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1

Prebiotic carbohydrates modify the mucosa associated microflora of the human large bowel  

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Background and aims: The mucosa associated flora of the large intestine is important in determining mucosal function although what controls its composition is unknown. This study has determined the effect of the prebiotic carbohydrates oligofructose and inulin on the mucosal flora.

Langlands, S. J.; Hopkins, M. J.; Coleman, N.; Cummings, J. H.

2004-01-01

2

Kinetics of the non-neoplastic mucosa of the large bowel of dimethylhydrazine-treated rats.  

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Administration of 1,2 dimethylhydrazine (DMH) to rats by weekly s.c. injections causes the development of multiple epithelial tumours of the large bowel. These appear to arise as localized dysplastic abnormalities in hitherto apparently morphologically normal crypts. This study was undertaken in order to examine cell proliferation in such apparently normal crypts of DMH-treated animals. A number of proliferative abnormalities are evident, including changes in the size of the crypts, changes i...

Sunter, J. P.; Watson, A. J.; Appleton, D. R.

1981-01-01

3

Large bowel resection - discharge  

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Ascending colectomy - discharge; Descending colectomy - discharge; Transverse colectomy - discharge; Right hemicolectomy - discharge; Left hemicolectomy - discharge; Hand assisted bowel surgery - discharge; Low ...

4

Irritable bowel syndrome: is the colonic mucosa to blame?  

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Irritable bowel syndrome (IBS) is characterized by chronic abdominal pain or discomfort and altered gastrointestinal function of unknown etiology. Studies of colonic mucosal biopsies from patients with IBS have suggested altered immune system function as a potential mechanism in the pathophysiology of IBS, but efforts to identify the mucosal mediators responsible for the manifestation of symptoms that define the disorder have been limited. In this issue of Neurogastroenterology and Motility, Buhner et al. and Balestra et al. report findings from studies linking increased excitability of the enteric nervous system with mucosal mediators released from biopsies of patients with IBS. These studies provide evidence for the concept that mediators present in the colonic mucosa may contribute to the manifestation of clinical symptoms present in IBS. PMID:23176660

Hoffman, Jill M

2012-12-01

5

The presence of oncofoetal antigens in large bowel carcinoma.  

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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

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

1982-02-01

6

Modifications in ornithine decarboxylase and diamine oxidase in small bowel mucosa of starved and refed rats.  

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Starvation followed by refeeding, which provides a model of intestinal adaptation characterised by proliferative and biochemical changes, was used to clarify the biological roles of ornithine decarboxylase (ODC) and diamine oxidase (DAO)--enzymes involved in polyamines metabolism. Ornithine decarboxylase and DAO were assayed in the proximal and distal small bowel mucosa of 55 rats, starved for four days and then refed. Rats (five per day) were killed after four days' starvation and at days 1,...

D Agostino, L.; Daniele, B.; Pignata, S.; Barone, M. V.; D Argenio, G.; Mazzacca, G.

1987-01-01

7

Actinomycosis simulating malignant large bowel obstruction  

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Full Text Available We present a case of a 58 year old white male who entered the hospital with abdominal pain and developed large bowel obstruction, simulating malignant disease. Anatomopathological examination showed abdominal actinomycosis, a rare presentation of this disease.

José Augusto Ferreira Bittencourt

2004-04-01

8

Actinomycosis simulating malignant large bowel obstruction.  

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We present a case of a 58 year old white male who entered the hospital with abdominal pain and developed large bowel obstruction, simulating malignant disease. Anatomopathological examination showed abdominal actinomycosis, a rare presentation of this disease. PMID:15361999

Bittencourt, José Augusto Ferreira; Andreis, Elmes Luiz; Lima, Eduardo Lahude; Dorn, Dalvani Elias; Muller, Virgínia

2004-04-01

9

Actinomycosis simulating malignant large bowel obstruction  

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We present a case of a 58 year old white male who entered the hospital with abdominal pain and developed large bowel obstruction, simulating malignant disease. Anatomopathological examination showed abdominal actinomycosis, a rare presentation of this disease.

José Augusto Ferreira Bittencourt; Elmes Luiz Andreis; Eduardo Lahude Lima; Dalvani Elias Dorn; Virgínia Muller

2004-01-01

10

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

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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

11

Large bowel injuries during gynecological laparoscopy  

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Laparoscopy is one of the most frequently preferred surgical options in gynecological surgery and has advantages over laparotomy, including smaller surgical scars, faster recovery, less pain and earlier return of bowel functions. Generally, it is also accepted as safe and effective and patients tolerate it well. However, it is still an intra-abdominal procedure and has the similar potential risks of laparotomy, including injury of a vital structure, bleeding and infection. Besides the well-known risks of open surgery, laparoscopy also has its own unique risks related to abdominal access methods, pneumoperitoneum created to provide adequate operative space and the energy modalities used during the procedures. Bowel, bladder or major blood vessel injuries and passage of gas into the intravascular space may result from laparoscopic surgical technique. In addition, the risks of aspiration, respiratory dysfunction and cardiovascular dysfunction increase during laparoscopy. Large bowel injuries during laparoscopy are serious complications because 50% of bowel injuries and 60% of visceral injuries are undiagnosed at the time of primary surgery. A missed or delayed diagnosis increases the risk of bowel perforation and consequently sepsis and even death. In this paper, we aim to focus on large bowel injuries that happen during gynecological laparoscopy and review their diagnostic and management options. PMID:25516859

Ülker, Kahraman; Anuk, Turgut; Bozkurt, Murat; Karasu, Yetkin

2014-01-01

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

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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)

13

Actinomycosis simulating malignant large bowel obstruction  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english We present a case of a 58 year old white male who entered the hospital with abdominal pain and developed large bowel obstruction, simulating malignant disease. Anatomopathological examination showed abdominal actinomycosis, a rare presentation of this disease. [...

José Augusto Ferreira, Bittencourt; Elmes Luiz, Andreis; Eduardo Lahude, Lima; Dalvani Elias, Dorn; Virgínia, Muller.

2004-04-01

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Plasma cells in the mucosa of patients with inflammatory bowel disease produce granzyme B and possess cytotoxic activities.  

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In both Crohn's disease (CD) and ulcerative colitis (UC), the gut is massively infiltrated with B cells and plasma cells, but the role of these cell types in the pathogenesis of gut tissue damage remains largely unknown. Human B cells express granzyme B (GrB) when cultured with IL-21, a cytokine overproduced in CD and UC mucosa. We therefore examined whether mucosal B cells express GrB and have cytotoxic activity in inflammatory bowel disease (IBD). GrB-expressing CD19(+) and IgA(+) cells were seen in the normal intestinal mucosa, but they were significantly more frequent in both CD and UC. In contrast, only a minority of CD19(+) and IgA(+) cells expressed perforin with no difference between IBD and controls. GrB-producing CD19(+) cells expressed CD27 and were CD38(high) and CD20 negative. CD19(+) B cells from IBD patients induced HCT-116 cell death. IL-21 enhanced GrB expression in control CD19(+) B cells and increased their cytotoxic activity. These data indicate that IBD-related inflammation is marked by mucosal accumulation of cytotoxic, GrB-expressing CD19(+) and IgA(+) cells, suggesting a role for these cells in IBD-associated epithelial damage. PMID:24835396

Cupi, Maria Laura; Sarra, Massimiliano; Marafini, Irene; Monteleone, Ivan; Franzè, Eleonora; Ortenzi, Angela; Colantoni, Alfredo; Sica, Giuseppe; Sileri, Pierpaolo; Rosado, M Manuela; Carsetti, Rita; MacDonald, Thomas T; Pallone, Francesco; Monteleone, Giovanni

2014-06-15

15

Characteristics of fecal and mucosa-associated microbiota in Chinese patients with inflammatory bowel disease.  

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The intestinal microbiota plays an important role in the pathogenesis of inflammatory bowel disease (IBD), and geographical and genetic backgrounds impact the composition of the intestinal microbiota. However, there is a lack of evidence regarding the overall changes and characteristics of fecal-associated microbiota (FAM) and mucosa-associated microbiota (MAM) in Chinese patients with IBD. We recruited 26 patients with Crohn's disease (CD), 46 patients with ulcerative colitis (UC), and 21 healthy individuals; we collected matched fresh fecal and mucosal samples from the same subjects. The microbial communities were studied by 454-pyrosequencing. Community-wide changes in FAM and MAM were observed in patients with IBD. The proportion of several butyrate-producing bacteria, such as of the genera Roseburia, Coprococcus, and Ruminococcus were significantly reduced, whereas the pathogens Escherichia-Shigella and Enterococcus were prevalent in patients with IBD. FAM and MAM were similar between CD and UC. FAM differed from MAM in healthy individuals and patients with UC. In conclusion, the compositions of FAM and MAM were altered in patients with IBD. The reduction of butyrate-producing bacteria and the increase in opportunistic pathogens might be associated with the pathogenesis of IBD. PMID:25121355

Chen, Liping; Wang, Wei; Zhou, Rui; Ng, Siew C; Li, Jin; Huang, Meifang; Zhou, Feng; Wang, Xin; Shen, Bo; A Kamm, Michael; Wu, Kaichun; Xia, Bing

2014-08-01

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

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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

Ricanek P

2015-01-01

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Large bowel obstruction due to gallstones: an endoscopic problem?  

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A 73-year-old man was admitted with symptoms of large bowel obstruction. An emergency CT scan revealed pneumobilia and large bowel obstruction at the level of the rectosigmoid due to a 4×4 cm impacted gallstone. Flexible sigmoidoscopy confirmed the diagnosis but initial attempts to drag the stone into the rectum failed. An endoscopic mechanical lithotripter was employed to repeatedly fracture the gallstone into smaller fragments, which were passed spontaneously the next day. The patient made a complete recovery avoiding the potential dangers of surgery. This case report discusses cholecystoenteric fistula and a novel minimally invasive treatment for large bowel obstruction due to gallstones. PMID:24390966

Waterland, Peter; Khan, Faisal Shehzaad; Durkin, Damien

2014-01-01

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Large bowel and small bowel obstruction due to gallstones in the same patient  

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This is the case report of an 85-year-old woman who on two consecutive occasions presented with acute abdominal pain. The first presentation was large bowel obstruction. CT abdomen revealed this was due to a cholecystocolic fistula, allowing a large gallstone to pass and obstruct in the sigmoid colon. The second presentation was after laparotomy; the second CT abdomen revealed another gallstone causing small bowel obstruction. This case is interesting because cholelithiasis rarely leads to sigmoid colon obstruction (gallstone coleus)1 and gallstone ileus. Unfortunately, this patient had both. A gallstone causing obstruction in either the small or large bowel is rare, but occurrence of both in the same patient has not been reported to date. This case also shows how the elderly unwell surgical patient was mismanaged and she could have been spared surgery and irradiation if she was managed appropriately from the start. PMID:22696674

Ranga, Natasha

2011-01-01

19

Anastomotic disruption after large bowel resection.  

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Anastomotic disruption is a feared and serious complication of colon surgery. Decades of research have identified factors favoring successful healing of anastomoses as well as risk factors for anastomotic disruption. However, some factors, such as the role of mechanical bowel preparation, remain controversial. Despite proper caution and excellent surgical technique, some anastomotic leaks are inevitable. The rapid identification of anastomotic leaks and the timely treatment in these cases are paramount. PMID:16688793

Nasirkhan, Mohammad U; Abir, Farshad; Longo, Walter; Kozol, Robert

2006-04-28

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Anastomotic disruption after large bowel resection  

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Anastomotic disruption is a feared and serious complication of colon surgery. Decades of research have identified factors favoring successful healing of anastomoses as well as risk factors for anastomotic disruption. However, some factors, such as the role of mechanical bowel preparation, remain controversial. Despite proper caution and excellent surgical technique, some anastomotic leaks are inevitable. The rapid identification of anastomotic leaks and the timely treatment in these cases are...

Nasirkhan, Mohammad U.; Abir, Farshad; Longo, Walter; Kozol, Robert

2006-01-01

 
 
 
 
21

Large bowel obstruction due to impaction of a gallstone.  

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Gallstone ileus is a complication of cholelithiasis resulting from a fistula between the gallbladder and the gastrointestinal tract. If sufficiently large, a gallstone may lodge at the narrowest part of the gastrointestinal tract, usually the terminal ileum, and present with small bowel obstruction. Here the authors present the unusual case of an 82-year-old man who developed symptoms and signs of large bowel obstruction due to an untreated gallstone, measuring 7×4.5 cm, that fistulated into the transvere colon and subsequently impacted in the sigmoid colon. An emergency laparotomy with sigmoid colotomy was undertaken to remove the obstructing gallstone, and the patient made a full recovery. PMID:22665402

Athwal, Tejinderjit Singh; Howard, Nicholas; Belfield, Jane; Gur, Ufuk

2012-01-01

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Emergency surgery for large bowel obstruction caused by cancer.  

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There are several options for surgical treatment of large bowel obstruction caused by cancer, depending on location of obstruction, intraoperative local findings (perforation, peritonitis, bowel dilatation proximal to obstruction) and patients' condition. Resection and anastomosis as one stage surgery would be prefered procedure. Anastomotic leakage, on the other hand, highly elevates risk of mortality and mobidity. The most important question is whether to, in resectable cases, perform primary resection with anastomosis or not. This study was retrospective and included 40 patients that have undergone emergency surgery for large bowel obstruction caused by cancer. According to whether resection and anastomosis was made at initial surgery or not, patients were grouped in group A (N = 18) and group B (N = 21), respectively. We have analysed the type of surgical procedure, days of hospitalization, mortality, anastomotic leakeage, wound infection and other postoperative complications. Our results show that there is no major difference in mortality and morbidity in these two groups, suggesting that for selected patients primary resection and anastomosis is a safe option of tratment with acceptable risk. Since there are no strict guidelines or scorring system which would point the tratment option the decision about the choice of procedure still remains the burden of surgeon and depends on its experience and subspeciality. Our experience recomends primary resection and anastomosis except in cases of bowel perforation on tumor site, in cases of extreme dilatation and atony of bowel proximal to obstruction site and severe hypoproteinemia and anemia. PMID:24851603

Busi?, Zeljko; Cupurdija, Kristijan; Kolovrat, Marijan; Servis, Drazen; Ami?, Fedor; Cavka, Mislav; Patrlj, Leonardo; Nikoli?, Igor; Cavka, Vlatka

2014-03-01

23

A case of duplication of the large bowel  

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Large bowel duplication is known to be a rare congenital anomaly, which could be a difficult diagnostic problem for radiologist. The authors report a case which is the type 2 according to the modified classification from Smith. Clinical, pathological and radiological findings are reviewed

24

Adult large bowel obstruction: A review of clinical experience  

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Full Text Available Background : Adult large bowel obstruction is an infrequent cause of acute obstruction in Africa and India. The cause of obstruction varies between regions of the world. Current controversy concerns the surgical management of the acutely obstructed left colon. Materials and Methods : This is a prospective study of adult patients with acute large bowel obstruction over a 6-year period. The diagnosis of adult obstruction was made from a history of constipation, abdominal distension, abdominal pain, nausea, and radiographic features of large bowel obstruction. Laparotomy was performed on all patients after resuscitation. If the obstruction involved the right colon resection and primary ileo-colic anastomosis was performed, while for a lesion in the left colon a resection and primary colocolic anastomosis was performed after intraoperative antegrade colonic irrigation. If the obstructing lesions were thought to be malignant and too advanced to merit any excisional or the patient?s general condition was too poor to withstand resection, a biopsy was taken and a decompressive bypass procedure given pending the confirmation of the diagnosis. The clinical course and postoperative outcome were carefully documented. Results : A total of 50 patients aged 20-80 years, with a median age of 49 years, presented with features consistent with large bowel obstruction. Of these, 32 had simple sigmoid volvulus and were offered sigmoid colectomy and primary colorectal anastomosis, while 3 further patients with compound sigmoid volvulus had double resection with primary ileo-ileal and colorectal anastomosis. A patient with sigmoid volvulus had a Hartmann?s procedure. Twelve patients had colon cancer, four had left hemicolectomy and primary colocolic anastomosis; three, sigmoid colectomy and primary colorectal anastomosis; three, low anterior resection and primary colorectal anastomosis; one decompressive colostomy and one, a right hemicolectomy and primary ileocolic anastomosis. The two patients with functional obstruction (Ogilvie syndrome had tube caecostomy. All resections and primary anastomosis involving the right colon were preceded by antegrade on-table colonic lavage. One clinical anastomotic leak occurred in a low rectal anastomosis and minor wound infection in 10 patients. Operative mortality occurred in three patients with sigmoid volvulus. Conclusion : Adult large bowel obstruction is infrequent in our community and is caused commonly by sigmoid volvulus. Resection and primary anastomosis of the acute left-sided large bowel obstruction seems safe after antegrade on-table colonic lavage, provided bowel gangrene with peritonitis or any additional risk factor for anastomotic breakdown is not present.

Sule A

2011-03-01

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Microevolution in fimH Gene of Mucosa-Associated Escherichia coli Strains Isolated from Pediatric Patients with Inflammatory Bowel Disease  

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Several studies reported increased numbers of mucosa-associated Escherichia coli strains in patients with inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC). The majority of E. coli strains possess type 1 fimbriae, whose tip fibrillum protein, FimH, naturally undergoes amino acid replacements, an important process in the adaptation of commensal E. coli strains to environmental changes, like those observed in IBD and urinary tract infections. In thi...

Iebba, Valerio; Conte, Maria Pia; Lepanto, Maria Stefania; Di Nardo, Giovanni; Santangelo, Floriana; Aloi, Marina; Totino, Valentina; Checchi, Monica Proietti; Longhi, Catia; Cucchiara, Salvatore; Schippa, Serena

2012-01-01

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The Bowel Microbiota and Inflammatory Bowel Diseases  

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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.

Gerald W. Tannock

2010-01-01

27

Radiological diagnosis of large-bowel obstruction: nonneoplastic etiology.  

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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

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

2012-08-01

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Excretion of ciprofloxacin into the large bowel of the rabbit.  

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The intestinal elimination of ciprofloxacin in the large bowel was studied in a rabbit model. Segments from the cecum, colon, and sigmoid colon along with their intact blood vessels were isolated and perfused, and their contents were collected over a 90-min period following the administration of a single parenteral dose of 27 mg of ciprofloxacin per kg of body weight. The elimination rates of ciprofloxacin were 0.126 +/- 0.084 micrograms.min-1.cm-2 in the cecum and 0.264 +/- 0.126, 0.11 +/- 0...

Ramon, J.; Dautrey, S.; Farinoti, R.; Carbon, C.; Rubinstein, E.

1996-01-01

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The double contrast examination in inflammatory large bowel disease  

International Nuclear Information System (INIS)

In a prospective clinical series of 2371 consecutive patients referred for double contrast examination (DCE) of the large bowel, 154 had clinical and/or radiographic signs of inflammatory disease. The patients were followed up from May 1976 until May 1981. At the time of interpretation of the roentgenograms, the radiologist was unaware of clinical and laboratory findings. In 31 patients, organ specimens were studied histologically and in 101 other multiple endoscopic biopsies were available. Basing on the clinical observations and the pathology reports, the accuracy of the DCE was calculated at 99%; the predictive value of a positive DCE at 92, and that of a negative DCE at 99%. (orig.)

30

Sarcomatous malignant peritoneal mesothelioma with large bowel involvement  

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Full Text Available Sarcomatous malignant peritoneal mesothelioma developing in the abdominal cavity is very rare, and little is known about its behavior. A 72-year-old woman was referred to our hospital with anemia and weight loss. Tumor marker levels were within normal limits. Abdominal computed tomography showed an 11¥7 cm tumor in the pelvis, with possible invasion of the large bowel. Colonoscopy revealed a tumor protruding into the cecal lumen with an ulceration of the cecal wall. Although malignancy was suspected, the histological type was not identified in the biopsy specimens. Right hemicolectomy and ileocolic anastomosis were performed as a treatment. A postoperative histopathological examination confirmed the initial diagnosis of malignant mesothelioma. Finally, immunohistochemical examination revealed a localized sarcomatous malignant peritoneal mesothelioma with regional lymph node metastases. The patient was followed up postoperatively as an outpatient, and local recurrence was detected in the abdominal cavity 11 months after surgery. In conclusion, localized malignant peritoneal mesothelioma, especially the sarcomatous type, with large bowel involvement is very rare. We should carefully consider the diagnosis and select adequate therapy, because little is known about the behavior of this disease.

Hironori Kaneko

2010-09-01

31

Combined small and large bowel MR imaging in patients with Crohn's disease: a feasibility study  

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MRI of the small bowel is a new method for the assessment of inflammatory bowel diseases. However, inflammatory bowel disease can affect both the small and large bowel. Therefore, our goal was to assess the feasibility of displaying the small bowel and colon simultaneously by MR imaging. Eighteen patients with inflammatory bowel disease were studied. For small bowel distension, patients ingested a solution containing mannitol and locust bean gum. Furthermore, the colon was rectally filled with water. MR examinations were performed on a 1.5-T system. Before and after intravenous gadolinium administration, a T1w data set was collected. All patients underwent conventional colonoscopy as a standard of reference. The oral ingestion and the rectal application of water allowed an assessment of the small bowel and colon in all patients. By means of MRI (endoscopy), 19 (13) inflamed bowel segments in the colon and terminal ileum were detected. Furthermore, eight additional inflammatory lesions in the jejunum and proximal ileum that had not been endoscopically accessible were found by MRI. The simultaneous display of the small and large bowel by MRI is feasible. Major advantages of the proposed MR concept are related to its non-invasive character as well as to the potential to visualize parts of the small bowel that cannot be reached by endoscopy. (orig.)

32

Radiological diagnosis of large-bowel obstruction: neoplastic etiology.  

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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

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

2013-01-01

33

The association between cancers of the small and large bowel.  

Science.gov (United States)

Malignant tumors of the small bowel are rare and little is known about their etiology, although adenocarcinomas share certain epidemiological features with colorectal cancer. This study investigated what cancers, if any, occurred as second neoplasms following adenocarcinomas, malignant carcinoid tumors, lymphomas, and sarcomas of the small bowel. For all 2581 cases of small bowel malignancy registered in one of the Surveillance, Epidemiology, and End-Results program areas, 1973-1988, the relative risk of a second malignancy was determined. The risk of colorectal cancer was increased following adenocarcinoma of the small bowel, and the risk of adenocarcinoma of the small bowel was increased following colorectal cancer in both males and females. This study also found an association between small bowel sarcomas and malignant melanoma in males, consistent with earlier studies, and an association between prostate cancer and malignant carcinoid tumors of the small bowel, a new observation. We conclude that adenocarcinomas of the small bowel may share risk factors with colorectal cancer. PMID:8268772

Neugut, A I; Santos, J

1993-01-01

34

Large bowel mucosal dysplasia and carcinoma in ulcerative colitis.  

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The clinicopathological details of eight cases of ulcerative colitis complicated by carcinoma of the colon are described. There was a total of 14 primary colonic cancers, six of which were not detected before pathological examination of the resection specimens. The reason for this may be related to atypical tumour growth patterns. Three occurred in flat mucosa, one in a mucosal plaque lesion, and another in polypoidal mucosa. The occurrence, distribution, and morphology of mucosal dysplasia w...

Allen, D. C.; Biggart, J. D.; Pyper, P. C.

1985-01-01

35

Gallstone Ileus of the Sigmoid Colon: An Unusual Cause of Large-Bowel Obstruction  

Directory of Open Access Journals (Sweden)

Full Text Available Gallstone ileus of the colon is an exceedingly rare cause of large-bowel obstruction. It is usually the result of fistula formation between the gallbladder and large bowel facilitating entry of the stone into gastrointestinal tract. Contrast enhanced abdominal computed tomography is an important diagnostic aid. Surgical management is the treatment of choice to prevent the disastrous complications of large-bowel obstruction. We describe the case of a 92-year-old man who presented with symptoms and signs of large-bowel obstruction. Radiological investigation showed a large gallstone impacted in the sigmoid colon. Open enterolithotomy was undertaken relieving the obstruction and the patient made a full recovery.

Andrzej Goscimski

2010-01-01

36

Sclerosing mesenteritis: A rare case of large bowel and rectum involvement.  

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Sclerosing mesenteritis (SM) is an uncommon non-neoplastic inflammatory process in the mesentery that is seen as a pseudotumour, usually involving the small-bowel mesentery and, less commonly, the mesentery of the large bowel. The disease has two well-established histological types: the acute or sub-acute form known as mesenteric panniculitis and the chronic form known as retractile or SM. Because SM lacks special clinical manifestation and typical signs, the possibility of misdiagnosis is very high. The correct diagnosis of SM depends on pathological examination. Here in, we report a case of a 41-year-old male patient with SM of the large bowel. PMID:22980600

Naser, Mahmoud; Dabeh, Maamoun

2012-06-01

37

MECHANICAL LARGE BOWEL OBSTRUCTION DUE TO APRICOT SEED: A RARE CAUSE OF INTESTINAL OBSTRUCTION. CASE REPORT  

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Phytobezoar which is a condition that appears everywhere in the world is very rare cause of the large bowel obstruction. In this case report, a patient with mechanical large bowel obstruction due to apricot seed swallowing is presented. A 35 year-old man admitted to our hospital, suffering from stomach pain, constipation, distension for 15 days. At radiological examinations mass wasn't been detected. At endoscopic examinations, narrowing of the lumen was observed at the ascending colon level ...

Ertu?rul Gür; Orhan ?ad; Gülen Do?usoy; Ahmet Midi

2008-01-01

38

Large bowel mucosal dysplasia and carcinoma in ulcerative colitis.  

Science.gov (United States)

The clinicopathological details of eight cases of ulcerative colitis complicated by carcinoma of the colon are described. There was a total of 14 primary colonic cancers, six of which were not detected before pathological examination of the resection specimens. The reason for this may be related to atypical tumour growth patterns. Three occurred in flat mucosa, one in a mucosal plaque lesion, and another in polypoidal mucosa. The occurrence, distribution, and morphology of mucosal dysplasia were noted in both resection specimens and biopsies taken at varying stages before resection. Tumour was associated with normal and adjacent dysplastic mucosa of varying grades. The extent and grade of dysplasia were not reliable indicators of tumour differentiation or subsequent clinical outcome. Only two cancers were poorly differentiated. In five cases a total of 23 mucosal biopsies were taken, all less than 12 months before resection. Three rectal biopsies were graded positive for dysplasia and three colonic biopsies indefinite for dysplasia. The subsequent resection specimens showed both dysplastic and carcinomatous changes. Three rectal and 14 colonic biopsies were graded negative for dysplasia despite positive findings in the subsequent resection specimens. This anomaly is partly attributed to the patchy nature of dysplasia in colitic mucosa. Two cases illustrate the possibility of dysplasia pursuing a rapidly progressive course. The mucosal changes of ulcerative colitis were assessed using a recently introduced and standardised international classification. PMID:3968207

Allen, D C; Biggart, J D; Pyper, P C

1985-01-01

39

[Functional and morphological studies on diverticulosis of the large bowel].  

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In comparison to the normal colon, longitudinal and circular musculature in diverticular disease (DD) was investigated--regarding motility and morphology--and a comparative measurement between musculature and mucosa was also performed with following results: 1. Only the tenia in DD revealed a spastically contracted muscle. 2. There was a ribbon formation due to contraction only in tenias of DD, although there was hypertrophy in both muscle groups. 3. The longitudinal muscle in DD was found to be shortened. PMID:456121

Raguse, T; Bubenzer, J

1979-01-01

40

Intake of Polyunsaturated Fatty Acids and Distal Large Bowel Cancer Risk in Whites and African Americans  

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Long-chain ?-3 polyunsaturated fatty acids (PUFAs) may have antineoplastic properties in the colon. The authors examined the association between intakes of different PUFAs and distal large bowel cancer in a population-based case-control study of 1,503 whites (716 cases; 787 controls) and 369 African Americans (213 cases; 156 controls) in North Carolina (2001–2006). Unconditional logistic regression was used to estimate odds ratios and 95% confidence intervals for distal large bowel cancer risk in relation to quartiles of PUFA intake. Increased consumption of long-chain ?-3 PUFAs was associated with reduced risk of distal large bowel cancer in whites (multivariable odds ratios = 0.88 (95% confidence interval (CI): 0.63, 1.22), 0.69 (95% CI: 0.49, 0.98), and 0.49 (95% CI: 0.34, 0.71) for second, third, and highest vs. lowest quartile) (Ptrend < 0.01). Intake of individual eicosapentaenoic acids and docosahexaenoic acids was inversely related to distal large bowel cancer risk, whereas the ratio of ?-6 to long-chain ?-3 PUFAs was associated with increased risk of distal large bowel cancer in whites, but not among African Americans (Pinteraction < 0.05). Study results support the hypothesis that long-chain ?-3 PUFAs have beneficial effects in colorectal carcinogenesis. Whether or not the possible benefit of long-chain ?-3 PUFAs varies by race warrants further evaluation. PMID:20392864

Kim, Sangmi; Sandler, Dale P.; Galanko, Joseph; Martin, Christopher; Sandler, Robert S.

2010-01-01

 
 
 
 
41

The role of the colonic flora in maintaining a healthy large bowel mucosa.  

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This work explores the intricate relationships between bacterial products of fermentation, the short chain fatty acids and the effect that these have on the colonic epithelium and the immune system. It confirms that butyrate is a major energy source for the colonic epithelium and there may be a minor epithelial abnormality in the metabolism of butyrate in patients with ulcerative colitis. Immunological studies suggest that butyrate has an effect on lymphocyte activation and inhibits cell prol...

Chapman, M. A.

2001-01-01

42

Combined small and large bowel MR imaging in patients with Crohn's disease: a feasibility study  

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MRI of the small bowel is a new method for the assessment of inflammatory bowel diseases. However, inflammatory bowel disease can affect both the small and large bowel. Therefore, our goal was to assess the feasibility of displaying the small bowel and colon simultaneously by MR imaging. Eighteen patients with inflammatory bowel disease were studied. For small bowel distension, patients ingested a solution containing mannitol and locust bean gum. Furthermore, the colon was rectally filled with water. MR examinations were performed on a 1.5-T system. Before and after intravenous gadolinium administration, a T1w data set was collected. All patients underwent conventional colonoscopy as a standard of reference. The oral ingestion and the rectal application of water allowed an assessment of the small bowel and colon in all patients. By means of MRI (endoscopy), 19 (13) inflamed bowel segments in the colon and terminal ileum were detected. Furthermore, eight additional inflammatory lesions in the jejunum and proximal ileum that had not been endoscopically accessible were found by MRI. The simultaneous display of the small and large bowel by MRI is feasible. Major advantages of the proposed MR concept are related to its non-invasive character as well as to the potential to visualize parts of the small bowel that cannot be reached by endoscopy. (orig.)

Narin, Burcu; Ajaj, Waleed; Goehde, Susanne; Lauenstein, Thomas C. [Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, 45122, Essen (Germany); Langhorst, Jost; Gerken, Guido [Department of Gastroenterology and Hepatology, University Hospital Essen, Essen (Germany); Akgoez, Haldun [Siyami Ersek Hastanesi, Istanbul (Turkey); Ruehm, Stefan G. [Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles (United States)

2004-09-01

43

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

Directory of Open Access Journals (Sweden)

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.

G. Marzocca

2009-11-01

44

RNA sequencing shows transcriptomic changes in rectosigmoid mucosa in patients with irritable bowel syndrome-diarrhea: a pilot case-control study.  

Science.gov (United States)

Our aim was to conduct a pilot case-control study of RNA expression profile using RNA sequencing of rectosigmoid mucosa of nine females with -diarrhea-predominant irritable bowel syndrome (IBS-D) with accelerated colonic transit and nine female healthy controls. Mucosal total RNA was isolated and purified, and next-generation pair-end sequencing was performed using Illumina TruSeq. Analysis was carried out using a targeted approach toward 12 genes previously associated with IBS and a hypothesis-generating approach. Of the 12 targeted genes tested, patients with IBS-D had decreased mRNA expression of TNFSF15 (fold change controls to IBS-D: 1.53, P = 0.01). Overall, up- and downregulated mRNA expressions of 21 genes (P = 10(-5) to 10(-8); P values with false detection rates are shown) were potentially relevant to IBS-D including the following: neurotransmitters [P2RY4 (P = 0.001), vasoactive intestinal peptide (VIP, P = 0.02)]; cytokines [CCL20 (P = 0.019)]; immune function [C4BPA complement cascade (P = 0.0187)]; interferon-related [IFIT3 (P = 0.016)]; mucosal repair and cell adhesion [trefoil protein (TFF1, P = 0.012)], retinol binding protein [RBP2 (P = 0.017)]; fibronectin (FN1, P = 0.009); and ion channel functions [guanylate cyclase (GUCA2B, P = 0.017), PDZ domain-containing protein 3 (PDZD3, P = 0.029)]. Ten genes associated with functions related to pathobiology of IBS-D were validated by RT-PCR. There was significant correlation in fold changes of the selected genes (Rs = 0.73, P = 0.013). Up- or downregulation of P2RY4, GUC2AB, RBP2, FNI, and C4BPA genes were confirmed on RT-PCR, which also revealed upregulation of farnesoid X receptor (FXR) and apical sodium-coupled bile acid transporter (IBAT/ASBT). RNA-Seq and RT-PCR analysis of rectosigmoid mucosa in IBS-D show transcriptome changes that provide the rationale for validation studies to explore the role of mucosal factors in the pathobiology of IBS-D. PMID:24763552

Camilleri, Michael; Carlson, Paula; Acosta, Andres; Busciglio, Irene; Nair, Asha A; Gibbons, Simon J; Farrugia, Gianrico; Klee, Eric W

2014-06-15

45

Chemoprevention by naturally occurring and synthetic agents in oral, liver, and large bowel carcinogenesis.  

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A number of naturally occurring compounds and several related synthetic agents were confirmed to exert chemopreventive properties against carcinogenesis in the digestive organs. Phenolic compounds, widely distributed as plant constituents, possess chemopreventive activities in tongue, liver, and large bowel of rodents. Of them, a simple phenolic protocatechuic acid seems to be a promising compound. Organosulfur compounds contained in the cruciferous vegetables and known to activate detoxifying enzymes are regarded as a candidate group for cancer preventive agents. We proved a strong protective effect of S-methylmethanethiosulfonate, a constituent in these vegetables, on azoxymethane (AOM)-induced large bowel carcinogenesis. Some oxygenated carotenoids (xanthophylls) are reported to have antitumor effects. Naturally occurring xanthophylls astaxanthin and canthaxanthin have considerable preventive activities on 4-nitroquinoline-1-oxide (4-NQO)-induced tongue carcinogenesis and AOM-induced large bowel carcinogenesis. A novel synthesized retinoidal butenolide, KYN-54, which suppresses large bowel as well as tongue carcinogenesis could be a useful agent for prevention of digestive organ cancers. Some trace elements are known to have anticarcinogenic effects. Magnesium hydroxide, a protective agent in colorectal carcinogenesis, inhibits c-myc expression and ornithine decarboxylase activity in the mucosal epithelium of the intestine. Our results show that many agents with preventive effects in tongue, liver, and large bowel control carcinogen-induced hyperproliferation of cells in these organs. Carcinogens used to induce large bowel cancers also induce apoptosis in the target sites. Telomerase activity is increased in the tissues of preneoplastic as well as neoplastic lesions in experimental models such as dimethylbenz[a]anthracene-induced oral carcinogenesis in hamsters. These could be useful biomarkers in studies for cancer chemoprevention. PMID:9591191

Mori, H; Tanaka, T; Sugie, S; Yoshimi, N; Kawamori, T; Hirose, Y; Ohnishi, M

1997-01-01

46

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

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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.)

Stranzinger, Enno [Inselspital Berne (University Hospital of Berne), Department of Diagnostic Radiology, Berne (Switzerland); University of Michigan Health System, Section of Pediatric Radiology, Ann Arbor, MI (United States); DiPietro, Michael A.; Yarram, Sai; Strouse, Peter J. [University of Michigan Health System, Section of Pediatric Radiology, Ann Arbor, MI (United States); Khalatbari, Shokoufeh [Michigan Institute for Clinical and Health Research (MIHR), Ann Arbor, MI (United States)

2009-01-15

47

A transmesenteric hernia in a child: gangrene of a long segment of small bowel through a large mesenteric defect.  

Science.gov (United States)

Intestinal obstruction is a common surgical emergency. Transmesenteric hernia is an unusual cause of bowel obstruction that may result in irreversible damage of the bowel and a fatal outcome. Once incarceration of the bowel occurs, strangulation and gangrene follow immediately. The mortality rate associated with this condition is about 15%, but in the presence of gangrene of the bowel, the mortality rate is more than 50%. An accurate preoperative diagnosis of a transmesenteric hernia is very difficult and rarely made. Therefore, in patients with small bowel obstruction, in the absence of a history of previous surgery to suggest adhesions or an external hernia, the possibility of a transmesenteric hernia must be considered. We describe a case with gangrene of a long segment of the small bowel caused by a transmesenteric hernia through a large defect of small bowel mesentery in a child. PMID:19458470

Park, Chan Yong; Kim, Jung Chul; Choi, Soo Jin Na; Kim, Shin Kon

2009-05-01

48

Whole Genome Gene Expression Meta-Analysis of Inflammatory Bowel Disease Colon Mucosa Demonstrates Lack of Major Differences between Crohn's Disease and Ulcerative Colitis  

Science.gov (United States)

Background In inflammatory bowel disease (IBD), genetic susceptibility together with environmental factors disturbs gut homeostasis producing chronic inflammation. The two main IBD subtypes are Ulcerative colitis (UC) and Crohn’s disease (CD). We present the to-date largest microarray gene expression study on IBD encompassing both inflamed and un-inflamed colonic tissue. A meta-analysis including all available, comparable data was used to explore important aspects of IBD inflammation, thereby validating consistent gene expression patterns. Methods Colon pinch biopsies from IBD patients were analysed using Illumina whole genome gene expression technology. Differential expression (DE) was identified using LIMMA linear model in the R statistical computing environment. Results were enriched for gene ontology (GO) categories. Sets of genes encoding antimicrobial proteins (AMP) and proteins involved in T helper (Th) cell differentiation were used in the interpretation of the results. All available data sets were analysed using the same methods, and results were compared on a global and focused level as t-scores. Results Gene expression in inflamed mucosa from UC and CD are remarkably similar. The meta-analysis confirmed this. The patterns of AMP and Th cell-related gene expression were also very similar, except for IL23A which was consistently higher expressed in UC than in CD. Un-inflamed tissue from patients demonstrated minimal differences from healthy controls. Conclusions There is no difference in the Th subgroup involvement between UC and CD. Th1/Th17 related expression, with little Th2 differentiation, dominated both diseases. The different IL23A expression between UC and CD suggests an IBD subtype specific role. AMPs, previously little studied, are strongly overexpressed in IBD. The presented meta-analysis provides a sound background for further research on IBD pathobiology. PMID:23468882

Østvik, Ann E.; Drozdov, Ignat; Gustafsson, Bjørn I.; Kidd, Mark; Beisvag, Vidar; Torp, Sverre H.; Waldum, Helge L.; Martinsen, Tom Christian; Damås, Jan Kristian; Espevik, Terje; Sandvik, Arne K.

2013-01-01

49

Small and large bowel volvulus: Clues to early recognition and complications  

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Small and large bowel volvulus are uncommon causes of bowel obstruction with nonspecific clinical manifestations which may delay the diagnosis and increase morbidity. Therefore, radiologists play an important role in promptly establishing the diagnosis, recognizing underlying congenital or acquired risk factors and detecting potentially life-threatening complications. Multidetector CT performed with intravenous contrast is currently the preferred modality for the evaluation of volvulus, which is best appreciated when imaging is perpendicular to the axis of bowel rotation, hence the benefit of multiplanar reformations. In this pictorial essay we review the pathophysiology of the different types of intestinal volvulus, discuss diagnostic criteria for prompt diagnosis of volvulus and emphasize early recognition of the complications.

Lepage-Saucier, Marianne [Departement de radiologie, Hopital Saint-Luc, Centre Hospitalier Universitaire de Montreal (CHUM), 1058 rue Saint-Denis, Montreal, Quebec, H2X 3J4 (Canada); Tang, An [Departement de radiologie, Hopital Saint-Luc, Centre Hospitalier Universitaire de Montreal (CHUM), 1058 rue Saint-Denis, Montreal, Quebec, H2X 3J4 (Canada)], E-mail: duotango@gmail.com; Billiard, Jean-Sebastien; Murphy-Lavallee, Jessica; Lepanto, Luigi [Departement de radiologie, Hopital Saint-Luc, Centre Hospitalier Universitaire de Montreal (CHUM), 1058 rue Saint-Denis, Montreal, Quebec, H2X 3J4 (Canada)

2010-04-15

50

Melatonin for the treatment of irritable bowel syndrome  

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Irritable bowel syndrome (IBS) is a common disorder characterized by recurrent abdominal pain or discomfort, in combination with disturbed bowel habits in the absence of identifiable organic cause. Melatonin (N-acetyl-5-methoxytryptamine) is a hormone produced by the pineal gland and also large number by enterochromaffin cells of the digestive mucosa. Melatonin plays an important part in gastrointestinal physiology which includes regulation of gastrointestinal motility, local anti-inflammator...

Siah, Kewin Tien Ho; Wong, Reuben Kong Min; Ho, Khek Yu

2014-01-01

51

Hormone Replacement Therapy, Oral Contraceptive Use and Distal Large Bowel Cancer: A Population-Based Case-Control Study  

Science.gov (United States)

Objective Lower incidence rates of distal large bowel cancer in women compared to men support the protective role of female hormones. We aimed to determine the associations between hormone replacement therapy, oral contraceptive use and distal large bowel cancer. Methods We conducted a population-based case-control study of incident distal large bowel cancer in North Carolina between 2001–2006. Data on hormone replacement therapy, oral contraceptive use, demographics and risk factors were obtained via in-person interviews. Odds ratios and 95% confidence intervals for the associations between oral contraceptive use, hormone replacement therapy and distal large bowel cancer were estimated via unconditional logistic regression models overall, by duration of use, and within strata of race. Results There were a total of 443 women with distal large bowel cancer and 405 controls. Ever use of hormone replacement therapy was strongly associated with a reduced risk of distal large bowel cancer (OR 0.52, 95% CI 0.38–0.72). Further reduction of distal large bowel cancer risk occurred with increased duration of use [<4 years (OR 0.77, 95% CI 0.44–1.35), 4–8 years (OR 0.64, 95% CI 0.37–1.10), 9–14 years (OR 0.47, 95% CI 0.27–0.81), ?15 years (OR 0.34, 95% CI 0.20–0.58)]. Ever use of oral contraceptives was not associated with reduced incidence of distal large bowel cancer (OR 0.95, 95% CI 0.67–1.34), nor was duration of use. There were no differences by race. Conclusions Hormone replacement therapy is associated with a lower risk of distal large bowel cancer. This risk is further reduced with increased duration of use. Hormone replacement therapy may be partially responsible for the reduced incidence of distal large bowel cancer in women compared to men. PMID:20354510

Long, Millie D.; Martin, Christopher F.; Galanko, Joseph A.; Sandler, Robert S.

2010-01-01

52

Visualization and quantification of large bowel motility with functional cine-MRI  

International Nuclear Information System (INIS)

Purpose: to develop and evaluate a method to visualize and quantify large bowel motility using functional cine MRI. Methods: fifteen healthy individuals (8males, 7 females, 20 to 45 years old) with no history or present symptoms of bowel disorders were enrolled in a functional cine MRI examination at 6 a. m. after a starving phase for at least eight hours before and after oral administration of Senna tea (mild stimulating purgative). Two consecutive sets of repeated measurements of the entire abdomen were performed using a 1.5T MRI system with coronal T2-weighted HASTE sequences anatomically adjusted to the course of the large bowel. A navigator technique was used for respiratory gating at the level of the right dorsal diaphragm. The changes in diameter (given in cm) were measured at 5 different locations of the ascending (AC), transverse (TC) and descending colon (DC), and assessed as parameters for the bowel motility. Results: the mean values as a statistical measure for large bowel relaxation were determined. Before ingestion of Senna tea, the mean diameter measured 3.41 cm (ascending colon), 3 cm (transverse colon) and 2.67 cm (descending colon). After the ingestion of Senna tea, the mean diameter increased to 3.69 cm (ascending colon) to 3.4 cm (transverse colon) and to 2.9 cm (descending colon). A statistically significant difference was demonstrated with the Wilcoxon test (level of confidence 0.05). For the determination of dynamic increase, the changes of the n of dynamic increase, the changes of the statistical scatter amplitude to the mean value were expressed as percentage before and after the ingestion of Senna tea. Thereby, an increase in variation and dynamic range was detected for the AC (112.9%) and DC (100%), but a decrease in the dynamics for the TC (69%). Conclusion: a non-invasive method for the assessment of bowel motility was developed for the first time. The use of functional cine MRI utilizing a prokinetic stimulus allowed visualisation and quantification of large bowel motility. Further studies have to determine whether this technique is clinically relevant. (orig.)

53

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

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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 larg...

Marzocca, G.; Tamo Tamo, G.; Varrone, F.; Macchitella, Y.; Staffieri, C.; Lo Gatto, M.

2009-01-01

54

MRI for chronic inflammatory bowel disease  

International Nuclear Information System (INIS)

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 T1-weighted gradient echo and T2-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 allowical improvements in 3D imaging will allow interactive postprocessing of the MR data. (orig.)

55

Mutations of p53 gene can be detected in the plasma of patients with large bowel carcinoma.  

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AIMS: To attempt to detect p53 gene mutations in the plasma of patients with large bowel carcinoma. METHODS: Plasma was collected from 20 control patients with no history of cancer and from 17 patients with large bowel carcinoma. Corresponding tumour and benign lymph node (control) samples for each of the carcinoma patients were obtained from paraffin blocks. A Dukes' stage was determined for each tumour. DNA was extracted from the plasma samples and the paraffin embedded tissue using previou...

Mayall, F.; Jacobson, G.; Wilkins, R.; Chang, B.

1998-01-01

56

Total colectomy with „J”-reservoir for synchronous neoplasia of the large bowel and rectum  

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Full Text Available Objective: we want to present two cases of multiple synchronous neoplasias of the colon and upper rectum admitted in our department,for which a limited excision was not enough. Case presentation: there were two cases for which we performed a total colectomy withileo-rectostomy with „J”-reservoir, avoiding a straight ileo-rectoanastomosis. Results: the patients recovered without complications, with fewbowel emissions per day. Post-surgery recovery was uneventful in both patients. One year after the surgery, the patients experienced two andthree normal bowel motions daily and no episodes of incontinence. Conclusion: the method is good for patients with multiple primary neoplasiasof large bowel and upper rectum and offers a good condition of life.

Daciana N. Chiril?

2012-09-01

57

A solitary rectal mucosa-associated lymphoid tissue (MALT) lymphoma  

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Mucosa-associated lymphoid tissue (MALT) is a type of extra nodal malignant lymphoma seen in organs such as the stomach, thyroid and salivary glands. Furthermore, occurrence of colorectal MALT lymphoma is extremely rare. We report a case of a solitary rectal MALT lymphoma treated by surgical resection and radiotherapy. Lymphoma should be considered as a rare differential diagnosis when dealing with large bowel pathology. We would advocate the use of surgery as a primary treatment option for a...

Samee, A.; Rukin, N.; Siddiqui, I.; Halliday, M.; Farmer, M.

2010-01-01

58

Colonization of the large bowel by Clostridium difficile in healthy infants: quantitative study.  

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Colonization of the large bowel of healthy infants by Clostridium difficile was studied. Feces were collected from five breast-fed aand five formula-fed infants throughout the first year of life, and levels of C. difficile were quantitated. Three breast-fed and five formula-fed infants were colonized for periods of between 8 and 42 weeks, and another infant harbored the organism only during week 1. Colonization of breast-fed infants commenced before or during weaning, with levels reaching 10(...

Stark, P. L.; Lee, A.; Parsonage, B. D.

1982-01-01

59

The use of computed tomography in the detection and characterisation of large bowel obstruction.  

Science.gov (United States)

Computed tomography (CT) has become the imaging modality of choice for the investigation of patients with clinico-radiological suspicion of obstruction. Appropriate CT technique is discussed, with recommendations on how to improve diagnostic confidence and to reduce radiation dose. The performance of CT in the investigation of LBO is compared to that of the plain abdominal radiograph and contrast enema. CT is unrivalled in its ability to detect and characterise the cause of large bowel obstruction (LBO), identify complications, and guide appropriate treatment. PMID:19966879

Godfrey, Edmund M; Addley, Helen C; Shaw, Ashley S

2009-10-30

60

Weekly large fraction radiotherapy and 5 fluorouracil as a palliative treatment for large bowel carcinoma: a pilot study  

International Nuclear Information System (INIS)

Palliative radiotherapy for large bowel cancer is generally given in fraction sizes of 2-3 Gy. Theoretical considerations led us to believe that a larger fraction size would not lead to a decreased response rate and practical considerations led us to treat patients once a week. The results of a pilot study of 32 patients with large bowel cancer are presented. Patients were treated with a fraction size of 6 Gy given weekly and combined with 5 FU. The response rate of 58% and the median survival of 9 months seems comparable with other regimens, as does the rate of acute side effects. The late high dose effect of subcutaneous fibrosis was seen in 30% of the long term survivors; the implications of this are discussed. We draw the conclusion that this treatment is convenient and effective in terms of tumor response, but that the late high dose effects were more severe than expected and that these effects may be potentiated by 5 FU

 
 
 
 
61

Cirugía de colon abierta con "Fast Track" o recuperación acelerada "Fast Track" large bowel surgery  

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Full Text Available Introducción: La Cirugía resectiva de colon se asocia a una hospitalización de 6 a 10 días. En el último tiempo se ha desarrollado el concepto de rehabilitación multimodal o "Fast track" que involucra una combinación de técnicas que llevan a reducir la respuesta al stress quirúrgico, optimizar la recuperación y reducir los días de hospitalización. Objetivo: Evaluar el postoperatorio de pacientes sometidos a cirugía electiva de colon y recto superior utilizando un protocolo de "Fast track". Material y Método: Ingresaron a un protocolo prospectivo de recuperación acelerada, todos los enfermos sometidos a cirugía electiva de colon y recto superior en el Hospital Militar de Santiago en el período comprendido entre Agosto 2004 a Noviembre 2005. Se evalúa íleo postoperatorio, días de hospitalización, complicaciones postoperatorias y satisfacción de pacientes. Resultados: Ingresaron 40 pacientes consecutivos, 19 hombres (48% y 21 mujeres (52%. La edad promedio fue 66 años (39-87, 24 pacientes (60% eran ASA II y 38% ASA I. El 97,5% expulsó gases en las primeras 48 h. La primera defecación ocurrió dentro de las primeras 48 h en el 47,5% de los pacientes y en el 37,5% a las 72 h. El 78% de los paciente fueron dados de alta al 4° día. La escala visual análoga (EVA para dolor a las 24 h era Introduction: Large Bowel resective surgery requires 6 to 10 days in-hospital stay. Recently the multimodality rehabilitation concept or "fast track" surgery, a combination of different techniques in order to reduce surgical stress, increase recuperation and decrease in-hospital stay, has become an option. Objective: Evaluate postoperative evolution of patients submitted for elective large bowel and rectum resection using "Fast Track" protocol. Material and Method: Prospective Fast track protocol includes all patients submitted for elective large bowel and rectum resection in Military Hospital of Santiago during August 2004 to November 2005. Outcomes concerning postoperative ileus, in-hospital stay, complications and patient satisfaction were recorded. Results: 40 patients, 19 male (48% and 21 female (52% consecutive patients were included. Average age 66 years (39-87, 24 patients (60% were classified ASA II and 38% ASA I. During the first 48 hrs 97.5% had anal flatulence. First defecation occurred before 48 hrs in 47.5% and in 37.5% at 72 hrs. Hospital discharge at 4*11 day was possible in 78%. Pain visual analogical scale at 24 hrs was less than 2 in 95%. Satisfaction rate was very good in 70%. Morbidity was 18% without mortality. Anastomotic dehiscence was 2.5%. Conclusions: Fast Track protocol reduces in- hospital stay, pain and postoperative ileus.

LEONARDO ESPÍNDOLA S

2009-04-01

62

Carcinoma of the large bowel after a single massive dose of radiation in healthy teenagers  

International Nuclear Information System (INIS)

Three healthy teenagers were exposed to a single pelvic x-ray irradiation as part of sterilization experiments performed in the Auschwitz concentration camp in 1943. Single and multiple carcinomas of the colon and rectum developed 40 years later in the radiation field. Histologic examination of surgical specimens revealed severe radiation-induced changes in all layers of tumor-adjacent areas. In contrast to previous reports of radiation-induced large bowel cancers, these women had not undergone repeated courses of radiation, had no known co-existing disease that might raise the risk for colonic and rectal malignancies, and had an extremely long and remarkably similar latency period. These cases emphasize the need for long-term surveillance in previously radiated patients. Since thousands of teenagers were subjected to similar sterilization experiments, awareness of this association might help in the early diagnosis of additional cases

63

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

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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.

C. Fotiadis

2007-03-01

64

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  

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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.

Lind Ragna

2006-03-01

65

Overlap between irritable bowel syndrome and inflammatory bowel disease.  

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While recent studies have indicated that the colonic mucosa in irritable bowel syndrome (IBS) shows an increase in inflammatory cells, this 'inflammation' is quantitatively less than in inflammatory bowel disease (IBD) and of a different nature with a predominance of mast cells, particularly in female patients. Inflammation can arise via numerous pathways including infection, stress, food allergy and changes in gut microbiota. Low-grade mucosal inflammation throughout the colon and including the terminal ileum can be seen for many months after an attack of acute gastroenteritis and is a feature of post-infective IBS. Measurements of gut permeability also show a prolonged increase in both the small and large bowel in both post-infective IBS and IBS with diarrhoea predominance. This has been linked to visceral hypersensitivity, but whether this is causal or an epiphenomenon remains uncertain. Studying the risk factors for post-infective IBS has shown the importance of both local and microbiological factors, as well as psychological factors, including adverse life events, anxiety and depression. Stress in both animals and humans can activate mast cells, which (by increasing gut permeability) may allow activation of the systemic immune system. Demonstration of the importance of the low-grade inflammation observed awaits definitive large scale trials of agents designed to specifically reverse these changes. PMID:20203497

Spiller, Robin C

2009-01-01

66

Accumulation of immunoglobulin-containing cells in the gut mucosa and presence of faecal immunoglobulin in severe combined immunodeficient (scid) mice with T cell-induced inflammatory bowel disease (IBD)  

DEFF Research Database (Denmark)

Scid mice transplanted either with a gut wall graft or with low numbers of purified CD4+ T cells from immunocompetent syngeneic donor mice show clinical signs of IBD 3-4 months post-transplantation. The disease is mediated by mucosa-infiltrating CD4+ TCR alphabeta+ T cells. The pathology of 52 individual colon segments obtained from 20 gut wall- or CD4+ T cell-transplanted diseased scid mice was evaluated by histology and the numbers of infiltrating immunoglobulin-containing cells were determined. In particular, cells positive for IgM, IgA and non-inflammatory immunoglobulin isotypes such as IgG1 and IgG2b were found to accumulate in colon segments displaying the most severe histopathology, including inflammatory cellular infiltration, epithelial hyperplasia and ulcerative lesions. Compared with colon segments of normal C.B-17 mice, the lesional scid colon shows increased levels of cells positive for the IgG classes. Faecal extracts of the CD4+ T cell-transplanted scid mice revealed the presence of all six murine immunoglobulin isotypes. Disease progression was accompanied by an increased level of excreted IgM and IgG3 and decreased levels of IgA. It is concluded that locally secreted immunoglobulins may play an immunomodulating role in the pathological changes observed in the present model of T cell-induced inflammatory bowel disease.

Bregenholt, S; Brimnes, J

1998-01-01

67

Discriminant histological features in the diagnosis of chronic idiopathic inflammatory bowel disease: analysis of a large dataset by a novel data visualisation technique  

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Background/Aims: The histopathological assessment of endoscopic colorectal biopsies is important in the distinction between normality and chronic idiopathic inflammatory bowel disease, and between ulcerative colitis and Crohn's disease, in subjects with symptoms of bowel dysfunction. This study aims to use carefully defined histopathological observations on a large study population to produce systems that improve classification into these diagnostic categories.

Cross, S. S.; Harrison, R. F.

2002-01-01

68

Multidetector row computed tomography findings from ischemia to infarction of the large bowel  

International Nuclear Information System (INIS)

Objective: MDCT is performed as first imaging examination for patients with acute abdomen in most Emergency Departments. Clinical suspicion of ischemic colitis and infarction is related to specific findings, however, differential diagnosis as well as the staging for a confirmed ischemic affection may be critical. The individual signs from ischemia to infarction of large bowel is a captivating topic. In this study, we report our experience of the MDCT assessment of acute colonic disease from vascular mesenteric disorders. Materials and methods: We retrospectively reviewed the MDCT findings of 71 patients admitted to our attention for acute abdomen, with final proven diagnosis of colonic ischemia and/or infarction made by surgery and/or endoscopy. CT-scanning of the abdomen and pelvis was performed after i.v. contrast medium administration, using a multidetector row CT equipment. We correlated the presence of parietal disease, the evidence of mesenteric arterial or venous vessels occlusion, the parietal features as well as others findings, such as free fluid and/or air in peritoneal recess or in retroperitoneum, with the surgical and/or endoscopic findings. Results: Analysis of our data showed a segmental (84%) or complete (16%) involvement of the colon; 57 cases were related to ischemia, 14 to infarction. Inferior mesenteric vessels defect of opacification was noted in 10 cases. Various degree of wall thickening and parietal enhancement, peritoneal fluid, mural or porthancement, peritoneal fluid, mural or portal-mesenteric pneumatosis were compared to evidence of mesenteric arterial or vein occlusion and to final proven diagnosis. A classification in a multi-stage grading for both decreased of arterial supply or impaired venous drainage disorders was done. Conclusions: A grading scale from ischemia to infarction affecting the large bowel from arterial or venous mesenteric vessels origin has been not previously reported in a series at our knowledge. MDCT findings may support the clinical evaluation of patients affected by acute colon from vascular disorders. In particular, it seems to provide effective and valuable information's in differentiating etiology and stage of disease

69

Sodium picosulphate compared with polyethylene glycol solution for large bowel lavage: a prospective randomised trial.  

Science.gov (United States)

Mechanical efficiency, patient acceptability and minimal biochemical perturbation are important factors in the choice of lavage solution for bowel preparation. This prospective randomised trial of 59 patients compared a polyethylene glycol bowel lavage solution (Klean Prep) to a sodium picosulphate solution (Picolax) considering their efficacy from both colonoscopists' and radiologists' points of view, patient acceptibility, and plasma biochemical changes. The sodium picosulphate solution was more acceptable to patients than the polyethylene glycol, and resulted in significantly less nausea and vomiting (p = 0.0025), and far fewer consumption difficulties (p magnesium (p bowel preparation. The changes in plasma biochemistry values are unlikely to cause clinical problems. PMID:8731641

Hamilton, D; Mulcahy, D; Walsh, D; Farrelly, C; Tormey, W P; Watson, G

1996-03-01

70

Limitations in assessment of mucosal healing in inflammatory bowel disease  

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Full Text Available An emerging parameter to define the effectiveness of new therapeutic agents in clinical trials, and by extension, for use in day-to-day clinical practice has been labeled mucosal healing. It has been hypothesized that complete healing of the intestinal mucosa in inflammatory bowel diseases should result in reduced disease complications, reduced hospitalization and reduced surgical treatment. By implication, the natural history of inflammatory bowel disease might then be altered. Measurement of mucosal healing, however, is largely observational, requiring repeated invasive endoscopic examinations, sometimes with mucosal biopsies. Other indirect imaging methods may play a role in this assessment along with other surrogate markers, including intestinal permeability. These measurements may have significant limitations that prohibit precise correlation with symptom-based disease activity indices in clinical trials. This likely reflects the dynamic nature of this evolving and individualized inflammatory process that tends to be focused, but not limited, to the mucosa of the intestinal tract.

Hugh James Freeman

2010-01-01

71

Asymptomatic perforation of large bowel and urinary bladder as a complication of ventriculoperitoneal shunt: Report of two cases  

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Introduction. Insertion of a ventriculoperitoneal (VP) shunt, the method of choice in the treatment of hydrocephalus, is often followed by various mechanical and/or infective complications. We present two children with asymptomatic perforation of the large bowel and urinary bladder, relatively rare and potentially severe complications of this surgical procedure. Outline of Cases. In both patients a VP shunt was implanted in the first month after birth; in a boy due to congenital hydroce...

Mihajlovi? Miljan; Tasi? Goran; Rai?evi? Mirjana; Mrdak Milan; Petrovi? Bojana; Radlovi? Vladimir

2012-01-01

72

Large-bowel carcinomas with different ploidy, related to secretory component, IgA, and CEA in epithelium and plasma.  

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Immunofluorescence staining for carcinoembryonic antigen (CEA), secretory component (SC), and epithelial IgA was evaluated semiquantitatively in 85 large-bowel carcinomas in relation to degree of tumour differentiation, Dukes' stage, and plasma CEA level. The tumours were divided into a near-diploid (ND, 28) and an aneuploid group (AN, 57) by means of flow-cytometric DNA measurements. Expression of SC and IgA in neoplastic epithelium was positively related to differentiation in both groups. T...

Rognum, T. O.; Thorud, E.; Elgjo, K.; Brandtzaeg, P.; Orjasaeter, H.; Nygaard, K.

1982-01-01

73

Cellobiose: mannitol differential permeability in small bowel disease.  

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Cellobiose and mannitol absorption were studied in patients with suspected abnormal function of the small bowel mucosa. The urinary cellobiose:mannitol ratio was increased in subtotal villous atrophy, iron deficiency anaemia, and small intestinal Crohn's disease. The test seems a sensitive indicator of the integrity of small bowel mucosa.

Hodges, S.; Ashmore, S. P.; Patel, H. R.; Tanner, M. S.

1989-01-01

74

The association of age and race and the risk of large bowel polyps.  

Science.gov (United States)

Background: Blacks have a higher incidence of colorectal cancer (CRC) and a younger age at diagnosis compared to Whites. Few studies have investigated racial differences in risk of metachronous adenomas and serrated polyps whether this risk differs by polyp characteristics or age of patient. Methods: We analyzed data pooled from three placebo-controlled adenoma chemoprevention trials to explore racial differences in the risk of large bowel polyps in patients ?50 and > 50 years of age. Using generalized linear regression, we estimated risk ratios (RR) and 95% confidence intervals (CI) as measures of the association between race and risk of one or more adenomas or serrated polyps after randomization. Results: Among the 2605 subjects who completed at least one follow-up exam, blacks ?50 years of age had a higher risk of any conventional adenoma (RR 1.70, 95% CI 0.99-2.92) and advanced neoplasms (RR 4.05, 95% CI 1.43-11.46) and a non-significantly lower risk of serrated polyps (RR 0.75 (95% CI 0.34-1.62) compared to whites. Among patients > 50 years there was no racial difference in risk of adenomas (RR 1.08, 95% CI 0.92-1.27) or advanced neoplasms (RR 1.05, 95% CI 0.71- 1.56)). However, blacks had a significantly lower risk of serrated polyps (RR 0.65, 95% CI 0.49-0.87) than whites. Conclusions: Our results demonstrate a higher risk of metachronous adenomas in blacks compared to whites at younger ages. Impact: Our results suggest that the racial disparity in CRC incidence may be due to an excess of neoplasia in younger blacks. PMID:25490989

Wallace, Kristin; Burke, Carol A; Ahnen, Dennis J; Barry, Elizabeth L; Bresalier, Robert S; Saibil, Fred; Baron, John A

2014-12-01

75

Colonic elongation inhibits pellet propulsion and migrating motor complexes in the murine large bowel  

Science.gov (United States)

The colonic migrating motor complex (CMMC) is a rhythmically occurring neurally mediated motor pattern. Although the CMMC spontaneously propagates along an empty colon it is responsible for faecal pellet propulsion in the murine large bowel. Unlike the peristaltic reflex, the CMMC is an ‘all or none’ event that appears to be dependent upon Dogiel Type II/AH neurons for its regenerative slow propagation down the colon. A reduction in the amplitude of CMMCs or an elongated colon have both been thought to underlie slow transit constipation, although whether these phenomena are related has not been considered. In this study we examined the mechanisms by which colonic elongation might affect the CMMC using video imaging of the colon, tension and electrophysiological recordings from the muscle and Ca2+ imaging of myenteric neurons. As faecal pellets were expelled from the murine colon, it shortened by up to ?29%. Elongation of the colon resulted in a linear reduction in the velocity of a faecal pellet and the amplitude of spontaneous CMMCs. Elongation of the oral end of a colonic segment reduced the amplitude of CMMCs, whereas elongation of the anal end of the colon evoked a premature CMMC, and caused the majority of CMMCs to propagate in an anal to oral direction. Dogiel Type II/AH sensory neurons and most other myenteric neurons responded to oral elongation with reduced amplitude and frequency of spontaneous Ca2+ transients, whereas anal elongation increased their amplitude and frequency in most neurons. The inhibitory effects of colonic elongation were reduced by blocking nitric oxide (NO) production with l-NA (100 ?m) and soluble guanylate cyclase with 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ; 10 ?m); whereas, l-arginine (1–2 mm) enhanced the inhibitory effects of colonic elongation. In conclusion, polarized neural reflexes can be triggered by longitudinal stretch. The dominant effect of elongation is to reduce CMMCs primarily by inhibiting Dogiel Type II/AH neurons, thus facilitating colonic accommodation and slow transit. PMID:20547675

Heredia, Dante J; Dickson, Eamonn J; Bayguinov, Peter O; Hennig, Grant W; Smith, Terence K

2010-01-01

76

Ostomy Surgery of the Bowel  

Science.gov (United States)

... an injury to the small or large intestine inflammatory bowel disease––longlasting disorders, such as Crohn’s disease ... surgeon performs an ileostomy most often to treat inflammatory bowel disease or rectal cancer. Read more about ...

77

Motility changes associated with large bowel obstruction and its surgical relief  

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Strain gauges and electrodes to detect intestinal motility were attached to the terminal ileum, right and left sides of the colon in Rhesus monkeys. Baseline recordings were made. An obstruction device was applied to the left colon at a laparotomy. Compromise of the bowel lumen leading to total obstruction occurred at 13 +/- 2 days. As obstruction progressed, contractions decreased in the terminal ileum and right colon but increased in the left colon proximal to the obstruction. Distention wa...

Catchpole, B. N.

1985-01-01

78

Glucagon gene 5'-flanking sequences direct expression of simian virus 40 large T antigen to the intestine, producing carcinoma of the large bowel in transgenic mice.  

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Glucagon and the glucagon-like peptides play important roles in the regulation of glucose homeostasis. Previous studies have demonstrated that approximately 1300 base pairs of rat glucagon gene 5'-flanking sequences direct transgene expression to the pancreas and brain, but not to the intestine, of transgenic mice. These observations suggested that different tissue-specific enhancer elements mediate activation of glucagon gene transcription in the pancreas and intestine. We have now generated mice that express SV40 large T antigen under the control of approximately 2000 base pairs of glucagon gene 5'-flanking sequences. Transgene expression was observed in the brain and pancreas in association with the development of pancreatic endocrine tumors. In contrast to the mice described previously, we also detected transgene expression throughout the gastrointestinal tract in endocrine cells of the stomach and small and large intestine. Focal areas of enteroendocrine cell hyperplasia in the large bowel invariably progressed to invasive and metastasizing plurihormonal endocrine carcinoma, which was clinically and pathologically evident by 4 weeks of age. In contrast, transgene expression in the small bowel and stomach was not associated with progression to either hyperplasia or carcinoma. The results of these studies provide functional evidence for the existence of an upstream cis-acting regulatory domain that directs glucagon gene transcription to the endocrine cells of the intestine in transgenic mice. PMID:1587847

Lee, Y C; Asa, S L; Drucker, D J

1992-05-25

79

Acute pseudo-obstruction of the large bowel with caecal perforation following normal vaginal delivery: a case report  

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Full Text Available Abstract Introduction Acute pseudo-obstruction of the large bowel following normal vaginal delivery is an extremely rare complication of normal vaginal delivery. It can be fatal if not recognized early. Only one previous report has been found in the English literature. Case presentation A 36-year old Caucasian, normally fit woman presented with abdominal distension and vomiting five days post-normal vaginal delivery at term. Localised peritonitis in the right iliac fossa developed in the next few days, and caecal perforation was found at laparotomy, without evidence of appendicitis or colitis. Conclusion Although very rare, Ogilvie's syndrome should be considered by obstetricians, general surgeons and general practitioners as a potential cause of vomiting and abdominal pain following normal vaginal delivery. Early recognition and management are essential to minimize the possibility of developing serious complications.

Seenath Marlon

2010-04-01

80

[Mucin histochemical changes in various colo-rectal polyps in relation to carcinoma of the large bowel].  

Science.gov (United States)

210 various colo-rectal polyps including 46 inflammatory polyps, 21 juvenile polyps, 9 hyperplastic polyps, 65 tubular adenomas, 51 familial polyps, 11 villous adenomas, 7 adenomatous polyps with focal cancer, and 14 carcinoma of the large bowel were investigated by HE,HID-AB,PAT-KOH-PAS staining in order to study the mucin changes of these lesions. N-acetylated and C7,C9 O-acetylated sialomucin were mainly obtained in those adenomas with moderate and severe dysplasia (55-64.3%) and the proportion was even higher in cases of villous adenomas, familial polyps, adenomas with focal cancer and advanced carcinoma. These mucins might be assumed as a criteria in representing malignant transformation. PMID:2582549

Yu, J Y

1989-06-01

 
 
 
 
81

Asymptomatic perforation of large bowel and urinary bladder as a complication of ventriculoperitoneal shunt: Report of two cases  

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Full Text Available Introduction. Insertion of a ventriculoperitoneal (VP shunt, the method of choice in the treatment of hydrocephalus, is often followed by various mechanical and/or infective complications. We present two children with asymptomatic perforation of the large bowel and urinary bladder, relatively rare and potentially severe complications of this surgical procedure. Outline of Cases. In both patients a VP shunt was implanted in the first month after birth; in a boy due to congenital hydrocephalus and in a girl due to the consequences of intracranial haemorrhage. Immediately after surgery, as well as during the further course, in both children growth and development were optimal and without any signs of infection or VP shunt malfunction. In the boy at age 6 months and in the girl at age 4 years, without any signs of complications, mothers noted the prominence of the VP shunt tip from the anus in the first case and from the urethral orifice in the second one. The VP shunts were immediately changed, so that both complications were resolved without any consequences. Conclusion. Insertion of a VP shunt represents the most frequent method of choice of the surgical treat- ment of hydrocephalus, but also potentially a highly risky procedure followed by various complications about which parents should be informed when patients are children. Owing to adequate approach in the follow-up of children with implanted VP shunt, large bowel and urinary bladder perforation, examples of severe and potentially fatal complications of this surgical intervention, could be disclosed on time and adequately resolved.

Mihajlovi? Miljan

2012-01-01

82

Deficiency of the intestinal growth factor, glucagon-like peptide 2, in the colon of SCID mice with inflammatory bowel disease induced by transplantation of CD4+ T cells  

DEFF Research Database (Denmark)

Glucagon-like peptide 2 (GLP-2) is produced in endocrine L-cells of the intestinal mucosa. Recently, GLP-2 was found to stimulate intestinal mucosal growth. Our objective was to study the content of GLP-2 in the large intestine in a murine model of T-cell-induced inflammatory bowel disease.

Schmidt, P T; Hartmann, B

2000-01-01

83

Cytapheresis in inflammatory bowel diseases: current evidence and perspectives.  

Science.gov (United States)

Ulcerative colitis and Crohn's disease are inflammatory bowel diseases with a chronic relapsing course. Management of both conditions is far from being fully satisfactory. For this reason in the last decade a large number of biological therapies, targeting cytokines involved in intestinal inflammation, has been developed with various results in terms of efficacy, safety and costs. Activated granulocytes and monocytes represent the major sources of pro-inflammatory cytokines in the intestinal mucosa, playing a pivotal role in inducing and maintaining intestinal inflammation. Leukocytapheresis using an adsorptive carrier-based system (Adacolumn) or a removal filter column (Cellsorba) has been proposed as a feasible, safe and effective therapy for ulcerative colitis and Crohn's disease. The objective of this paper is to provide an overview on the current knowledge about mechanisms of action, available clinical data and the possible future perspectives for the use of Adacolumn and Cellsorba in the management of inflammatory bowel diseases. PMID:18382085

Danese, Silvio; Angelucci, Erika; Stefanelli, Tommaso; Omodei, Paolo; Luigiano, Carmelo; Finazzi, Silvia; Pagano, Nico; Repici, Alessandro; Vecchi, Maurizio; Malesci, Alberto

2008-01-01

84

Extraintestinal manifestations in a large series of Italian inflammatory bowel disease patients  

Science.gov (United States)

AIM: To investigate prevalence, type and time of onset of extraintestinal manifestations (EIMs) in a series of Italian inflammatory bowel disease (IBD) patients. METHODS: Data of 811 IBD consecutive patients, first referred to our Centre from 2000 to 2011, were retrospectively evaluated. RESULTS: Eight hundred and eleven IBD patients (437 M, 374 F) were studied: 595 ulcerative colitis (UC) (73.4%) and 216 Crohn’s disease (CD) (26.6%). Among these, 329 (40.6%) showed EIMs: 210 UC (35.3%) and 119 CD (55.1%) (P < 0.0001). Considering the time of the diagnosis of IBD, 37 EIMs (11.2%) were developed before, 229 (69.6%) after and 63 (19.2%) were simultaneous. The type of EIM were as follows: 240 musculoskeletal (29.6%), in 72 CD patients and in 168 UC (P < 0.0001); 47 mucocutaneous (5.8%), in 26 CD and in 21 UC (P = 0.0049); 26 ocular (3.2%), in 16 CD and in 10 UC (CD 7.4% vs UC 1.7%, P = 0.0093); 6 hepatobiliary (0.8%); 10 endocrinological (1.2%). In particular, with regards to the involvement of the musculoskeletal system, arthritis Type 1 was found in 41 CD (19%) and in 61 UC (10.2%) (P = 0.0012) and Type 2 in 25 CD (11.6%) and in 100 UC (16.8%) (P = 0.0012). CONCLUSION: Mucocutaneous manifestations, arthritis Type 1 and uveitis were significantly more frequent in CD than UC. The complications of the musculoskeletal system were the mostly observed ones, often with symptoms more severe than intestinal ones, confirming the need for close cooperation with rheumatologists. PMID:25516659

Zippi, Maddalena; Corrado, Claudia; Pica, Roberta; Avallone, Eleonora Veronica; Cassieri, Claudio; De Nitto, Daniela; Paoluzi, Paolo; Vernia, Piero

2014-01-01

85

Obstrução do íleo terminal por mucosa gástrica heterotópica / Terminal ileum obstruction owing to heterotopic gastric mucosa  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A mucosa gástrica ectópica localizada no intestino delgado, distal ao ligamento de Treitz é muito rara, excetuando-se a encontrada habitualmente no divertículo de Meckel e na duplicação intestinal. Existem formas congênita e adquirida, sendo esta última secundária à processos inflamatórios intestina [...] is. As diferenças entre estas formas são basicamente histológicas, determinando no entanto aspectos fisiopatológicos distintos. Apresentamos caso de mucosa gástrica ectópica em paciente de 34 anos de idade, manifestada por obstrução do íleo terminal. Submetido a duas enterectomias e anastomoses primárias, apresentou boa evolução pós-operatória. O aspecto histopatológico, típico da forma adquirida com mucosa antral e intensa fibrose, foi provavelmente relacionado à quadro recente de tuberculose intestinal, porém não confirmada histologicamente. O antecedente de tuberculose pulmonar recente na família, aliado à linfoadenomegalia mesentérica encontrada a operação, sustentam tal suspeita. Este é fato inédito na literatura dentre as outras 28 publicações de heterotopia gástrica no jejuno e íleo. Abstract in english Heterotopic gastric mucosa situated in the small bowel distal to the Treitz suspensory ligament is very rare, except in Meckel's diverticulum and in intestinal duplications. There are two forms of this disease, congenital and acquired. The former is secondary to inflammatory bowel disease. The main [...] difference between these forms is histological, although determining diverse physiopathological aspects. A case of a 34 year old man with heterotopic gastric mucosa in the terminal ileum manifested by intestinal obstruction is reported. He was treated surgically by enterectomy of two small bowel segments, both reconstructed by primary suture. His postoperative course was remarkable. The histopathologic study showed a typical pattern of the acquired type because of the presence of antral the antral mucosa and intense fibrosis. That is probably related to intestinal tuberculosis, but was not histologically confirmed. Individual and family recent history of pulmonary tuberculosis corroborates the suspicion. This is a unique report in the literature, among 28 other heterotopic gastric mucosa situated in the jejunum and ileum.

F. A., Atik; M., Ricci; J. C., Del Grande; C. M., Haddad.

1998-12-01

86

Bowel preparations as quality indicators for colonoscopy  

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Colonoscopy is the principal investigative procedure for colorectal neoplasms because it can detect and remove most precancerous lesions. The effectiveness of colonoscopy depends on the quality of the examination. Bowel preparation is an essential part of high-quality colonoscopies because only an optimal colonic cleansing allows the colonoscopist to clearly view the entire colonic mucosa and to identify any polyps or other lesions. Suboptimal bowel preparation not only prolongs the overall p...

Jang, Jae Young; Chun, Hoon Jai

2014-01-01

87

Development of a pH-Responsive Particulate Drug Delivery Vehicle for Localized Biologic Therapy in Inflammatory Bowel Disease  

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The treatment of inflammatory bowel disease (IBD) recently has been revolutionized by the introduction of protein-based biologic therapies. However, biologic therapy is complicated by the requirement for administration with a needle, systemic side effects, and high cost. Particulate drug delivery systems have been shown to deliver drugs locally to the intestinal mucosa via oral administration. However, these systems have been largely unexplored for the delivery of biologics due to harsh parti...

Capurso, Noah A.; Fahmy, Tarek M.

2011-01-01

88

Gastric, small bowel, and colorectal cancer  

International Nuclear Information System (INIS)

The majority of gastrointestinal (GI) tract malignancies are adenocarcinomas. In the colon, adenocarcinoma is practically the only clinically significant tumor, and it is the second most common tumor in the small bowel, with carcinoid being the most common. The stomach harbors the greatest variety of malignant neoplasms. Adenocarcinoma, however, is still the predominant cell type, followed by lymphoma and leiomyosarcoma. Various diagnostic procedures have been used to screen patients for GI tract tumors. Fiberoptic endoscopic examination has been advocated as the study of choice to screen the population at risk of developing stomach and colon cancer because of its ability to directly visualize the mucosa and to permit biopsy of suspicious lesions. However, because fiberoptic endoscopy requires patient sedation, the number of endoscopists is limited, and the number of patients is large, single-contrast and double-contrast roentgenographic examinations of the GI tract remain the most widely accepted screening procedures

89

Small bowel hamartoma: a huge diverticulum of small bowel.  

Science.gov (United States)

A-20-year old male, with no significant medical history, presented with clinical features mimicking a perforated acute appendicitis. Because of features of peritonitis, a laparotomy was performed which showed a segment of small bowel with multiple large diverticula and mesenteric cysts. A segmental small bowel resection was performed. The patient made an uneventful recovery from surgery. Histology revealed features of a small bowel hamartoma. PMID:24454405

Ebdewi, Hamdi; Eltweri, Amar M; Salama, Yahya; Gorgees, Neshtman; Naidu, Leena; Bowrey, David J

2013-01-01

90

Eating and Bowel Control  

Science.gov (United States)

... Home Living with Bowel Control Problems Resources Bowel Control Awareness Campaign Home Resources for Health Care Providers ... Home : Eating and Bowel Control Eating and Bowel Control Some bowel control problems improve simply by changing ...

91

Pregnancy and inflammatory bowel disease.  

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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 ...

Zeldis, J. B.

1989-01-01

92

Lysis of colonic epithelial cells by allogeneic mononuclear and lymphokine activated killer cells derived from peripheral blood and intestinal mucosa: evidence against a pathogenic role in inflammatory bowel disease.  

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A sensitive 4 h 51Cr-release cytotoxicity assay has been developed using as targets colonic epithelial cells obtained by Dispase-collagenase digestion of resected mucosa or colonoscopic biopsies. Peripheral blood mononuclear cells (MNC) from most healthy donors showed low, but significant levels of cytotoxicity for normal epithelial cell target cells of 8.7 (4.4) % (mean (SD] and similar levels were found in 14 ulcerative colitis (6.5 (4.4) %) and 16 Crohn's disease (6.2 (5.2) %) patients. Ne...

Gibson, P. R.; Pol, E.; Pullman, W.; Doe, W. F.

1988-01-01

93

MRI for chronic inflammatory bowel disease; MRT chronisch entzuendlicher Darmerkrankungen  

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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.)

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

94

Colonic stent placement as a bridge to surgery in patients with left-sided malignant large bowel obstruction. An observational study.  

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Background. Acute left-sided malignant colonic obstruction is common in elderly patients, in which emergency surgery is related with high morbidity and mortality rates, and often necessitates a two-step resection. Although the use of self-expanding metallic stents (SEMS) in elderly patients has not been adequately described yet, there are almost two international important trials which are still in progress, the stenting technique is established to be, by the international literature, an useful treatment with low morbidity and mortality. It's also a bridge to surgery, since the insertion of a SEMS can decompress the obstruction, making bowel and patient preparation possible and facilitating singlestage surgical resection. Palliative stenting can improve quality of life when compared to surgery in patients with metastasis or high co-morbidity. The aim of this study is to analyze mortality, avoidance of stoma, short- and long-term survival in patient with malignant left-sided large bowel obstruction who underwent to stent placement in our Emergency Surgery Unit, which is operative since November 2010 in our city Hospital in Ferrara. Patients and methods. Between November 2010 and December 2012 a total of 15 patients with acute left-sided malignant large bowel obstruction suitable for colonic stent application were admitted to Emergency Surgery Unit. Among these patients, 9 underwent to self-expanding metallic stent placement (group A), the other (group B) 6 patient underwent to emergency surgery. In this observational not-randomized study we analyzed the efficacy and safety of SEMS placement for patients either as a bridge to surgery or as a palliation, beside the short term and long term outcomes, versus those patients operated straight. Results. Self-expanding metallic stents were successfully implanted in 9 of the 15 patients with acute left-sided malignant large bowel obstruction. No acute procedure-related complication was observed. All the patients in group A kept the stent in place for an average of 7,7 days, then everyone underwent to surgery. A large bowel resection with one-time recanalization was performed in 8 of the 9 patients. None Hartmann resection was necessary. Only one underwent again to surgery because of a dehiscence, a stoma was necessary. Between the other 6 patients in group B who underwent directly to surgery, In one case was necessary an Hartmann resection, another one incurred in dehiscence of the anastomosis that required reoperation with stoma creation. Conclusions. Placement of SEMS seems to be an useful alternative to emergent surgery in the management of acute left-sided bowel obstruction, both as a bridge to surgery and as a palliative procedure. SEMS can provide an effective and safe therapeutic option compared to emergency surgery, most of all in elderly patients, with a lower mortality rate, a significantly higher rate of primary anastomosis and the avoidance of stoma. However, to fully determine their role for these indications, more data and more high level evidence is required. PMID:25644730

Occhionorelli, S; Tartarini, D; Cappellari, L; Stano, R; Vasquez, G

2014-01-01

95

A novel barley cultivar (Himalaya 292) with a specific gene mutation in starch synthase IIa raises large bowel starch and short-chain fatty acids in rats.  

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Himalaya 292 (Hordeum vulgare, var. himalaya 292) is a novel, hull-less barley cultivar with a single nucleotide change in the gene encoding starch synthase IIa (EC 2.4.1.21). This leads to loss of enzyme activity, resulting in a grain with less total starch and a higher proportion of amylose. These changes, plus higher total and soluble nonstarch polysaccharides (NSP), could increase its resistant starch (RS) content. Accordingly, rats were fed a diet containing stabilized whole-grain barley flours from Himalaya 292 or two commercial varieties (Namoi or Waxiro) or wheat or oat bran at equivalent NSP concentrations for 14 d. There were favorable significant changes in a number of bowel health-related indices. Fecal output by rats fed Himalaya 292 was higher than by those fed Namoi or oat bran, whereas total large bowel digesta mass was higher than in those fed WAXIRO: Cecal starch concentrations and pools were higher in rats fed Himalaya 292 than in all other groups. Fecal and cecal digesta pH was lower in rats fed Himalaya 292 than in all other groups except that fed oat bran. Colonic digesta pH was lower in rats fed Himalaya 292 than in those fed wheat bran or NAMOI: Fecal total SCFA excretion was higher in rats fed Himalaya 292 than in those fed Namoi or oat bran. Although cecal total SCFA pools did not differ among groups, colonic SCFA were higher in rats fed Himalaya 292 than in those fed Namoi or WAXIRO: These data indicate that changes in Himalaya 292 grain composition result in greater RS with consequent alterations in large bowel SCFA and pH when fed to rats. PMID:15051833

Bird, Anthony R; Flory, Corinna; Davies, Debra A; Usher, Sylvia; Topping, David L

2004-04-01

96

The cytokines in inflammatory bowel disease  

Directory of Open Access Journals (Sweden)

Full Text Available Inflammatory bowel disease includes ulcerative colitis and Crohn’s disease. It is a group of chronic disorders of unknown etiology characterized by inflammation of the gastrointestinal tract. The etiopathogenesis of inflammatory bowel disease is multifactorial. Recent data show that the development of inflammatory bowel disease is associated with the interplay of genetic, bacterial, and environmental factors and dysregulation of the intestinal immune system. The latest research is focused on the key role of cytokines in inflammatory bowel disease. In patients with inflammatory bowel disease, a number of recruited monocytes and activated macrophages are the source of cytokines in the inflamed alimentary tract mucosa. The role of pro-inflammatory cytokines (IL-1?, IL-1?, IL-2, -6, -8, -12, -17, -23, TNF, IFN in inflammatory bowel disease is associated with the initiation and progression of ulcerative colitis and Crohn’s disease. Anti-inflammatory cytokines (IL-4, -10, -13 also contribute to the pathogenesis of inflammatory bowel disease, decreasing the inflammatory response by down-regulating proinflammatory cytokine production.

Beata Poli?ska

2009-08-01

97

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

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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.

Júlio César M Santos Jr.

2010-06-01

98

Limitations in assessment of mucosal healing in inflammatory bowel disease  

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An emerging parameter to define the effectiveness of new therapeutic agents in clinical trials, and by extension, for use in day-to-day clinical practice has been labeled mucosal healing. It has been hypothesized that complete healing of the intestinal mucosa in inflammatory bowel diseases should result in reduced disease complications, reduced hospitalization and reduced surgical treatment. By implication, the natural history of inflammatory bowel disease might then be altered. Measurement o...

Hugh James Freeman

2010-01-01

99

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)

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.

Drossman Douglas A

2008-07-01

100

Prostanoid synthesis by cultured intestinal epithelial and mononuclear cells in inflammatory bowel disease.  

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Intestinal epithelial and mononuclear cells were isolated from normal colonic mucosa and from intestinal mucosa of inflammatory bowel disease patients. Prostanoid synthesis by primary cultures of intestinal mononuclear cells were four to six fold higher than its synthesis by primary cultures of epithelial cells. Prostaglandin E2, prostacyclin and thromboxane A2 synthesis by cultured mononuclear cells isolated from inflamed ileal mucosa of four Crohn's disease patients: 5.6 +/- 1.2; 3.2 +/- 1....

Zifroni, A.; Treves, A. J.; Sachar, D. B.; Rachmilewitz, D.

1983-01-01

 
 
 
 
101

Bowel preparations as quality indicators for colonoscopy.  

Science.gov (United States)

Colonoscopy is the principal investigative procedure for colorectal neoplasms because it can detect and remove most precancerous lesions. The effectiveness of colonoscopy depends on the quality of the examination. Bowel preparation is an essential part of high-quality colonoscopies because only an optimal colonic cleansing allows the colonoscopist to clearly view the entire colonic mucosa and to identify any polyps or other lesions. Suboptimal bowel preparation not only prolongs the overall procedure time, decreases the cecal intubation rate, and increases the costs associated with colonoscopy but also increases the risk of missing polyps or adenomas during the colonoscopy. Therefore, a repeat examination or a shorter colonoscopy follow-up interval may be suitable strategies for a patient with suboptimal bowel preparation. PMID:24659866

Jang, Jae Young; Chun, Hoon Jai

2014-03-21

102

Cryopreserved tissue engineered mucosa.  

Directory of Open Access Journals (Sweden)

Full Text Available Single cells suspensions used for grafting in the clinical setting may be reliably cryopreserved by established protocols. However, for tissue engineered constructs which now also get used as grafts in the clinic such established protocols and assays which indicate graft viability and their function as graft do not exist. a The purpose was to develop a cryoprotocol and an animal model to test the efficacy of tissue engineered to act as graft after cryopreservation. b Therefore, tissue engineered mucosa grafts consisting of keratinocytes and fibroblasts grown in a collagen sponge were cryopreserved and grafted in the nude rat to test its efficacy to function as mucosa graft. At different points after cryopreservation the mucosa was grafted into the nude rats. Healing of grafts was allowed for one or three weeks. c Sufficient cells survived the cryopreservation allowing for the development of epithelial-fibroblast tissue in the collagen sponge. After three weeks of healing the formation of mucosa tissue was more complete and more collagen sponge had disappeared. d The nude rat model is suitable to assess the efficacy of tissue engineered mucosa to function as graft after cryopreservation. The formation of human epithelial-fibroblast tissue in vivo has to be interpreted as proof of principle that the approach of cryopreservation of tissue engineered grafts is working.

G??nter Lauer

2009-01-01

103

Postinfectious irritable bowel syndrome.  

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A small but significant subgroup of patients with irritable bowel syndrome (IBS) report a sudden onset of their IBS symptoms after a bout of gastroenteritis. Population-based surveys show that although a history of neurotic and psychologic disorders, pain-related diseases, and gastroenteritis are all risk factors for developing IBS, gastroenteritis is the most potent. More toxigenic organisms increase the risk 11-fold, as does an initial illness lasting more than 3 weeks. Hypochondriasis and adverse life events double the risk for postinfective (PI)-IBS and may account for the increased proportion of women who develop this syndrome. PI-IBS is associated with modest increases in mucosal T lymphocytes and serotonin-containing enteroendocrine cells. Animal models and some preliminary human data suggest this leads to excessive serotonin release from the mucosa. Both the histologic changes and symptoms in humans may last for many years with only 40% recovering over a 6-year follow-up. Celiac disease, microscopic colitis, lactose intolerance, early stage Crohn's disease, and bile salt malabsorption should be excluded, as should colon cancer in those over the age of 45 years or in those with a positive family history. Treatment with Loperamide, low-fiber diets, and bile salt- binding therapy may help some patients. Serotonin antagonists are logical treatments but have yet to be evaluated. PMID:12761724

Spiller, Robin C

2003-05-01

104

Melatonin for the treatment of irritable bowel syndrome.  

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Irritable bowel syndrome (IBS) is a common disorder characterized by recurrent abdominal pain or discomfort, in combination with disturbed bowel habits in the absence of identifiable organic cause. Melatonin (N-acetyl-5-methoxytryptamine) is a hormone produced by the pineal gland and also large number by enterochromaffin cells of the digestive mucosa. Melatonin plays an important part in gastrointestinal physiology which includes regulation of gastrointestinal motility, local anti-inflammatory reaction as well as moderation of visceral sensation. Melatonin is commonly given orally. It is categorized by the United States Food and Drug Administration as a dietary supplement. Melatonin treatment has an extremely wide margin of safety though it may cause minor adverse effects, such as headache, rash and nightmares. Melatonin was touted as a potential effective candidate for IBS treatment. Putative role of melatonin in IBS treatment include analgesic effects, regulator of gastrointestinal motility and sensation to sleep promoter. Placebo-controlled studies in melatonin suffered from heterogeneity in methodology. Most studies utilized 3 mg at bedtime as the standard dose of trial. However, all studies had consistently showed improvement in abdominal pain, some showed improvement in quality of life of IBS patients. Melatonin is a relatively safe drug that possesses potential in treating IBS. Future studies should focus on melatonin effect on gut mobility as well as its central nervous system effect to elucidate its role in IBS patients. PMID:24627586

Siah, Kewin Tien Ho; Wong, Reuben Kong Min; Ho, Khek Yu

2014-03-14

105

Recent understanding of leukocytapheresis (LCAP) for the treatment of inflammatory bowel disease.  

Science.gov (United States)

Inflammatory bowel disease (IBD) is frequently associated with the infiltration of a large number of leukocytes into the bowel mucosa. Therefore, the removal of circulating leukocytes may be an attractive approach for the treatment of IBD. Leukocytapheresis with Cellsorba, a column of polyethylenephtarate fibers that captures monocytes, granulocytes, and lymphocytes, has been used to treat IBD, particularly ulcerative colitis, in Japan. The objective of this paper is to provide an overview of current knowledge regarding the mechanisms of action, available clinical data, and possible future perspectives for the use of LCAP with Cellsorba in the management of IBD. Leukocytapheresis appears to remove or inactivate inflammatory cells, to reset immunity by modulating immune system components like cytokines, and to repair the intestinal mucosa by mobilizing mesenchymal progenitors. Although the majority of clinical studies had an open-label design and enrolled only a small number of patients, leukocytapheresis has been demonstrated to exert clinical efficacy with an excellent safety profile. Although leukocytapheresis with Cellsorba appears very promising, its future in the treatment of IBD requires further evaluation. PMID:19519448

Mitsuyama, Keiichi; Yamasaki, Hiroshi; Kuwaki, Kotaro; Takedatsu, Hidetoshi; Sata, Michio

2009-01-01

106

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

DEFF Research Database (Denmark)

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.

Perner, Anders; Rask-Madsen, J

1999-01-01

107

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

DEFF Research Database (Denmark)

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.

Perner, A; Rask-Madsen, J

1999-01-01

108

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

Science.gov (United States)

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. PMID:25609952

Buda, Andrea; Facchin, Sonia; Dassie, Elisa; Casarin, Elisabetta; Jepson, Mark A; Neumann, Helmut; Hatem, Giorgia; Realdon, Stefano; D’Incà, Renata; Sturniolo, Giacomo Carlo; Morpurgo, Margherita

2015-01-01

109

Spectral analysis of bowel sounds in intestinal obstruction using an electronic stethoscope  

Directory of Open Access Journals (Sweden)

Full Text Available AIM: To determine the value of bowel sounds analysis using an electronic stethoscope to support a clinical diagnosis of intestinal obstruction. METHODS: Subjects were patients who presented with a diagnosis of possible intestinal obstruction based on symptoms, signs, and radiological findings. A 3M™ Littmann® Model 4100 electronic stethoscope was used in this study. With the patients lying supine, six 8-second recordings of bowel sounds were taken from each patient from the lower abdomen. The recordings were analysed for sound duration, sound-to-sound interval, dominant frequency, and peak frequency. Clinical and radiological data were reviewed and the patients were classified as having either acute, subacute, or no bowel obstruction. Comparison of bowel sound characteristics was made between these subgroups of patients. In the presence of an obstruction, the site of obstruction was identified and bowel calibre was also measured to correlate with bowel sounds. RESULTS: A total of 71 patients were studied during the period July 2009 to January 2011. Forty patients had acute bowel obstruction (27 small bowel obstruction and 13 large bowel obstruction, 11 had subacute bowel obstruction (eight in the small bowel and three in large bowel and 20 had no bowel obstruction (diagnoses of other conditions were made. Twenty-five patients received surgical intervention (35.2% during the same admission for acute abdominal conditions. A total of 426 recordings were made and 420 recordings were used for analysis. There was no significant difference in sound-to-sound interval, dominant frequency, and peak frequency among patients with acute bowel obstruction, subacute bowel obstruction, and no bowel obstruction. In acute large bowel obstruction, the sound duration was significantly longer (median 0.81 s vs 0.55 s, P = 0.021 and the dominant frequency was significantly higher (median 440 Hz vs 288 Hz, P = 0.003 when compared to acute small bowel obstruction. No significant difference was seen between acute large bowel obstruction and large bowel pseudo-obstruction. For patients with small bowel obstruction, the sound-to-sound interval was significantly longer in those who subsequently underwent surgery compared with those treated non-operatively (median 1.29 s vs 0.63 s, P < 0.001. There was no correlation between bowel calibre and bowel sound characteristics in both acute small bowel obstruction and acute large bowel obstruction. CONCLUSION: Auscultation of bowel sounds is non-specific for diagnosing bowel obstruction. Differences in sound characteristics between large bowel and small bowel obstruction may help determine the likely site of obstruction.

Siok Siong Ching

2012-01-01

110

Abdominal scintigraphy for ectopic gastric mucosa: a retrospective analysis of 143 studies  

International Nuclear Information System (INIS)

A retrospective analysis of 143 studies of abdominal scintigraphy with technetium-99m pertechnetate for the diagnosis of ectopic gastric mucosa (usually located in Meckel diverticulum) was undertaken. The rectilinear scanner was used for 57 studies and the gamma camera for 86. The final diagnosis, at laparotomy or after clinical and laboratory investigation with long-term clinical follow-up, was correlated to the interpretation of the scintigrams. Of 57 rectilinear scans, five were true positive, 46 true negative, two false positive, and four false negative. Of the 86 camera studies 10 were true positive, 74 true negative, one false negative, and one patient showed large bowel activity (positive atypical study). The results of this analysis indicate the value of the properly performed and interpreted abdominal pertechnetate scintigraphy in the diagnosis of (bleeding) ectopic gastric mucosa; it was also shown that the sensitivity and the specificity of this test have improved since the introduction of the gamma camera and the standardization of the procedure

111

Short Bowel Syndrome  

Science.gov (United States)

... or more of the small intestine to treat intestinal diseases, injuries, or defects present at birth. In newborns, ... another part of the intestine Crohn's disease, an inflammatory bowel disease bowel injury from loss of blood ...

112

Irritable Bowel Syndrome  

Medline Plus

Full Text Available ... intestinal disorder that can cause abdominal pain and changes in bowel habits. This reference summary will help ... irritable bowel syndrome includes a variety of lifestyle changes. Depending on what seems to be causing IBS, ...

113

Irritable Bowel Syndrome  

Medline Plus

Full Text Available ... is stronger after meals that are high in fat. Normal bowel function can vary from 3 bowel ... serious colon diseases: • blood in the stools • weight loss • fever • continuous pain Symptoms of IBS can vary, ...

114

Buccal mucosa urethroplasty in a reoperative and reconstructive challenge hypospadias: A case report  

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Buccal mucosa graft is usually used in a second operation. A buccal mucosa graft from the lower lip was used for large fistula reconstruction in one patients. The patient previously had been operated on several times at another center. The use of the buccal mucosa graft for urethral reconstruction in complex urethroplasties is a successful method with a low incidence of complications.

Hayrettin Ozturk

2014-01-01

115

Irritable Bowel Syndrome  

Medline Plus

Full Text Available ... meals that are high in fat. Normal bowel function can vary from 3 bowel movements per day to 3 per week. A bowel movement is considered normal if it: • is well-formed, • contains no blood, and • is passed easily without pain or cramping ...

116

Role of capsule endoscopy in inflammatory bowel disease.  

Science.gov (United States)

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

Kopylov, Uri; Seidman, Ernest G

2014-02-01

117

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)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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.

Júlio César M, Santos Jr..

2010-06-01

118

Clinicopathological features of gastric mucosa associated lymphoid tissue (MALT) lymphomas: high grade transformation and comparison with diffuse large B cell lymphomas without MALT lymphoma features  

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Aims—To investigate the clinicopathological differences among gastric low grade MALT lymphomas (low MALT), large B cell lymphomas with low grade components (secondary high grade MALT lymphomas, high MALT), and diffuse large B cell lymphomas without low grade features (primary high grade MALT lymphomas, DLL).

Yoshino, T.; Omonishi, K.; Kobayashi, K.; Mannami, T.; Okada, H.; Mizuno, M.; Yamadori, I.; Kondo, E.; Akagi, T.

2000-01-01

119

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)

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

Buda A

2015-01-01

120

Cytokine gene polymorphisms in inflammatory bowel disease.  

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BACKGROUND: Concordance rates in siblings and twins provide strong evidence that genetic susceptibility is important in the pathogenesis of inflammatory bowel disease. The number and identity of susceptibility genes is largely uncertain. Cytokine genes are attractive candidate loci. AIMS: To study allelic frequencies of polymorphisms of the interleukin-1 receptor antagonist (IL-1RA) gene and the tumour necrosis factor alpha gene in patients with inflammatory bowel disease. SUBJECTS: One hundr...

Louis, Edouard; Satsangi, J; Roussomoustakaki, M.; Parkes, M.; Fanning, G.; Welsh, K.; Jewell, D.

1996-01-01

 
 
 
 
121

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.)

122

Clostridium difficile Carriage Rate in Outpatients with Inflammatory Bowel Diseases  

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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 outpatie...

Mohammad Hosain Salari; Homayoun Vahedi; Khadije Moridi; sedighe Ghorchian,; Farzane Amin Harati; Abolfazl Davoudabadi

2013-01-01

123

[Genetics and environment in chronic inflammatory bowel diseases].  

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Inflammatory bowel diseases are both environmental and genetic illnesses. More than one hundred genes or loci involved in the regulation of innate or acquired immune response as well as intestinal mucosa homeostasis have been identified. Environmental studies have been less numerous up to now and only smoking and appendectomy have been validated, as protector for ulcerative colitis, while smoking is clearly associated with an increased risk and more severe forms of Crohn's disease. An importa...

Louis, Edouard; Kemseke, Catherine; Latour, Pascale; Belaiche, Jacques; Reenaers, Catherine

2012-01-01

124

Epithelial restitution and wound healing in inflammatory bowel disease  

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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 inflamma...

Andreas Sturm, Axel U. Dignass

2008-01-01

125

Probiotics in Inflammatory Bowel Diseases and Associated Conditions  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

Mack, David R.

2011-01-01

126

Small-bowel permeability in collagenous colitis  

DEFF Research Database (Denmark)

OBJECTIVE: 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. MATERIAL AND METHODS: Ten patients with CC and chronic diarrhoea participated in the study. Coeliac disease was excluded by small-bowel biopsy and/or serology. Intestinal permeability was assessed as urinary excretion (ratios) 2, 4 and 6 h after ingestion of 14C-labelled mannitol (14C-mannitol) and 99mTc-labelled diethylenetriamine-pentaacetic acid (99mTc-DTPA). Data were compared with the results from healthy controls. RESULTS: No difference was found between groups in urinary excretion of 14C-mannitol and 99mTc-DTPA after 2, 4 or 6 h, respectively. Likewise, no significant differences in the 99mTc-DTPA/14C-mannitol ratios between patients and controls were detected after 2 h: 0.030 (0.008-0.130) versus 0.020 (0.007-0.030), p = 0.19, after 4 h: 0.040 (0.009-0.180) versus 0.020 (0.008-0.040), p = 0.14 or after 6 h: 0.040 (0.012-0.180) versus 0.020 (0.010-0.040), p = 0.17. CONCLUSIONS: No alterations in intestinal permeability in patients with CC could be demonstrated. Impairment of the integrity of the mucosa of the small bowel and the presence of a general dysfunction of the small intestine in patients with CC seem unlikely.

Wildt, Signe; Madsen, Jan L

2006-01-01

127

Povidone-iodine bowel irrigation before resection of colorectal carcinoma.  

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Preoperative mechanical bowel preparation, peroperative topical antiseptic measures, and postoperative antibiotic therapy have all been shown to reduce infection after colorectal surgery. We report the results of a randomised trial of preoperative irrigation with a 10% aqueous solution of povidone-iodine (Betadine) versus water in patients undergoing major resection for large bowel carcinoma. All patients had mechanical bowel preparation, preoperative topical povidone-iodine and per and posto...

Parker, M. C.; Ashby, E. C.; Nicholls, M. W.; Dowding, C. H.; Brookes, J. C.

1985-01-01

128

Irritable bowel syndrome: new findings in pathophysiological and therapeutic field.  

Science.gov (United States)

Irritable bowel syndrome (IBS) is a high prevalence disease, whose symptoms are reported by a large number of young adults with significant effects on quality of life and social costs. Traditionally, IBS has been treated with dietary and lifestyle modification, fiber supplementation, psychological and pharmacological therapy. Since its complex and multifactorial etiopathogenesis is only partially known, therapeutic choices may be difficult and not always effective. New research efforts focused on the role of relationship between central nervous system and gut disorders (brain-gut axis), altered composition of gut microbiota (e.g. an eight times increased risk for IBS after Salmonella infection), immune activation with an increased number of T lymphocytes and mast cells associated with mucosa as well as an increased level of pro-inflammatory cytokines (IL-10 and IL-12, suggesting Th1 polarization), visceral hypersensitivity causing perception of pain even for minimal abdominal distension. Based on these findings, new possibilities of treatment are emerging with encouraging outcomes. Attention is directed to drugs that showed good tolerability profile and poor systemic absorption, which may make them suitable for repeated or long term treatments, as frequently required in patients with IBS. They have been successfully used drugs such as tachykinin receptors antagonists, tryptophan hydroxylase inhibitors, bile acid sequestrants, µ agonist and ? antagonist opioid receptors. Recent studies are discussed in this review, focusing both on new therapeutic approaches and innovative adaptation of previously available treatments. PMID:24780949

Catanzaro, R; Occhipinti, S; Calabrese, F; Anzalone, M G; Milazzo, M; Italia, A; Marotta, F

2014-06-01

129

Selective leukocyte apheresis for the treatment of inflammatory bowel disease.  

Science.gov (United States)

The etiology of inflammatory bowel disease (IBD) is not completely understood, thus current therapies have been empirical and directed at treating symptoms rather than addressing the cause. In IBD, the overexpression of proinflammatory cytokines, such as tumor necrosis factor-alpha, interleukin-1beta, interleukin-6, leads to a persistent intestinal inflammatory response that damages the intestinal mucosa. Recent advances in pharmacologic therapies that target specific cytokines, chemokines, and adhesion molecules have proved successful in alleviating symptoms for some patients. There are 2 selective adsorption apheresis devices that remove leukocytes from whole blood, which are currently available in Japan and Europe-the Cellsorba leukocytapheresis column and the Adacolumn adsorptive extracorporeal granulocyte/monocyte apheresis device. The purported mechanisms of action of these devices have been extensively reviewed and are believed to exert an immunomodulatory and/or anti-inflammatory effect on patients with systemic inflammatory disease. The clinical trials presented here indicate that selective leukocyte apheresis effectively removes activated granulocytes and monocytes/macrophages from peripheral blood while maintaining an excellent safety profile. Despite these findings, large controlled trials of selective leukocyte apheresis in the treatment of IBD are needed to determine the true efficacy of this approach. PMID:18090155

Abreu, Maria T; Plevy, Scott; Sands, Bruce E; Weinstein, Robert

2007-01-01

130

Patterns of airway involvement in inflammatory bowel diseases.  

Science.gov (United States)

Extraintestinal manifestations occur commonly in inflammatory bowel diseases (IBD). Pulmonary manifestations (PM) of IBD may be divided in airway disorders, interstitial lung disorders, serositis, pulmonary vasculitis, necrobiotic nodules, drug-induced lung disease, thromboembolic lung disease and enteropulmonary fistulas. Pulmonary involvement may often be asymptomatic and detected solely on the basis of abnormal screening tests. The common embryonic origin of the intestine and the lungs from the primitive foregut, the co-existence of mucosa associated lymphoid tissue in both organs, autoimmunity, smoking and bacterial translocation from the colon to the lungs may all be involved in the pathogenesis of PM in IBD. PM are mainly detected by pulmonary function tests and high-resolution computed tomography. This review will focus on the involvement of the airways in the context of IBD, especially stenoses of the large airways, tracheobronchitis, bronchiectasis, bronchitis, mucoid impaction, bronchial granulomas, bronchiolitis, bronchiolitis obliterans syndrome and the co-existence of IBD with asthma, chronic obstructive pulmonary disease, sarcoidosis and a1-antitrypsin deficiency. PMID:25400999

Papanikolaou, Ilias; Kagouridis, Konstantinos; Papiris, Spyros A

2014-11-15

131

Surveillance of the gastrointestinal mucosa by sensory neurons.  

Science.gov (United States)

A dense network of extrinsic and intrinsic sensory neurons supplies the gastrointestinal tract. Intrinsic sensory neurons provide the enteric nervous system with the kind of information that this brain of the gut requires for its autonomic control of digestion, whereas extrinsic afferents notify the brain about processes that are relevant to energy and fluid homeostasis and the sensation of discomfort and pain. The sensory repertoire of afferent neurons is extended by their responsiveness to mediators released from enteroendocrine and immune cells, which act like "taste buds" of the gut and serve as interface between the gastrointestinal lumen and the sensory nerve terminals in the lamina propria of the mucosa. Functional bowel disorders such as non-ulcer dyspepsia and irritable bowel syndrome are characterized by abdominal discomfort or pain in the absence of an identifiable organic cause. It is hypothesized with good reason that infection, inflammation or trauma causes sensory pathways to undergo profound phenotypic and functional alterations that outlast the acute insult. The pertinent changes involve an exaggerated sensitivity of the peripheral afferent nerve fibres as well as a distorted processing and representation of the incoming information in the brain. This concept identifies a number of receptors and ion channels that are selectively expressed by primary afferent neurons as important molecular targets at which to aim novel therapies for functional bowel disorders. PMID:11787755

Holzer, P; Michl, T; Danzer, M; Jocic, M; Schicho, R; Lippe, I T

2001-12-01

132

Histological and histochemical changes of the intestinal mucosa at the urothelial-enteric anastomotic site  

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OBJECTIVE: The incorporation of bowel segments for urinary tract reconstruction may induce intestinal mucosal changes with the development of metabolic, nutritional, gastrointestinal and carcinogenic complications. The early histological and histochemical changes of the intestinal mucosa in contact with the feces-urine mixture, are evaluated in the present study. MATERIALS AND METHODS: Twelve rats (operated group) were submitted to a vesico-colonic anastomosis, and 10 rats (control group) und...

Castro, Marcos A.; Ubirajara Ferreira; Martins, Mario H.; Stoppiglia, Rafael M.; Rodrigues Netto Jr, N.

2006-01-01

133

Detection of ectopic gastric mucosa using 99mTc pertechnetate. Review of the literature  

International Nuclear Information System (INIS)

Technetium-99m (99mTc) pertechnetate scintigraphy in a child with acute gastrointestinal bleeding of unknown origin suggests ectopic gastric mucosa caused by Meckel's diverticulum or gastrointestinal duplication cysts. Our objective was to define the patterns of scintigraphic findings likely to be encountered in patients with ectopic gastric mucosa with illustrative cases and to review the literature. Fifty children (age 1 year to 14 years) were evaluated for ectopic gastric mucosa using 99mTc pertechnetate scintigraphy. Functioning ectopic gastric mucosa was detected in eight patients with Meckel's diverticula and three patients with bowel duplication. Three patients showed atypical findings on scintigraphy which were perforated appendix, calyceal stasis, and regional enteritis. Ectopic functioning gastric mucosa in Meckel's diverticulum is visualized simultaneously with the stomach, whereas in intestinal duplications tracer activity can be visualized in the dynamic sequence or before gastric tracer visualization in an irregular pattern. A variety of scintigraphic patterns can be found in patients with ectopic gastric mucosa undergoing 99mTc pertechnetate scintigraphy depending on the location and size of the ectopic tissue. Also, acquisition of delayed images is useful when the initial images are equivocal in children. (author)

134

Buccal mucosa urethroplasty in a reoperative and reconstructive challenge hypospadias: A case report  

Directory of Open Access Journals (Sweden)

Full Text Available Buccal mucosa graft is usually used in a second operation. A buccal mucosa graft from the lower lip was used for large fistula reconstruction in one patients. The patient previously had been operated on several times at another center. The use of the buccal mucosa graft for urethral reconstruction in complex urethroplasties is a successful method with a low incidence of complications.

Hayrettin Ozturk

2014-01-01

135

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

Gandolfo, Sergio; Pentenero, Monica

2002-01-01

136

Epithelial expression of interleukin-37b in inflammatory bowel disease.  

Science.gov (United States)

Interleukin (IL)-37 is a member of the IL-1 cytokine family. We investigated IL-37b expression in the inflamed mucosa of inflammatory bowel disease (IBD) patients. Furthermore, we analysed IL-37b expression in human colonic epithelial cells. The human colonic epithelial cell line T84 and human colonic subepithelial myofibroblasts (SEMFs) were used. IL-37b expression in the IBD mucosa was evaluated by immunohistochemistry. IL-37b mRNA and protein expression were determined by real time-polymerase chain reaction (PCR) and Western blotting, respectively. IL-37b was not detected in the normal colonic mucosa. In the inflamed mucosa of IBD patients, epithelial IL-37b expression was increased markedly. In ulcerative colitis (UC) and Crohn's disease (CD) patients, IL-37b expression was enhanced in the affected mucosa. In the intestinal epithelial cell line T84, the expression of IL-37b mRNA and protein was enhanced by tumour necrosis factor (TNF)-?. This IL-37b induction by TNF-? was mediated by nuclear factor (NF)-?B and activator protein (AP)-1 activation. Furthermore, IL-37b inhibited TNF-?-induced interferon-?-inducible protein (IP)-10 expression significantly in human colonic SEMFs. Epithelial IL-37b expression was increased in IBD patients, especially UC patients. IL-37b may be involved in the pathophysiology of IBD as an anti-inflammatory cytokine and an inhibitor of both innate and acquired immune responses. PMID:23600829

Imaeda, H; Takahashi, K; Fujimoto, T; Kasumi, E; Ban, H; Bamba, S; Sonoda, H; Shimizu, T; Fujiyama, Y; Andoh, A

2013-06-01

137

Irritable Bowel Syndrome  

Medline Plus

Full Text Available ... the anus The walls of the intestines have muscles that contract and relax to push digested food ... very helpful for having a bowel movement. Intestinal muscle contractions are partially controlled by the nervous system, ...

138

Irritable Bowel Syndrome  

Medline Plus

Full Text Available ... of IBS. Irritable bowel syndrome is an intestinal disorder that can cause abdominal pain and changes in ... but also by the food we eat and hormones in the blood. This is why some people feel the urge ...

139

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 ... Infections and Diarrhea Eating Well While Eating Out Lactose Intolerance Digestive System Celiac Disease Ulcers Inflammatory Bowel Disease ...

140

Irritable Bowel Syndrome  

Medline Plus

Full Text Available ... the patient eats, how much the patient eats, emotional stress, and menstrual cycle in women. Therefore, it ... seem to produce symptoms of IBS include diet, emotional stress, and hormones. Patients with irritable bowel syndrome ...

 
 
 
 
141

Inflammatory Bowel Disease  

Science.gov (United States)

... than the digestive tract? How does a healthy digestive system work? How does inflammatory bowel disease interfere with ... separately. Return to top How does a healthy digestive system work? A normal digestive system breaks down food ...

142

Irritable Bowel Syndrome  

Medline Plus

Full Text Available ... that seem to produce symptoms of IBS include diet, emotional stress, and hormones. Patients with irritable bowel ... step in reducing symptoms of IBS. Changing the diet in various ways can help to reduce IBS ...

143

Irritable Bowel Syndrome  

Medline Plus

Full Text Available ... have a bowel movement about an hour after eating. This urge is stronger after meals that are ... fatty foods, coffee, and alcohol is often beneficial. Eating smaller meals may also help. Including more fiber ...

144

Irritable Bowel Syndrome  

Medline Plus

Full Text Available ... known to cause symptoms of IBS. They include: • Milk products • Fatty foods • Chocolate • Caffeine • Alcohol This document ... that seem to produce symptoms of IBS include diet, emotional stress, and hormones. Patients with irritable bowel ...

145

Irritable Bowel Syndrome  

Medline Plus

Full Text Available ... patient eats, how much the patient eats, emotional stress, and menstrual cycle in women. Therefore, it is ... to produce symptoms of IBS include diet, emotional stress, and hormones. Patients with irritable bowel syndrome are ...

146

[Transabdominal bowel sonography.  

Science.gov (United States)

This focused review describes the current use and future perspectives regarding transabdominal bowel sonography (TABS). The technique for B-mode and Doppler is described and the use of ultrasound contrast and elastography is discussed. Pathology and subsequent imaging findings are focused on appendicitis, diverticulitis, inflammatory bowel diseases and within paediatric conditions along with other common intestinal pathology. In conclusion we find that TABS is a fast, efficient, low-cost and non-ionization imaging technique without any patient discomfort. PMID:25096012

Wilkens, Rune; Strandberg, Charlotte

2014-03-01

147

Xanthomatosis of the gastrointestinal tract with focus on small bowel involvement  

DEFF Research Database (Denmark)

Accumulation of foamy lipid-laden histiocytic cells is most often seen in the skin and tendons, usually associated with congenital or acquired hyperlipidaemia, as seen in patients with diabetes mellitus, obstructive jaundice, and familial hypercholesterolaemia. The pathogenesis of xanthomatous lesions in other sites, including the urinary bladder, prostate, and gastrointestinal tract seems to be less consistent. Within the gastrointestinal tract the gastric mucosa is the most frequently cited location. Involvement of the oesophagus and bowel has rarely been described. Only three such cases largely confined to the small bowel have previously been documented. We here present an additional small bowel example accompanied by a short review of the existing literature in English on gastrointestinal xanthomatous lesions, including a discussion on its possible pathogenesis. Histologically, the lesion is unique and a correct diagnosis does not pose significant difficulties. Identification of diverse phagocytosed cytoplasmic deposits in other histiocytic lesions may require ancillary studies. More importantly, malignant lesions composed of clear cells or signet ring cells, primary or metastatic, need consideration. With a high index of suspicion coupled with appropriate histochemical and immunohistochemical reactions, the correct diagnosis will easily be accomplished. The process is characterised by aggregates of foamy histiocytes, unaccompanied by fibrosis or giant cells as seen in xanthogranulomatous lesions.  Well-defined clusters of such foamy histiocytes have been labelled xanthoma. The diffusely infiltrating counterpart has been termed xanthomatosis. When forming a bulky mass lesion, the label xanthomatous pseudotumour has been applied 11 12 and the subtle collection of xanthoma cells is often referred to as xanthelasma. 13 In this letter we collectively refer to these lesions, which may be related, as xanthomatous lesions (XAN).

Nielsen, S.L.; Ingeholm, P.

2007-01-01

148

Bowel vaginoplasty in children  

Directory of Open Access Journals (Sweden)

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.

Sarin Yogesh

2006-01-01

149

Living with Bowel Control Problems  

Science.gov (United States)

... You can also talk with your doctor and contact professional or patient-advocacy groups for information and support. See Links to Other Organizations . [ Top ] How are bowel control problems treated? Treatment for bowel control problems may ...

150

Abnormalities of mucosal folds of the small intestine: a guide in interpretation of small bowel series  

International Nuclear Information System (INIS)

Normal small intestinal folds are less than 2mm in thickness and criss-cross in appearance. Many diseases of the small intestine produce an abnormality in mucosal folds, namely thickening and parallel (perpendicular to the bowel lumen) arrangement of folds, nodularity, destruction, and ulcer. Diseases causing submucosal edema produce regular smooth thickening whereas diseases producing submucosal hemorrhage produce regular spiky thickening. Inflammatory bowel diseases and lymphoma produce irregular (in width, or distorted or bent at peculiar angles to the bowel lumen) thickening nodularity of the mucosa. Severe inflammatory processes as well as malignant tumors produce mucosal destruction and ulcer. Proposed here is an approach to narrow the category of disease processes based on mucosal fold abnormality. This approach with sufficient clinical history is invaluable in the interpretation of small bowel series

151

Abnormalities of mucosal folds of the small intestine: a guide in interpretation of small bowel series  

Energy Technology Data Exchange (ETDEWEB)

Normal small intestinal folds are less than 2mm in thickness and criss-cross in appearance. Many diseases of the small intestine produce an abnormality in mucosal folds, namely thickening and parallel (perpendicular to the bowel lumen) arrangement of folds, nodularity, destruction, and ulcer. Diseases causing submucosal edema produce regular smooth thickening whereas diseases producing submucosal hemorrhage produce regular spiky thickening. Inflammatory bowel diseases and lymphoma produce irregular (in width, or distorted or bent at peculiar angles to the bowel lumen) thickening nodularity of the mucosa. Severe inflammatory processes as well as malignant tumors produce mucosal destruction and ulcer. Proposed here is an approach to narrow the category of disease processes based on mucosal fold abnormality. This approach with sufficient clinical history is invaluable in the interpretation of small bowel series.

Lim, Jae Hoon [Samsung Medical Center, Seoul (Korea, Republic of)

1994-11-15

152

Irritable Bowel Syndrome  

Medline Plus

Full Text Available ... normal if it: • is well-formed, • contains no blood, and • is passed easily without pain or cramping Symptoms Common symptoms of irritable bowel syndrome include: abdominal cramps, bloating, gas and diarrhea or constipation or both. IBS does ...

153

Gut-homing CD4+ T cell receptor alpha beta+ T cells in the pathogenesis of murine inflammatory bowel disease  

DEFF Research Database (Denmark)

We studied which T cell subsets from the gut-associated lymphoid tissue (GALT) can migrate out of the gut mucosa and repopulate GALT compartments of an immunodeficient (semi)syngeneic host. Many distinct lymphocyte subsets were found in GALT of immunocompetent H-2d (BALB/c, BALB/cdm2, C.B-17+/+) mice. No antigen receptor-expressing lymphoid cells were found in GALT of congenic C.B-17 scid/scid (scid) mice. The heterotopic transplantation of a full-thickness gut wall graft from the ileum or colon of immunocompetent (C.B-17+/+, BALB/cdm2) donor mice onto immunodeficient scid mice selectively reconstituted a CD3+ T cell receptor alpha beta+ CD4+ T cell subset. CD4+ cells of this subset expressed the surface phenotype of mucosa-seeking, memory T cells. In the immunodeficient scid host, this gut-derived CD4+ T cell subset was found in spleen, peritoneal cavity, mesenteric lymph nodes (LN), epithelial layer and lamina propria of the small and large intestine, but not in peripheral LN. Scid mice heterotopically transplanted with gut from a congenic, immunocompetent donor developed clinical and histological signs of inflammatory bowel disease (IBD). Hence, the selective repopulation of GALT compartments with CD4+ T cells from normal GALT plays an essential role in the pathogenesis of IBD in an immunodeficient host.

Rudolphi, A; Boll, G

1994-01-01

154

Colonoscopia como método diagnóstico e terapêutico das moléstias do instestino grosso: análise de 2.567 exames Colonoscopy as a diagnostic and therapeutic method of the large bowel diseases: analysis of 2,567 exams  

Directory of Open Access Journals (Sweden)

Full Text Available RACIONAL: Com o surgimento das fibras ópticas na área médica, houve grande avanço tecnológico na observação do aparelho digestivo, com a introdução dos endoscópios flexíveis, usados anteriormente para o trato digestivo superior. OBJETIVO: Rever os resultados da aplicação da colonoscopia diagnóstica e terapêutica na Disciplina de Coloproctologia da Faculdade de Medicina da Universidade de São Paulo, respeitando as características de instituição de ensino e aprimoramento médico. CASUÍSTICA E MÉTODOS: Análise retrospectiva dos dados referentes a 2.567 exames de fibrocolonoscopia realizados entre os anos de 1984 e 2002, seja em regime de internação hospitalar ou ambulatorial. As principais indicações de exame nesta casuística foram o sangramento retal/anemia em 571 (22,24% doentes, alteração do hábito intestinal em 379 (14,76%, moléstia inflamatória em 222 (8,65% e pós-operatório de neoplasia em 186 (7,25%. O preparo intestinal com manitol foi realizado na maioria dos doentes. A sedação, quando não contra-indicada, foi feita com meperidina e benzodiazepínico. Todos exames foram feitos com monitorização com oxímetro de pulso. RESULTADOS: O resultado do exame foi normal em 1.089 (42,42% casos. Pólipos foram diagnosticados em 397 (15,47% casos, doença diverticular em 330 (12,86%, doença inflamatória em 305 (11,88% e câncer colorretal em 262 (10,21%. Foram realizadas 819 polipectomias em 397 doentes, gerando a média de 2,21 polipectomias por doente com pólipo. A colonoscopia foi considerada incompleta (quando não atingiu o ceco em 181 (7,05% casos. Houve um caso de perfuração por fratura de tumor subestenosante de retossigmóide. Complicações relacionadas à sedação levaram à interrupção do exame em 0,42% das vezes, sem maiores prejuízos aos pacientes. CONCLUSÃO: A colonoscopia foi método eficaz no diagnóstico e tratamento de afecções colorretais, sendo seguro e com baixo índice de morbidade em ambiente universitário.BACKGROUND: Since the sixties, when the optic fibers were reported, colonoscopy had emerged as the first line imaging investigation of the colon. AIM: To review the results of diagnostic and therapeutic colonoscopy at the Discipline of Coloproctology of the University of São Paulo Medical School, São Paulo, SP, Brazil, respecting the characteristics of an institution of medical eduction. METHODS: Retrospective analysis of basis related to 2,567 fibro colonoscopies between 1984 and 2002. The procedure was performed in hospitalized and in outpatients. The most common indications for colonoscopy were investigation of rectal bleeding and anemia (22.4%, change of bowel habit (14.76%, inflammatory bowel disease (8.65% and carcinoma (7.25%. Bowel preparation with manitol was used by most of the patients. Sedation, when not contra-indicated, was administered. The most common combination was meperidine and benzodiazepine. All the exams were monitored with pulse oximeter. A normal colonoscopy to the point of maximum insertion was reported in 42.42% of procedures. The most common diagnosis was polyps (15.47%, followed by diverticular disease (12.86%. Inflammatory disease was recorded in 11.88% and carcinoma in 10.21%. Polypectomy was undertaken in 397 patients (2.21 polypectomy per patient with polyps. Colonoscopy was considered incomplete (when the colonoscope did not pass to the cecum or terminal ileum in 181 (7.05% cases. Perforation was reported in one patient who had a subestenosing retossigmoid tumor. In 0.42%, reasons for failing to complete the procedure included complication related to sedation, with no further prejudice for the patients. CONCLUSIONS: Colonoscopic examination of the entire colon remains the standard for visualization, biopsy and treatment of colonic affections. The incidence of complication of endoscopy of the large bowel is quite low, even in a school hospital.

Sergio Carlos Nahas

2005-06-01

155

Colonoscopia como método diagnóstico e terapêutico das moléstias do instestino grosso: análise de 2.567 exames / Colonoscopy as a diagnostic and therapeutic method of the large bowel diseases: analysis of 2,567 exams  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese RACIONAL: Com o surgimento das fibras ópticas na área médica, houve grande avanço tecnológico na observação do aparelho digestivo, com a introdução dos endoscópios flexíveis, usados anteriormente para o trato digestivo superior. OBJETIVO: Rever os resultados da aplicação da colonoscopia diagnóstica [...] e terapêutica na Disciplina de Coloproctologia da Faculdade de Medicina da Universidade de São Paulo, respeitando as características de instituição de ensino e aprimoramento médico. CASUÍSTICA E MÉTODOS: Análise retrospectiva dos dados referentes a 2.567 exames de fibrocolonoscopia realizados entre os anos de 1984 e 2002, seja em regime de internação hospitalar ou ambulatorial. As principais indicações de exame nesta casuística foram o sangramento retal/anemia em 571 (22,24%) doentes, alteração do hábito intestinal em 379 (14,76%), moléstia inflamatória em 222 (8,65%) e pós-operatório de neoplasia em 186 (7,25%). O preparo intestinal com manitol foi realizado na maioria dos doentes. A sedação, quando não contra-indicada, foi feita com meperidina e benzodiazepínico. Todos exames foram feitos com monitorização com oxímetro de pulso. RESULTADOS: O resultado do exame foi normal em 1.089 (42,42%) casos. Pólipos foram diagnosticados em 397 (15,47%) casos, doença diverticular em 330 (12,86%), doença inflamatória em 305 (11,88%) e câncer colorretal em 262 (10,21%). Foram realizadas 819 polipectomias em 397 doentes, gerando a média de 2,21 polipectomias por doente com pólipo. A colonoscopia foi considerada incompleta (quando não atingiu o ceco) em 181 (7,05%) casos. Houve um caso de perfuração por fratura de tumor subestenosante de retossigmóide. Complicações relacionadas à sedação levaram à interrupção do exame em 0,42% das vezes, sem maiores prejuízos aos pacientes. CONCLUSÃO: A colonoscopia foi método eficaz no diagnóstico e tratamento de afecções colorretais, sendo seguro e com baixo índice de morbidade em ambiente universitário. Abstract in english BACKGROUND: Since the sixties, when the optic fibers were reported, colonoscopy had emerged as the first line imaging investigation of the colon. AIM: To review the results of diagnostic and therapeutic colonoscopy at the Discipline of Coloproctology of the University of São Paulo Medical School, Sã [...] o Paulo, SP, Brazil, respecting the characteristics of an institution of medical eduction. METHODS: Retrospective analysis of basis related to 2,567 fibro colonoscopies between 1984 and 2002. The procedure was performed in hospitalized and in outpatients. The most common indications for colonoscopy were investigation of rectal bleeding and anemia (22.4%), change of bowel habit (14.76%), inflammatory bowel disease (8.65%) and carcinoma (7.25%). Bowel preparation with manitol was used by most of the patients. Sedation, when not contra-indicated, was administered. The most common combination was meperidine and benzodiazepine. All the exams were monitored with pulse oximeter. A normal colonoscopy to the point of maximum insertion was reported in 42.42% of procedures. The most common diagnosis was polyps (15.47%), followed by diverticular disease (12.86%). Inflammatory disease was recorded in 11.88% and carcinoma in 10.21%. Polypectomy was undertaken in 397 patients (2.21 polypectomy per patient with polyps). Colonoscopy was considered incomplete (when the colonoscope did not pass to the cecum or terminal ileum) in 181 (7.05%) cases. Perforation was reported in one patient who had a subestenosing retossigmoid tumor. In 0.42%, reasons for failing to complete the procedure included complication related to sedation, with no further prejudice for the patients. CONCLUSIONS: Colonoscopic examination of the entire colon remains the standard for visualization, biopsy and treatment of colonic affections. The incidence of complication of endoscopy of the large bowel is quite low, even in a school hospital.

Sergio Carlos, Nahas; Carlos Frederico Sparapan, Marques; Sérgio Alonso, Araújo; Adilson Akihide, Aisaka; Caio Sérgio Rizkallah, Nahas; Rodrigo Ambar, Pinto; Desidério Roberto, Kiss.

2005-06-01

156

Bowel preparation prior to colonoscopy: a continual search for excellence.  

Science.gov (United States)

Bowel preparation prior to colonoscopy is essential to maximize the benefits of colonoscopy. Numerous bowel preparations have been studied, ranging from 4 L polyethylene glycol (PEG) to split-dose regimens to 2 L PEG with an adjunct laxative (senna, bisacodyl, ascorbic acid). Due to the large volume of PEG required for adequate bowel preparation, many studies have focused on reducing this large volume to only 2 L PEG with the addition of an adjunct. Recently, a randomized controlled trial by Tajika et al showed that the addition of mosapride to only 1.5 L PEG was non-inferior to mosapride and 2 L PEG for bowel cleansing but did provide improvements in patient tolerance. This study offers yet another potential bowel preparation for patients undergoing colonoscopy and may trigger further studies with 1.5 L PEG with an adjunct. In this letter, we discuss the current state of bowel preparation prior to colonoscopy and offer information to guide clinicians on choosing the appropriate bowel preparation for their patients. PMID:23345936

Bechtold, Matthew L; Choudhary, Abhishek

2013-01-14

157

Bowel preparation prior to colonoscopy: A continual search for excellence  

Directory of Open Access Journals (Sweden)

Full Text Available Bowel preparation prior to colonoscopy is essential to maximize the benefits of colonoscopy. Numerous bowel preparations have been studied, ranging from 4 L polyethylene glycol (PEG to split-dose regimens to 2 L PEG with an adjunct laxative (senna, bisacodyl, ascorbic acid. Due to the large volume of PEG required for adequate bowel preparation, many studies have focused on reducing this large volume to only 2 L PEG with the addition of an adjunct. Recently, a randomized controlled trial by Tajika et al showed that the addition of mosapride to only 1.5 L PEG was non-inferior to mosapride and 2 L PEG for bowel cleansing but did provide improvements in patient tolerance. This study offers yet another potential bowel preparation for patients undergoing colonoscopy and may trigger further studies with 1.5 L PEG with an adjunct. In this letter, we discuss the current state of bowel preparation prior to colonoscopy and offer information to guide clinicians on choosing the appropriate bowel preparation for their patients.

Matthew L Bechtold

2013-01-01

158

Expression of HLA-DR antigens by colonic epithelium in inflammatory bowel disease.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The expression of HLA-DR and HLA-A,B,C antigens by human colonic epithelium has been examined in tissue sections of patients with inflammatory bowel disease using an immunohistological technique. Colonic epithelial cells from all 21 control subjects with histologically normal colonic mucosa were HLA-DR-. In contrast, in nine of 13 patients with active ulcerative colitis and 11 of 12 with active Crohn's disease the epithelium of involved colonic mucosa was HLA-DR+. HLA-DR antigens were found o...

Selby, Ws; Janossy, G.; Mason, Dy; Jewell, Dp

1983-01-01

159

Tc-99m sucralfate scanning for inflammatory bowel disease  

International Nuclear Information System (INIS)

The authors investigated 14 patients with idiopathic inflammatory bowel disease (IBD) by administering Tc-99m sucralfate (TcS) orally and imaging the abdomen 4 and 24 hours after dose. All patients had either barium radiographic studies or colonoscopy before the scan. The scan identified seven of nine patients who had radiologically demonstrated small-bowel lesions and four of five patients with colonic disease. The authors' preliminary experience suggests that TcS maybe a useful procedure to document location and extent of active disease. It provides information about both small and large bowel in one procedure, is noninvasive, easy to perform, and has low radiation absorbed dose

160

Diagnosis of ectopic gastric mucosa using Tc99m-pertechnetate: spectrum of findings and utility of delayed imaging  

International Nuclear Information System (INIS)

Introduction: The utility of Tc99m-pertechnetate scintigraphy in the diagnosis of ectopic gastric mucosa is well established, particularly in the case of Meckel's diverticulum. However, there is substantial variation in the reported sensitivity of Tc99m-pertechnetate scintigraphy for the diagnosis of ectopic gastric mucosa. None of these authors used delayed imaging. Aims and Objectives: We highlight spectrum of scintigraphic findings likely to be encountered in patients with ectopic gastric mucosa with illustrative cases for each such finding and the utility of delayed imaging as a part of Tc99m-pertechnetate scintigraphy in the diagnosis of ectopic gastric mucosa, when initial images are equivocal or negative. Materials and Methods: Six children (aged 4 months to 48 months, all males) underwent Tc99m-pertechnetate scintigraphic evaluation for ectopic gastric mucosa. Static images were obtained for 1 minute for every 5 minutes during the first 60 minutes and subsequently at 6 hours post injection. Results: Ectopic gastric mucosa was found in intrathoracic fore-gut duplication cysts in two, in small bowel duplications in two, in a gastric duplication in one and in a Meckel's diverticulum in one patient. In the two patients with intrathoracic duplication cysts, the ectopic gastric mucosa was evident only in delayed images. Conclusion: A variety of scintigraphic patterns may be found in patients with ectopic gastric mucosa undergoing Tc99m-pertechnetate scintigraphy depgoing Tc99m-pertechnetate scintigraphy depending upon the location and size of the ectopic tissue. Acquisition of delayed images may be useful when the initial images are negative, particularly in infants with intrathoracic ectopic gastric mucosa

 
 
 
 
161

Small bowel enteroclysis with magnetic resonance imaging and computed tomography in patients with failed and uncertain passage of a patency capsule  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Video capsule enteroscopy (VCE has revolutionized small bowel imaging, enabling visual examination of the mucosa of the entire small bowel, while MR enteroclysis (MRE and CT enteroclysis (CTE have largely replaced conventional barium enteroclysis. A new indication for MRE and CTE is the clinical suspicion of small bowel strictures, as indicated by delayed or non-delivery of a test capsule given before a VCE examination, to exclude stenosis. The aim of this study was to determine the clinical value of subsequent MRE and CTE in patients in whom a test capsule did not present itself in due time. Methods Seventy-five consecutive patients were identified with a delayed or unnoticed delivery of the test capsule. Seventy patients consented to participate and underwent MRE (44 or CTE (26. The medical records and imaging studies were retrospectively reviewed and symptoms, laboratory results and imaging findings recorded. Results Lesions compatible with Crohns disease were shown by MRE in 5 patients, by CTE in one and by VCE in four, one of whom had lesions on MRE. In patients without alarm symptoms and findings (weight loss, haematochezia, anaemia, nocturnal diarrheoa, ileus, fistula, abscess and abnormal blood tests imaging studies did not unveil any such lesion. VCE's were performed in only 20 patients, mainly younger than 50 years of age, although no stenotic lesion was shown by MRE and CTE. In the remaining 50 patients no VCE or other endoscopic intervention was performed indicating that the referring physician was content with the diagnostic information from MRE or CTE. Conclusion The diagnostic value of MRE and CTE is sufficient for clinical management of most patients with suspected small bowel disease, and thus VCE may be omitted or at least postponed for later usage.

Fork Frans-Thomas

2012-02-01

162

Localization of ectopic gastric mucosa by scintigraphy  

International Nuclear Information System (INIS)

When gastric mucosal tissue occurs outside of the confines of the stomach, it is termed ectopic or heterotopic. Ectopic gastric mucosa may be found within Meckel's diverticulum, duplications of the alimentary tract, and Barrett's esophagus. In addition, a surgeon may inadvertently leave behind antral gastric mucosa while performing a partial gastrectomy for peptic ulcer disease (i.e., retained gastric antrum). It is important to detect the presence and location of ectopic mucosa because acid and pepsin secretion may cause ulceration in the adjacent tissue resulting in serious complications. The only currently available specific diagnostic technique for detecting ectopic gastric mucosa is pertechnetate Tc 99m (TcO4-) scintigraphy. This chapter reviews the functional anatomy of gastric mucosa, the mechanism of TcO4- localization, the various entities containing ectopic gastric mucosa, and the methods and results of TcO4- scanning for these disorders

163

Use of biosimilars in inflammatory bowel disease: Statements of the Italian Group for Inflammatory Bowel Disease.  

Science.gov (United States)

The introduction of biological therapies, particularly anti-TNF? agents, has revolutionized the management of inflammatory bowel disease in those cases which are refractory to conventional treatment; however these drugs are not risk-free and their use has substantially increased the cost of treatment. As marketing protection expires for original, first-generation biopharmaceuticals, lower-cost "copies" of these drugs produced by competitor companies-referred to as biosimilars-are already entering the market. In September 2013, the European Medicines Agency approved two infliximab biosimilars for treatment of adult and paediatric inflammatory bowel disease patients, a decision based largely on efficacy and safety data generated in studies of patients with ankylosing spondylitis and rheumatoid arthritis. For many clinicians, extrapolation practices and the general question of interchangeability between biosimilars and reference biologics are cause for concern. In the present paper, the Italian Group for inflammatory bowel disease presents its statements on these issues, with emphasis on the peculiar clinical characteristics of inflammatory bowel disease and the importance of providing physicians and patients with adequate information and guarantees on the safety and efficacy of these new drugs in the specific setting of inflammatory bowel disease. PMID:25139379

Annese, Vito; Vecchi, Maurizio

2014-11-01

164

Inflammatory Bowel Disease in Childhood: Aspects of Surgical Therapy  

Directory of Open Access Journals (Sweden)

Full Text Available Following the diagnosis as exactly as permitted, many children will have to undergo corrective surgery, mainly dependent on the complications of CD or UC respectively and/ or the intractability to conservative therapy. Surgery may be corrective mainly in CD cases or colectomy if the disease is restricted to the large bowel for CD. In cases of UC colectomy is curative. The indication and results of surgical intervention is discussed. Key words: Inflammatory Bowel Disease, Children, Surgery

G. Christopoulos-Geroulanos

2007-04-01

165

Bowel Preparation for Colonoscopy  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Colonoscopy is the premier method for colonic evaluation and its diagnostic accuracy and therapeutic safety depends on the quality of the colonic cleansing. Bowel cleansing with polyethylene glycol and sodium phosphate provides cleansing with high-quality preparations with an acceptably low morbidity rate and a high degree of patient satisfaction in a cost-effective manner. Modifications have reduced the volume of the polyethylene glycol preparations. Sodium phosphate has been associated with...

Beck, David E.

2010-01-01

166

Irritable Bowel Syndrome  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A 28-year-old woman presents with a 7-month history of recurrent, crampy pain in the left lower abdominal quadrant, bloating with abdominal distention, and frequent, loose stools. She reports having had similar but milder symptoms since childhood. She spends long times in the bathroom because she is worried about uncontrollable discomfort and fecal soiling if she does not completely empty her bowels before leaving the house. She feels anxious and fatigued and is frustrated that her previous p...

Mayer, Emeran A.

2008-01-01

167

Inflammatory bowel disease.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

An increasing number of options are available for the treatment of inflammatory bowel disease; the selection depends on the extent and severity of the disease. Experience with sulfasalazine and corticosteroids has led to a proliferation of 5-aminosalicylic acid (5-ASA) compounds and experimentation with alternative corticosteroid preparations. Given rectally 5-ASA is particularly effective in the treatment of distal ulcerative colitis, and experience is accumulating with several oral formulat...

Rosendaal, G. M.

1989-01-01

168

Short bowel syndrome.  

LENUS (Irish Health Repository)

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.

Donohoe, Claire L

2012-02-01

169

Untreated Celiac Disease in a Patient with Dermatitis Herpetiformis Leading to a Small Bowel Carcinoma  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Usually, celiac disease has a benign course, though the overall morbidity and mortality have increased. Treatment with a gluten-free diet restores the damaged intestinal mucosa. In rare cases a small bowel adenocarcinoma develops. Unfortunately, the clinical presentation is not always recognized and prognosis is bad. We present a 69-year-old man with a history of dermatitis herpetiformis who presented to our tertiary center for a second opinion for a suspected gastric motility disorder. This ...

Derikx, Monique H. M.; Bisseling, Tanya M.

2012-01-01

170

Analysis of small bowel tumors.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

OBJECTIVES Small bowel tumors are remarkably rare. The colon is affected 40 times than the small bowel. Even though the small intestine accounts for 80% of the length and 90% of the mucosal surface of the gastrointestinal tract, only 3-6% of the gastrointestinal malignancies arise from the small bowel. The aim of the study is to enlighten the subject in our community including: therapeutic intervention, the histopathologic types, the risk factors and outcome. ...

Abdul-rahman, Maad M.; Al-waali, Mustafa M.; Al-naaimi, Ahmed S.

2004-01-01

171

Medical Treatment of Irritable Bowel Syndrome  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The identification, diagnosis, and treatment of irritable bowel syndrome (IBS) have a tremendous impact on the large number of patients with this syndrome and on physicians representing a wide variety of general and specialty practices. There are well-established diagnostic criteria and algorithms for the initial evaluation of patients presenting with the symptoms of IBS. The symptoms can be targeted for therapy with a variety of pharmaceutical and nonpharmaceutical agents. Therapy should be ...

Reina, Jason; Smith, James W.

2005-01-01

172

Laser treatment of oral mucosa tattoo.  

Science.gov (United States)

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 buccal mucosa. The metal particles may accidentally reach the area of the oral mucosa during various dentistry interventions. The therapy most often involves surgical intervention with excisional biopsy while in the recent period the low power laser therapy has provided exceptional results. The aim of the paper was to present the successful removal of the oral mucosa tattoo in a single visit. PMID:23408182

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

2011-12-01

173

Oral purgative and simethicone before small bowel capsule endoscopy  

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Full Text Available AIM: To evaluate small bowel cleansing quality, diagnostic yield and transit time, comparing three cleansing protocols prior to capsule endoscopy. METHODS: Sixty patients were prospectively enrolled and randomized to one of the following cleansing protocols: patients in Group A underwent a 24 h liquid diet and overnight fasting; patients in Group B followed protocol A and subsequently were administered 2 L of polyethylene glycol (PEG the evening before the procedure; patients in Group C followed protocol B and were additionally administered 100 mg of simethicone 30 min prior to capsule ingestion. Small bowel cleansing was independently assessed by two experienced endoscopists and classified as poor, fair, good or excellent according to the proportion of small bowel mucosa under perfect conditions for visualization. When there was no agreement between the two endoscopists, the images were reviewed and discussed until a consensus was reached. The preparation was considered acceptable if > 50% or adequate if > 75% of the mucosa was in perfect cleansing condition. The amount of bubbles was assessed independently and it was considered significant if it prevented a correct interpretation of the images. Positive endoscopic findings, gastric emptying time (GET and small bowel transit time (SBTT were recorded for each examination. RESULTS: There was a trend favoring Group B in achieving an acceptable (including fair, good or excellent level of cleansing (Group A: 65%; Group B: 83.3%; Group C: 68.4% [P = not significant (NS] and favoring Group C in attaining an excellent level of cleansing (Group A: 10%; Group B: 16.7%; Group C: 21.1% (P = NS. The number of patients with an adequate cleansing of the small bowel, corresponding to an excellent or good classification, was 5 (25% in Group A, 5 (27.8% in Group B and 4 (21.1% in Group C (P = 0.892. Conversely, 7 patients (35% in Group A, 3 patients (16.7% in Group B and 6 patients (31.6% in Group C were considered to have poor small bowel cleansing (P = 0.417, with significant fluid or debris such that the examination was unreliable. The proportion of patients with a significant amount of bubbles was 50% in Group A, 27.8% in Group B and 15.8% in Group C (P = 0.065. This was significantly lower in Group C when compared to Group A (P = 0.026. The mean GET was 27.8 min for Group A, 27.2 min for Group B and 40.7 min for Group C (P = 0.381. The mean SBTT was 256.4 min for Group A, 256.1 min for Group B and 258.1 min for Group C (P = 0.998. Regarding to the rate of complete examinations, the capsule reached the cecum in 20 patients (100% in Group A, 16 patients (88.9% in Group B and 17 patients (89.5% in Group C (P = 0.312. A definite diagnosis based on relevant small bowel endoscopic lesions was established in 60% of the patients in Group A (12 patients, 44.4% in Group B (8 patients and 57.8% in Group C (11 patients (P = 0.587. CONCLUSION: Preparation with 2 L of PEG before small bowel capsule endoscopy (SBCE may improve small bowel cleansing and the quality of visualization. Simethicone may further reduce intraluminal bubbles. No significant differences were found regarding GET, SBTT and the proportion of complete exploration or diagnostic yield among the three different cleansing protocols.

Bruno Joel Ferreira Rosa

2013-01-01

174

Physiologic effects of bowel preparation  

DEFF Research Database (Denmark)

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.

Holte, Kathrine; Nielsen, Kristine Grubbe

2004-01-01

175

Chlamydia trachomatis antigens in enteroendocrine cells and macrophages of the small bowel in patients with severe irritable bowel syndrome  

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Full Text Available Abstract Background Inflammation and immune activation have repeatedly been suggested as pathogentic factors in irritable bowel syndrome (IBS. The driving force for immune activation in IBS remains unknown. The aim of our study was to find out if the obligate intracellular pathogen Chlamydia could be involved in the pathogenesis of IBS. Methods We studied 65 patients (61 females with IBS and 42 (29 females healthy controls in which IBS had been excluded. Full thickness biopsies from the jejunum and mucosa biopsies from the duodenum and the jejunum were stained with a monoclonal antibody to Chlamydia lipopolysaccharide (LPS and species-specific monoclonal antibodies to C. trachomatis and C. pneumoniae. We used polyclonal antibodies to chromogranin A, CD68, CD11c, and CD117 to identify enteroendocrine cells, macrophages, dendritic, and mast cells, respectively. Results Chlamydia LPS was present in 89% of patients with IBS, but in only 14% of healthy controls (p C. trachomatis major outer membrane protein (MOMP. Staining for C. pneumoniae was negative in both patients and controls. Chlamydia LPS was detected in enteroendocrine cells of the mucosa in 90% of positive biopsies and in subepithelial macrophages in 69% of biopsies. Biopsies taken at different time points in 19 patients revealed persistence of Chlamydia LPS up to 11 years. The odds ratio for the association of Chlamydia LPS with presence of IBS (43.1; 95% CI: 13.2-140.7 is much higher than any previously described pathogenetic marker in IBS. Conclusions We found C. trachomatis antigens in enteroendocrine cells and macrophages in the small bowel mucosa of patients with IBS. Further studies are required to clarify if the presence of such antigens has a role in the pathogenesis of IBS.

Sandström Gunnar

2010-02-01

176

An important regulatory role for CD4+CD8?? T cells in the intestinal epithelial layer in the prevention of inflammatory bowel disease  

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The normal immunoregulatory mechanisms that maintain homeostasis in the intestinal mucosa, despite continuous provocation by environmental antigens, are jeopardized in inflammatory bowel diseases. Although previous studies have suggested that intestinal intraepithelial lymphocytes prevent spontaneous intestinal inflammation, there is limited knowledge about the characteristics of regulatory cells in the intestinal intraepithelial lymphocytes population. Here we show that CD4+CD8??+ double-p...

Das, Gobardhan; Augustine, Mathew M.; Das, Jyoti; Bottomly, Kim; Ray, Prabir; Ray, Anuradha

2003-01-01

177

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

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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.

Ernst, Anja; Andersen, Vibeke

2011-01-01

178

Altered gastric emptying in patients with irritable bowel syndrome  

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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.)

179

Altered gastric emptying in patients with irritable bowel syndrome  

Energy Technology Data Exchange (ETDEWEB)

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.

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

180

Intestinal epithelial cells in inflammatory bowel diseases  

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Full Text Available The pathogenesis of inflammatory bowel diseases (IBDs seems to involve a primary defect in one or more of the elements responsible for the maintenance of intestinal homeostasis and oral tolerance. The most important element is represented by the intestinal barrier, a complex system formed mostly by intestinal epithelial cells (IECs. IECs have an active role in producing mucus and regulating its composition; they provide a physical barrier capable of controlling antigen traffic through the intestinal mucosa. At the same time, they are able to play the role of non-professional antigen presenting cells, by processing and presenting antigens directly to the cells of the intestinal immune system. On the other hand, immune cells regulate epithelial growth and differentiation, producing a continuous bi-directional cross-talk within the barrier. Several alterations of the barrier function have been identified in IBD, starting from mucus features up to its components, from epithelial junctions up to the Toll-like receptors, and altered immune responses. It remains to be understood whether these defects are primary causes of epithelial damage or secondary effects. We review the possible role of the epithelial barrier and particularly describe the role of IECs in the pathogenesis of IBD.

Giulia Roda, Alessandro Sartini, Elisabetta Zambon, Andrea Calafiore, Margherita Marocchi, Alessandra Caponi, Andrea Belluzzi, Enrico Roda

2010-09-01

 
 
 
 
181

CT findings of small bowel metastases from primary lung cancer  

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To evaluate the CT findings of small bowel metastases from primary lung cancer. Of the 1468 patients with primary lung cancer between 1990 and 2000, 13 patients who had metastasis to the small intestine were collected. Of these 13 patients, nine who underwent CT scan were included for analysis. The pathologic diagnoses of primary lung cancer in these nine patients were squamous cell carcinoma in six, adenocarcinoma in two, and large cell carcinoma in one. CT scans were analyzed with regard to the site and patterns (intraluminal mass/bowel wall thickening/bowel implants) of metastatic masses, and the presence or absence of complication such as intussusception, obstruction, or perforation of the small bowel. The medical records of the patients were also reviewed retrospectively for evaluation of presenting abdominal symptom and time interval of metastases from initial diagnosis of lung cancer. Metastatic lesions were distributed throughout the small intestine: the duodenum in five, the jejunum in four, the ileum in six, and both jejunum and ileum in one patient. The size of metastatic masses of small bowel ranged from 1.3 cm to 5.0 cm (mean size, 2.6 cm) On CT, the small bowel was involved with intraluminal masses (mean size, 3.4 cm) in eight patients, diffuse wall thickening (mean thickness, 1.6 cm) in five, and bowel implants (mean size, 2.2 cm) in two. Complications occurred in seven patients, including intussusceptions without obstruction in two patients and with obstruction in two, obstruction without intussusceptions in two, and bowel perforation in one. Of 9 patients, 6 had at least one symptom referable to the small bowel including abdominal pain in 4, anemia in 3, vomiting in 1, and jaundice in 1. Lung cancer and small bowel lesions were detected simultaneously in four patients and the time interval of metastases from initial diagnosis of lung cancer ranged from 10 days to 30 months (median interval, 54 days) in patients. CT helps in defining the extent and pattern of small bowel metastases as well as in demonstrating their complication.

Kim, Jae Wook; Ha, Hyun Kwon; Kim, Ah Young; Kim, Gab Choul; Kim, Tae Kyoung; Kim, Pyo Nyun; Lee, Moon Gyu [Ulsan University College of Medicine, Seoul (Korea, Republic of)

2002-11-01

182

Posterior rectus sheath hernia causing intermittent small bowel obstruction.  

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A posterior rectus sheath hernia is an abdominal wall hernia that is rarely encountered. Owing to its rarity, it can be easily overlooked in the setting of a patient presenting with abdominal pain. We report a case of a posterior rectus sheath hernia that caused intermittent small bowel obstruction. The unusual aspects of this case are that the defect was large, measuring 6 cm in the transverse diameter, and that it contained small bowel within a large portion of the rectus sheath. Because the defect was large and affected nearly the entire posterior rectus sheath, it was difficult to discern on computed tomography until a small bowel obstruction developed. In this case, a limited awareness of this clinical entity contributed to the delay in diagnosis. PMID:25426248

Lenobel, Scott; Lenobel, Robert; Yu, Joseph

2014-09-01

183

Torsion of Meckel's diverticulum as a cause of small bowel obstruction: A case report.  

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Axial torsion and necrosis of Meckel's diverticulum causing simultaneous mechanical small bowel obstruction are the rarest complications of this congenital anomaly. This kind of pathology has been reported only eleven times. Our case report presents this very unusual case of Meckel's diverticulum. A 41-year-old man presented at the emergency department with complaints of crampy abdominal pain, nausea and retention of stool and gases. Clinical diagnosis was small bowel obstruction. Because the origin of obstruction was unknown, computer tomography was indicated. Computed tomography (CT)-scan revealed dilated small bowel loops with multiple air-fluid levels; the oral contrast medium had reached the jejunum and proximal parts of the ileum but not the distal small bowel loops or the large bowel; in the right mid-abdomen there was a 11 cm × 6.4 cm × 7.8 cm fluid containing cavity with thickened wall, which was considered a dilated bowel-loop or cyst or diverticulum. Initially the patient was treated conservatively. Because of persistent abdominal pain emergency laparotomy was indicated. Abdominal exploration revealed distended small bowel loops proximal to the obstruction, and a large (12 cm × 14 cm) Meckel's diverticulum at the site of obstruction. Meckel's diverticulum was axially rotated by 720°, which caused small bowel obstruction and diverticular necrosis. About 20 cm of the small bowel with Meckel's diverticulum was resected. The postoperative course was uneventful and the patient was discharged on the fifth postoperative day. We recommend CT-scan as the most useful diagnostic tool in bowel obstruction of unknown origin. In cases of Meckel's diverticulum causing small bowel obstruction, prompt surgical treatment is indicated; delay in diagnosis and in adequate treatment may lead to bowel necrosis and peritonitis. PMID:25346803

Murruste, Marko; Rajaste, Geidi; Kase, Karri

2014-10-27

184

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

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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.

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

2013-01-01

185

Dexamethasone inhibits mucosal adaptation after small bowel resection.  

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The present study examined the effects of dexamethasone on mucosal adaptation after massive small bowel resection. Rats underwent 80% jejunoileal resection or a sham operation and received either vehicle or 128 micrograms.kg-1.day-1 sc dexamethasone for 7 days. Dexamethasone infusion resulted in decreased weight, DNA content, and protein content in the duodenojejunal and ileal mucosa in both sham and resected rats. Sucrase, lactase, and maltase activities (all in mumol.g protein-1.min-1) in the duodenojejunal mucosa were elevated by dexamethasone infusion. By contrast, enzyme activities were elevated only in the ileal mucosa of dexamethasone-infused sham-operated rats compared with sham-operated control rats, and dexamethasone did not elevate enzyme activities in resected rats. We further examined whether the inhibitory effects of dexamethasone on mucosal adaptation may be related to changes in either insulin-like growth factor (IGF) or IGF binding protein (BP) serum levels. Serum IGF-I and IGF-II levels were markedly decreased in dexamethasone-infused resected and sham-operated rats. IGF BP-1 serum levels were elevated by dexamethasone treatment with a concomitant depression in serum IGF BP-2 levels. IGF BP-3 levels were lowered by dexamethasone treatment in sham-operated rats and by gut resection, and serum IGF BP-4 levels did not change. These results suggest that the growth-inhibiting effects of dexamethasone in small intestinal mucosa may be partially mediated by decreased serum IGF levels or by alterations in IGF activity associated with changes in serum levels of IGF BPs. PMID:7513128

Park, J H; McCusker, R H; Mohammadpour, H; Blackwood, D J; Hrbek, M; Vanderhoof, J A

1994-03-01

186

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

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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

Dorofeyev AE

2011-06-01

187

Sleep and Irritable Bowel Syndrome  

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... Are Contact Us Donate Sleep and Irritable Bowel Syndrome Sleep difficulties are common in people with irritable ... Medicine; and Chief of the Psychophysiology Research Laboratory, West Los Angeles VA GLA Health Care; and from ...

188

Neurostimulation for Neurogenic Bowel Dysfunction  

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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 NB...

Worsøe, J.; Rasmussen, M.; Christensen, P.; Krogh, K.

2013-01-01

189

Microalbuminuria in inflammatory bowel disease.  

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Microalbuminuria independently predicts the development of nephropathy and increased cardiovascular morbidity and mortality in diabetic patients, but it may be an indicator of the acute phase response. This study examined microalbuminuria as a marker of the acute phase response in patients with inflammatory bowel disease and correlated it with the disease activity in 95 patients with inflammatory bowel disease (ulcerative colitis (n = 52), Crohn's disease (n = 43)) determined by the simple in...

Kelleher, Dermot P.

1994-01-01

190

Candida albicans translocation across the gut mucosa following burn injury.  

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Normal guinea pigs were challenged intragastrically with Candida albicans 1 hr prior to a 30 or 50% flame burn to determine if burn injury increased translocation of the yeasts across gut mucosa. Tissues were harvested between 3 and 24 hr postburn and cultured on Sabouraud dextrose agar. Control animals (no yeast challenge) showed no yeast in intestinal homogenates or in the mesenteric lymph nodes (MLN). At a dose of 1 X 10(9) yeasts, they did not escape from the gut lumen, with either a 30 or 50% burn. At a dose of 2 to 4 X 10(10) organisms, they translocated to the MLN in 92% of the 50%-burned animals (P less than 0.001), 75% of the 30%-burned animals (P less than 0.05), and 12.5% of unburned animals. The ileal mucosa appeared to be the most susceptible site for yeast invasion. To observe the penetration through the gut mucosa and/or translocation to other tissues, yeasts were labeled with biotin before administration, and tissues were stained with avidin-peroxidase diaminobenzidine sequence. With biotinylated yeasts, phagocytized organisms were observed in large numbers in the lamina propria and mesenteric lymph nodes but they were not viable upon culture. Toluidine blue staining of semithin sections revealed that translocated yeasts were located selectively in the lymphoid follicles of the MLN, entrapped by macrophages. PMID:3287002

Inoue, S; Wirman, J A; Alexander, J W; Trocki, O; Cardell, R R

1988-05-01

191

Long-Term Outcomes of Simultaneous Skin and Bowel Flaps for Esophageal Reconstruction.  

Science.gov (United States)

Esophageal reconstruction can be performed with skin or bowel flaps. The choice of flap remains controversial, as the long-term outcomes of skin flaps cannot always be assessed in patients with limited life expectancies due to advanced malignancy, unlike the pediatric and benign cases which have had esophageal reconstruction using bowel flaps. We report the long-term clinical and histopathological outcomes in a series of 45 cases repaired with combined skin and bowel flaps.Four patients developed symptomatic strictures after corrosive esophageal injuries were repaired with a combination of a tubed free radial forearm fasciocutaneous flap and a pedicled bowel flap. On average, 24 years had passed since uneventful initial esophageal reconstructions. Barium esophagograms were obtained in all cases and pathological examination was performed upon all surgical specimens.The cutaneous portions of the reconstructed esophagus exhibited a variety of findings on barium examination. Each of the 4 cases developed an esophagocutaneous fistula after revision; an average of 4 surgeries was required to close these fistulae. The inner surfaces of the portion of esophagus repaired with skin flaps showed extensive ulceration, polypoid lesions, and fibrosis. Pathology specimens from skin flaps showed extensive acute and chronic inflammation, microabscesses, fibrosis, and acanthosis, with depletion and degeneration of the pilosebaceous units. By contrast, adjacent parts of the esophagus repaired with bowel were widely patent with normal appearing mucosa.Our findings indicate that a bowel flap is durable with good tolerance to gastrointestinal content over long periods, whereas skin flaps often developed morphological changes and could not maintain long-term esophageal function without eventual stricture and dysphagia. We therefore recommend use of bowel flaps for esophageal reconstruction in patients with long life expectancy. PMID:25003411

Imaizumi, Atsushi; Liem, Anita A; Yang, Chun-Fan; Chen, Wency; Chen, Shih-Heng; Chen, Hung-Chi

2014-07-01

192

Imbalance of stromelysin-1 and TIMP-1 in the mucosal lesions of children with inflammatory bowel disease  

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BACKGROUND—Degradation of the extracellular matrix and ulceration of the mucosa are major features of inflammatory bowel disease (IBD). One of the most important enzymes in degrading the matrix and produced in excess by cytokine activated stromal cells, is stromelysin-1. The activity of stromelysin-1 is controlled by tissue inhibitor of metalloproteinase (TIMP-1), its natural inhibitor. In model systems excess stromelysin-1 produces mucosal degradation.?METHODS—Quantitative competitive ...

Heuschkel, R.; Macdonald, T.; Monteleone, G.; Bajaj-elliott, M.; Smith, J.; Pender, S.

2000-01-01

193

Role of Antimicrobial Peptides in Inflammatory Bowel Disease  

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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.

Stefan Vordenbäumen

2011-11-01

194

Probiotics in Inflammatory Bowel Diseases and Associated Conditions  

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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.

David R. Mack

2011-02-01

195

Small bowel tumors  

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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.

Xynopoulos D.

2007-03-01

196

Lymphocyte migration to the middle ear mucosa.  

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We investigated the migration of antigen-specific IgA-forming cells to the middle ear mucosa. Antigen-specific lymphocytes of IgA and IgG classes were induced in guinea pigs according to an immunization strategy previously described. From those animals, chromium 51-labeled lymphocytes of Peyer's patches and spleen were transferred to radiated chimera recipients. The radioactivity levels of the middle ears with antigenic and nonantigenic stimuli were significantly higher than those of the control ears (p .05). Many labeled cells were observed in the middle ear effusion, while few were found in the inflamed mucosa. These findings suggest that in the early stage of inflammation, lymphocytes, including antigen-specific T and B cells, may be recruited from the blood circulation to the inflamed middle ear mucosa by nonspecific inflammatory processes that may mask antigen-specific factors in lymphocyte migration. PMID:8311387

Kato, H; Watanabe, N; Bundo, J; Mogi, G

1994-02-01

197

Value of transabdominal bowel ultrasonography and splanchic vascular parameters in the evaluation of inflammatory bowel disease  

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Background: Although non-specific, transabdominal bowel ultrasonography, in real time or in color Doppler; has been beneficial in evaluating the location, extent and activity of inflammatory bowel disease (IBD). Aim: To assess the potential role of bowel transabdominal bowel ultrasonography in the diagnosis and follow-up of IBD. Patients and Methods: A cohort of 30 adults histologically-proven active IBD pat...

Manal Kamel; Magdy El-Serafy; Hussein Attia; Hanan Abdeel-Haleem; Naglaa Zayed; Maha Hasab-Allah; Zakaria Salama

2013-01-01

198

If I Had - Bowel Control Issues  

Medline Plus

Full Text Available ... have problems controlling the bowel, and typically controlling gas is less of a problem than controlling the ... flax seed, for example, which is a wonderful, natural lubricant that helps the bowel to move better. ...

199

Biologic targeting in the treatment of inflammatory bowel diseases  

Directory of Open Access Journals (Sweden)

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

Matteo Bosani

2009-02-01

200

Differential patterns of histone acetylation in inflammatory bowel diseases  

Directory of Open Access Journals (Sweden)

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.

Adcock Ian M

2011-01-01

 
 
 
 
201

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)

202

Gastrointestinal adaptation following small bowel bypass for obesity.  

Science.gov (United States)

Small intestinal morphologic and biochemical changes were studied following jejuno-ileal bypass for obesity after body weight stabilization had occurred. Four patients underwent biopsy of in-continuity and bypassed jejunal and ileal segments of the small intestine 11 to 22 months after the bypass operation. Microscopically, marked mucosal villus hypertrophy of the in-continuity bowel was observed, especially in the ileum. Bypassed jejunal mucosa underwent atrophy compared with pre-bypass jejunum, whereas bypassed ileum appeared similar microscopically to pre-bypass ileum. The specific activities of mucosal disaccharidase enzymes (maltase, sucrase, lactase and trehalase) in units per mg protein remained similar to pre-bypass levels in segments of the in-continuity jejunum and the bypassed jejunum and ileum. On the other hand, elevated mucosal disaccharidase levels were measured in biopsy specimens of the in-continuity ileum. Total enzyme activity per unit length of intestine, however, was estimated to be elevated in both in-continuity jejunum and ileum secondary to mucosal villus hypertrophy. These data indicate that following small bowel bypass: (1) the in-continuity ileum undergoes greater biochemical and morphologic adaptation than the jejunum; and (2) intraluminal nutrients and chyme appear to be essential to maximal intestinal adaptation. PMID:871220

Dudrick, S J; Daly, J M; Castro, G; Akhtar, M

1977-06-01

203

Irritable bowel syndrome in primary care  

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Irritable bowel syndrome (IBS) is a functional bowel disorder in which abdominal pain or discomfort is associated with a change in bowel habit, or with features of disordered defecation. Patients and doctors in primary care generally agree on IBS symptomatology and consider pain and bloating as its main features. Consultation behaviour is mainly driven by the severity of IBS symptomatology, rather than by its impact on quality of life or psychological distress. Irritable bowel syndrome is ass...

Bijkerk, C. J.

2008-01-01

204

Inflammatory Bowel Disease in the Obese Patient  

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Obesity is becoming increasingly more common among patients with inflammatory bowel disease. In this review, we will explore the epidemiological trends of inflammatory bowel disease, the complex interplay between the proinflammatory state of obesity and inflammatory bowel disease, outcomes of surgery for inflammatory bowel disease in obese as compared with non-obese patients, and technical concerns pertaining to restorative proctocolectomy and ileoanal pouch reservoir, stoma creation and lapa...

Boutros, Marylise; Maron, David

2011-01-01

205

Inflammatory bowel disease: Medical management  

Directory of Open Access Journals (Sweden)

Full Text Available Various papers have been published on inflammatory bowel disease in the Kingdom of Saudi Arabia and other Gulf States during last decade. Apparently, the published data contradict previous belief and indi-cate that, we might deal here with a medical problem. However, data on the magnitude of this disease in our community remains uncertain. Could we attribute this possible change to the improvement in diag-nostic procedure or to the change in life style? Unfortunately, the literature does not provide us with a convicting answer to this question yet. However, at this stage a review of the medical management in inflammatory bowel disease seems to be justified. Hence currently used drugs in the management in inflammatory bowel disease are reviewed in this paper. Some of the potentially effective drugs for the future are also summarized.

Al-Gindan Yusuf

1995-01-01

206

Epithelial restitution and wound healing in inflammatory bowel disease  

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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.

Andreas Sturm, Axel U Dignass

2008-01-01

207

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.)

208

Therapeutic leukocytapheresis in inflammatory bowel disease: clinical efficacy and mechanisms of action.  

Science.gov (United States)

Intense infiltration of the intestinal mucosa by activated leukocytes is a hallmark of inflammatory bowel disease (IBD). Therefore, removal of circulating leukocytes may be an attractive approach for treating IBD. Leukocytapheresis with Cellsorba, a column of polyethylenephtarate fibers that captures monocytes, granulocytes and lymphocytes, has been used to treat IBD, particularly ulcerative colitis, in Japan and Europe. This article reviews the clinical efficacy and safety data and the mechanisms of action of leukocytapheresis in IBD. Although the majority of clinical studies enrolled only small numbers of patients and had open-labeled designs, leukocytapheresis showed clinical efficacy with an excellent safety profile. Leukocytapheresis depletes granulocytes, monocytes, lymphocytes and platelets, alters cell population profiles, modulates cytokine production, and induces bone marrow-derived cells. In conclusion, leukocytapheresis exerts anti-inflammatory and tissue-repairing effects on the intestinal mucosa in IBD. Further studies are needed to explain the exact mechanism of action and to determine the true efficacy of this approach. PMID:19241197

Mitsuyama, Keiichi; Sata, Michio

2009-01-01

209

Obstrução do íleo terminal por mucosa gástrica heterotópica Terminal ileum obstruction owing to heterotopic gastric mucosa  

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A mucosa gástrica ectópica localizada no intestino delgado, distal ao ligamento de Treitz é muito rara, excetuando-se a encontrada habitualmente no divertículo de Meckel e na duplicação intestinal. Existem formas congênita e adquirida, sendo esta última secundária à processos inflamatórios intestinais. As diferenças entre estas formas são basicamente histológicas, determinando no entanto aspectos fisiopatológicos distintos. Apresentamos caso de mucosa gástrica ectópica em pac...

Atik, F. A.; Ricci, M.; Del Grande, J. C.; Haddad, C. M.

1998-01-01

210

Radioprotective effect of captopril on the mouse jejunal mucosa  

Energy Technology Data Exchange (ETDEWEB)

Captopril, an inhibitor of angiotensin I converting enzyme, has been shown to modify radiation damage and prevent radiation injury of normal tissue in rats and pigs. The present study was carried out to determine whether captopril would reduce radiation changes in the proximal small bowel in mice. Mice were subjected to whole body irradiation with 9 Gy or 15 Gy. Captopril was administered in drinking water at a regimen of 62.5 mg/kg/day (captopril group I) and 125 mg/kg/day (captopril group II), continuously from 7 days before irradiation to the end of each designed experiment. The jejunal damage was evaluated microscopically by crypt count per circumference and by histologic damage grading. Crypt number in the sham-irradiated control was 133 {plus_minus} 6.8/circumference. In both captopril group I and II, crypt numbers and histologic scores were not significantly different from those in the normal group. The 9 Gy and 15 Gy radiation alone groups showed significantly lower crypt counts and histologic scores compared with the sham-irradiated control group (p<0.05). The groups exposed to 9 Gy radiation plus captopril I and II showed significantly higher crypt counts and lower histologic damage scores on the third day, and lower histologic damage scores on the fifth day compared with the 9 Gy radiation alone group (p<0.05). The 15 Gy radiation plus captopril I and II groups had significantly higher crypt counts and lower histologic damage scores on the third day than those of the 15 Gy radiation alone group (p<0.05). All mice of the 15 Gy radiation group succumbed to intestinal radiation death. Our results suggest that captopril provides protection from acute radiation damage to the jejunal mucosa in mice. 28 refs., 5 figs., 4 tabs.

Yoon, Se-Chul; Park, Jeong-Mi; Jang, Hong-Seok [Catholic University Medical College, Seoul (Korea, Republic of)] [and others

1994-11-15

211

Controversies about the use of serological markers in diagnosis of inflammatory bowel disease  

Directory of Open Access Journals (Sweden)

Full Text Available The serological markers are increasingly used in diagnosis of inflammatory bowel disease (IBD. D-lactate and diamine oxidase are new indicators that can be used to reveal the damage to intestinal mucosa and permeability alteration in IBD. Although the two biological markers seem more sensitive, recent clinical trials and animal experiments have shown controversies about the use of them in diagnosis of IBD. Therefore, these markers should be interpreted cautiously and further prospective studies are needed to establish their clinical role in diagnosis of IBD.

Qin Xie, Hua-Tian Gan

2010-01-01

212

Ectopic intestinal glands after segmental small bowel irradiation in the cat  

International Nuclear Information System (INIS)

Following segmental irradiation of the small bowel, 5 of 64 cats demonstrated ectopic intestinal glands in the submucosal tissue. In addition, one of these 5 cats had foci of abnormal glands in the muscularis mucosae. In 2 of the 5 animals, cellular polymorphism, nucleolar irregularity and loss of cellular polarity were present in irradiation-induced ectopic intestinal glands. The review of the literature indicates that intestinal irradiation may induce intestinal adenocarcinomas with metastatic growth. The possibility that ectopic intestinal glands are precancerous lesions in the irradiated cat is discussed. (Auth.)

213

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.

214

A multidisciplinary approach to short bowel syndrome.  

Science.gov (United States)

Short bowel syndrome is a complex clinical picture, characterized by signs and symptoms of malabsorption and subsequent malnutrition, which often occurs after extensive bowel resections. Short bowel syndrome's treatment must begin together with the planning of the first surgery, especially for disease that may need multiple interventions. Patients with short bowel should be individually managed because they all are different in diagnosis, length of the remaining bowel and in psychosocial characteristics. For all these reasons, a multidisciplinary approach between the various specialists is therefore needed. PMID:24393697

Denegri, Andrea; Paparo, Francesco; Denegri, Roberto; Revelli, Matteo; Frascio, Marco; Rollandi, Gian Andrea; Fornaro, Rosario

2014-01-01

215

A critical review of auscultating bowel sounds.  

Science.gov (United States)

Auscultation (listening for bowel sounds) is part of an abdominal physical assessment and is performed to determine whether normal bowel sounds are present. This article evaluates the technique involved in listening for bowel sounds and the significance of both normal and abnormal auscultation findings. Review of the relevant literature reveals conflicting information and a lack of available research on the topic of auscultating bowel sounds. The clinical significance of auscultation findings when there is no evidence base to support the practice of listening for bowel sounds is explored by further analysis of the literature and reflection by the author on the teaching she received and her own personal practice. PMID:19966732

Baid, Heather

216

Bowel dysfunction in spinal cord injury.  

Science.gov (United States)

Bowel Dysfunction is one of the least looked at problems in Spinal Cord Injury (SCI). The goals of this study are to understand bowel dysfunction in SCI and its effects on quality of life (QOL). Cross-sectional study based on interview and assessment of 41 clients. A majority of them were dissatisfied. Bowel opening time was long in about 65% while 76.6% were incontinent. Socially, approximately half refrained from outings even though 90.3% of them carried out bowel evacuation before going out. Attention to bowel education is necessary to improve social continence. PMID:18942293

Naicker, A S; Roohi, S A; Naicker, M S; Zaleha, O

2008-06-01

217

Case report of bacteremia due to Neisseria mucosa.  

Science.gov (United States)

Neisseria mucosa, a Gram-negative diplococcus, is part of normal nasopharyngeal flora. We report a case of bacteremia caused by N. mucosa in a 50-year-old neutropenic patient suffering from non-secretory multiple myeloma stage IIIA. This case underscores that mostly nonpathogenic N. mucosa can cause bacteremia in neutropenic patients who developed mucositis after hematopoietic stem cell transplantation. PMID:23905778

Mechergui, Arij; Achour, Wafa; Baaboura, Rekaya; Ouertani, Hela; Lakhal, Amal; Torjemane, Lamia; Othman, Tarek Ben; Hassen, Assia Ben

2014-04-01

218

Lymphocyte-mucosal interaction of the middle ear mucosa.  

Science.gov (United States)

The middle ear mucosa possesses immunologic features similar to those of the peripheral mucosa sites in the common mucosal immune system and after mucosal immunization, antigenspecific IgA-forming cells appear in the inflamed mucosa of the tympanic cavity. Recent investigations suggest that lymphocyte migration to lymphoid tissues is regulated by lymphocyte-high endothelial venules (HEV) interaction. However, the lymphocyte migration mechanism to the middle ear mucosa is still unclear. We investigated whether or not organ-specific determinants which lymphocytes bind with are present on the middle ear mucosa by in vivo and in vitro lymphocyte adherence assays by using fluorescein-labeled lymphocytes from various lymphoid tissues. Many lymphocytes from Peyer's patches and hilar lymphnodes adhered on the inflamed middle ear mucosa with or without mucosal immunization, while these cells were not found on the normal tympanic mucosa. The number of the cells was smaller than that in the gastrointestinal mucosa. Lymphocyte adherence to the middle ear mucosa was not suppressed by anti-T cell antibody. These findings suggest that the middle ear mucosa possesses organ-specific mucosal determinants which B-lymphocytes selectively bind with, and that those determinants which regulate lymphocyte migration to the middle ear mucosa differ from those of other mucosae in the gastrointestinal tract. PMID:1636413

Watanabe, N; Yoshimura, H; Shinoda, M; Bundo, J; Mogi, G

1992-01-01

219

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 thickneod 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)

220

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

Energy Technology Data Exchange (ETDEWEB)

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)

Tateno, Atsushi; Miyashita, Tsuguhiro; Kumazaki, Tatsuo [Nippon Medical School, Tokyo (Japan)

1999-12-01

 
 
 
 
221

Inflammatory Bowel Disease (For Children)  

Science.gov (United States)

... is available if you do? What Is IBD? Inflammatory (say: in-FLAM-uh-tor-ee) bowel disease is not a single ailment. It actually refers to a number of disorders that cause inflammation (say: in-fluh-MAY-shun) and, often, ulcers in the intestinal (say: in-TES-tuh-nul) tract. Ulcers are ...

222

Dysbiosis in inflammatory bowel disease  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abundant data have incriminated intestinal bacteria in the initiation and amplification stages of inflammatory bowel diseases. However, the precise role of intestinal bacteria remains elusive. One theory has suggested a breakdown in the balance between putative species of “protective” versus “harmful” intestinal bacteria—this concept has been termed “dysbiosis”. Arguments in support of this concept are discussed.

Tamboli, C. P.; Neut, C.; Desreumaux, P.; Colombel, J. F.

2004-01-01

223

Cancer in inflammatory bowel disease  

Directory of Open Access Journals (Sweden)

Full Text Available Patients with long-standing inflammatory bowel disease (IBD have an increased risk of developing colorectal cancer (CRC. Many of the molecular alterations responsible for sporadic colorectal cancer, namely chromosomal instability, microsatellite instability, and hypermethylation, also play a role in colitis-associated colon carcinogenesis. Colon cancer risk in inflammatory bowel disease increases with longer duration of colitis, greater anatomic extent of colitis, the presence of primary sclerosing cholangitis, family history of CRC and degree of inflammation of the bowel. Chemoprevention includes aminosalicylates, ursodeoxycholic acid, and possibly folic acid and statins. To reduce CRC mortality in IBD, colonoscopic surveillance with random biopsies remains the major way to detect early mucosal dysplasia. When dysplasia is confirmed, proctocolectomy is considered for these patients. Patients with small intestinal Crohn’s disease are at increased risk of small bowel adenocarcinoma. Ulcerative colitis patients with total proctocolectomy and ileal pouch anal-anastomosis have a rather low risk of dysplasia in the ileal pouch, but the anal transition zone should be monitored periodically. Other extra intestinal cancers, such as hepatobiliary and hematopoietic cancer, have shown variable incidence rates. New endoscopic and molecular screening approaches may further refine our current surveillance guidelines and our understanding of the natural history of dysplasia.

Jianlin Xie, Steven H Itzkowitz

2008-01-01

224

Bowel loops and eyelid droops  

Science.gov (United States)

Abstract: A patient presented with a small-bowel obstruction associated with signs and symptoms of botulism. Fecal cultures were positive for viable Clostridium botulinum. This case emphasizes the importance of a broad differential diagnosis and doing a complete examination to account for all signs and symptoms. PMID:18936457

Spiegelman, Jamie; Cescon, David W.; Friedman, Yael; Mazza, Brie V.; Austin, John W.; Rachlis, Anita; Murray, Brian J.

2008-01-01

225

Bowel loops and eyelid droops  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract: A patient presented with a small-bowel obstruction associated with signs and symptoms of botulism. Fecal cultures were positive for viable Clostridium botulinum. This case emphasizes the importance of a broad differential diagnosis and doing a complete examination to account for all signs and symptoms.

Spiegelman, Jamie; Cescon, David W.; Friedman, Yael; Mazza, Brie V.; Austin, John W.; Rachlis, Anita; Murray, Brian J.

2008-01-01

226

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.)

227

The use of FK506 and RS61443 for reversal of small-bowel rejection.  

Science.gov (United States)

Successful clinical small-bowel transplantation is still difficult to achieve. Two features render the small intestine unique among vascularised solid organ grafts. First, the bowel contains a large amount of lymphoid tissue within the Peyer's patches, mesenteric lymph nodes, and intraepithelial lymphocytes, which are thought to mediate graft-versus-host disease and provide a major stimulus for the recipient's immune system. Unfortunately, mere surgical reduction of these tissues, by using segmental allografts, does not furnish any immunological advantage. Second, the small bowel lacks specific serum markers such as blood urea nitrogen (BUN) in the kidney or bilirubin in liver transplantation. Clinical signs such as fever, pain, or tenderness of the abdomen may indicate an already advanced destruction of the graft. Therefore, very potent immunosuppressive regimens are necessary to avoid small-bowel allograft rejection or even to reverse an ongoing rejection process. Cyclosporin was shown in small and large animal models to control rejection reactions sufficiently. However, there are two even more promising immunosuppressive agents currently under investigation. FK506, a macrolide lactone isolated from Streptomyces tsukubaensis, leads to long-term survival of small-bowel allografts in a rodent model and has already been used in a few clinical small-bowel transplantations. RS61443, a mycophenolic acid morpholinoethylester, selectively inhibits T- and B-cell proliferation. We have investigated the use of FK506 and RS61443 for the reversal of small-bowel allograft rejection in a small animal model. PMID:14621800

Stangl, M J; Gräb, C; Fischer, T; Mebert, H; Weiss, M; Hammer, C

1992-01-01

228

Inflammatory bowel disease: clinical aspects and treatments  

Directory of Open Access Journals (Sweden)

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

Fakhoury M

2014-06-01

229

Bacteria, genetics and irritable bowel syndrome.  

LENUS (Irish Health Repository)

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.

Craig, Orla F

2010-06-01

230

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

231

Emerging Leadership Lecture: Inflammatory Bowel Disease in Asia: Emergence of a "Western Disease"  

Science.gov (United States)

More than a decade ago, inflammatory bowel disease (IBD) is rare in Asia. Today, the importance of IBD in Asia is exemplified by its rapidly increasing incidence, complicated disease behavior and substantial morbidity. In the first large scale population-based epidemiologic study in Asia, the incidence of IBD varied from 0.60 to 3.44 per 100,000. There has been a two- to three-fold increase in the incidence of IBD in several countries in Asia. Ulcerative colitis (UC) is more prevalent than Crohn's disease (CD), although CD incidence is rapidly increasing. A positive family history is much less common than in the West, as are extra-intestinal disease manifestations. Complicated and penetrating CD are common in Asia. These epidemiologic changes may relate to increased contact with the West, westernization of diet, improved hygiene, increasing antibiotics use, or changes in the gut microbiota. Asian patients with CD have altered gut microbiota compared with their healthy counterparts and Caucasian CD subjects. Mucosa-associated microbiota in IBD may differ geographically. In a population-based case-control study, breastfeeding, having pets and better sanitary conditions were protective of IBD suggesting that childhood environment plays an important role in modulating disease development. Genetic factors also differ between Asians and Caucasians. NOD2 and autophagy variants were not associated with CD, but TNF-SF15 polymorphisms were strongly associated with CD in East Asians. Research in Asia, an area of rapidly changing IBD epidemiology, may lead to the discovery of critical etiologic factors that lead to the development of IBD. PMID:25469874

Ng, Siew C

2014-12-01

232

Influência da glutamina na mucosa do instestino de ratos submetidos à enterectomia extensa Influence of glutamine on intestinal mucosa of rats after extensive enterectomy  

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Full Text Available OBJETIVO: Avaliar a influência de uma dieta suplementada com glutamina sobre as alterações adaptativas no intestino delgado de ratos com enterectomia extensa. MÉTODO: Vinte ratos Wistar, divididos aleatoriamente em dois grupos de dez animais, foram enterectomizados e alimentados com dois tipos diferentes de dieta nos 14 dias de pós-operatório: grupo controle (GC-dieta padrão; grupo glutamina (GG-dietapadrão acrescida de 3,05% de glutamina. Avaliou-se evolução ponderal, peso da mucosa intestinal (PM, profundidade das criptas (PC, altura das vilosidades (AV, espessura da parede (EP e o conteúdo de ácido desoxirribonucléico (DNA na mucosa intestinal, no início e no final do experimento. RESULTADOS: Com exceção da PC ileal do Grupo GG, todas as variáveis estudadas tiveram um aumento significativo em seus valores finais tanto no jejuno quanto no íleo (p0,05. No jejuno inicial, a PC no grupo GC foi maior (p=0,005. A EP do jejuno e íleo final foi maior no grupo GC. CONCLUSÃO: A suplementação dietética com a glutamina não melhorou as alterações adaptativas que ocorrem no remanescente intestinal.BACKGROUND: The aim of the present study was to investigate the effects of glutamine supplementation in the adaptive response of the intestinal mucosa in rats submitted to extensive resection of the small bowel. METHODS: Twenty Wistar rats were randomized to two groups of ten animals which received different nutrition regimens after operation: control group (GC n=10-standard rat chow; glutamine group (GG n=10-standart rat chow supplemented with 3.05% glutamine. The weight evolution, mucosa weight (PM, crypts depth (PC, vilus height (AV, thickness wall (EP and the mucosal content of DNA were evaluated at the beginning and at the end of the experiment both at the jejunum and ileum. RESULTS: In both groups all parameters showed significant increase in final values both at the jejunum and ileum (p<0,05, except for ileal PC of GG group (p=0,06. Among groups, the PC in the GC group was higher than GG at the initial jejunum (p=0.005 and the EP, both at the final jejunum and ileum was higher in GC group..There was no significant difference in the others comparations. CONCLUSION: there was no increase in the adaptative response using glutamine supplementation.

José de Souza Neves

2003-12-01

233

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)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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.

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

2007-12-01

234

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  

Directory of Open Access Journals (Sweden)

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 bicarbonatada 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.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 neoplastic 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.

Enrico Salomão Ioriatti

2007-12-01

235

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  

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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 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 regiões 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 < 0.01 do que nos outros dois sacos em ambas as regiões. CONCLUSÃO: Os SCFA protegem a mucosa intestinal distal e diminuem o acumulo de neutrófilos na lamina própria após IRI.

José Eduardo de Aguilar-Nascimento

2006-02-01

236

[Optimizing biopsies of the oral mucosa].  

Science.gov (United States)

We had for aim to describe and illustrate the artefacts observed in biopsies of the oral mucosa, as well as the impact of sending non-representative histological material to a laboratory. This article was based on an international literature review, as well as on our experience. We analysed the problems raised, for the pathologists and the histology lab-technicians, by these artefacts as well as their impact on the pathology report patient management. We suggest simple solutions. PMID:23017279

Raybaud, H; Voha, C; Cardot-Leccia, N; Monteil, R A

2012-11-01

237

Benign Papules and Nodules of Oral Mucosa  

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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.

Mehmet Salih Gürel

2012-12-01

238

Calcium secretion in canine tracheal mucosa  

International Nuclear Information System (INIS)

Calcium (Ca) affects many cellular functions of the respiratory tract mucosa and might alter the viscoelastic properties of mucus. To evaluate Ca homeostasis in a respiratory epithelium we investigated transport of Ca by the canine tracheal mucosa. Mucosal tissues were mounted in Ussing-type chambers and bathed with Krebs-Henseleit solution at 37 degrees C. Unidirectional fluxes of 45Ca were determined in tissues that were matched by conductance and short-circuit current (SCC). Under short-circuit conditions there was a significant net Ca secretion of 1.82 +/- 0.36 neq . cm-2 . h-1 (mean +/- SE). Under open-circuit conditions, where the spontaneous transepithelial potential difference could attract Ca toward the lumen, net Ca secretion increased significantly to 4.40 +/- 1.14 compared with 1.54 +/- 1.17 neq . cm-2 . h-1 when the preparation was short-circuited. Addition of a metabolic inhibitor, 2,4-dinitrophenol (2 mM in the mucosal bath), decreased tissue conductance and SCC and slightly decreased the unidirectional movement of Ca from submucosa to lumen. Submucosal epinephrine (10 microM) significantly enhanced Ca secretion by 2.0 +/- 0.63 neq . cm-2 . h-1. Submucosal ouabain (0.1 mM) failed to inhibit Ca secretion. The data suggest that canine tracheal mucosa secretes Ca; this secretory process is augmented by epinephrine or by the presence of a transepithelial potential difference as found under in vivo conditions

239

An Interesting Case of Recurrent Small Bowel Obstruction.  

Science.gov (United States)

Sclerosing mesenteritis is associated with a spectrum of diseases which include mesenteric lipodystrophy and mesenteric panniculitis. This inflammatory and fibrosing disorder can affect the small and large bowel wall and mesenteric vessels by exerting a mass effect. The following case highlights the difficulties with diagnosing and managing this unusual disease. A 64-year-old man presented with acute central abdominal pain, radiating to his back, and profuse vomiting. He was diagnosed clinically with small bowel obstruction. He had had an episode of small bowel obstruction 6 years earlier. At this time, he underwent an exploratory laparotomy, and a mass was identified in the small bowel mesentery. The features were thought to be in keeping with sclerosing mesenteritis. He had a dramatically favourable response to the initiation of prednisolone. He continued to be well and asymptomatic for a further 5 years on long-term maintenance low-dose steroids and 6-mercaptopurine. He re-presented in 2009 (six years after initial presentation) with very severe acute abdominal pain and vomiting. He had no recent change in weight or appetite, and had not had time off work. He underwent a second laparotomy and the tissue diagnosis was of metastatic carcinoid tumour involving the small bowel mesentery. This is the first case to our knowledge where sclerosing mesenteritis has been confirmed histologically on biopsy and then subsequently diagnosed with histologically proven carcinoid tumour. For this particular reason it must be always remembered that sclerosing mesenteritis is a 'pathological' and not a radiological diagnosis and that a large proportion of cases are associated with neoplasia. PMID:21103263

Allen, P B; De Cruz, P; Efthymiou, M; Fox, A; Taylor, A C F; Desmond, P V

2009-01-01

240

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

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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.

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

2008-06-01

 
 
 
 
241

Roentgenographic findings of experimental bowel ischaemia in dogs following occlusion of the superior mesenteric artery  

International Nuclear Information System (INIS)

The results after ligation of the superior mesenteric artery in 17 dogs demonstrate that a gasless abdomen and small bowel pseudoobstruction are unspecific early roentgenographic findings and bowel-wall thickening with narrowed lumen and increased distance to neighbouring loops are a specific early roentgenographic plain-film finding of acute bowel ischemia following mesenteric vascular occlusion. Approximately 10 hours after ligation a combined distension of small and large bowel with dilatation and air-fluid levels is demonstrable as a sign of paralytic ileus with diffuse peritonitis without possibility of differentiation from other causes of this entity. Gas in the bowel wall, in the superior mesenteric vein and in the portal venous system is a late specific plain-film finding resulting from the invasion of gas-forming bacteria into the devitalized bowel wall with advanced gangrene and a sign of infaust prognosis. The results of the plain-film examinations are correlated to angiographic, clinical and laboratory findings, as well as to histology and bacteriology of the ischemic bowel segments. (orig.)

242

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 detrved. 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

243

Genetics of inflammatory bowel disease.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

1. The aetiology of the chronic inflammatory bowel diseases, Crohn's disease and ulcerative colitis, is uncertain. Studies of specific environmental factors and immune dysfunction have provided little insight into disease pathogenesis. 2. Concordance rates in twin pairs and siblings provide strong evidence that genetic factors are important in disease pathogenesis. In Oxford, information was obtained from 433 adult patients with Crohn's disease. Compared with the prevalence in the general pop...

Satsangi, J; Parkes, M.; Jewell, Dp; Bell, JI

1994-01-01

244

Probiotics and inflammatory bowel disease  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Enteric microflora profiles vary considerably between active inflammatory bowel diseases (IBD) and healthy conditions. Intestinal microflora may partake in the pathogenesis of IBD by one or some ways: specific pathogenic infection induces abnormal intestinal mucosal inflammation; aberrant microflora components trigger the onset of IBD; abnormal host immune response loses normal immune tolerance to luminal components; luminal antigens permeate through the defective mucosal barrier into mucosal...

Bai, A?p; Ouyang, Q.

2003-01-01

245

Cytokines in inflammatory bowel disease  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Over the past decade, much has been learned regarding the role of various cytokines in the pathogenesis of inflammatory bowel disease. Several cytokine ‘knockout’ models in mice have been shown to develop colitis, while alterations in the production of various cytokines has been documented in human Crohn's disease and ulcerative colitis. In recent years, attempts have been made to treat these diseases through modulation of cytokine production or action. This review focuses on the cytokine...

Beck, P. L.; Wallace, J. L.

1997-01-01

246

Inflammatory bowel disease: Medical management  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Various papers have been published on inflammatory bowel disease in the Kingdom of Saudi Arabia and other Gulf States during last decade. Apparently, the published data contradict previous belief and indi-cate that, we might deal here with a medical problem. However, data on the magnitude of this disease in our community remains uncertain. Could we attribute this possible change to the improvement in diag-nostic procedure or to the change in life style? Unfortunately, the literature does not ...

Al-Gindan Yusuf

1995-01-01

247

Anemia and inflammatory bowel diseases  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Too often anemia is considered a rare or unimportant manifestation in inflammatory bowel disease (IBD). However, over the last 10 years a number of studies have been conducted and the most relevant conclusions obtained are: (1) anemia is quite common in IBD; (2) although in many cases anemia parallels the clinical activity of the disease, many patients in remission have anemia, and iron, vitamin B12 and/or folic acid deficiency; (3) anemia, and also iron deficiency without anemia, have import...

Fernando Gomollo?n, Javier P. Gisbert

2009-01-01

248

Nutritive support in short Bowel syndrome (sbs  

Directory of Open Access Journals (Sweden)

Full Text Available Short bowel syndrome most commonly result after bowel resection for necrosis of the bowel. It may be caused by arterial or venous thrombosis, volvolus and in children, necrotizing enterocolitis. The other causes are Crohn,s disease intestinal atresia. The factors influencing the risk on short bowel syndrome are the remaining length of the small bowel, the age of onset, the length of the colon, the presence or absence of the ileo-coecal valve and the time after resection. Besides nutritional deficiencies there some other consequences of extensive resections of the small intestine (gastric acid hypersecretion, d-lactic acidosis, nephrolithiasis, cholelithiasis, which must be diagnosed, treated, and if possible, prevented. With current therapy most patients with short bowel have normal body mass index and good quality of life.

Simi? Dušica

2003-01-01

249

Neurostimulation for neurogenic bowel dysfunction  

DEFF Research Database (Denmark)

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.

WorsØe, J; Rasmussen, Mikkel Mylius

2013-01-01

250

Management of malignant bowel obstruction.  

Science.gov (United States)

Malignant bowel obstruction (MBO) is a common and distressing outcome particularly in patients with bowel or gynaecological cancer. Radiological imaging, particularly with CT, is critical in determining the cause of obstruction and possible therapeutic interventions. Although surgery should be the primary treatment for selected patients with MBO, it should not be undertaken routinely in patients known to have poor prognostic criteria for surgical intervention such as intra-abdominal carcinomatosis, poor performance status and massive ascites. A number of treatment options are now available for patients unfit for surgery. Nasogastric drainage should generally only be a temporary measure. Self-expanding metallic stents are an option in malignant obstruction of the gastric outlet, proximal small bowel and colon. Medical measures such as analgesics according to the W.H.O. guidelines provide adequate pain relief. Vomiting may be controlled using anti-secretory drugs or/and anti-emetics. Somatostatin analogues (e.g. octreotide) reduce gastrointestinal secretions very rapidly and have a particularly important role in patients with high obstruction if hyoscine butylbromide fails. A collaborative approach by surgeons and the oncologist and/or palliative care physician as well as an honest discourse between physicians and patients can offer an individualised and appropriate symptom management plan. PMID:18359221

Ripamonti, Carla Ida; Easson, Alexandra M; Gerdes, Hans

2008-05-01

251

Incorporation of fatty acids from fish oil and olive oil into colonic mucosal lipids and effects upon eicosanoid synthesis in inflammatory bowel disease.  

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The incorporation of the fatty acids in fish and olive oil into the colonic mucosa of patients with inflammatory bowel disease was examined during 12 weeks' dietary supplementation with the oils, and the influence on colonic mucosal prostaglandin and thromboxane generation was measured. With a dietary supplement of 18 g fish oil daily, concentrations of the major polyunsaturated fatty acids in fish oil, eicosapentaenoic acid and docosahexaenoic acid, were significantly raised in mucosal lipid...

Hillier, K.; Jewell, R.; Dorrell, L.; Smith, C. L.

1991-01-01

252

The immune system in irritable bowel syndrome.  

Science.gov (United States)

The potential relevance of systemic and gastrointestinal immune activation in the pathophysiology and symptom generation in the irritable bowel syndrome (IBS) is supported by a number of observations. Infectious gastroenteritis is the strongest risk factor for the development of IBS and increased rates of IBS-like symptoms have been detected in patients with inflammatory bowel disease in remission or in celiac disease patients on a gluten free diet. The number of T cells and mast cells in the small and large intestine of patients with IBS is increased in a large proportion of patients with IBS over healthy controls. Mediators released by immune cells and likely from other non-immune competent cells impact on the function of enteric and sensory afferent nerves as well as on epithelial tight junctions controlling mucosal barrier of recipient animals, isolated human gut tissues or cell culture systems. Antibodies against microbiota antigens (bacterial flagellin), and increased levels of cytokines have been detected systemically in the peripheral blood advocating the existence of abnormal host-microbial interactions and systemic immune responses. Nonetheless, there is wide overlap of data obtained in healthy controls; in addition, the subsets of patients showing immune activation have yet to be clearly identified. Gender, age, geographic differences, genetic predisposition, diet and differences in the intestinal microbiota likely play a role and further research has to be done to clarify their relevance as potential mechanisms in the described immune system dysregulation. Immune activation has stimulated interest for the potential identification of biomarkers useful for clinical and research purposes and the development of novel therapeutic approaches. PMID:22148103

Barbara, Giovanni; Cremon, Cesare; Carini, Giovanni; Bellacosa, Lara; Zecchi, Lisa; De Giorgio, Roberto; Corinaldesi, Roberto; Stanghellini, Vincenzo

2011-10-01

253

Anorexia nervosa complicating inflammatory bowel disease.  

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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...

Mallett, P.; Murch, S.

1990-01-01

254

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

Directory of Open Access Journals (Sweden)

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.

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

255

Biologic therapy for inflammatory bowel disease.  

Science.gov (United States)

Despite all of the advances in our understanding of the pathophysiology of inflammatory bowel disease (IBD), we still do not know its cause. Some of the most recently available data are discussed in this review; however, this field is changing rapidly and it is increasingly becoming accepted that immunogenetics play an important role in the predisposition, modulation and perpetuation of IBD. The role of intestinal milieu, and enteric flora in particular, appears to be of greater significance than previously thought. This complex interplay of genetic, microbial and environmental factors culminates in a sustained activation of the mucosal immune and non-immune response, probably facilitated by defects in the intestinal epithelial barrier and mucosal immune system, resulting in active inflammation and tissue destruction. Under normal situations, the intestinal mucosa is in a state of 'controlled' inflammation regulated by a delicate balance of proinflammatory (tumour necrosis factor [TNF]-alpha, interferon [IFN]-gamma, interleukin [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 IBD therapy using specific cytokine inhibitors. Biotechnology agents targeted against TNF, leukocyte adhesion, T-helper cell (T(h))-1 polarisation, T-cell activation or nuclear factor (NF)-kappaB, and other miscellaneous therapies are being evaluated as potential therapies for IBD. In this context, infliximab is currently the only biologic agent approved for the treatment of inflammatory and fistulising Crohn's disease. Other anti-TNF biologic agents have emerged, including CDP 571, certolizumab pegol (CDP 870), etanercept, onercept and adalimumab. However, ongoing research continues to generate new biologic agents targeted at specific pathogenic mechanisms 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. Therapeutic agents that inhibit leukocyte trafficking include natalizumab, MLN-02 and alicaforsen (ISIS 2302). Other agents being investigated for the treatment of Crohn's disease include inhibitors of T-cell activation, peroxisome proliferator-activated receptors, proinflammatory cytokine receptors and T(h)1 polarisation, and growth hormone and growth factors. Agents being investigated for treatment of ulcerative colitis include many of those mentioned for Crohn's disease. More 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 perspectives on the development of therapies for IBD. PMID:16266194

Ardizzone, Sandro; Bianchi Porro, Gabriele

2005-01-01

256

Midgut volvulus induced extensive bowel infarction.  

Science.gov (United States)

Midgut volvulus, mostly occurs due to congenital midgut malrotation, has been reported as a rare but lethal complication of some acquired medical conditions, such as postoperative adhesion bands, tumors, and mesenteric cysts. It is a surgical emergency to cause extensive bowel ischemia resulted from torsion of superior mesenteric artery. Early diagnosis and intervention is the only manner to prevent extended bowel necrosis. Here, we report a case of midgut volvulus with typical computed tomography features-the whirl sign, the transposition of the superior mesenteric artery and vein, and the ischemic change of bowel supplied by superior mesenteric artery. Early operation prevented the fate of extended bowel resection. PMID:24891783

Huang, Tai-Yu; Chang, Hsing; Chen, Kun-Chuan; Hu, Sheng-Chuan; Tsai, Ming-Jen

2014-04-01

257

Histological assessment of small bowel hypoperfusion lesions in the pig  

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Background Authors propose the use of a quantitative morphological assessment for helping in studies concerning intestinal hypoperfusion. The method was applied to the small intestine mucosa stained with the standard hematoxylin and eosin, from pigs that underwent severe hypotension due to acute hemorrhage.,. Methods Six Large White pigs underwent total intravenous anesthesia with propofol and remifentanil. 25 ml/kg of arterial blood were passively removed from the femoral artery...

Oliveira, A. L.; Ferreira, D.; Vala, Helena

2010-01-01

258

An Interesting Case of Recurrent Small Bowel Obstruction  

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Sclerosing mesenteritis is associated with a spectrum of diseases which include mesenteric lipodystrophy and mesenteric panniculitis. This inflammatory and fibrosing disorder can affect the small and large bowel wall and mesenteric vessels by exerting a mass effect. The following case highlights the difficulties with diagnosing and managing this unusual disease. A 64-year-old man presented with acute central abdominal pain, radiating to his back, and profuse vomiting. He was diagnosed clinica...

Allen, P. B.; Cruz, P.; Efthymiou, M.; Fox, A.; Taylor, A. C. F.; Desmond, P. V.

2009-01-01

259

Screening for asymptomatic bowel cancer in general practice.  

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General practitioners screened 4284 asymptomatic people aged over 40 to compare the incidence of large bowel cancer and polyps with a control general practice (4288 patients). Compliance was best in young women (60%), and overall it was 42%. Twenty six patients who had a positive Haemoccult test result (1.5% of those screened) were examined by colonoscopy and 10 had polyps. The incidence of cancers in the two groups was similar but in the control (unscreened patients) practice no polyps were ...

Lallemand, R. C.; Vakil, P. A.; Pearson, P.; Box, V.

1984-01-01

260

Elderly diabetic patient with surgical site mucormycosis extending to bowel  

Directory of Open Access Journals (Sweden)

Full Text Available Mucormycosis is rare in clinical practice. Most infections are acquired by inhalation; other portals of entry are traumatic implantation and ingestion in immunocompromised host. Mucormycosis is life threatening infection in immunocompromised host with variable moratlity ranging from 15 -81% depending upon site of infection. General treatment principles include early diagnosis, correction of underlying immunosuppression and metabolic disturbances, adequate surgical debridement along with amphotericin therapy. We describe surgical site mucormycosis extended to involve large bowel in elderly diabetic patient.

Patel Atul

2010-01-01

 
 
 
 
261

Intestinal protease-activated receptor-2 and fecal serine protease activity are increased in canine inflammatory bowel disease and may contribute to intestinal cytokine expression.  

Science.gov (United States)

Serine proteases elicit cellular responses via protease-activated receptor-2 (PAR-2) which is known to regulate inflammation and the immune response. Although the gastrointestinal tract is exposed to large amounts of proteolytic enzymes, the role of PAR-2 in canine inflammatory bowel disease (IBD) remains unclear. The objective of this study was to investigate the effects of PAR-2 activation on inflammatory cytokine/chemokine gene expression in canine intestine and the expression of intestinal PAR-2 and fecal serine protease activity in dogs with IBD. Duodenal biopsies from healthy dogs were cultured and treated ex vivo with trypsin or PAR-2 agonist peptide, and inflammatory cytokine/chemokine gene expression in the tissues was then quantified by real-time PCR. PAR-2 mRNA and protein expression levels in the duodenal mucosa were examined by real-time PCR and immunohistochemistry, respectively. Fecal serine protease activity was determined by azocasein assay. In ex vivo-cultured duodenum, trypsin and PAR-2 agonist peptide induced significant up-regulation of mRNA expression levels of interleukin-1 ? (IL-1?), IL-8, mucosae-associated epithelial chemokine (MEC) and fractalkine, and this up-regulation was inhibited by a serine protease inhibitor. Duodenal PAR-2 mRNA and protein expression levels were higher in dogs with IBD than in healthy control dogs. Fecal serine protease activity was significantly elevated in dogs with IBD, and the level of activity correlated positively with the clinical severity score. These results suggest that PAR-2 may contribute to the pathogenesis of canine IBD by inducing expression of inflammatory mediators in response to luminal serine proteases. PMID:24829081

Maeda, Shingo; Ohno, Koichi; Uchida, Kazuyuki; Igarashi, Hirotaka; Goto-Koshino, Yuko; Fujino, Yasuhito; Tsujimoto, Hajime

2014-08-01

262

Oral lymphangioma of the buccal mucosa a rare case report  

Science.gov (United States)

The lymphangioma are benign hamartomatous tumors of lymphatic vessels that arises from the sequestration of lymphatic that fails to communicate with the lymphatic system. Most common intra oral site being the anterior two-thirds of tongue, usually superficial in location and demonstrates a pebbly surface that resembles a cluster of translucent vesicles, they are typically soft and fluctuant masses. Secondary hemorrhage into the lymphatic spaces may cause some of these vesicles to become purple. They have been known to grow to large size causing difficulties in mastication and speech. A variant of lymphangioma is cystic hygroma grows as lymphatic anomaly found in the neck commonly present with significant airway obstruction. We present a rare case of lymphangioma affecting the buccal mucosa of a 14-year-old male. PMID:25210370

Yoganna, Saligrama Seema; Rajendra Prasad, Rame Gowda; Sekar, B.

2014-01-01

263

Mucosal barrier, bacteria and inflammatory bowel disease: possibilities for therapy.  

Science.gov (United States)

The mucosal barrier has three major components, the mucus layer, the epithelial glycocalyx and the surface epithelium itself, whose integrity largely depends on tight junction function. In health, there is relatively little direct interaction between the luminal microbiota and the epithelium - the continuous mucus layer in the colon keeps the surface epithelium out of contact with bacteria and the ileo-caecal valve ensures that the distal small intestine is relatively microbe free. Most interaction takes place at the Peyer's patches in the distal ileum and their smaller colonic equivalents, the lymphoid follicles. Peyer's patches are overlain by a 'dome' epithelium, 5% of whose cells are specialised M (microfold) epithelial cells, which act as the major portal of entry for bacteria. There are no goblet cells in the dome epithelium and M cells have a very sparse glycocalyx allowing easy microbial interaction. It is intriguing that the typical age range for the onset of Crohn's disease (CD) is similar to the age at which the number of Peyer's patches is greatest. Peyer's patches are commonly the sites of the initial lesions in CD and the 'anti-pancreatic' antibody associated with CD has been shown to have as its epitope the glycoprotein 2 that is the receptor for type-1 bacterial fimbrial protein (fimH) on M cells. There are many reasons to believe that the mucosal barrier is critically important in the pathogenesis of inflammatory bowel disease (IBD). These include (i) associations between both CD and ulcerative colitis (UC) with genes that are relevant to the mucosal barrier; (ii) increased intestinal permeability in unaffected relatives of CD patients; (iii) increased immune reactivity against bacterial antigens, and (iv) animal models in which altered mucosal barrier, e.g. denudation of the mucus layer associated with oral dextran sulphate in rodents, induces colitis. Whilst some IBD patients may have genetic factors leading to weakening of the mucosal barrier, it is likely that environmental factors may be even more important. Some may be subtle and indirect, e.g. the effects of stress on the mucosa barrier, whilst others may be more obvious, e.g. the effect of pathogen-related gastroenteritis, known often to act as trigger for IBD relapse. We have also been very interested in the potentially harmful effects of ingested detergents - either by contamination of cutlery by inadequate rinsing or via ingestion of processed foods containing permitted emulsifiers. In vitro and ex vivo studies show that even very small trace amounts of these surfactants can greatly increase bacterial translocation. Implications for therapy are not yet so obvious. We advise our IBD patients to avoid processed foods containing emulsifiers and to rinse their dishes well - whilst accepting that there is no direct evidence yet to support this. Therapies that aim to enhance the mucosal barrier have yet to come to market, but trials of enteric-delivered phosphatidylcholine in UC are promising. The faecal concentration of mucus-degrading bacterial enzymes (particularly proteases, sulphatases and sialidases) correlates with disease activity in UC, and these represent good targets for therapy. PMID:24969297

Merga, Yvette; Campbell, Barry J; Rhodes, Jonathan M

2014-01-01

264

Honey and Apoptosis in Human Gastric Mucosa  

Directory of Open Access Journals (Sweden)

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.

Alireza Ostadrahimi

2012-07-01

265

Functional bowel symptoms and diet.  

Science.gov (United States)

It is well recognised that ingestion of food is a trigger for functional bowel symptoms, particularly those associated with irritable bowel syndrome (IBS). Patients often use manipulation of diet as a means of controlling symptoms. Despite description of multiple dietary methods, few have scientific backing or quality evidence of efficacy. One approach is to define how specific food components influence the pathophysiology of IBS and then rationally design dietary approaches. For example, short-chain poorly absorbed carbohydrates (fermentable oligo-, di- and mono-saccharides and polyols (FODMAP)) cause luminal distension, which is a major stimulus for the development of symptoms in patients with visceral hypersensitivity. By determining food content of FODMAP, a diet in which foods low in FODMAP are favoured over those high in FODMAP can be designed. Observational, comparative and randomised controlled treatment and rechallenge studies have shown that such an approach is efficacious in the majority of patients with IBS. The low FODMAP diet is now the primary dietary therapy for such patients. Similar approaches can be applied to other food components, including proteins (such as gluten), fats and natural bioactive food chemicals. Such approaches have suggestions of efficacy, but the evidence base remains underdeveloped. An additional and important consideration for any dietary therapy is its nutritional adequacy and potential adverse health effects. Dietary manipulation is now a key management strategy in patients with functional bowel symptoms. Future well-designed interventional studies will lead to refinement of dietary approaches taken and to a better understanding of their long-term safety. PMID:24134168

Gibson, P R; Barrett, J S; Muir, J G

2013-10-01

266

Bowel movement: the sixth vital sign.  

Science.gov (United States)

Bowel movements provide vital information on how the body is functioning, and constipation among older adults is especially problematic. Although we do not like hearing the details of someone else's bowel movement, it is a function that nurses need to assess, support, and treat with the same attitude as when caring for patients with pain. PMID:24722614

Holl, Rita M

2014-01-01

267

Henoch–Schonlein Purpura with Ischaemic Bowel  

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Henoch–Schonlein purpura is a vasculitis affecting small arterial vessels. Occasionally, cases are referred for a general surgical opinion due to bowel involvement in the form of abdominal pain with or without rectal bleeding. However, surgical intervention is rarely required. We describe a case of Henoch–Schonlein purpura in a young man who went on to develop ischaemic bowel requiring resection.

Hameed, Shema; Dua, Sascha; Taylor, Hugo W.

2008-01-01

268

Immunoregulatory mechanisms in nonspecific inflammatory bowel disease.  

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Little is known of either the etiology or the pathogenesis of nonspecific inflammatory bowel disease (IBD). One hypothesis proposes the presence of a disorder of immune regulation as an initiating or perpetuating mechanism of continued bowel wall inflammation in these diseases. This chapter examines the basis for this proposal and reviews recent studies directed toward the demonstration of defective immunoregulatory mechanisms in IBD.

Strickland, Rg; Jewell, Dp

1983-01-01

269

Radiopathological review of small bowel carcinoid tumours  

International Nuclear Information System (INIS)

Full text: Small bowel carcinoid tumours are endocrine tumours of the gastrointestinal tract. This pictorial essay will review the pathology, clinical features, treatment and prognosis and illustrate the radiographic, computed tomographic, sonographic, magnetic resonance and nuclear medicine appearances of small bowel carcinoid tumours.

270

Metabolic inflammation in inflammatory bowel disease: crosstalk between adipose tissue and bowel.  

Science.gov (United States)

: Epidemiological studies show that both the incidence of inflammatory bowel disease (IBD) and the proportion of people with obesity and/or obesity-associated metabolic syndrome increased markedly in developed countries during the past half century. Obesity is also associated with the development of more active IBD and requirement for hospitalization and with a decrease in the time span between diagnosis and surgery. Patients with IBD, especially Crohn's disease, present fat-wrapping or "creeping fat," which corresponds to ectopic adipose tissue extending from the mesenteric attachment and covering the majority of the small and large intestinal surface. Mesenteric adipose tissue in patients with IBD presents several morphological and functional alterations, e.g., it is more infiltrated with immune cells such as macrophages and T cells. All these lines of evidence clearly show an association between obesity, adipose tissue, and functional bowel disorders. In this review, we will show that the mesenteric adipose tissue and creeping fat are not innocent by standers but actively contribute to the intestinal and systemic inflammatory responses in patients with IBD. More specifically, we will review evidence showing that adipose tissue in IBD is associated with major alterations in the secretion of cytokines and adipokines involved in inflammatory process, in adipose tissue mesenchymal stem cells and adipogenesis, and in the interaction between adipose tissue and other intestinal components (immune, lymphatic, neuroendocrine, and intestinal epithelial systems). Collectively, these studies underline the importance of adipose tissue for the identification of novel therapeutic approaches for IBD. PMID:25248003

Gonçalves, Pedro; Magro, Fernando; Martel, Fátima

2015-02-01

271

Adhesive bowel obstruction? Not always  

Directory of Open Access Journals (Sweden)

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.

Mittapalli D

2011-01-01

272

Morphometric analysis of intestinal mucosa. V. Quantitative histological and immunocytochemical studies of rectal mucosae in gluten sensitivity.  

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To study changes in rectal mucosa that might be attributable to the effects of gluten, rectal biopsy specimens from untreated and treated gluten sensitised subjects were analysed morphometrically and by immunohistochemical techniques and were compared with a series of disease control mucosae. Although morphometry showed increased populations of plasma cells, lymphocytes, and mast cells in the mucosae of untreated patients, which were reduced (except for mast cells) by dietary gluten restricti...

Ensari, A.; Marsh, M. N.; Loft, D. E.; Morgan, S.; Moriarty, K.

1993-01-01

273

Gut-lung crosstalk in pulmonary involvement with inflammatory bowel diseases  

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Full Text Available Pulmonary abnormalities, dysfunction or hyper-reactivity occurs in association with inflammatory bowel disease (IBD more frequently than previously recognized. Emerging evidence suggests that subtle inflammation exists in the airways among IBD patients even in the absence of any bronchopulmonary symptoms, and with normal pulmonary functions. The pulmonary impairment is more pronounced in IBD patients with active disease than in those in remission. A growing number of case reports show that the IBD patients develop rapidly progressive respiratory symptoms after colectomy, with failure to isolate bacterial pathogens on repeated sputum culture, and often request oral corticosteroid therapy. All the above evidence indicates that the inflammatory changes in both the intestine and lung during IBD. Clinical or subclinical pulmonary inflammation accompanies the main inflammation of the bowel. Although there are clinical and epidemiological reports of chronic inflammation of the pulmonary and intestinal mucosa in IBD, the detailed mechanisms of pulmonary-intestinal crosstalk remain unknown. The lung has no anatomical connection with the main inflammatory site of the bowel. Why does the inflammatory process shift from the gastrointestinal tract to the airways? The clinical and subclinical pulmonary abnormalities, dysfunction, or hyper-reactivity among IBD patients need further evaluation. Here, we give an overview of the concordance between chronic inflammatory reactions in the airways and the gastrointestinal tract. A better understanding of the possible mechanism of the crosstalk among the distant organs will be beneficial in identifying therapeutic strategies for mucosal inflammatory diseases such as IBD and allergy.

Hui Wang

2013-01-01

274

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)e use of CT enteroclysis. (author)

275

Blood-group-related carbohydrates are expressed in organotypic cultures of human skin and oral mucosa  

DEFF Research Database (Denmark)

Cellular maturation and migration are usually associated with changes in cell-surface carbohydrates, but the relationship between these changes and cell behaviour is at present largely unknown. To investigate whether an organotypic culture system can be used as an in vitro model to study the function of cell-surface carbohydrates, we established organotypic cultures of skin and buccal mucosa. In these cultures, keratinocytes are grown at the air-liquid interface on a supporting matrix consisting of homologous fibroblasts embedded in a collagen type I gel. We examined the expression of blood-group-related carbohydrate structures, including Lewis x, sialylated Lewis x, Lewis y, Lewis a, and Lewis b, on the surface of epithelial cells in the cultures. We compared the results with the expression of more well-established markers, including cytokeratins, integrins, bullous pemphigoid antigen and laminin, in the same cultures. The organotypic skin and oral mucosa cultures showed a histological differentiation pattern analogous to that of normal skin and buccal mucosa, and a tissue-specific expression of carbohydrate structures and cytokeratins. However, both types of organotypic cultures also expressed markers which are normally seen during wound healing, including Lewis y, cytokeratin 16, and cytokeratin 19. We conclude that the organotypic cultures of oral mucosa and skin are suitable models for future studies of the function of cell-surface carbohydrates, although the expression of wound healing markers has to be taken into consideration.

GrØn, B; Andersson, A

1999-01-01

276

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)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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.

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

2012-02-01

277

Probiotics and Irritable Bowel Syndrome  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Irritable bowel syndrome (IBS is a major cause of abdominal discomfort and gut dysfunction worldwide. It is a poorly understood functional gastrointestinal disorder for which no effective medication is available. It is a benign condition, but its social and economic burden is significant. The symptoms consist of abdominal pain, bloating, flatulence, and irregular bowel movements. Alterations in the intestinal microbiota and mucosal inflammation may contribute to the development of IBS and probiotics could thus relieve the symptoms. This review gives an overview on the existing data on the effects of probiotics on the gastrointestinal symptoms of IBS. Methods: A PUBMED search was made to review the relevant literature, and additional studies were obtained from the references of the selected articles. Results: Clinical trials suggest that certain probiotics or combinations of bacteria have beneficial effects on the IBS symptoms. However the heterogeneity of studies, e.g. suboptimal study design, inadequate number of subjects, different doses and vehicles, inadequate length, make it difficult to compare the differences between probiotics and the effect may be strain-specific. Conclusions: Though evidence is very promising, no general recommendations on the use of probiotics in IBS can be given yet. Further clinical trials and data on the mechanisms of action are needed. Probiotics are considered safe and if future scientific data is able to substantiate their efficacy in IBS, they certainly could be a treatment option in relieving the symptoms in IBS.

Riitta Korpela

2012-06-01

278

Minimization of small bowel volume within treatment fields using customized small bowel displacement system (SBDS)  

International Nuclear Information System (INIS)

Authors designed a customized Small Bowel Displacement System(SBDS) to displace the small bowel from the pelvic radiation fields and minimize treatment-related bowel morbidities. From August 1995 to May 1996, 55 consecutive patients who received pelvic radiation therapy with the SBDS were included in this study. The SBDS consists of a customized styrofoam compression device which can displace the small bowel from the radiation fields and an individualized immobilization abdominal board for easy daily setup in prone position. After opacifying the small bowel with Barium, the patients were laid prone and posterior-anterior (PA) and lateral (LAT) simulation films were taken with and without the SBDS. The areas of the small bowel included in the radiation fields with and without the SBDS were compared. Using the SBDS, the mean small bowel area was reduced by 59% on PA and 51% on LAT films (P=0.0001). In six patients (6/55, 11%), it was possible that no small bowel was included within the treatment fields. The mean upward displacement of the most caudal small bowel was 4.8 cm using the SBDS. Only 15% (8/55) of patients treated with the SBDS manifested diarrhea requiring medication. The SBDS is a novel method that can be used to displace the small bowel away from the treatment portal effectively and reduce the radiation therapy morbidities. Compliance with setup is excellent when the SBDS is used. (author)

279

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 contro sequential radiographs in 5 health controls. Conclusion: Quantification of bowel gas based on plain abdominal radiograph and computer is simple, rapid, and reliable

280

Glucagon-like peptide 2 improves nutrient absorption and nutritional status in short-bowel patients with no colon  

DEFF Research Database (Denmark)

Glucagon-like peptide 2 (GLP-2) is intestinotrophic, antisecretory, and transit-modulating in rodents, and it is mainly secreted from the intestinal mucosa of the terminal ileum and colon after food ingestion. We assessed the effect of GLP-2 on the gastrointestinal function in patients without a terminal ileum and colon who have functional short-bowel syndrome with severe malabsorption of wet weight (>1.5 kg/day) and energy (>2.3 MJ/day) and no postprandial secretion of GLP-2.

Jeppesen, P B; Hartmann, B

2001-01-01

 
 
 
 
281

Microbial Induction of Inflammatory Bowel Disease Associated Gene TL1A (TNFSF15) in Antigen Presenting Cells  

Digital Repository Infrastructure Vision for European Research (DRIVER)

TL1A is a member of the TNF superfamily and its expression is increased in the mucosa of inflammatory bowel disease (IBD) patients. Neutralizing anti-mouse TL1A Ab attenuates chronic colitis in two T cell driven murine models, suggesting that TL1A is a central modulator of gut mucosal inflammation in IBD. We showed previously that TL1A is induced by immune complexes (IC) via the Fc?R signaling pathway. In this study, we report that multiple bacteria, including gram negative organisms (E. col...

Shih, David Q.; Kwan, Lola Y.; Chavez, Valerie; Cohavy, Offer; Gonsky, Rivkah; Chang, Elmer Y.; Chang, Christopher; Elson, Charles O.; Targan, Stephan R.

2009-01-01

282

Association of Levels of Antibodies from Patients with Inflammatory Bowel Disease with Extracellular Proteins of Food and Probiotic Bacteria  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Inflammatory bowel disease (IBD) is an autoimmune disease characterized by a chronic inflammation of the gastrointestinal tract mucosa and is related to an abnormal immune response to commensal bacteria. Our aim of the present work has been to explore the levels of antibodies (IgG and IgA) raised against extracellular proteins produced by LAB and its association with IBD. We analyzed, by Western-blot and ELISA, the presence of serum antibodies (IgA and IgG) developed against extracellular pro...

Arancha Hevia; Xf Pez, Patricia L.; Ana Suárez; Claudine Jacquot; Urdaci, Mar Xed A. C.; Abelardo Margolles; Xe Nchez, Borja S.

2014-01-01

283

Systemic mastocytosis mimicking inflammatory bowel disease: A case report and discussion of gastrointestinal pathology in systemic mastocytosis.  

Science.gov (United States)

Gastrointestinal (GI) symptoms are present in up to 80% of patients with systemic mastocytosis (SM). GI symptoms include mainly abdominal pain, diarrhea, nausea, and vomiting. It is believed that most of the GI symptoms are due to the secondary effect of mast cell mediators on the GI tract. Direct involvement of the GI tract by neoplastic mast cell infiltration has not been well documented. We report a case of SM that initially mimicked inflammatory bowel disease based on clinical, radiographic, endoscopic, and histopathologic findings. On routine histologic sections of small bowel and colonic mucosal biopsies, there was expansion of the lamina propria by mononuclear inflammatory cells, foci of erosions with associated acute inflammation, and evidence of chronic mucosal injury with architectural distortion and gland foreshortening. Only on repeat biopsies and with ancillary tests for mast cells was a diagnosis of SM made, with extensive involvement of the GI tract. This is the first reported case of SM presenting as and mimicking inflammatory bowel disease. It is critical that clinicians and pathologists are aware that neoplastic mast cells in patients with SM can infiltrate the mucosa throughout the GI tract and that this infiltration can lead to symptoms and findings that can mimic inflammatory bowel disease. PMID:17063092

Bedeir, Ahmed; Jukic, Drazen M; Wang, Linan; Mullady, Daniel K; Regueiro, Miguel; Krasinskas, Alyssa M

2006-11-01

284

New treatment strategies for treatment of inflammatory bowel disease  

Directory of Open Access Journals (Sweden)

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.

Ole HaagenNielsen

2014-03-01

285

Role of the intestinal barrier in inflammatory bowel disease  

Directory of Open Access Journals (Sweden)

Full Text Available A critical function of the intestinal mucosa is to form a barrier that separates luminal contents from the interstitium. The single layer of intestinal epithelial cells (IECs serves as a dynamic interface between the host and its environment. Cell polarity and structural properties of the epithelium is complex and is important in the development of epithelial barrier function. Epithelial cells associate with each other via a series of intercellular junctions. The apical most intercellular junctional complex referred to as the Apical Junction Complex (AJC is important in not only cell-cell recognition, but also in the regulation of paracellular movement of fluid and solutes. Defects in the intestinal epithelial barrier function have been observed in a number of intestinal disorders such as inflammatory bowel disease (IBD. It is now becoming evident that an aberrant epithelial barrier function plays a central role in the pathophysiology of IBD. Thus, a better understanding of the intestinal epithelial barrier structure and function in healthy and disease states such as IBD will foster new ideas for the development of therapies for such chronic disorders.

Mike G Laukoetter, Porfirio Nava, Asma Nusrat

2008-01-01

286

Clostridium difficile Carriage Rate in Outpatients with Inflammatory Bowel Diseases  

Directory of Open Access Journals (Sweden)

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.

Mohammad Hosain Salari

2013-10-01

287

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)

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.

Shanahan, Fergus

2012-02-03

288

Tissue engineering of oral mucosa: a shared concept with skin.  

Science.gov (United States)

Tissue-engineered oral mucosa, in the form of epithelial cell sheets or full-thickness oral mucosa equivalents, is a potential solution for many patients with congenital defects or with tissue loss due to diseases or tumor excision following a craniofacial cancer diagnosis. In the laboratory, it further serves as an in vitro model, alternative to in vivo testing of oral care products, and provides insight into the behavior of the oral mucosal cells in healthy and pathological tissues. This review covers the old and new generation scaffold types and materials used in oral mucosa engineering; discusses similarities and differences between oral mucosa and skin, the methods developed to reconstruct oral mucosal defects; and ends with future perspectives on oral mucosa engineering. PMID:25326194

Kinikoglu, Beste; Damour, Odile; Hasirci, Vasif

2014-10-18

289

The value of MR enteroclysis with air infusion in the diagnosis of small bowel disease  

International Nuclear Information System (INIS)

Objective: To investigate the value of MR enteroclysis with air infusion in the diagnosis of small bowel disease. Methods: Sixteen patients with suspected small bowel disease, but without acute inflammatory disease or bowel obstruction, received MR enteroclysis with air infusion. There were 12 males and 4 females, and their age ranged from 17 to 75 years. 10 patients had abdominal pain, 4 with melena or blood stool, and 2 with diarrhea. The longest course was 7 years, and the shortest 1 week. Before MR imaging, a nasoenteric catheter was inserted into the distal part of duodenum, and about 1000 ml of air was infused through the tube to distend the small bowel. 20 mg of IV anisodamine was given to reduce small-bowel peristalsis. All patients were imaged with fat-saturated Gd-DTPA enhanced coronal and axial T1-weighted spin-echo (SE) sequence and fast spoiled gradient echo (FSPGR) sequence. Comparison between the diagnosis of MRI and the results of surgery, pathology or clinic was performed to assess the sensitivity and specificity of MRI. Results: 5 cases were normal, 6 with Crohn disease, 2 with gastric intestinal stromal tumor (GIST), and 1 each of lymphoma, tuberculosis and irritable bowel syndrome. The lumen of normal small bowel in MR enteroclysis was no signal, the wall was outlined as middle signal by intraluminal air and surrounding air-distended bowel and was between 1-3 mm thick, and the diameter of the lumen was between 17-28 mm. Crohn disease shoen was between 17-28 mm. Crohn disease showed segmental mural thickening, increased enhancement, luminal stricture, and even extraluminal inflammatory mass or fistula. Intestinal tuberculosis invaded the distal section of ileum, cecum, and the proximal ascending colon, the wall thickened and enhanced apparently, and cecum and proximal ascending colon shortened. GIST showed a mass that was iso-signal on T1WI, high signal on T2WI, and enhanced significantly after IV Gd-DTPA. 1 recurrent lymphoma of ileum showed mural thickening and increased enhancement but no stenosis. 1 irritable bowel syndrome is disfunction, so its shape and signal is normal. Except 1 Crohn disease, which showed a large mass, was misdiagnosed as lymphoma and no abnormality was found in 1 irritable bowel syndrome, the other diagnosis of MRI was correct. The sensitivity in diagnosing small intestinal disease was 100%, and the specificity was 83%. Conclusion: MR enteroclysis with air infusion is a sensitive method in diagnosing the small bowel disease, especially in Crohn disease and tumor. It can clearly display the mural thickening and the extraluminal inflammatory mass

290

The role of nuclear medicine in inflammatory bowel disease. A review with experiences of aspecific bowel activity using immunoscintigraphy with 99mTc anti-granulocyte antibodies  

International Nuclear Information System (INIS)

The diagnosis of inflammatory bowel disease (IBD) needs a complex diagnostic work-up. Beside verifying the disease itself, it is fundamental to assess disease extent and activity and to detect associated complications, to find the most effective treatment and for follow up. Scintigraphy with radiolabelled leukocytes is able to provide a complete survey of the whole intestinal tract, both the small and large bowel, and detects septic complications successfully with negligible risk. Radionuclide procedures are useful in establishing or ruling out IBD in patients with intestinal complaints, in assessing disease severity, and in the evaluation of extraintestinal septic complications. Widely available radionuclide procedures are discussed, i.e. scintigraphy by 111Indium oxime or 99mTechnetium HMPAO labelled white blood cells and immunoscintigraphy with 99mTc anti-granulocyte antibodies. Advantages and disadvantages of all three methods are stressed out. Patients and methods: The immunoscintigraphies with 99mTc anti-granulocyte antibodies (ANTI-GRANULOCYTE[reg] BW 250/183) of 27 patients with suspicion of IBD were retrospectively analysed. Planar anterior and posterior images were obtained 4 and 24 h postinjection, respectively. The bowel was divided into six segments and the activity was visually graded with reference to bone marrow in each segments. The scans were compared with the results of radiological and endoscopical investts of radiological and endoscopical investigations. The diagnosis of IBD was proved or ruled out by means of enteroclysis, large bowel enema or endoscopy. Results: In the 27 patients, 74 bowel segments with increased activity were detected. In the case of 30 segments in 16 patients, bowel inflammation was revealed by the other methods (true positives). In the case of 44 bowel segments, no underlying bowel inflammation could be verified, and these activities were regarded as aspecific activity. We could not differentiate between true positive and aspecific activity based on scan pattern or intensity. Discussion: These findings of aspecific bowel activity using imuunoscintigraphy are in contrast with the results of former studies, while the existence of non-specific activity decreases the reliability of the method. Based on the literature and our experiences, we conclude that 99mTc HMPAO labelling should be the method of choice for the investigation of IBD patients

291

Bowel endometriosis: Recent insights and unsolved problems  

Directory of Open Access Journals (Sweden)

Full Text Available Bowel endometriosis affects between 3.8% and 37% of women with endometriosis. The evaluation of symptoms and clinical examination are inadequate for an accurate diagnosis of intestinal endometriosis. Transvaginal ultrasonography is the first line investigation in patients with suspected bowel endometriosis and allows accurate determination of the presence of the disease. Radiological techniques (such as magnetic resonance imaging and multidetector computerized tomography enteroclysis are useful for estimating the extent of bowel endometriosis. Hormonal therapies (progestins, gonadotropin releasing hormone analogues and aromatase inhibitors significantly improve pain and intestinal symptoms in patients with bowel stenosis less than 60% and who do not wish to conceive. However, hormonal therapies may not prevent the progression of bowel endometriosis and, therefore, patients receiving long-term treatment should be periodically monitored. Surgical excision of bowel endometriosis should be offered to symptomatic patients with bowel stenosis greater than 60%. Intestinal endometriotic nodules may be excised by nodulectomy or segmental resection. Both surgical procedures improve pain, intestinal symptoms and fertility. Nodulectomy may be associated with a lower rate of complications.

Simone Ferrero, Giovanni Camerini, Umberto Leone Roberti Maggiore, Pier L Venturini, Ennio Biscaldi, Valentino Remorgida

2011-03-01

292

Expression stability of common housekeeping genes is differently affected by bowel inflammation and cancer: implications for finding suitable normalizers for inflammatory bowel disease studies.  

Science.gov (United States)

Instability of housekeeping genes (HKG), supposedly unregulated and hence used as normalizers, may dramatically change conclusions of quantitative PCR experiments. The effect of bowel inflammation on HKG remains unknown. Expression stability of 15 HKG (ACTB, B2M, GAPDH, GUSB, HPRT1, IPO8, MRPL19, PGK1, PPIA, RPLP0, RPS23, SDHA, TBP, UBC, and YWHAZ) in 166 bowel specimens (91 normal, 35 cancerous, and 40 inflamed) was ranked by coefficients of variation (CV%) or using dedicated software: geNorm and NormFinder. The RPS23, PPIA, and RPLP0 were top-ranked, whereas IPO8, UBC and TBP were the lowest-ranked HKG across inflamed/cancerous/normal colonic tissues. The pairs RPS23/RPLP0, PGK1/MRPL19, or PPIA/RPLP0 were optimal reference by CV%, NormFinder, and geNorm, respectively. Colon inflammation affected HKG more pronouncedly than cancer with ACTB significantly down- and B2M upregulated. In inflammatory bowel disease (IBD), different genes were top-ranked in a large and small bowel, whereas TBP, UBC, and IPO8 were lowest-ranked in both. For patients with IBD at large, RPS23/PPIA, PGK1/MRPL19, and PPIA/RPLP0 were found optimal by CV%, NormFinder, and geNorm, respectively. ACTB and B2M expression was related to CRC stage and positively correlated with clinical activity of IBD. Although GAPDH was upregulated neither in CRC nor IBD, it tended to positively correlate with tumor depth and Crohn's disease activity index. Normalizing against GAPDH affected experimental conclusions in a small but not large bowel. Bowel inflammation significantly affects several classic HKG. The pair PPIA/RPLP0 is a common optimal reference for studies encompassing tissues sampled from colorectal cancer and IBD patients. Using ACTB or B2M is not recommended. PMID:24859296

Krzystek-Korpacka, Malgorzata; Diakowska, Dorota; Bania, Jacek; Gamian, Andrzej

2014-07-01

293

Effects Aerosol of Industrial Bleach and Detergent Mixture on Mucosa Layer and Lamina Mucosa Conjunctiva in Mice  

Directory of Open Access Journals (Sweden)

Full Text Available Today bleach and detergents are being frequently used and some people use their mixture for more cleaning. Because of chemical interaction of bleach and detergent, chlorine gas was released and thereby it could be dangerous for human health. This study examined the effects of exposed toxic mixture of bleach and detergent on the Mucosa layer and Lamina mucosa conjunctiva in the mice. In this study, 42 adult male mice NMRI race weighing 35-40 gr and from age 8 to 10 weeks were divided into 6 experimental groups and one control group. Experimental groups 1-2-3 with the use of chamber, the exposed 20 minutes were exposed to spray the amount 1 cc of mixture of bleach and detergent by nebulizer. Experimental groups 4-5-6 were for 35 minutes to inhale the same amount of material. Mice killed at 24-48-72 hours after exposed and the Mucosa Layer and Lamina mucosa conjunctiva tissue was studied pathology. In the study of microscopic sections prepared of mouse mucosa layer and Lamina mucosa conjunctiva tissue experimental group comparison with the control group, significant decrease was observed in mucosa layer the have (p ? 0.001  and significant decrease was observed in the Lamina mucosa have(p ? 0. 01,  p ? 0.001. As a result, increasing the exposed time of mixing bleach and detergent, as time passed, increasing the tissue damage and changes.

Gh. Vaezi

2013-06-01

294

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)

295

Computed tomography enterography for evaluation of inflammatory bowel disease.  

Science.gov (United States)

Computed tomography enterography (CTE) has become a main modality for the evaluation of inflammatory bowel disease (IBD). It simultaneously offers visualization of the small bowel and extraintestinal status, which is helpful for diagnosing IBD. Crohn disease has long segmental enhancing wall thickening related with the eccentric longitudinal distribution. In addition, mural stratification, fibrofatty proliferation, positive comb sign by increased mesenteric vascularity and internal/perianal fistula are characteristics of Crohn disease and can be identified on CTE. Short segmental inflammatory wall thickening and the central low attenuated lymph nodes are favorable CT finding of intestinal tuberculosis. A geographic, relatively large, and deep penetrating ulcer with bowel wall thickening and mural hyperenhancement in ileocecal area are characteristics of intestinal Behcet disease. Each of CTE findings for the IBDs is helpful for differential diagnosis. The main disadvantage of this technique is the requisite radiation exposure of patients, particularly in young patients. However, recent development of advanced CT techniques is promising for radiation dose reduction without compromising diagnostic image quality. PMID:23964329

Park, Min Jung; Lim, Joon Seok

2013-07-01

296

A self administered reliable questionnaire to assess lower bowel symptoms  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Bowel symptoms are considered indicators of the presence of colorectal cancer and other bowel diseases. Self administered questionnaires that elicit information about lower bowel symptoms have not been assessed for reliability, although this has been done for upper bowel symptoms. Our aim was to develop a self administered questionnaire for eliciting the presence, nature and severity of lower bowel symptoms potentially related to colorectal cancer, and ass...

Katelaris Peter H; Macaskill Petra; Irwig Les; Adelstein Barbara-Ann; Jones David B; Bokey Les

2008-01-01

297

Disturbances in small bowel motility.  

LENUS (Irish Health Repository)

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.

Quigley, E M

2012-02-03

298

Anemia and inflammatory bowel diseases  

Directory of Open Access Journals (Sweden)

Full Text Available Too often anemia is considered a rare or unimportant manifestation in inflammatory bowel disease (IBD. However, over the last 10 years a number of studies have been conducted and the most relevant conclusions obtained are: (1 anemia is quite common in IBD; (2 although in many cases anemia parallels the clinical activity of the disease, many patients in remission have anemia, and iron, vitamin B12 and/or folic acid deficiency; (3 anemia, and also iron deficiency without anemia, have important consequences in the clinical status and quality of life of the patient; (4 oral iron can lead to gastrointestinal intolerance and failure of treatment; (5 intravenous iron is an effective and safe way to treat iron deficiency; (6 erythropoietin is needed in a significant number of cases to achieve normal hemoglobin levels. Thus, the clinician caring for IBD patients should have a comprehensive knowledge of anemia, and apply recently published guidelines in clinical practice.

Fernando Gomollón, Javier P Gisbert

2009-10-01

299

Occult small bowel perforation in a patient with Ehlers Danlos syndrome: a case report and review of the literature  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Patients who present with a co-existing connective tissue disorder add a degree of complexity to operative intervention. We present an unusual case of a 53-year-old Caucasian female patient with Ehlers Danlos syndrome who presented with an occult perforation of the distal ileum. The patient had known small bowel diverticulae yet the perforation occurred within the normal bowel wall. The pre-operative CT only showed malrotation of the large bowel and did not correlate with the intra-operative ...

Leake, Tessa Frances; Singhal, Tarun; Chandra, Aninda; Ashcroft, Alexandra; Doddi, Sudeendra; Hussain, Abdulzahra; Smedley, Frank

2010-01-01

300

If I Had - Bowel Control Issues  

Medline Plus

Full Text Available ... what he would do if he had a family member with bowel control issues. Dr. Galloway: Well, ... problem of muscle weakness. If I had a family member suffering from fecal incontinence… Dr. Galloway: Well, ...

 
 
 
 
301

If I Had - Bowel Control Issues  

Medline Plus

Full Text Available ... the anal sphincter. Some patients are left after childbirth with an opening, called a fistula, between the bowel and the vagina, which means that the continence mechanism cannot protect against leakage. There are many kinds ...

302

If I Had - Bowel Control Issues  

Medline Plus

Full Text Available ... he would do if he had a family member with bowel control issues. Dr. Galloway: Well, fecal ... of muscle weakness. If I had a family member suffering from fecal incontinence… Dr. Galloway: Well, I ...

303

If I Had - Bowel Control Issues  

Medline Plus

Full Text Available ... wrong way to go. How should my doctor approach this issue? Dr. Galloway: I think the first ... to stimulate the bowel to empty. And these approaches, typically, can be used very safely on a ...

304

If I Had - Bowel Control Issues  

Medline Plus

Full Text Available ... patients that we see who come to a bladder control clinic are also going to have bowel ... similar to situations that we see with the bladder where oftentimes patients who don’t empty their ...

305

If I Had - Bowel Control Issues  

Medline Plus

Full Text Available ... In 60 In Depth In the Spotlight If I Had... Universities and Hospitals By Disease or Symptom ... Glargine Just as Effective as Insulin Lispro If I Had - Bowel Control Issues - Dr. Niall Galloway, MD, ...

306

Magnetic resonance imaging of the small bowel  

Energy Technology Data Exchange (ETDEWEB)

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.

Deeab, Dhafer A., E-mail: dhafer_ahmed@yahoo.co [Department of Radiology, St Mary' s Campus, Imperial College NHS Trust, London (United Kingdom); Dick, Elizabeth; Sergot, Antoni A.; Sundblon, Lauren; Gedroyc, Wady [Department of Radiology, St Mary' s Campus, Imperial College NHS Trust, London (United Kingdom)

2011-02-15

307

Microvascular studies in human radiation bowel disease  

International Nuclear Information System (INIS)

The microvasculature was investigated in the normal bowel (n=43 patients) and in radiation bowel disease (n=18 patients). Tissue samples obtained from postoperative colectomy specimens in which the intramural vessels had been perfused with barium sulphate suspension were examined. Microradiography was used to study vascular pattern which was abnormal in radiation bowel disease. A recently described radiography fluorescence system was used to estimate barium concentration, and hence microvascular volume. The radiation group showed a highly significant reduction in barium concentration (p<0.001), when compared with the normal group. This reduction was diffuse in samples from 15 patients who had received combined intracavity and external radiotherapy, but localised in two patients who had received intracavity treatment only. It is concluded that microvascular compromise is an important factor in the natural history of radiation bowel disease. (author)

308

Small bowel video capsule endoscopy: an overview.  

Science.gov (United States)

Video capsule endoscopy (VCE) is being increasingly used to investigate small bowel pathology. It is the gold standard for obscure gastrointestinal bleeding and iron deficiency anemia. VCE has been in use since 2001 and indications for its use are expanding. VCE is also a useful diagnostic tool in small bowel Crohn's disease, celiac disease, surveillance of polyps, small bowel malignancy and drug-induced small bowel injury. Although VCE is considered a safe and easy procedure, there are a few limitations. These include cost, capsule retention and inability to take a biopsy and perform any therapeutic maneuvers. Contraindications for VCE include pregnancy, patients with a swallowing disorder, history of previous abdominal surgery or concurrent abdomino-pelvic irradiation. This is an overview of VCE, its role and indications in clinical practice, potential complications and contraindications, as well as the ongoing and expected advances in the field. PMID:23639090

Mustafa, Barzin F; Samaan, Mark; Langmead, Louise; Khasraw, Mustafa

2013-05-01

309

If I Had - Bowel Control Issues  

Medline Plus

Full Text Available ... cause damage to the pelvic floor or the anal sphincter. Some patients are left after childbirth with an opening, called a fistula, between the bowel and the vagina, which means ...

310

Clinical patterns of familial inflammatory bowel disease.  

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BACKGROUND: Although many recent studies have shown the increased risk of inflammatory bowel disease in relatives of patients with Crohn's disease and ulcerative colitis, clinical patterns of disease within families remain relatively poorly documented. AIMS: In this study, clinical characteristics (disease type, extent, age on onset, need for surgery, and presence of extraintestinal manifestations) have been compared in affected subjects in multiply-affected families, with inflammatory bowel ...

Satsangi, J; Grootscholten, C.; Holt, H.; Jewell, Dp

1996-01-01

311

Diffuse small bowel involvement in malignant histiocytosis.  

Science.gov (United States)

The extremely unusual patient reported here had malignant histiocytosis with extensive gastrointestinal involvement. The presenting symptoms were those of a gastrointestinal disorder and barium studies of the upper gastrointestinal tract revealed an infiltrative process of the entire small bowel. A biopsy of the small bowel demonstrated abnormal malignant cells and the diagnosis of malignant histiocytosis was considered and confirmed at postmortem. Strongyloidiasis, which was also found in this patient, may represent a hyperinfestation phenomenon due to altered host-parasite balance. PMID:1130388

Chawla, S K; Lopresti, P A; Burdman, D; Sileo, A; Govoni, A F; Smulewicz, J J

1975-02-01

312

Small bowel emergency surgery: literature's review  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Emergency surgery of the small bowel represents a challenge for the surgeon, in the third millennium as well. There is a wide number of pathologies which involve the small bowel. The present review, by analyzing the recent and past literature, resumes the more commons. The aim of the present review is to provide the main indications to face the principal pathologies an emergency surgeon has to face with during his daily activity.

Di Saverio Salomone

2011-01-01

313

Novel susceptibility genes in inflammatory bowel disease  

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The inflammatory bowel disease, Crohn’s disease and ulcerative colitis, are polygenic disorders with important environmental interactions. To date, the most widely adopted approach to identifying susceptibility genes in complex diseases has involved genome wide linkage studies followed by studies of positional candidate genes in loci of interest. This review encompasses data from studies into novel candidate genes implicated in the pathogenesis of inflammatory bowel disease. Novel technique...

Noble, Colin; Nimmo, Elaine; Gaya, Daniel; Russell, Richard K.; Satsangi, Jack

2006-01-01

314

Cutaneous manifestations of inflammatory bowel disease  

Directory of Open Access Journals (Sweden)

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.

Al Roujayee Abdulaziz

2007-01-01

315

[Contemporary dietotherapy of the irritable bowel syndrome].  

Science.gov (United States)

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

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

2013-01-01

316

Bellyboard device reduces small bowel displacement  

International Nuclear Information System (INIS)

The ability to cure several pelvic malignancies is hampered by the inability to deliver doses greater than 45 to 50 Gy, beyond which radiation enteritis becomes dose-limiting. The design and fabrication of a device that allows exclusion of small bowel from the pelvis during radiation therapy are described in this study. A prospective dose-volume analysis conducted on 30 patients reveals a 66 percent reduction in the volume of small bowel within the radiation portals

317

Mechanical bowel preparation for elective colorectal surgery  

DEFF Research Database (Denmark)

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

Güenaga, Katia F; Matos, Delcio

2011-01-01

318

The Immune System in Irritable Bowel Syndrome  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The potential relevance of systemic and gastrointestinal immune activation in the pathophysiology and symptom generation in the irritable bowel syndrome (IBS) is supported by a number of observations. Infectious gastroenteritis is the strongest risk factor for the development of IBS and increased rates of IBS-like symptoms have been detected in patients with inflammatory bowel disease in remission or in celiac disease patients on a gluten free diet. The number of T cells and mast cells in the...

Barbara, Giovanni; Cremon, Cesare; Carini, Giovanni; Bellacosa, Lara; Zecchi, Lisa; Giorgio, Roberto; Corinaldesi, Roberto; Stanghellini, Vincenzo

2011-01-01

319

Rifaximin Therapy of Irritable Bowel Syndrome  

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Irritable bowel syndrome (IBS) is a common gastrointestinal disorder characterized by abdominal pain and altered bowel habits in the absence of specific organic pathology. Although the underlying pathogenesis of IBS is not well-understood, small intestinal bacterial overgrowth (SIBO) or other abnormalities in the gut flora is believed to contribute to the development of a subset of IBS cases. Rifaximin is a poorly absorbed antimicrobial with activity against enteric pathogens. A number of stu...

Koo, Hoonmo L.; Saman Sabounchi; Huang, David B.; Dupont, Herbert L.

2012-01-01

320

Feasibility of laparoscopy for small bowel obstruction  

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Abstract Background Adherential pathology is the most common cause of small bowel obstruction. Laparoscopy in small bowel obstruction does not have a clear role yet; surely it doesn't always represent only a therapeutic act, but it is always a diagnostic act, which doesn't interfere with abdominal wall integrity. Methods We performed a review without any language restrictions considering international literature indexed from 1980 to 2007 in Medline, Embase and C...

De Sol Angelo A; Migliaccio Carla; Delmonaco Pamela; Cattorini Lorenzo; Morelli Umberto; La Mura Francesco; Cirocchi Roberto; Farinella Eriberto; Cozzaglio Luca; Sciannameo Francesco

2009-01-01

 
 
 
 
321

Rifaximin Resistance in Escherichia coli Associated with Inflammatory Bowel Disease Correlates with Prior Rifaximin Use, Mutations in rpoB, and Activity of Phe-Arg-?-Naphthylamide-Inhibitable Efflux Pumps  

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Escherichia coli is implicated in the pathogenesis of inflammatory bowel disease (IBD). Rifaximin, a nonabsorbable derivative of rifampin effective against E. coli, improves symptoms in mild-to-moderate IBD. However, rifaximin resistance can develop in a single step in vitro. We examined the prevalence and mechanisms of rifaximin resistance in 62 strains of E. coli isolated from the ileal mucosa of 50 patients (19 with ileal Crohn's disease [L1+L3], 6 with colonic Crohn's disease [L2], 13 wit...

Kothary, Vishesh; Scherl, Ellen J.; Bosworth, Brian; Jiang, Zhi-dong; Dupont, Herbert L.; Harel, Josee; Simpson, Kenneth W.; Dogan, Belgin

2013-01-01

322

Phenotypic change of muscularis mucosae in early invasive colorectal adenocarcinoma  

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Background—Invasive colorectal adenocarcinomas have bundles of eosinophilic spindle cells, which are regarded as myofibroblasts, in their desmoplastic stroma, some of which are continuous with the muscularis mucosa.

Ban, S.; Kamada, K.; Mitsuki, N.; Goto, Y.; Shimizu, Y.; Takahama, M.; Shibata, T.

2000-01-01

323

Angiography of ileal hemorrhage from heterotopic gastric mucosa  

International Nuclear Information System (INIS)

The angiographic and pathologic findings of ileal hemorrhage from heterotopic gastric mucosa (HGM) without Meckel's diverticulum are presented. The pathogenesis is discussed and a short literature review is given. (orig.)

324

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

Directory of Open Access Journals (Sweden)

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.

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

2008-06-01

325

Comparing measures of acute bowel toxicity in patients with prostate cancer treated with external beam radiation therapy  

International Nuclear Information System (INIS)

Purpose This study strives to compare early measures of bowel toxicity in patients with prostate cancer receiving definitive or adjuvant 3D conformal external beam radiation therapy and concurrent daily endorectal application of amifostine. Methods Eighteen patients were enrolled in the clinical study with a median follow-up of 12 months. Prescription doses ranged from 66 Gy to 76 Gy with a daily fractionation of 2 Gy. Acute bowel toxicity was measured at baseline, at Weeks 5 and 7 of radiotherapy, and at 1 and 3 months after the completion of therapy. Measures of acute bowel toxicity included the Radiation Therapy Oncology Group (RTOG) acute radiation morbidity scoring criteria, Expanded Prostate Cancer Index Composite (EPIC) self-assessment questionnaires, and proctoscopic examinations. Results The mean EPIC bowel scores changed significantly through the course of therapy and follow-up (p < 0.0001), with a progressive decrease in scores at Weeks 5 and 7 of treatment, a partial recovery at 3 months, and a correlation to the gold standard RTOG grade (p = 0.004). Proctoscopic toxicity scores were low, did not vary over time, and did not correlate with either EPIC or RTOG scores. Conclusion The EPIC questionnaire measurements are most sensitive to changes in acute bowel toxicity through a course of radiotherapy and correlate with RTOG acute toxicity scores. Endoscopic examination of the rectal mucosa at the end and immediate follow-up of a course of therapy does not seelow-up of a course of therapy does not seem to be informative or reproducible between observers in the acute setting

326

Speech and Swallowing Outcomes in Buccal Mucosa Carcinoma  

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Buccal carcinoma is one of the most common malignant neoplasms among all oral cancers in India. Understanding the role of speech language pathologists (SLPs) in the domains of evaluation and management strategies of this condition is limited, especially in the Indian context. This is a case report of a young adult with recurrent squamous cell carcinoma of the buccal mucosa with no deleterious habits usually associated with buccal mucosa carcinoma. Following composite resection, pectoralis maj...

John, Sunila; Hassuji, Rashida M.; Rajashekhar, B.

2011-01-01

327

Gastrin-releasing peptide in human nasal mucosa.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Gastrin-releasing peptide (GRP), the 27 amino acid mammalian form of bombesin, was studied in human inferior turbinate nasal mucosa. The GRP content of the mucosa measured by radioimmunoassay was 0.60 +/- 0.25 pmol/g tissue (n = 9 patients; mean +/- SEM). GRP-immunoreactive nerves detected by the immunogold method of indirect immunohistochemistry were found predominantly in small muscular arteries, arterioles, venous sinusoids, and between submucosal gland acini. 125I-GRP binding sites determ...

Baraniuk, J. N.; Lundgren, J. D.; Goff, J.; Peden, D.; Merida, M.; Shelhamer, J.; Kaliner, M.

1990-01-01

328

Morphological changes of gastric mucosa depending on functional dyspepsia syndrome  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 chang...

Svintsitskyy A.; Korendovych I.; Kuryk O.; Solovyova G.

2014-01-01

329

Obstrução do íleo terminal por mucosa gástrica heterotópica  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A mucosa gástrica ectópica localizada no intestino delgado, distal ao ligamento de Treitz é muito rara, excetuando-se a encontrada habitualmente no divertículo de Meckel e na duplicação intestinal. Existem formas congênita e adquirida, sendo esta última secundária à processos inflamatórios intestinais. As diferenças entre estas formas são basicamente histológicas, determinando no entanto aspectos fisiopatológicos distintos. Apresentamos caso de mucosa gástrica ectópica em pac...

Atik F. A.; Ricci M.; Del Grande J.C.; Haddad C. M.

1998-01-01

330

Ultrastructural pathology of the rectal mucosa in Shigella dysentery.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Colonocyte damage in the rectal mucosa in shigellosis is the result of bacterial invasion and leads to ulceration. Additional factors in colonocyte damage may be the Shigella cytotoxin and, especially in colonic crypt cells, bacterial endotoxin. A vascular lesion was present in the lamina propria of the rectal mucosa, which resembled endothelial damage secondary to bacterial endotoxins. In patients with longer duration of symptoms, relative vascular insufficiency, activated lymphocytes, eosin...

Mathan, M. M.; Mathan, V. I.

1986-01-01

331

Ectopic gastric mucosa in the oesophagus mimicking ulceration  

International Nuclear Information System (INIS)

We report two patients with ectopic gastric mucosa in the oesophagus in whom emergency contrast medium studies after traumatic endoscopy revealed broad, flat depressions on the right lateral wall of the upper oesophagus that could initially be mistaken for ulcers or even intramural dissections. However, the appearance and location of these lesions is so characteristic of ectopic gastric mucosa that confirmation with endoscopic biopsy specimens probably is not required in asymptomatic patients

332

Pharmacokinetics of EMLA cream 5% application to oral mucosa.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Plasma concentrations of lidocaine and prilocaine were measured following the application of a 5% eutectic mixture of local anesthetics (EMLA) topical anesthetic cream to the oral mucosa of twelve subjects. For each subject, a total of 8 g of EMLA was occluded to 18 cm2 of buccal mucosa for 30 min. Analysis was carried out by high-pressure liquid chromatography, and results showed peak concentrations at 40 min for lidocaine and prilocaine. The maximum concentration measured in any subject was...

Vickers, E. R.; Marzbani, N.; Gerzina, T. M.; Mclean, C.; Punnia-moorthy, A.; Mather, L.

1997-01-01

333

Inflammatory bowel disease in pregnancy  

Directory of Open Access Journals (Sweden)

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.

Dawn B Beaulieu

2011-01-01

334

Malignancies in inflammatory bowel disease.  

Science.gov (United States)

Abstract Patients with inflammatory bowel diseases (IBDs) are at increased risk of colorectal cancer (CRC), but the risk varies between different studies and seems to be decreasing. The cumulative risk of CRC has been reported to be 1%, 2%, and 5% after 10, 20, and over 20 years of disease duration, respectively, in recent meta-analysis. Disease duration and grade of inflammation are the main driving forces of dysplasia and CRC development. Also, the risk of extraintestinal cancers is increased in IBD, where the degree of immunosuppression and its duration are the most important risk factors. Most important extraintestinal malignancies are lymphomas and non-melanoma skin cancers, both of which are increased in patients receiving thiopurines. Also, extraintestinal manifestations or concomitant diseases such as primary sclerosing cholangitis predispose IBD patients to malignancies such as cholangiocarcinoma. History of previous cancer increases the risk of developing either new or recurrent cancers and should be taken into account when choosing therapy and planning surveillance. Dysplasia and cancer screening and surveillance must be individualized according to patients' risk factors. Malignancies are the second most common cause of death after cardiovascular diseases in both genders in patients with IBD. PMID:25523559

Nieminen, Urpo; Färkkilä, Martti

2015-01-01

335

Colonic mucosa-associated lymphoid tissue lymphoma identified by chromoendoscopy  

Science.gov (United States)

Colonic mucosa-associated lymphoid tissue (MALT) lymphomas are a rare occurrence and the definitive treatment has not been established. Solitary or multiple, elevated or polypoid lesions are the usual appearances of MALT lymphoma in the large intestine and sometimes the surface may reveal abnormal vascularity. Herein, we report a case of MALT lymphoma and review the relevant literature. Upon colonoscopy, a suspected pathologic lesion was observed in the proximal transverse colon. The lesion could be distinguished more prominently after using narrow-band imaging mode and indigo carmine-dye spraying chromoendoscopy. Histopathologic examination of this biopsy specimen revealed lymphoepithelial lesions with diffuse proliferation of atypical lymphoid cells effacing the glandular architecture and centrocyte-like cells infiltrating the lamina propria. Immunohistochemical analyses showed that tumor cells were positive for CD20 and Bcl-2e, and negative for CD10, CD23, and Bcl-6. According to Ann-Arbor staging system, the patient had stage IIE. A partial colectomy with dissection of the paracolic lymph nodes was performed. Until now, there is no recurrence of lymphoma at follow-up. PMID:25561821

Seo, Sang-Wook; Lee, Seung-Hwa; Lee, Duck-Joo; Kim, Kwang-Min; Kang, Joon-Koo; Kim, Do-Wan; Lee, Jeong-Hun

2014-01-01

336

Colonic mucosa-associated lymphoid tissue lymphoma identified by chromoendoscopy.  

Science.gov (United States)

Colonic mucosa-associated lymphoid tissue (MALT) lymphomas are a rare occurrence and the definitive treatment has not been established. Solitary or multiple, elevated or polypoid lesions are the usual appearances of MALT lymphoma in the large intestine and sometimes the surface may reveal abnormal vascularity. Herein, we report a case of MALT lymphoma and review the relevant literature. Upon colonoscopy, a suspected pathologic lesion was observed in the proximal transverse colon. The lesion could be distinguished more prominently after using narrow-band imaging mode and indigo carmine-dye spraying chromoendoscopy. Histopathologic examination of this biopsy specimen revealed lymphoepithelial lesions with diffuse proliferation of atypical lymphoid cells effacing the glandular architecture and centrocyte-like cells infiltrating the lamina propria. Immunohistochemical analyses showed that tumor cells were positive for CD20 and Bcl-2e, and negative for CD10, CD23, and Bcl-6. According to Ann-Arbor staging system, the patient had stage IIE. A partial colectomy with dissection of the paracolic lymph nodes was performed. Until now, there is no recurrence of lymphoma at follow-up. PMID:25561821

Seo, Sang-Wook; Lee, Seung-Hwa; Lee, Duck-Joo; Kim, Kwang-Min; Kang, Joon-Koo; Kim, Do-Wan; Lee, Jeong-Hun

2014-12-28

337

Heterotaxy syndromes and abnormal bowel rotation  

International Nuclear Information System (INIS)

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.)

338

Heterotaxy syndromes and abnormal bowel rotation  

Energy Technology Data Exchange (ETDEWEB)

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.)

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

339

Expression of carcinoembryonic antigen, T-antigen, and oncogene products as markers of neoplastic and preneoplastic colonic mucosa.  

Science.gov (United States)

Several crypt abnormalities have been demonstrated in the mucosa of neoplastic and preneoplastic lesions of the large intestine. In addition, certain tumor markers are expressed in large intestinal carcinoma but not in normal mucosa. To determine whether any correlation exists between tumor marker expression and crypt abnormalities and at what stage markers are expressed, we studied specimens of large intestinal mucosa from 13 patients with preneoplastic conditions (adenomatous polyp, familial polyposis, Crohn's disease, and ulcerative colitis). The tumor markers examined include carcinoembryonic antigen (CEA), the ras gene products p21 and p21ser (mutated form), and beta-D-galactosyl-(1----3)-alpha-N-acetyl-D-galactosamine (gal--gal NAc, also known as T-antigen). Results were compared to those of five cases of adenocarcinoma of colon and three control cases of colonic mucosa obtained at immediate autopsy. All four markers were expressed in three of the five cases of adenocarcinoma, but none were expressed in the control cases. Variable expression of each marker was demonstrated in the dilated, distorted crypts of preneoplastic lesions. CEA and gal--gal NAc appeared to be expressed most frequently, suggesting that these are common markers or are expressed at an earlier stage in the neoplastic process than p21 or p21ser. Demonstration of such markers in preneoplastic conditions may be of use in determining the malignant potential and in monitoring these lesions. PMID:3500109

McKenzie, K J; Purnell, D M; Shamsuddin, A M

1987-12-01

340

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: English Abstract in spanish 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.

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

2011-04-01

 
 
 
 
341

Endometriosis involving the mucosa of the intestinal tract: a clinicopathologic study of 15 cases.  

Science.gov (United States)

Endometriosis involving the mucosa of the intestines is rare, but may lead to diagnostic pitfalls. We reviewed 15 cases (seven biopsies and eight resections) from 14 patients. The patients' mean age is 48 years (31-66 years). Presenting symptoms included lower gastrointestinal bleeding, pelvic pain, rectal urgency, abdominal mass, and bowel obstruction. In the majority of cases, the lesion was located in the rectum (73%) with the remainder in the sigmoid colon (20%) and ileum (7%). The most common indication for biopsy was a polypoid lesion seen endoscopically (eight cases). For patients who underwent resections, the most common clinical impression was colonic carcinoma (75%), due to mass lesions and stricture as the most common macroscopic findings. Histologically, one case had stromal endometriosis only, but the remaining 14 cases had both endometrial glands and stroma. Epithelial metaplasia was present in all cases, mostly tubal metaplasia (ciliated epithelium). Hybrid glands and replacement of the surface epithelium by endometrial epithelium were also seen. Crypt architectural distortion, cryptitis, and crypt abscesses were seen in some cases, mimicking chronic active colitis or enteritis. A panel of immunohistochemical stains (CK7, CK20, CDX2, and ER) was found to be useful in biopsies with suspected endometriosis demonstrating unusual histology or only containing endometrioid stroma tissue. Vascular involvement by endometriosis was identified in one case. Endometrial hyperplasia (n=2) and cancer (n=1) were also seen in the ectopic tissue. All patients were alive at follow-up (3-216 months, mean 67 months). PMID:23579618

Jiang, Wei; Roma, Andres A; Lai, Keith; Carver, Paula; Xiao, Shu-Yuan; Liu, Xiuli

2013-09-01

342

Histological and histochemical changes of the intestinal mucosa at the urothelial-enteric anastomotic site  

Directory of Open Access Journals (Sweden)

Full Text Available OBJECTIVE: The incorporation of bowel segments for urinary tract reconstruction may induce intestinal mucosal changes with the development of metabolic, nutritional, gastrointestinal and carcinogenic complications. The early histological and histochemical changes of the intestinal mucosa in contact with the feces-urine mixture, are evaluated in the present study. MATERIALS AND METHODS: Twelve rats (operated group were submitted to a vesico-colonic anastomosis, and 10 rats (control group underwent a sham operation (the colon was opened and immediately sutured. On the operated group, the left colon was divided into 3 equal portions and the middle segment was used for the bladder-colonic anastomosis. After 20 weeks, the animals were sacrificed and the entire left colon in each group, as well as the bladder and the vesico-colonic anastomosis in the operated group, was removed. The proximal, middle (anastomotic site in the operated group and sutured portion in the control group and distal colon were used for histological and histochemical studies. RESULTS: Metaplasia, chronic inflammatory process and fibrosis were significantly greater at the anastomotic site compared to the middle segment of the control group. There were no differences in both groups in terms of dysplasia, atrophy and hypertrophy either on the proximal, middle or anastomotic area and distal portion of the left colon. All animals in the operated group showed a reduced presence of sulfomucin and an increase in the sialomucin content. CONCLUSION: The histological changes observed in this study may suggest a precancerous phenomenon.

Marcos A. Castro

2006-04-01

343

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)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese 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

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

2006-02-01

344

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)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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

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

2011-08-01

345

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

LENUS (Irish Health Repository)

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.

Medani, Mekki

2009-01-01

346

Detection of acute inflammatory bowel disease with Tc-99m-HSA-sucralfate scans  

International Nuclear Information System (INIS)

Sucralfate binds to mucosal ulcerations. Twelve studies were performed in 11 patients with inflammatory bowel disease. Technetium-sucralfate was prepared in vitro and given orally. Images were obtained at 4-6, 24, and 48 hours. Persistent focal abnormalities or activity in the large bowel beyond 48 hours was interpreted as positive. Patients' charts were reviewed. Technetium-sucralfate was positive in ten of ten studies in nine patients with active disease, one with equivocal activity, and negative in one patient with inactive disease. Nine of 19 abnormal sites were detected with technetium-sucralfate and radiology or endoscopy; six of ten were detected with technetium-sucralfate only. Technetium-sucralfate is very sensitive in detecting active inflammatory bowel disease in individual patients

347

Effects of Formaldehyde on Respiratory Mucosa in Rats Efectos del Formaldehído sobre la Mucosa Respiratoria en Ratas  

Directory of Open Access Journals (Sweden)

Full Text Available Formaldehyde inhalation, are known to be nasal mucosa irritating feature. This study we are examined the effects histopathologic of formaldehyde inhalation on rats by using light microscopy. 16 adult wistar albino rats were used in this study. 8 rats were in control group and 8 rats were in experiment group. Experiment group was exposed to 10 ppm formaldhyde 8hours/day,5days/week for 8 week. Nasal mucosa was removed and placed in 10% formaline. Sections were stained with Hematoxylene-Eosine and observed under light microscopy. The lining epithelium of respiratory mucosa showed a loss of ciliated cells with metaplasia of goblet cells and hyperplasia of squamous cells.Es conocido que la inhalación de formaldehído tiene caraterísticas irritantes para la mucosa nasal. En este estudio se examinaron los efectos histopatológicos de la inhalación de formaldehído en ratas mediante microscopía de luz. Se utilizaron en este estudio 16 ratas Wistar albinas adultas, ocho ratas como grupo control y ocho como grupo experimental. El grupo experimental fue expuesto a 10 ppm formaldehído 8 horas/día, 5 días/semana por 8 semanas. La mucosa nasal fue retirada y colocada en formalina al 10%. Las secciones obtenidas fueron teñidas con Hematoxilina-Eosina y observadas al microscopio óptico. El epitelio de revestimiento de la mucosa respiratoria mostró una pérdida de células ciliadas con metaplasia de las células caliciformes e hiperplasia de células escamosas.

E Yorgancilar

2012-06-01

348

Small bowel adenocarcinoma. Two case reports.  

Science.gov (United States)

Introduction. Small bowel adenocarcinoma is a rare tumor, with a still not well studied tumorigenesis process, and non-specific symptoms that cause a delay in the diagnosis and consequently a worst outcome for the patient. Videocapsule endoscopy (VCE) and double-balloon enteroscopy (DBE) have revolutionized the diagnosis and management of patients with small bowel diseases. Surgery is the treatment of choice when feasible, while the chemotherapeutic approach is still not well standardized. Case reports. Two cases in 2 months (two women 52 and 72-yr-old) of primary bowel adenocarcinoma is reported. The site of the tumor was in jejunum, instead of the most common site in duodenum. The patients underwent DBE with biopsy and ink mark. Laparoscopic-assisted bowel segmental resection was performed. The pathologic diagnosis was primary jejunum adenocarcinoma. No post-operative mortality or significant morbidities were noted. Conclusion. The combination of DBE and laparocopic-assisted bowel surgery represents an ideal diagnostic and therapeutic method. PMID:22958804

Anania, G; Santini, M; Vedana, L; Marzetti, A; Scagliarini, L; Zelante, A; Pezzoli, A; Resta, G; Cavallesco, G

2012-01-01

349

The "Pavia model" of experimental small bowel transplantation in pigs: technical variations for ischemia reperfusion injury studies.  

Science.gov (United States)

Ischemia reperfusion injury (IRI) is a major field of study in small bowel transplantation because of its implications regarding intestinal immunity. In this study, we have introduced some variations to the described models of IRI in pigs to make possible a complete isolation of the small bowel for IRI studies. In swine, two anatomical barriers make impossible a complete isolation of the small bowel at the origin of superior mesenteric artery (SMA) and vein (SMV): the main colic vessels, which originate distally to form SMA and SMV, and the blood supply of the distal portion of the duodenum and the cephalic part of the pancreas. In a group of Large White pigs (n = 5), we have performed a complete isolation of the small bowel, including sub-total colectomy and pancreaticoduodenectomy. Both SMA and SMV were isolated at the origin from the aorta and at the junction of the splenic vein, respectively. Intestinal continuity was restored with duodenojejunal anastomosis and with ileotransverse colon anastomosis. One pig died on postoperative day 5 from intestinal occlusion due to adhesions. The remaining four pigs were killed on postoperative day 7 after an uneventful postoperative course. No complications were found at autopsy. In swine, resection of part of the pancreas and duodenum and removal of the large bowel does not affect short-term survival, allowing a full isolation of the entire small bowel mimicking the transplantation procedure. Thus, this model appears to be attractive for IRI studies in the field of intestinal transplantation. PMID:25131126

Alessiani, M; Cobianchi, L; Viganò, J; Dominioni, T; Bottazzi, A; Zonta, S; Dionigi, P

2014-01-01

350

Aggregation factor as an inhibitor of bacterial binding to gut mucosa.  

Science.gov (United States)

Modern research in the area of probiotics is largely devoted to discovering factors that promote the adherence of probiotic candidates to host mucosal surfaces. The aim of the present study was to test the role of aggregation factor (AggL) and mucin-binding protein (MbpL) from Lactococcus sp. in adhesion to gastrointestinal mucosa. In vitro, ex vivo, and in vivo experiments in rats were used to assess the adhesive potential of these two proteins expressed in heterologous host Lactobacillus salivarius BGHO1. Although there was no influence of MbpL protein expression on BGHO1 adhesion to gut mucosa, expression of AggL had a negative effect on BGHO1 binding to ileal and colonic rat mucosa, as well as to human HT29-MTX cells and porcine gastric mucin in vitro. Because AggL did not decrease the adhesion of bacteria to intestinal fragments in ex vivo tests, where peristaltic simulation conditions were missing, we propose that intestinal motility could be a crucial force for eliminating aggregation-factor-bearing bacteria. Bacterial strains expressing aggregation factor could facilitate the removal of pathogens through the coaggregation mechanism, thus balancing gut microbial ecosystems in people affected by intestinal bacteria overgrowth. PMID:24823989

Lukic, Jovanka; Strahinic, Ivana; Milenkovic, Marina; Nikolic, Milica; Tolinacki, Maja; Kojic, Milan; Begovic, Jelena

2014-10-01

351

How do SSRIs help patients with irritable bowel syndrome?  

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Selective serotonin reuptake inhibitor antidepressants seem to promote global well being in some patients with irritable bowel syndrome and, possibly, some improvement in abdominal pain and bowel symptoms, but this effect appears to be independent of improved depression

Creed, F.

2006-01-01

352

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

Directory of Open Access Journals (Sweden)

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.

István Rácz

2013-01-01

353

Mucosal healing in the era of biologic agents in treatment of inflammatory bowel disease.  

Science.gov (United States)

Abstract Mucosal healing has been a central issue in inflammatory bowel disease (IBD) for the last years, and has been proposed to be included as the new treatment goal in IBD. The molecular understanding of both the disruption and the healing of the intestinal epithelial cell lining and the mucosal barrier in IBD is complex and only partly understood. There is no general agreement on how to define healed mucosa, but there is a general acceptance that clinicians should use endoscopy and imaging technique in their assessments. Mucosal healing is an old concept that has been actualized in the present era of the highly effective biological agents. Randomized clinical studies with mucosal healing as end-point parameters have been reported, and early mucosal healing has been associated with low complication rates. We are waiting for documentation of whether treatment to healed mucosa can change the natural course of IBD. The concept of immunological remission has recently been introduced and can be the new treatment goal and one of several criteria for discontinuation of biological treatment in IBD. In conclusion, mucosal healing is a fairly novel concept and goal for biological treatment of IBD. There is a need for a standardization of its assessment and validation of the prognostic value. PMID:25523555

Florholmen, Jon

2015-01-01

354

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

Directory of Open Access Journals (Sweden)

Full Text Available 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. 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.

Octavio Germán Muñoz Maya

2006-01-01

355

Clinical significance of cytomegalovirus infection in patients with inflammatory bowel disease  

Directory of Open Access Journals (Sweden)

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.

Elena Garrido

2013-01-01

356

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

Science.gov (United States)

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. PMID:25557336

Aalykke, Claus; Jensen, Michael Dam; Fallingborg, Jan; Jess, Tine; Langholz, Ebbe; Meisner, Søren; Andersen, Nynne Nyboe; Riis, Lene Buhl; Thomsen, Ole Østergaard; Tøttrup, Anders

2015-01-01

357

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

Directory of Open Access Journals (Sweden)

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.

Ebubekir ?ENATE?

2013-03-01

358

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

Directory of Open Access Journals (Sweden)

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.

Gerhard Rogler

2010-01-01

359

Effect of commensals and probiotics on visceral sensitivity and pain in irritable bowel syndrome.  

Science.gov (United States)

The last ten years' wide progress in the gut microbiota phylogenetic and functional characterization has been made evidencing dysbiosis in several gastrointestinal diseases including inflammatory bowel diseases and irritable bowel syndrome (IBS). IBS is a functional gut disease with high prevalence and negative impact on patient's quality of life characterized mainly by visceral pain and/or discomfort, representing a good paradigm of chronic gut hypersensitivity. The IBS features are strongly regulated by bidirectional gut-brain interactions and there is increasing evidence for the involvement of gut bacteria and/or their metabolites in these features, including visceral pain. Further, gut microbiota modulation by antibiotics or probiotics has been promising in IBS. Mechanistic data provided mainly by animal studies highlight that commensals or probiotics may exert a direct action through bacterial metabolites on sensitive nerve endings in the gut mucosa, or indirect pathways targeting the intestinal epithelial barrier, the mucosal and/or systemic immune activation, and subsequent neuronal sensitization and/or activation. PMID:25181491

Theodorou, Vassilia; Belgnaoui, Afifa Ait; Agostini, Simona; Eutamene, Helene

2014-07-01

360

Small bowel intussusception due to metastatic bladder carcinoma  

Science.gov (United States)

The common sites of metastasis from a urinary bladder carcinoma include lymph nodes, bones, lung, liver, and peritoneum. Only a few cases of small bowel metastasis from urinary bladder malignancy have been reported in the English literature. Only one of these cases presented with bowel intussusception. We report a case of an adult small bowel intussusception due to metastasis from a urinary bladder carcinoma which is extremely rare as small bowel metastasis occur mostly from breast, lungs or melanomas. PMID:25378829

Singh, Seema; Ranjan, Rakesh; Sharma, Naveen

2014-01-01

 
 
 
 
361

Transient small bowel angioedema due to intravenous iodinated contrast media  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

Xiu-Hua Hu; Xiang-Yang Gong; Peng Hu

2012-01-01

362

Inflammatory bowel disease in exclusively breast-fed infants.  

Science.gov (United States)

Inflammatory bowel disease is uncommon in infants. We present the clinical, endoscopic and pathologic findings for two exclusively breast-fed infants with a diagnosis of inflammatory bowel disease. We emphasize that although inflammatory bowel disease is rare in infants, chronic bloody diarrhea must be a sufficiently alarming symptom to consider a differential diagnosis of inflammatory bowel disease in young infants is considered, even when they are exclusively breast-fed. PMID:17060132

Kulo?lu, Zarife; Kansu, Aydan; Kirsaçlio?lu, Ceyda; Ince, Erdal; Ensari, Arzu; Girgin, Nurten

2006-11-01

363

Arteriovenous malformation detected by small bowel endoscopy.  

Science.gov (United States)

Gastrointestinal bleeding that originates in the small intestine is often difficult to diagnose. When successful diagnosis reveals a lesion that can be localized preoperatively, the laparoscopic approach is an appropriate and beneficial treatment modality for small bowel resection. A 69-year-old man presented with a 6-month history of gastrointestinal bleeding and symptomatic transfusion-dependent anemia. Upper and lower endoscopy were normal. Double-balloon endoscopy established the source of the bleeding as a 0.5-cm polypoid mass appearing as a submucosal tumor with redness and pulsation in the lower ileum, suggesting a vascular lesion. Laparoscopic small bowel resection was successful in removing the mass in the ileum. Histological evaluation of the mass revealed an arteriovenous malformation. Preoperative small bowel endoscopy can be useful for diagnosing the cause and localization of arteriovenous malformation in the small intestine. PMID:25473391

Fujii, Takaaki; Morita, Hiroki; Sutoh, Toshinaga; Takada, Takahiro; Tsutsumi, Soichi; Kuwano, Hiroyuki

2014-09-01

364

Twin pregnancy complicated with bowel strangulation.  

Science.gov (United States)

A 31-year-old primigravida at 35 weeks of gestation with twins who had no prior abdominal surgical history presented with worsening nausea, vomiting and abdominal pain. Initial screening ruled out obstetrical causes that may threaten the pregnancy. Twelve hours after the onset of symptoms, a transabdominal ultrasound revealed abdominal free fluid. A CT scan confirmed strangulated ileus involving the small bowels. Owing to non-reassuring fetal status in one of the twins, an emergency caesarean section and subsequent laparotomy were performed. The first twin presenting with fetal distress had to be resuscitated postdelivery but recovered uneventfully and met all developmental milestones by 3 months of age. The mother had a strangulated small bowel that had to be resected. She had an uncomplicated postsurgical course and gained full bowel function prior to discharge from the hospital. PMID:25199197

Wong, Tze Fang; Imai, Shunichi; Tomita, Masato

2014-01-01

365

The complement system in inflammatory bowel disease.  

Science.gov (United States)

Complement is well appreciated to be a potent innate immune defense against microbes and is important in the housekeeping act of removal of apoptotic and effete cells. It is also understood that hyperactivation of complement, or the lack of regulators, may underlie chronic inflammatory diseases. A pipeline of products to intervene in complement activation, some already in clinical use, is being studied in various chronic inflammatory diseases. To date, the role of complement in inflammatory bowel disease has not received a lot of research interest. Novel genetically modified laboratory animals and experiments using antagonists to complement effector molecules have kindled important research observations implicating the complement system in inflammatory bowel disease pathogenesis. We review the evidence base for the role and potential therapeutic manipulation of the complement cascade in inflammatory bowel disease. PMID:24831561

Jain, Umang; Otley, Anthony R; Van Limbergen, Johan; Stadnyk, Andrew W

2014-09-01

366

Immunohistochemical analysis of the distribution of measles related antigen in the intestinal mucosa in inflammatory bowel disease  

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BACKGROUND—Measles virus is implicated in the aetiology of Crohn's disease. This measles hypothesis is mainly supported by immunohistochemical findings that the measles related antigen is present in the intestine of patients with Crohn's disease. Recently we isolated this antigen from the intestine of a patient with Crohn's disease using a molecular cloning technique and produced the monoclonal antibody against it (designated 4F12).?AIM—To discover whether the measles related antigen is...

Iizuka, M.; Chiba, M.; Yukawa, M.; Nakagomi, T.; Fukushima, T.; Watanabe, S.; Nakagomi, O.

2000-01-01

367

Inflammatory bowel disease in pediatric patients  

International Nuclear Information System (INIS)

Optimal management of chronic idiopathic inflammatory bowel disease requires determination of disease localization and intensity. Scintigraphy with the use of 99mTc - HMPAO- White Bloods Cells (99mTc - 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 99mTc - HMPAO- WBC scan and that shown by endoscopic, radiologic, or surgical methods. Additionally the 99mTc - HMPAO-WBC scan has the ability of identifying extra intestinal site of inflammation, such as appendicitis and others. The 99mTc - 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 99mTc - 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 99mTc - HMPAO-WBC scan is now part of the initial evaluation, and follow-up of patients with inflammatory bowel disease. In conclusion the 99mTc - HMPAO-WBC is excellent for the detection, localization and characterization of inflammatory bowel disease in children. Compared with bowel disease in children. Compared with the other methods of investigation this study requires no bowel preparation, is noninvasive and has excellent diagnostic accuracy

368

Multidetector CT findings of bowel Transection in blunt abdominal trauma  

International Nuclear Information System (INIS)

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.

369

Multidetector CT findings of bowel Transection in blunt abdominal trauma  

Energy Technology Data Exchange (ETDEWEB)

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.

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

370

Diffuse mesenterial sclerosis: a characteristic feature of chronic small-bowel allograft rejection.  

Science.gov (United States)

Chronic rejection is the major cause of late intestinal allograft dysfunction. The aim of this study was to analyze in detail the histopathological features of chronic rejection in the ACI-to-Lewis rat model of intestinal transplantation. Chronic rejection was achieved in orthotopic small-bowel allografts (ACI-Lewis) by limited immunosuppression with cyclosporin A (CyA). Isogeneic transplants (ACI-ACI) as well as native bowels (ACI) with and without immunosuppression served as controls. Bowels were removed together with the mesenteries 90 days postoperatively and analyzed using sections stained with hematoxylin and eosin as well as Masson's trichrome. The slides were coded, randomized and analyzed by grading of histological abnormalities. The most striking alterations of the allografts were noticed in the mesenteries exhibiting an extensive infiltration by mononuclear cells accompanied by a progressive diffuse fibrosis with shrinking of the mesenteries. These changes were most pronounced in the perivascular areas of the mesenteric arteriae and venae rectae. Three of five allografts showed vasculitis with myointimal proliferation of the arteriae rectae. Focally, there was spill-over of the inflammatory cells onto the intestinal muscularis propria. The mucosa of the allografts showed mild blunting, lymphocytic infiltration of the crypt epithelium and increased crypt cell apoptoses. The submucosa was unaffected, and there were no detectable abnormalities of the enteric ganglion cells. The present data support the view that chronic rejection of intestinal allografts is characterized by a diffuse sclerosing mesenteritis which may significantly contribute to late graft dysfunction. The present model may be useful to study the pathomechanisms of this inflammatory fibrosing process. PMID:12536314

Klaus, Alexander; Margreiter, Raimund; Pernthaler, Heinz; Klima, Günther; Offner, Felix A

2003-01-01

371

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

Directory of Open Access Journals (Sweden)

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.

U. Fagundes-Neto

2000-12-01

372

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english 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 secreti [...] on, 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.

U., Fagundes-Neto; S., De Martini-Costa; M.Z., Pedroso; I.C.A., Scaletsky.

1437-14-01

373

Trichobezoar: A rare cause of bowel obstruction  

Directory of Open Access Journals (Sweden)

Full Text Available A bezoar is an intraluminal mass formed by the accumulation of undigested material in the gastrointestinal tract. A trichobezoar is a bezoar made up of hair and is a rare cause of bowel obstruction of the proximal gastrointestinal tract. They are seen mostly in young women with trichotillomania and trichotillophagia and symptoms include epigastric pain, nausea, loss of appetite and bowel or gastric outlet obstruction. We herein describe a case of a trichobezoar that presented as a gastric outlet obstruction and was subsequently successfully removed via a laparotomy.

Sébastien Gaujoux

2011-01-01

374

[Perspectives in inflammatory bowel diseases treatment].  

Science.gov (United States)

Development in immunology and better understanding of prolonged inflammatory process is basic in inflammatory bowel diseases treatment development. The new generation of drugs could be included infliximab and adalimumab. To the same group we include tumour necrosis factor inhibitors (infliximab, adalimumab, etanercept, certolizumab, onercept), selective adhesive molecules inhibitors (natalizumab, alicaforsen), Th1 dependent reaction inhibitors (anti-il-12, tacrolismus, il-10), lymphocytes migration inhibitors (natalizumab). Those drug are under development or in various clinical trials phases and are the future of inflammatory bowel diseases treatment. PMID:19606725

Jalocha, Lukasz; Wojtu?, Stanis?aw; Dyrla, Przemyslaw; B?aszak, Antoni; Wojtkowiak, Marek; Zy?ko, Bogus?aw; Stelmaszuk, Tomasz; Gil, Jerzy

2009-05-01

375

[Neurological complications of inflammatory bowel diseases].  

Science.gov (United States)

Inflammatory bowel diseases, such as Crohn's disease, ulcerative colitis, autoantibody driven celiac disease and infectious Whipple's disease can all be associated with neurological symptoms. The neurological manifestation may occur even before the gastrointestinal symptoms or the enteropathic symptoms can even be absent as in celiac disease. These diseases can be caused by malresorption and lack of vitamins due to enteral inflammation as well as (auto-)immunological mechanisms and drug-associated side effects. Thus, inflammatory bowel diseases have to be considered in the differential diagnosis. In this review the most common neurological manifestations of these diseases will be described as well as the diagnostic approach. PMID:23392266

Cieplik, N; Stangel, M; Bachmann, O

2013-02-01

376

Embolisation of Posttraumatic Superior Mesenteric Artery Pseudoaneurysm in a Patient with Short Bowel Syndrome Preceding Bowel Transplantation  

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Penetrating abdominal trauma often causes bowel injuries which may lead to “short bowel syndrome” which is a potential indication for bowel transplantation. Posttraumatic pseudoaneurysms of abdominal arteries are often a result of penetrating abdominal trauma. We report a successful embolisation of posttraumatic superior mesenteric artery (SMA) branch pseudoaneurysm using microcoil, in a patient with short bowel syndrome who was successfully transplanted three months after embolisation.

Vinko Vidjak; Karlo Novacic; Marko Slavica

2011-01-01

377

Biologic targeting in the treatment of inflammatory bowel diseases [Retraction  

Directory of Open Access Journals (Sweden)

Full Text Available Bosani M, Ardizzone S, Porro GB. Biologics: Targets and Therapy. 2009;3:77–97.This paper has been retracted after we were made aware that it contains a large amount of reused, and uncited material that was not placed within quotation marks.The following statement has been supplied by Dr Sandro Ardizzone:The review entitled "Biologic targeting in the treatment of inflammatory bowel disease" has been commissioned by this journal and published in 2009 (Matteo Bosani, Sandro Ardizzone, Gabriele Bianchi Porro. Biologics: Targets & Therapy 2009;3:77–97. The paper was written by our young coworker (Dr M Bosani. He has consulted many papers, including our previous reviews published years before. The not perfect knowledge of English language has greatly influenced the writing of the paper itself. So he saved in word file several parts of our previous papers (Ardizzone S, Bianchi Porro G. Inflammatory bowel disease: new insights into pathogenesis and treatment. J Intern Med 2002;252:475–496 – Ardizzone S, Bianchi Porro G. Biologic therapy for inflammatory bowel disease. Drugs 2005:2253–2286, and then transferred to the final paper. He was unaware as we are, of the fact that he could not reuse previously published material in other journals. The reuse of this material was made in good faith.Taking our responsibility for what happened, we intend to apologize for this inconvenience to the Editor (Dr Doris Benbrook and Publisher (Dr Tim Hill. Moreover, for the reasons mentioned above, I consider appropriate to retract the paper itself.This retraction relates to this paper.

Bosani M

2014-01-01

378

Bowel perforations in a patient affected by Churg-Strauss syndrome under high-dose steroid treatment: will alternative drugs reduce risk of surgery?  

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Abstract Churg–Strauss syndrome is a relapsing–remitting vasculitis that frequently involves digestive system. Ischemic perforation of the large bowel is relatively rare and potentially life threatening. We report a case treated with high dose of steroids for a relapsing of Churg–Strauss vasculopathy that underwent emergency surgery for multiple large-bowel perforations. Massive use of steroids is common for controlling relapse of this disease, but this increases the risk of ...

Venditti, Dario; Valerio, Balassone; Ielpo, Benedetto; Buonomo, Oreste; Petrella, Giuseppe

2009-01-01

379

Potential association between TLR4 and chitinase 3-like 1 (CHI3L1/YKL-40) signaling on colonic epithelial cells in inflammatory bowel disease and colitis-associated cancer  

Science.gov (United States)

Inflammatory bowel disease (IBD) is a group of inflammatory disorders in the small and large intestines. Several studies have proved that persistent and disregulated host/microbial interactions are required for the development of IBD. It is well known that chronic IBD is strongly associated with an increased risk of developing colorectal cancer by 0.5–1% annually, 8–10 years after the initial diagnosis. To detect the tiny dysplasia or early stage of cancer in chronic IBD patients, a tremendous amount of effort is currently directed for improving colonoscopic technology and noninvasive serological marker development. However, there is only a limited amount of data available to understand the exact mechanism of how long term chronic colitis is connected to the development of colorectal tumors. Recently, our group has identified that significantly increased expression of chitinase 3-like 1 (CHI3L1) molecule in non-dysplastic mucosa from patients with IBD and remote dysplasia/cancer, compared to patients with IBD without dysplasia or healthy controls. CHI3L1 seems to contribute to the proliferation, migration, and neoplastic progression of colonic epithelial cells (CECs) under inflammatory conditions. Furthermore, the CHI3L1-mediated intracellular signaling cascade is likely to interact with TLR4 signaling in CECs. In this review article, we have concisely summarized the cellular and molecular mechanisms underlining the development of IBD and colitis-associated cancer, with particular focus on the CHI3L1-and TLR4-signaling pathways in CECs. PMID:23170831

Kamba, Alan; Lee, In-Ah; Mizoguchi, Emiko

2013-01-01

380

Cytogenetic biomonitoring of oral mucosa cells of crack cocaine users.  

Science.gov (United States)

The aim of the present study was to comparatively evaluate genomic damage (micronucleus) and cellular death (pyknosis, karyolysis, and karyorrhexis) in exfoliated oral mucosa cells from crack cocaine users by micronucleus test. A total of 30 crack cocaine users and 30 health controls (non-exposed individuals) were included in this setting. Individuals had epithelial cells from cheek mechanically exfoliated, placed in fixative, and dropped in clean slides, which were checked for the above nuclear phenotypes. The results pointed out significant statistical differences (p?mucosa cells from crack cocaine users. Exposure to crack cocaine caused an increase of other nuclear alterations closely related to cytotoxicity such as karyolysis in oral cells as well. In summary, these data indicate that crack cocaine is able to induce chromosomal breakage and cellular death in oral mucosa cells of users. PMID:24430497

das Graças Alonso de Oliveira, Maria; Dos Santos, Jean Nunes; Cury, Patrícia Ramos; da Silva, Victor Hugo Pereira; Oliveira, Nara Rejane Cruz; da Costa Padovani, Ricardo; Tucci, Adriana Marcassa; Ribeiro, Daniel Araki

2014-04-01

 
 
 
 
381

Ultrastructure observation of middle ear mucosa with laser irradiation  

Science.gov (United States)

In order to study the effects of He-Ne laser on the mucosa of middle ear mucosa from 9 patients with chronic otitis media, all of who had slight damp eardrum, were irradiated by low power He-Ne laser ten minutes per day for ten days. Specimen was taken before and after irradiation and observed under scanning electron microscope. It was found that the surface structure of the mucosa was more integral, the arrangement of the epithelial cell was closer together and microvilli arose among the noncilliated cells after irradiation. The inflammatory cell disappeared arid the morphologic structure appeared normal. These data provided the therapeutic evidence for the lower power He-Ne laser irradiation on patients with chronic purulent otitis midia.

Kang, Mengkui; Yang, Shulan; Fang, Yaoyun; Sun, Jianhe

1998-08-01

382

CT enteroclysis in small bowel Crohn's disease  

Energy Technology Data Exchange (ETDEWEB)

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.

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

383

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

StefanoGuandalini

2014-01-01

384

Neuro-immune interactions in inflammatory bowel disease and irritable bowel syndrome: Future therapeutic targets  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The gastro-intestinal tract is well known for its largest neural network outside the central nervous system and for the most extensive immune system in the body. Research in neurogastroenterology implicates the involvement of both enteric nervous system and immune system in symptoms of inflammatory bowel disease and irritable bowel syndrome. Since both disorders are associated with increased immune cell numbers, nerve growth and activation of both immune cells and nerves, we focus in this rev...

Kraneveld, A. D.; Rijnierse, A.; Nijkamp, F. P.; Garssen, J.

2008-01-01

385

Inflammatory bowel diseases: principles of nutritional therapy  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

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

2002-01-01

386

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.)

387

Analysis of bowel perforation in necrotizing enterocolitis  

Energy Technology Data Exchange (ETDEWEB)

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.

Frey, E.E.; Smith, W.; Franken, E.A. Jr.; Wintermeyer, K.A.

1987-07-01

388

Inflammatory bowel disease raises risk of melanoma  

Science.gov (United States)

Patients with inflammatory bowel disease (IBD) are at higher risk of melanoma, a form of skin cancer, report researchers at Mayo Clinic. Researchers found that IBD is associated with a 37 percent greater risk for the disease. The findings were presented at the Digestive Disease Week 2013 conference in Orlando, Fla.

389

Small bowel endoscopy and coeliac disease.  

Science.gov (United States)

Coeliac disease (CD) is a gluten-responsive, chronic inflammatory enteropathy that shares many features with classical autoimmune diseases. Coeliac disease affects about 1-2% of Caucasians, North Africans and Asians who possess the necessary susceptibility genes encoding HLA DQ2 or HLA DQ8. It is not only unique among the autoimmune diseases in that the precise trigger (gluten from wheat, rye and barley) has been identified, but also in that it has lent itself well to advancements in endoscopic imaging. Since its introduction, flexible endoscopy has allowed tissue to be collected from the small bowel with relative ease and safety, and recently has facilitated direct imaging and sampling of the entire small intestine. It is now fifty years since the Crosby capsule first allowed clinicians the ability to non-surgically biopsy the small bowel leading to an enhanced diagnosis of coeliac disease. The introduction of wireless video capsule endoscopy (VCE), small bowel enteroscopy and in particular double balloon enteroscopy (DBE), have expedited the accurate diagnosis of coeliac disease and its more serious complications such as small bowel adenocarcinoma, refractory coeliac disease type II (RCDII) and enteropathy associated T cell lymphoma (EATL). PMID:22704573

Daveson, A James M; Anderson, Robert P

2012-06-01

390

Bowel wall visualisation at CT colonography  

International Nuclear Information System (INIS)

Purpose: To evaluate the quality of bowel wall visualisation at CT colonography and the impact of examination in the supine and prone positions. Material and Methods: After bowel preparation, 111 patients underwent CT colonography. Air distension, degree of fluid redistribution with change in body position (supine and prone), influence of residual stool on bowel wall assessability, and quality of overall colon visualisation were evaluated using scales. Results: Thirty of 110 patients (27%) had complete overall visualisation of the colon wall and 52 (47%) had subtotal visualisation of a limited part of the colon. The entire colon was more often air-filled in the prone position (46%) than in the supine position (18%). Joint review of supine and prone data showed that for all colon segments, except the sigmoid (86%), 95% of the patients had complete air filling. All patients had residual fluid. In 75% to 99%, depending on segment, fluid did not interfere with the bowel wall visualisation in the combined evaluation of supine and prone data sets. Thirty-one patients had residual stool with potential negative influence on polyp detection. Conclusions: The colon wall was completely, or almost completely, visualised in 75% of the patients, and examination in the supine and prone positions was necessary for complete visualisation

391

If I Had - Bowel Control Issues  

Medline Plus

Full Text Available ... healthy conditions, the bowel should be emptied by nerves and muscles. And those nerves and muscles function in a way that effectively ... problems. Oftentimes, this is associated with problems with nerves and muscles, so patients who have an inability ...

392

Primary small bowel melanoma: a case report.  

Science.gov (United States)

The small intestine is the most common site of gastrointestinal metastasis from cutaneous melanoma. However, the small intestine itself is rarely the site of a primary melanotic tumour. We describe a case of primary small bowel melanoma in a 70-year-old man, and discuss the features of primary and metasttic melanoma. PMID:15912983

Sanyal, Sudip; Kaman, Lileswar; Behera, Arunanshu; Kakkar, Nandita

2004-01-01

393

Value of transabdominal bowel ultrasonography and splanchic vascular parameters in the evaluation of inflammatory bowel disease  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Although non-specific, transabdominal bowel ultrasonography, in real time or in color Doppler; has been beneficial in evaluating the location, extent and activity of inflammatory bowel disease (IBD. Aim: To assess the potential role of bowel transabdominal bowel ultrasonography in the diagnosis and follow-up of IBD. Patients and Methods: A cohort of 30 adults histologically-proven active IBD patients; ulcerative colitis (UC (n = 20, Crohn’s disease (CD (n = 10 were prospectively assessed in addition to 20 non-IBD participants representing the control group. All participants underwent the full colonoscopy in addition to real time and color Doppler ultrasonography. Bowel wall thickness, peri-enteric changes, and hemodynamic changes in the portal vein and mesenteric arteries were recorded at initial enrollment and after complete remission in 10 IBD patients. Results: Bowel wall was significantly thickened in all active IBD patients with a significant decrease after disease quiescence in CD patients; p value p value was

Manal Kamel

2013-05-01

394

ARMA-based spectral bandwidth for evaluation of bowel motility by the analysis of bowel sounds.  

Science.gov (United States)

Approximately 10%-20% of adults and adolescents suffer from irritable bowel syndrome (IBS) worldwide. IBS is characterized by chronic gastrointestinal dysfunction which may reflect in altered motility. Currently, the diagnosis of IBS is made through expensive invasive radiographic and endoscopic examinations. However these are inconvenient and unsuited for community screening. Bowel sounds (BSs) can be easily recorded with non-invasive and low-cost equipment. Recently, several researchers have pointed out changes in features obtained from BS according to the pathological condition of bowel motility. However a widely accepted, simple automatic BS detection algorithm still has to be found, and the appropriate recording period needs to be investigated for further evaluation of bowel motility. In this study we propose a novel simple automatic method to detect the BSs based on the 3 dB bandwidth of the frequency peaks in the autoregressive moving average spectrum. We use the measure, sound-to-sound interval (SSI) obtained by the proposed method, to capture bowel motility. In this paper, we show that the proposed method for automatic detection could achieve a sensitivity of 87.8±5.88%, specificity of 91.7±4.33% and area under the curve of 0.923 when working on 16 healthy volunteers during mosapride administrations. Furthermore, we show that the measured SSI averaged over a period of 30 min can clearly capture bowel motility. Our findings should have the potential to contribute toward developing automated BS-based diagnosis of IBS. PMID:23893043

Emoto, Takahiro; Shono, Koichi; Abeyratne, Udantha R; Okahisa, Toshiya; Yano, Hiromi; Akutagawa, Masatake; Konaka, Shinsuke; Kinouchi, Yohsuke

2013-08-01

395

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

Energy Technology Data Exchange (ETDEWEB)

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.)

Ajaj, Waleed; Goehde, Susanne C.; Ruehm, Stefan G.; Debatin, Joerg F.; Lauenstein, Thomas C. [Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, 45122, Essen (Germany); Schneemann, Hubert [Institute of Pharmacy and Pharmaceutical Sciences, University Hospital Essen, Essen (Germany)

2004-03-01

396

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.)

397

Zinc and alkaline phosphatase in developing rat oral mucosa  

International Nuclear Information System (INIS)

Alkaline phosphates (AlkPase) of many different tissues and species have been shown to be zinc metalloenzymes. Specific regions of rat oral mucosa have a high activity of AlkPase. Combined autoradiography and enzyme histochemistry showed that they also retained injected radioactive zinc (65Zn). The AlkPase activity was inactivated by EDTA and reactivated with zinc. However, it could not be verified by polyacrylamide gel electrophoresis, combined with radioactivity measurements and enzyme analysis, that the 65Zn uptake of oral mucosa was incorporated in the AlkPase molecule

398

The mucosa beyond the polyps in juvenile polyposis.  

Science.gov (United States)

Little is known of early histologic changes in the mucosa of the colon aside from the polyps in Juvenile Polyposis. Provided with a surgical specimen of a total colectomy of a 6-year-old boy with this condition, this report describes those changes. The mucosa depicted a peculiar serrated profile of the uppermost part of the crypts due to elongation of them, dilated openings, and scant stroma. Also present were frequent aberrant crypts. Early juvenile polyps presented associated with lympho-glandular sites as distorted and microcystically dilated crypts containing granular and filamentous mucoid material. The findings possibly represent the abnormal cytologic potential of this genetic condition. PMID:22050186

Drut, Ricardo

2012-02-01

399

Irritable bowel syndrome. A survey of nurses' knowledge.  

Science.gov (United States)

Nurses in a variety of clinical settings are often involved in educating and managing patients with irritable bowel syndrome, though their knowledge and perceptions of irritable bowel syndrome are not well known. A national survey was undertaken as a part of a larger study of patients and healthcare providers to determine nurses' knowledge of irritable bowel syndrome, including diagnosis, etiology, disease impact, management, beliefs, and attitudes regarding irritable bowel syndrome. In addition, the nurses' perceptions of the effect of irritable bowel syndrome on the patient's lifestyle and the severity of symptoms were compared to those of irritable bowel syndrome patients. One hundred practicing registered nurses were randomly selected and then interviewed by telephone using a questionnaire. A random-digit dialing method was used to identify and recruit 1,014 women with irritable bowel syndrome. The majority of registered nurses interviewed (75%) felt that nurses played a moderate-to-major role in counseling patients with irritable bowel syndrome. Only 13%, however, were aware of the diagnostic criteria for irritable bowel syndrome. The majority of nurse subjects felt the current therapies for irritable bowel syndrome had limited effectiveness varying from 6-21% depending on the symptom being treated. Almost half of the nurses felt they had an important role in management of irritable bowel syndrome and that both they and their patients needed more education about irritable bowel syndrome. There was close agreement between the nurses and the patients with regard to the impact of irritable bowel syndrome. With increased public attention on irritable bowel syndrome as a common problem affecting women, there is a need for nurses working in a variety of settings to have increased knowledge regarding the syndrome. In this article, recommendations are made regarding how to increase nurses' knowledge about this common health problem. PMID:11837213

Heitkemper, M; Olden, K; Gordon, S; Carter, E; Chang, L

2001-01-01

400

Identification of CD68(+) neutrophil granulocytes in in vitro model of acute inflammation and inflammatory bowel disease.  

Science.gov (United States)

CD-68 is widely regarded as a selective marker for human monocytes and macrophages and is commonly used in human pathology studies. The purpose of this study was to investigate the expression of CD-68 in human peripheral blood mononuclear cells (PBMCs), neutrophil granulocytes (NGs) and in inflamed intestinal tissue samples for comparison. PBMCs and NGs were isolated from heparinized human blood samples. Intestinal biopsies were obtained during routine endoscopic procedures from patients with inflammatory bowel disease (IBD), e.g. ulcerative colitis and Crohn's disease. Gene and protein expression was analyzed by real-time RT-PCR, Western blot and immunohistochemistry. Both PBMCs and NGs preparations contained cells that were positive for CD-68 and either neutrophil elastase (NE), or myeloperoxidase (MPO). CD-68(+)/NE(-)/MPO(-) cells were regarded as monocytes. CD-68 mRNA expression was detected in PBMCs and NGs preparations. With Western blot and by performing immunoprecipitation of cell lysate, we could clearly detect CD-68 in NGs, U-937, THP-1, Hep-G2, Jurkat cells and PBMCs. Identification of inflammatory cells in acutely inflamed colonic mucosa obtained from patients with IBD revealed a strong accumulation of CD-68(+)/MPO(+) cells compared to normal colonic mucosa. The uptake of the marker by phagocytosis was excluded by performing a double staining with CD-163/NE and CD-163/MPO in PBMCs, NGs cultures and in inflamed colonic mucosa. These results identify CD-68(+) NGs in peripheral blood and inflamed colonic mucosa. CD-68 is not only a marker for the macrophages-monocytes but also for NGs. PMID:23573303

Amanzada, Ahmad; Malik, Ihtzaz Ahmed; Blaschke, Martina; Khan, Sajjad; Rahman, Hazir; Ramadori, Giuliano; Moriconi, Federico

2013-01-01

 
 
 
 
401

Identification of CD68+ neutrophil granulocytes in in vitro model of acute inflammation and inflammatory bowel disease  

Science.gov (United States)

CD-68 is widely regarded as a selective marker for human monocytes and macrophages and is commonly used in human pathology studies. The purpose of this study was to investigate the expression of CD-68 in human peripheral blood mononuclear cells (PBMCs), neutrophil granulocytes (NGs) and in inflamed intestinal tissue samples for comparison. PBMCs and NGs were isolated from heparinized human blood samples. Intestinal biopsies were obtained during routine endoscopic procedures from patients with inflammatory bowel disease (IBD), e.g. ulcerative colitis and Crohn’s disease. Gene and protein expression was analyzed by real-time RT-PCR, Western blot and immunohistochemistry. Both PBMCs and NGs preparations contained cells that were positive for CD-68 and either neutrophil elastase (NE), or myeloperoxidase (MPO). CD-68+/NE-/MPO- cells were regarded as monocytes. CD-68 mRNA expression was detected in PBMCs and NGs preparations. With Western blot and by performing immunoprecipitation of cell lysate, we could clearly detect CD-68 in NGs, U-937, THP-1, Hep-G2, Jurkat cells and PBMCs. Identification of inflammatory cells in acutely inflamed colonic mucosa obtained from patients with IBD revealed a strong accumulation of CD-68+/MPO+ cells compared to normal colonic mucosa. The uptake of the marker by phagocytosis was excluded by performing a double staining with CD-163/NE and CD-163/MPO in PBMCs, NGs cultures and in inflamed colonic mucosa. These results identify CD-68+ NGs in peripheral blood and inflamed colonic mucosa. CD-68 is not only a marker for the macrophages-monocytes but also for NGs. PMID:23573303

Amanzada, Ahmad; Malik, Ihtzaz Ahmed; Blaschke, Martina; Khan, Sajjad; Rahman, Hazir; Ramadori, Giuliano; Moriconi, Federico

2013-01-01

402

Treatment of postinfectious irritable bowel syndrome and noninfective irritable bowel syndrome with mesalazine / Tratamento da síndrome do intestino irritável pós-infecciosa e da síndrome do intestino irritável não-infecciosa com mesalazina  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese CONTEXTO: Estudos recentes sustentam a hipótese que a síndrome do intestino irritável pós-infecciosa e alguns pacientes com síndrome do intestino irritável mostram sinais menores de inflamação persistente da mucosa. A mesalazina tem propriedades anti-inflamatórias intestinais, incluindo a inibição d [...] a ciclooxigenase e das prostaglandinas. Os efeitos da mesalazina na síndrome do intestino irritável pós-infecciosa e em pacientes com síndrome do intestino irritável não-infecciosa ainda são desconhecidos. OBJETIVO- Observar os efeitos da mesalazina em pacientes com síndrome do intestino irritável pós-infecciosa e síndrome do intestino irritável com diarréia não-infecciosa. MÉTODOS: Com base nos critérios de Roma III, 61 pacientes síndrome do intestino irritável acompanhado de diarréia (18 anos ou mais de idade) foram incluídos na avaliação. Os pacientes foram divididos em dois grupos: grupo síndrome do intestino irritável pós-infecciosa, com 18 pacientes medicados com mesalazina 800 mg 3 vezes ao dia por 30 dias; grupo síndrome do intestino irritável não-infecciosa, com 43 pacientes medicados com mesalazina 800 mg 3 vezes ao dia por 30 dias. Avaliações dos sintomas no início e após o tratamento foram realizadas por meio de uma escala Likert de 4 pontos, incluindo a frequência das evacuações, forma e consistência das fezes (Bristol Stool Scale), dor e distensão abdominal (pontuação máxima: 16; pontuação mínima: 4). RESULTADOS: O grupo síndrome do intestino irritável pós-infecciosa apresentou redução estatisticamente significante do escore total de sintomas (P Abstract in english CONTEXT: Recent studies support the hypothesis that postinfectious irritable bowel syndrome and some irritable bowel syndrome patients display persistent signs of minor mucosal inflammation. Mesalazine has intestinal anti-inflammatory properties including cyclooxygenase and prostaglandin inhibition. [...] The effects of mesalazine on postinfectious irritable bowel syndrome and noninfective irritable bowel syndrome patients are still unknown. OBJECTIVE: To observe the effects of mesalazine on postinfectious irritable bowel syndrome and noninfective irritable bowel syndrome with diarrhea patients. METHODS: Based on Rome III criteria, 61 irritable bowel syndrome with diarrhea patients (18 years old or more) were included in the evaluation. Patients were divided into two groups: postinfectious irritable bowel syndrome group, with 18 patients medicated with mesalazine 800 mg 3 times a day for 30 days; noninfective irritable bowel syndrome group, with 43 patients medicated with mesalazine 800 mg 3 times a day for 30 days. Symptom evaluations at baseline and after treatment were performed by means of a four-point Likert scale including stool frequency, stool form and consistency (Bristol Stool Scale), abdominal pain and distension (maximum score: 16; minimum score: 4). RESULTS: Postinfectious irritable bowel syndrome group presented a statistically significant reduction of the total symptom score (P

Mauro, Bafutto; José Roberto de, Almeida; Nayle Vilela, Leite; Enio Chaves, Oliveira; Salustiano, Gabriel-Neto; Joffre, Rezende-Filho.

2011-03-01

403

Treatment of postinfectious irritable bowel syndrome and noninfective irritable bowel syndrome with mesalazine Tratamento da síndrome do intestino irritável pós-infecciosa e da síndrome do intestino irritável não-infecciosa com mesalazina  

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Full Text Available CONTEXT: Recent studies support the hypothesis that postinfectious irritable bowel syndrome and some irritable bowel syndrome patients display persistent signs of minor mucosal inflammation. Mesalazine has intestinal anti-inflammatory properties including cyclooxygenase and prostaglandin inhibition. The effects of mesalazine on postinfectious irritable bowel syndrome and noninfective irritable bowel syndrome patients are still unknown. OBJECTIVE: To observe the effects of mesalazine on postinfectious irritable bowel syndrome and noninfective irritable bowel syndrome with diarrhea patients. METHODS: Based on Rome III criteria, 61 irritable bowel syndrome with diarrhea patients (18 years old or more were included in the evaluation. Patients were divided into two groups: postinfectious irritable bowel