies. Attention was focused on the presence of reduced early enhancement of the bowel wall and closed loop obstruction. Results were correlated with surgical findings in 15 cases and clinical follow-up in 100 cases. Sensitivity and specificity were calculated, and kappa statistics were used to analyze interobserver agreement. In all, 13 cases were surgically confirmed small bowel ischemia. Sensitivity, specificity, positive predictive value, and negative predictive value for the diagnosis of ischemia were 85%, 96%-97%, 73%-79%, and 97%-98%, respectively, for radiologists and 69%-93%, 93%-95%, 63%-64%, and 96%-99%, respectively, for residents. For agreement in the interpretations of reduced early enhancement of bowel wall, closed loop obstruction, and presence of bowel ischemia, the values were 0.62, 0.71, and 0.80, respectively, between radiologists and 0.57-0.70, 0.63-0.74, and 0.56-0.68, respectively, between radiologists and residents. There was moderate or substantial agreement for the diagnosis of small bowel ischemia between radiologists and residents. However, there was substantial agreement for the presence of closed loop obstruction. (author)

  20. Ileal Fecaloma Presenting with Small Bowel Obstruction.

    Science.gov (United States)

    Yoo, Ha Yeong; Park, Hye Won; Chang, Seong-Hwan; Bae, Sun Hwan

    2015-09-01

    A fecaloma refers to a mass of accumulated feces that is much harder than a mass associated with fecal impaction. Fecalomas are usually found in the rectosigmoid area. A 10-year-old male with chronic constipation was admitted because of increasing abdominal pain. An abdominal computed tomography scan and a simple abdominal x-ray revealed rapidly evolving mechanical obstruction in the small intestine. Most of the fecalomas are successfully treated by conservative methods such as laxatives, enemas and rectal evacuation. When conservative treatments have failed, surgical intervention may be needed. In this case, an emergency operation was performed and a 4×3×2.5 cm fecaloma was found in the distal ileum. We thus report a case of ileal fecaloma inducing small bowel obstruction in a patient with chronic constipation, who required surgical intervention. When symptoms of acute small intestinal obstruction develop in a patient with chronic constipation, a fecaloma should be considered in differential diagnosis. PMID:26473140

  1. Intestinal epithelium in inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    MehmetCoskun

    2014-08-01

    Full Text Available The intestinal epithelium has a strategic position as a protective physical barrier to luminal microbiota and actively contributes to the mucosal immune system. This barrier is mainly formed by a monolayer of specialized intestinal epithelial cells (IECs that are crucial in maintaining intestinal homeostasis. Therefore, dysregulation within the epithelial layer can increase intestinal permeability, lead to abnormalities in interactions between IECs and immune cells in underlying lamina propria, and disturb the intestinal immune homeostasis, all of which are linked to the clinical disease course of inflammatory bowel disease (IBD. Understanding the role of the intestinal epithelium in IBD pathogenesis might contribute to an improved knowledge of the inflammatory processes and the identification of potential therapeutic targets.

  2. Surgical treatment of inflammatory bowel diseases

    International Nuclear Information System (INIS)

    Purpose: To summarize current knowledge on surgical therapy in patients with inflammatory bowel disease (Crohn's disease, ulcerative colitis and diverticulitis). Material and methods: To discuss surgical indications and strategies, we reviewed major peer review publications of the last 10 years, and we also analysed data from patients with Crohn's disease who were treated in our institution between 1978 and 1994. Results: With Crohn's disease (305 patients), emergency surgery should be avoided as much as possible, since morbidity (50% vs 8.8%) and mortality (11% vs 0.6%) rise significantly in comparison to elective procedures. With ulcerative colitis, operative therapy is indicated in patients with secondary malignoma, and urgent surgery is requested in cases with associated perforation, toxic megacolon or massive bleeding. With diverticulitis, the first episode should be managed conservatively. Surgery is indicated in patients with recurrent episodes or with secondary complications. (orig.)

  3. Irritable Bowel Syndrome: Yoga as Remedial Therapy.

    Science.gov (United States)

    Kavuri, Vijaya; Raghuram, Nagarathna; Malamud, Ariel; Selvan, Senthamil R

    2015-01-01

    Irritable bowel syndrome (IBS) is a group of symptoms manifesting as a functional gastrointestinal (GI) disorder in which patients experience abdominal pain, discomfort, and bloating that is often relieved with defecation. IBS is often associated with a host of secondary comorbidities such as anxiety, depression, headaches, and fatigue. In this review, we examined the basic principles of Pancha Kosha (five sheaths of human existence) concept from an Indian scripture Taittiriya Upanishad and the pathophysiology of a disease from the Yoga approach, Yoga Vasistha's Adhi (originated from mind) and Vyadhi (ailment/disease) concept. An analogy between the age old, the most profound concept of Adhi-Vyadhi, and modern scientific stress-induced dysregulation of brain-gut axis, as it relates to IBS that could pave way for impacting IBS, is emphasized. Based on these perspectives, a plausible Yoga module as a remedial therapy is provided to better manage the primary and secondary symptoms of IBS. PMID:26064164

  4. FUNCTIONAL NATURAL INGREDIENTS FOR IRRITABLE BOWEL SYNDROME

    Directory of Open Access Journals (Sweden)

    Baidyanath Mishra*, Debjani Sarkar, Shilpi Srivastava, Saraswathi Deepthi, Chetan N

    2013-01-01

    Full Text Available Irritable bowel syndrome (IBS is a common gut disorder, causing abdominal cramps and pain. It impacts the lifestyle and interrupts daily functioning, which leads to increased stress. Because of its multiple factors of pathophysiology, the conventional medical approach is more complex and challenging, whereas a holistic herbal therapy seems promising for many individuals. Nearly more than 80% of the population depends on herbal medication for their primary health care. Herbal remedies may be considered as a supplement or alternative to treat IBS patients. However, parallelly it should address all possible contributing factors, such as stress, diet and lifestyle. In this context, various herbs such as curcuma, peppermint oil, fennel and ginger have been proved for their management of gut disorders such as IBS. Even though the mechanism of action varies between herb to herb but as a whole the consumer interest towards these functional ingredients is increasing due to hopeful results.

  5. MAP kinases in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Coskun, Mehmet; Olsen, JØrgen

    2011-01-01

    The mammalian family of mitogen-activated protein kinases (MAPKs) is activated by diverse extracellular and intracellular stimuli, and thereby they play an essential role in connecting cell-surface receptors to changes in transcriptional programs. The MAPK signaling pathways regulate a wide range of cellular activities and have been implicated in the pathogenesis of several diseases, including inflammatory bowel disease (IBD). This review summarizes recent findings on the regulatory mechanism of MAPK signaling pathways, focusing on nuclear targets and their role in IBD. Finally, it summarizes how these signaling pathways have been exploited for the development of therapeutics and discuss the current knowledge of potential MAPK inhibitors and their anti-inflammatory effects in clinical trials related to IBD.

  6. Use of thiopurines in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Frei, Pascal; Biedermann, Luc

    2013-01-01

    The use of thiopurines as immunosuppression for the treatment of refractory or chronic active inflammatory bowel disease is established for both Crohn's disease and ulcerative colitis. Nevertheless, many questions remain concerning the optimal treatment regimens of azathioprine, 6-mercaptopurine and thioguanine. We will briefly summarize dose recommendations, indications for thiopurine therapy and side effects which are relevant in clinical practice. We discuss some currently debated topics, including the combination of azathioprine and allopurinol, switching of thiopurine therapy in case of side effects, the use of azathioprine in pregnancy, the infection risk using thiopurines and the evidence when to stop thiopurines. Excellent reviews have been published on the thiopurine metabolic pathway which will not be discussed here in detail.

  7. Use of thiopurines in inflammatory bowel disease

    Science.gov (United States)

    Frei, Pascal; Biedermann, Luc; Nielsen, Ole Haagen; Rogler, Gerhard

    2013-01-01

    The use of thiopurines as immunosuppression for the treatment of refractory or chronic active inflammatory bowel disease is established for both Crohn's disease and ulcerative colitis. Nevertheless, many questions remain concerning the optimal treatment regimens of azathioprine, 6-mercaptopurine and thioguanine. We will briefly summarize dose recommendations, indications for thiopurine therapy and side effects which are relevant in clinical practice. We discuss some currently debated topics, including the combination of azathioprine and allopurinol, switching of thiopurine therapy in case of side effects, the use of azathioprine in pregnancy, the infection risk using thiopurines and the evidence when to stop thiopurines. Excellent reviews have been published on the thiopurine metabolic pathway which will not be discussed here in detail. PMID:23467510

  8. Use of thiopurines in inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Pascal Frei

    2013-01-01

    Full Text Available The use of thiopurines as immunosuppression for the treatment of refractory or chronic active inflammatory bowel disease is established for both Crohn's disease and ulcerative colitis. Nevertheless, many questions remain concerning the optimal treatment regimens of azathioprine, 6-mercaptopurine and thioguanine. We will briefly summarize dose recommendations, indications for thiopurine therapy and side effects which are relevant in clinical practice. We discuss some currently debated topics, including the combination of azathioprine and allopurinol, switching of thiopurine therapy in case of side effects, the use of azathioprine in pregnancy, the infection risk using thiopurines and the evidence when to stop thiopurines. Excellent reviews have been published on the thiopurine metabolic pathway which will not be discussed here in detail.

  9. Intestinal epithelium in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Coskun, Mehmet

    2014-01-01

    The intestinal epithelium has a strategic position as a protective physical barrier to luminal microbiota and actively contributes to the mucosal immune system. This barrier is mainly formed by a monolayer of specialized intestinal epithelial cells (IECs) that are crucial in maintaining intestinal homeostasis. Therefore, dysregulation within the epithelial layer can increase intestinal permeability, lead to abnormalities in interactions between IECs and immune cells in underlying lamina propria, and disturb the intestinal immune homeostasis, all of which are linked to the clinical disease course of inflammatory bowel disease (IBD). Understanding the role of the intestinal epithelium in IBD pathogenesis might contribute to an improved knowledge of the inflammatory processes and the identification of potential therapeutic targets.

  10. Dysplasia and cancer in inflammatory bowel disease.

    Science.gov (United States)

    Basseri, Robert J; Basseri, Benjamin; Papadakis, Konstantinos A

    2011-02-01

    Inflammatory bowel disease (IBD) is a chronic gastrointestinal disease associated with an increased risk of colorectal cancer (CRC). Although CRC occurs in a minority of IBD patients (1%), it carries a high mortality and accounts for 20% of IBD-related mortality. Established risk factors for the development of CRC in IBD include disease duration of 8 years or more, family history of CRC, extensive colitis and primary sclerosing cholangitis. Meticulous colonoscopy and anti-inflammatory medications can reduce the risk of developing CRC. The future of IBD surveillance involves the use of novel endoscopic techniques (chromoendoscopy, narrow-band imaging, confocal laser endomicroscopy and autofluorescence) to enhance colonoscopic accuracy, in concert with chemopreventative medications to help reduce the risk of CRC in IBD. PMID:21309672

  11. Neurobiology of Depression and Irritable Bowel Syndrome Comorbidity

    Directory of Open Access Journals (Sweden)

    Ozlem Donat Eker

    2009-08-01

    Full Text Available Irritable bowel syndrome is a disabling functional disorder with a frequent comorbidity of depression though underlying mechanisms remain yet little understood. Various signs and symptoms have been determined as diagnostic criteria in recent years and standardized as Rome-III criteria. Irritable bowel syndrome can have constipation-dominant, diarrhea-dominant or mixed clinical presentations. Main features can be summarized as continuous and recurrent abdominal pain or discomfort associated with a change of stool frequency or consistency and usually relief of symptoms with defe-cation in the absence of physical or laboratory abnormalities indicative of an organic etiology. The frequency of major depressive disorder diagnosis reaches up to two thirds of irritable bowel syndrome patients. Moreover, the comorbidity of irritable bowel syndrome among patients with major depression is highly frequent (30%. The mechanism underlying irritable bowel syndrome which have been considered as a kind of a somatization disorder for a long time and now as a functional bowel disease is in the brain-gut axis. Low grade mucosal inflammation and cytokines originating from mucosal inflammation have important functions in the pathophysiology of irritable bowel syndrome and its comorbidity with major depression. Besides the inflammatory factors lumbosacral visceral hyperexcitability which is an individual variation is proposed as the main underlying cause of irritable bowel syndrome. Visceral hyper-excitability is mediated by cytokines and neuro-mediators and stress is known to increase the effect of this mechanism. Furthermore, molecules participating in this mechanism (e.g. cytokines, corticotrophin releasing factor, neurokinins and monoamines play important roles in the pathophysiology of depression. Increased activation in the pain matrix (thalamus – insula – prefrontal cortex and insufficiency of endogenous pain inhibitory system are regarded as possible casuses of excessive feeling of irritable bowel syndrome symptoms leading to the dysfunction in the cortical representation of bodily states and negative emotional experiences. Individual variations in the interaction of cytokines, corticotrophin releasing factor, neurokinins (substance P, neurokinin A and neurokinin B and monoamines (serotonin and norepinephrine, and neuroanatomic functions may answer the question of “why do some irritable bowel syndrome patients experience depression and some do not?”. Moreover, irritable bowel syndrome patients with comorbid depression and anxiety disorders are reported to be complaining more about their irritable bowel syndrome symptoms. Although several treatment strategies are considered by clinicians in the management of irritable bowel syndrome, it is suggested that antidepressant medications to have the priority in the treatment of irritable bowel syndrome with the comorbidity of depression. Selective serotonin re-uptake inhibitors are the drug of choice regarding their safety and side effects profile. Nevertheless, tricyclic antidepressants may also have beneficial effects in lower doses than needed to treat clinical depression. Hypnosis, supportive or cognitive behavioral therapies, dietary and defecation habits management are also suggested as beneficial. The recognition of irritable bowel syndrome by psychiatrists may enhance the success of treatment of depression with the comorbidity of irritable bowel syndrome, which disables the patient and frequently accompanies to major depression. In this review, evidence for depression and irritable bowel syndrome comorbidity, the possible underlying mechanisms of this comorbidity and current treatment approaches regarding proposed mechanisms will be discussed.

  12. Multiphasic MDCT in small bowel volvulus

    International Nuclear Information System (INIS)

    Objective: Evaluate the use of MDCT with 3D CT angiography (CTA) and CT portal venography (CTPV) reconstruction for the diagnosis of small bowel volvulus (SBV). Methods: Multiphasic MDCT findings in nine patients (seven males and two females, age range 2-70) with surgically proven SBV were retrospectively reviewed. Non-contrast and double phase contrast enhanced MDCT including 3D CTA and CTPV reconstruction were performed in all the patients. Two experienced abdominal radiologists evaluated the images and defined the location, direction and degree of SBV. Results: On axial MDCT images, all cases show segmental or global dilatation of small intestine. Other findings include circumferential bowel wall thickening in eight cases, halo appearance and hyperemia in seven cases, whirl sign in six cases, beak-like appearance in six cases, closed loops in six cases and ascites in one case. CTA/CTPV showed abnormal courses involving main trunks of superior mesenteric artery (SMA) and superior mesenteric vein (SMV) in seven cases, with or without distortion of their tributaries. Normal course of SMA but abnormal course of SMV was seen in the other two cases. Of all the nine cases, whirl sign was seen in six cases and barber's pole sign in five cases. Dilated SMV was observed in eight cases and abrupt termination of SMA was found in one case. Compared with surgical findings, the location, direction and degree of SBV were correctly estimated in all cases based on CTA/CTPV. Conclusion: Multiphasic MDCT with CTA/CTPV reconstruction can play an important role in the diagnosis of SBV. The location, direction and degree of SBV can all be defined preoperatively using this method.

  13. Management of refractory Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    S.S Goulas

    2007-04-01

    Full Text Available Medical management of active inflammatory bowel disease (IBD depends on the extent and the severity of the disease estimated by both clinical and endoscopic parameters. Based on these parameters a flare of IBD, either of ulcerative colitis (UC or of Crohn?s disease (CD can be mild, moderate or severe. Mild or moderate IBD is treated on an outpatient basis, while severe disease requires hospitalization. Although in the literature there is no clear cut definition of resistance, we characterize as refractory the disease that does not respond to drug treatment, consisting of salicylates and steroids in doses appropriate for the severity of the episode for a four week period in combination with topical therapy. In severe IBD the critical period is much shorter (5 days. In refractory mild IBD, steroids (prednisone 20-40 mg combined with a double dose of topical treatment are appropriate. In refractory moderate disease, therapeutic options are: the intensive scheme of severe disease, immunomodulators, Infliximab or consideration for surgery. In refractory severe cases cyclosporine (mainly for UC or Infliximab either early or after cyclosporine failure appear to be effective approaches, which must be compared to surgical treatment in controlled clinical trials. In conclusion, although refractory IBD is a challenge for the clinician there are several therapeutic options. Apart from old friends (steroids, immunomodulators, surgery the new group of biologic agents, in the form of anti-TNF factor (Infliximab at present, has emerged as an option in the medical management of moderate, severe and refractory IBD. Key words: Inflammatory bowel disease, IBD, ulcerative colitis, Crohn?s disease, refractory IBD.

  14. Rheumatic manifestations of inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Tatiana Sofía Rodríguez-Reyna, Cynthia Martínez-Reyes, Jesús Kazúo Yamamoto-Furusho

    2009-11-01

    Full Text Available This article reviews the literature concerning rheumatic manifestations of inflammatory bowel disease (IBD, including common immune-mediated pathways, frequency, clinical course and therapy. Musculoskeletal complications are frequent and well-recognized manifestations in IBD, and affect up to 33% of patients with IBD. The strong link between the bowel and the osteo-articular system is suggested by many clinical and experimental observations, notably in HLA-B27 transgenic rats. The autoimmune pathogenic mechanisms shared by IBD and spondyloarthropathies include genetic susceptibility to abnormal antigen presentation, aberrant recognition of self, the presence of autoantibodies against specific antigens shared by the colon and other extra-colonic tissues, and increased intestinal permeability. The response against microorganisms may have an important role through molecular mimicry and other mechanisms. Rheumatic manifestations of IBD have been divided into peripheral arthritis, and axial involvement, including sacroiliitis, with or without spondylitis, similar to idiopathic ankylosing spondylitis. Other periarticular features can occur, including enthesopathy, tendonitis, clubbing, periostitis, and granulomatous lesions of joints and bones. Osteoporosis and osteomalacia secondary to IBD and iatrogenic complications can also occur. The management of the rheumatic manifestations of IBD consists of physical therapy in combination with local injection of corticosteroids and nonsteroidal anti-inflammatory drugs; caution is in order however, because of their possible harmful effects on intestinal integrity, permeability, and even on gut inflammation. Sulfasalazine, methotrexate, azathioprine, cyclosporine and leflunomide should be used for selected indications. In some cases, tumor necrosis factor-? blocking agents should be considered as first-line therapy.

  15. Association and symptom characteristics of irritable bowel syndrome among bronchial asthma patients in Kuwait

    Directory of Open Access Journals (Sweden)

    Panicker Radhakrishna

    2010-01-01

    Full Text Available Context : Excess prevalence of irritable bowel syndrome in asthma has been reported, suggesting a link between these two conditions. Aims: To investigate the association between irritable bowel syndrome (IBS and asthma, and explore the symptoms of IBS among asthma patients in Kuwait. Settings and Design: Case control study. Methods: In a tertiary center, for allergy and asthma, 138 patients aged 20-65 years, with asthma, diagnosed clinically and by spirometry,were compared with 145 healthy, non-asthmatic controls matched for age, gender and nationality. Cases and controls completed a self-administered questionnaire of irritable bowel syndrome diagnosis (ROME II criteria. Statistical Analysis Used: The data were analyzed using SPSS software, and proportions were tested with Chi-square or Fisher?s test. Odds ratio (OR with 95% Confidence Interval (CI were calculated to identify the associated risk factors. The demographic variables were selected for logistic regression analysis. Results : A significantly large proportion (39.13% of asthmatics had IBS as compared to 7.93% controls (P < 0.001. A higher proportion of females with IBS were observed in cases and controls (74%, 61.54%. IBS was seen in 87% cases using inhalers, and in 13% with additional oral theophylline (P < 0.001. As many as 66.6% cases, had IBS with relatively short duration of asthma (1-5 years, P < 000. Predominant symptoms of IBS in asthmatics were abdominal discomfort or distension (64.8% vs. 11.5%, (P < 0.000, OR = 14.1; 95%CI: 3.748-53.209, bloated feeling of abdomen (74.1% vs. 34.62% (P < 0.001, OR = 5.38; 95%CI:1.96-14.84, increased frequency of stools (63%, P < 0.006. Conclusions: Irritable bowel syndrome in asthmatics was significantly high, more in the female asthmatics. Abdominal discomfort, persistent bloated feeling, increased frequency of passing stools were the most common IBS symptoms observed.

  16. An experimental study on radiological examination of obstructed small bowel with various contrast media

    International Nuclear Information System (INIS)

    For the evaluation of the level and cause of small bowel obstruction, an oral barium study is usually chosen. When perforation is whether barium or a water-soluble contrast agent should be used, because barium causes from foreign body reactions as well as adhesions in the extraluminal tissues. Water-soluble contrast agent, on the other hand, are less satisfactory but in general have no untoward effects in the extraluminal tissues. Because of hyperosomolarity, water-soluble contrast agents attract large amounts of fluid with subsequent dilution and loss of contrast and pose a risk of pulmonary edema if aspirated. The use of the newer non-ionic and low-osmolarity water-soluble contrast will likely avoid pulmonary complications due to aspiration. The author performed this experimental study to compare the radiological efficacy of different contrast media in enteric follow-through examinations of obstructed small bowel. Rate had a ligature applied to the distal ileum via laparotomy. Four contrast media were subjected to testing by instillation via oro-gastric tube immediately after laparotomy. Radiographs were exposed at 1, 4 and 8 hours and evaluated later. After 24 hours the animals were sacrificed and the stomach and small bowels, free from mesentery and omental tissue, were weighted with contrasts. The progression in the bowel was proportionate to the osmolarity of the contrast media. After 1 hour, the observations indicated sodium diatrizoate (Gastrografin, Schering) to be the least favorable medium with respect to sharpness of the mucosal border. After 8 hours, barium gave a poorer delineation compared to Ioxaglate (Hexabric, Guerbet) and Iopromide (Ultravist, Schering). Early deaths were noted in the sodium diatrizoate and ioxaglate groups. So we conclude that when using a rather high-volume bolus, low-osmolar non-ionic contrast media seem to have significant prospects for general diagnostic use in patients with suspected intestinal obstruction

  17. An experimental study on radiological examination of obstructed small bowel with various contrast media

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yong; Kim, Sung Jin; Han, Moon Hee; Park, Jae Hyung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1991-03-15

    For the evaluation of the level and cause of small bowel obstruction, an oral barium study is usually chosen. When perforation is whether barium or a water-soluble contrast agent should be used, because barium causes from foreign body reactions as well as adhesions in the extraluminal tissues. Water-soluble contrast agent, on the other hand, are less satisfactory but in general have no untoward effects in the extraluminal tissues. Because of hyperosomolarity, water-soluble contrast agents attract large amounts of fluid with subsequent dilution and loss of contrast and pose a risk of pulmonary edema if aspirated. The use of the newer non-ionic and low-osmolarity water-soluble contrast will likely avoid pulmonary complications due to aspiration. The author performed this experimental study to compare the radiological efficacy of different contrast media in enteric follow-through examinations of obstructed small bowel. Rate had a ligature applied to the distal ileum via laparotomy. Four contrast media were subjected to testing by instillation via oro-gastric tube immediately after laparotomy. Radiographs were exposed at 1, 4 and 8 hours and evaluated later. After 24 hours the animals were sacrificed and the stomach and small bowels, free from mesentery and omental tissue, were weighted with contrasts. The progression in the bowel was proportionate to the osmolarity of the contrast media. After 1 hour, the observations indicated sodium diatrizoate (Gastrografin, Schering) to be the least favorable medium with respect to sharpness of the mucosal border. After 8 hours, barium gave a poorer delineation compared to Ioxaglate (Hexabric, Guerbet) and Iopromide (Ultravist, Schering). Early deaths were noted in the sodium diatrizoate and ioxaglate groups. So we conclude that when using a rather high-volume bolus, low-osmolar non-ionic contrast media seem to have significant prospects for general diagnostic use in patients with suspected intestinal obstruction.

  18. Effects of perfluoroctylbromide and glucagon on the appearance of bowel and bowel-related artifacts on MR images

    International Nuclear Information System (INIS)

    This paper determines the effects of perfluoroctylbromide (PFOB) ingestion and glucagon injection on the MR appearance of the abdomen and pelvis. MR examinations were performed in a total of 30 subjects, including 14 patients and 16 normal volunteers. Standard T1 and T2-weighted images were obtained in each subject before and after the administration of PFOB. MR imaging was also performed before and after the subcutaneous administration of 1 mg of glucagon in 22 subjects who had ingested PFOB. The images were analyzed with respect to the degree of bowel marking, the clarity of visualization of bowel and abdominal parenchymal organs, and the severity of bowel-related artifacts

  19. Tatuagem extensa por amálgama em mucosa gêngivo-alveolar Extensive amalgam tattoo on the alveolar-gingival mucosa

    Directory of Open Access Journals (Sweden)

    Vivian C Galletta

    2011-10-01

    Full Text Available Tatuagens por amálgama são lesões pigmentadas, exógenas, de frequente ocorrência na mucosa bucal, que resultam da introdução acidental de partículas de amálgama nos tecidos moles. O diagnóstico da tatuagem por amálgama é simples, geralmente, baseado em achados clínicos, complementado pela história recente ou pregressa de remoção de restauração por amálgama. Radiografias intraorais podem ser úteis na detecção de radiopacidade, associadas à partícula de amálgama. Nos casos em que as tatuagens por amálgama não permitem diferenciação de outras lesões melanocíticas, o exame histopatológico deve ser realizado. Os autores relatam à ocorrência de lesão extensa por tatuagem de amálgama com confirmação histopatológica.Amalgam tattoos are common exogenous pigmented lesions of the oral mucosa occurring mainly by inadvertent placement of amalgam particles into soft tissues. The diagnosis of amalgam tattoo is simple, usually based on clinical findings associated with presence or history of amalgam fillings removal. Intraoral X-rays may be helpful in detecting amalgam-related radiopacity. In cases where amalgam tattoo cannot be differentiated from other causes of oral pigmentation, a biopsy should be performed. This article deals with an extensive amalgam tattoo lesion which required a biopsy for a definitive diagnosis.

  20. Tatuagem extensa por amálgama em mucosa gêngivo-alveolar / Extensive amalgam tattoo on the alveolar-gingival mucosa

    Scientific Electronic Library Online (English)

    Vivian C, Galletta; Gabriela, Artico; Aluana M. C, Dal Vechio; Celso A, Lemos Jr; Dante A, Migliari.

    2011-10-01

    Full Text Available Tatuagens por amálgama são lesões pigmentadas, exógenas, de frequente ocorrência na mucosa bucal, que resultam da introdução acidental de partículas de amálgama nos tecidos moles. O diagnóstico da tatuagem por amálgama é simples, geralmente, baseado em achados clínicos, complementado pela história r [...] ecente ou pregressa de remoção de restauração por amálgama. Radiografias intraorais podem ser úteis na detecção de radiopacidade, associadas à partícula de amálgama. Nos casos em que as tatuagens por amálgama não permitem diferenciação de outras lesões melanocíticas, o exame histopatológico deve ser realizado. Os autores relatam à ocorrência de lesão extensa por tatuagem de amálgama com confirmação histopatológica. Abstract in english Amalgam tattoos are common exogenous pigmented lesions of the oral mucosa occurring mainly by inadvertent placement of amalgam particles into soft tissues. The diagnosis of amalgam tattoo is simple, usually based on clinical findings associated with presence or history of amalgam fillings removal. I [...] ntraoral X-rays may be helpful in detecting amalgam-related radiopacity. In cases where amalgam tattoo cannot be differentiated from other causes of oral pigmentation, a biopsy should be performed. This article deals with an extensive amalgam tattoo lesion which required a biopsy for a definitive diagnosis.

  1. Helicobacter pylori in the gastric mucosa of violently deceased adults Presencia de Helicobacter pylori en la mucosa gástrica de cadáveres

    Directory of Open Access Journals (Sweden)

    Fernando Gutiérrez

    1995-03-01

    Full Text Available

    We studied the stomachs of 50 adults who died in a violent way and did not receive any treatment before death. Specimens were obtained from the gastric mucosa of body and antrum; after standard tissue processing they were stained with Hematoxilin-Eosin and by the Warthin. Starry method. Forty one specimens (82% were positive for H. pylori and 3 of them showed no inflammatory changes. There was a clear association between the presence of H. pylori and gastritis.

    Se estudiaron 50 cadáveres de adultos que fallecieron en forma violenta y no recibieron tratamiento para el hecho que los llevó a la muerte. Se tomaron muestras de cuerpo y antro gástricos, se preservaron en formol al 10%, se incluyeron en parafina y se colorearon con hematoxilina-eosina y tinción de Warthin Starry. Se encontró que el 92% de las muestras fueron positivas para H. pylori y que 6% de ellas no mostraban cambios inflamatorios de la mucosa gástrica. Se observó una clara asociación entre H. pylori y cambios de gastritis.

  2. Dose-volume relationships between enteritis and irradiated bowel volumes during 5-fluorouracil and oxaliplatin based chemoradiotherapy in locally advanced rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gunnlaugsson, Adalsteinn; Kjellen, Elisabeth; Bendahl, Paer-Ola; Johnsson, A nders [Dept. of Oncology, Lund Univ. Hospital, Lund (Sweden); Nilsson, Per [Dept. o f Radiation Physics, Lund Univ. Hospital, Lund (Sweden); Willner, Julian [Dept. of Radiology, Lund Univ. Hospital, Lund (Sweden)

    2007-10-15

    Purpose. Radiation enteritis is the main acute side-effect during pelvic irradiation. The aim of this study was to quantify the dose-volume relationship between irradiated bowel volumes and acute enteritis during combined chemoradiotherapy for rectal cancer. Material and methods. Twenty-eight patients with locally advanced rectal cancer received chemoradiotherapy. The radiation therapy was given with a traditional multi-field technique to a total dose of 50 Gy, with concurrent 5-Fluorouracil (5-FU) and oxaliplatin (OXA) based chemotherapy. All patients underwent three-dimensional CT-based treatment planning. Individual loops of small and large bowel as well as a volume defined as 'whole abdomen' were systematically contoured on each CT slice, and dose-volume histograms were generated. Diarrhea during treatment was scored retrospectively according to the NCI Common Toxicity Criteria scale. Results. There was a strong correlation between the occurrence of grade 2+diarrhea and irradiated small bowel volume, most notably at doses >15 Gy. Neither irradiated large bowel volume, nor irradiated 'whole abdomen' volume correlated significantly with diarrhea. Clinical or treatment related factors such as age, gender, hypertension, previous surgery, enterostomy, or dose fractionation (1.8 vs. 2.0 Gy/fraction) did not correlate with grade 2+diarrhea. Discussion. This study indicates a strong dose-volume relationship between small bowel volume and radiation enteritis during 5-FU-OXA-based chemoradiotherapy. These findings support the application of maneuvers to minimize small bowel irradiation, such as using a 'belly board' or the use of IMRT technique aiming at keeping the small bowel volume receiving more than 15 Gy under 150 cc.

  3. Better Check Your Bowels: Screening for Colon and Rectal Cancer

    Science.gov (United States)

    ... Better Check Your Bowels Screening for Colon and Rectal Cancer Colorectal cancer is the second-leading cause of ... the results, and when? Gut Check Colon and Rectal Cancer NIHSeniorHealth: Colorectal Cance r Colonoscopy Virtual Colonoscopy Colorectal ...

  4. Steroid allergy in patients with inflammatory bowel disease.

    LENUS (Irish Health Repository)

    Malik, M

    2007-11-01

    Background: Contact allergy to a steroid enema leading to worsening of inflammatory bowel disease (IBD) has recently been reported. This study was designed to look for evidence of steroid allergy in patients with IBD.

  5. Taking Care of Your Bowels--The Basics

    Science.gov (United States)

    ... into the body and to get rid of waste. The bowel is where the waste products of eating are stored until they are ... much fiber or bulk (such as fruits and vegetables, bran, whole grain breads and cereals) do you ...

  6. Risk of Cancer in Patients With Inflammatory Bowel Diseases

    DEFF Research Database (Denmark)

    Kappelman, Michael D; Farkas, Dora K; Long, Millie D; Erichsen, Rune; Sandler, Robert S; Sørensen, Henrik T; Baron, John A

    2014-01-01

    Data regarding the risk of gastrointestinal and extraintestinal cancers in Crohn's disease (CD) and ulcerative colitis (UC) are needed to understand the clinical course of inflammatory bowel diseases (IBDs) and their treatments.

  7. Changes of bacterial population connected with bowel diseases.

    Czech Academy of Sciences Publication Activity Database

    Kope?ný, Jan; Hajer, J.; Mrázek, Jakub

    2004-01-01

    Ro?. 44, - (2004), s. 18. ISSN 0926-5287. [Gut Microbiology. 21.06.2004-24.06.2004, Clermont Ferrand] R&D Projects: GA ?R GA525/02/0402 Keywords : bowel diseases Subject RIV: EE - Microbiology, Virology

  8. PALATINE MUCOSA ANGIOARCHITECTURE STUDY OF YOUNG RABBITS USING SCANNING ELECTRON MICROSCOPY ESTUDIO DE LA ANGIOARQUITECTURA DE LA MUCOSA PALATINA DE CONEJOS JÓVENES USANDO MICROSCOPÍA ELECTRÓNICA DE BARRIDO

    Directory of Open Access Journals (Sweden)

    Marcia Consentino Kronka

    2000-01-01

    Full Text Available A few papers have been related to young animal's angioarchitecture. This study tries to contribute to research about development of three-dimensional distribution in masticatory mucosa. The vascular corrosion casts were obtained using low viscosity resin - Mercox® CL-2B. We could note specific networks at dome of palatine rugae, inter-rugae areas and labial mucosa. Capillary loops were observed only at transverse palatine rugaePocos trabajos han relatado la angioarquitectura de animales jóvenes. Este estudio contribuye con las investigaciones acerca de la distribución tridimensional de la mucosa palatina en conejos jóvenes usando MEB. La corrosión vascular del molde fue obtenida usando resina de baja densidad - Mercox® CL-2B. No pudimos observar redes específicas en la cúpula de los pliegues palatinos, en los interpliegues y mucosa labial. Fueron observados solamente loops capilares y pliegues transversos palatinos

  9. Efficient Genetic Analysis of Microdissected Samples by Agarose-Bead Method: Alterations of ?-Catenin Gene in Fundic Gland Polyp and Heterotopic Gastric Mucosa of Duodenum

    International Nuclear Information System (INIS)

    Molecular genetic analyses of archival formalin-fixed, paraffin-embedded (FFPE) pathological specimens taken at biopsy or autopsy, are occasionally compromised because the DNA molecules therein are inevitably degraded. Furthermore, since these tissue samples comprise various cell types, the analyses based on mixtures of such heterogeneous populations often fail to reflect the nature of the affected cells. In the present study, to elucidate the contribution of ?-catenin gene mutation to the fundic gland polyp and the heterotopic gastric mucosa in the duodenum, we successfully introduced an agarose-bead mediated technique as an effectual tool for retrospective morphology-oriented genetic analyses. Microdissected samples were embedded in low-melting agarose, and directly treated with proteinase K. A fragment of the agarose-bead was used as a template for polymerase chain reaction to analyze ?-catenin mutation. Of the six cases of heterotopic gastric mucosa in the duodenum associated with fundic gland polyps, one showed a common 1-bp missense mutation at codon 37 shared by both the fundic gland polyp and the heterotopic gastric mucosa. Alternatively, a 1-bp silent mutation at codon 33 and missense mutation at codon 32 were identified only in the heterotopic gastric mucosa. Agarose-bead mediated technique shows superior sensitivity to the previously described techniques and is an effectual tool for retrospective morphology-oriented genetic analyses using a large number of archival pathological samples stored for long periods in the pathology laboratory

  10. Comparison of methods to facilitate postoperative bowel function.

    Science.gov (United States)

    Crainic, Christina; Erickson, Kathie; Gardner, Janet; Haberman, Sheri; Patten, Pam; Thomas, Pat; Hays, Victoria

    2009-01-01

    Improving postoperative return of bowel function after abdominal surgery is an important nursing and medical goal. One promising intervention to achieve this goal is to have patients chew gum several times per day in the early postoperative period to stimulate the cephalic-vagal reflex and bowel peristalsis. A study to determine if return of gastrointestinal function after abdominal surgery could be hastened by the simple intervention of chewing gum or sucking on hard candy three times per day is described. PMID:20552850

  11. Bizarre behaviour, bizarre intruder and bizarre bowel obstruction

    OpenAIRE

    Di Saverio, Salomone; Catena, Fausto; Coccolini, Federico; Gazzotti, Filippo; Filicori, Filippo; Ansaloni, Luca

    2010-01-01

    An 82-year-old woman, with previous history of hiatal hernia, cholecystectomy and depression, has been admitted for worsening diffuse abdominal pain with constipation and vomiting for 4 days. She lived alone, without signs of dementia or cognitive impairment. The abdomen was distended and tender in middle quadrants. Abdominal x-ray revealed concentric distension of bowel loops. CT scan confirmed mechanical small bowel obstruction with a transition point in the right iliac fossa. At laparotomy...

  12. International bowel function extended spinal cord injury data set

    DEFF Research Database (Denmark)

    Krogh, K; Perkash, I; Stiens, S A; Biering-Sørensen, F

    2008-01-01

    STUDY DESIGN: International expert working group.Objective:To develop an International Bowel Function Extended Spinal Cord Injury (SCI) Data Set presenting a standardized format for the collection and reporting of an extended amount of information on bowel function. SETTING: Working group consisting of members appointed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS). METHODS: A draft prepared by the working group was reviewed by Executive Commi...

  13. International bowel function basic spinal cord injury data set

    DEFF Research Database (Denmark)

    Krogh, K; Perkash, I; Stiens, S A; Biering-Sørensen, F

    2008-01-01

    STUDY DESIGN: International expert working group. OBJECTIVE: To develop an International Bowel Function Basic Spinal Cord Injury (SCI) Data Set presenting a standardized format for the collection and reporting of a minimal amount of information on bowel function in daily practice or in research. SETTING: Working group consisting of members appointed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS). METHODS: A draft prepared by the working group w...

  14. International bowel function basic spinal cord injury data set

    DEFF Research Database (Denmark)

    Krogh, K; Perkash, I; Stiens, S A; Biering-Sørensen, F

    2008-01-01

    Study design:International expert working group.Objective:To develop an International Bowel Function Basic Spinal Cord Injury (SCI) Data Set presenting a standardized format for the collection and reporting of a minimal amount of information on bowel function in daily practice or in research.Setting:Working group consisting of members appointed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS).Methods:A draft prepared by the working group was revi...

  15. International bowel function extended spinal cord injury data set

    DEFF Research Database (Denmark)

    Krogh, K; Perkash, I; Stiens, S A; Biering-Sørensen, F

    2008-01-01

    Study design:International expert working group.Objective:To develop an International Bowel Function Extended Spinal Cord Injury (SCI) Data Set presenting a standardized format for the collection and reporting of an extended amount of information on bowel function.Setting:Working group consisting of members appointed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS).Methods:A draft prepared by the working group was reviewed by Executive Committee ...

  16. Bowel imaging: a reassessment. Pt. 2. CT and MRI

    International Nuclear Information System (INIS)

    This is the second part of a review of bowel imaging. While the first part addressed conventional X-ray techniques and ultrasonography, the second part discusses the diagnostic features of computed tomography (CT) and magnetic resonance imaging (MRI) including virtual colonography and PET-CT in the diagnosis of bowel disorders. Indications, performance and the diagnostic impact of the different methods are presented and discussed in the context of competitive methods such as (capsule-)endoscopy. (orig.)

  17. Bowel function measurements of individuals with different eating patterns.

    OpenAIRE

    Davies, G. J.; Crowder, M; Reid, B; Dickerson, J W

    1986-01-01

    Bowel function was assessed in 51 subjects: 10 women and seven men who habitually consumed an omnivorous, vegetarian, or vegan diet. The subjects on these diets had a mean intake of fibre of 23 g, 37 g, and 47 g respectively. Mean transit times were variable and not significantly different between the groups. Vegans, however, had a greater frequency of defecation and passed softer stools. All measurements of bowel function were significantly correlated with total dietary fibre. As dietary fib...

  18. Whirl sign as CT finding in small-bowel volvulus

    International Nuclear Information System (INIS)

    In three patients with ileus CT showed a whirl sign in which the bowel and mesenteric folds encircled the superior mesenteric vein in a whirl-like pattern. Two patients were confirmed surgically to have small-bowel volvulus arising from postoperative adhesions. The whirl sign is useful in decision-making about the need for surgery. A CT examination should be performed for patients with ileus of unknown cause. (orig.)

  19. Transient small bowel angioedema due to intravenous iodinated contrast media

    Directory of Open Access Journals (Sweden)

    Xiu-Hua Hu

    2012-01-01

    Full Text Available Three cases of transient proximal small bowel angioedema induced by intravenous administration of nonionic iodinated contrast media (CM are presented. Computed tomography (CT images in the venous phase displayed the proximal small bowel with circumferential thickening of the wall including the duodenum and proximal segment of the jejunum. The bowel wall was normal in non-enhanced images, and normal or inconspicuous in arterial phase enhanced images. In one of the three cases, the bowel wall was thickened in venous phase but disappeared in the 40 s delayed phase images. No filling defect was seen in the lumen of the superior mesenteric artery and vein. No peritoneal effusion or mesentery abnormality was found. Each of these patients reported only mild abdominal discomfort and recovered without specific treatment within a short time. Only one patient suffered mild diarrhea after scanning which had resolved by the following day. The transient anaphylactic small bowel angioedema due to intravenous iodinated contrast media was easily diagnosed based on its characteristic CT findings and clinical symptoms. Differential diagnosis may include inflammatory and ischemic bowel disease, as well as neoplasms. A three-phase CT protocol and good understanding of this disorder are fundamentally important in the diagnosis of this condition. The supposed etiology behind the transient anaphylactic reaction to intravenous administration of iodinated CM in small bowel is similar to other CM-induced hypersensitive immediate reactions. The predilection location of transient anaphylactic bowel angioedema is the small intestine, particularly the proximal segment. A speculated cause may be the richer supply of vessels in the small intestine, ample mucous folds and loose connective tissue in the duodenum and the jejunum.

  20. Clinical aspects of bowel symptoms in Parkinson's disease

    DEFF Research Database (Denmark)

    Krogh, K; Østergaard, Karen; Sabroe, S; Laurberg, S

    2008-01-01

    BACKGROUND: The clinical importance of bowel symptoms in Parkinson's disease (PD) remains to be described in detail. METHODS: A 33-item questionnaire including background parameters, the Cleveland Constipation Score (CCS), and items from the Neurogenic Bowel Dysfunction score was sent to 468 PD patients. Results were compared to a control group (CG) (n = 45). A CCS of at least 15 was used to define severe constipation. RESULTS: Four hundred and sixteen subjects (89%) responded. Median CSS was on...

  1. Abdominal cocoon with small bowel obstruction: two case reports.

    Science.gov (United States)

    Kaur, Ravinder; Chauhan, Dinesh; Dalal, Usha; Khurana, Ujjawal

    2012-04-01

    Abdominal cocoon is a rare condition that results in an intestinal obstruction due to total or partial encapsulation of the small bowel by a fibrocollagenous membrane. Treatment is surgical resection of the membrane and free the bowel. Preoperative diagnosis is possible with combination of sonography and CT scan. We report two cases where the diagnosis of abdominal cocoon was suggested preoperatively based on the sonography and CT scan of abdomen. PMID:21643736

  2. Evaluation Of Irritable Bowel Syndrome Symptoms Amongst Warsaw University Students

    Directory of Open Access Journals (Sweden)

    Niemyjska Sylwia

    2015-05-01

    Full Text Available Irritable bowel syndrome (IBS belongs to functional gastrointestinal disorders and is characterized by abdominal pain and change in stool consistency and/or bowel habits. Etiological factors include gastrointestinal peristalsis disturbances, visceral hypersensitivity, chronic inflammation of the mucous membrane, dysbacteremia, intestinal infections, psychosomatic and nutritional factors. Gastrointestinal motility disturbances in case of IBS are manifested by the inhibition of the intestinal passage, which favors the development of constipation or occurrence of diarrhea.

  3. Validated tools for evaluating opioid-induced bowel dysfunction

    DEFF Research Database (Denmark)

    Olesen, Anne Estrup; Drewes, Asbjørn Mohr

    2011-01-01

    Adverse effects on the gastrointestinal system are problematic for pain patients receiving opioid treatment. Opioid-induced bowel dysfunction (OIBD) is often misinterpreted as constipation as this is the most frequently reported symptom of OIBD; however, it actually comprises the whole gut with symptoms such as nausea, reflux, bloating, and anorexia being very prevalent as well. Validated methods to evaluate these symptoms are essential before the action of a drug on bowel dysfunction can be eva...

  4. Experimental model of traumatic ulcer in the cheek mucosa of rats Modelo experimental de úlcera traumática em mucosa jugal de ratos

    OpenAIRE

    Galyléia Meneses Cavalcante; Renata Janaína Sousa de Paula; Leonardo Peres de Souza; Fabrício Bitu Sousa; Mário Rogério Lima Mota; Ana Paula Negreiros Nunes Alves

    2011-01-01

    PURPOSE: To establish an experimental model of traumatic ulcer in rat cheek mucosa for utilization in future alternative therapy studies. METHODS: A total of 60 adult male rats (250 - 300g) were used. Ulceration of the left cheek mucosa was provoked by abrasion using a nº 15 scalpel blade. The animals were observed for 10 days, during which they were weighed and their ulcers were measured. The histological characteristics were analyzed and scored according to the ulcer phase. In the statistic...

  5. Reconstrução uretral com retalho autógeno de mucosa bucal após uretrostomia, em cães Urethral reconstruction with autogenous buccal mucosa graft following urethrostomy in dogs

    OpenAIRE

    Neusa Margarida Paulo; Fernando Ferro da Silva; George Alves de Brito; Adilson Donizeti Damasceno; Luiz Augusto Batista Brito; José de Souza Freitas; Patrícia Lorena Neves; Maira Harumi Akinaga; Lorena Magalhães Barbosa; Cleizony Morais Vêncio

    2004-01-01

    OBJETIVO: Verificar se fragmentos de mucosa bucal autógena poderiam ser adequados para reconstrução uretral na presença de tecido fibroso, e se tal procedimento poderia determinar a formação de fístulas e ou saculações nos sítios implantares. MÉTODOS: Sete cães adultos foram submetidos à uretrostomia pré-escrotal. Após 40 dias, a uretrostomia foi corrigida por meio da implantação de fragmentos de mucosa bucal na parede ventral da uretra. Os animais foram observados durante 40 dias, quando ent...

  6. Irritable bowel syndrome immune hypothesis: the role of lymphocytes and mast cells Hipótesis inmune del síndrome del intestino irritable: Primera parte: papel de los linfocitos y mastocitos

    Directory of Open Access Journals (Sweden)

    M. Ortiz Lucas

    2010-11-01

    Full Text Available Objective: To review the available evidence on the role of T-lymphocytes and mast cells in the etiopathogenesis of Irritable Bowel Syndrome. Methods: Bibliographic retrieval on PubMed including the terms "Irritable Bowel Syndrome, "Immune System", "T-Lymphocytes" and "Mast Cells". Results: Twenty-five case-control studies and one randomized controlled trial were retrieved. Noteworthy in the blood is the increase in activated T cells destined to migrate to the bowel in these patients. A high frequency of T-lymphocytes is described in the intestinal mucosa, although the study findings are, at times, contradictory. An evident increase in mast cells (and in their activity between the terminal ileum and descending colon is also observed. Conclusions: The heterogeneity of diagnostic criteria and experimentation methods could account for some of the differences in the results found in the selected research. There are indications that give reason to believe these patients have "low-grade intestinal inflammation", and the increase in T-lymphocytes and mast cells has been associated with disorders found in IBS such as the communication between the intestine and the nervous system, the increase in intestinal permeability and changes in the microbiota.Objetivo: Revisar la evidencia disponible sobre el papel de los linfocitos T y mastocitos en la etiopatogenia del Síndrome del Intestino Irritable. de las vías biliares. Métodos: Recuperación bibliográfica en PubMed incluyendo los t?rminos "Irritable Bowel Syndrome, "Immune System", "T-Lymphocytes" y "Mast Cells". Resultados: Se recuperaron 25 estudios casos-control y un ensayo clínico aleatorizado. A nivel sanguíneo destaca el aumento de células T activadas destinadas a migrar al intestino en estos pacientes. En la mucosa intestinal se describe un patrón elevado de linfocitos T, aunque los resultados de los estudios son en ocasiones contradictorios, y un aumento claro de mastocitos (y de su actividad entre el íleon terminal y colon descendente. Conclusiones: La heterogeneidad de criterios diagnósticos y de métodos de experimentación podría explicar algunas de las diferencias en los resultados que se encuentran en las investigaciones seleccionadas. Existen indicios que conducen a pensar que existe una "inflamación intestinal de bajo grado" en estos pacientes, y se ha relacionado el aumento de linfocitos T y de mastocitos con trastornos encontrados en el SII como la comunicación entre el intestino y el sistema nervioso, el aumento de la permeabilidad intestinal y los cambios en la microbiota.

  7. Pharmacological treatment of bowel obstruction in cancer patients.

    LENUS (Irish Health Repository)

    O'Connor, Brenda

    2012-02-01

    INTRODUCTION: Malignant bowel obstruction (MBO) is a common complication of advanced cancer, occurring most frequently in gynaecological and colorectal cancer. Its management remains complex and variable. This is in part due to the lack of evidence-based guidelines for the clinicians involved. Although surgery should be considered the primary treatment, this may not be feasible in patients with a poor performance status or advanced disease. Advances have been made in the medical management of MBO which can lead to a considerable improvement in symptom management and overall quality of life. AREAS COVERED: This review emphasizes the importance of a prompt diagnosis of MBO with early introduction of pharmacological agents to optimize symptom control. The authors summarize the treatment options available for bowel obstruction in those patients for whom surgical intervention is not a feasible option. The authors also explore the complexities involved in the introduction of parenteral hydration and total parenteral nutrition in this group of patients. EXPERT OPINION: It is not always easy to distinguish reversible from irreversible bowel obstruction. Early and aggressive management with the introduction of pharmacological agents including corticosteroids, octreotide and anti-cholinergic agents have the potential to maintain bowel patency, and allow for more rapid recovery of bowel transit. A combination of analgesics, anti-emetics and anti-cholinergics with or without anti-secretory agents can successfully improve symptom control in patients with irreversible bowel obstruction.

  8. Mesenteric Air Embolism Following Enteroscopic Small Bowel Tattooing Procedure

    Directory of Open Access Journals (Sweden)

    Natalie Chen

    2012-01-01

    Full Text Available Double balloon enteroscopy (DBE is a revolutionary procedure in which the entire small bowel can be visualized endoscopically. DBE has the advantage of both diagnostic and therapeutic capabilities in the setting of small bowel neoplasms and vascular malformations. We present a unique case of a 76-year-old female who underwent small bowel DBE tattoo marking of a distal small bowel tumor complicated by development of severe abdominal pain postprocedure secondary to bowel air embolism into the mesenteric veins. Mesenteric air can be seen after other endoscopic procedures such as biopsy, mucosal clip placement and polypectomy, or following a colonoscopy. Mesenteric air embolism following small bowel tattooing procedure has not been previously reported in the literature. Mesenteric air when present may be attributed to mesenteric ischemia and can subject the patient to unnecessary surgical intervention if misdiagnosed. Thus, this report holds significance for the radiologist as computed tomography (CT findings of mesenteric air embolism must be evaluated in the context of appropriate clinical history before treatment decisions are made.

  9. The role of fecal calprotectin in investigating inflammatory bowel diseases

    Directory of Open Access Journals (Sweden)

    Mustafa Erbayrak

    2009-05-01

    Full Text Available INTRODUCTION: Invasive and non-invasive tests can be used to evaluate the activity of inflammatory bowel diseases. OBJECTIVE: The aim of the present study was to investigate the role of fecal calprotectin in evaluating inflammatory bowel disease activity and the correlation of fecal calprotectin with the erythrocyte sedimentation rate and C reactive protein values in inflammatory bowel disease. METHOD: Sixty-five patients affected with inflammatory bowel disease were enrolled. Twenty outpatients diagnosed with inflammatory bowel disease comprised the control group. RESULTS: In the present study, all patients in the control group had an fecal calprotectin value lower than the cut-off point (50 mg/kg. CONCLUSION: In conclusion, fecal calprotectin was found to be strongly associated with colorectal inflammation indicating organic disease. Fecal calprotectin is a simple and non-invasive method for assessing excretion of macrophages into the gut lumen. Fecal calprotectin values can be used to evaluate the response to treatment, to screen asymptomatic patients, and to predict inflammatory bowel disease relapses.

  10. CT Findings of Small Bowel Anisakiasis: Analysis of Four Cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Wee Kyoung; Song, Soon Young; Cho, On Koo; Koh, Byung Hee [Hanyang University College of Medicine, Seoul (Korea, Republic of); Kim, Yong Soo; Jung, Woo Kyoung; Kim, Min Yeong [Hanyang University Guri Hospital, College of Medicine, Guri (Korea, Republic of)

    2011-02-15

    We wanted to describe the CT findings of small bowel anisakiasis with the pathologic correlation. Four patients with surgically and pathologically proven small bowel anisakiasis were included in this retrospective study. They were three men and one woman and their ages ranged from 28 to 43 years (mean age: 38 years). We evaluated their clinical, CT and histological findings. All the patients had a history of ingesting raw fish within 24 hours from the time of symptom onset. They complained of abdominal pain (n=4), nausea (n=4), vomiting (n=2) and diarrhea (n=1). Physical examination revealed tenderness (n=4), rebound tenderness (n=4) and increased bowel sounds (n=3). Leukocytosis was noted in all the patients on the laboratory examination. None of the patients showed eosinophilia. The CT findings were segmental small bowel wall thickening with preserved layering (n=4), focal segmental luminal narrowing with proximal dilatation (n=4), peritoneal thickening (n=3), mesenteric or omental infiltration (n=4) and varying degrees of ascites (n=4). On the histopathologic examination, they revealed an infiltration of eosinophils (n=4) in all layers of the bowel wall with severe edema. The larvae were found on surgico-pathologic examination in all the cases. The CT findings may be helpful to make the specific diagnosis of small bowel anisakiasis in a patient with the clinical findings of an acute abdomen and a history of eating raw fish

  11. Mucosa gástrica ectópica na ampola de Vater: Uma causa de ectasia da via biliar Ectopic gastric mucosa in the ampulla of Vater: A cause of bile duct ectasia

    Directory of Open Access Journals (Sweden)

    Ana Caldeira

    2010-09-01

    Full Text Available INTRODUÇÃO: A mucosa gástrica ectópica pode encontrar-se em qualquer segmento do tubo digestivo, na vesícula ou vias biliares. CASO CLÍNICO: Apresenta-se o caso de uma doente, com episódio de dor no hipocôndrio direito associado a dilatação da via biliar principal. A ecoendoscopia identificou vegetação intraluminal justa-papilar podendo condicionar algum grau de obstrução da via biliar. A colangiopancreatografia retrógrada endoscópica confirmou ectasia da via biliar principal e vegetação imediatamente adjacente à papila. O estudo histológico permitiu diagnóstico de mucosa gástrica ectópica, confirmado com cintigrama. Após esfincterotomia ampla, a doente apresentou remissão das queixas álgicas e redução do diâmetro da via biliar. CONCLUSÃO: A mucosa gástrica ectópica é, essencialmente, um diagnóstico histológico. Sendo, geralmente, um achado incidental é também uma entidade subdiagnosticada.INTRODUCTION: Ectopic gastric mucosa can be found in any segment of the digestive tract as well as in the gallbladder and bile ducts. CASE REPORT: A patient with episodes of pain in right hypochondrium associated with common bile duct ectasia. Ultrasound endoscopy identified an intraluminal juxta-papillary vegetation which was associated with some degree of obstruction in the bile duct. ERCP confirmed common bile duct ectasia and the vegetation immediately adjacent to the papilla. Histologic examination allowed the diagnosis of ectopic gastric mucosa, confirmed with scintigraphy. A wide sphincterotomy was performed, with remission of pain and reduction of the biliary duct dimension. CONCLUSION: Ectopic gastric mucosa is essentially a histological diagnosis. It is usually an incidental finding and so it represents an underdiagnosed entity.

  12. Oxidative stress disturbs energy metabolism of mitochondria in ethanol-induced gastric mucosa injury

    Directory of Open Access Journals (Sweden)

    Jin-Shui Pan, Shao-Zhen He, Hong-Zhi Xu, Xiao-Juan Zhan, Xiao-Ning Yang, Hong-Min Xiao, Hua-Xiu Shi, Jian-Lin Ren

    2008-10-01

    Full Text Available AIM: To study the role of mitochondrial energy disorder in the pathogenesis of ethanol-induced gastric mucosa injury.METHODS: Wistar rats were used in this study. A gastric mucosal injury model was established by giving the rats alcohol. Gross and microscopic appearance of gastric mucosa and ultrastructure of mitochondria were evaluated. Malondiadehyde (MDA in gastric mucosa was measured with thiobarbituric acid. Expression of ATP synthase (ATPase subunits 6 and 8 in mitochondrial DNA (mtDNA was determined by reverse transcription polymerase chain reaction (RT-PCR.RESULTS: The gastric mucosal lesion index was correlated with the MDA content in gastric mucosa. As the concentration of ethanol was elevated and the exposure time to ethanol was extended, the content of MDA in gastric mucosa increased and the extent of damage aggravated. The ultrastructure of mitochondria was positively related to the ethanol concentration and exposure time. The expression of mtDNA ATPase subunits 6 and 8 mRNA declined with the increasing MDA content in gastric mucosa after gavage with ethanol.CONCLUSION: Ethanol-induced gastric mucosa injury is related to oxidative stress, which disturbs energy metabolism of mitochondria and plays a critical role in the pathogenesis of ethanol-induced gastric mucosa injury.

  13. Rabies virus in the salivary glands and nasal mucosa of naturally infected skunks.

    OpenAIRE

    Charlton, K.M.; Casey, G. A.; Webster, W A

    1984-01-01

    Several salivary glands and the nasal mucosa of rabid skunks (Mephitis mephitis) contained rabies virus. Generally titers were high in the submandibular, moderate in the parotid and low to moderate in the zygomatic, molar and sublingual salivary glands. The nasal mucosa (glands and epithelium) contained virus at low to moderate titers that occasionally were equal to titers in brain.

  14. Evaluating patients' preferences for type of bowel preparation prior to screening CT colonography: Convenience and comfort versus sensitivity and specificity

    International Nuclear Information System (INIS)

    Aims: To explore the relative value patients place on comfort and convenience versus test sensitivity and specificity in the context of computed tomographic colonography (CTC) screening. Materials and methods: Twenty semi-structured interviews were carried out with patients attending hospital for radiological tests unrelated to CTC. Preferences for CTC with different types of bowel preparation for CTC screening were examined and interviews were analysed thematically. The discussion guide included separate sections on CTC, bowel preparation methods (non-, reduced- and full-laxative), and sensitivity and specificity. Patients were given information on each topic in turn and asked about their views and preferences during each section. Results: Following information about the test, patients' attitudes towards CTC were positive. Following information on bowel preparation, full-laxative purgation was anticipated to cause more adverse physical and lifestyle effects than using reduced- or non-laxative preparation. However, stated preferences were approximately equally divided, largely due to patients anticipating that non-laxative preparations would reduce test accuracy (because the bowel was not thoroughly cleansed). Following information on sensitivity and specificity (which supported patients' expectations), the predominant stated preference was for full-laxative preparation. Conclusions: Patients are likely to value test sensitivity and specificity over a more comfortable and convenient preparation. Future research should test this hypothesis on a larger sample

  15. Synovial Sarcoma of the Buccal Mucosa: A Rare Case Report

    Science.gov (United States)

    Mahesh, Kumar T. S.; Ponnuswamy, Indira Annamalai; David, Maria Priscilla; Shivhare, Peeyush; Puttaranganayak, Mahalakshmi Ikkanur; Sinha, Pooja

    2013-01-01

    Synovial sarcoma (SS) is a rare malignant neoplasm that arises most commonly in joint capsules and articular tendons, but its relationship to the synovium is not always obvious. Synovial sarcoma is a malignant soft tissue tumor representing 5.6% to 10% of all soft tissue sarcomas. They are termed SS because of their histologic resemblance to the synovium, but they rarely involve a synovial structure and are thought to arise from pluripotential mesenchymal cells. The tumor usually occurs in close association with tendon sheaths, bursae, and joint capsules, primarily in the para-articular regions of the extremities, with approximately 9% occurring in the head and neck region. Synovial sarcoma has been reported rarely in the oral cavity. We report a very rare case of Synovial sarcoma of the buccal mucosa in a 24-year-old male patient. PMID:23762651

  16. Myoepithelial carcinoma of buccal mucosa: A rare tumor

    Directory of Open Access Journals (Sweden)

    Jeevan Lata

    2014-01-01

    Full Text Available Myoepithelial carcinoma is a rare neoplasm of salivary glands that account for < 1% of all salivary gland tumors. The most common sites of involvement are major salivary glands mainly parotid gland. Intraorally, it can arise from minor salivary glands; palate is the most common site of occurrence. It also occurs in nasopharynx, paranasal sinuses, nasal cavity and larynx in head and neck region. Myoepithelial tumors were first described in 1943. Their malignant variant, myoepithelial carcinoma, was first reported by Stromeyer et al., in 1975, characterized by distinct morphologic heterogeneity and an infiltrative growth pattern into adjacent tissues. Here, we report a rare case of a 55-year-old female with myoepithelial carcinoma of buccal mucosa. It was also rare because of unusual location of tumor. Our patient was treated with wide local resection and remained free of disease for 15 months.

  17. Intestinal mucosa development in broiler chickens fed natural growth promoters

    Scientific Electronic Library Online (English)

    ERL, Pelicano; PA, Souza; HBA, Souza; DF, Figueiredo; MM, Boiago; SR, Carvalho; VF, Bordon.

    2005-12-01

    Full Text Available This study evaluated the use of probiotics and prebiotics on the histological and morphological indexes of the intestinal mucosa of broilers at 21 days of age. Thirty-six birds were randomly distributed in a 3 x 3 factorial arrangement, considering 3 probiotics and prebiotics sources in the diet. Th [...] ere were 9 treatments with 4 repetitions. Diet treatments were: 1 - Control (without growth promoters); 2 - Bacillus subtilis-based probiotic (Pro 1); 3 - Probiotic (Pool) based on Lactobacillus acidophilus and casei, Streptococcus lactis and faecium, Bifidobacterium bifidum and Aspergillus oryzae (Pro 2); 4 - Prebiotic based on Phosphorylated Mannanoligosaccharide (MOS) and Organic Acidifier (OA) (Pre 1); 5 - MOS-based prebiotic (Pre 2); 6 - Pro 1 + Pre 1; 7 - Pro 1 + Pre 2; 8 - Pro 2 + Pre 1; 9 - Pro 2 + Pre 2. Higher villus height (VH) (p

  18. Neurosecretory effect of ouabain on isolated rabbit ileal mucosa

    Energy Technology Data Exchange (ETDEWEB)

    Hubel, K.A.; Renquist, K.S.

    1988-01-01

    Ouabain, when added to fluid bathing rabbit ileal mucosa mounted in a flux chamber, transiently increases short circuit current, implying a paradoxical secretory response. To determine the cause of this change, the authors studied unidirectional fluxes of /sup 36/Cl and /sup 23/Na and the effects of ion substitution, of reduced Ca concentration, verapamil, tetrodotoxin and atropine. Ouabain 0.1 mM, transiently increased the serosal to mucosal flux of Cl and Na, increased Isc and PD and reduced ion conductance. The Isc response to ouabain was diminished by reducing the bath fluid concentration of CL, of Ca, and by adding verapamil. Tetrodotoxin both delayed and reduced the maximal Isc response; atropine had no effect. They conclude that ouabain acts by releasing a neurotransmitter of unknown identity and by increasing the serosal to mucosal flux to Cl.

  19. Separation and characteristics of two histaminocytes from rat gastric mucosa.

    Science.gov (United States)

    Lemmi, C A

    1984-02-01

    To determine the properties of rat gastric cells involved in histamine metabolism (histaminocytes), fundic mucosa was enzymatically dispersed prior to separation by sedimentation methods. The distribution of histamine content, histidine decarboxylase (HDC) activity and incorporation of radioactive histidine metabolites were used to determine the characteristics of various populations of gastric cells. All activities measured, as well as most of the dispersed gastric cells, occurred in a narrow range of density between 1.083 and 1.091 g/ml. Velocity sedimentation showed that two populations of histaminocytes can be distinguished. One population has a higher sedimentation rate, suggesting a larger size, contains histamine, HDC activity and incorporates radioactive metabolites. Another population, in fractions with lower sedimentation rates, contains little histamine, has a higher HDC activity than the previous population and also incorporates radiolabelled histidine metabolites. For the first time, two populations of viable histaminocytes have been separated that differ in their biochemical properties. PMID:6711385

  20. [Melanoma of nasal cavity and paranasal sinus mucosa].

    Science.gov (United States)

    Go?abek, W; Siwiec, H; Klatka, J; Morshed, K

    2001-01-01

    In a group of 15 patients with malignant melanoma of the nasal cavity and paranasal sinuses the place of origin was nasal mucosa in 11 patients, the ethmoid cells in 2 cases and the maxillary sinus in 2 cases. Only 5 patients had tumour limited to infrastructure of the nasomaxillary complex, in 10 patients tumour occupied also suprastructure. Total maxillectomy was performed in 4 patients, partial maxillectomy in 8 patients with orbital exenteration in 3 patients. Of 12 patients operated on three patients died one year, two patients two years and one patient 6 years after surgery. One patient is alive 12 years, three patients are alive three years and one patient is alive one year after surgery. PMID:11766322

  1. Probiotics in inflammatory bowel disease--therapeutic rationale and role.

    LENUS (Irish Health Repository)

    Shanahan, Fergus

    2012-02-03

    The intestinal flora has a conditioning effect on intestinal homeostasis, delivering regulatory signals to the epithelium, the mucosal immune system and to the neuromuscular activity of the gut. Beneficial metabolic activities of the enteric flora include nutrient production, metabolism of dietary carcinogens, conversion of prodrugs to active drugs. However, increasing evidence suggests that some components of the enteric flora are essential ingredients in the pathogenesis of inflammatory bowel disease (IBD); this has prompted interest in therapeutic manipulation of the flora with probiotics. Probiotics are biologic control agents-described as live microbial food supplements which confer a health benefit beyond inherent basic nutrition. Multiple potential beneficial effects have been attributed to the probiotic use of lactic acid bacteria, bifidobacteria and other non-pathogenic commensals. At present, much of the promise of probiotics remains outside the realm of evidence-based medicine and awaits the results of prospective trials, now underway. No reliable in vitro predictors of in vivo efficacy of putative probiotics have been identified. Rigorous comparisons of probiotic performance have not been performed and the suitability of a given probiotic for different individuals is largely unexplored. Notwithstanding, an improved understanding of the normal commensal flora and host-flora interactions has the potential to open up new therapeutic strategies for inflammatory disorders of the gut.

  2. Serological antibodies in inflammatory bowel disease: a systematic review.

    Science.gov (United States)

    Prideaux, Lani; De Cruz, Peter; Ng, Siew C; Kamm, Michael A

    2012-07-01

    The diagnosis of inflammatory bowel disease (IBD) is traditionally based on a combination of clinical, endoscopic, histological, and radiological criteria. However, further testing is needed in cases of diagnostic uncertainty and in predicting disease course. This systematic review focuses on the potential for 10 serological antibodies to fill these roles: pANCA, ASCA, anti-OmpC, anti-CBir1, anti-I2, ALCA, ACCA, AMCA, anti-L, and anti-C. We discuss their prevalence in IBD and health; their role in disease diagnosis and risk stratification; their stability over time; their presence in unaffected relatives; their association with genetic variants; and differences across ethnic groups. Serological antibodies have some role in primary diagnosis and in differentiating between Crohn's disease and ulcerative colitis. In indeterminate colitis, preoperative measurement of serological antibodies can help to predict the likelihood of complications among patients undergoing pouch surgery. The combined presence and magnitude of a large panel of antibodies appear to be of value in predicting disease progression. There is currently insufficient evidence to recommend the use of antibody testing to predict responses to treatment or surgery in patients with IBD. PMID:22069240

  3. Reconstrucción tridimensional in vitro de mucosa vesical humana / In vitro three-dimensional reconstruction of human bladder mucosa

    Scientific Electronic Library Online (English)

    E. de, Diego Rodríguez; A., Roca Edreira; A., Villanueva Peña; A., Meana Infiesta; S., Gómez Llames; B., Martín García; J.Mª, Gómez Ortega.

    2006-02-01

    Full Text Available Objetivo: Aplicar las técnicas de cultivo in vitro de queratinocitos así como los principios de la ingeniería tisular al epitelio urinario humano, con el fin de reconstruir tridimensionalmente una mucosa vesical humana in vitro, apta para trasplantar. Material y Métodos: Se obtuvieron muestras de mu [...] cosa vesical de pacientes programados para cirugía abierta de próstata, previo consentimiento de los mismos, las cuales fueron cultivadas in vitro, para proceder posteriormente al estudio histomorfológico de los tejidos obtenidos. Resultados: Se obtuvo un tejido tridimensional compuesto por una submucosa bioartificial a base de un gel de fibrina y fibroblastos, sobre la que descansan las células uroepiteliales, pudiendo utilizar una malla de ácido poliglicólico, que facilite la manipulación de la mucosa y el posterior injerto de la misma. El tejido obtenido tenía el aspecto de un epitelio inmaduro con muy escasa reacción a citoqueratinas, sin poderse demostrar inmunohistoquímicamente el desarrollo de una membrana basal. Conclusiones: Las técnicas de cultivo in vitro de queratinocitos son aplicables a otros epitelios, entre ellos el urotelio humano. En un periodo de tiempo relativamente corto se puede obtener un tejido in vitro tridimensional apto para trasplantar, precisando posiblemente de las interacciones con el lecho receptor para poder madurar. Abstract in english Objetive: The purpose of this study is to apply the in vitro keratinocyte culture techniques and the tissue engineering principles to human urothelium, to reconstruct an in vitro three-dimensional human bladder mucosa, suitable for grafting. Material and Methods: Biopsy specimens of human bladder mu [...] cosa were obtained from patients undergoing suprapubic prostatectomy, in vitro cultured and finally, an immunohistochemical study was made. Results: A three-dimensional in vitro tissue was obtained, composed of a bio-artificial submucosa (fibrin gel and fibroblast) where the uroepithelial cells were seeding. We used a biodegradable polyglycolic acid mesh to facilitate the tissue manipulation and implantation. An immature epithelium was obtained with a weak immunostaining to cytokeratins. The immunohistochemical study could not demonstrate the development of basement membrane. Conclusions: In vitro keratinocyte culture techniques could be applied to other epithelial tissues like the urothelium. We obtained a three-dimensional in vitro tissue suitable for grafting in a relatively short time, which needs the matrix interactions in order to mature.

  4. Serum biomarkers for Irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Alexandra Chira

    2015-07-01

    Full Text Available Background and aim. Irritable bowel syndrome (IBS is one of the most frequent and common functional gastrointestinal diseases. For its diagnosis, clinical criteria are still used. Our objective was to asses if there are specific serum biomarkers for the diagnosis of IBS, and as secondary purpose we aimed to analyze the specificity and sensitivity – where determined – for the proposed biomarkers.Methods. We performed a review in order to find potential serum biomarkers useful for the diagnosis of IBS. MEDLINE and Cochrane databases were searched in May 2015. Inclusion criteria were: original studies that assessed serological markers in IBS patients, markers potentially useful for diagnosing IBS or in differentiating subtypes of IBS. Exclusion criteria were biomarkers assessed in IBS patients not for the diagnosis of IBS, but used in order to exclude other conditions or diseases in these patients; or markers that were not addressed to IBS; or papers that assessed only fecal biomarkers, or histological or surrogate - indirect biomarkers.Results. From the 268 papers retrieved by our initial search, using a modified strategy we identified 58 papers. Out of the 58 papers retrieved by the search, six papers were selected and other nine studies were eventually analyzed. Of the results of the computerized search, a number of papers were not included for various reasons: some were not related to the subject (26, others were not appropriate for the subject (19 because they addressed inflammatory bowel disorders, in others fecal markers were the subject of the study,  six were reviews, others were impossible to gain access to (1. Twelve out of the 14 studies included are case-control studies, IBS diagnosis being established in all of the selected results based on the Rome criteria. A higher sensitivity of 81% was found using a combination of markers but with lower specificity, while one study that assessed also a combination of markers, found a higher specificity but sensitivity was only 50 %; none reached the characteristics for an ideal biomarker.Conclusions. For the moment, just one serum biomarker with a high specificity and sensitivity useful in the diagnosis of IBS was identified. We consider that in the future a combination of several biomarkers could better identify IBS than a single biomarker. Therefore, clinical criteria are still to be used for the diagnosis of IBS in attendance for newer research or validation of results. 

  5. Clostridium difficile infection and inflammatory bowel disease.

    Science.gov (United States)

    Cojocariu, Camelia; Stanciu, Carol; Stoica, Oana; Singeap, Ana Maria; Sfarti, Catalin; Girleanu, Irina; Trifan, Anca

    2014-12-01

    Over the past 15 years, Clostridium difficile infection (CDI) in patients with inflammatory bowel disease (IBD) has increased both in incidence and severity. Traditional risk factors for CDI are similar in IBD and non-IBD populations, but there is a significant proportion of IBD patients which have distinctive characteristics. Patients with ulcerative colitis (UC) are more susceptible to CDI and have more severe outcomes than those with Crohn's disease (CD). CDI may be difficult to distinguish from an IBD flare due to similar clinical presentation, and therefore screening for CDI is recommended at every flare in such patients. Several studies showed worse clinical outcomes in IBD patients with CDI, including longer hospital stay, higher colectomy and mortality rates than in those without CDI. Vancomycin and metronidazole appear to have similar efficacy in patients with moderate disease, but vancomycin is preferred in severe disease. Measures must be taken to prevent the spread of infection. Clinicians should have a high index of suspicion for CDI when evaluating a patient with IBD flare, as rapid detection and prompt treatment of infection improve outcomes. This review summarizes the available literature on epidemiology, risk factors, clinical aspects, diagnostic methods, treatment, outcome, and prevention of CDI in IBD patients. PMID:25599768

  6. Inflammatory bowel disease: immunodiagnostics, immunotherapeutics, and ecotherapeutics.

    LENUS (Irish Health Repository)

    Shanahan, F

    2012-02-03

    Treatment options for inflammatory bowel disease (IBD) reflect a continuing shift from empiricism to strategies based on improved understanding of the pathophysiology of disease. In susceptible individuals, IBD appears to be the result of defective regulation of mucosal immune interactions with the enteric microflora. This has prompted research directed at the interface of the traditional disciplines of immunology, microbiology, and epithelial cell biology. Whereas immunodiagnostics have been of limited clinical value in IBD, assessments of mucosal rather than systemic immune function are promising. Therapeutically, there is an increasing trend toward more aggressive and earlier use of immunomodulatory agents, particularly for prevention of relapse, with cytokine manipulation as a bridge therapy to achieve remission in patients with acute severe disease. Although most drug treatments are directed toward altering the host response, the rationale for manipulating the enteric flora appears sound and will be the basis of additional future therapeutic strategies. Notwithstanding the widening range of options for drug therapy in IBD, other outcome modifiers and well-established principles of managing chronic disease are as important as ever.

  7. Diagnostic difficulties in inflammatory bowel disease pathology.

    Science.gov (United States)

    Yantiss, R K; Odze, R D

    2006-01-01

    This review summarizes some of the common diagnostic problems encountered by pathologists when evaluating patients with chronic colitis and in whom inflammatory bowel disease (IBD) is either suspected or within the differential diagnosis. Both ulcerative colitis (UC) and Crohn's disease (CD) show characteristic, but non-specific, pathological features that may overlap and result in a diagnosis of 'indeterminate colitis' (IC). However, other reasons why pathologists may entertain a diagnosis of IC include failure to recognize or accept certain 'hardcore' histological features as indicative of CD, an attempt to classify cases of chronic colitis based on mucosal biopsy material or in the absence of adequate clinical and radiographic information, and the presence of other disease processes that mask, or mimic, IBD. In addition, some cases of UC may show unusual CD-like features, such as discontinuous or patchy disease, ileal inflammation, extracolonic inflammation, granulomatous inflammation in response to ruptured crypts, aphthous ulcers, or transmural inflammation. Furthermore, other forms of colitis, such as microscopic colitis, diverticulitis and diversion colitis may, on occasion, also show IBD-like changes. The clinical and pathological features that aid in the distinction between these entities, and others, are covered in detail in this review. PMID:16405661

  8. Infliximab pharmacokinetics in inflammatory bowel disease patients.

    Science.gov (United States)

    Ternant, David; Aubourg, Alexandre; Magdelaine-Beuzelin, Charlotte; Degenne, Danielle; Watier, Hervé; Picon, Laurence; Paintaud, Gilles

    2008-08-01

    Infliximab, a chimeric monoclonal antibody, has profoundly modified the treatment of several inflammatory diseases, but no satisfactory description of its pharmacokinetics is available. The objective of this study is to describe the pharmacokinetics of infliximab and to explore the sources of its interindividual variability. Thirty-three chronic inflammatory bowel disease patients were studied. Infliximab serum concentrations, obtained during therapeutic drug monitoring, were analyzed using a population approach. Influence of sex, weight, age, concomitant immunosuppressive treatment, and development of antibodies toward infliximab (ATI) on pharmacokinetic parameters was investigated. A two-compartment model with first-order distribution and elimination constants allowed a satisfactory description of infliximab serum concentrations. Mean population distribution and elimination half-lives were 4.3 and 18.5 days, respectively. Weight and sex were found to significantly influence volume of distribution of the central compartment, which increased with weight and was higher in men. Clearance was 2.7 times higher, and elimination half-life was 34% lower in the presence of ATI. In two patients, an increase in infliximab dose or a decrease in dosing interval lead to a decrease in infliximab clearance toward its value in patients without ATI. Infliximab pharmacokinetics are similar to those of other monoclonal antibodies, notably with an elimination half-life of approximately 3 weeks. Both body weight and sex were found to influence infliximab pharmacokinetics, and its clearance increased thrice in the presence of ATI. PMID:18641542

  9. Role of cytokines in inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Fausto Sanchez-Muñoz, Aaron Dominguez-Lopez, Jesus K Yamamoto-Furusho

    2008-07-01

    Full Text Available Inflammatory bowel disease (IBD, which includes Crohn’s disease (CD and ulcerative colitis (UC, represents a group of chronic disorders characterized by inflammation of the gastrointestinal tract, typically with a relapsing and remitting clinical course. Mucosal macrophages play an important role in the mucosal immune system, and an increase in the number of newly recruited monocytes and activated macrophages has been noted in the inflamed gut of patients with IBD. Activated macrophages are thought to be major contributors to the production of inflammatory cytokines in the gut, and imbalance of cytokines is contributing to the pathogenesis of IBD. The intestinal inflammation in IBD is controlled by a complex interplay of innate and adaptive immune mechanisms. Cytokines play a key role in IBD that determine T cell differentiation of Th1, Th2, T regulatory and newly described Th17 cells. Cytokines levels in time and space orchestrate the development, recurrence and exacerbation of the inflammatory process in IBD. Therefore, several cytokine therapies have been developed and tested for the treatment of IBD patients.

  10. Diagnostics in inflammatory bowel disease: Ultrasound

    Directory of Open Access Journals (Sweden)

    Deike Strobel

    2011-01-01

    Full Text Available Diagnosis of chronic inflammatory bowel diseases (IBD is based on a combination of clinical symptoms, laboratory tests and imaging data. Imaging of the morphological characteristics of IBD includes the assessment of mucosal alterations, transmural involvement and extraintestinal manifestations. No single imaging technique serves as a diagnostic gold standard to encompass all disease manifestations. Ultrasound, computed tomography (CT or magnetic resonance imaging (MRI allow cross-sectional imaging of the transmural alterations and extraintestinal manifestations. While in the USA the technique of choice is CT, in Europe the focus is more on MRI and ultrasound (US. Most patients with chronic IBD are diagnosed at a young age. After baseline diagnosis many of these young patients have to undergo repetitive imaging procedures during the variable clinical course of the disease, characterized by alternate periods of remission and active disease, and in monitoring the response to treatment. US has the advantage of being noninvasive, less costly, and easily repeatable, and thus can be very useful in following up patients with IBD. In addition, rising concern about radiation exposure in young adults indicates the demand for radiation-sparing techniques like US and MRI. This article focuses on the current clinical practice of US in IBD, describing the current technologies used in transabdominal intestinal US and the characteristic sonographic findings in Crohn´s disease and ulcerative colitis.

  11. Legal risks in treating irritable bowel syndrome.

    Science.gov (United States)

    Feld, Andrew D

    2003-01-01

    Physicians who treat irritable bowel syndrome (IBS) reasonably seek strategies to reduce the risk of malpractice. They are concerned that, in the absence of laboratory or radiographic markers specific for the disorder, what appears to be a reasonable diagnosis of IBS could lead to a malpractice claim if an alternate diagnosis is later discovered. Physicians need to understand the sources of malpractice risk, and risk management strategies related to these sources, to reduce their exposure to liability suits in this area. This article outlines these sources of risk, or conditions under which physicians may be sued, known as torts. The tort of negligence is covered, including its 4 elements: the duty to provide care to a patient, medical practice below the standard of care, the resultant harm, and the establishment of compensable damages. The concepts of informed consent and vicarious liability are also presented. This discussion is developed within the context of a risk management approach, to assist physicians in developing a preventative approach to malpractice liability when considering the diagnosis of IBS. PMID:14502114

  12. Iron deficiency anemia in inflammatory bowel disease.

    Science.gov (United States)

    Kaitha, Sindhu; Bashir, Muhammad; Ali, Tauseef

    2015-08-15

    Anemia is a common extraintestinal manifestation of inflammatory bowel disease (IBD) and is frequently overlooked as a complication. Patients with IBD are commonly found to have iron deficiency anemia (IDA) secondary to chronic blood loss, and impaired iron absorption due to tissue inflammation. Patients with iron deficiency may not always manifest with signs and symptoms; so, hemoglobin levels in patients with IBD must be regularly monitored for earlier detection of anemia. IDA in IBD is associated with poor quality of life, necessitating prompt diagnosis and appropriate treatment. IDA is often associated with inflammation in patients with IBD. Thus, commonly used laboratory parameters are inadequate to diagnose IDA, and newer iron indices, such as reticulocyte hemoglobin content or percentage of hypochromic red cells or zinc protoporphyrin, are required to differentiate IDA from anemia of chronic disease. Oral iron preparations are available and are used in patients with mild disease activity. These preparations are inexpensive and convenient, but can produce gastrointestinal side effects, such as abdominal pain and diarrhea, that limit their use and patient compliance. These preparations are partly absorbed due to inflammation. Non-absorbed iron can be toxic and worsen IBD disease activity. Although cost-effective intravenous iron formulations are widely available and have improved safety profiles, physicians are reluctant to use them. We present a review of the pathophysiologic mechanisms of IDA in IBD, improved diagnostic and therapeutic strategies, efficacy, and safety of iron replacement in IBD. PMID:26301120

  13. The Intestinal Microbiota and Irritable Bowel Syndrome.

    Science.gov (United States)

    Ringel, Yehuda; Ringel-Kulka, Tamar

    2015-01-01

    Irritable bowel syndrome (IBS) is the most prevalent and the best studied functional gastrointestinal disorder. The etiology and the pathogenesis of IBS are still not clear; however, recent studies have implicated a role for alterations in the intestinal microbiota (dysbiosis) in the pathophysiology of the disorder. Epidemiological observations have demonstrated that the development of IBS symptoms is often preceded by a disruption of the individual's normal intestinal microbiota, and microbiological studies have demonstrated compositional differences in the intestinal microbiota between patients with IBS patients and healthy controls. In addition, animal studies and a few recent human clinical studies have demonstrated that compositional changes in the intestinal microbiota in IBS are associated with relevant abnormal gastrointestinal and brain-gut axis functions that are often observed in patients with IBS. This article discusses points of interest from the current research on the microbiota-gut-brain interactions in IBS and highlights the relevance of the emerging data to our understanding of the disorder and the clinical implications for patients' care. PMID:26447966

  14. Genetic determination of irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Cristina Hotoleanu, Radu Popp, Adrian Pavel Trifa, Laurentiu Nedelcu, Dan L Dumitrascu

    2008-11-01

    Full Text Available Irritable bowel syndrome (IBS is a common functional gastrointestinal disorder. According to the Rome III criteria, IBS is defined as recurrent abdominal pain or discomfort for at least 3 d per month during the previous 3 mo associated with two or more of the following symptoms: improvement with defecation, onset associated with a change in the frequency of stool and/or onset associated with a change in form or appearance of stool. There is growing evidence regarding the genetic contribution in IBS, however the precise etiology of IBS is still unknown. The evaluation of the genetic influence is based on twin studies, familial aggregation and genetic epidemiological investigations. Most studies showed a concordance for IBS significantly greater in monozygotic than in dizygotic twins. The majority of the studies have shown that familial aggregation may represent exposures to a similar environment, as well as the influence of genetic factors. Whereas no specific gene has been identified in association with IBS, recent studies have noticed the importance of polymorphisms in the promoter region of the serotonin reuptake transporter gene, G-protein beta 3 subunit gene (C825T, cholecystokinin receptor (CCKAR gene 779T>C, and high-producer tumor necrosis factor genotype. Further studies are necessary to determine how genetic factors influence the clinical manifestations and therapeutical response in IBS patients.

  15. [Quality of care in inflammatory bowel disease].

    Science.gov (United States)

    Seo, Geom Seog

    2015-03-01

    Since inflammatory bowel disease (IBD) is a chronic and relapsing disorder, maintaining high quality of care plays an important role in the management of patients with IBD. To develop process-based quality indicator set to improve quality of care, the indicator should be based directly on evidence and consensus. Initially, ImproveCareNow group demonstrated quality improvement by learning how to apply quality improvement methods to improve the care of pediatric patients with IBD. The American Gastroenterological Association has developed adult IBD physician performance measures set and Crohn's and Colitis Foundation of America (CCFA) has developed a set of ten most highly rated process and outcome measures. Recently, The Emerging Practice in IBD Collaborative (EPIC) group generated defining quality indicators for best-practice management of IBD in Canada. Quality of Care through the Patient's Eyes (QUOTE-IBD) was developed as a questionnaire to measure quality of care through the eyes of patients with IBD, and it is widely used in European countries. The current concept of quality of care as well as quality indicator will be discussed in this article. PMID:25797376

  16. Molecular forms of trefoil factor 1 in normal gastric mucosa and its expression in normal and abnormal gastric tissues

    OpenAIRE

    Ren, Jian-Lin; Luo, Jin-Yan; Lu, Ya-Pi; Wang, Lin; Shi, Hua-Xiu

    2006-01-01

    AIM: To study the molecular forms of trefoil factor 1 (TFF1) in normal gastric mucosa and its expression in normal and abnormal gastric tissues (gastric carcinoma, atypical hyperplasia and intestinalized gastric mucosa) and the role of TFF1 in the carcinogenesis and progression of gastric carcinoma and its molecular biological mechanism underlying gastric mucosa protection.

  17. Angiogénesis en lesiones premalignas y malignas de la mucosa bucal

    Scientific Electronic Library Online (English)

    Floribel, Cedeño; Paola, Tonino.

    2005-05-01

    Full Text Available Estabelecesse para baixo que o crescimento, a progressão e o metástasis dos tumores contínuos, constituem processos dependentes do angiogénesis (formação de embarcações de sangue novas dos capilares preexistentes). Na mucosa oral os ferimentos diversos ocorrem pré-malignas e malignas, quais foram us [...] ados como um modelo da progressão do tumor. No estudo atual a densidade vascular foi determinada, como uma medida da resposta do angiogénesis, nos grupos dos ferimentos com graus diferentes da displasia e dos carcinomas espinocelulares, por meio da quantificação de embarcações de sangue identificadas com fatorVIII de von Willebrand por técnicas do inmunohistoquímica. Os resultados revelaram um aumento na densidade vascular com severidade do diagnóstico. A densidade vascular (a média (desvio padrão) era menor no grupo ligeiro do displasia (12.70 (3.04), com um aumento progressivo em esse do displasia moderado (21.62(1.99), e destilador mais significativo no grupo severo do displasia (59.50(8.73) e carcinoma a espinocelular (60.62 (8.74). Não obstante, não as diferenças eram estatísticamente significativas (p = 0.05) no a densidade vascular entre o displasia pesa e modera, nem entre o displasia severo e os espinocelulares dos carcinomas. Estes achados sugerem-no angiogénesis, possivelmente acontece cedo no desenvolvimento do carcinogénesis oral, principalmente no displasia severo e no carcinoma. Abstract in spanish Se ha establecido que el crecimiento, la progresión y las metástasis de los tumores sólidos, constituyen procesos dependientes de la angiogénesis (formación de nuevos vasos sanguíneos a partir de capilares preexistentes). En la mucosa bucal se producen diversas lesiones premalignas y malignas, las c [...] uales se han empleado como un modelo de progresión tumoral. En el presente estudio se determinó la densidad vascular, como una medida de la respuesta angiogénica, en grupos de lesiones con diferentes grados de displasia y carcinomas espinocelulares, mediante la cuantificación de vasos sanguíneos identificados con el Factor VIII de von Willebrand por técnicas de inmunohistoquímica,. Los resultados revelaron un incremento en la densidad vascular con la severidad del diagnóstico. La densidad vascular (media ± desviación estándard) fue menor en el grupo de displasia leve (12.70 ± 3.04), con un progresivo incremento en el de displasia moderada (21.62 ± 1.99), y más significativo aún en el grupo de displasia severa (59.50 ± 8.73) y carcinoma espinocleular (60.62 ± 8.74). Sin embargo, no se encontraron diferencias estadísticamente significativas (p= 0,05) en la densidad vascular entre la displasia leve y moderada, ni entre la displasia severa y los carcinomas espinocelulares. Estos hallazgos sugieren que la angiogénesis, posiblemente ocurre tempranamente en el desarrollo de la carcinogénesis oral, principalmente en la displasia severa y carcinoma. Abstract in english It has been established that growth, progression and metastasis of solid tumors are processes angiogenesis-dependent (new blood vessels formation from preexistent capillaries). Several kind of premalignant and malignant lesions in the oral mucosa, has also been used as a model of tumor progression. [...] In the present study we determined the vascular density, as a measure of the angiogenesis response, in groups of lesion with differents grade of dysplasia and squamous carcinomas, through the quantification of blood vessels identified with the von Willebrand Factor VIII by immunohistochemistry techniques. Results revealed an increase in the vascular density with the diagnosis severity. The vascular density (media ± standard deviation) was lower in the group of mild dysplasia (12.70 ± 3.04), with a progressive increase in the moderate dysplasia (21.62 ± 1.99), and furthermore significative in the group of severe dysplasia (59.50 ± 8.73) and squamous carcinoma (60.62 ± 8.74). However, no statistically significant differences (p= 0.05) were found in the vascular density either betw

  18. Evaluation of diagnosis and surgical therapy in cases with acute mechanical bowel obstruction due to colon carcinoma

    Directory of Open Access Journals (Sweden)

    Mustafa Uygar Kalayc?

    2005-01-01

    Full Text Available Objective: Acute mechanical large bowel obstructions comprise 15% of colorectal emergencies as well as 30% of hospital admittance due to colon carcinoma. Surgical therapy options are still debatable. Morbidity and mortality rates are high in elderly cases with comorbid diseases. The aim of this study is to evaluate the surgical therapy options in cases presenting with mechanical large bowel obstructions due to colon carcinoma. Material and Methods: Thirty-two cases with acute mechanical large bowel obstruction presenting with abdominal pain, nausea and vomiting among 184 cases operated for colon carcinoma between March 2003 and November 2005 were included in this retrospective study. Age, gender, presenting symptoms on admittance, presence of comorbid diseases, diagnosis, adjuvant treatment options, type of surgical and endoscopic therapy, and results were evaluated. Results: Female to male ratio was 12/20 with a mean age of 58 (48-85. Twenty-one cases had (65.6% comorbid diseases. Emergency colonoscopy was performed in 19 cases (59.3% to confirm the diagnosis. Type of surgical procedure performed was sigmoid resection in 14 cases (43.7%, right hemicolectomy in 7 cases (21.8%, and subtotal colectomy in 5 cases (15.6%. In 11 of these cases (34.3% primary anastomosis was performed whereas either colostomy or ileostomy was performed in the remaining 15 cases (46.8%. Stent placement was applied to 6 cases (18.7%. The morbidity rate was 37.5% (12 cases with 6 of them being major complications occurring in the abdomen. Mean hospital stay was 11.9 (3-25 days. The mortality rate was 15.6% (5 cases. Conclusion: There are several treatment options in the therapy of acute mechanical large bowel obstructions. Emergency colonoscopy is beneficial in diagnosis and selection of the appropriate treatment. Primary anastomosis, colostomy or stent placements are the favorite options according to the condition of the cases.

  19. Cytologic alterations in the oral mucosa after chronic exposure to ethanol Alterações citológicas na mucosa bucal após exposição crônica ao etanol

    Directory of Open Access Journals (Sweden)

    Sílvia Regina de Almeida Reis

    2006-04-01

    Full Text Available The effects of ethanol alone on the oral mucosa are still poorly understood, especially because there are few non-smoking chronic consumers of alcoholic beverages. The aim of this study was to evaluate the frequency of micronucleus, abnormal nucleus/cytoplasm ratio, pyknosis, karyorrhexis and karyolysis in exfoliated cells from the buccal mucosa and from the lateral border of the tongue in 36 non-smoker alcoholics (ethanol group and 18 non-smokers and non-drinkers (control group. The Papanicolaou method was used. Since alcoholics generally have hepatobiliary involvement, the association between serum gamma-glutamyl transpeptidase (GGT and some of the analyzed oral mucosa alterations was also investigated. The ethanol group showed a significant increase in the frequency of all alterations analyzed in the tongue cells when compared with the control group (p 0.05; Mann-Whitney. In the ethanol group, the correlation between serum GGT and the frequency of micronucleus and abnormal nucleus/cytoplasm ratio in oral mucosa cells was not significant (p > 0.05; Spearman. In conclusion, chronic exposure to ethanol may be associated with carcinogenic cytologic changes in the oral mucosa, even in the absence of tobacco smoking. These alterations were not correlated with hepatobiliary injury.Os efeitos do etanol isoladamente sobre a mucosa bucal permanecem pouco esclarecidos, sobretudo devido ao baixo número de não-fumantes consumidores crônicos de bebidas alcoólicas. O objetivo deste estudo foi avaliar as freqüências de micronúcleo, relação núcleo/citoplasma anormal, picnose, cariorrexe e cariólise em células esfoliadas da mucosa jugal e do bordo lateral da língua de 36 alcoólatras não-fumantes (grupo etanol e 18 abstêmios de álcool e fumo (grupo controle. O método de Papanicolaou foi utilizado. Uma vez que indivíduos alcoólatras geralmente apresentam comprometimento hepatobiliar, a associação entre gama-glutamil transpeptidase (GGT sérica e algumas das alterações citológicas analisadas também foi investigada. O grupo etanol mostrou um aumento significativo nas freqüências de todas as alterações investigadas nas células da língua quando comparado ao grupo controle (p 0,05; Mann-Whitney. No grupo etanol, a correlação entre GGT sérica e as freqüências de micronúcleo e a relação núcleo/citoplasma anormal em células da mucosa bucal não foi significativa (p > 0,05; Spearman. Conclui-se que o consumo crônico de etanol pode estar associado a alterações citológicas carcinogênicas na mucosa bucal, mesmo na ausência de exposição ao fumo. Tais alterações não apresentaram correlação com o comprometimento hepatobiliar.

  20. Control of deoxyribonucleic acid synthesis in normal rabbit colonic mucosa.

    Science.gov (United States)

    Alpers, D H; Philpott, G W

    1975-10-01

    Although cyclic adenosine 3':5'-monophosphate (cyclic AMP, cAMP) is known to suppress DNA synthesis is cultured cells and experimental tumors, its role in normal intact tissue has been little explored. This study helps to define the influence of modifiers of cyclic AMP levels on DNA synthesis in rabbit colonic mucosa maintained in short term organ culture system. Base line studies showed that incorporation of [3H]thymidine into DNA was linear for 24 hr and predominantly in mucosal cells, as shown by autoradiography. Colon from a normal fed rabbit showed a gradient of DNA synthesis, lowest in the cecum and increasing to a maximum, 3-fold greater, at the splenic flexure. This pattern was obliterated by fasting, at which time no formed stool remained in the colon, and all colon mucosa incorporated thymidine at the lower level of the right colon. Known modifiers of intracellular cAMP were found to depress colonic DNA synthesis. Theophylline inhibited DNA synthesis by 35% at 0.5 mM concentration and increased intracellular cAMP levels. This inhibition took 10 hr to be manifest and was at least partly reversible. It was by far the most active of the methylxanthines, consistent with its potency as a phosphodiesterase inhibitor. N6,02-dibutyryl cyclic AMP inhibited DNA synthesis at concentrations as low as 0.025 mM, whereas adenosine and sodium butyrate were ineffective up to 1.0 mM. 5'-AMP did inhibit DNA synthesis, but only at 0.1 mM or higher and did not elevate intracellular cAMP levels. Other modifiers of cAMP which were effective included prostaglandins E1, E2, and F2alpha (2 times 10(-6) M) and papaverine (1 muM). Thymidine uptake was not affected by any of these drugs. The intrinsic thymidine pool was estimated at 20 muM by isotope dilution, and was not altered by theophylline. DNA synthesis in rabbit colon can be suppressed by increased cAMP levels within the time period allowed by organ culture. Thus, these drugs that elevated cAMP levels did not seem to suppress DNA synthesis by decreasing intracellular thymidine concentrations. PMID:170158

  1. Prevalence of inflammatory bowel disease in two districts of Sri Lanka: a hospital based survey

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    Satharasinghe Raveendra L

    2010-03-01

    Full Text Available Abstract Background Inflammatory bowel disease (IBD is being increasingly diagnosed in Asia. However there are few epidemiological data from the region. Methods To determine prevalence and clinical characteristics of IBD, a hospital-based survey was performed in the Colombo and Gampaha districts (combined population 4.5 million in Sri Lanka. Patients with established ulcerative colitis (UC and Crohn's disease (CD, who were permanent residents of these adjoining districts, were recruited from hospital registries and out-patient clinics. Clinical information was obtained from medical records and patient interviews. Results There were 295 cases of IBD (UC = 240, CD = 55, of which 34 (UC = 30, CD = 4 were newly diagnosed during the study year. The prevalence rate for UC was 5.3/100,000 (95% CI 5.0-5.6/100,000, and CD was 1.2/100,000 (95% CI 1.0-1.4/100,000. The incidence rates were 0.69/100,000 (95% CI 0.44-0.94/100,000 for UC and 0.09/100,000 (95% CI 0.002-0.18/100,000 for CD. Female:male ratios were 1.5 for UC and 1.0 for CD. Mean age at diagnosis was (males and females 36.6 and 38.1y for UC and 33.4 and 36.2y for CD. Among UC patients, 51.1% had proctitis and at presentation 58.4% had mild disease. 80% of CD patients had only large bowel involvement. Few patients had undergone surgery. Conclusions The prevalence of IBD in this population was low compared to Western populations, but similar to some in Asia. There was a female preponderance for UC. UC was mainly mild, distal or left-sided, while CD mainly involved the large bowel.

  2. Value of “protruding lips” sign in malignant bowel obstructions

    International Nuclear Information System (INIS)

    Objective: This study aims to evaluate the diagnostic accuracy of a new CT sign in order to define or exclude a malignant aetiology of bowel obstruction. Materials and methods: CT scans of 137 patients affected by bowel obstruction were reviewed. Colonic obstruction occurred in 47 (34%) cases, small bowel obstruction in 90 (66%). Neoplastic aetiology was found in 42 cases (31%), while in the remaining 95 (69%) obstruction was caused by non-neoplastic conditions. Definitive diagnosis was surgically confirmed in all patients. CT images were evaluated searching for bowel obstruction's signs and for the presence of the “protruding lips” sign on the proximal surface of stenosis, which is represented by the evidence of a protrusion within the dilated loop. Results: The sign was found in 31 (23%) cases, all of neoplastic origin. When malignant obstruction was diagnosed, sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy values of the described sign were 74%, 100%, 100%, 90% and 92%, respectively. Conclusions: The “protruding lips” sign represents an alteration to be searched when bowel obstruction is diagnosed by CT examination. Its evidence correlates to a malignant condition with a 100% probability and when it is not found, the probability of a non-neoplastic condition is 90%.

  3. Irritable bowel syndrome: the burden and unmet needs in Europe.

    LENUS (Irish Health Repository)

    Quigley, E M M

    2012-02-03

    Irritable bowel syndrome affects approximately 10-15% of the European population, although prevalence rates vary depending on the classification used and the country surveyed. This may be due to differences in patterns of medical care and diagnosis of the condition. Up to 70% of individuals with irritable bowel syndrome may not have been formally diagnosed. The disorder affects 1.5-3 times as many women as men and poses a significant economic burden in Europe, estimated at euro 700-euro 1600 per person per year. It also reduces quality of life and is associated with psychological distress, disturbed work and sleep, and sexual dysfunction. It is a chronic disorder, which affects many individuals for more than 10 years. Most patients are managed in primary care, although some are referred to gastroenterologists and other specialists. Patients with irritable bowel syndrome undergo more abdomino-pelvic surgery than the general population. We propose that a positive diagnosis of the condition may avoid the delay in diagnosis many patients experience. We conclude that, in Europe, there are significant unmet needs including lack of familiarity with irritable bowel syndrome, difficulties in diagnosis and lack of effective treatments for the multiple symptoms of the disorder. The development of pan-European guidelines for irritable bowel syndrome will benefit patients with this condition in Europe.

  4. Computed tomography of the bowel: A prospective comparison study between four techniques

    Energy Technology Data Exchange (ETDEWEB)

    Paparo, Francesco [Department of Radiology, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa (Italy); Garlaschi, Alessandro [School of Radiology, University of Genoa, Via Leon Battista Alberti 4, 16132 Genoa (Italy); Biscaldi, Ennio; Bacigalupo, Lorenzo [Department of Radiology, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa (Italy); Cevasco, Luca [School of Radiology, University of Genoa, Via Leon Battista Alberti 4, 16132 Genoa (Italy); Rollandi, Gian Andrea, E-mail: gianandrea.rollandi@galliera.it [Department of Radiology, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa (Italy)

    2013-01-15

    Objectives: The major objective was to prospectively compare the grade of bowel distension obtained with four different computed tomography (CT) techniques dedicated for the examination of the small intestine (CT enteroclysis [CTE] and enterography [CTe]), of the colon (CT with water enema [CT-WE]), or both (CTe with water enema [CTe-WE]). The secondary objective was to assess patients’ tolerance toward each CT protocol. Materials and methods: Recruitment was designed to obtain four groups of the same number of patients (30). Each group corresponded to a specific CT technique, for a total of 120 consecutive outpatients (65 male and 55 female, mean age 51.09 ± 13.36 years). CTE was performed after injection of methylcellulose through a nasojejunal tube, while in the CTe protocol a polyethylene glycol electrolyte solution was orally administered to patients prior to the CT acquisition. In the CT-WE protocol intraluminal contrast (water) was administered only by a rectal enema, while CTe-WE technique included both a rectal water enema and oral ingestion of neutral contrast material to obtain a simultaneous distension of small and large bowel. CT studies were reviewed in consensus by two gastrointestinal radiologists who performed a quantitative and qualitative analysis of bowel distension on a per segment basis. The presence and type of adverse effects were recorded. Results: CTE provided the best distension of jejunal loops (median diameter 27 mm, range 17–32 mm) when compared to all the other techniques (p < 0.0001). The frequency of patients with an adequate distension of the terminal ileum was not significantly different among the four groups (p = 0.0608). At both quantitative and qualitative analysis CT-WE and CTe-WE determined a greater and more consistent luminal filling of the large intestine than that provided by both CTE and CTe (p < 0.0001 for all colonic segments). Adverse effects were more frequent in patients belonging to the CTE group (p < 0.0028). Conclusions: CTE allows an optimal distension of jejunal loops, but it is the most uncomfortable CT protocol. When performing CT-WE, an adequate retrograde distension of the terminal ileum was provided in a particularly high percentage of patients. CTe-WE provides a simultaneous optimal distension of both small and large bowel.

  5. Computed tomography of the bowel: A prospective comparison study between four techniques

    International Nuclear Information System (INIS)

    Objectives: The major objective was to prospectively compare the grade of bowel distension obtained with four different computed tomography (CT) techniques dedicated for the examination of the small intestine (CT enteroclysis [CTE] and enterography [CTe]), of the colon (CT with water enema [CT-WE]), or both (CTe with water enema [CTe-WE]). The secondary objective was to assess patients’ tolerance toward each CT protocol. Materials and methods: Recruitment was designed to obtain four groups of the same number of patients (30). Each group corresponded to a specific CT technique, for a total of 120 consecutive outpatients (65 male and 55 female, mean age 51.09 ± 13.36 years). CTE was performed after injection of methylcellulose through a nasojejunal tube, while in the CTe protocol a polyethylene glycol electrolyte solution was orally administered to patients prior to the CT acquisition. In the CT-WE protocol intraluminal contrast (water) was administered only by a rectal enema, while CTe-WE technique included both a rectal water enema and oral ingestion of neutral contrast material to obtain a simultaneous distension of small and large bowel. CT studies were reviewed in consensus by two gastrointestinal radiologists who performed a quantitative and qualitative analysis of bowel distension on a per segment basis. The presence and type of adverse effects were recorded. Results: CTE provided the best distension of jejunal loops (median diameter 27 mm, range 17–32 mm) when compared to all the other techniques (p < 0.0001). The frequency of patients with an adequate distension of the terminal ileum was not significantly different among the four groups (p = 0.0608). At both quantitative and qualitative analysis CT-WE and CTe-WE determined a greater and more consistent luminal filling of the large intestine than that provided by both CTE and CTe (p < 0.0001 for all colonic segments). Adverse effects were more frequent in patients belonging to the CTE group (p < 0.0028). Conclusions: CTE allows an optimal distension of jejunal loops, but it is the most uncomfortable CT protocol. When performing CT-WE, an adequate retrograde distension of the terminal ileum was provided in a particularly high percentage of patients. CTe-WE provides a simultaneous optimal distension of both small and large bowel

  6. Biodistribution of the radiopharmaceutical sodium pertechnetate (Na99mTcO4) after massive small bowel resection in rats

    International Nuclear Information System (INIS)

    Purpose: To evaluate the biodistribution of sodium pertechnetate (Na99mTcO4) in organs and tissues, the morphometry of remnant intestinal mucosa and ponderal evolution in rats subjected to massive resection of the small intestine. Methods:Twenty-one Wistar rats were randomly divided into three groups of 7 animals each. The short bowel (SB) group was subjected to massive resection of the small intestine; the control group (C) rats were not operated on, and soft intestinal handling was performed in sham rats. The animals were weighed weekly. On the 30th postoperative day, 0.1 mL of Na99mTcO4, with mean activity of 0.66 MBq was injected intravenously into the orbital plexus. After 30 minutes, the rats were killed with an overdose of anesthetic, and fragments of the liver, spleen, pancreas, stomach, duodenum, small intestine, thyroid, lung, heart, kidney, bladder, muscle, femur and brain were harvested. The biopsies were washed with 0.9% NaCl.,The radioactivity was counted using Gamma Counter WizardTM 1470, Perkin-Elmer. The percentage of radioactivity per gram of tissue (%ATI/g) was calculated. Biopsies of the remaining jejunum were analysed by HE staining to obtain mucosal thickness. Analysis of variance (ANOVA) and the Tukey test for multiple comparisons were used, considering p99mTcO4 in the organs of the groups studied (p>0.05). An increase in the weight of the SB rats was observed after the second postoperative week. The jejunal mucosal thickness of the SB rats was significantly greater than that of C and sham rats (p99mTcO4 was not affected by massive intestinal resection, suggesting that short bowel syndrome is not the cause of misleading interpretation, if an examination using this radiopharmaceutical is indicated. (author)

  7. Inflammatory Bowel Disease (IBD and the Liver

    Directory of Open Access Journals (Sweden)

    A. B. Adamopoulos

    2007-04-01

    Full Text Available Hepatobiliary Diseases (HBDs accompanies in a 5-10% of patients with Inflammatory Bowel Diseases (IBD. They are either extra-intestinal manifestations or drug side effects. The main extra-intestinal manifestation is Primary Sclerosing Cholangitis (PSC, which as an entity, includes the former ?pericholangitis?, now called small duct Primary Sclerosing Cholangitis. It mainly affects young males with ulcerative colitis. It is a chronic cholestatic disease with a broad spectrum of clinical manifestations. The asymptomatic disease has a better prognosis than the symptomatic one. It eventually leads to cirrhosis and is the 4th cause of orthotopic liver transplantation. Cholangiocarcinoma is the most ominous complication and its presence is also accompanied by increased frequency of colon dysplasia or cancer. A less frequent complication is the ascending cholangitis with or without (pigmented biliary stones. Auto-immune Hepatitis (type-1 is another extra-intestinal manifestation of IBD, but its frequency seems to be very low under the new diagnostic criteria, compared to the frequency reported in previous publications. An overlap syndrome may also occur. Fatty liver is the commonest occurring liver disease, specially in patients with ulcerative colitis and is usually indolent. Uncommon manifestations include granulomas and granulomatous hepatitis, amyloidosis and hepatic abscesses. Biliary stones are often related to Crohn?s Disease, probablydue to altered bile component balance. Drugs used for the treatment of IBD may cause liver damage, either acute or chronic. Azathioprine and cyclosporine are newly recognized as such dings. Alertness, proper use and serial tests for monitoring the liver function and morphology can minimize their side effects. More sophisticated tests are not yet routine clinical practice.

  8. Maintenance treatment in Inflammatory Bowel Disease (IBD

    Directory of Open Access Journals (Sweden)

    C. Markoglou

    2007-04-01

    Full Text Available Ulcerative colitis and Crohn's disease are complex disorders reflected by wide variation in clinical practice. Lifelong maintenance treatment is recommended for all patients with ulcerative colitis, especially those with left - sided or extensive disease and those with distal disease, who relapse more than once a year. Oral mesalazine 2g/day should be considered as first-line therapy. Steroids are not effective at maintaining remission. Azathioprine 1,5-2,5 mg/ kg/day or mercaptopurine 0,75-1,5 mg/kg/day should be reserved for patients who frequently relapse, despite adequate doses of aminosalicylates. Patients who have failed to respond to immunomodulators benefit from repeated maintenance therapy with infliximab, ideally on an every 8 week basis. The efficacy of drug therapy in the maintenance treatment of Crohn's disease depends on whether remission was achieved with medical or surgical therapy, on the risk of relapse and on the site of disease. Mesalazine seems to be ineffective at doses < 2 g/day. It is clearly ineffective for those who have needed steroids to induce remission. Azathioprine should be reserved as second line therapy. Steroid dependent patients and patients with steroid refractory disease should be considered for treatment with immunomodulators. Infliximab is effective at a dose of 5 mg/kg every 8 weeks in patients who have responded to the initial infusion. It is best used with immunomodulators. Moreover, it is the best evidenced-based therapy for the fistulating disease at the present time. Ulcerative colitis and Crohn's disease, collectively termed inflammatory bowel disease, are complex disorders reflected by wide variation in clinical practice.

  9. Serological markers of inflammatory bowel disease.

    Science.gov (United States)

    Kuna, Andrea Tesija

    2013-01-01

    Inflammatory bowel disease (IBD) is a heterogeneous group of chronic inflammatory disorders of the gastrointestinal tract with two main distinguishable entities, Crohn's disease (CD) and ulcerative colitis (UC). IBD-unclassified (IBD-U) is a diagnosis that covers the "grey" zone of diagnostic uncertainty between UC and CD. Current diagnosis of IBD relies on the clinical, endoscopic, radiological, histological and biochemical features, but this approach has shortcomings especially in cases of overlapping symptoms of CD and UC. The need for a diagnostic tool that would improve the conventional methods in IBD diagnosis directed the search towards potential immunological markers, since an aberrant immune response against microbial or endogenous antigens in a genetically susceptible host seems to be implicated in IBD pathogenesis. The spectrum of antibodies to different microbial antigens and autoantibodies associated with IBD is rapidly expanding. Most of these antibodies are associated with CD like anti-glycan antibodies: anti-Saccharomices cerevisiae (ASCA) and the recently described anti-laminaribioside (ALCA), anti-chitobioside (ACCA), anti-mannobioside (AMCA), anti-laminarin (anti-L) and anti-chitin (anti-C) antibodies; in addition to other antibodies that target microbial antigens: anti-outer membrane porin C (anti-OmpC), anti-Cbir1 flagellin and anti-12 antibody. Also, autoantibodies targeting the exocrine pancreas (PAB) were shown to be highly specific for CD. In contrast, UC has been associated with anti-neutrophil cytoplasmic autoantibodies (pANCA) and antibodies against goblet cells (GAB). Current evidence suggests that serologic panels of multiple antibodies are useful in differential diagnosis of CD versus UC and can be a valuable aid in stratifying patients according to disease phenotype and risk of complications. PMID:23457764

  10. Intravenous iron in inflammatory bowel disease

    Directory of Open Access Journals (Sweden)

    Manuel Muñoz, Susana Gómez-Ramírez, José Antonio García-Erce

    2009-10-01

    Full Text Available The prevalence of anemia across studies on patients with inflammatory bowel disease (IBD is high (30%. Both iron deficiency (ID and anemia of chronic disease contribute most to the development of anemia in IBD. The prevalence of ID is even higher (45%. Anemia and ID negatively impact the patient’s quality of life. Therefore, together with an adequate control of disease activity, iron replacement therapy should start as soon as anemia or ID is detected to attain a normal hemoglobin (Hb and iron status. Many patients will respond to oral iron, but compliance may be poor, whereas intravenous (IV compounds are safe, provide a faster Hb increase and iron store repletion, and presents a lower rate of treatment discontinuation. Absolute indications for IV iron treatment should include severe anemia, intolerance or inappropriate response to oral iron, severe intestinal disease activity, or use of an erythropoietic stimulating agent. Four different products are principally used in clinical practice, which differ in their pharmacokinetic properties and safety profiles: iron gluconate and iron sucrose (lower single doses, and iron dextran and ferric carboxymaltose (higher single doses. After the initial resolution of anemia and the repletion of iron stores, the patient’s hematological and iron parameters should be carefully and periodically monitored, and maintenance iron treatment should be provided as required. New IV preparations that allow for giving 1000-1500 mg in a single session, thus facilitating patient management, provide an excellent tool to prevent or treat anemia and ID in this patient population, which in turn avoids allogeneic blood transfusion and improves their quality of life.

  11. Transcriptional Analyses of Barrett's Metaplasia and Normal Upper GI Mucosae

    Directory of Open Access Journals (Sweden)

    Michael T. Barrett

    2002-01-01

    Full Text Available Over the last two decades, the incidence of esophageal adenocarcinoma (EA has increased dramatically in the US and Western Europe. It has been shown that EAs evolve from premalignant Barrett's esophagus (BE tissue by a process of clonal expansion and evolution. However, the molecular phenotype of the premalignant metaplasia, and its relationship to those of the normal upper gastrointestinal (GI mucosae, including gastric, duodenal, and squamous epithelium of the esophagus, has not been systematically characterized. Therefore, we used oligonucleotide-based microarrays to characterize gene expression profiles in each of these tissues. The similarity of BE to each of the normal tissues was compared using a series of computational approaches. Our analyses included esophageal squamous epithelium, which is present at the same anatomic site and exposed to similar conditions as Barrett's epithelium, duodenum that shares morphologic similarity to Barrett's epithelium, and adjacent gastric epithelium. There was a clear distinction among the expression profiles of gastric, duodenal, and squamous epithelium whereas the BE profiles showed considerable overlap with normal tissues. Furthermore, we identified clusters of genes that are specific to each of the tissues, to the Barrett's metaplastic epithelia, and a cluster of genes that was distinct between squamous and nonsquamous epithelia.

  12. Cytokeratin expression in human fetal tongue and buccal mucosa

    Indian Academy of Sciences (India)

    M M Vaidya; Sharda S Sawant; Anita M Borges; N K Naresh; Manda C Purandare; A N Bhisey

    2000-09-01

    Expression of cytokeratins (CK), a subset of intermediate filament (IF) proteins in epithelia, is developmentally regulated. CK expression may also change after malignant transformation. Our earlier studies on CK expression in human oral tumours and pre-cancerous lesions have shown specific changes in CK expression. We analysed CK expression in human tongue and buccal mucosa (BM) in fetuses in the embryonic age group of 16 to 27 weeks using biochemical and immunohistochemical techniques to find out whether there is any similarity in CK expression in human oral squamous cell carcinomas (SCC) and fetal oral tissues. CK 1, 8 and 18 were detected in a majority of samples using both techniques. Our earlier studies had shown aberrant expression of CK 1 and 18 in many of the oral SCC and leukoplakias. Studies by immunohistochemistry showed that these different CK antigens were expressed in different cell layers. CK 1(2) were present in the stratified epithelial layers whereas CK 8 and 18 were restricted to glandular epithelium. Till 27 weeks of gestation, both tongue and BM expressed CK 1, 8 and 18 along with CK 6 and 16. Thus, fetal tissues showed some similarities in CK pattern with their respective SCC.

  13. CT appearances of mucosa-associated lymphoid tissue (MALT) lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Kessar, P. [Dept. of Diagnostic Imaging, St. Bartholomew`s Hospital, London (United Kingdom); Norton, A. [Dept. of Pathology, St. Bartholomew`s Hospital, London (United Kingdom); Rohatiner, A.Z.S.; Lister, T.A. [ICRF Dept. of Medical Oncology, St. Bartholomew`s Hospital, London (United Kingdom); Reznek, R.H. [Academic Dept. of Radiology, St. Bartholomew`s Hospital, London (United Kingdom)

    1999-05-01

    Mucosa-associated lymphoid tissue (MALT) lymphoma is a low-grade lymphoma that differs from high-grade non-Hodgkin lymphoma both clinically and histologically. The CT appearances of MALT lymphoma are described. Of 40 patients referred with biopsy-proven MALT lymphoma, only seven had not had gastrectomy or chemotherapy prior to CT examination. The CT scans of these seven cases were analysed for the degree and extent of gastric wall thickening, enlargement of abdominal and extra-abdominal lymph nodes, and presence of extranodal disease. In all patients the stomach was distended with oral contrast medium and scans performed at narrow collimation, after intravenous administration of 20 mg hyoscine butylbromide. In six patients focal thickening of the gastric wall was 1 cm or less. One patient had thickening of over 4 cm. There was no enlargement of abdominal or extra-abdominal lymph nodes or extension to adjacent organs. Thus on CT, at presentation, MALT lymphoma results in minimal gastric wall thickening, unlike high-grade non-Hodgkin lymphoma, which typically causes bulky gastric disease, nodal enlargement and extension into adjacent organs. CT is therefore of limited value in monitoring response to treatment. With disease greater than minimal thickening, transformation to a higher grade should be considered. (orig.) With 4 figs., 1 tab., 28 refs.

  14. Irradiation of histiocytosis X confined to the oral mucosa

    International Nuclear Information System (INIS)

    Background: Histiocytosis X is a rare granulomatous disease and it is still under debate as to whether this disease has to be counted among malignant tumors or benign immunologic lesions. The typical localization is confined to the bone. In rare cases histiocytosis X may be localized in the oropharyngeal mucosa. Patients and Methods: We report about a case of a 75-year-old woman presenting with histiocytosis X lesions solely located in the oral cavity. A total dose of 19.5 Gy was administered without any side effects. Results: Two weeks after completion of irradiation a rapid regression of mucosal ulcerations and improvement of symptoms occurred. In a follow-up of 24 months the patient is still in complete remission observed. Conclusion: Review of the literature revealed only casuistic reports about solitary lesions of histiocytosis X without bone involvement in the adulthood. External beam radiotherapy with total doses between 10 and 20 Gy seems to be effective for local control of this disease. (orig.)

  15. The oral mucosa as a therapeutic target for xerostomia.

    Science.gov (United States)

    Thelin, W R; Brennan, M T; Lockhart, P B; Singh, M L; Fox, P C; Papas, A S; Boucher, R C

    2008-11-01

    Autoimmune disorders, medical interventions, and aging are all known to be associated with salivary gland hypofunction, which results in the uncomfortable feeling of dry mouth (xerostomia) and significantly diminished oral health. The current therapeutic regimen includes increasing oral hydration using over-the-counter oral comfort agents and the use of systemic cholinergic drugs to stimulate salivary output. However, these approaches produce very transient relief or are associated with uncomfortable side-effects. Thus, new treatments that provide long-lasting relief from discomfort and improve oral health with minimal side-effects would benefit the therapy of this disease. The processes that mediate fluid loss from the oral cavity, such as the absorption of fluid from the oral mucosa, represent novel therapeutic targets for xerostomia. Preventing fluid absorption from the oral cavity is predicted to improve oral hydration and alleviate the clinical symptoms and discomfort associated with dry mouth. Furthermore, therapeutic strategies that prevent fluid absorption should complement current approaches that increase salivary output. This review discusses the current understanding of oral fluid balance and how these processes may be manipulated to provide relief for those suffering from dry mouth. PMID:19193197

  16. Pain and paresthetic phenomenon of oral cavity mucosa

    Directory of Open Access Journals (Sweden)

    Dychko Ye.N.

    2013-03-01

    Full Text Available In the theoretical and practical dentistry, neurology and psychiatry, there is ambivalence about neurodental pathological processes, including glossalgia and glossodynia. In these patients persistent clinical signs, mainly in the oral cavity in the form of excruciating burning pain and paresthesias of the tongue occur. However, after a short period of time patient is immersed into a range of neurotic and psychiatric symptoms, main of them depressed mood, decreased work performance, cancerogenic phobia, insomnia, depression. Therefore, all neurodental diseases are falsely at¬tributed to severe neurological disease that requires special medical ap¬proach and a long follow-up. A well-designed health care complex allows to obtain a high performance - 60% to 80%, however, there remains a need in profound study of the nature glossalgia and glossodynia for targeted treatment. The study involved 205 patients with glossalgia and glossodynia in clinical, para-clinical and laboratory aspects. It was found that in most cases there is presence of chronic somatic diseases in case of sudden external stimuli (like trigger. Chronic diseases of the nervous, cardiovascular, endocrine and digestive system, often - their combination should be considered as main etiological factors neurodental pathological processes. However, irritation of the mechanical, chemical and thermal nature of the oral cavity are important. In the pathogenesis of the phenomenon the role of nerve, autonomic and cardiovascular disorders, especially at the level of the microcirculation of the oral mucosa is underlined. It is proposed to systematize glossalgia as sympathicotonic, vagotonic and mixed.

  17. Bowel ischemia and necrosis in anorexia nervosa: A case report and review of the literature

    OpenAIRE

    Neychev, Vladimir; Borruso, John

    2015-01-01

    Bowel ischemia and necrosis is an uncommon complication of anorexia nervosa.•We present a case of a 30 year old woman with long-standing AN complicated by ischemia and necrosis of the entire small bowel and the right hemicolon.•A high index of suspicion of bowel ischemia is necessary when patients with AN present with abdominal symptoms.•Timely diagnosis and treatment may prevent bowel necrosis and death.

  18. A pseudoneoplastic finding of deep endometriosis: laparoscopic triple segmental bowel resection

    OpenAIRE

    COSMA, STEFANO; Ceccaroni, Marcello; BENEDETTO, Chiara

    2014-01-01

    Bowel endometriosis affects 3–37% of patients with endometriosis, involving more frequently the rectum and the rectosigmoid junction. Severe endometriosis with bowel involvement is often refractory to standard medical therapy. For these reasons, surgery for bowel treatment is frequently needed. We report the case of a 36-year-old woman with deep endometriosis of the pelvis, triple segmental bowel involvement (recto-sigma, ileum-cecum, transverse colon) and massive endometriotic ascites with s...

  19. Genetic susceptibility and genotype-phenotype association in 588 Danish children with inflammatory bowel disease

    DEFF Research Database (Denmark)

    Jakobsen, C; Cleynen, I

    2014-01-01

    AIM: To investigate the association between known inflammatory bowel disease (IBD)-associated genetic variants and development of paediatric IBD, and specific clinical sub-phenotypes. MATERIAL AND METHODS: In this case-control study we included IBD patients <18years of age at diagnosis from the Danish National Patient Registry and healthy children <18years of age were randomly selected from the Danish Central Office of Civil Registration. The latter had filled out a questionnaire regarding health status, and DNA was obtained from blood samples and the buccal mucosa. Patient files were retrieved and clinical information was extracted. DNA was obtained from Guthrie cards from the Danish National Neonatal Screening Biobank (PKU-biobanken) at Statens Serum Institut and from blood samples. RESULTS: A total of 588 IBD patients (244 Crohn's disease (CD), 318 ulcerative colitis (UC) and 26 IBD-unclassified (IBDU)) and 543 healthy controls were included. We found an association between CD and rs22411880 (ATG16L1, odds ratio (OR)=1.7 [1.1-1.7], p=0.003), rs5743289 (NOD2, OR=1.4 [1.1-1.9], p=0.009) and the paediatric specific rs1250550 (ZMIZ1, OR=0.7 [0.5-0.9], p=0.01). None of the investigated 41 SNPs were associated with disease localisation, medical treatment or surgery after correcting for multiple analyses. CONCLUSION: We found an association between CD and three previously published genetic variants and replicated the association with the paediatric specific ZMIZ1 gene. No Bonferroni corrected significant genotype-phenotype associations were found. For future studies aimed at finding predictors for disease course in (paediatric) IBD, it will be worthwhile to include a combination of genetic, clinical and serological markers.

  20. [The relationship between inflammatory bowel disease (IBD) and complications of urinary and male genital tracts].

    Science.gov (United States)

    Yumura, Yasushi; Oota, Jun-Ichi; Fujikawa, Atsushi; Yokomizo, Yumiko; Moriyama, Masatoshi

    2009-11-01

    Crohn's disease (CD) and ulcerative colitis (UC) are inflammatory bowel diseases (IBD) that may often involve organs other than those of the gastrointestinal tract. We investigated retrospectively the frequency, diagnosis and treatment of urinary and male genital complications of CD and UC. From February 1998 to July 2007, 93 patients with CD and 75 patients with UC consulted our department for urinary and male genital complications. Thirty, 19 and 16 of the 93 patients with CD were diagnosed as having fistulas to the urinary and male genital systems, urolithiasis and hydronephrosis, respectively. Fifteen, 14 and 13 of the 75 patients with UC were diagnosed as having urolithiasis, urinary tract infection (UTI) and lower urinary tract symptoms (LUTS), respectively. Fistula to the urinary and male genital systems in CD occurred more often in men. In 22 CD patients who had undergone surgical operation and were definitively diagnosed as fistula, the positive rate of cystogram (CG) was 38.1% (8/21). They presented with pyuria (10 cases), pneumaturia (7), hematuria (7), fecaluria (2) and urorrhea (2). Cystoscopy was performed in 20 patients. Fistula opening in the urinary bladder was found in only 2 patients. Other findings in the bladder were edema (14 cases), redness of mucosa (6) and debris (3). Hydronephrosis in CD occurred in 16 patients. Placing a percutaneus nephrostomy (PNS) or ureteral stent was performed in 11 patients and surgical therapy was performed in 12 patients. Only two of the 34 patients with urolithiasis (CD 19, UC 15 cases) underwent ESWL and/or TUL. Almost all patients with UTI in UC were treated with antibiotics and improved, but one patient died from Fournier's Gangrene due to erirectal abscess. PMID:19946184