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1

Large bowel resection - discharge  

Science.gov (United States)

... having large bowel surgery: Pain when you cough, sneeze, and make sudden movements. This may last 1 ... your incision when you need to cough or sneeze. This may lessen the pain. Ask your doctor ...

2

Mucosa-associated Lymphoid Tissue Lymphoma Presenting with Bowel Obstruction of the Duodenum and Small Bowels: A Case Report  

International Nuclear Information System (INIS)

The occurrence of primary duodenal mucosa associated lymphoid tissue (MALT) lymphoma is extremely rare, and more so is the obstruction of the duodenum for the MALT lymphoma. We describe the small bowel follow through and CT findings in an uncommon case of MALT lymphoma presenting with bowel obstruction of the 2nd portion of the duodenum and small bowels

2010-01-01

3

Immunoregulatory function of human intestinal mucosa lymphoid cells: evidence for enhanced suppressor cell activity in inflammatory bowel disease.  

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Abnormalities in immune regulation at the gut level may be relevant to the pathogenesis of inflammatory bowel disease, but little is known about the immunoregulatory properties of intestinal mononuclear cells. Therefore, we wished to see if lymphoid cells derived from the lamina propria of surgically resected bowel specimens have any modulatory effect upon the immune response of peripheral blood mononuclear cells from patients with ulcerative colitis or Crohn's disease. When autologous peripheral blood and intestinal lamina propria lymphoid cells were mixed at different ratios and cultured in the presence of phytohaemagglutinin, we were able to show that intestinal mononuclear cells had the capacity to modify the mitogenic response of the cultured cells. These intestinal immunoregulatory cells, when obtained from mucosa affected by inflammatory bowel disease, express a significantly enhanced suppressor cell activity as compared with those from non-inflamed control mucosa. Such suppressor cell activity varies with cell concentration and requires cell proliferation, but it is independent of anatomical origin (small vs large bowel), type of inflammatory bowel disease (ulcerative colitis vs Crohn's disease) or immunosuppressive therapy. These findings point to an important functional difference between inflammatory bowel disease and control intestinal mucosa mononuclear cells. The enhanced suppressor activity of lamina propria mononuclear cells may be associated with impairment of cell-mediated immunity at the gut level. This may be related to the pathogenesis of inflammatory bowel disease by leading to defective intestinal immune regulatory events, which may not be detectable at the peripheral level.

Fiocchi, C; Youngman, K R; Farmer, R G

1983-01-01

4

Large bowel resection - Series (image)  

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The large bowel [large intestine or the colon] is part of the digestive system. It runs from the small intestine to the rectum. ... The diseased part of the large intestine (colon) is removed. The ... then sewn or stapled back together and the incision is closed. A ...

5

Large bowel resection  

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... including: A block in the intestine due to scar tissue Colon cancer Diverticular disease (disease of the large ... the ureter or bladder Problems with the colostomy Scar tissue that forms in the belly and causes a ...

6

Parvovirus B19 Infection Localized in the Intestinal Mucosa and Associated with Severe Inflammatory Bowel Disease?  

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Infection by human parvovirus B19 is widespread and can be associated with a wide range of different pathologies and clinical manifestations. We provide the first evidence of localization of an active parvovirus B19 infection in the intestinal mucosa and its association with a severe inflammatory bowel disease, characterized by duodenal villous atrophy with increased intraepithelial lymphocytes and inflammatory infiltrates in the colonic mucosa. Virus in the intestinal mucosa was detected in ...

Pironi, Loris; Bonvicini, Francesca; Gionchetti, Paolo; D Errico, Antonia; Rizzello, Fernando; Corsini, Catia; Foroni, Laura; Gallinella, Giorgio

2009-01-01

7

Parvovirus B19 Infection Localized in the Intestinal Mucosa and Associated with Severe Inflammatory Bowel Disease?  

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Infection by human parvovirus B19 is widespread and can be associated with a wide range of different pathologies and clinical manifestations. We provide the first evidence of localization of an active parvovirus B19 infection in the intestinal mucosa and its association with a severe inflammatory bowel disease, characterized by duodenal villous atrophy with increased intraepithelial lymphocytes and inflammatory infiltrates in the colonic mucosa. Virus in the intestinal mucosa was detected in cells of the inflammatory infiltrate, identified as T lymphocytes and selectively localized in sites of active tissue degeneration.

Pironi, Loris; Bonvicini, Francesca; Gionchetti, Paolo; D'Errico, Antonia; Rizzello, Fernando; Corsini, Catia; Foroni, Laura; Gallinella, Giorgio

2009-01-01

8

The innervation of human bowel mucosa and its alterations in Hirschsprung's disease using a whole-mount preparation technique.  

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The innervation of the human bowel wall and its structural and functional changes in Hirschsprung's disease (HD) are well-recognised. The luminal surface of the bowel acts as a multifunctional barrier, and modifications in its physiochemical properties can result in serious complications such as enterocolitis (EC). The whole-mount preparation (WMP) technique produces a three-dimensional (3D) picture to better demonstrate the neuronal networks and the relationship of branching and interconnecting nerve fibres to each other. The aim of this study was to investigate the innervation of the mucosal layer in normal and HD bowel using a WMP immunohistochemistry technique in order to better understand the pathophysiology of HD. Full-thickness bowel specimens were collected from 9 HD patients at pull-through operation. Normal control small- and large-bowel specimens were collected from 10 patients at the time of bladder augmentation. Suction rectal biopsies from 8 patients with chronic constipation and 2 patients with HD were also included in this study. A WMP of the mucosal layer was made and stained with various neuronal markers (S100, PGP 9.5, and LICAM) using fluorescein immunohistochemistry. PGP 9.5, S100, and L1CAM immunofluorescence staining of the normal mucosa demonstrated a characteristic 3D meshlike neuronal network of uniform thickness surrounding the crypts. In the aganglionic bowel S100, PGP 9.5, and L1CAM-positive meshlike networks were replaced by thick nerve trunks in the muscosa without any interconnecting network. The present study demonstrates for the first time the 3D morphology of mucosal innervation in normal and aganglionic bowel. The WMP technique clearly demonstrated that the mucosal innervation in HD is morphologically abnormal, and this may adversely influence secretory and absorptive functions of the bowel. WMPs using suction rectal biopsy specimens may be a useful additional technique to diagnose HD. PMID:10898229

Nemeth, L; Puri, P

2000-01-01

9

Large-bowel surgery, 1979: self-assessment.  

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Evidence of wide variability in the immediate results of large-bowel surgery stimulated self-assessment during 1979. The hazards of large-bowel surgery can usually be avoided by good bowel preparation, sound anastomotic technique, primary resection in large bowel emergencies, avoidance of anastomosis when hazardous, and antibiotic lavage for extant or potential peritoneal and wound contamination.

Matheson, N. A.; Valerio, D.

1980-01-01

10

Large bowel perforation: morbidity and mortality.  

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Perforations of large bowel are rare but severe complications, mainly of colorectal cancer and colonic diverticulitis. The choice of the surgical procedure is still debated. We retrospectively studied peritonitis caused by large bowel perforation to assess predictors of mortality and safety of primary resection and anastomosis. We investigated 59 patients with large bowel perforation treated surgically as emergency cases: 18 patients underwent primary resection and anastomosis, 36 had primary resection of the diseased part of bowel without anastomosis, and 5 patients had non-resective procedures. The severity of peritonitis was assessed using Hinchey's classification and the Mannheim peritonitis index (MPI). Overall mortality was 16.9%. MPI score was significantly lower for survivors vs. non-survivors, and for patients with resection and anastomosis vs. those who underwent resection without anastomosis (p<0.001). The mortality rate was 11.1% for primary resection with anastomosis, and 22.2% for primary resection without anastomosis. No patient with MPI less than 25 died, while 10 (38.5%) of the patients with MPI of 26-36 died. In conclusion, a radical aggressive approach is recommended for most patients with large bowel perforation. Mortality and morbidity are closely related to the extent of intraperitoneal infection and the incidence of postoperative complications is higher in patients with perforation due to non-malignant causes. PMID:12525912

Bielecki, K; Kami?ski, P; Klukowski, M

2002-12-01

11

Experimental studies on the pathogenesis of the chronic radiation ulcer of the large bowel in rats  

International Nuclear Information System (INIS)

Following local irradiation of a 24 mm segment of the large bowel with 23 Gy, 90% of Wistar rats developed a chronic radiation ulcer leading to progressive large bowel obstruction within 8 weeks. The incidence and latency of the chronic radiation damage was markedly altered by local treatments after irradiation, especially those which modified the amount and texture of the feces. The results of these studies suggest that the primary radiation damage to the large bowel is to the microvasculature of the mucosal and submucosal stroma leading to progressive mucosal atrophy which thus becomes very vulnerable. The chronic radiation ulcer and the hypertrophic, cystic mucosa (which is the result of hyperregeneration of subclinical ulcers) are secondary to the interaction of the primary radiation damage to the vascular-connective tissue of the intestinal wall with mechanical and infectious damage to the chronically atrophic mucosa

1986-01-01

12

Probiotics and small bowel mucosa: Molecular aspects of their interactions  

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Probiotics are described as “friendly bacteria” that could improve the intestine defense by interacting with the resident microflora. There is a large body of evidence suggesting that consumption of functional food containing probiotics exerts positive effects on human health. Several clinical trials have highlighted the efficiency of probiotics in the prevention and treatment of different gastrointestinal disorders including the prevention of antibiotic associated diarrhea, the remission...

Saulnier, N.; Zocco, M. A.; Di Caro, S.; Gasbarrini, G.; Gasbarrini, A.

2006-01-01

13

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.

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

1994-03-01

14

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

International Nuclear Information System (INIS)

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

1994-03-01

15

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)

2004-06-01

16

Histopathology reporting in large bowel cancer.  

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A review of histopathology reports on 2046 patients in the large bowel cancer project showed considerable observer variation in histological grading. Dukes staging, and lymph node harvest. These parameters have a well-established relationship to prognosis, but, if they are to be applied for both clinical and research purposes, they must be assessed consistently. A minimal level of information which should be recorded from a resection specimen is suggested, with a description of the methods by...

Blenkinsopp, W. K.; Stewart-brown, S.; Blesovsky, L.; Kearney, G.; Fielding, L. P.

1981-01-01

17

Qualitative and quantitative analyses of the bifidobacterial microbiota in the colonic mucosa of patients with colorectal cancer, diverticulitis and infl ammatory bowel disease  

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AIM: To characterize the bifidobacterial microbiota of the colonic mucosa in patients with colon cancer, inflammatory bowel disease or diverticulitis. METHODS: A sample of the distal colonic mucosa was taken during surgery from a total of 34 patients, twenty-one with diagnosed colorectal cancer, nine with diverticulitis and four with inflammatory bowel disease, requiring surgery for their condition. Bacterial DNA was extracted from the resected mucosal samples and bifidobacterial mucosa-a...

Gueimonde Ferna?ndez, Miguel; Ouwehand, Arthur C.; Huhtinen, Heikki; Salminen, Eeva; Salminen, Seppo

2007-01-01

18

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

19

Diverticulitis of the right large bowel  

International Nuclear Information System (INIS)

Perforation in the course of diverticulitis of the right side of the large bowel is a rare disease, which is mostly misinterpreted as appendicitis and generally disregarded in the differentialdiagnosis of pathological processes of the lower right abdomen. The results of radiological investigations (plane film, barium enema, CT) are demonstrated in two cases and diagnostic findings are discussed. Plane film of the abdomen allows only unspecific diagnosis of an inflammatory process in the rigth lower quadrant, barium enema reveales changes in the wall of the colon due to abscess formation. CT is also suitable to show those peridiverticular inflammatory changes, which lead to the right diagnosis. (orig.)

1981-01-01

20

Use of coculture of colonic mucosal biopsies to investigate the release of eicosanoids by inflamed and uninflamed mucosa from patients with inflammatory bowel disease.  

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Eicosanoid production was measured in cultured biopsies of colonic mucosa from control patients, with the irritable bowel syndrome, and from patients with proctosigmoiditis and with colonic Crohn's disease. Cultured inflamed colonic mucosa from patients with proctosigmoiditis and Crohn's disease produced more prostaglandin E2 and leukotrienes C4 than control tissues. In addition, eicosanoid production by macroscopically uninflamed or 'quiescent' mucosa from the right colon was examined in pat...

Wardle, T. D.; Hall, L.; Turnberg, L. A.

1992-01-01

 
 
 
 
21

Adult large bowel obstruction: A review of clinical experience  

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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 distensi...

Sule A; Ajibade A

2011-01-01

22

Alveolar Soft Part Sarcoma Metastatic to Small Bowel Mucosa Causing Polyposis and Intussuseption  

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A report of alveolar soft part sarcoma metastatic to the small bowel is presented. Hematogenous metastases to the small bowel from primary tumors outside the abdominal cavity are uncommon, and most remain asymptomatic and are not discovered until autopsy. However, small bowel metastases can lead to intestinal obstruction, intussuseption or even perforation. While metastases to the small bowel have been described for other tumor types, including melanoma and lung cancer, this is extremely uncommon for sarcoma, especially alveolar soft part sarcoma. We describe a 42-year-old male with a long history of alveolar soft part sarcoma, metastatic to the lung and brain, who developed an intussuseption from metastases to the small bowel.

Sabel, Michael S.; Litwin, Allan; Mcgrath, Brian; Kraybill, William B.; Brooks, John J.

2001-01-01

23

Large bowel leiomyosarcoma - a case report  

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The authors report a case of a 49-year-old male patient with leiomyosarcoma of the ascending colon. The patient presented with anemia and an abdominal mass, and the symptoms progressed until a final diagnosis was made nine months later. A plain abdominal x-ray showed the presence of gas outside the bowel, in the right hypochondrium. The double contrast barium enema showed a sublevel displacement of the hepatic flexure and diverticula. An abdominal ultrasound revealed a heterogeneous expansive lesion below the liver containing gas, and a computed tomography of the abdomen revealed an excavated mass below the liver containing liquid, that was not filled by contrast medium. The patient was submitted to a right hemicolectomy with ileocoloanastomosis and the histopathological analysis of the excised material revealed a leiomyosarcoma of the ascending colon. (author)

2001-01-01

24

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

25

Endocrine cells in the oxyntic mucosa of the stomach in patients with irritable bowel syndrome  

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AIM: To study the different endocrine cell types in the oxyntic mucosa of patients with irritable bowel syndrome (IBS). METHODS: Seventy-six patients with IBS were included in the study (62 females and 14 males; mean age 32 years, range 18-55 years), of which 40 also fulfilled the Rome III criteria for functional dyspepsia (FDP). Of the entire IBS cohort, 26 had diarrhea as the predominant symptom (IBS-D), 21 had a mixture of diarrhea and constipation (IBS-M), and 29 had constipation as the predominant symptom (IBS-C). Forty-three age and sex-matched healthy volunteers without any gastrointestinal complaints served as controls. The patients were asked to complete the Birmingham IBS symptom questionnaire. Both the patients and controls underwent a standard gastroscopy, during which three biopsy samples were taken from the corpus. Sections from these biopsy samples were immunostained using the avidin-biotin complex (ABC) method, for ghrelin, serotonin, somatostatin and histamine. The densities of these cell types and immunoreactivity intensities were quantified using computerized image analysis with Olympus cellSens imaging software (version 1.7). RESULTS: The densities of the ghrelin cells in the control, IBS-total, IBS-D, IBS-M and IBS-C groups were 389 (320, 771), 359 (130, 966), 966 (529, 1154), 358 (120, 966) and 126 (0, 262) cells/mm2, respectively. There was a significant difference between the tested groups (P ghrelin cell density was significantly higher in IBS-D and lower in IBS-C than in the controls (P = 0.03 and 0.0008, respectively). The ghrelin cell density in patients with both IBS and FDP was 489 (130, 966), and in those with IBS only 490 (130, 956). There was no statistical significant difference between these 2 groups of patients (P = 0.9). The immunoreactivity intensity did not differ between any of the groups (P = 0.6). The diarrhea score of the Birmingham IBS symptom questionnaire was significantly positively correlated with ghrelin cell density (r = 0.65; P < 0.0001) and significantly inversely correlated with that of constipation (r = 90.69; P < 0.0001). The densities of the serotonin cells were 63 (51, 82), 51 (25, 115), 120 (69, 128), 74 (46, 123) and 40 (0, 46) cells/mm2 in the control, IBS-total, IBS-D, IBS-M and IBS-C groups, respectively. A statistically significant difference was found between the tested groups (P < 0.0001). Posttest revealed that serotonin cell density was significantly higher in IBS-D and lower in IBS-C than in controls (P = 0.02 and 0.004, respectively), but did not differ in the IBS-total and IBS-M groups from that in controls (P = 0.5 and 0.4, respectively). The serotonin cell density in patients with both IBS and FDP was 62 (25, 115) and in those with IBS only 65 (25, 123). There was no statistically significant difference between these 2 groups of patients (P = 1). The immunoreactivity intensity of serotonin did not differ significantly between any of the groups (P = 0.0.9). The serotonin cell density was significantly positively correlated with the diarrhea score of the Birmingham IBS symptom questionnaire (r = 0.56; P < 0.0001) and significantly inversely correlated with that of constipation (r = 0.51; P < 0.0001). The densities of the somatostatin cells were 97 (72, 126), 72 (0, 206), 29 (0, 80), 46 (0, 103) and 206 (194, 314) cells/mm2 in the control, IBS-total, IBS-D, IBS-M and IBS-C groups, respectively (Figures 7 and 8). There was a statistically significant difference between the controls and the IBS subgroups (P < 0.0001). The density of somatostatin cells was significantly lower in the IBS-D and IBS-M groups but higher in IBS-C patients than in the controls (P < 0.01, P = 0.02, and P = 0.0008, respectively). The somatostatin cell density in patients with both IBS and FDP was 86 (0-194), and in those with IBS only 110 (0-206). There was no statistically significant difference between these 2 groups of patients (P = 0.6). There was no significant difference in somatostatin

El-Salhy, Magdy; Gilja, Odd Helge; Gundersen, Doris; Hausken, Trygve

2014-01-01

26

Dyspnea and large bowel obstruction: a misleading Chilaiditi syndrome.  

Science.gov (United States)

Chilaiditi sign is named after the Greek radiologist Demetrius Chilaiditi who first described it when he was working in Vienna In (1910), and it is an incidental radiographic finding. This sign can be more frequently mistaken for pneumoperitoneum which is usually an indication of bowel perforation and can lead to needless surgical intervention. There are several case report reported in literature that describe the association between colonic volvulus and Chilaiditi syndrome that underline the frequent association between these anatomical condition instead no previous report described the association between Chilaiditi syndrome and large bowel obstruction secondary to a malignant sigmoid stenosis in a man presenting with symptoms and signs of upper respiratory distress combined with subacute bowel obstruction. PMID:21861981

Antonacci, Nicola; Di Saverio, Salomone; Biscardi, Andrea; Giorgini, Eleonora; Villani, Silvia; Tugnoli, Gregorio

2011-11-01

27

Hormone Therapy in Relation to Survival from Large Bowel Cancer  

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

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

2009-01-01

28

Surgical options for left-sided large bowel emergencies.  

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Current choices of operation for left-sided large bowel emergencies have been established by a questionnaire sent to 218 consultant surgeons asking which operation they would perform under varying circumstances for obstructing sigmoid carcinoma and diverticular disease. A 92% response rate was obtained. Hartmann's procedure (with or without a mucus fistula) is the most popular operation for all conditions. Sigmoid colectomy with primary anastomosis is performed by 40% of surgeons for obstruct...

1991-01-01

29

Small bowel adenocarcinoma mimicking a large adrenal tumor  

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Introduction. Adenocarcinoma of the small bowel is a rare gastrointestinal neoplasm usually affecting the distal duodenum and proximal jejunum. Because of their rarity and poorly defined abdominal symptoms, a correct diagnosis is often delayed. Case Outline. We present a 43-year-old woman admitted at the Clinic for Endocrinology due to a large tumor (over 7 cm) of the left adrenal gland. The tumor was detected by ultrasound and confirmed by CT scan. The patient complained of abdominal p...

Ivovi? Miomira; Živaljevi? Vladan; Vujovi? Svetlana; Marina Ljiljana; Tan?i?-Gaji? Milina; Dun?erovi? Dušan; Bara? Marija; Mici? Dragan

2013-01-01

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Identification of Restricted Subsets of Mature microRNA Abnormally Expressed in Inactive Colonic Mucosa of Patients with Inflammatory Bowel Disease.  

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BACKGROUND: Ulcerative Colitis (UC) and Crohn's Disease (CD) are two chronic Inflammatory Bowel Diseases (IBD) affecting the intestinal mucosa. Current understanding of IBD pathogenesis points out the interplay of genetic events and environmental cues in the dysregulated immune response. We hypothesized that dysregulated microRNA (miRNA) expression may contribute to IBD pathogenesis. miRNAs are small, non-coding RNAs which prevent protein synthesis through translational suppression or mRNAs d...

Fasseu, Magali; Tre?ton, Xavier; Guichard, Ce?cile; Pedruzzi, Eric; Cazals-hatem, Dominique; Richard, Christophe; Aparicio, Thomas; Daniel, Fanny; Soule?, Jean-claude; Moreau, Richard; Bouhnik, Yoram; Laburthe, Marc; Groyer, Andre?; Ogier-denis, Eric

2010-01-01

31

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

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Full Text Available 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 and biopsy was performed. The result of the biopsy showed fibrosis in the wall. At laparatomic examinations a mass was found in the ascending colon and right hemicolectomi and ileotransversotomy was performed. On macroscopic examination we found an apricot seed that was causing the thickening of the wall and superficial ulcer in the mucosa. In the cases of mechanical intestinal obstructions existence of a radyolucent foreign material (bezoars must be keep in mind, especially in the children, debile patients and the patients that have gastrointestinal system operations.

Ertu?rul Gür

2008-01-01

32

Cytokine changes in colonic mucosa associated with Blastocystis spp. subtypes 1 and 3 in diarrhoea-predominant irritable bowel syndrome.  

Science.gov (United States)

SUMMARY We determined cytokines (e.g. interleukin-8, 10, 12 and TNF-?) expression by peripheral blood mononuclear cells (PBMCs) and in rectal mucosa in diarrhoea-predominant irritable bowel syndrome (D-IBS) with Blastocystis spp. Eighty patients with D-IBS and Blastocystis spp. infection were classified as 'cases' and 80 with D-IBS without Blastocystis spp. infection were classified as 'control'. Cases were subdivided into D-IBS and Blastocystis sp. defined type 1 (subtype-specific primer SB83) and type 3 (SB227). Stool microscopy and culture were performed. Rectal biopsies were obtained for histology and cytokines by real-time PCR for mRNA expression of cytokines. PBMCs IL-8 was similar in different groups but in type 1, IL-8mRNA was increased compared with type 3 (P = 0·001) and control (P = 0·001). In type 1, IL-10 by PBMCs had a low mean value (14·5±1·6) compared with (16·7±1·5) type 3 and (16±2·3) in controls (PBlastocystis sp. type 1, low IL-10 was associated with lymphocyte and plasma cell infiltration (P = 0·015 and P = 0·002, respectively). In Blastocystis sp. type 1 and type 3, IL-12 was associated with goblet cell depletion 23 (85%) (PBlastocystis sp. type 1, low IL-10 was associated with a proinflammatory response characterized by IL-8. PMID:24598032

Yakoob, Javed; Abbas, Zaigham; Usman, Muhammad Waqas; Sultana, Aisha; Islam, Muhammad; Awan, Safia; Ahmad, Zubair; Hamid, Saeed; Jafri, Wasim

2014-06-01

33

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

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

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

2007-01-01

34

Sarcomatous malignant peritoneal mesothelioma with large bowel involvement  

Directory of Open Access Journals (Sweden)

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

35

Immunoregulatory function of human intestinal mucosa lymphoid cells: evidence for enhanced suppressor cell activity in inflammatory bowel disease.  

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Abnormalities in immune regulation at the gut level may be relevant to the pathogenesis of inflammatory bowel disease, but little is known about the immunoregulatory properties of intestinal mononuclear cells. Therefore, we wished to see if lymphoid cells derived from the lamina propria of surgically resected bowel specimens have any modulatory effect upon the immune response of peripheral blood mononuclear cells from patients with ulcerative colitis or Crohn's disease. When autologous periph...

Fiocchi, C.; Youngman, K. R.; Farmer, R. G.

1983-01-01

36

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

Directory of Open Access Journals (Sweden)

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

Shaw Aidan G

2007-11-01

37

The histological appearance of large intestinal biopsies in dogs with clinical signs of large bowel disease.  

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Colonic and rectal forceps and excision biopsies of 355 dogs with clinical signs of large bowel disease were investigated. Five percent of the forceps biopsies were unsuitable for examination; all excision biopsies were of good quality. Forceps biopsies were obtained from one to eight sites, up to 60 cm cranial from the anus, while excision biopsies, mostly from tumors, were from the rectoanal region. Slight to severe colitis and/or proctitis was found in 192 dogs (54%). A single type of coli...

1988-01-01

38

Proximal large bowel volvulus in children: 6 new cases and review of the literature  

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Background: Proximal large bowel volvulus is considered as an extremely rare surgical emergency in children. Approximately 40 cases have been reported, and because of its rarity, the diagnosis is often missed or delayed. The purpose of this study was to review the presentation, treatment, and clinical outcome of proximal large bowel volvulus.Methods: A systematic review and analysis of the data relating to 6 patients from the author's practice and cases published in the English literature fro...

Semiu Eniola Folaranmi; Alex Cho; Farhan Tareen; Antonino Morabito; George Rakoczy; Tamas Cserni; Cserni Tamás (1967-) (gyermeksebész)

2011-01-01

39

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

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

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

1986-01-01

40

Single-layer anastomosis in the large bowel: ten years' experience.  

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Satisfactory experience with single-layer colorectal anastomosis during 1969-74 led to an analysis of the results of single-layer large bowel anastomosis during the subsequent years 1975-79. This technique has continued to be associated with a low incidence of anastomotic failure, but anastomotic integrity also depends on rigorous attitudes to bowel preparation, to bacterial contamination and to the avoidance of anastomosis when the risk of anastomotic failure is high.

Matheson, N. A.; Valerio, D.; Farquharson, A.; Thomson, H.

1981-01-01

 
 
 
 
41

Primary restorative colectomy in malignant left-sided large bowel obstruction.  

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A series of 18 consecutive patients who underwent primary resection and immediate anastomosis as the treatment for malignant left-sided large bowel obstruction are presented. Intraoperative mechanical preparation of the colon was omitted. There was no clinical evidence of anastomotic dehiscence or wound infection. The mean duration of hospital stay was 11 days. It is suggested that colonic continuity can be restored immediately and safely without mechanical bowel preparation, providing attent...

Dorudi, S.; Wilson, N. M.; Heddle, R. M.

1990-01-01

42

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

International Nuclear Information System (INIS)

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

2003-01-01

43

Ischemic colitis and large bowel infarction: A case report  

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Full Text Available Ischemic bowel disease results from an acute or chronic drop in the blood supply to the bowel and may have various clinical presentations, such as intestinal angina, ischemic colitis or intestinal infarction. Elderly patients with systemic atherosclerosis who are symptomatic for the disease in two or more vascular beds have multiple comorbidities and are particularly at risk. The clinical evolution and outcome of this disease are difficult to predict because of its pleomorphic aspects and the general lack of statistical data. In this paper, we present the case of a patient who was monitored in our unit for six years. For this patient, we encountered iterative changes in the clinical pattern, beginning with chronic “intestinal angina” and finishing with signs of acute mesenteric ischemia after an episode of ischemic colitis. This evolution is particularly rare in clinical practice, and the case is instructive because it raises discussions about the natural history of the condition and the therapeutic decisions that should be made at every stage of the disease. An important lesson is that ischemic bowel disease should always be considered in patients who have multiple risk factors for atherosclerosis and have experienced recurrent “indistinct” abdominal symptoms. In these cases, aggressive investigation and therapeutic decisions must be taken whenever possible. Despite an absence of standardized protocols, angiographic evaluation and revascularization procedures have beneficial outcomes. Current advances in endovascular therapy, such as percutaneous transluminal angioplasty with stenting, should be increasingly used in patients with chronic mesenteric ischemia. Such therapy can avoid the risks that are associated with open repair. However, technical difficulties, especially in severe stenotic lesions, frequently occur.

Eugen Florin Georgescu

2012-01-01

44

The rare presentations of a large polyp and an esophageal carcinoma in heterotropic gastric mucosa: a case series  

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Abstract Background Heterotopic gastric mucosa (HGM) is commonly seen in the upper esophagus during endoscopyand is generally considered a benign disease. A hyperplastic polyp and an adenocarcinoma arising in heterotopic gastric mucosa are quite rare occurences. Case presentations We present two cases: The first is a patient who suffered from dysphagia because of a large hyperplastic polyp that arose from HGM; the polyp was excised endoscopically. Secondly, we r...

Alagozlu Hakan; Ergun Meltem; Cindoruk Mehmet; Unal Selahattin; Dumlu Sukru; Poyraz Aylar; Dursun Ayse

2007-01-01

45

Double synchronous occluding tumors of the large bowel: a report of three cases.  

Science.gov (United States)

The development of acute large bowel obstruction secondary to colorectal cancer is very common and, while right hemicolectomy with a primary anastomosis is the accepted procedure for right-sided obstructing tumors, the different strategies performed for left-sided tumors, including staged procedures, Hartmann's procedure, and resection with anastomosis, remain a subject of controversy. We present herein the case reports of three patients who developed two synchronous occlusive tumors of the large bowel. Complete exploration of the entire colon is highly recommended to assess the most feasible therapeutic option in such cases, as the second occlusive tumor, often hidden within the bowel segments, can cause failure of limited resection or intestinal decompression. PMID:8931227

Tuscano, D; D'Amore, L; Negro, P; Scaccia, M; Talarico, C; Gossetti, F; Flati, D; Carboni, M

1996-01-01

46

Methylation of TNFRSF13B and TNFRSF13C in duodenal mucosa in canine inflammatory bowel disease and its association with decreased mucosal IgA expression.  

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Although decreased intestinal IgA expression has been reported in dogs with inflammatory bowel disease (IBD), the mechanism underlying this decrease is unknown. Transmembrane activator and calcium-modulating cyclophilin-ligand interactor (TACI) and B cell-activating factor of the TNF family (BAFF) receptor (BAFF-R) are key receptors for T cell-independent IgA class switching by the binding of IgA-inducing cytokine a proliferation-inducing ligand (APRIL) and BAFF. Here we show decreased TACI and BAFF-R mRNA expression and hypermethylation of their corresponding genes TNFRSF13B and TNFRSF13C, respectively in the duodenal mucosa of dogs with IBD. To examine whether DNA methylation of the TNFRSF13B and TNFRSF13C influences the mRNA expression of TACI and BAFF-R, respectively, we first analyzed methylation and mRNA expression levels in vitro using 2 canine B lymphoid cell lines, GL-1 and CLBL-1. Methylation profiles in the cells were examined by bisulfite sequencing and methylation-specific PCR (MSP) with primer pairs specific to methylated or unmethylated sequences. These methylation analyses revealed hypermethylation of the CpG islands of both TNFRSF13B and TNFRSF13C in GL-1, but not in CLBL-1 cells. The mRNA expression levels of TACI and BAFF-R were significantly lower in GL-1 than in CLBL-1 cells. Treatment with 5-aza-2'-deoxycytidine significantly increased TACI and BAFF-R mRNA expression in GL-1 cells through demethylation of TNFRSF13B and TNFRSF13C, respectively. These results suggest that the mRNA expression of TACI and BAFF-R is regulated through methylation of their genes in canine B cells. Quantitative real-time MSP showed significant hypermethylation of the CpG islands of TNFRSF13B and TNFRSF13C in the duodenal mucosa of dogs with IBD. Furthermore, duodenal mRNA expression levels of TACI and BAFF-R were significantly lower in dogs with IBD than in healthy controls. The mRNA expression levels of TACI positively correlated with intestinal IgA expression, whereas the methylation level of its gene (TNFRSF13B) negatively correlated with IgA expression. The present results suggest the role of TACI in the regulation of mucosal IgA expression through epigenetic modifications. PMID:24814046

Maeda, Shingo; Ohno, Koichi; Fujiwara-Igarashi, Aki; Tomiyasu, Hirotaka; Fujino, Yasuhito; Tsujimoto, Hajime

2014-07-15

47

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

48

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

49

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

International Nuclear Information System (INIS)

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.

2010-04-01

50

Rectal mucosa: malignant and premalignant changes after radiation therapy  

International Nuclear Information System (INIS)

A spectrum of changes that range from crypt basophilia through varying degrees of dysplasia and carcinoma in situ have been observed in the flat, nonraised mucosa of the rectum in a patient who received pelvic irradiation for carcinoma of the cervix. This case demonstrates (1) the morphological evidence of the relationship between radiation and large-bowel carcinoma, (2) that large-bowel carcinoma may arise directly from the flat mucosa without having to go through a benign polyp-cancer sequence, (3) that early carcinoma arising from the flat mucosa may clinically resemble radiation proctocolitis, and therefore, (4) that increased vigilance is needed for the follow-up of patients who undergo pelvic irradiation

1981-01-01

51

Resistant starch, large bowel fermentation and a broader perspective of prebiotics and probiotics.  

Science.gov (United States)

The metabolic end products of the large bowel microbiota contribute significantly to human health. After weaning to solid foods, some of the most important of these are the short chain fatty acids (SCFA) produced by the fermentation of undigested dietary components and endogenous secretions. The main SCFA are acetate, propionate and butyrate which have numerous documented effects promoting large bowel function. Of the major acids, butyrate seems especially important. It is a major metabolic fuel for colonocytes and promotes a normal phenotype in these cells, potentially lowering the risk of diseases such as colo-rectal cancer. Imbalances in the microbiota are thought to predispose to large bowel dysfunction and probiotics are being developed to correct this. However, most commercial products contain bacteria (lactobacilli and bifidobacteria) which are dominant species in milk-fed infants but have limited roles in adults. Prebiosis is defined usually by the specific stimulation of these bacteria. However, the end products of most probiotics do not include butyrate or propionate which raises questions about their effectiveness in promoting bowel health in adults. Resistant starch (RS) is a dietary fibre component and its fermentation generally favours butyrate production. Dietary RS intakes and faecal butyrate levels are high in populations at low risk of diet-related large bowel diseases. Conversely, RS intakes and faecal butyrate levels are very low in high risk groups. This raises the possibility that greater RS consumption could be of health benefit. RS is not regarded widely as a prebiotic but (according to the accepted definition) most forms show the requisite features in stimulating specific bacteria, giving raised total SCFA and butyrate levels and a consequent benefit to the host. Current efforts to improve public health through increasing RS consumption could be facilitated by greater recognition of its prebiotic role. PMID:21831780

Bird, A R; Conlon, M A; Christophersen, C T; Topping, D L

2010-11-01

52

The rare presentations of a large polyp and an esophageal carcinoma in heterotropic gastric mucosa: a case series  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Heterotopic gastric mucosa (HGM is commonly seen in the upper esophagus during endoscopyand is generally considered a benign disease. A hyperplastic polyp and an adenocarcinoma arising in heterotopic gastric mucosa are quite rare occurences. Case presentations We present two cases: The first is a patient who suffered from dysphagia because of a large hyperplastic polyp that arose from HGM; the polyp was excised endoscopically. Secondly, we report a rare case of adenocarcinoma arising in HGM of the cervical esophagus. Conclusion Morphologic changes or malignant transformation can develop in the inlet patch. Therefore, gastroenterologists should be aware of the possibility of HGM just distal to the upper esophageal sphincter.

Alagozlu Hakan

2007-11-01

53

Butyrate production from dietary fibre and protection against large bowel cancer in a rat model.  

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Butyrate slows the growth of cancer cells cultured in vitro. To determine the relevance of the fermentative production of butyrate in vivo, colonic butyrate concentrations were manipulated by feeding different dietary fibres and were related to tumour development in the rat dimethylhydrazine model of large bowel cancer. It has previously been shown that guar gum and oat bran, while highly fermentable, are associated with low butyrate levels in the distal colon, while wheat bran causes signifi...

Mcintyre, A.; Gibson, P. R.; Young, G. P.

1993-01-01

54

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

55

The effect of irradiated volume on the chronic radiation damage of the rat large bowel  

International Nuclear Information System (INIS)

The dependence of the structural and the functional chronic radiation damage in the large bowel of rats was investigated in order to develop criteria for optimising treatment plans. Rats were locally irradiated to different volumes of their rectum. The resulting chronic damage was determined by clinical observation, by rectoscopy and by histopathology. The structural damage as well as the functional damage depend very much on the dose distribution in the llarge bowel, however, this influence is different for structural and for functional damage expression. Much less field size effect was seen for the structural damage of ulceration than for the functional damage of rectal obstruction when the length of whole circumference irradiation was reduced or when only half of the circumference was irradiated. (orig.)

1995-06-01

56

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...

1998-01-01

57

Imbalanced shift of cytokine expression between T helper 1 and T helper 2 (Th1/Th2 in intestinal mucosa of patients with post-infectious irritable bowel syndrome  

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Full Text Available Abstract Background Irritable bowel syndrome (IBS is a common functional bowel disorder. The post-infectious IBS (PI-IBS occurs in IBS patients with a history of intestinal infection preceding the onset of symptoms. However, the underlying cause of PI-IBS is not fully understood, and the purpose of this study was to investigate the immune regulatory mechanism of PI-IBS. Methods Participants enrolled in this study were divided into three groups including PI-IBS patients (n?=?20, IBS patients without a history of infection (non-PI-IBS, n?=?18, and healthy controls (n?=?20. The expression levels of the Th1-derived cytokines IFN-? and IL-12, and the Th2-derived cytokines IL-4 and IL-10 in the mucosal specimens, and in the ascending colon, the descending colon, and the rectal segments were measured by RT-PCR and western blot. Results The IFN-? mRNA levels in the intestinal mucosa were significantly higher in the PI-IBS group than in the non-PI-IBS or control group (both P? Conclusions An increase in IFN-? levels and a decrease in IL-10 levels were found in the intestinal mucosa of PI-IBS patients, suggesting that the infection may affect the Th1/Th2 balance. Thus, the dysregulation of the immune response is likely an important cause of IBS.

Chen Ji

2012-07-01

58

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 allow interactive postprocessing of the MR data. (orig.)

2001-01-01

59

New Large Bowel Segmentation on Plain Abdominal Radiography in Comparison with the Conventional Method  

Directory of Open Access Journals (Sweden)

Full Text Available Plain abdominal radiography is a very basic examination and plays an important role in primary care. The objectives of this study were to clarify colon distributions on plain abdominal radiographs. Forty-three healthy volunteers underwent gastric fluoroscopy, and 2 hours later, plain abdominal radiography in the supine position. A region of interest (ROI was defined uniformly on each X-ray image to divide the image into 600 zones. The area corresponding to the large bowel within the ROI was divided into 4 segments (ascending colon, transverse colon, descending colon, and sigmoid colon?rectum. The percentage of barium in each segment relative to the total volume of barium used was calculated to evaluate the percent ROI occupancy. The large bowel covered 76.7% of the entire ROI, with the percent duplication being 55%. The duplicated area corresponded to the transverse colon region. When the method proposed by Arhan et al. was used, the percentage of the colon actually present in each segment relative to that determined theoretically was 99.6% for the right colon segment, 92.2% for the left colon segment, and 92.2% for the sigmoid/rectal segment. However, in cases in which the transverse colon descended partially from the fifth lumbar vertebra, the percentage occupied by the sigmoid colon?rectum decreased to 57.2%. We applied a new large bowel segmentation method especially for patients with ptosis, by devising a line joining the lateral side of the right lesser pelvis and the lower ends of both sacroiliac joints.

Ochi,Koji

2012-06-01

60

Follow-up studies by large intestinal biopsies and necropsy in dogs with clinical signs of large bowel disease.  

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The results of follow-up studies in 77 dogs with clinical signs of large bowel disease are presented. In 32 dogs colonic and/or rectal biopsy follow-up studies were done, combined with necropsy in seven dogs. In 45 dogs a follow-up necropsy only was done. The time between the first and the last series of biopsies varied from three to 729 days and between the first series of biopsies and necropsy from one to 980 days. Colitis found in 45 dogs in the initial biopsies was still present in 29 cas...

1989-01-01

 
 
 
 
61

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

Science.gov (United States)

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

Nakayama, Yoshifumi; Kusuda, Shinichi; Nagata, Naoki; Yamaguchi, Koji

2009-01-01

62

Clinical applications of small bowel capsule endoscopy  

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

Kopylov U

2013-07-01

63

Imaging findings of midgut volvuIus associated with a large small-bowel diverticulum in an aduIt patient: case report  

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Although most patients with jejunoileal diverticulum are asymptomatic, a large, small-bowel diverticulum can be associated with midgut volvulus in an adult. We present a rare case of midgut volvulus that was associated with a large, small-bowel diverticulum in a 77-year-old woman presenting with chronic recurrent abdominal pain. The CT showed the characteristic whirl sign of twisted mesentery, the small bowel loops along the superior mesenteric artery and a large sac-like small-bowel diverticulum. A small bowel series also demonstrated a corkscrew appearance of proximal jejunum, a finding suggestive of midgut volvulus, and a large jejunal diverticulum. During the laparotomy, the small bowel was seen twisted counterclockwise 270 .deg.. The mesenteric root was very shortened. A 4 cm sized diverticulum was seen on the mesenteric border of jejunum, on the portion about 40 cm distal from the Treitz ligament.

Kim, Jee Young; Rha, Sung Eun; Oh, Soon Nam; Bo, Seal Hwang; Byun, Jae Young [College of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of)

2004-05-01

64

Altered Th1/Th2 cytokine profiles in the intestinal mucosa of patients with inflammatory bowel disease as assessed by quantitative reversed transcribed polymerase chain reaction (RT-PCR).  

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Cytokines serve a central function as key factors in the regulation of the intestinal immune response and mediation of tissue damage in inflammatory bowel disease (IBD). Abnormalities in the expression of immunoregulatory cytokines such as IL-2, IL-4, IL-10 and interferon-gamma (IFN-gamma) may indicate a dysregulation of intestinal immunity probably associated with pathogenic events. Therefore, cytokine mRNA concentrations were determined in the mucosa of patients with IBD at sites of active (n = 13) and inactive (n = 12) ulcerative colitis (UC), active (n = 11) and inactive (n = 11) Crohn's disease (CD) and in control patients (n = 14) using quantitative RT-PCR. IL-10 mRNA concentrations were significantly increased in patients with both active UC (P cytokines. Furthermore, the increased IL-10 mRNA expression at sites of active IBD suggests that IL-10 is an important regulatory component involved in the control of the inflammatory response in inflammatory bowel disease. Images Fig. 1 Fig. 4

Niessner, M; Volk, B A

1995-01-01

65

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

1986-02-15

66

Bacterial biofilms associated with food particles in the human large bowel.  

Science.gov (United States)

Bacteria within the gastro-intestinal tract affect host function via production of short-chain fatty acids and synthesis of vitamins. Additionally, the commensal enteric bacteria modulate the immune system and provide protection from potentially pathogenic bacteria. Only recently heterogeneous bacterial biofilms were found to be associated with food particles within the intestinal tract. There are a number of studies investigating the formation and function of pathogenic and single-species biofilms, though few studies have investigated the dynamics of multispecies biofilms, especially with regard to food/microbial/host interactions. The scope of this review is to discuss the current knowledge of bacterial biofilms associated with food particles in the human large bowel, examine the established mathematical models depicting bacterial attachment, and elucidate key areas for further research. PMID:21638777

Van Wey, Amy S; Cookson, Adrian L; Roy, Nicole C; McNabb, Warren C; Soboleva, Tanya K; Shorten, Paul R

2011-07-01

67

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

68

[Two cases of acute large bowel obstruction caused by advanced cancer treated with stenting "bridge to surgery" procedure].  

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Obstructive colorectal cancer accounts for 3.1-15.8% of total colorectal cancer cases, therefore it is not a rare condition. Formerly, it has been often treated with emergent operation such as colostomy or trans-anal tube decompression. Since 2012, revision of the medical payment system, it has become possible to be treated with elective operation when using endoscopic metal stent placement that enable to decompress enlarged intestine by transanal approach. This procedure provides safe elective surgery with sufficient preoperative inspection and conventional bowel preparation. We report two cases of acute large bowel obstruction due to colon cancer treated with endoscopic stent placement as a "bridge to surgery". PMID:24693688

Ishii, Aya; Sugiyama, Masahiko; Ohta, Mitsuhiko; Sumida, Yorinobu; Kimura, Yasue; Tsutsumi, Norifumi; Yamashita, Yo-Ichi; Saeki, Hiroshi; Uchiyama, Hideaki; Kawanaka, Hirofumi; Morita, Masaru; Sakaguchi, Yoshihisa; Ikeda, Tetsuo; Kusumoto, Tetsuya; Harada, Naohiko; Ikejiri, Koji; Maehara, Yoshihiko

2013-12-01

69

Liver uptake of sup(99m)Tc-labeled diphosphonate (DPD) by metastatic lesions from large bowel carcinoma  

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Accumulation of sup(99m)Tc-diphosphonate was observed in 2 of 12 patients with liver metastases who had primary adenocarcinoma of the large bowel. The area of excessive radionuclide concentration corresponded well to the location of the hepatic metastases. The literature on this subject is reviewed and a possible mechanism of radionuclide accumulation is discussed. (orig.)

1985-05-01

70

Morphologic Observation of Mucosa-Associated Lymphoid Tissue in the Large Intestine of Bactrian Camels (Camelus bactrianus).  

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The structure and distribution of the mucosa-associated lymphoid tissue (MALT) throughout the large intestine of 10 Bactrian camels were comparatively studied by anatomical and histological methods. The results showed that Peyer's patches (PPs) were mainly located on the mucosal surfaces of the entire ileocecal orifice, the beginning of the cecum and the first third of the colon. The shape of PPs gradually changed from "scrotiform" to "faviform" along the large intestine with the scrotiform PP as the major type in the ileocecal orifice. The distribution density also gradually decreased from the ileocecal orifice to the colon. The histological observations further revealed that the MALT in the form of PPs or isolated lymphoid follicles (ILF) and lamina propria lymphocytes was mainly present in the lamina propria and submucosa from the entire ileocecal orifice, where the muscularis mucosa is usually incomplete, to the colonic forepart. In addition, lymphoid tissue was much more abundant in the lamina propria and submucosa of the ileocecal orifice as compared to the cecum and colon. Statistically, the MALT of the ileocecal orifice contained a higher number of lymphoid follicles (37.7/10 mm(2) ) than that of the cecum, colon, or rectum (P?large intestine of the Bactrian camel; and that scrotiform PPs are likely to the result of long-term adaptation of the Bactrian camel to the harsh living environment. Anat Rec, 297:1292-1301, 2014. © 2014 Wiley Periodicals, Inc. PMID:24820911

ZhaXi, Yingpai; Wang, Wenhui; Zhang, Wangdong; Gao, Qiang; Guo, Minggang; Jia, Shuai

2014-07-01

71

Outcomes after stenting for malignant large bowel obstruction without radiologist support  

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AIM: To assess outcomes after colonic stent insertion for obstructing colorectal malignancies performed by an endoscopist without radiologist support. METHODS: This is a retrospective study of all stents inserted by a single surgeon in a District General Hospital over an eight year period. All stents were inserted for patients with acute large bowel obstruction secondary to a malignant colorectal pathology either for palliation or as a bridge to surgery. Procedures were performed by a single surgeon endoscopically with fluoroscopic control in the X-ray department but without the support of an interventional radiologist. Data was collected prospectively on a pre-designed database. RESULTS: The indication for all stent procedures was an obstructing colorectal malignancy. Out of 53 patients, the overall success rate was 90.6%. Eight patients had a stent intended as a bridge to surgery and 45 as a palliative procedure. Technical success was achieved in 50 out of 53 procedures (94.3%) and clinical success in 48 of those remaining 50 (96.0%). Those with unsuccessful technical or clinical procedures went on to have defunctioning stomas to treat their obstruction. There were six complications from the technically successful stents (12.0%). These included one migration, one persisting obstructive symptoms and four cases of tumour overgrowth of the stents at a later date. Haemorrhagic complications, perforation or mortality were not observed in our series. Our results are comparable to several other studies assessing stent outcomes for obstructing bowel cancer. CONCLUSION: Our data suggests that colorectal stents can be inserted without radiologist support by an adequately trained individual with good outcomes.

Mehmood, Rao Khalid; Parker, Jody; Kirkbride, Patricia; Ahmed, Shakil; Akbar, Fayyaz; Qasem, Eays; Zeeshan, Muhammad; Jehangir, Ernest

2014-01-01

72

Clinical applications of small bowel capsule endoscopy  

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

Kopylov U; Eg, Seidman

2013-01-01

73

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

Scientific Electronic Library Online (English)

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

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

74

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

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

Humberto Osnaya M

2013-02-01

75

Combined transplantation of small and large bowel. FK506 versus cyclosporine A in a porcine model.  

Science.gov (United States)

Clinically, FK506 is superior to CsA after solitary small bowel transplantation (SBTx). Development of diarrhea after SBTx has been the rationale for adding the colon to small bowel grafts. However, the additional lymphoid and bacterial content transferred with total small plus large bowel transplants (TBTx) might aggravate the alloimmune response-rejection and graft-versus-host disease (GVHD)-and increase the risk of infection. We studied the incidence of rejection, GVHD, and infection after TBTx and the impact of CsA versus FK506. We performed orthotopic TBTx with portal drainage after total enterectomy in outbred Yorkshire Landrace pigs, divided into 3 groups: control pigs (n=6) received no immunosuppression; CsA pigs (n= 14) received CsA (5 mg/kg), antilymphocyte globulin (10 mg/kg for 10 days), prednisone (2 mg/kg), and AZA (2.5 mgtkg); and FK506 pigs (n=9) received FK506 (0.2 mg/kg) and prednisone (2 mg/kg). Trough CsA whole blood levels were >400 ng/ml for the first 7 days and >200 ng/ml thereafter. FK506 levels were > 15 ng/ml. We excluded from further analysis 5 early deaths (<3 days) due to anesthesiologic (n=2) or technical reasons (n=3). Median survival of control pigs was 9.5 days (range, 4-13). Cyclosporine did not extend survival: median, 9 days (range, 5-31) (P=0.6). FK506 prolonged survival: median, 37 days (range, 21-49) (P<0.001 vs. control and CsA pigs). Of FK506 pigs, 60% gained weight (+75 g/day), whereas 100% of controls and 75% of CsA pigs lost weight (-550 g/day and -300 g/day, respectively). All control pigs died of rejection within 2 weeks versus none of the FK506 pigs. However, 36% of CsA pigs died of rejection. Groupwise comparison showed less rejection in FK506 versus control pigs (P<0.001) and in FK506 versus CsA pigs (P<0.03), but no difference between CsA and control pigs. None of the control pigs died of GVHD versus 18% of CsA pigs (by day 31) and 37% of FK506 pigs (by day 49). Groupwise comparison showed increased GVHD in FK506 versus control pigs (P<0.001) and a tendency toward increased GVHD in FK506 versus CsA pigs (P=0.08). None of the control pigs died of infection alone versus 22% of CsA pigs (by day 31) and 67% of FK506 pigs (by day 49). Groupwise comparison showed increased infection in FK506 versus control pigs (P<0.001). We detected significant endotoxemia early and late postoperatively. But we saw no specific correlation between endotoxemia, rejection, GVHD, or infection. Based on this study, we have drawn several conclusions: (1) In untreated pigs, TBTx provokes a severe rejection response, but no lethal GVHD. (2) Cyclosporine and particularly FK506 pigs have a high incidence of infection and lethal GVHD, a complication that we had not seen after solitary SBTx. (3) FK506 is superior to CsA in controlling rejection and in prolonging graft and recipient survival; FK506, however, does not reduce GVHD, but rather tends to augment it. (4) TBTx causes endotoxemia. As with solitary SBTx, FK506 is superior to CsA after TBTx. However, longterm survival is difficult to achieve on FK506 recipients because of the development of GVHD and infection. PMID:8685944

Pirenne, J; Benedetti, E; Gruessner, A; Moon, C; Hakim, N; Fryer, J P; Troppmann, C; Nakhleh, R E; Gruessner, R W

1996-06-27

76

Disease-Dependent Adhesion of Lactic Acid Bacteria to the Human Intestinal Mucosa  

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Their adhesion to the intestinal mucosa is considered one of the main reasons for the beneficial health effects of specific lactic acid bacteria (LAB). However, the influence of disease on the mucosal adhesion is largely unknown. Adhesion of selected LAB to resected colonic tissue and mucus was determined in patients with three major intestinal diseases (i.e., diverticulitis, rectal carcinoma, and inflammatory bowel disease) and compared to healthy control tissue. All strains were observed to...

Ouwehand, Arthur C.; Salminen, Seppo; Roberts, Peter J.; Ovaska, Jari; Salminen, Eeva

2003-01-01

77

Effect of small bowel preparation with simethicone on capsule endoscopy*  

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Background: Capsule endoscopy is a novel non-invasive method for visualization of the entire small bowel. The diagnostic yield of capsule endoscopy depends on the quality of visualization of the small bowel mucosa and its complete passage through the small bowel. To date, there is no standardized protocol for bowel preparation before capsule endoscopy. The addition of simethicone in the bowel preparation for the purpose of reducing air bubbles in the intestinal lumen had only been studied by ...

Fang, You-hong; Chen, Chun-xiao; Zhang, Bing-ling

2009-01-01

78

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

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

Bartolotta Tommaso E

2005-10-01

79

Oral mucosa at Crohn’s disease  

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Introduction: Crohn’s disease (CD) is an inflammatory disorder of unclear etiology. Beside the systemic symptoms, often some oral mucosa manifestations are present. Oral symptoms may occur even before the bowel ones. The most common presentations are lip swelling, buccal cobblestoning, deep linear sulcal ulceration, gingival hyperplasia and angular cheillitis. Aim of study Aim of study: The purpose of this study was to present the occurence of oral mucosa changes at patients with CD. Ma...

Anna Paradowska

2008-01-01

80

Viabilidade celular da mucosa do intestino delgado de ratos, após correção de choque hipovolêmico com solução de NaCl 7,5% / Celular viability of rat small bowel mucosa, after hypovolemic shock correction with NaCl 7,5% solution  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Estudar o efeito da correção volêmica com diferentes tipos de solução, na mucosa do intestino delgado de ratos. MÉTODOS: Foram utilizados 120 ratos Wistar (Rattus norvegicus albinus), machos, adultos, com peso individual entre 310 e 410g, oriundos do Instituto Evandro Chagas de Belém do Pa [...] rá, submetidos a período de adaptação por 15 dias, recebendo água e ração ad libitum, durante todo o experimento. Os animais foram distribuídos em: Grupo Padrão (P), Grupo Choque (C), Grupo Solução Fisiológica (SF) e Grupo Solução Hipertônica (SH), com 30 animais cada. Estes foram divididos em subgrupos com 10 animais cada, de acordo com o dia de pós-operatório (DPO) previsto para a eutanásia dos animais, (1º, 3º ou 7º DPO), sendo após esta, colhido material para realização de teste de absorvância pelo MTT em todos os animais. RESULTADOS: O grupo SF apresentou menores índices de viabilidade celular comparado aos grupos SH e C (p Abstract in english PURPOSE: Study the effect of the volemic correction with different solutions, in the mucous of the small bowel in rats. METHODS: Were used 120 rats Wistar (Rattus norvegicus albinus), males, adults, seemingly healthy, with individual weight varying between 310 and 410g, originating from of the Insti [...] tuto Evandro Chagas of Belém of Pará, submitted to an adaptation period of 15 days, receiving water and ration ad libitum, during the role experiment. For the research, ten animals were distributed, in groups and subgroups as following: Standard group (S), Shock group (Sh), Physiological Solution group (PS) and Hypertonic Solution Group (HS). The groups were divided in subgroups with 10 animals each, in agreement with the day of postoperative (DPO) foreseen for the euthanasis of the animals, (1st, 3rd or 7th DPO), being after this, picked material for cellular viability in every animals. RESULTS: The group PS took less quantity viable cells. CONCLUSION: The volemic correction with chloride of sodium solution at 7.5%, when compared the correction with chloride of sodium at 0.9% (isotonic solution), took the maintenance of larger amount of viable cells, in the small bowel in rats.

Marcus Vinicius Henriques, Brito; Amaury José Texeira, Nigro; Edna Frasson de Souza, Montero; José Luiz Martins do, Nascimento; Paula Roberta Ferreira da, Silva; Roberta Bianca Peres, Siqueira.

 
 
 
 
81

Viabilidade celular da mucosa do intestino delgado de ratos, após correção de choque hipovolêmico com solução de NaCl 7,5% Celular viability of rat small bowel mucosa, after hypovolemic shock correction with NaCl 7,5% solution  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: Estudar o efeito da correção volêmica com diferentes tipos de solução, na mucosa do intestino delgado de ratos. MÉTODOS: Foram utilizados 120 ratos Wistar (Rattus norvegicus albinus, machos, adultos, com peso individual entre 310 e 410g, oriundos do Instituto Evandro Chagas de Belém do Pará, submetidos a período de adaptação por 15 dias, recebendo água e ração ad libitum, durante todo o experimento. Os animais foram distribuídos em: Grupo Padrão (P, Grupo Choque (C, Grupo Solução Fisiológica (SF e Grupo Solução Hipertônica (SH, com 30 animais cada. Estes foram divididos em subgrupos com 10 animais cada, de acordo com o dia de pós-operatório (DPO previsto para a eutanásia dos animais, (1º, 3º ou 7º DPO, sendo após esta, colhido material para realização de teste de absorvância pelo MTT em todos os animais. RESULTADOS: O grupo SF apresentou menores índices de viabilidade celular comparado aos grupos SH e C (pPURPOSE: Study the effect of the volemic correction with different solutions, in the mucous of the small bowel in rats. METHODS: Were used 120 rats Wistar (Rattus norvegicus albinus, males, adults, seemingly healthy, with individual weight varying between 310 and 410g, originating from of the Instituto Evandro Chagas of Belém of Pará, submitted to an adaptation period of 15 days, receiving water and ration ad libitum, during the role experiment. For the research, ten animals were distributed, in groups and subgroups as following: Standard group (S, Shock group (Sh, Physiological Solution group (PS and Hypertonic Solution Group (HS. The groups were divided in subgroups with 10 animals each, in agreement with the day of postoperative (DPO foreseen for the euthanasis of the animals, (1st, 3rd or 7th DPO, being after this, picked material for cellular viability in every animals. RESULTS: The group PS took less quantity viable cells. CONCLUSION: The volemic correction with chloride of sodium solution at 7.5%, when compared the correction with chloride of sodium at 0.9% (isotonic solution, took the maintenance of larger amount of viable cells, in the small bowel in rats.

Marcus Vinicius Henriques Brito

2003-08-01

82

Primary double-contrast examination of large bowel under artificial hypotension conditions (concerning diagnosis of tumor-associated acute obturative obstruction)  

International Nuclear Information System (INIS)

A study of 23 patients suffering tumor-associated acute obstruction of the large bowel made a case for application of primary double-contrast examination of the large intestine under artificial hypotension to establish relevant lesions, their site as well as the nature of obstruction

1988-01-01

83

Large bowel leiomyosarcoma - a case report; Leiomiosarcoma do intestino grosso - relato de um caso  

Energy Technology Data Exchange (ETDEWEB)

The authors report a case of a 49-year-old male patient with leiomyosarcoma of the ascending colon. The patient presented with anemia and an abdominal mass, and the symptoms progressed until a final diagnosis was made nine months later. A plain abdominal x-ray showed the presence of gas outside the bowel, in the right hypochondrium. The double contrast barium enema showed a sublevel displacement of the hepatic flexure and diverticula. An abdominal ultrasound revealed a heterogeneous expansive lesion below the liver containing gas, and a computed tomography of the abdomen revealed an excavated mass below the liver containing liquid, that was not filled by contrast medium. The patient was submitted to a right hemicolectomy with ileocoloanastomosis and the histopathological analysis of the excised material revealed a leiomyosarcoma of the ascending colon. (author)

Lopes, Simone Goncalves; Marchiori, Edson; Brick, Julieta Figueiredo; Curty Neto, Eduardo; Scherman, Alexandre; Silva, Ana Carina Gamboa da; Machado, Bruno Beber [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia]. E-mail: edmarchiori@zipmail.com.br

2001-04-01

84

Management of Recurrent Large Bowel Obstruction Due to Stent Occlusion by ‘Stent-Over-Stent’: A Case Report and Literature Review  

Directory of Open Access Journals (Sweden)

Full Text Available Endoscopic stenting for malignant large bowel obstruction is common nowadays. However, recurrent obstruction secondary to stent occlusion due to tumour ingrowth or overgrowth might occur. We reported a case of a 70-year-old man with large bowel obstruction initially treated with colonic stenting. It was complicated with recurrent intestinal obstruction, with colonoscopy showing stent blockage by tumour ingrowth over distal part of the stent. Successful endoscopic implantation of additional colonic stent over the old stent was achieved and intestinal obstruction was resolved afterwards.

D. Yi-Po Tsang

2011-10-01

85

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

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

Sandrasegaran, K. [Department of Radiology, Indiana University School of Medicine (United States)], E-mail: ksandras@iupui.edu; Maglinte, D.D.T.; Jennings, S.G. [Department of Radiology, Indiana University School of Medicine (United States); Chiorean, M.V. [Department of Medicine, Division of Gastroenterology, Indiana University School of Medicine (United States)

2008-06-15

86

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

International Nuclear Information System (INIS)

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

2008-06-01

87

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

88

[Large-bowel obstruction as a result of occult diaphragmatic hernia 11 years after injuries].  

Science.gov (United States)

Diaphragmatic injury accompanied by herniation through the thoracic cavity is a well documented complication of penetrating or blunt abdominal trauma. It occurs in 3% of abdominal lesions, with strong prevalence for blunt trauma. In the acute setting the diagnosis may be difficult because of the lack of peculiar clinical signs or the wrong interpretation of radiological findings. For this reason, medical history taking should be very accurate, in order to underline the correlation between a past traumatic event and the present symptoms. If the defect is not promptly recognized, the patient has a considerable increase in morbidity and mortality risk. In our case the presentation of the diaphragmatic injury was delayed and the correct diagnosis was not suspected initially. We report the case of a 28 years old man presenting to our department for sudden abdominal pain associated with bowel obstruction. Patient underwent an urgent laparotomy that revealed a postero-lateral diaphragmatic hernia with incarcerated colon and omentum, which appeared ischemic and were therefore resected, with successive closure of the diaphragmatic breach. During medical history taking the patient signaled a penetrating trauma occurred eleven years before symptoms presentation. . PMID:23064304

Goi, Gloria; Callegaro, Dario; Villa, Roberta; Moroni, Eliana; Bondurri, Andrea; Danelli, Piergiorgio

2012-01-01

89

What to do with a non-rolling stone? Surgical on-table dilemma in large bowel obstruction due to an impacted gallstone.  

Science.gov (United States)

We present a rare case of large bowel obstruction secondary to colonic gallstones in a frail nonagenarian. Uniquely, the stone was impacted in the descending colon-sigmoid junction, in the absence of underlying bowel pathology distal to the stone. In light of worsening pain and distension after failed endoscopic treatment, the patient was treated with an emergency laparotomy. After an on-table dilemma, a proximal defunctioning loop colostomy was fashioned and the stone left in situ, with the eventual fate of the stone currently undecided. We also discuss alternative treatment options and explain the thought processes that lead to our decision. PMID:25002453

Das, Niloy; Plummer, Nicholas R; Raja, Hassan; Vashist, Ashok

2014-01-01

90

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

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

Simone Gonçalves Lopes

2001-04-01

91

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

Scientific Electronic Library Online (English)

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

Simone Gonçalves, Lopes; Edson, Marchiori; Julieta Figueiredo, Brick; Eduardo, Curty Neto; Alexandre, Scherman; Ana Carina Gamboa da, Silva; Bruno Béber, Machado.

92

The effect of cis-diammine dichloro platinum(II) on radiation injury in the rat bowel  

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This experimental study was performed for evaluate the effects of cis-diamminedichloroplatinum(II) (cis-DDP) on the radiation injury of rat bowel by histopathologic changes. Rats were exposed to entire abdomen by a single doses of X-ray(6-10 Gy) without or with cis-DDP(2.5mg/kg). Rats were divided into 3 groups such as radiation alone, cis-DDP alone and combined group. In combined group, cis-DDP was given 30 minutes before or immediately after irradiation. Cis-DDP induced the inflammatory cell infiltrations with focal necrosis of the mucosa in the small bowel and no abnormal change in the large bowel. In radiation alone group, mucosal necrosis, submucosal fibrosis and muscular necrosis were prominent changes in small bowel and submucosal fibrosis in the large bowel. The submucosal fibrosis in the small bowel was appeared in 10 Gy of radiation alone group and 8 Gy of cis-DDP infusion after radiation and 6 Gy of cis-DDP infusion before radiation of combined group. In the large bowel, submucosal fibrosis was noted in 8 Gy of radiation alone group 8 Gy of cis-DDP infusion after radiation and 6 Gy of cis-DDP infusion before radiation of combined group. In the small bowel, the enhancement ratio was 1.67 in a group of cis-DDP infusion before radiation and 1.25 in group of cis-DDP infusion after radiation as the end point was the submucosal fibrosis. In the large bowel, the enhancement ratio was 1.33 in a group of cis-DDP infusion before radiation and 1.0 in a group of cis-DDP infusion after radiation as the end point was the submucosal fibrosis. This study suggested that cis-DDP enhance the radiation effect in the small and large bowel especially when cis-DDP was infused before radiation.

Lee, Kyung Ja; Rhee, Chung Sik [Ewha Womans Univ., Seoul (Korea, Republic of)

1995-12-01

93

Gene methylation profiles of normal mucosa, and benign and malignant colorectal tumors identify early onset markers  

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Full Text Available Abstract Background Multiple epigenetic and genetic changes have been reported in colorectal tumors, but few of these have clinical impact. This study aims to pinpoint epigenetic markers that can discriminate between non-malignant and malignant tissue from the large bowel, i.e. markers with diagnostic potential. The methylation status of eleven genes (ADAMTS1, CDKN2A, CRABP1, HOXA9, MAL, MGMT, MLH1, NR3C1, PTEN, RUNX3, and SCGB3A1 was determined in 154 tissue samples including normal mucosa, adenomas, and carcinomas of the colorectum. The gene-specific and widespread methylation status among the carcinomas was related to patient gender and age, and microsatellite instability status. Possible CIMP tumors were identified by comparing the methylation profile with microsatellite instability (MSI, BRAF-, KRAS-, and TP53 mutation status. Results The mean number of methylated genes per sample was 0.4 in normal colon mucosa from tumor-free individuals, 1.2 in mucosa from cancerous bowels, 2.2 in adenomas, and 3.9 in carcinomas. Widespread methylation was found in both adenomas and carcinomas. The promoters of ADAMTS1, MAL, and MGMT were frequently methylated in benign samples as well as in malignant tumors, independent of microsatellite instability. In contrast, normal mucosa samples taken from bowels without tumor were rarely methylated for the same genes. Hypermethylated CRABP1, MLH1, NR3C1, RUNX3, and SCGB3A1 were shown to be identifiers of carcinomas with microsatellite instability. In agreement with the CIMP concept, MSI and mutated BRAF were associated with samples harboring hypermethylation of several target genes. Conclusion Methylated ADAMTS1, MGMT, and MAL are suitable as markers for early tumor detection.

Vatn Morten

2008-12-01

94

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

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Proteus syndrome is an extremely rare congenital disorder that produces multifocal overgrowth of tissue. This report presents a surgical case of a large lipoma in the abdominal wall of a patient with Proteus syndrome. She was diagnosed with Proteus syndrome based on certain diagnostic criteria. The neoplasm increased in size gradually, producing hemihypertrophy of her left lower extremity and trunk, and spread to her retroperitoneum and her left abdominal wall. She experienced gradually progr...

Nakayama, Yoshifumi; Kusuda, Shinichi; Nagata, Naoki; Yamaguchi, Koji

2009-01-01

95

Feasibility of iodine-125 labeled anti-human hemoglobin antibody in the detection of bleeding sites from the large bowel-A preliminary study  

International Nuclear Information System (INIS)

A monoclonal anti-human hemoglobin antibody that cross-reacts with mouse hemoglobin was labeled with Iodine-125 through the Chloramine-T method. The labeled antibody was used in an attempt to recognize bleeding sites from the large bowel in a mouse model, through a non-invasive enema-like study. In vitro experiments after double column chromatography of the labeled antibody and 10% trichloroacetic acid conjugation revealed that about 80% of the radioactivity was incorporated into protein. Inhibition assay containing could (non-radiolabeled) antibody showed that Iodine-125 radiolabeled antibody preserved its immunoreactivity. Autoradiographs exquisitely demonstrated accumulation of isotope in the corresponding intestinal bleeding areas. These findings suggest that this method can be useful for scintigraphic localization of bleeding sites in the large bowel. (author)

2001-07-01

96

Preparing the bowel for colonoscopy.  

Science.gov (United States)

Bowel preparation methods for total colonoscopy in children generally involve whole gut irrigation with electrolyte lavage solutions, which in most children will require hospitalisation for nasogastric tube administration. The aim of the study was to determine the efficacy of oral bisacodyl combined with a single phosphate enema as a bowel preparation regimen in children. In an open prospective trial, 30 children (aged 18 months-15 years) were given oral bisacodyl on each morning of the two days before colonoscopy. The children were maintained on a normal diet. A phosphate enema was administered on the morning of the procedure. The adequacy of bowel preparation was graded as grade I if no faecal material was encountered, grade II if small amounts of faecal material were present in scattered locations, and grade III if there was poor preparation with faecal material precluding satisfactory visualisation of the bowel mucosa. Eight children (26.6%) had minor abdominal cramps when taking bisacodyl, but all had a previous history of similar pain. Five children (16.6%), all under 5 years of age, cried during the administration of phosphate enema. Bowel preparation was considered excellent (grade I) in 26 (86.6%) and good (grade II) in four (13.3%). In all patients adequate visualisation of the bowel mucosa was obtained. Oral bisacodyl combined with a single phosphate enema provides an ideal method of preparing the bowel for total colonoscopy. This preparation allows colonoscopy to be carried out as a day case procedure in children while maintaining them on a normal diet.

Abubakar, K; Goggin, N; Gormally, S; Durnin, M; Drumm, B

1995-01-01

97

Disruption of the Murine Glp2r Impairs Paneth Cell Function and Increases Susceptibility to Small Bowel Enteritis  

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Exogenous glucagon-like peptide-2 receptor (GLP-2R) activation elicits proliferative and cytoprotective responses in the gastrointestinal mucosa and ameliorates experimental small and large bowel gut injury. Nevertheless, the essential physiological role(s) of the endogenous GLP-2R remain poorly understood. We studied the importance of the GLP-2R for gut growth, epithelial cell lineage allocation, the response to mucosal injury, and host-bacterial interactions in Glp2r?/? and littermate c...

Lee, Seung-jun; Lee, Jennifer; Li, Karen K.; Holland, Dianne; Maughan, Heather; Guttman, David S.; Yusta, Bernardo; Drucker, Daniel J.

2012-01-01

98

Gastric, small bowel, and colorectal cancer  

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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

1985-01-01

99

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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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 tissu...

Bjørkkjær Tormod; Brun Johan G; Valen Merete; Arslan Gülen; Lind Ragna; Brunborg Linn A; Berstad Arnold; Frøyland Livar

2006-01-01

100

Viabilidade celular da mucosa do intestino delgado de ratos, após correção de choque hipovolêmico com solução de NaCl 7,5% Celular viability of rat small bowel mucosa, after hypovolemic shock correction with NaCl 7,5% solution  

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OBJETIVO: Estudar o efeito da correção volêmica com diferentes tipos de solução, na mucosa do intestino delgado de ratos. MÉTODOS: Foram utilizados 120 ratos Wistar (Rattus norvegicus albinus), machos, adultos, com peso individual entre 310 e 410g, oriundos do Instituto Evandro Chagas de Belém do Pará, submetidos a período de adaptação por 15 dias, recebendo água e ração ad libitum, durante todo o experimento. Os animais foram distribuídos em: Grupo Padrão (P), Grupo Choque (C...

2003-01-01

 
 
 
 
101

Macroscopic small bowel mucosal injury caused by chronic nonsteroidal anti-inflammatory drugs (NSAIS) use as assessed by capsule endoscopy / Valoración mediante cápsulas endoscópicas de las lesiones intestinales mucosas causadas por antiinflamatorios no esteroideos (AINE)  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in english Objective: to evaluate the type, frequency, and severity of macroscopic small bowel mucosal injury after chronic NSAID intake as assessed by capsule endoscopy (CE), as well as to correlate the severity of gastroduodenal and intestinal damage in these patients. Material and methods:a prospective, end [...] oscopist-blind, controlled trial. Sixteen patients (14F/2M; age: 57.06 ± 10.16 yrs) with osteoarthritis (OA) on chronic therapy with NSAIDs underwent CE and upper gastrointestinal endoscopy (UGE). Seventeen patients with OA (9F/2M; age: 57.47 ± 9.82 yrs) who did not take NSAIDs were included as a control group. A scale ranging from 0 to 2 (0 = no lesions, 1-minor = red spots or petechiae, denuded areas and/or 1-5 mucosal breaks; 2-major = > 5 mucosal breaks and/or strictures, or hemorrhage) was designed to assess the severity of small bowel mucosal injuries. Results: CE found intestinal lesions in 75% (12/16) of patients in the study group and in 11.76% (2/17) of controls (p

Caunedo-Álvarez, A.; Gómez-Rodríguez, B. J.; Romero-Vázquez, J.; Argüelles-Arias, F.; Romero-Castro, R.; García-Montes, J. M.; Pellicer-Bautista, F. J.; Herrerías-Gutiérrez, J. M..

102

Elevated levels of the pro-carcinogenic adduct, O6-methylguanine, in normal DNA from the cancer prone regions of the large bowel  

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BACKGROUND—The pro-mutagenic lesion O6-methyldeoxyguanosine (O6-MedG), a marker of exposure to many N-nitroso compounds (NOC), can be detected in normal and tumour DNA isolated from colorectal tissue. The biological significance of this exposure is, as yet, unknown but in situ NOC formation is bacterially catalysed suggesting that NOC formation and potentially DNA alkylation will vary throughout the large bowel.?AIMS—To determine if O6-MedG levels in colorectal DNA vary within the l...

Povey, A.; Hall, C.; Badawi, A.; Cooper, D.; O Connor, P.

2000-01-01

103

Recolonization and colonization resistance of the large bowel after three methods of preoperative preparation of the gastrointestinal tract for elective colorectal surgery.  

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The impact of three current types of preoperative large bowel preparation on the microbial flora and the colonization resistance (CR) was investigated in 15 volunteers. In the first group a whole gut irrigation was performed without administration of antibiotics (group WGI). In the second group 0.5 g/l metronidazole and 1 g/l neomycin was added to the irrigation fluid (group WGI + AB). A whole gut irrigation with prior oral administration of 1 l mannitol 10% was performed in the third group. ...

Den Bogaard, A. E.; Weidema, W. F.; Boven, C. P.; Waay, D.

1986-01-01

104

Bowel incontinence  

Science.gov (United States)

... bowel incontinence due to diarrhea, medications such as loperamide (Imodium) may be used to control the diarrhea ... or codeine) or diphenoxylate (lomotil), as well as loperamide (Imodium) increase intestinal tone and decrease movement of ...

105

Relato de caso: metástase de carcinoma de mama para o intestino grosso / Case report: metastasis from breast cancer to the large bowel  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O envolvimento metastático do trato gastrointestinal é relativamente infreqüente. Tumores malignos de mama, entretanto, podem muito raramente produzir metástases para o intestino. Relatamos aqui o caso de uma paciente com quadro clínico compatível com o de um abdômen agudo obstrutivo submetida a lap [...] arotomia exploradora com colectomia. O exame anátomo-patológico da peça cirúrgica revelou tratar-se de um carcinoma metastático, sendo que a história clínica da paciente indicava o tratamento cirúrgico prévio de um carcinoma lobular de mama. Nossa revisão da literatura demonstrou que o carcinoma lobular, dentre as neoplasias malignas da mama, é o que mais freqüentemente leva ao comprometimento metastático do intestino, sendo o estômago o local mais afetado. Como a disseminação sistêmica é comum nestes casos, o tratamento conservador, quando possível, é o mais indicado, sendo a cirurgia reservada para as complicações. Abstract in english Gastrointestinal manifestations of breast cancer are not commom. We report a case of a female patient who was submitted to a laparotomy with clinical and radiological signs of large bowell obstruction. Her clinical hitory showed that she was treated for breast cancer several years before. Pathology [...] indicated that a metastatic carcinoma within the bowell wall was the cause of the obstruction. Previous reports described the lobular carcinoma of the breast as the most commom type of breast cancer to produce bowell metastases. The stomach is described as the most frequent site of this metastatic dissemination. Since sistemic disease is common within these patients, surgical ressection is indicated only in the presence of complications like obstruction or bleeding.

Lúcio Sarubbi, Fillmann; Cláudia Müller, Pinho; Henrique Sarubbi, Fillmann; Érico Ernesto Pretzel, Fillmann.

106

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

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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

107

Fibrolipoma of buccal mucosa.  

Science.gov (United States)

The lipoma is a very common benign tumor of adipose tissue, but its presence in the oral and oropharyngeal region is relatively uncommon. Fibrolipoma, a histological variant of lipoma, mostly affect the buccal mucosa and causes functional and cosmetic disabilities. Hence, accurate histopathological examination of lipomas is important for a correct treatment plan. This article describes a case of 10 year old girl with fibrolipoma of the buccal mucosa with a relevant review of tumors. PMID:22629049

Khubchandani, Monika; Thosar, Nilima R; Bahadure, Rakesh N; Baliga, M S; Gaikwad, Rahul N

2012-04-01

108

Fibrolipoma of buccal mucosa  

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The lipoma is a very common benign tumor of adipose tissue, but its presence in the oral and oropharyngeal region is relatively uncommon. Fibrolipoma, a histological variant of lipoma, mostly affect the buccal mucosa and causes functional and cosmetic disabilities. Hence, accurate histopathological examination of lipomas is important for a correct treatment plan. This article describes a case of 10 year old girl with fibrolipoma of the buccal mucosa with a relevant review of tumors.

Khubchandani, Monika; Thosar, Nilima R.; Bahadure, Rakesh N.; Baliga, M. S.; Gaikwad, Rahul N.

2012-01-01

109

Irritable Bowel Syndrome  

Medline Plus

Full Text Available Irritable Bowel Syndrome Introduction Irritable bowel syndrome, or IBS, is a very common intestinal disorder. About 15% of all American adults have symptoms of IBS. Irritable bowel ...

110

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

111

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

112

The use of autologous buccal mucosa grafts in vaginal reconstruction.  

Science.gov (United States)

Vaginal reconstruction can be challenging when there is a paucity of tissue, as the ideal donor source has yet to be determined. Many of the existing and commonly used techniques, such as vaginal replacement with skin grafts or bowel segments, have both advantages and disadvantages. A novel technique for vaginal replacement and reconstruction is with autologous buccal mucosa, an epithelium which is an excellent tissue match to the vagina. As urologists often have extensive experience with the use of oral mucosa for urethral reconstruction, it is fitting to apply these techniques to procedures where native vaginal tissue is lacking. This review presents the existing literature as well as the author's own experience with the use of autologous buccal mucosa for a variety of vaginal reconstructive procedures. PMID:24948036

Grimsby, Gwen M; Baker, Linda A

2014-08-01

113

[Use of bowel segments for ureter reconstruction].  

Science.gov (United States)

When ureter damage is extensive or affects the midureter continuity can be restored using bowel segments. The principle issues of these techniques comprise reconstruction of the urinary tract preserving renal function in a long-term setting. The safety of ureters reconstructed from bowel segments has been validated in several large series as a reliable last resort solution with favorable results and low complication rates. Ureter reconstruction with bowel segments is doomed to fail in patients with short-bowel syndrome or Crohn's disease. Furthermore, the applicability in children and patients with progressive renal deficiency is severely limited. To prevent renal deterioration the use of retubularized bowel segments as a substitute for ureter defects has been postulated. Whereas antirefluxive implantation seems unnecessary in patients with a native bladder in situ or orthotopic bladder substitution, it is recommended in continent bowel reservoirs with cutaneous stoma. PMID:22772491

Kocot, A; Vergho, D C; Riedmiller, H

2012-07-01

114

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

Directory of Open Access Journals (Sweden)

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

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

2007-03-01

115

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

116

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

117

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

118

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

Energy Technology Data Exchange (ETDEWEB)

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.

Sfakianakis, G.N.; Haase, G.M.

1982-01-01

119

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

1982-01-01

120

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.

Santos Jr., Júlio César M.

 
 
 
 
121

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, ...

122

Irritable bowel syndrome - aftercare  

Science.gov (United States)

Irritable bowel syndrome (IBS) may be a lifelong condition. You may be suffering from cramping and loose stools, ... follow your doctor’s instructions when using medicines for irritable bowel syndrome. You should not take a different amount ...

123

Phase-inversion tissue harmonic imaging compared to fundamental B-mode ultrasound in the evaluation of the pathology of large and small bowel.  

Science.gov (United States)

Our purpose was to compare phase-inversion harmonic imaging (PIHI) with conventional B-mode ultrasound (US) regarding image quality in the evaluation of bowel pathology. Forty-one patients prospectively underwent intestinal ultrasound scans with US and PIHI in randomly chosen order. Crucial technical parameters were standardized. Bowel morphology as well as perienteric pathology and complications were documented. In 24 cases, the ultrasound results were compared to those of other imaging modalities. Three radiologists evaluated (1) overall image quality, (2) lesion conspicuity and diagnostic confidence, and (3) detection of free fluid on hardcopy films. The ratings for image quality were compared using the two-sample paired t test for means and Bowker's test for symmetry (p=0.05). Compared to US, PIHI provided significantly better overall image quality, lesion conspicuity and diagnostic confidence, as well as better detection of free fluid (p< 0.05). Bowel wall pathology, detected by both modalities, showed good correlation to additional imaging modalities. In 12 patients (29.3%), a gain of crucial diagnostic information was observed with PIHI when compared to US. PIHI significantly enhances sonography of the intestine by offering better overall image quality, better visualization of bowel pathology and associated changes. Additionally, PIHI adds crucial diagnostic information in several patients. PMID:15818478

Schmidt, T; Hohl, C; Haage, P; Honnef, D; Mahnken, A H; Krombach, G; Piroth, W; Günther, R W

2005-09-01

124

Canalicular adenoma of buccal mucosa.  

Science.gov (United States)

Canalicular adenoma is a benign tumor which comprises 1% of salivary gland neoplasms and 4% of minor salivary gland tumors. It occurs in the upper lip mucosa in about 90% of cases. The next most common location is the buccal mucosa (9.5% of tumors). We present herein a new case of canalicular adenoma of buccal mucosa involving a 74-year-old man. He was suffering of a slowly growing and painless nodule of the right buccal mucosa. The treatment was surgery and histological findings were consistent with the diagnosis of canalicular adenoma. No recurrence was noted one year later. PMID:17987725

Maamouri, F; Bellil, K; Bellil, S; Chelly, I; Mekni, A; Kchir, N; Haouet, S; Zitouna, M

2007-06-01

125

Heat Shock Proteins in Inflammatory Bowel Disease  

Directory of Open Access Journals (Sweden)

Full Text Available Stress or heatshock proteins (HSPs belong to five families of highly conserved intracellular proteins functioning as constitutive chaperones maintaining protein trafficking, structural integrity and repair. Their synthesis is induced by numerous stimuli ranging from environmental stress to inflammation regardless of etiology or malignancy. In normal mucosa HSP27 and HSP70 an normally expressed in the surface epithelium of the colon, an area continually subjected to inducible signals from the enteric flora and short chain fatty acids, rendering the epithelium resistant to bacterial toxins and inflammation associated stress. In inflammatory bowel disease (IBD the heatshock proteins may play in important role as there is accumulating evidence that they suppress proinflammatory genes relevant to its pathogenesis. The mechanisms of suppression or induction of HSPS in inflamed gut mucosa need further research with the ultimate purpose that these molecules could be a target for therapeutic interventions.

C. Barbatis

2009-10-01

126

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

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

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

2010-01-01

127

Increased group II phospholipase A2 in colonic mucosa of patients with Crohn's disease and ulcerative colitis.  

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The immunochemical protein content of group II phospholipase A2 (PLA2) and PLA2 enzymatic activity were measured for colonic mucosal biopsy samples obtained from patients with either Crohn's disease of the colon or ulcerative colitis, and control patients without inflammatory bowel disease. Immunoreactive group II PLA2 (IR-PLA2 II) content and PLA2 activity in actively inflamed colonic mucosa of Crohn's disease patients were significantly higher than those in inactively inflamed mucosa of Cro...

Minami, T.; Tojo, H.; Shinomura, Y.; Matsuzawa, Y.; Okamoto, M.

1994-01-01

128

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

129

Buccal Mucosa Ureteroplasty for the Treatment of Complex Ureteric Injury  

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Bowel interposition and auto-transplantation of kidney, thought to be a major undertaking, remain the traditional option for the treatment of major and complex ureteric lesions. Buccal mucosa, a well known tissue for urethral reconstruction, can be used safely for the repair of ureter. However, this has been reported poorly in the literature. Here we report a 59- year-old female who had a major ureteric injury by Dormia basket during ureteroscopic extraction of a 2.6 cm impacted stone at pelv...

2011-01-01

130

Bowel preparation prior to colonoscopy: A continual search for excellence  

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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 ...

2013-01-01

131

Small Bowel Transglutaminase 2-specific IgA Deposits in Dermatitis Herpetiformis.  

Science.gov (United States)

Dermatitis herpetiformis (DH) is an extraintestinal manifestation of coeliac disease. Untreated coeliac disease patients are known to have transglutaminase 2 (TG2)-targeted IgA deposits in the small bowel mucosa. To evaluate whether similar intestinal IgA deposits are also present in DH and whether the deposits disappear with gluten-free diet, 47 untreated and 27 treated DH patients were studied. Seventy-nine percent of untreated and 41% of the treated DH patients had TG2-specific IgA deposits in the small bowel, and the presence of the deposits showed a significant association with the degree of small bowel villous atrophy (p?DH patients. The results show that the majority of untreated DH patients have similar gluten-dependent TG2-specific IgA deposits the small bowel mucosa as coeliac disease patients. PMID:24352382

Salmi, Teea T; Hervonen, Kaisa; Laurila, Kaija; Collin, Pekka; Mäki, Markku; Koskinen, Outi; Huhtala, Heini; Kaukinen, Katri; Reunala, Timo

2014-06-24

132

Chronic inflammatory bowel disease in childhood.  

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The diagnosis of Crohn's disease in childhood has been facilitated by the use of fibreoptic endoscopy with biopsies, complemented by double-contrast radiology. Clinical suspicion leads initially to several relevant blood tests. These are followed by endoscopy and multiple colonic biopsies or barium follow-through studies depending on whether large-bowel or small-bowel disease is suspected. The present approach to diagnosis is based on corroborative investigative techniques-endoscopy, radiolog...

Chong, S. K.; Bartram, C.; Campbell, C. A.; Williams, C. B.; Blackshaw, A. J.; Walker-smith, J. A.

1982-01-01

133

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

134

Host-microbiota interactions in inflammatory bowel disease  

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

2012-01-01

135

Changes of the cytokine profile in inflammatory bowel diseases  

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Cytokines are indispensable signals of the mucosa-associated immune system for maintaining normal gut homeostasis. An imbalance of their profile in favour of inflammation initiation may lead to disease states, such as that is observed in inflammatory bowel diseases (IBD). Although Crohn’s disease (CD) is often described as a prototype of T-helper 1-type diseases, and ulcerative colitis (UC) is traditionally viewed as a T-helper 2-mediated condition, the classic paradigm, which categori...

2012-01-01

136

The Emerging Therapeutic Role of Probiotics in Inflammatory Bowel Disease  

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Nonpathogenic bacteria in a genetically susceptible individual play a suggestive role in the pathogenesis of inflammatory bowel disease (IBD). Probiotics are living organisms that exert a protective effect on intestinal mucosa. Although evidence supporting their use for inducing or maintaining remission of IBD remains limited, it may be reasonable to use probiotics as an adjunct to standard therapy for mild-to-moderate disease. Genetically modified probiotics may provide novel delivery method...

Chandler, Matthew; Wollins, Eric; Toles, Anastasia; Borum, Marie; Doman, David B.

2008-01-01

137

CT findings of bowel injury following blunt abdominal trauma  

Energy Technology Data Exchange (ETDEWEB)

To determine the diagnostic value of CT, the author retrospectively reviewed preoperative CT findings of 57 cases with surgically proven bowel injury following blunt trauma. The small bowel injuries were divided into two groups, i.e., those without mesenteric injury, group A, and those with mesenteric injury, group B. The incidence of CT findings including extraluminal air, bowel wall thickening, peritoneal fluid, mesenteric thickening, and high density hematoma, were determined. CT findings were also assessed by time intervals between injury and examination. CT scans of small bowel injury were compared with those of surgically proven 25 cases of mesenteric injury without bowel injury, group C. CT showed findings suggestive of bowel injury in 96.4% of the cases. There were 5 false negative CT scans, which consisted of 4 small bowel and one large bowel injuries, all performed within 2 hours from injury. The patients in group A small bowel injury had a higher incidence of pneumoperitoneum on CT scans performed over 4 hours after injury than on those performed within 4 hours. Bowel wall thickening was more frequent in group A than in group B or C. Peritoneal fluid collection within 4 hours from injury was less frequent in group A than in group B or C. High density hematoma was more frequent in group B and C than in group A. The analysis suggested that early diagnosis of isolated small bowel injury was difficult because of lack of signs indicating mesenteric injury. In these cases bowel wall thickening appeared earlier, then peritoneal fluid developed, with and without mesenteric thickening or extraluminal air. Thus in those with suspicion of bowel injury, bowel wall thickening on initial CT should be carefully followed up in regard to additional or progressive findings. Operative indication can be determined with careful clinical correlation before detection of extraluminal air. (K.H.)

Machida, Yukino [St. Marianna Univ. School of Medicine, Kawasaki, Kanagawa (Japan)

1997-10-01

138

Avaliação e seguimento de pacientes adultos com síndrome do intestino curto pelo exame contrastado de trânsito intestinal / Barium follow through in the assessment and follow-up of adult patients with short bowel syndrome  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A síndrome do intestino curto é definida pela incapacidade da superfície do intestino delgado em manter as condições adequadas de absorção de nutrientes, ocasionando deficiências nutricionais. Em adultos, as principais causas de síndrome do intestino curto são as ressecções cirúrgicas amplas ou múlt [...] iplas, secundárias a infarto mesentérico, doença de Crohn e enterite actínica. Além de avaliar o tempo de trânsito até o intestino grosso, o exame contrastado de trânsito intestinal pode ser utilizado na medição da extensão do intestino remanescente e no acompanhamento dos fenômenos de adaptação estrutural das alças delgadas e colônicas. Em pacientes com síndrome do intestino curto, a adaptação estrutural do intestino delgado consiste na hiperplasia das vilosidades e das pregas mucosas, que se tornam mais numerosas, profundas e de maior diâmetro, assim como a dilatação do segmento remanescente. Esses achados morfológicos são mais pronunciados e bem estabelecidos nas alças ileais, evidenciando sua maior capacidade adaptativa. O conhecimento dos achados por imagem das características morfológicas e adaptativas do intestino delgado é de grande importância na abordagem multidisciplinar da síndrome do intestino curto. Abstract in english Short bowel syndrome is defined as the small bowel functional absorptive surface inability to provide adequate nutrition, leading to intestinal failure and chronic malnutrition. In adult individuals the main etiologies for short bowel syndrome are related to extensive or multiple surgical bowel rese [...] ctions secondary to mesenteric ischemia, Crohn's disease and actinic enteritis. Besides evaluating the transit time through the large bowel, barium follow through may be utilized in the measurement of bowel remnants length as well as in the follow-up of structural adaptation phenomena of small bowel and colonic loops. In patients with short bowel syndrome, structural small bowel adaptation consists in hyperplasia of villi and mucosal folds, which become more numerous, deeper and larger in diameter, as well as remnant segment dilation. Such morphological findings are more prominent and best established in the ileal loops, whose remarkable adaptive capacity has been well documented. Therefore, the knowledge of imaging findings regarding morphological and adaptive characteristics of the small bowel is extremely relevant in the multidisciplinary approach to short bowel syndrome.

Francisco Abaeté das, Chagas Neto; André Rodrigues Façanha, Barreto; Valdair Francisco, Muglia; Jorge, Elias Junior; Ângela Delete, Bellucci; Júlio Sérgio, Marchini; Selma Freire de Carvalho da, Cunha.

139

Povidone-iodine bowel irrigation before resection of colorectal carcinoma.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

140

Irritable bowel syndrome.  

Science.gov (United States)

Irritable bowel syndrome (IBS) is a disease of unclear, complex pathophysiology characterised by abdominal pain and discomfort and altered bowel activity. It affects an estimated 10-15% of individuals worldwide and has a large impact on quality of life (QOL) and both direct and indirect healthcare costs. Symptoms of IBS are usually triggered by disruption of gastrointestinal (GI) function secondary to infection, dietary factors, lifestyle changes or psychological stress. While most currently available pharmacological treatments of IBS focus on symptomatic treatment of the syndrome, agents that attempt to address the pathophysiology of the disease, in particular the role of serotonin, have received much attention in recent years. However, there is growing concern that serotonergic agents as a class may be associated with rare, but serious, episodes of ischaemic colitis, with several cases of this complication having been reported in association with use of serotonergic agents that have reached the market. Thus, there remains an important need for safe and effective agents that treat the symptoms of IBS. Otilonium bromide, a spasmolytic agent, has been widely used worldwide and has been found to be effective and safe for managing abdominal pain. Clinical trials indicate that it improves baseline abdominal pain and distension, and is particularly effective in reducing diarrhoea. Combining otilonium bromide with benzodiazepines, such as diazepam, may improve the efficacy of the agent with respect to GI symptoms, while also treating underlying anxiety disorders. More research is required to confirm the efficacy and mechanisms of action associated with this combination therapy in IBS. Safety data from clinical trials and postmarketing sources indicate that otilonium bromide is well tolerated, with a safety profile comparable to placebo in clinical trials and only two reported cases of adverse reactions (urticaria) among 10-year postmarketing data. This article reviews the pathophysiology and treatment of IBS with a particular focus on the role of otilonium bromide in the management of this condition. PMID:17177577

Spinelli, Antonella

2007-01-01

 
 
 
 
141

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

142

Oral manifestations of patients with inflammatory bowel disease  

Directory of Open Access Journals (Sweden)

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

Flora Zervou

2007-03-01

143

Type 1 Diabetes Is Associated With Enterovirus Infection in Gut Mucosa  

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Enterovirus infections have been linked to type 1 diabetes in several studies. Enteroviruses also have tropism to pancreatic islets and can cause beta-cell damage in experimental models. Viral persistence has been suspected to be an important pathogenetic factor. This study evaluates whether gut mucosa is a reservoir for enterovirus persistence in type 1 diabetic patients. Small-bowel mucosal biopsy samples from 39 type 1 diabetic patients, 41 control subjects, and 40 celiac disease patients ...

2012-01-01

144

Inflammatory bowel disease  

International Nuclear Information System (INIS)

Radiology is of considerable value in all forms of inflammatory bowel disease to establish its presence and extent, and to differtiate lesions. The commenest inflammatory bowel diseases are Crohn's disease and ulcerative colitis. Crohn's disease may occur anywhere in the disgestive tract, but is most common in the terminal ileum. Since there is no practical endoscopic method of examining the small bowel, barium studies of the latter are most important. Modern radiological techniques, especially the doublecontrast barium enema, show excellent correlation between the macroscopic changes and the radiological features. Radiology alone does not provide the answers and the radiological features must be interpreted in conjunction with clinical investigation

1985-01-01

145

Gastroesophageal heterotopia and HER2/neu overexpression in an adenocarcinoma arising from a small bowel duplication.  

Science.gov (United States)

Small bowel duplications are congenital structures commonly lined by heterotopic gastric or pancreatic mucosa. Though benign in children, small bowel duplications have the potential for malignant degeneration in adulthood. Here, we present the first reported case of metastatic adenocarcinoma arising from a small bowel duplication lined by gastroesophageal mucosa. The cancer demonstrated overexpression of the HER2/neu oncoprotein and amplification of the HER2/neu gene. This represents the only report of HER2 overexpression in this type of lesion. The patient is being treated with traditional chemotherapeutic agents in addition to monoclonal antibody therapy directed at the HER2 protein, and has demonstrated a clinical benefit from treatment. This case demonstrates that the anatomic location of a mass may be distinct from its biological origin, and this difference may have important practical implications for diagnostic testing and treatment. PMID:24576036

Nussbaum, Daniel P; Bhattacharya, Syamal D; Jiang, Xiaoyin; Cardona, Diana M; Strickler, John H; Blazer, Dan G

2014-03-01

146

Irritable Bowel Syndrome  

Science.gov (United States)

... flag” symptoms such as: Rectal bleeding Weight loss Anemia (iron deficiency) Nighttime symptoms, like diarrhea that awakens you Family history of colorectal cancer , inflammatory bowel disease , or celiac disease Medical tests include ...

147

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 ...

148

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 ...

149

Irritable Bowel Syndrome  

Medline Plus

Full Text Available ... with irritable bowel syndrome are NOT at an increased risk of developing cancer. Patients who have IBS are also not at an increased risk of developing psychological or psychiatric problems. CT Scan ...

150

Urinary retention presenting as complete bowel obstruction.  

Science.gov (United States)

A 59-year-old male was admitted to hospital for clinical and radiological signs of large bowel obstruction with clinical signs of generalized peritonitis. As such, he was scheduled to undergo emergency exploratory laparotomy. During preoperative preparation, over 2000 mL of urine was obtained after catheterization. We suggested re-evaluation, and after several hours the symptoms resolved. Although rare, pressure from the distended bladder due to urinary retention can cause complete bowel obstruction and signs of peritonitis. If a large volume of urine is obtained during preoperative preparation for mechanical bowel obstruction, it is recommended to re-evaluate the patient to avoid unnecessary surgery and imaging studies. PMID:24409213

Papeš, Dino; Altarac, Silvio; Arslani, Nuhi; Rajkovi?, Zoran

2013-01-01

151

Surgical treatment of inflammatory bowel disease.  

Science.gov (United States)

Appropriate surgical management of Crohn disease is predicated on multiple variables, but stricturoplasty is generally reserved for small bowel disease, whereas resection is utilized in ileocolonic inflammation and favored for large bowel disease. Laparoscopic resection is becoming increasingly useful and justified for ileocolic resections, and segmental resection should be strongly considered for limited large bowel inflammation. Some centers are also using a laparoscopic approach for the surgical treatment of acute or chronic ulcerative colitis, although the benefits are less apparent. Proctocolectomy with ileostomy or ileal pouch-anal anastomosis returns the patient's quality of life to a level comparable to that enjoyed by the general population. Creation of a pouch is performed in most instances, but early complications may warrant pouch revision and later complications, such as pouchitis, can mandate pouch excision. PMID:17033319

Strong, Scott A

2002-07-01

152

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

153

Irritable bowel syndrome.  

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1. Irritable bowel syndrome is a functional disorder of the lower intestinal tract affecting approximately 10% of the population and causing a wide range of symptoms. 2. Most cases of irritable bowel syndrome can be diagnosed in general practice on the basis of the presenting history and clinical examination but some patients may need to be referred to a gastro-enterologist for further assessment including sigmoidoscopy and barium enema. 3. The clinical picture may include symptoms of abdomin...

1992-01-01

154

An experimental animal model of granulomatous bowel disease.  

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A study has been undertaken of the granulomatous response induced in the ascending colon and terminal ileum of the guinea pig by the direct inoculation of mycobacterial antigens. Live BCG (Pasteur) 2 x 10(7) at two weeks induced epithelioid cell granulomas in both large and small bowel and in the draining lymph nodes. The area of infiltration was significantly greater for a given inoculum in the large bowel. Acid fast bacilli were present on Ziehl Neelson stained sections of the large bowel i...

Mitchell, I. C.; Turk, J. L.

1989-01-01

155

Noninvasive videomicroscopic monitoring of rat small-bowel rejection.  

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Successful small-bowel transplantation requires an early diagnosis of graft rejection. To date, little is known about macroscopic mucosal alterations during rejection. In the present study, these changes were analyzed in detail. Videomicroscopic monitoring of an enterostoma was performed after allogeneic heterotopic small-bowel transplantation in the rat (BN to LEW). Up to postoperative day (POD) 3 a mucosal edema was noticed (stage I of videomicroscopical alterations). The earliest changes related to rejection appeared on POD 6. The mucosa of the grafted intestine developed patchy paleness and interruptions in mucosal architecture. Crypts were slightly widened and their color turned to dark red (stage IIa). Progressively, these alterations spread over the mucosa on POD 7 (stage IIb). On POD 9, the mucosa appeared pale, villi were shortened, and crypts appeared wide and rounded. The mucosal surface was coated with fibrinous membranes (stage III). The videomicroscopic findings were closely related to the histological grading of rejection. We regard this technique of mucosal monitoring a simple and noninvasive method of detecting allograft rejection. PMID:10188832

Hoppe, H; Gasser, M; Gassel, A M; Vowinkel, T; Timmermann, W; Otto, C; Tykal, K; Thiede, A

1999-01-01

156

Evolving diagnostic strategies for inflammatory bowel disease.  

Science.gov (United States)

Advances in serologic markers, endoscopy, and radiology have led to rapid expansion of diagnosis and disease activity assessment of inflammatory bowel disease (IBD). Serologic markers may have diagnostic value in patients with an intermediate pretest probability of IBD, but these serology tests lack complete sensitivity, and a negative serology result does not exclude the possibility of IBD. Several recent studies have confirmed the utility of serologies in predicting intestinal complications and need for surgery in Crohn's disease. Serum C-reactive protein concentrations correlate with clinical, endoscopic, and radiologic measures of disease activity and appear to have prognostic value in acute severe colitis. Capsule and double balloon endoscopy allow visual inspection of previously inaccessible areas of the small intestine and are useful for patients with suspected small bowel involvement but negative results on conventional testing. CT enterography, which entails oral ingestion of a large volume of a neutral or negative contrast agent and scanning that highlights differences in contrast between the lumen and the bowel wall, appears to be more sensitive than small bowel follow-through for detecting small bowel Crohn's disease and provides extraluminal information. Magnetic resonance enterography uses principles similar to those for CT enterography, and early results are encouraging. PMID:17105687

Bruining, David H; Loftus, Edward V

2006-12-01

157

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

1994-11-01

158

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

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Abstract Background Gene transfer to the gastrointestinal (GI) mucosa is a therapeutic strategy which could prove particularly advantageous for treatment of various hereditary and acquired intestinal disorders, including inflammatory bowel disease (IBD), GI infections, and cancer. Methods We evaluated vesicular stomatitis virus glycoprotein envelope (VSV-G)-pseudotyped lentiviral vectors (LV) for efficacy of gene transfer to both murine rectosigmoid colon in...

2010-01-01

159

An experimental animal model of granulomatous bowel disease.  

Science.gov (United States)

A study has been undertaken of the granulomatous response induced in the ascending colon and terminal ileum of the guinea pig by the direct inoculation of mycobacterial antigens. Live BCG (Pasteur) 2 x 10(7) at two weeks induced epithelioid cell granulomas in both large and small bowel and in the draining lymph nodes. The area of infiltration was significantly greater for a given inoculum in the large bowel. Acid fast bacilli were present on Ziehl Neelson stained sections of the large bowel infiltrate, but only rarely in sections from the small bowel lesions. The response to skin testing with a standardised amount of purified protein derivative was less in animals inoculated in the small bowel. Inoculation with 2 x 10(9) cobalt irradiated BCG gave rise, at five weeks, to granulomas containing lesser numbers of epithelioid cells and caseation was sometimes evident. There was a similar but smaller difference in the degree of infiltration at the two inoculation sites. Ziehl Neelson staining failed to reveal the presence of acid fast bacilli in any sections of the bowel infiltrates. Skin testing with purified protein derivative gave a response which was greater in animals inoculated in the small bowel. An identical dose of Cobalt irradiated M leprae induced at five weeks a predominantly macrophage granuloma in both the large and small bowel, with no significant difference in the degree of infiltration at the two sites. No acid fast bacilli were seen in Ziehl Neelson stained sections of the bowel and skin testing with purified protein derivative was reduced. These findings and their relevance to studies of the aetiology of Crohn's disease are discussed. PMID:2684805

Mitchell, I C; Turk, J L

1989-10-01

160

Recent advances of endoscopy in inflammatory bowel diseases.  

Science.gov (United States)

Endoscopy plays a key role in the diagnosis and treatment in inflammatory bowel disease (IBD). The most valuable tool for distinguishing different types of IBD is a complete ileocolonoscopy with mucosal biopsy. Endoscopic localization of the disease not only aids in determining prognosis and appropriateness of medical therapies but also aids decision-making in those undergoing surgical therapy. With regard to therapeutic applications, obstructive symptoms caused by benign fibrotic strictures can be treated adequately by endoscopic balloon dilation. Epidemiological studies have demonstrated an increased risk of colorectal cancer in patients with both ulcerative colitis and colonic Crohn's disease (CD). Colonoscopy is currently considered to be the gold standard for cancer surveillance. Published guidelines recommend that two to four biopsy samples should be obtained every 10 cm in the colorectum, necessitating 20-50 samplings per examination. This may result in standard colonoscopy - which is also very time-consuming and laborious - missing significant numbers of small lesions. Various novel techniques have been applied to reduce the required number of biopsy samples and the duration of examinations, including chromoendoscopy with or without magnification, fluorescence endoscopy, narrow-band imaging, optical coherence tomography, and confocal laser endomicroscopy. Until recently the only way to evaluate the small-bowel mucosa in a patient with CD was by barium small-bowel radiographs and intubation of the distal terminal ileum. Both wireless-capsule endoscopy (WCE) and double-balloon enteroscopy (DBE) allow light to be used in the inspection of the small bowel and may replace radiological methods. WCE is more convenient than DBE for probing small-bowel mucosal changes, but only DBE allows a biopsy sample to be obtained from the deep small bowel, and these two examinations can be considered complementary. The wider application of new techniques in the near future might increase the role played by endoscopy in the management of IBD. PMID:20485627

Cheon, Jae Hee; Kim, Won Ho

2007-12-01

 
 
 
 
161

Inflammatory Bowel Disease  

Science.gov (United States)

... the body other than the digestive tract? Yes. Inflammatory bowel disease (IBD) can cause a number of problems outside of the digestive tract. One common problem that occurs because of loss of blood from the digestive tract is anemia (uh-NEE-mee-uh). Anemia means that the ...

162

Enhancing the quality of colonoscopy through split-dose bowel preparation.  

Science.gov (United States)

Colonoscopy is a primary method for colorectal cancer screening, yet its efficacy as a screening tool is largely dependent on the quality of bowel preparation. An estimated 25% of patients undergoing colonoscopy have poor bowel preparations at the time of their procedure. There is empirical evidence to support that split-dose bowel preparations yield better bowel cleansing than day-prior bowel preparation regimens. The aim of this quality improvement project was to enhance the quality of colonoscopy at a large urban academic center through the use of split-dose bowel preparation. A total of 74 patients participated, with about half undergoing the current practice of day-prior bowel preparation and half undergoing the intervention of split-dose bowel preparation. Several procedural and patient outcome measures were collected and used for comparison to determine which bowel preparation was optimal for use in the practice setting. The findings revealed that split-dose bowel preparation resulted in better bowel cleansing, reduced recall intervals for the time to the next recommended colonoscopy, and improved patient tolerance, supporting its use in the practice setting to enhance the quality of colonoscopy. PMID:24691085

Riegert, Monica; Nandwani, Monica

2014-01-01

163

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.

Bechtold, Matthew L; Choudhary, Abhishek

2013-01-01

164

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

165

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

166

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

167

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

1988-01-01

168

Inflammatory pathways of importance for management of inflammatory bowel disease.  

Science.gov (United States)

Inflammatory bowel disease (IBD) is a group of chronic disorders of the gastrointestinal tract comprising Crohn's disease (CD) and ulcerative colitis (UC). Their etiologies are unknown, but they are characterised by an imbalanced production of pro-inflammatory mediators, e.g., tumor necrosis factor (TNF)-?, as well as increased recruitment of leukocytes to the site of inflammation. Advantages in understanding the role of the inflammatory pathways in IBD and an inadequate response to conventional therapy in a large portion of patients, has over the last two decades lead to new therapies which includes the TNF inhibitors (TNFi), designed to target and neutralise the effect of TNF-?. TNFi have shown to be efficient in treating moderate to severe CD and UC. However, convenient alternative therapeutics targeting other immune pathways are needed for patients with IBD refractory to conventional therapy including TNFi. Indeed, several therapeutics are currently under development, and have shown success in clinical trials. These include antibodies targeting and neutralising interleukin-12/23, small pharmacologic Janus kinase inhibitors designed to block intracellular signaling of several pro-inflammatory cytokines, antibodies targeting integrins, and small anti-adhesion molecules that block adhesion between leukocytes and the intestinal vascular endothelium, reducing their infiltration into the inflamed mucosa. In this review we have elucidated the major signaling pathways of clinical importance for IBD therapy and highlighted the new promising therapies available. As stated in this paper several new treatment options are under development for the treatment of CD and UC, however, no drug fits all patients. Hence, optimisations of treatment regimens are warranted for the benefit of the patients either through biomarker establishment or other rationales to maximise the effect of the broad range of mode-of-actions of the present and future drugs in IBD. PMID:24415859

Pedersen, Jannie; Coskun, Mehmet; Soendergaard, Christoffer; Salem, Mohammad; Nielsen, Ole Haagen

2014-01-01

169

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

170

Irritable Bowel Syndrome subtypes: constipation, diarrhea…and mixed bowel pattern: Tertium datur.  

Science.gov (United States)

The study by Su et al. published in this issue of NGM provides helpful insight into a relatively large, yet understudied, subgroup of IBS known as IBS with mixed bowel pattern (IBS-M). These investigators found among their 289 IBS subjects who underwent detailed assessment the IBS-M subtype to be particularly common. Interestingly, prior use of laxatives or antidiarrheal agents was found to potentially explain the mixed bowel pattern in approximately 30% of patients. These IBS-M patients tended to report more severe IBS symptoms. IBS-M patients had bowel symptoms more similar to IBS-D than IBS-C, particularly with regard to the rectal urgency. Hopefully many more studies will be forthcoming to further our understanding of IBS-M. PMID:24329945

Cremonini, F; Lembo, A

2014-01-01

171

Immune activation in the intestinal mucosa before the onset of colitis in Galphai2-deficient mice.  

Science.gov (United States)

G-protein subunit Galphai2-deficient mice spontaneously develop an inflammatory bowel disease that clinically and histopathologically resembles ulcerative colitis in humans. The aim of this study was to determine whether immunological changes precede the development of colitis in Galphai2-deficient mice. Therefore, Galphai2-deficient mice with no clinical or histopathological signs of colitis were compared with Galphai2-deficient mice with established colitis and wild-type animals, concerning immunological parameters. Healthy Galphai2-deficient mice displayed an increased frequency of CD4+ T cells and a decreased frequency of CD19+ B lymphocytes in the intestinal mucosa compared with control mice. The CD4+ population was characterized by a memory phenotype, i.e. increased expression of CD44 and decreased expression of CD45RB and CD62L, as well as increased expression of the mucosal homing receptors integrins alpha4beta7 and alphaEbeta7. Production of pro-inflammatory cytokines, interleukin (IL)-1beta and interferon (IFN)-gamma, were increased in Galphai2-deficient mice before clinical signs of disease were evident. In addition, total immunoglobulin (Ig)G and IgA levels in large intestinal secretions were increased significantly compared with wild-type mice, and antibodies specific for the normal intestinal flora in large intestinal secretions were present in Galphai2-deficient mice several weeks before the onset of colitis. In contrast, antibodies against tropomyosin, a putative autoantigen in human ulcerative colitis, were not found in Galphai2-deficient mice before the onset of colitis, although they were present in animals with established disease. In conclusion, activation of the intestinal immune system precedes histopathological and clinical signs of inflammation in Galphai2-deficient mice, suggesting that immune abnormalities play an important role in the induction of colitis. PMID:10886787

Ohman, L; Franzén, L; Rudolph, U; Harriman, G R; Hultgren Hörnquist, E

2000-07-01

172

Oral manifestations of patients with inflammatory bowel disease  

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Background: Crohn?s disease (CD) is considered to be a disease involving the whole gastrointestinal tract, while ulcerative colitis (UC) is a disease exclusively located in the large bowel. The aim of this study was to examine whether patients with either CD or UC are at increased risk for developing oral manifestations. Patients-Methods: A wide spectrum of oral lesions was carefully sought by the same oral dentist in a consecutive series of 30 patients with inflammatory bowel disease (I...

2007-01-01

173

Measurement of in vivo proliferation in human colorectal mucosa using bromodeoxyuridine.  

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In vivo bromodeoxyuridine (BrdUrd) labelling of the human large bowel was performed and a detailed histochemical localisation of label in sections of crypts was undertaken using a monoclonal antibody to BrdUrd containing DNA. Flow cytometric studies on extracted nuclei were also performed (data presented elsewhere). The average crypt in the human large bowel (excluding the rectum) was 82 cells in height and 41 cells in circumference, with a total of about 2000 cells (assuming a topographical ...

Potten, C. S.; Kellett, M.; Roberts, S. A.; Rew, D. A.; Wilson, G. D.

1992-01-01

174

Indwelling bowel management system as a cause of life-threatening rectal bleeding.  

Science.gov (United States)

A 79-year-old male was transferred to the intensive care unit for postoperative respiratory support. An indwelling bowel management system was inserted for containment of noninfective diarrhoea. Following only 11 days of continual use the patient developed life-threatening rectal bleeding. Preoperative normal rectal mucosa and anatomy were documented. There was no evidence of postoperative coagulopathy. Mesenteric angiography identified bleeding from a branch of the superior rectal artery. Rectal mucosa pressure necrosis secondary to the indwelling Flexi-Seal® Fecal Management System was diagnosed. The patient required an 11-unit transfusion of packed red cells. Following intraarterial coil embolization of the superior rectal artery the bleeding abated. Indwelling bowel management systems are commonly used in immobile and critically ill patients with diarrhoea or faecal incontinence. This is the first report of this important complication in the literature. PMID:21490868

Bright, Elizabeth; Fishwick, Guy; Berry, David; Thomas, Michael

2008-01-01

175

Small bowel mesentery fibroma  

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Fibromas are rarely localized in the abdomen, but almost always in the mesentery or omentum. We present a 63-year old woman in whom the examination of the upper abdominal pain showed a well distinct abdominal mass at the level of the lower edge of the pancreas. During the operation a tumor 100 ? 87 x 70 mm in size, from the radix of small bowel mesentery, was excised, Seven months later the patient is symptom-free with normal ultrasonographic and CT findings.

?olovi? Radoje B.; Micev Marjan; Zogovi? Sergej; Grubor Nikica M.; Stojkovi? Mirjana

2002-01-01

176

Bowel Preparation: Current Status  

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Despite emerging evidence from randomized controlled trials and meta-analyses questioning its use, mechanical bowel preparation (MBP) continues to hold an accepted place among surgeons. MBP has been administered to patients for over a century, and though the methods and agents used for intestinal cleansing have evolved over time, many surgeons still embrace MBP as a necessary, essential regimen. The accepted rationale for MBP includes evacuation of stool to allow visualization of the luminal ...

2009-01-01

177

Bowel disease after radiotherapy  

Energy Technology Data Exchange (ETDEWEB)

The clinical presentation, operative findings and outcome in 40 patients who required surgery for bowel disease after radiotherapy are presented. The type of presentation varied according to the time after radiotherapy. In the first month, many patients had a proctitis but none required surgery. Five patients were operated on within one month, 2 for radiation-induced acute ileitis and 3 for exacerbations of pre-existing disease (diverticular disease 2, ulcerative colitis 1). The commonest time of presentation was between 3 and 18 months after radiotherapy, when 20 patients needed surgery for bowel disease caused by radiation-induced local ischaemia. Twelve of these patients had chronic perforation, 6 had severe rectal bleeding and 2 had painful anorectal ulceration. Fifteen patients presented between 2 and 24 years after radiotherapy, usually with incomplete intestinal obstruction due to a fibrous stricture, but 2 patients had rectal carcinoma. Wide resection of the involved bowel was the principal method of treatment but any anastomosis was protected by a proximal defunctioning stoma. There was no operative mortality but 10 patients have died subsequently. The danger of dismissing these patients as having incurable malignancy is stressed because, although the condition is infrequent, it is usually amenable to adequate surgery.

Schofield, P.F.; Holden, D.; Carr, N.D. (Christie Hospital and Holt Radium Inst., Manchester (UK))

1983-06-01

178

Bowel disease after radiotherapy  

International Nuclear Information System (INIS)

The clinical presentation, operative findings and outcome in 40 patients who required surgery for bowel disease after radiotherapy are presented. The type of presentation varied according to the time after radiotherapy. In the first month, many patients had a proctitis but none required surgery. Five patients were operated on within one month, 2 for radiation-induced acute ileitis and 3 for exacerbations of pre-existing disease (diverticular disease 2, ulcerative colitis 1). The commonest time of presentation was between 3 and 18 months after radiotherapy, when 20 patients needed surgery for bowel disease caused by radiation-induced local ischaemia. Twelve of these patients had chronic perforation, 6 had severe rectal bleeding and 2 had painful anorectal ulceration. Fifteen patients presented between 2 and 24 years after radiotherapy, usually with incomplete intestinal obstruction due to a fibrous stricture, but 2 patients had rectal carcinoma. Wide resection of the involved bowel was the principal method of treatment but any anastomosis was protected by a proximal defunctioning stoma. There was no operative mortality but 10 patients have died subsequently. The danger of dismissing these patients as having incurable malignancy is stressed because, although the condition is infrequent, it is usually amenable to adequate surgery. (author)

1983-01-01

179

[A case of mucosa-associated lymphoid tissue lymphoma of the rectum].  

Science.gov (United States)

We report a case of mucosa-associated lymphoid tissue (MALT) lymphoma of the rectum in a 67-year-old woman who was admitted to our hospital owing to bowel abnormalities. Colonoscopic examination revealed a submucosal tumor (SMT) in the lower rectum. However, no malignancy was found on rectal mucosa biopsy. After providing informed consent, the patient underwent transanal surgery for the SMT. Rectal MALT lymphoma was diagnosed based on results of histological and immunohistochemical examinations. According to the Lugano International Conference classification system, the present case was classified as stage I MALT lymphoma. After the operation, Helicobacter pylori infection occurred, for which eradication therapy was performed, but no further complications or recurrence occurred. PMID:24394011

Tokunou, Kazuhisa; Yamamoto, Tatsuhito; Toshimitsu, Hiroaki; Kitamura, Yoshinori; Ando, Seiichirou

2013-11-01

180

Osteoporosis in Inflammatory Bowel Disease  

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Osteoporosis commonly afflicts patients with inflammatory bowel disease, and many factors link the 2 states together. A literature review was conducted about the pathophysiology of osteoporosis in relation to inflammatory bowel disease. Screening guidelines for osteoporosis in general as well as those directed at patients with inflammatory bowel disease are reviewed, as are currently available treatment options. The purpose of this article is to increase physician awareness about osteopenia a...

Ali, Tauseef; Lam, David; Bronze, Michael S.; Humphrey, Mary Beth

2009-01-01

 
 
 
 
181

Indwelling Bowel Management System as a Cause of Life-Threatening Rectal Bleeding  

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A 79-year-old male was transferred to the intensive care unit for postoperative respiratory support. An indwelling bowel management system was inserted for containment of noninfective diarrhoea. Following only 11 days of continual use the patient developed life-threatening rectal bleeding. Preoperative normal rectal mucosa and anatomy were documented. There was no evidence of postoperative coagulopathy. Mesenteric angiography identified bleeding from a branch of the superior rectal artery. Re...

Bright, Elizabeth; Fishwick, Guy; Berry, David; Thomas, Michael

2008-01-01

182

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

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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,...

Ae, Dorofeyev; Ea, Kiriyan; Iv, Vasilenko; Oa, Rassokhina; Af, Elin

2011-01-01

183

Can we improve the diagnostic yield of small bowel video-capsule endoscopy?  

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Video-capsule endoscopy has revolutionized the examination of small bowel mucosa. However, this modality is relatively young and its diagnostic yield is low. Herein, we discuss different approaches to improve examination’s diagnostic yield. There are strong data supporting some of them while there is speculation about the rest. As capsule endoscopy continues to evolve there is also a strong belief that technology will overcome at least some of the obstacles that hamper capsule endoscopy’s...

Konstantinos Triantafyllou

2010-01-01

184

Neurotensin receptor 1 overexpression in inflammatory bowel diseases and colitis-associated neoplasia  

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AIM: To explore the association of neurotensin receptor 1 (NTSR1) with inflammatory bowel diseases (IBD) and colitis-associated neoplasia. METHODS: NTSR1 was detected by immunohistochemistry in clinical samples of colonic mucosa with IBD colitis, colitis-associated raised low-grade dysplasia (LGD) including dysplasia-associated lesions or masses (DALMs, n = 18) and adenoma-like dysplastic polyps (ALDPs, n = 4), colitis-associated high-grade dysplasia (HGD, n = 11) and colitis-associated color...

Xianyong Gui; Shuhong Liu; Yuchu Yan; Zuhua Gao

2013-01-01

185

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

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

Wagner, Michael

2010-01-01

186

Impairment of intestinal glutathione synthesis in patients with inflammatory bowel disease  

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Background—Reactive oxygen species contribute to tissue injury in inflammatory bowel disease (IBD). The tripeptide glutathione (GSH) is the most important intracellular antioxidant. ?Aims—To investigate constituent amino acid plasma levels and the GSH redox status in different compartments in IBD with emphasis on intestinal GSH synthesis in Crohn's disease. ?Methods—Precursor amino acid levels were analysed in plasma and intestinal mucosa. Reduced (rGSH) and o...

Sido, B.; Hack, V.; Hochlehnert, A.; Lipps, H.; Herfarth, C.; Droge, W.

1998-01-01

187

In vitro effects of oxpentifylline on inflammatory cytokine release in patients with inflammatory bowel disease.  

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BACKGROUND: Inflammatory cytokines, including tumour necrosis factor-alpha (TNF-alpha) and interleukin (IL)-1 beta, have been implicated as primary mediators of intestinal inflammation in inflammatory bowel disease. AIM: To investigate the in vitro effects of oxpentifylline (pentoxifylline; PTX; a phosphodiesterase inhibitor) on inflammatory cytokine production (1) by peripheral mononuclear cells (PBMCs) and (2) by inflamed intestinal mucosa cultures from patients with Crohn's disease and pat...

Reimund, J. M.; Dumont, S.; Muller, C. D.; Kenney, J. S.; Kedinger, M.; Baumann, R.; Poindron, P.; Duclos, B.

1997-01-01

188

Osteoporosis in Inflammatory Bowel Disease  

Science.gov (United States)

Osteoporosis commonly afflicts patients with inflammatory bowel disease, and many factors link the 2 states together. A literature review was conducted about the pathophysiology of osteoporosis in relation to inflammatory bowel disease. Screening guidelines for osteoporosis in general as well as those directed at patients with inflammatory bowel disease are reviewed, as are currently available treatment options. The purpose of this article is to increase physician awareness about osteopenia and osteoporosis occurring in patients with inflammatory bowel disease and to provide basic, clinically relevant information about the pathophysiology and guidelines to help them treat these patients in a cost-effective manner.

Ali, Tauseef; Lam, David; Bronze, Michael S.; Humphrey, Mary Beth

2010-01-01

189

Novel specific microRNA biomarkers in idiopathic inflammatory bowel disease unrelated to disease activity.  

Science.gov (United States)

The diagnosis of idiopathic inflammatory bowel disease can be challenging. MicroRNAs (miRNAs) are small, non-coding RNAs that regulate protein synthesis through post-transcriptional suppression. This study is to identify new miRNA markers in inflammatory bowel disease, and to examine whether miRNA biomarkers might assist in the diagnosis of inflammatory bowel disease. Illumina small RNA sequencing was performed on non-dysplastic fresh-frozen colonic mucosa samples of the distalmost colectomy tissue from 19 patients with inflammatory bowel disease (10 ulcerative colitis and 9 Crohn disease) and 18 patients with diverticular disease serving as controls. To determine differentially expressed miRNAs, the USeq software package identified 44 miRNAs with altered expression (fold change ?2 and false discovery rate ?0.10) compared with the controls. Among them, a panel of nine miRNAs was aberrantly expressed in both ulcerative colitis and Crohn disease. Validation assays performed using quantitative reverse transcription PCR (qRT-PCR) on additional frozen tissue from ulcerative colitis, Crohn disease, and control groups confirmed specific differential expression in inflammatory bowel disease for miR-31, miR-206, miR-424, and miR-146a (PmiR-146a are novel specific biomarkers of inflammatory bowel disease. Furthermore, miR-31 is universally expressed in both ulcerative colitis and Crohn disease not only in fresh-frozen but also in formalin-fixed, paraffin-embedded tissues. PMID:24051693

Lin, Jingmei; Welker, Noah C; Zhao, Zijin; Li, Yong; Zhang, Jianjun; Reuss, Sarah A; Zhang, Xinjun; Lee, Hwajeong; Liu, Yunlong; Bronner, Mary P

2014-04-01

190

Small bowel faeces sign in patients without small bowel obstruction  

International Nuclear Information System (INIS)

Aim: To evaluate frequency and clinical relevance of the 'small bowel faeces' sign (SBFS) on computed tomography (CT) in patients with and without small bowel obstruction (SBO) presenting with acute abdominal or acute abdominal and flank pain. Methods: Abdominal CTs of consecutive patients presenting to the emergency department with abdominal or flank pain over a 6 month period were retrospectively reviewed by six radiologists, independently, for the presence of the SBFS. Examinations with positive SBFS were further evaluated in consensus by three radiologists, blinded to the final diagnosis. The small bowel was graded as non-dilated (4 cm) dilated. The location of SBFS and presence of distal small bowel collapse indicative of SBO was recorded. Imaging findings were subsequently correlated with the final diagnosis via chart review and compared between patients with and without SBO. Results: Of 1642 CT examinations, a positive SBFS was found in 100 (6%) studies. Of 100 patients with a positive SBFS, 32 (32%) had documented SBO. The remaining 68 patients had other non-obstructive diagnoses. SBFS was located in proximal, central, distal and multisegmental bowel loops in one (3.1%), eight (25.0%), 21 (65.6%) and two (6.3%) patients with SBO, and in zero (0%), 10 (14.7%), 53 (77.9%) and five (7.4%) of patients without SBO (p < 0.273). The small bowel was non-dilated and mildly, moderately or severely dilated in one (3%), five (16%), 20 (62%) and six (19%) patients with SBO, and in 61(90%), seven (10%), zero (0%) and zero (0%) patients without SBO. Normal or mildly dilated small bowel was seen in all (100%) patients without SBO, but only in six (19%) of 32 patients with SBO (p < 0.0001). Moderate or severe small bowel dilatation was seen in 26 (81%) patients with SBO (p < 0.0001), but it was absent in patients without SBO. Distal small bowel collapse was found in 27 (84.4%) of 32 patients with SBO, but not in patients without SBO (p < 0.0001). A combination of SBFS, moderate or severe small bowel distension and distal collapse was found in 23 (71.9%) patients with SBO (p < 0.0001), but was not found in patients without SBO. Conclusion: A SBFS is more frequent in patients presenting with acute abdominal/flank pain without bowel obstruction. When seen in association with moderate or severe small bowel dilatation, a SBFS is significantly more common in patients with SBO. When a SBFS is associated with normal or mildly dilated small bowel, the majority of patients have no bowel obstruction

2007-04-01

191

Breastfeeding and genetic factors in the etiology of inflammatory bowel disease in children  

Directory of Open Access Journals (Sweden)

Full Text Available Inflammatory bowel disease is a chronic, debilitating disorder of the gastrointestinal tract. The etiology of inflammatory bowel disease has not been elucidated, but is thought to be multifactorial with both environ-mental and genetic influences. A large body of research has been conducted to elucidate the etiology of inflammatory bowel disease. This article reviews this literature, emphasizing the studies of breastfeeding and the studies of genetic factors, particularly NOD2 polymorphisms.

Theresa A Mikhailov, Sylvia E Furner

2009-01-01

192

Urethral fistula following circumcision: salvaged by buccal mucosa graft urethroplasty  

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

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

2009-01-01

193

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

194

Small bowel intussusception in adults.  

Science.gov (United States)

Intussusception is the telescoping of a proximal segment of the gastrointestinal tract into an adjacent distal segment. This rare form of bowel obstruction occurs infrequently in adults. We report a case of small bowel intussusception in an adult male patient. We have also performed a literature review of this rare condition. PMID:24417823

Potts, J; Al Samaraee, A; El-Hakeem, A

2014-01-01

195

Small bowel mesentery fibroma  

Directory of Open Access Journals (Sweden)

Full Text Available Fibromas are rarely localized in the abdomen, but almost always in the mesentery or omentum. We present a 63-year old woman in whom the examination of the upper abdominal pain showed a well distinct abdominal mass at the level of the lower edge of the pancreas. During the operation a tumor 100 ? 87 x 70 mm in size, from the radix of small bowel mesentery, was excised, Seven months later the patient is symptom-free with normal ultrasonographic and CT findings.

?olovi? Radoje B.

2002-01-01

196

Irritable Bowel Syndrome  

Science.gov (United States)

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 physician did not seem to take her distress seriously. Physical examination is unremarkable except for tenderness over the left lower quadrant. How should her case be evaluated and treated?

Mayer, Emeran A.

2013-01-01

197

CT evaluation of bowel obstruction  

International Nuclear Information System (INIS)

This paper determines the ability of CT to help diagnose the presence and etiology of bowel obstruction. The authors reviewed the records of 169 patients with a clinical diagnosis of small bowel or colonic obstruction. Ninety-five patients had CT scans, and 83 were available for review. Diagnosis was established by surgery (38), barium radiography (17), or clinical course (28). Etiologies included adhesions (37), metastases (six), primary tumor (six), Crohn disease (four), hernias (three, hematoma (two), colonic diverticulitis (two), and other (four). Six patients with nonobstructive ileus were evaluated. Thirteen patients with suspected obstruction proved to not have obstruction. The scans were retrospectively evaluated by a pair of readers (without knowledge of histories) for the presence of bowel obstruction, grade, level, and etiology; 83 randomly selected scans in patients without history of bowel obstruction served as controls. Obstruction was defined as the presence of a marked discrepancy in the caliber of proximal and distal bowel loops

1990-11-25

198

Imaging of inflammatory bowel disease. How?  

Energy Technology Data Exchange (ETDEWEB)

Traditionally the small bowel (barium) follow through (SBFT) has been the investigation of choice for that otherwise inaccessible length of gut between the duodenum and the ileocaecal valve. Whilst it is still a widely practised examination by radiologists it is being largely overtaken by other imaging modalities with CT, MRI and capsule endoscopy (CE) all competing for the territory. At the end of the last century, proponents of enteroclysis were predicting the eventual decline of the SBFT (in adults) although at that stage, in a 'state of the art' article, they were still brave enough to say that 'only in the small bowel does barium radiography remain unchallenged'. The same authors now write of how radiological investigations complement other techniques but are no longer the mainstay. (orig.)

Hiorns, Melanie P. [Great Ormond Street Hospital for Children, Radiology Department, London (United Kingdom)

2008-06-15

199

Imaging of inflammatory bowel disease. How?  

International Nuclear Information System (INIS)

Traditionally the small bowel (barium) follow through (SBFT) has been the investigation of choice for that otherwise inaccessible length of gut between the duodenum and the ileocaecal valve. Whilst it is still a widely practised examination by radiologists it is being largely overtaken by other imaging modalities with CT, MRI and capsule endoscopy (CE) all competing for the territory. At the end of the last century, proponents of enteroclysis were predicting the eventual decline of the SBFT (in adults) although at that stage, in a 'state of the art' article, they were still brave enough to say that 'only in the small bowel does barium radiography remain unchallenged'. The same authors now write of how radiological investigations complement other techniques but are no longer the mainstay. (orig.)

2008-06-01

200

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

Directory of Open Access Journals (Sweden)

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

 
 
 
 
201

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

202

Altered gastric emptying in patients with irritable bowel syndrome  

International Nuclear Information System (INIS)

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

1999-04-29

203

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

DEFF Research Database (Denmark)

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.

Andersen, Vibeke

2011-01-01

204

CT findings of small bowel metastases from primary lung cancer  

Energy Technology Data Exchange (ETDEWEB)

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

205

Severe adhesive small bowel obstruction.  

Science.gov (United States)

Adhesive small bowel obstruction is a frequent cause of hospital admission. Water soluble contrast studies may have diagnostic and therapeutic value and avoid challenging demanding surgical operations, but if bowel ischemia is suspected, prompt surgical intervention is mandatory. A 58-year-old patient was operated for extensive adhesive small bowel obstruction after having had two previous laparotomies for colorectal surgery, and had a complex clinical course with multiple operations and several complications. Different strategies of management have been adopted, including non-operative management with the use of hyperosmolar water soluble contrast medium, multiple surgical procedures, total parenteral nutrition (TPN) support, and finally use of antiadherences icodextrin solution. After 2 years follow-up the patient was doing well without presenting recurrent episodes of adhesive small bowel obstruction. For patients admitted several times for adhesive small bowel obstruction, the relative risk of recurring obstruction increases in relation to the number of prior episodes. Several strategies for non-operative conservative management of adhesive small bowel obstruction have already addressed diagnostic and therapeutic value of hyperosmolar water soluble contrast. According to the most recent evidence-based guidelines, open surgery is the preferred method for surgical treatment of strangulating adhesive small bowel obstruction as well as after failed conservative management. Research interest and clinical evidence are increasing in adhesions prevention. Hyaluronic acid-carboxycellulose membrane and icodextrin may reduce incidence of adhesions. PMID:23054502

Di Saverio, Salomone; Catena, Fausto; Kelly, Michael D; Tugnoli, Gregorio; Ansaloni, Luca

2012-12-01

206

Adenocarcinoma of the small bowel  

International Nuclear Information System (INIS)

Adenocarcinoma of small bowel is generally a rather rare primary tumour of small bowel with a prevalence rate of 0.5 - 3.0 / 100.000 population, but the most frequent tumour of small intestine. It more often involves the duodenum and jejunum than the ileum. The aim of this paper is also to point out the value of small bowel follow through (SBFT) in the diagnosis of stenosing lesions. An 83 - year old male patient suffered from abdominal pain, malaise, vomiting, cachexia and diarrhoea for 3 months. The result of occult blood testing was negative. Haemoglobin level was normal. Proctoscopy, colonoscopy, upper gastrointestinal (GI) endoscopy, and ultrasonography (US) did not explain the patient's problems. Ileus of the small bowel was established with abdominal plain film. Small bowel follow through (SBFT) and computer tomography (CT) showed a stenosing tumour in the jejunum. Adenocarcinoma of the small bowel was established with histological examination after resection of the tumor. SBFT, with manual compression of all segments of the small bowel, can be a very accurate diagnostic investigation for evaluation of stenosing lesions in this part of the intestine. (author)

2007-06-01

207

[Virus diseases of the mouth mucosa].  

Science.gov (United States)

In accordance with the system of viral species, viral disorders of the oral mucosa may be classified with regard to their intensity of affection. There are but few viral infections exclusively affecting the oral mucosa like e.g. 1. Glossitis papulosa of Michelson, representing a special form of vaccinia inoculata, 2. Gingivo-stomatitis herpetica and 3. warts of the mucosa or condyloma-like papillomas of the oral mucosa including oral papillomatosis, that, itself shows morphological and clinical similarities to laryngeal papilloma. A second group of disorders mainly affecting the oral mucosa includes the "Aphthoid of Pospischill and Feyrter", Zahorsky's herpangina and other viral infections by the Coxsackie group, like vesicular stomatitis. The 3rd group represents viral infections of other organs in which affection of the oral mucosa is a prerogative, e.g. smallpox, varicella, foot-and-mouth disease and pharyngo-conjunctival fever. A 4th group includes those viral infections of the organs in which co-affection of oral mucosa occurs frequently or once in a while (at occasions). Here, we find eczema vaccinatum, herpes zoster, herpes simplex of the oral mucosa mostly on the hard palate, eczema herpeticatum, post-herpetic Erythema exsudativum multiforme, Mononucleosis infectiosa Pfeiffer, viral flu, German measles, parotitis epidemica, rubeola and ECHO-exanthema. A 5th and last group is made up by viral infections of other organs, in which affection of the oral mucosa hardly occurs at all. This group contains paravaccinal Ecthyma contagiosum, poliomyelitis, viral infection of the city of Marburg and some Arbovirus infections. Relatively few viral disorders never co-exist with lesions on the oral mucosa like e.g. Virus-hepatitis or some viral encephalitides. Groups 1 and 2, most important of all, are presented in detail regarding clinics, diagnostics, differential-diagnosis and therapy. The disorders within the other 3 groups are discussed only regarding their importance in the field of ENT-related symptoms of the oral mucosa. A number of pictures and tables completes important clinical details and give further hints to their differential-diagnosis. PMID:830106

Nasemann, T

1976-01-01

208

Laser Treatment of Oral Mucosa Tattoo  

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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 ...

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

2011-01-01

209

CT assessment of anastomotic bowel leak  

Energy Technology Data Exchange (ETDEWEB)

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

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

2007-01-15

210

Intestinal Failure (Short Bowel Syndrome)  

Science.gov (United States)

... removed due to Crohn’s disease N Patients with intestinal pseudo-obstruction or abnormal motility of the bowel N Patients who have had surgery for volvulus (twisting of the intestine) N Patients who have had parts of the ...

211

Pregnancy and Irritable Bowel Syndrome  

Science.gov (United States)

... Mobile App Who We Are Contact Us Donate Pregnancy and Irritable Bowel Syndrome Jump to Topic Living ... is not known. Do IBS symptoms worsen during pregnancy? For several reasons, the data related to pregnancy ...

212

Chlamydiae and inflammatory bowel disease.  

Science.gov (United States)

No association was found between inflammatory bowel disease and infection with C. trachomatis or C. psittaci when patients were tested for the presence of these organisms using immunohistological, cell culture isolation, and serological techniques. PMID:7461473

Elliott, P R; Forsey, T; Darougar, S; Treharne, J D; Lennard-Jones, J E

1981-01-01

213

Chlamydiae and inflammatory bowel disease.  

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No association was found between inflammatory bowel disease and infection with C. trachomatis or C. psittaci when patients were tested for the presence of these organisms using immunohistological, cell culture isolation, and serological techniques.

Elliott, P. R.; Forsey, T.; Darougar, S.; Treharne, J. D.; Lennard-jones, J. E.

1981-01-01

214

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

Directory of Open Access Journals (Sweden)

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

Bai-Sui Feng

2009-09-01

215

Omega-3 fatty acids induce biochemical changes in the small bowel of rats before and after resection Efeito do ácido graxo ômega-3 no intestino delgado de ratos antes e após ressecção  

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In the present study, the effect of dietary fish oil, a highly unsaturated fat source, on the intestinal mucosa before and after proximal small bowel resection in rats was studied. Forty Wistar rats were fed defined diets containing fish oil (experimental group) or corn oil (control group). After 2 weeks, animals underwent a 50% proximal small bowel resection. Mucosal disaccharidases, alkaline phosphatase, aminopeptidase, protein, DNA, and TBARs levels were assessed in samples immediately bef...

João Carlos Nunes de Oliveira; Clarice Izumi; Sergio Zucoloto; Arony Aparecido Lopes; Camila Alves Areda; Osvaldo de Freitas

2005-01-01

216

Cancer in inflammatory bowel disease  

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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 sc...

Jianlin Xie, Steven H. Itzkowitz

2008-01-01

217

Preparing the bowel for colonoscopy.  

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Bowel preparation methods for total colonoscopy in children generally involve whole gut irrigation with electrolyte lavage solutions, which in most children will require hospitalisation for nasogastric tube administration. The aim of the study was to determine the efficacy of oral bisacodyl combined with a single phosphate enema as a bowel preparation regimen in children. In an open prospective trial, 30 children (aged 18 months-15 years) were given oral bisacodyl on each morning of the two d...

Abubakar, K.; Goggin, N.; Gormally, S.; Durnin, M.; Drumm, B.

1995-01-01

218

Probiotics and Irritable Bowel Syndrome  

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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 o...

Riitta Korpela; Leena Niittynen

2012-01-01

219

Reoperative Inflammatory Bowel Disease Surgery  

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With the advent of restorative proctocolectomy or ileal pouch–anal anastomosis (IPAA) for ulcerative colitis (UC), not only has there been potential for cure of UC but also patients have enjoyed marked improvements in bowel function, continence, and quality of life. However, IPAA can be complicated by postoperative small bowel obstruction, disease recurrence, and pouch failure secondary to pelvic sepsis, pouch dysfunction, mucosal inflammation, and neoplastic transformation. These may neces...

Ramirez, Rowena L.; Fleshner, Phillip

2006-01-01

220

Small bowel faeces sign in patients without small bowel obstruction  

Energy Technology Data Exchange (ETDEWEB)

Aim: To evaluate frequency and clinical relevance of the 'small bowel faeces' sign (SBFS) on computed tomography (CT) in patients with and without small bowel obstruction (SBO) presenting with acute abdominal or acute abdominal and flank pain. Methods: Abdominal CTs of consecutive patients presenting to the emergency department with abdominal or flank pain over a 6 month period were retrospectively reviewed by six radiologists, independently, for the presence of the SBFS. Examinations with positive SBFS were further evaluated in consensus by three radiologists, blinded to the final diagnosis. The small bowel was graded as non-dilated (<2.5 cm) and mildly (2.5-2.9 cm), moderately (3-4 cm) or severely (>4 cm) dilated. The location of SBFS and presence of distal small bowel collapse indicative of SBO was recorded. Imaging findings were subsequently correlated with the final diagnosis via chart review and compared between patients with and without SBO. Results: Of 1642 CT examinations, a positive SBFS was found in 100 (6%) studies. Of 100 patients with a positive SBFS, 32 (32%) had documented SBO. The remaining 68 patients had other non-obstructive diagnoses. SBFS was located in proximal, central, distal and multisegmental bowel loops in one (3.1%), eight (25.0%), 21 (65.6%) and two (6.3%) patients with SBO, and in zero (0%), 10 (14.7%), 53 (77.9%) and five (7.4%) of patients without SBO (p < 0.273). The small bowel was non-dilated and mildly, moderately or severely dilated in one (3%), five (16%), 20 (62%) and six (19%) patients with SBO, and in 61(90%), seven (10%), zero (0%) and zero (0%) patients without SBO. Normal or mildly dilated small bowel was seen in all (100%) patients without SBO, but only in six (19%) of 32 patients with SBO (p < 0.0001). Moderate or severe small bowel dilatation was seen in 26 (81%) patients with SBO (p < 0.0001), but it was absent in patients without SBO. Distal small bowel collapse was found in 27 (84.4%) of 32 patients with SBO, but not in patients without SBO (p < 0.0001). A combination of SBFS, moderate or severe small bowel distension and distal collapse was found in 23 (71.9%) patients with SBO (p < 0.0001), but was not found in patients without SBO. Conclusion: A SBFS is more frequent in patients presenting with acute abdominal/flank pain without bowel obstruction. When seen in association with moderate or severe small bowel dilatation, a SBFS is significantly more common in patients with SBO. When a SBFS is associated with normal or mildly dilated small bowel, the majority of patients have no bowel obstruction.

Jacobs, S.L. [Department of Radiology, Montefiore Medical Center, Bronx, NY (United States)]. E-mail: stacylynnjacobs@yahoo.com; Rozenblit, A. [Department of Radiology, Montefiore Medical Center, Bronx, NY (United States); Ricci, Z. [Department of Radiology, Montefiore Medical Center, Bronx, NY (United States); Roberts, J. [Department of Radiology, Montefiore Medical Center, Bronx, NY (United States); Milikow, D. [Department of Radiology, Montefiore Medical Center, Bronx, NY (United States); Chernyak, V. [Department of Radiology, Montefiore Medical Center, Bronx, NY (United States); Wolf, E. [Department of Radiology, Montefiore Medical Center, Bronx, NY (United States)

2007-04-15

 
 
 
 
221

Sensitization to epithelial antigens in chronic mucosal inflammatory disease. Characterization of human intestinal mucosa-derived mononuclear cells reactive with purified epithelial cell-associated components in vitro.  

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To explore the auto-reactive potential of cells infiltrating the gut mucosa in idiopathic chronic inflammatory bowel disease, intestinal lamina propria mononuclear cells (LPMC) were isolated, characterized morphologically and phenotypically, and evaluated for antigen-specific reactivity. The last was assessed by quantitating LPMC cytotoxic capabilities against purified, aqueous-soluble, organ-specific epithelial cell-associated components (ECAC) characterized previously. Enzyme-isolated infla...

Roche, J. K.; Fiocchi, C.; Youngman, K.

1985-01-01

222

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 competit...

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

2000-01-01

223

Cytomegalovirus (CMV)-Specific Perforin and Granzyme B ELISPOT Assays Detect Reactivation of CMV Infection in Inflammatory Bowel Disease  

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The role of cytomegalovirus (CMV) infection in the pathogenesis and exacerbation of Inflammatory Bowel Disease (IBD) has been unresolved. Typically, the CMV genome remains dormant in infected cells, but a breakdown of immune surveillance can lead to re-activation of viral replication in the gut mucosa, which is not necessarily associated with viremia or changes in antibody titers. We hypothesized that the detection of CMV-specific CD8 effector T cells should permit the distinction between dor...

Nowacki, Tobias M.; Dominik Bettenworth; Matthias Ross; Jan Heidemann; Lehmann, Paul V.; Andreas Lügering

2012-01-01

224

Radiation tolerance of the vaginal mucosa  

International Nuclear Information System (INIS)

Sixteen patients with cancer of the vagina that were controlled locally for a minimum of eighteen months after teletherpay (T) or brachytherapy (B) or both (T and B), were analyzed for radiation tolerance of the vaginal mucosa. The site of vaginal necrosis did not always coincide with the site of the tumor. The posterior wall appeared more vulnerable than the anterior or lateral walls. For the distal vaginal mucosa, necrosis requiring surgical intervention occurred following combined T and B, if summated rad exceeded9800. The upper vagina tolerated higher dosages. No patient surgery for upper vaginal necrosis even though summated (T and B) dosage up to 14,000 rad was applied. Placing radioactive needles on the surface of the vaginal cylinder with or without interstitial perincal needles should be avoided. Further accumulation of data is needed to define these vaginal mucosa tolerance limits more closely

1980-01-01

225

Bowel hath no fury like a gallbladder inflamed.  

Science.gov (United States)

Gallstone ileus is a well-established phenomenon in which a large gallstone leads to mechanical small bowel obstruction. This case, however, reports the novel finding of a patient presenting with suprapubic pain and guarding caused by paralytic ileus of the small bowel and a duodenal perforation secondary to a necrotic gallbladder. It highlights the importance of distinguishing between gallstone ileus and paralytic ileus and how the management of the two conditions differs. Furthermore, this article discusses how paralytic ileus caused by intra-abdominal inflammatory conditions such as cholecystitis can mask the typical clinical findings making the diagnosis difficult. PMID:24876462

Khan, Amad; Flavin, Kathyrn Ellen; Harris, Lauren Sarah; Chaudhry, Mohammad Naushad; Reading, Nicholas

2014-04-01

226

Irritable bowel syndrome: a "mesh" of a situation.  

Science.gov (United States)

The diagnosis of irritable bowel syndrome (IBS) frequently is made after the exclusion of a mechanical etiology for a patient's symptoms. This case demonstrates that IBS symptoms can be caused by a rare complication of a common surgery: mesh herniorrhaphy repair. The patient is a 50-year-old woman who underwent periumbilical Marlex mesh herniorrhaphy 13 years before presentation. After her operation, the patient developed constipation (approximately one bowel movement per week) alternating with diarrhea for approximately 10 years. An abdominal radiograph showed large amounts of stool, and after a normal colonoscopy the patient was diagnosed with IBS. The patient was treated with tegaserod (Zelnorm) and polyethylene glycol (MiraLAX), which did not palliate her symptoms. The patient presented with obstructive symptoms and physical findings of an incarcerated umbilical hernia. A computed tomography (CT) scan of the abdomen confirmed an umbilical hernia involving a segment of small bowel with surrounding fecalization of enteric contents. During operative repair, the patient was found to have Marlex mesh fully eroded into the lumen of the small bowel, causing a partial obstruction. The involved section of small bowel was resected, and during serial follow-up the patient had complete resolution of her IBS-like symptoms. A discussion follows regarding the implications of mesh migration, and questions are posed for future research. PMID:22218633

Barnes, Matthew G

2012-01-01

227

The evolution of bowel preparation and new developments.  

Science.gov (United States)

Bowel preparation is essential for successful colonoscopy examination, and the most important factor is the bowel preparation agent used. However, selection of a bowel preparation agent invariably involves compromise. Originally, bowel preparation was performed for radiologic and surgical purposes, when the process involved dietary limitations, cathartics, and enemas, which had many side effects. Development of polyethylene glycol (PEG) solution led to substantive advancement of bowel preparation; however, despite its effectiveness and safety, the large volume involved, and its salty taste and unpleasant odor reduce compliance. Accordingly, modified PEG solutions requiring consumption of lower volumes and sulfate-free solutions were developed. Aqueous sodium phosphate is more effective and better tolerated than PEG solutions; however, fatal complica-tions have occurred due to water and electrolyte shifts. Therefore, aqueous sodium phosphate was withdrawn by the US Food and Drug Administration, and currently, only sodium phosphate tablets remain available. In addition, oral sulfate solution and sodium picosulfate/magnesium citrate are also available, and various studies have reported on adjunctive preparations, such as hyperosmolar or stimulant laxatives, antiemetics, and prokinetics, which are now in various stages of development. (Korean J Gastroenterol 2014;63:268-275). PMID:24870298

Park, Jeong Bae; Lee, Yong Kook; Yang, Chang Heon

2014-05-25

228

Bowel infarction: Complication of ethanol ablation of renal tumor  

International Nuclear Information System (INIS)

A case of infarction of the large bowel resulting from transcatheder ablation of a malignant renal tumor with absolute ethanol is presented. The causal mechanism of this complication is described to that preventive steps can be taken to avoid this accident in the future. (orig.)

1983-04-01

229

Left over bowels: an unique complication in a surviving twin  

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Conjoint twins have always been a surgical challenge. The authors report an unusual finding in a surviving epigastric heteropagus twin. A 17 year old boy who underwent laparotomy for acute intestinal obstruction revealed a blind ending but complete duplication of the large bowel and an accessory liver in the falciform ligament, along with a separate gall bladder but with fused bile ducts.

George, A.; Varkey, S.; Kalam, A.; Surendran, N.

2004-01-01

230

Detoxification of hydrogen sulfide and methanethiol in the cecal mucosa  

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Colonic bacteria liberate large quantities of the highly toxic gases hydrogen sulfide (H2S) and methanethiol (CH3SH). The colonic mucosa presumably has an efficient means of detoxifying these compounds, which is thought to occur through methylation of H2S to CH3SH and CH3SH to dimethylsulfide (CH3SCH3). We investigated this detoxification pathway by incubating rat cecal mucosal homogenates with gas containing H2S, CH3SH, or CH3SCH3. Neither CH3SH nor CH3SCH3 was produced during H2S catabolism...

1999-01-01

231

Spitz nevus of the genital mucosa  

Directory of Open Access Journals (Sweden)

Full Text Available We herein report an 11-year-old girl who came to our clinic with a swelling on the genital area of 2 months duration. Dermatological examination of the patient was performed and a pigmented lesion was found on the inner surface of the labium majus of the mucosa. The lesion was well circumscribed and approximately 1 cm in diameter, with homogenous color distribution. The patient was diagnosed as Spitz nevus on the basis of clinical and histopathological findings. Our case is probably the first reported case of Spitz nevus localized to the genital mucosa in the English literature.

Polat Mualla

2009-01-01

232

Bloating in irritable bowel syndrome  

Science.gov (United States)

Aim The purpose of this study was to describe the occurrence of self report bloating and related factors in patients with irritable bowel syndrome (IBS). Background Bloating symptoms are common in patients with IBS and have significant impact on normal daily function. Patients and methods This study was a community-based cross-sectional survey that conducted using a valid questionnaire base on Rome III criteria. Univariate analysis was used for investigation about distribution of self reported bloating according to demographic and psychological factors in irritable bowel syndrome patients. Results Out of 18180 subjects under study, 198 cases met criteria for the diagnosis of the irritable bowel syndrome according to criteria ROME III and 61.6% reported bloating symptoms. Bloating symptoms were more prevalent among patients with intermittent symptoms and diarrhea than in patients with constipation. Catastrophic events and depression were independent risk factors for bloating. Conclusion Findings of this study support the clinical impression regarding the high prevalence of bloating symptoms in patients with irritable bowel syndrome. Further studies are needed to understand the role of physiological and psychological factors and their interaction in development of bloating in irritable bowel syndrome patients.

Safaee, Azadeh; Pourhoseingholi, Mohamad Amin; Vahedi, Mohsen; Habibi, Manijeh; Pourhoseingholi, Asma; Ghafarnejad, Fatemeh

2011-01-01

233

If I Had - Bowel Control Issues  

Medline Plus

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

234

If I Had - Bowel Control Issues  

Medline Plus

Full Text Available ... Lispro If I Had - Bowel Control Issues - Dr. Niall Galloway, MD, FRCS Back to Home Page If I Had - Bowel Control Issues - Dr. Niall Galloway, MD, FRCS (March 27, 2008 - Insidermedicine) Welcome to ...

235

If I Had - Bowel Control Issues  

Science.gov (United States)

... Lispro If I Had - Bowel Control Issues - Dr. Niall Galloway, MD, FRCS Back to Home Page If I Had - Bowel Control Issues - Dr. Niall Galloway, MD, FRCS (March 27, 2008 - Insidermedicine) Welcome to ...

236

If I Had - Bowel Control Issues  

Medline Plus

Full Text Available ... patient manage to hold this in?” But, in effect, under perfect healthy conditions, the bowel should be ... in the pelvis that can have a profound effect on bowel function and can drive patients towards ...

237

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

Scientific Electronic Library Online (English)

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

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

238

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)

2013-09-01

239

Uncommon cause of small bowel obstruction - gallstone ileus: a case report  

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Gallstone ileus is an uncommon cause of small bowel obstruction. We present a case of small intestinal obstruction owing to a large gallstone in lower ileum in a 65 years old man. The diagnosis was made by computed tomography.

Zahid, Fatima Ezzahra; Benjelloun, El Bachir; Ousadden, Abdelmalek; Mazaz, Khalid; Taleb, Khalid Ait

2009-01-01

240

Optimal and Safe Bowel Preparation for Colonoscopy  

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Effective colonoscopy requires an adequate level of cleansing as a basic component. This review will describe a compact review about general considerations in bowel preparation for colonoscopy and specific considerations for various patients. A low-fiber diet instead of a regular diet on the day before colonoscopy is an independent predictor of adequate bowel preparation. Improved bowel cleansing does not result from the routine use of enemas or prokinetics in addition to oral bowel preparati...

Moon, Won

2013-01-01

 
 
 
 
241

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...

2008-01-01

242

Wnt pathway-related gene expression in inflammatory bowel disease.  

Science.gov (United States)

The purpose of this study was to examine the expression of Wnt pathway-related genes in patients with ulcerative colitis (UC). RNA from colonoscopic biopsies from noninflammatory bowel disease (non-IBD) subjects and UC patients were obtained and examined with a Wnt-specific microarray for the expression of Wnt pathway-related genes. Paired samples from uninflamed and inflamed areas of the colon were obtained for the UC patients. WNT2B, WNT3A, WNT5B, WNT6, WNT7A, WNT9A, and WNT11 exhibited significantly increased expression in UC compared to non-IBD patients. Frizzled 3 (FZD3) and FZD4 exhibited significantly increased expression, and FZD1 and FZD5 exhibited significantly decreased expression in UC patients. Genes with increased expression in inflamed mucosa included DKK4, DVL2, SOX17, and COL1A1. There was no difference in the expression of a panel of Wnt target genes. The expression of inducible nitric oxide synthase (INOS) was variably influenced by inflammation. Significant differences in extracellular and cell-surface components of the Wnt pathway exist in the colonic mucosa of patients with UC compared with non-IBD patients, which may influence the strength or specificity of Wnt signaling. In inflammation, inhibitory components of the Wnt pathway exhibit increased expression, but no changes in Wnt pathway target gene expression are seen. The role and complex regulation of Sox17 and iNOS in IBD warrant further investigation. PMID:17939044

You, Joann; Nguyen, Anthony V; Albers, C Gregory; Lin, Fritz; Holcombe, Randall F

2008-04-01

243

Adenoid cystic carcinoma of buccal mucosa.  

Science.gov (United States)

Adenoid cystic carcinoma is a malignant neoplasm most commonly originating in salivary glands of head and neck region. Here we present a case report of a 50 year old male who was diagnosed with adenoid cystic carcinoma of the right buccal mucosa. The peculiarity of the lesion and the approach we made is the key factor in the presentation. PMID:22190804

Singh, Sanjay; Gokkulakrishnan; Jain, Jinendra; Pathak, Sachin; Singh, Kumar Tathagat

2010-09-01

244

Adenoid Cystic Carcinoma of Buccal Mucosa  

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Adenoid cystic carcinoma is a malignant neoplasm most commonly originating in salivary glands of head and neck region. Here we present a case report of a 50 year old male who was diagnosed with adenoid cystic carcinoma of the right buccal mucosa. The peculiarity of the lesion and the approach we made is the key factor in the presentation.

Singh, Sanjay; Gokkulakrishnan; Jain, Jinendra; Pathak, Sachin; Singh, Kumar Tathagat

2010-01-01

245

Mucocele of the lower lip mucosa  

Directory of Open Access Journals (Sweden)

Full Text Available Mucocele, also known as mucous extravasation phenomenon, is a pseudocyst of traumatic etiology, in which a minor salivary gland ductruptures. Clinically it can be observed as a tumefaction or bubble; it is flaccid on palpation, asymptomatic, with a smooth surface andvariable size, and with coloring equal to that of the adjacent mucosa, or bluish, depending on its depth in the tissue. The patient generally reports a bubble that has burst and fills up again, releasing a salty tasting liquid. There is greater incidence in women (25.4%, between the ages of 8 and 14 years, the commonest site being the mucosa of the lower lip. In the present study, the authors will present a clinical case of mucocele seen at the School of Dentistry at the Federal University of Pelotas, in the State of Rio Grande do Sul, Brazil, in a patient, a 23-year-old leukoderma man, who presented a lesion situated in the mucosa of the lower lip on the right side, close to the bottom of the fold, measuring approximately 0.6 cm, with coloring similar to the adjacent normal mucosa. The treatment performed was surgical excision of the mucocele and the accessory glands involved in the region of the lesion. The histopathologic report confirmed the clinical diagnosis of mucocele.

Tais Frenzel da Rosa

2008-01-01

246

Perforated small bowel in omphalocele at birth  

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Full Text Available The rupture of an omphalocele sac during birth is a well recognized entity. The associated lesions due to vascular compromise can result in necrosis of the bowel with perforation. Spontaneous bowel perforation in an omphalocele at birth is not reported in the literature. We describe a case with bowel perforation at the fundus of an omphalocele in a newborn.

Kale R

2006-01-01

247

Gastrointestinal symptoms in the irritable bowel compared with peptic ulcer and inflammatory bowel disease.  

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Symptoms of 50 patients with the irritable bowel syndrome were compared with those of 49 with endoscopically proven peptic ulcer disease and 49 with radiologically or endoscopically proven inflammatory bowel disease using a questionnaire which was administered after the diagnosis was made. Symptoms of bowel dysfunction including pain related to bowel movements were more likely to occur in the irritable bowel syndrome than peptic ulcer disease. Only abdominal distension, straining at stool and...

Thompson, W. G.

1984-01-01

248

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

249

Prophylactic and therapeutic management of acute radiation related morbidity of the skin and mucosa. Part I. Results of a German multicenter questionnaire  

International Nuclear Information System (INIS)

In this work, it was to evaluate the remedies, which are used for prevention and therapeutic management of acute radiation related morbidity of the skin and mucosa (mouth, pharynx, esophagus, small and large bowel, rectum and vagina). A questionnaire was sent to 130 radiotherapeutic departments in Germany in Juli 1995. The questionnaire had been designed with 22 open questions concerning the preventive and therapeutic management of acute radiation related morbidity of skin and mucosal sites. From 130 questionnaires, 89 (68.4%) were sent back till August 1995. All of them were evaluable. The recommendations showed a broad spectrum for each site. Especially the oral mucositis was treated in many different ways and combinations. The prevention and therapy of complicating superinfections seem to be the joint principle of most of the recommendations. The management of the acute radiation related morbidity has a wide clinical spectrum among different radiation therapy centers. Systematic prospectively designed investigations are necessary in order to achieve a further reduction in the radiation related acute morbidity. Therefore, a multicenter collaborative working group has been founded. (orig./MG)

1998-03-01

250

Acute bowel ischemia: CT findings  

Energy Technology Data Exchange (ETDEWEB)

Acute bowel ischemia represents one of the most dramatic abdominal emergencies and, despite the fact it is more and more frequently observed in clinical practice, its mortality rate remains very high. In recent years Computed Tomography (CT) has proved to be a valid diagnostic tool in the evaluation of patients with acute abdominal syndrome and in the visualization of early signs of bowel ischemia. This paper reviews the aetiological and pathophysiological aspects as well as a broad spectrum of CT findings of this clinical condition.

Angelelli, Giuseppe E-mail: g.angelelli@radiologia.uniba.it; Scardapane, Arnaldo; Memeo, Maurizio; Stabile Ianora, Amato Antonio; Rotondo, Antonio

2004-04-01

251

Faecal peritonitis secondary to perforated recto sigmoid colon by a large gallstone: a case report  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Large bowel obstruction is an important surgical emergency. The cause of obstruction may be benign or malignant, and include large bowel volvulus, polyps, intraperitoneal adhesions, strictures and neoplastic growths. Large bowel obstruction caused by gallstone(s) is a very rare phenomenon and not many cases are reported in the English literature. The present report describes a case of large bowel obstruction and faecal peritonitis caused by a gallstone perforating sigmoid colon. A database se...

Qureshi, Nafees Ahmad; Dua, Saacha; Leonard, Oscar; Myint, Fiona

2009-01-01

252

Can we improve the diagnostic yield of small bowel video-capsule endoscopy?  

Directory of Open Access Journals (Sweden)

Full Text Available Video-capsule endoscopy has revolutionized the examination of small bowel mucosa. However, this modality is relatively young and its diagnostic yield is low. Herein, we discuss different approaches to improve examination’s diagnostic yield. There are strong data supporting some of them while there is speculation about the rest. As capsule endoscopy continues to evolve there is also a strong belief that technology will overcome at least some of the obstacles that hamper capsule endoscopy’s diagnostic yield sometime in the near future.

Konstantinos Triantafyllou

2010-05-01

253

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

254

Leiomyoma of the small bowel  

International Nuclear Information System (INIS)

Diagnosis and surgical treatment of a leiomyoma of the small bowel are described. The special findings in this case are the unusual location of this tumors and the fact that histological examination revealed a benign process, although the tumor had a diameter of more than 16 cm. (orig.)

1986-01-01

255

Cancer in inflammatory bowel disease  

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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

256

Fetal bowel anomalies - US and MR assessment  

International Nuclear Information System (INIS)

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

2012-01-01

257

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

258

Bowel resection in Nigerian children  

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

Abdur-Rahman L

2009-01-01

259

Oral Mucocele of Unusual Size on the Buccal Mucosa: Clinical Presentation and Surgical Approach  

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Oral mucoceles are small-size, benign minor salivary gland pathologies. The most frequent localizations of these lesions are the lower lip mucosa. However, in some cases, they grow to an unusual size and hinder the preliminary diagnosis of mucocele. The purpose of this article is to report a case of a large oral mucocele with a diameter of 3.5 cm on the buccal mucosa of a 43-years-old male patient. The surgical procedure was carried out for a complete removal of the lesion.

2012-01-01

260

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

 
 
 
 
261

Oral mucosa grafts for urethral reconstruction  

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Background: Urethral reconstruction has continued to present formidable and enormous challenges for urologic, paediatric and plastic surgeons as diverse opinions have been expressed on the quality and type of ideal substitution material. This literature review is aimed at drawing attention of surgeons to the versatile nature of oral mucosal grafts. Methods: A review of the utilization of oral mucosa in urethral reconstruction was made. Structured Medline search was performed ...

Mungadi I; Ugboko V

2009-01-01

262

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

1985-01-01

263

Candidiasis de la mucosa bucal: Revisión bibliográfica  

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

Judy Rodríguez Ortega

2002-08-01

264

Dopamine receptors in human gastrointestinal mucosa  

International Nuclear Information System (INIS)

Dopamine is a putative enteric neurotransmitter that has been implicated in exocrine secretory and motility functions of the gastrointestinal tract of several mammalian species including man. This study was designed to determine the presence of dopamine binding sites in human gastric and duodenal mucosa and to describe certain biochemical characteristics of these enteric receptor sites. The binding assay was performed in triplicate with tissue homogenates obtained from healthy volunteers of both sexes using 3H-dopamine as a ligand. The extent of nonspecific binding was determined in the presence of a 100-fold excess of unlabeled dopamine. Scatchard analysis performed with increasing concentrations of 3H-dopamine (20-500 nM) revealed a single class of saturable dopamine binding sites in gastric and duodenal mucosa. The results of this report demonstrate the presence of specific dopamine receptors in human gastric and duodenal mucosa. These biochemical data suggest that molecular abnormalities of these receptor sites may be operative in the pathogenesis of important gastrointestinal disorders. 33 references, 2 figures

1987-12-21

265

Calcium secretion in canine tracheal mucosa  

Energy Technology Data Exchange (ETDEWEB)

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.

Al-Bazzaz, F.J.; Jayaram, T.

1985-10-01

266

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.

267

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

268

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

Science.gov (United States)

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

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

2000-10-01

269

Nutrition in inflammatory bowel diseases.  

Science.gov (United States)

The relationship between nutrition and inflammatory bowel disease (IBD) is a complex one, the evaluation and correction of nutritional deficits being integral part of therapy in these patients. The diet that consists in excessive consumption of meat, sugar, fats (with a higher 0 6 /o) 3 polyunsaturated fatty acids ratio) are factors involved in the epidemiology and pathogenesis of IBD. Malnutrition is present among most IBD patients, being the result of multiple mechanisms from digestive symptoms to inflammatory process, intestinal resection and administration of medications. Oral diet is high-calorie, high protein at correcting the vitamin and mineral deficiencies. Enteral diet has both an adjuvant role and that of inducing and maintaining remission as single treatment, particularly in children. Parenteral nutrition is reserved for patients with obstruction, fistula, toxic megacolon, short bowel syndrome, severe malabsorption, and other conditions that make enteral nutrition impossible or inefficient. PMID:24502032

Mihai, C?t?lina; Prelipcean, Cristina Cijevschi; Pintilie, Iulia; Nedelciuc, Otilia; Jigaranu, Anca-Olivia; Dranga, Mihaela; Mihai, B

2013-01-01

270

Inflammatory bowel disease in pregnancy  

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Concerns about sexual health, fertility, and pregnancy are common in patients with inflammatory bowel disease (IBD). Fertility is usually normal, although may be decreased in women with active Crohn's disease. Women with active IBD (especially Crohn's disease) are at risk of having small and premature babies. In some patients with IBD it may be desirable to continue drug treatment during pregnancy in order to control disease activity. Early engagement in discussion of these issues is importan...

Alstead, E.

2002-01-01

271

Anemia and inflammatory bowel diseases  

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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...

2009-01-01

272

Angiogenesis and inflammatory bowel disease  

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Inflammatory bowel disease (IBD) has gained immense attention recently due primarily to increasing prevalence. The exact disease mechanism is still unknown. There is considerable evidence of interrelation between the mechanisms of angiogenesis and the chronic inflammation of IBD. This evidence was obtained from animal models of colitis and confirmed in human studies. Serum levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (b-FGF) have been found to be sign...

Azzam Nahla

2007-01-01

273

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

274

Reoperative inflammatory bowel disease surgery.  

Science.gov (United States)

With the advent of restorative proctocolectomy or ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC), not only has there been potential for cure of UC but also patients have enjoyed marked improvements in bowel function, continence, and quality of life. However, IPAA can be complicated by postoperative small bowel obstruction, disease recurrence, and pouch failure secondary to pelvic sepsis, pouch dysfunction, mucosal inflammation, and neoplastic transformation. These may necessitate emergent or expeditious elective reoperation to salvage the pouch and preserve adequate function. Local, transanal, and transabdominal approaches to IPAA salvage are described, and their indications, outcomes, and the clinical parameters that affect the need for salvage are discussed. Pouch excision for failed salvage reoperation is reviewed as well. Relaparotomy is also frequently required for recurrent Crohn's disease (CD), especially given the nature of this as yet incurable illness. Risk factors for CD recurrence are examined, and the various surgical options and margins of resection are evaluated with a focus on bowel-sparing policy. Stricturoplasty, its outcomes, and its importance in recurrent disease are discussed, and segmental resection is compared with more extensive procedures such as total colectomy with ileorectal anastomosis. Lastly, laparoscopy is addressed with respect to its long-term outcomes, effect on surgical recurrence, and its application in the management of recurrent CD. PMID:20011321

Ramirez, Rowena L; Fleshner, Phillip

2006-11-01

275

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; Mylius Rasmussen, Mikkel

2013-01-01

276

Proteomic analysis of the inflamed intestinal mucosa reveals distinctive immune response profiles in Crohn's disease and ulcerative colitis.  

Science.gov (United States)

Although Crohn's disease (CrD) and ulcerative colitis (UC) share several clinical features, the mechanisms of tissue injury differ. Because the global cellular function depends upon the protein network environment as a whole, we explored changes in the distribution and association of mucosal proteins to define key events involved in disease pathogenesis. Endoscopic biopsies were taken from CrD, UC, and control colonic mucosa, and Multi-Epitope-Ligand-Cartographie immunofluorescence microscopy with 32 different Abs was performed. Multi-Epitope-Ligand-Cartographie is a novel, highly multiplexed robotic imaging technology which allows integrating cell biology and biomathematical tools to visualize dozens of proteins simultaneously in a structurally intact cell or tissue. In CrD, the number of CD3+CD45RA+ naive T cells was markedly increased, but only activated memory, but not naive, T cells expressed decreased levels of Bax, active caspase-3 or -8. In UC, only CD4+ T cells coexpressing NF-kappaB were caspase-8 and poly(ADP-ribose)-polymerase positive. Furthermore, the number of CD4+CD25+ T cells was elevated only in UC, whereas in CrD and controls, the number of these cells was similar. By using hub analysis, we also identified that the colocalization pattern with NF-kappaB+ and poly(ADP-ribose)-polymerase+ as base motifs distinguished CrD from UC. High-content proteomic analysis of the intestinal mucosa demonstrated for the first time that different T cell populations within the intestinal mucosa express proteins translating distinct biological functions in each form of inflammatory bowel disease. Thus, topological proteomic analysis may help to unravel the pathogenesis of inflammatory bowel disease by defining distinct immunopathogenic profiles in CrD and UC. PMID:17579049

Berndt, Uta; Bartsch, Sebastian; Philipsen, Lars; Danese, Silvio; Wiedenmann, Bertram; Dignass, Axel U; Hämmerle, Marcus; Sturm, Andreas

2007-07-01

277

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

278

Oral bowel lavage preparation for colonoscopy.  

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Colonoscopy is a commonly performed diagnostic and therapeutic procedure in most general hospitals, which requires effective bowel preparation to be worthwhile. We report the effect of replacing a diet, laxative and bowel washout preparation with oral bowel lavage using a balanced electrolyte formulation, in our unit. The preparation was acceptable to patients, medical and nursing staff, generally preferred to previous preparations by those who had experienced them, allowed a more complete co...

Burke, D. A.; Manning, A. P.; Murphy, L.; Axon, A. T.

1988-01-01

279

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

280

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

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

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

1983-10-01

 
 
 
 
281

CT findings in acute small bowel diverticulitis  

International Nuclear Information System (INIS)

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

2004-02-01

282

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

283

Pathophysiologic Findings of Irritable Bowel Syndrome in China  

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The mechanism of irritable bowel syndrome (IBS) is still incompletely understood in the world although large amount of investigations have been carried out on it. There are many studies on the pathophysiology of IBS in China, which has huge amount of population suffering from IBS with special ethnicity and culture, including Mainland China, Hong Kong and Taiwan. We collected the literatures to show the results and discuss whether there were any differences in the pathophysiologic findings bet...

Zhong, Likun; Hou, Xiaohua

2012-01-01

284

Premalignant alterations of the gastric mucosa  

International Nuclear Information System (INIS)

Atrophic gastritus or intestinal metaplasia is the precursor to many gastric carcinomas that arise in a dysplatic epithelium. The authors retrospectively reviewed the radiographic features of the gastric mucosa in 30 patients with the pathologic diagnosis of intestinal metaplasia (27) or atrophic gastritus (3). In 12 patients (40%) the area gastricae were enlarged to 5 mm or greater. In these 12 patients and in an additional 11 (total of 23, or 76%), a polypoid-nodular gastric mucosal pattern was seen. These findings and patterns are illustrated, and the differential diagnosis and clinical implications are discussed

1986-12-05

285

Spitz nevus of the genital mucosa  

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We herein report an 11-year-old girl who came to our clinic with a swelling on the genital area of 2 months duration. Dermatological examination of the patient was performed and a pigmented lesion was found on the inner surface of the labium majus of the mucosa. The lesion was well circumscribed and approximately 1 cm in diameter, with homogenous color distribution. The patient was diagnosed as Spitz nevus on the basis of clinical and histopathological findings. Our case is probably the first...

Polat Mualla; Topcuoglu Mehmet; Tahtaci Yasemin; Hapa Asli; Yilmaz Fahri

2009-01-01

286

Tumor of small bowel  

International Nuclear Information System (INIS)

Young woman who is having episodes of overt obscure gastrointestinal bleeding that requires transfusions. The endoscopic study consists of 2 endoscopies of the upper digestive system and two colonoscopies. The tests do not find the cause of the digestive hemorrhage. A double-balloon enteroscopy is performed and it is found that the Ileum has an ulcerate subepithelial lesion with neoplasia appearance which is marked with Chinese ink and biopsies are taken from the tissue which are not diagnosed. Studies of staging are performed ant the result is negative. A laparotomy is performed for diagnosis and treatment which includes the intestinal resection of ileum where the tumor is placed. The result of the test shows to be a neuroendocrine carcinoma of high degree of large cells undifferentiated. One appears in addition a revision to overt obscure gastrointestinal bleeding and neuroendocrine tumor of small

2009-01-01

287

Small bowel imaging- a rapidly changing field and a challenge to radiology  

Energy Technology Data Exchange (ETDEWEB)

There was a time when the small bowel follow-through (SBFT) was the primary method of diagnosing diseases of the small intestine. Enteroclysis was reinvented in the 70's and with the SBFT remained the dominant methods of investigating the mesenteric small intestine to the late 90's. Since the introduction of the first commercial computed tomography (CT) scanner in 1973, the ability of monoslice CT to diagnose different causes of intestinal obstruction and inflammatory bowel diseases emerged. The introduction of helical CT technology in 1989 and subsequently multichannel CT further changed small bowel imaging. Faster aquisition of a large volume of data with thinner collimation allowed multiplanar reformatting a distinct advantage in evaluating an organ which is longer than wide. The introduction of magnetic resonance (MR) imaging with its increased soft tissue contrast, lack of ionizing radiation, and the ability to acquire ultrafast sequences has made MR imaging an important tool in small bowel imaging (1). (orig.)

Maglinte, Dean D.T. [Indiana University School of Medicine, Department of Radiology, Indianapolis, IN (United States)

2006-05-15

288

Relationship between buccal mucosa ridging and viscoelastic behaviour of oral mucosa.  

Science.gov (United States)

The aim of this study was to clarify the relationship between the buccal mucosa ridging (BMR), which has been mentioned to be a clinical sign of clenching, and the viscoelastic behaviour of oral mucosa. Twenty-three people with BMR and 21 people without BMR participated as volunteers in this study. Measurements of viscoelastic behaviour were performed using a suction viscoelastic meter on central part of lower labial mucosa. A suction pressure of 300 hPa was applied for 2 s and then released for 2 s, and the time-dependent changes in the deformation of the mucosa over this 4 s were recorded as a deformation curve. Distensibility, remaining deformation and elastic recovery, which describe viscoelastic behaviour, were calculated by the deformation curve. These parameters were compared between groups with and without BMR. No significant difference was found in distensibility between the two groups (P=0·349). There were significant differences for the remaining deformation (P=0·012) and the elastic recovery (P=0·032), and the group with BMR showed higher remaining deformation and lower elastic recovery than the group without BMR. Based on these results, it clarified that the BMR is related to the mucosal viscoelastic behaviour, in particular remaining deformation and elastic recovery. PMID:21054483

Kumakura, S; Sakurai, K; Tahara, Y; Nakagawa, K

2011-06-01

289

The effects of water-soluble contrast media on luminal distension and blood flow in closed loops of small bowel in minipigs  

International Nuclear Information System (INIS)

The effects of iohexol, sodium diatrizoate and physiologic saline on intestinal distension and circulation were observed for 8 h in nine minipigs with closed-loop obstruction of the small bowel. The two contrast media led to an elevation of intraluminal pressures when initially instilled at pressures above 35 mm Hg. These elevated pressures were not high enough to cause rupture of the bowel wall. Both contrast media caused severe mucosal ischaemia as judged from histologic sections, loops containing sodium diatrizoate more so than iohexol. The blood circulation of the bowel wall, examined by laser Doppler flowmetry, was after 6 to 8 h reduced to about 10% of the values of non-obstructed bowel at intraluminal pressures of about 70 mm Hg in the loops with iohexol and sodium diatrizoate. The correlation to osmolality was obvious when compared with concurrent observations in the loops with physiologic saline. In the bowel loops filled with physiologic saline, the pressure fell to 5 mm Hg after 8 h, regaining approximately one-third of pre-instillation levels of blood flow. On microscopy these bowel loops had a nearly normal mucosa

1988-01-01

290

Effects of water-soluble contrast media on luminal distension and blood flow in closed loops of small bowel in minipigs  

Energy Technology Data Exchange (ETDEWEB)

The effects of iohexol, sodium diatrizoate and physiologic saline on intestinal distension and circulation were observed for 8 h in nine minipigs with closed-loop obstruction of the small bowel. The two contrast media led to an elevation of intraluminal pressures when initially instilled at pressures above 35 mm Hg. These elevated pressures were not high enough to cause rupture of the bowel wall. Both contrast media caused severe mucosal ischaemia as judged from histologic sections, loops containing sodium diatrizoate more so than iohexol. The blood circulation of the bowel wall, examined by laser Doppler flowmetry, was after 6 to 8 h reduced to about 10% of the values of non-obstructed bowel at intraluminal pressures of about 70 mm Hg in the loops with iohexol and sodium diatrizoate. The correlation to osmolality was obvious when compared with concurrent observations in the loops with physiologic saline. In the bowel loops filled with physiologic saline, the pressure fell to 5 mm Hg after 8 h, regaining approximately one-third of pre-instillation levels of blood flow. On microscopy these bowel loops had a nearly normal mucosa.

Stordahl, A.; Laerum, F.; Lunde, O.C.; Aase, S.

1988-01-01

291

Mucoadhesion dependence of pharmaceutical polymers on mucosa characteristics.  

Science.gov (United States)

Well known mucoadhesive polymers such as Carbopol 974P and Pharmacoat 606 and three different mucosas (sublingual, oesophageal and duodenal bovine) were used to verify how the mucoadhesive properties of materials may depend on the mucosa characteristics and if a polymer may reveal more mucoadhesive than another and vice versa by changing the type of interacting mucosa. So, tablets of Carbopol 974P and Pharmacoat 606 were prepared and their mucoadhesion on the three mucosas was set in terms of maximum load and work of detachment, using a texture analyzer. At the same time, mucosas were characterized by immunohistochemical techniques and lectin histochemistry. Results obtained from the Tensile test analyses show that the adhesive power of the two polymers is different in the three mucosas. Particularly, in the sublingual mucosa, Carbopol was more mucoadhesive than Pharmacoat. On the contrary, Pharmacoat was more mucoadhesive than Carbopol in duodenal mucosa. The significantly different behavior of polymers was correlated with the desquamation layer thickness and the differential sialic acid and fucose exposition in the targeted mucosas. PMID:15196578

Accili, Daniela; Menghi, Giovanna; Bonacucina, Giulia; Martino, Piera Di; Palmieri, Giovanni F

2004-07-01

292

Colorectal dysplasia in inflammatory bowel disease: a clinicopathologic perspective.  

Science.gov (United States)

Surveillance for neoplasia in colitis is the most challenging diagnostic colonoscopic procedure. The detection and treatment of colorectal dysplasia in inflammatory bowel disease remain problematic to the point that unsuspected colorectal cancers (CRCs) are still identified. Excellent bowel preparation and use of high-resolution colonoscopes with chromoendoscopy facilitate the detection and characterization of subtle neoplasia. This approach is superior to taking random biopsy specimens and should be the standard of care for surveillance but requires adequate training. Suspicious lesions should be assessed carefully and described using objective terminology. The terms dysplasia-associated lesions/masses and flat dysplasia are best avoided because they may be open to misinterpretation. Most suspicious lesions detected during surveillance can be removed endoscopically, precluding the need for surgery. Nevertheless, endotherapy in colitis can be difficult as a result of underlying inflammation and scarring. Lesions that are not endoscopically resectable need to be removed surgically, although the possibility that some lesions might be amenable to local resection (including lymphadenectomy) rather than subtotal colectomy may need to be re-evaluated. Despite surveillance programs, patients still present clinically with CRC. This may occur because lesions are missed (possibly because of the failure to use optimal techniques), lesions are not adequately removed, patients fail to return for colonoscopy, or CRCs arise rapidly in mucosa that is minimally dysplastic and the CRCs are not recognized as being potentially invasive even on biopsy. Future advances in, for example, stool DNA assays, use of confocal endomicroscopy, or use of endoscopic ultrasound, may help in the identification of high-risk patients and the assessment of dysplastic lesions. PMID:23756224

Rutter, Matthew D; Riddell, Robert H

2014-03-01

293

Honey and apoptosis in human gastric mucosa.  

Science.gov (United States)

Background: Gastric cancer is the fourth most common malignancy in the world. Honey is a complex mixture of special biological active constituents. Honey possesses antioxidant and antitumor properties. Nutritional studies have indicated that consumption of honey modulates the risk of developing gastric cancer. On the other hand, apoptosis has been reported to play a decisive role in precancerous changes. Our chief study was conducted to assess the relationship between consumption of honey and apoptosis in human gastric mucosa. Method: This cross-sectional study was conducted on 98 subjects over 18 years old, referred to two hospitals in Tabriz, Iran. Subjects were undergone an upper gastrointestinal endoscopy, 62 subjects were finally enrolled. Honey consumption was assessed by a Food Frequency Questionnaire (FFQ) and apoptosis was detected by TUNEL technique. We tested polynomial curve to find 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(honey amount) - 0.533(honey amount)2 +1.833×10-5(honey amount)7. Conclusion: Honey consumption had positive effects on gastric cancer by inducing apoptosis in gastric mucosa. PMID:24688918

Ghaffari, Aida; Somi, Mohammad H; Safaiyan, Abdolrasoul; Modaresi, Jabiz; Ostadrahimi, Alireza

2012-01-01

294

Cholesterol esterase activity of human intestinal mucosa  

International Nuclear Information System (INIS)

It has been suggested that cholesterol absorption in humans is dependent on bile acid pool composition and that expansion of the cholic acid pool size is followed by an increase of the absorption values. Similar observations were reported in rats. In the present study, therefore, the authors investigated some general properties of human intestinal cholesterol esterase, with particular emphasis on the effect of bile acids on this enzymatic activity. Twenty-nine segments of small intestine were taken during operations; the enzymatic activity was studied by using mucosal homogenate as a source of enzyme and oleic acid, cholesterol, and 14C-labeled cholesterol as substrates. The time-activity relationship was linear within the first two hours; optimal pH for esterification ranged between 5 and 6.2. There was little difference between the esterifying activity of the jejunal and ileal mucosa. Esterification of cholesterol was observed with all the investigated fatty acids but was maximal with oleic acid. Bile acids did not affect cholesterol esterase activity when present in the incubation mixture at 0.1 and 1.0 mM; the enzymatic activity, however, was significantly inhibited when bile acids were added at 20 mM. In conclusion, this study has shown that the human intestinal mucosa possesses a cholesterol esterase activity; at variance with the rat, however, the human enzyme does not seem to be stimulated by trihydroxy bile acids

1985-01-01

295

Sensitization to epithelial antigens in chronic mucosal inflammatory disease. Characterization of human intestinal mucosa-derived mononuclear cells reactive with purified epithelial cell-associated components in vitro.  

Science.gov (United States)

To explore the auto-reactive potential of cells infiltrating the gut mucosa in idiopathic chronic inflammatory bowel disease, intestinal lamina propria mononuclear cells (LPMC) were isolated, characterized morphologically and phenotypically, and evaluated for antigen-specific reactivity. The last was assessed by quantitating LPMC cytotoxic capabilities against purified, aqueous-soluble, organ-specific epithelial cell-associated components (ECAC) characterized previously. Enzyme-isolated inflammatory bowel disease LPMC were constituted primarily by T lymphocytes (57 +/- 12% OKT 3-positive), B lymphocytes (18 +/- 9% surface immunoglobulin-positive), and macrophages (11 +/- 6% esterase-positive), and were responsive to phytohemagglutinin (mean uptake 86,933 cpm/5 X 10(5) cells). LPMC present in abnormal segments from 71% of patients with chronic inflammatory bowel disease were cytotoxic for ECAC isolated from colon (12.5 +/- 8.9% specific lysis) and small bowel (7.1 +/- 6.5%), but not for kidney control antigen (0.8 +/- 1.1%) isolated in a manner analogous to that used for ECAC (P less than 0.02). In contrast, despite comparable responses to phytohemagglutinin (mean uptake 59,200 cpm/5 X 10(5) cells), LPMC from histologically normal mucosa of patients with benign (adult megacolon, Hirshsprung's disease, diverticulosis) or malignant disease failed to lyse indicator cells labeled with colon-derived ECAC (0.3 +/- 0.08%), small bowel-derived ECAC (0.4 +/- 1.11%), or kidney antigen (0.29 +/- 0.79%). LPMC reactivity for individual gel-purified macromolecules of small bowel-derived ECAC (designated as the "P" series of components) was greatest against component P1 (by 2-3-fold), but was detectable against three other purified components as well. The addition of patient's serum did not enhance cytotoxicity to ECAC. Characterization of the cytotoxic cell showed that it was nonadherent to plastic surfaces, bore T lymphocyte-specific markers detectable by OKT 11 and OKT 3 monoclonal antibodies, and could be depleted by removal of cells with receptors for sheep erythrocytes. ECAC-specific reactivity was markedly reduced (greater than 93%) in most experiments when LPMC were preincubated for 1 h with ECAC. These data support the concept that autosensitization to several epithelial cell-associated components has occurred in patients with chronic inflammatory bowel disease, and provide initial evidence that antigen-specific, cell-mediated mechanisms may play a role in the pathogenesis of these disorders. Images

Roche, J K; Fiocchi, C; Youngman, K

1985-01-01

296

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

297

Intestino Corto Short bowel syndrome  

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

María Matilde Socarrás Suárez

2004-06-01

298

Validation of a new bowel preparation scale for measuring colon cleansing for colonoscopy: the chicago bowel preparation scale.  

Science.gov (United States)

Objectives:Current bowel preparation scales (BPSs) have significant limitations including an inability to distinguish among bowel preparations that adequately cleanse a high percentage of colons. We assessed the reliability and validity of the new Chicago BPS and compared it with existing BPSs.Methods:We performed a prospective evaluation of the cleanliness of 150 colons. Inter-rater agreement was assessed using kappa and Pearson correlation coefficients. Each colon was rated by a gastroenterologist and physician's assistant using the Ottawa BPS, the Boston BPS, a dichotomous (adequate/inadequate) BPS (where adequate was defined as being able to visualize at least 95% of the mucosa), and the Chicago BPS.Results:Pearson correlation coefficients between the gastroenterologists and physician's assistant for total BPS scores were 0.79 (95% confidence interval (CI): 0.73, 0.85), 0.79 (95% CI: 0.72, 0.84), and 0.84 (95% CI: 0.79, 0.88) for the Ottawa, Boston, and Chicago BPSs, respectively. Kappa coefficients for right, middle, and distal colon segment ratings were 0.66, 0.53, and 0.49, respectively, for the Ottawa BPS; 0.64, 0.66, and 0.54, respectively, for the Boston BPS; and 0.70, 0.62, and 0.63, respectively, for the Chicago BPS. Differences between the Chicago BPS and the other BPSs were not statistically significant. The Chicago BPS exhibited the best correspondence between BPS total score and the adequate/inadequate BPS.Conclusions:This study demonstrated the validity and reliability of the Chicago BPS. The better defined grading criteria, better designed numerical ratings scale, and better correspondence between Chicago BPS total score and the adequate/inadequate BPS make the Chicago BPS an attractive alternative to the Ottawa BPS and the Boston BPS. PMID:24304940

Gerard, David P; Foster, Diane B; Raiser, Manfred W; Holden, John L; Karrison, Theodore G

2013-01-01

299

The Treatment of Irritable Bowel Syndrome  

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Irritable bowel syndrome (IBS) is a highly prevalent functional bowel disorder routinely encountered by healthcare providers. Although not life-threatening, this chronic disorder reduces patients’ quality of life and imposes a significant economic burden to the healthcare system. IBS is no longer considered a diagnosis of exclusion that can only be made after performing a batte...

Lacy, Brian E.; Weiser, Kirsten; Lee, Ryan

2009-01-01

300

Perforated Small Bowel Diverticulitis After Gastric Bypass  

Science.gov (United States)

We report a rare case of complicated jejunal diverticulitis in a patient with previous bariatric surgery. Small bowel diverticulosis is generally considered an inoffensive disease. In this report we describe a case of small bowel perforation in an obese subject who had undergone laparoscopic Roux-en-Y gastric bypass.

Pavel, Mihai; Lacy, Antonio

2014-01-01

 
 
 
 
301

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

302

Pneumobilia associated with small-bowel obstruction  

Energy Technology Data Exchange (ETDEWEB)

The authors present a patient who admitted complaining of nausea, vomiting, and abdominal distention. A roentgenogram of the abdomen revealed a dilated stomach and pneumobilia. At surgery, he was found to have proximal small-bowel obstruction. To their knowledge, this is the first case of pneumobilia associated with proximal small-bowel obstruction not associated with a gallstone.

Bautista, J.L.; Budhraja, M.D.; Barcia, T.D.; Shankel, S.W.

1988-10-07

303

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

304

Kidney Risk Spurs Warning on Bowel Cleansers  

Science.gov (United States)

... they are used at higher doses for bowel cleansing. The available data show no risk of acute kidney injury when OTC products are used at the lower doses as laxatives. But these products ... for bowel cleansing. FDA is recommending that consumers not use OTC ...

305

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

Energy Technology Data Exchange (ETDEWEB)

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 /sup 111/In-oxine 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 inflammed segments. The inability to show non-inflammed segments (n=5) and to localise small bowel stenoses exactly is disadvantageous in the scan. The advantage of the leucocyte scan is a noninvasive examination without specific bowel preparation and the ability to diagnose additionally inflammed 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.

Becker, W.; Jenett, M.; Fischbach, W.; Boerner, W.

1986-07-01

306

Multidisciplinary laparoscopic treatment for bowel endometriosis.  

Science.gov (United States)

Endometriosis is a handicapping disease affecting young females in the reproductive period. It mainly occurs in the pelvis and affects the bowel in 3-37%. Endometriosis can cause menstrual and non-menstrual pelvic pain and infertility. Colorectal involvement results in alterations of bowel habit such as constipation, diarrhoea, tenesmus, and rarely rectal bleeding. A precise diagnosis about the presence, location and extent is necessary. Based on clinical examination, the diagnosis of bowel endometriosis can be made by transvaginal ultrasound, barium enema examination and magnetic resonance imaging. Multidisciplinary laparoscopic treatment has become the standard of care and depending on size of the lesion and site of involvement full-thickness disc excision or bowel resection is performed by an experienced colorectal surgeon. Anastomotic complications occur around 1%. Long-term outcome after bowel resection for severe endometriosis is good with a pregnancy rate of 50%. PMID:24485255

Wolthuis, Albert M; Tomassetti, Carla

2014-02-01

307

Immunological basis of inflammatory bowel disease: role of the microcirculation.  

Science.gov (United States)

Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the intestine and/or colon of unknown etiology in which patients suffer from severe diarrhea, rectal bleeding, abdominal pain, fever, and weight loss. Active episodes of IBD are characterized by vasodilation, venocongestion, edema, infiltration of large numbers of inflammatory cells, and erosions and ulcerations of the bowel. It is becoming increasingly apparent that chronic gut inflammation may result from a dysregulated immune response toward components of the normal intestinal flora, resulting in a sustained overproduction of proinflammatory cytokines and mediators. Many of these Th1 and macrophage-derived cytokines and lipid metabolites are known to activate microvascular endothelial cells, thereby promoting leukocyte recruitment into the intestinal interstitium. This review discusses the basic immune mechanisms involved in the regulation of inflammatory responses in the gut and describes how a breakdown in this protective response initiates chronic gut inflammation. PMID:11687942

Laroux, F S; Grisham, M B

2001-10-01

308

Altered transcription of murine genes induced in the small bowel by administration of probiotic strain Lactobacillus rhamnosus HN001.  

Science.gov (United States)

Lactobacillus rhamnosus HN001 is a probiotic strain reported to increase resistance to epithelium-adherent and -invasive intestinal pathogens in experimental animals. To increase understanding of the relationship between strain HN001 and the bowel, transcription of selected genes in the mucosa of the murine small bowel was measured. Mice previously naive to lactobacilli (Lactobacillus-free mice) were examined after daily exposure to HN001 in drinking water. Comparisons were made to results from matched Lactobacillus-free mice. Infant and adult mice were investigated to provide a temporal view of gene expression in response to exposure to HN001. Genes sgk1, angptl4, and hspa1b, associated with the apoptosis pathway, were selected for investigation by reverse transcription-quantitative PCR on the basis of a preliminary duodenal DNA microarray screen. Normalized to gapdh gene transcription, these three genes were upregulated after 6 to 10 days exposure of adult mice to HN001. Angptl4 was shown by immunofluorescence to be upregulated in duodenal epithelial cells of mucosal samples. Epithelial cell migration was faster in HN001-exposed mice than in the Lactobacillus-free controls. Transcriptional responses in infant mice differed according to bowel region and age. For example, sgk1 was upregulated in duodenal, jejunal, and ileal mucosa of mice less than 25 days old, whereas angptl4 and hspa1b were upregulated at 10 days in the duodenum but downregulated in the jejunal mucosa until mice were 25 days old. Overall, the results provide links between a probiotic strain, mucosal gene expression, and host phenotype, which may be useful in delineating mechanisms of probiotic action. PMID:24584241

Tannock, Gerald W; Taylor, Corinda; Lawley, Blair; Loach, Diane; Gould, Maree; Dunn, Amy C; McLellan, Alexander D; Black, Michael A; McNoe, Les; Dekker, James; Gopal, Pramod; Collett, Michael A

2014-05-01

309

Probiotics and Irritable Bowel Syndrome  

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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

310

Micronucleus level in exfoliated buccal mucosa cells of cancer patients  

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Micronucleus levels in exfoliated buccal mucosa cells of patients with primary breast, lung, cervix uteri cancer, and patients with Hodgkin's disease were studied (n=59). Significantly increased number of micronuclei in cells of cancer patients was observed compared with healthy persons (n=45). The evaluation of micronuclei number in buccal mucosa cells shows genomic instability in somatic cells of humans.

Nersesyan Armen K.; Vardazaryan Nina S.; Gevorgyan Ani L.; Arutyunyan Rouben M.

2002-01-01

311

Micronucleus level in exfoliated buccal mucosa cells of cancer patients  

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Full Text Available Micronucleus levels in exfoliated buccal mucosa cells of patients with primary breast, lung, cervix uteri cancer, and patients with Hodgkin's disease were studied (n=59. Significantly increased number of micronuclei in cells of cancer patients was observed compared with healthy persons (n=45. The evaluation of micronuclei number in buccal mucosa cells shows genomic instability in somatic cells of humans.

Nersesyan Armen K.

2002-01-01

312

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

International Nuclear Information System (INIS)

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

2003-01-01

313

Efecto del Tisuacryl sobre la mucosa oral  

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

Gastu00F3n Garcu00EDa-Simons

2006-01-01

314

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)

1997-09-01

315

Glycosphingolipids of fetal and adult sheep colonic mucosa.  

Science.gov (United States)

The ganglioside and neutral glycosphingolipid composition of fetal and adult sheep colonic mucosa were characterized and compared. Mono- and tetrahexosylceramide were the major neutral glycolipids of both fetal and adult colons. Adult, but not fetal, mucosa also possessed di- and trihexosylceramide. Similarly, GD1a, GM3 and GM2 were found to be the principal gangliosides in fetal and adult tissue. Adult colonic mucosa possessed significant amounts of GT1a not present in fetal tissue. Analysis of the hydroxy and nonhydroxy fatty acids as well as of the long chain bases of the major glycosphingolipids revealed differences between these lipophilic components of glycolipids in fetal and adult colonic mucosa. The present results, therefore, indicate that both quantitative and qualitative differences in glycosphingolipid composition exist between fetal and adult sheep colonic mucosa. PMID:4021741

Dahiya, R; Brasitus, T A

1985-06-01

316

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

317

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 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

2004-05-01

318

Clostridium difficile Carriage Rate in Outpatients with Inflammatory Bowel Diseases  

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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

319

Changes of the cytokine profile in inflammatory bowel diseases  

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Full Text Available Cytokines are indispensable signals of the mucosa-associated immune system for maintaining normal gut homeostasis. An imbalance of their profile in favour of inflammation initiation may lead to disease states, such as that is observed in inflammatory bowel diseases (IBD. Although Crohn’s disease (CD is often described as a prototype of T-helper 1-type diseases, and ulcerative colitis (UC is traditionally viewed as a T-helper 2-mediated condition, the classic paradigm, which categorises cytokines into pro- and anti-inflammatory groups, has recently been changed. The inflammation regulatory pathways may not be mutually exclusive as individual cytokines can have diverse and even opposing functions in various clinical and immunological settings. None the less there are many common immunological responses in IBD that are mediated by cytokines. Although they regulate and influence the development, course and recurrence of the inflammatory process, the concrete pathogenic role of these small signaling molecules is sometimes not unambiguous in the subtypes of the disease. Our aim is to review the current information about pro- and anti-inflammatory effects of traditionally studied and recently discovered cytokines in the pathogenesis of UC and CD. The better understanding of their production and functional activity may lead to the development of new therapeutic modalities.

Györgyi M?zes

2012-01-01

320

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

Science.gov (United States)

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

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

2009-09-01

 
 
 
 
321

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

322

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 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

2000-09-01

323

Small bowel neoplastic disease: demonstration by MRI.  

Science.gov (United States)

This study demonstrates the appearance of small bowel tumors on MR images. Sixteen patients with tumors involving small bowel were studied by MRI. All tumors were proven with histopathology. Eleven patients had primary tumors of the small bowel, which included the following: four carcinoid tumors, three adenocarcinomas, two lymphomas, one leiomyosarcoma, and one leiomyoma. Five patients had recurrent or metastatic disease to small bowel: two patients had colon cancer, one patient had pancreatic cancer, one patient had uterine leiomyosarcoma, and one patient had chloroma (leukemia). MR examination included breath-hold T1-weighted spoiled gradient echo (all patients), immediate postgadolinium-spoiled gradient echo (10 patients), and 2 to 4 minutes postgadolinium T1-weighted, fat-suppressed images (all patients). Tumor size, local extent, signal intensity, and enhancement features of tumor and adjacent tissue were determined. Tumor ranged in diameter from 1 to 9 cm (mean, 4.0 cm). Tumors had similar signal intensity to normal small bowel on precontrast images. Fourteen malignant tumors showed heterogeneous enhancement greater than adjacent bowel on gadolinium-enhanced images. Tumor local extent was best shown on precontrast-spoiled gradient-echo images and postgadolinium T1-weighted fat-suppressed images. Image quality was most consistent on breath-hold images. The results of this study show that small bowel tumors are demonstrable on MR images. Precontrast breath-hold T1-weighted spoiled gradient-echo images and gadolinium-enhanced fat suppressed images demonstrate tumor extent most reliably. PMID:8956128

Semelka, R C; John, G; Kelekis, N L; Burdeny, D A; Ascher, S M

1996-01-01

324

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

325

Epstein-Barr Virus Infection is Common in Inflamed Gastrointestinal Mucosa  

Science.gov (United States)

Background and Aims Epstein-Barr virus (EBV) is present in the malignant epithelial cells of 10% of all gastric adenocarcinomas, however localization of the virus in normal gastrointestinal mucosa is largely unexplored. In the current study, we measured EBV DNA and localized viral gene products in gastritis specimens (n=89), normal gastric and colonic mucosa (n=14), Crohn’s disease (n=9), and ulcerative colitis (n=11) tissues. Methods A battery of sensitive and specific quantitative polymerase chain reactions targeted six disparate regions of the EBV genome: BamH1W, EBNA1, LMP1, LMP2, BZLF1, and EBER1. EBV infection was localized by EBV-encoded RNA (EBER) in situ hybridization and by immunohistochemical stains for viral latent proteins LMP1 and LMP2 and for viral lytic proteins BMRF1 and BZLF1. B lymphocytes were identified using CD20 immunostains. Results EBV DNA was essentially undetectable in normal gastric mucosa but was present in 46% of gastritis lesions, 44% of normal colonic mucosa, 55% of Crohn’s disease, and 64% of ulcerative colitis samples. Levels of EBV DNA exceeded what would be expected based on the numbers of B lymphocytes in inflamed tissues, suggesting that EBV is preferentially localized to inflammatory gastrointestinal lesions. Histochemical staining revealed EBER expression in lymphoid cells of some PCR-positive lesions. The viral lytic viral proteins, BMRF1 and BZLF1, were expressed in lymphoid cells of two ulcerative colitis tissues, both of which had relatively high viral loads by quantitative PCR. Conclusion EBV-infected lymphocytes are frequently present in inflamed gastric and colonic mucosa. Active viral replication in some lesions raises the possibility of virus-related perpetuation of gastrointestinal inflammation.

Ryan, Julie L.; Shen, You-Jun; Morgan, Douglas R.; Thorne, Leigh B.; Kenney, Shannon C.; Dominguez, Ricardo L.; Gulley, Margaret L.

2012-01-01

326

Does MRI with oral contrast medium allow single-study depiction of inflammatory bowel disease enteritis and colitis?  

Energy Technology Data Exchange (ETDEWEB)

To assess the feasibility and utility of magnetic resonance (MR) imaging of the bowel in concurrent small- and large-bowel evaluation for the presence of inflammatory bowel disease (IBD). Over a 5-year period, 62 MR examinations performed on 53 patients demonstrated evidence of IBD. Sixteen of these 53 (30.1%) patients had imaging findings of colonic disease and underwent 19 formal MR small bowel examinations. These were further evaluated for bowel distention and image quality. The sensitivity and specificity of the technique compared with colonoscopy as the 'gold standard' was evaluated. Simultaneous imaging of the colon is feasible at MR small bowel follow-through with moderate-to-excellent colonic visibility and colon distention obtained when the contrast medium is present in the colon at the time of image acquisition. MR imaging had a sensitivity of 80% (0.56-0.93), specificity of 100% (0.77-1.00), positive predictive value (PPV) of 1 and a negative predictive value (NPV) of 0.8 for the identification of colitis (based on available concurrent correlation of 38/62 examinations with colonoscopy). Small and large bowel MR imaging with orally consumed contrast medium represents a promising, feasible, non-invasive, non-radiating single mode of assessment of the entire gastrointestinal tract, performed at a single sitting. (orig.)

Cronin, Carmel G.; Lohan, Derek G.; Browne, Ann Michelle; Roche, Clare; Murphy, Joseph M. [University College Hospital, Department of Radiology, Galway (Ireland)

2010-07-15

327

Review article: Osteoporosis and inflammatory bowel disease.  

Science.gov (United States)

Studies using dual-energy X-ray absorptiometry have suggested a high prevalence of osteoporosis in inflammatory bowel disease. However, population-based data on fracture incidence suggest only a small increased risk of fracture amongst patients with inflammatory bowel disease compared with the general population. Therefore, it would be helpful to identify patients with inflammatory bowel disease at particularly high risk for fracture so that these risks might be modified or interventions might be undertaken. The data on calcium intake as a predictor of bone mineral density are conflicting. Although there are data suggesting that a one-time survey to determine current calcium intake will not help to predict bone mineral density in inflammatory bowel disease, persistently reduced calcium intake does appear to lead to lower bone mineral density. In the general population, body mass is strongly correlated with bone mineral density, which also appears to be true in Crohn's disease. Hence, subjects with inflammatory bowel disease and considerable weight loss, or who are obviously malnourished, could be considered for bone mineral density testing, and the finding of a low bone mineral density would suggest the need for more aggressive nutritional support. Although vitamin D is undoubtedly important in bone health, vitamin D intake and serum vitamin D levels do not correlate well with bone mineral density. Sex hormone deficiency can also adversely affect bone health, although a well-developed strategy for sex hormone measurements in patients with inflammatory bowel disease remains to be established. Ultimately, the determination of genetic mutations that accurately predict fracture susceptibility may be the best hope for developing a simplified strategy for managing bone health in inflammatory bowel disease. The therapy of osteoporosis in inflammatory bowel disease has been adapted from other osteoporosis settings, such as post-menopausal or corticosteroid-induced osteoporosis. To date, there remains no therapy proven to be efficacious in inflammatory bowel disease-related osteoporosis; however, calcium and vitamin D supplementation and bisphosphonates have their roles. PMID:15113361

Bernstein, C N; Leslie, W D

2004-05-01

328

A mucosa oral na hanseníase: um estudo clínico e histopatológico / The oral mucosa in leprosy: a clinical and histopathological study  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese INTRODUÇÃO: a anseníase multibacilar pode causar comprometimento da mucosa oral, com ou sem lesões aparentes. Há poucos estudos que tratam deste assunto na era da multidrogaterapia. OBJETIVO: Verificar a freqüência do comprometimento da mucosa oral em pacientes de hanseníase multibacilar. CASUÍSTICA [...] E MÉTODOS: Foi realizado um estudo transversal em vinte pacientes de hanseníase multibacilar, não-tratados, atendidos consecutivamente em Dracena, São Paulo, entre o período de 2000 e 2002. Foi realizado exame clínico completo da mucosa oral. Os pacientes foram submetidos a biópsias na mucosa jugal, na língua e no palato mole, em alteração ou em pontos pré-estabelecidos. Os cortes foram corados pelas técnicas da hematoxilina-eosina e Ziehl-Neelsen. O encontro de granuloma e bacilos álcool-ácido-resistentes ao exame histopatológico determinou o comprometimento específico. RESULTADOS: O estudo envolveu 19 pacientes multibacilares com tempo médio de evolução de 2,5 anos. Ocorreu comprometimento histopatológico específico em apenas um paciente virchowiano, com mucosa oral clinicamente normal, na língua e no palato mole. CONCLUSÕES: 1. Alteração clínica na mucosa oral não implica em comprometimento pela doença, é necessário confirmação histopatológica. 2. Alterações clínicas específicas aparentes são raras. 3. A mucosa oral clinicamente normal pode exibir comprometimento histopatológico específico. Abstract in english INTRODUCTION: Multibacillary leprosy may involve the oral mucosa, with or without apparent lesions. There are few studies that deal with this issue in the era of multidrug therapy. AIM: To assess the frequence of oral mucosa involvement in multibacillary leprosy patients. PATIENTS AND METHODS: A tra [...] nsversal study with twenty non-treated multibacillary leprosy patients. The patients were treated in Dracena, São Paulo, between 2000 and 2002. Clinical examination of the oral mucosa was carried out. All patients were submitted to jugal mucosa, soft palate and tongue biopsies, in altered or in pre-established sites. The cross-sections were stained by techniques of hematoxilin-eosin and Ziehl-Neelsen. Granuloma and alcohol-acid-resistant bacilli findings determined the specific histopathological involvement. RESULTS: The study involved 19 patients with an average of 2.5 years of disease progression. Specific histopathological involvement occurred in the tongue and soft palate of one lepromatous patient with an apparently normal oral mucosa. CONCLUSIONS: (1) Clinical alterations in the oral mucosa does not imply disease involvement, it is necessary to have histopathological confirmation. (2) Apparent specific clinical alterations are rare. (3) The clinically normal oral mucosa can show specific histopathological involvement.

Marilda Aparecida Milanez Morgado de, Abreu; Nilceo Schwery, Michalany; Luc Louis Maurice, Weckx; Dalva Regina, Neto Pimentel; Cleonice Hitomi Watashi, Hirata; Maurício Mota de Avelar, Alchorne.

329

A mucosa oral na hanseníase: um estudo clínico e histopatológico The oral mucosa in leprosy: a clinical and histopathological study  

Directory of Open Access Journals (Sweden)

Full Text Available INTRODUÇÃO: a anseníase multibacilar pode causar comprometimento da mucosa oral, com ou sem lesões aparentes. Há poucos estudos que tratam deste assunto na era da multidrogaterapia. OBJETIVO: Verificar a freqüência do comprometimento da mucosa oral em pacientes de hanseníase multibacilar. CASUÍSTICA E MÉTODOS: Foi realizado um estudo transversal em vinte pacientes de hanseníase multibacilar, não-tratados, atendidos consecutivamente em Dracena, São Paulo, entre o período de 2000 e 2002. Foi realizado exame clínico completo da mucosa oral. Os pacientes foram submetidos a biópsias na mucosa jugal, na língua e no palato mole, em alteração ou em pontos pré-estabelecidos. Os cortes foram corados pelas técnicas da hematoxilina-eosina e Ziehl-Neelsen. O encontro de granuloma e bacilos álcool-ácido-resistentes ao exame histopatológico determinou o comprometimento específico. RESULTADOS: O estudo envolveu 19 pacientes multibacilares com tempo médio de evolução de 2,5 anos. Ocorreu comprometimento histopatológico específico em apenas um paciente virchowiano, com mucosa oral clinicamente normal, na língua e no palato mole. CONCLUSÕES: 1. Alteração clínica na mucosa oral não implica em comprometimento pela doença, é necessário confirmação histopatológica. 2. Alterações clínicas específicas aparentes são raras. 3. A mucosa oral clinicamente normal pode exibir comprometimento histopatológico específico.INTRODUCTION: Multibacillary leprosy may involve the oral mucosa, with or without apparent lesions. There are few studies that deal with this issue in the era of multidrug therapy. AIM: To assess the frequence of oral mucosa involvement in multibacillary leprosy patients. PATIENTS AND METHODS: A transversal study with twenty non-treated multibacillary leprosy patients. The patients were treated in Dracena, São Paulo, between 2000 and 2002. Clinical examination of the oral mucosa was carried out. All patients were submitted to jugal mucosa, soft palate and tongue biopsies, in altered or in pre-established sites. The cross-sections were stained by techniques of hematoxilin-eosin and Ziehl-Neelsen. Granuloma and alcohol-acid-resistant bacilli findings determined the specific histopathological involvement. RESULTS: The study involved 19 patients with an average of 2.5 years of disease progression. Specific histopathological involvement occurred in the tongue and soft palate of one lepromatous patient with an apparently normal oral mucosa. CONCLUSIONS: (1 Clinical alterations in the oral mucosa does not imply disease involvement, it is necessary to have histopathological confirmation. (2 Apparent specific clinical alterations are rare. (3 The clinically normal oral mucosa can show specific histopathological involvement.

Marilda Aparecida Milanez Morgado de Abreu

2006-06-01

330

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)

2006-01-01

331

Neurotensin receptor 1 overexpression in inflammatory bowel diseases and colitis-associated neoplasia  

Directory of Open Access Journals (Sweden)

Full Text Available AIM: To explore the association of neurotensin receptor 1 (NTSR1 with inflammatory bowel diseases (IBD and colitis-associated neoplasia. METHODS: NTSR1 was detected by immunohistochemistry in clinical samples of colonic mucosa with IBD colitis, colitis-associated raised low-grade dysplasia (LGD including dysplasia-associated lesions or masses (DALMs, n = 18 and adenoma-like dysplastic polyps (ALDPs, n = 4, colitis-associated high-grade dysplasia (HGD, n = 11 and colitis-associated colorectal carcinoma (CACRC, n = 13, sporadic colorectal adenomatous polyp (SAP, n = 17, and sporadic colorectal carcinoma (SCRC, n = 12. The immunoreactivity of NTSR1 was semiquantitated (as negative, 1+, 2+, and 3+ and compared among different conditions. RESULTS: NTSR1 was not detected in normal mucosa but was expressed similarly in both active and inactive colitis. LGD showed a significantly stronger expression as compared with non-dysplastic colitic mucosa, with significantly more cases showing > 2+ intensity (68.75% in LGD vs 32.26% in nondysplastic mucosa, P = 0.001. However, no significant difference existed between DALMs and ALDPs. CACRC and HGD showed a further stronger expression, with significantly more cases showing 3+ intensity than that in LGD (61.54% vs 12.50% for CACRC vs LGD, P = 0.022; 58.33% vs 12.50% for CACRC/HGD vs LGD, P = 0.015. No significant difference existed between colitis-associated and non-colitic sporadic neoplasia. CONCLUSION: NTSR1 in colonic epithelial cells is overexpressed in IBD, in a stepwise fashion with sequential progress from inflammation to dysplasia and carcinoma.

Xianyong Gui

2013-01-01

332

Neurotensin receptor 1 overexpression in inflammatory bowel diseases and colitis-associated neoplasia  

Science.gov (United States)

AIM: To explore the association of neurotensin receptor 1 (NTSR1) with inflammatory bowel diseases (IBD) and colitis-associated neoplasia. METHODS: NTSR1 was detected by immunohistochemistry in clinical samples of colonic mucosa with IBD colitis, colitis-associated raised low-grade dysplasia (LGD) including dysplasia-associated lesions or masses (DALMs, n = 18) and adenoma-like dysplastic polyps (ALDPs, n = 4), colitis-associated high-grade dysplasia (HGD, n = 11) and colitis-associated colorectal carcinoma (CACRC, n = 13), sporadic colorectal adenomatous polyp (SAP, n = 17), and sporadic colorectal carcinoma (SCRC, n = 12). The immunoreactivity of NTSR1 was semiquantitated (as negative, 1+, 2+, and 3+) and compared among different conditions. RESULTS: NTSR1 was not detected in normal mucosa but was expressed similarly in both active and inactive colitis. LGD showed a significantly stronger expression as compared with non-dysplastic colitic mucosa, with significantly more cases showing > 2+ intensity (68.75% in LGD vs 32.26% in nondysplastic mucosa, P = 0.001). However, no significant difference existed between DALMs and ALDPs. CACRC and HGD showed a further stronger expression, with significantly more cases showing 3+ intensity than that in LGD (61.54% vs 12.50% for CACRC vs LGD, P = 0.022; 58.33% vs 12.50% for CACRC/HGD vs LGD, P = 0.015). No significant difference existed between colitis-associated and non-colitic sporadic neoplasia. CONCLUSION: NTSR1 in colonic epithelial cells is overexpressed in IBD, in a stepwise fashion with sequential progress from inflammation to dysplasia and carcinoma.

Gui, Xianyong; Liu, Shuhong; Yan, Yuchu; Gao, Zuhua

2013-01-01

333

Mesenteric Air Embolism Following Enteroscopic Small Bowel Tattooing Procedure  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Double balloon enteroscopy (DBE) is a revolutionary procedure in which the entire small bowel can be visualized endoscopically. DBE has the advantage of both diagnostic and therapeutic capabilities in the setting of small bowel neoplasms and vascular malformations. We present a unique case of a 76-year-old female who underwent small bowel DBE tattoo marking of a distal small bowel tumor complicated by development of severe abdominal pain postprocedure secondary to bowel air embolism into the ...

Chen, Natalie; Lamba, Ramit; Lee, John; Lall, Chandana

2012-01-01

334

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

335

[Bowel endometriosis: a benign disease?].  

Science.gov (United States)

Endometriosis is generally assumed to be a benign disease, but it is estimated that 1% of cases are associated with cancer, especially when both conditions are present in the ovary. Extra-ovarian lesions in the rectovaginal septum, colon, bladder, vagina and peritoneum were already associated with malign neoplasia. Several characteristics of endometrial tissue are very similar to the neoplasia phenotype. Endometriosis itself typically behaves as a neoplasia process, spreading over adjacent stroma and being associated with distant lesions. This is an update on the diagnostic, clinical, and therapeutic knowledge of, management of bowel implants of endometrial tissue, as well as the relation with neoplastic processes to better understand its benign nature or eventual potential for malignancy. PMID:19918666

Bassi, Marco Antonio; Podgaec, Sérgio; Dias Júnior, João Antonio; Sobrado, Carlos Walter; D Amico Filho, Nicolau

2009-01-01

336

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

337

Angiogenesis and inflammatory bowel disease  

Directory of Open Access Journals (Sweden)

Full Text Available Inflammatory bowel disease (IBD has gained immense attention recently due primarily to increasing prevalence. The exact disease mechanism is still unknown. There is considerable evidence of interrelation between the mechanisms of angiogenesis and the chronic inflammation of IBD. This evidence was obtained from animal models of colitis and confirmed in human studies. Serum levels of vascular endothelial growth factor (VEGF and basic fibroblast growth factor (b-FGF have been found to be significantly higher in patients with IBD than in controls. In addition, it was found that these factors correlate well with disease activity and decrease with the use of steroids. Therefore pharmacological inhibition of angiogenesis has the potential to be a therapeutic strategy in IBD.

Azzam Nahla

2007-01-01

338

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

339

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

International Nuclear Information System (INIS)

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

1995-07-30

340

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

Energy Technology Data Exchange (ETDEWEB)

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

Mason, K.A.; Milas, L.; Peters, L.J. [Univ. of Texas, Houston, TX (United States)

1995-07-30

 
 
 
 
341

If I Had - Bowel Control Issues  

Medline Plus

Full Text Available ... a profound effect on bowel function and can drive patients towards problems with fecal incontinence. How do ... because when we become dehydrated, the body takes fluid from the only place it can, which is ...

342

Thromboxane synthase immunohistochemistry in inflammatory bowel disease  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: Thromboxanes are produced in excess in inflammatory bowel disease. Preliminary reports suggest that ridogrel, a thromboxane synthase inhibitor, is anti-inflammatory and may have therapeutic benefits in patients with ulcerative colitis.

Carty, E.; Nickols, C.; Feakins, R. M.; Rampton, D. S.

2002-01-01

343

Small Bowel Obstruction from Capsule Endoscopy  

Directory of Open Access Journals (Sweden)

Full Text Available Over the past decade, capsule endoscopy has become the accepted modality for small bowel imaging in the United States. It is very helpful in making the diagnosis of Crohn’s disease; however, this patient population is also at an increased risk of small bowel obstruction secondary to capsule impaction. We present the case of a 60-year-old female with undiagnosed Crohn’s disease who presented to the emergency department with small bowel obstruction after capsule ingestion. She was successfully disimpacted with diatrizoate upper gastrointestinal (GI series with small bowel follow-through and intravenous steroids. Review of the endoscopic video images revealed findings consistent with Crohn’s disease. [West J Emerg Med. 2010; 11(1:71-73.

Boysen, Megan M

2010-02-01

344

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 ...

345

Patient-specific finite element analysis of viscoelastic masticatory mucosa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The purpose of this study was to analyze the stress and strain inside of the oral mucosa in partially-edentulous patients. The patient-specific finite element models of the mucosa and the bone were constructed using the CT images and in-vivo surface measurement during a continuous load. The mean initial shear modulus of 8.3 × 10–5 (GPa) and the mean relaxation time of 503 (s) were determined as the viscoelastic properties of the mucosa. The increase of the highest maximum compressive strai...

Wakabayashi, Noriyuki; Suzuki, Tetsuya

2013-01-01

346

Acute effects of irradiation on middle ear mucosa  

International Nuclear Information System (INIS)

Single field, fixed irradiation of bilateral tympanic cavities using 200-kV x-rays was administered to five guinea pigs. The irradiation dose was 30 Gy. They were killed immediately after irradiation, and bilateral middle ear mucosa was examined for ciliary activity and epithelial structure. Significant deterioration of the ciliary activity in the middle ear mucosa was observed, proximal as well as distal to the eustachian tube. Electron microscopy showed various changes in the irradiated middle ear mucosa. The most conspicuous findings were hyperreactivity in secretion, vacuolation of ciliated cells, and stomal edema

1988-01-01

347

Small Bowel Obstruction due to Phytobezoar  

Directory of Open Access Journals (Sweden)

Full Text Available Bezoars are foreign bodies impacted in the digestive tract resulting of their ingestion and accumulation, involving mainly the stomach,small bowel. Phytobezoars are a rare cause of acute small bowel obstruction. It should be suspected in patients with an increased risk of bezoar formation, such as in the presence of previous gastric surgery and a history suggestive of increased fiber intake. The aim of this work was to identify the diagnostic difficulties and treatment of this rare entity.

Bar?? Morkavuk

2012-10-01

348

Small bowel emergency surgery: literature's review.  

Science.gov (United States)

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. PMID:21214933

Vallicelli, Carlo; Coccolini, Federico; Catena, Fausto; Ansaloni, Luca; Montori, Giulia; Di Saverio, Salomone; Pinna, Antonio D

2011-01-01

349

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

350

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

351

Small bowel function after aortic surgery.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

One cause of post-operative morbidity in the elective repair of abdominal aortic aneurysms is the development of a paralytic or 'adynamic' ileus. In a series of 20 consecutive patients undergoing such a procedure, the maintenance of small bowel motility and absorptive capacity in the immediate post-operative period was assessed using barium sulphate and xylose passed down a naso-duodenal tube sited at the time of surgery. This simple study demonstrated that small bowel function was preserved ...

Barker, S. G.; Dodds, R. D.; Middlemiss, A.; Bennett, C. E.; Russell, M. H.; Sellick, B. C.; Thomas, M. H.

1991-01-01

352

Probiotic Therapy for Irritable Bowel Syndrome  

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The etiology of irritable bowel syndrome (IBS) is thought to be multifactorial, with several factors (including alterations in gut motility, small-bowel bacterial overgrowth, microscopic inflammation, and visceral hypersensitivity) potentially playing a role. Recent studies have suggested that probiotics may be useful in the treatment of IBS. Although the exact mechanism for how probiotics may aid in the reduction of symptoms commonly found in IBS is unknown, the effects of probiotics on alte...

Aragon, George; Graham, Deborah B.; Borum, Marie; Doman, David B.

2010-01-01

353

Irritable Bowel Syndrome, Gut Microbiota and Probiotics  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

Lee, Beom Jae; Bak, Young-tae

2011-01-01

354

Rheumatic manifestations of inflammatory bowel disease  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This article reviews the literature concerning rheumatic manifestations of inflammatory bowel disease (IBD), including common immune-mediated pathways, frequency, clinical course and therapy. Musculoskeletal complications are frequent and well-recognized manifestations in IBD, and affect up to 33% of patients with IBD. The strong link between the bowel and the osteo-articular system is suggested by many clinical and experimental observations, notably in HLA-B27 transgenic rats. The autoimmune...

Rodri?guez-reyna, Tatiana Sofi?a; Marti?nez-reyes, Cynthia; Yamamoto-furusho, Jesu?s Kazu?o

2009-01-01

355

Fungal infections of the oral mucosa.  

Science.gov (United States)

Fungal infections in humans occur as a result of defects in the immune system. An increasing emergence in oral Candidal and non-Candidal fungal infections is evident in the past decade owing to the rise in the immunodeficient and immunocompromised population globally. Oral Candidal infection usually involves a compromised host and the compromise may be local or systemic. Local compromising factors include decreased salivation, poor oral hygiene, wearing dentures among others while systemic factors include diabetes mellitus, nutritional deficiency, HIV infection/AIDS and others. Oral candidiasis is generally a localized infection and rarely appears as a systemic fungal disease whereas oral non-Candidal fungal infections are usually signs of disseminated disease. Some of the non-Candidal fungi that were once considered exotic and geographically restricted are now seen worldwide, beyond their natural habitat, probably attributed to globalization and travels. Currently infections from these fungi are more prevalent than before and they may present either as primary oral lesions or as oral manifestations of systemic mycoses. This review discusses the various predisposing factors, clinical presentations, clinical differential diagnosis, diagnosis and management of oral candidiasis, as well as briefly highlights upon a few of the more exotic non-Candidal fungi that infect the oral mucosa. PMID:23422613

Krishnan, P Anitha

2012-01-01

356

Preliminary mechanical characterization of the small bowel for in vivo robotic mobility.  

Science.gov (United States)

In this work we present test methods, devices, and preliminary results for the mechanical characterization of the small bowel for intra luminal robotic mobility. Both active and passive forces that affect mobility are investigated. Four investigative devices and testing methods to characterize the active and passive forces are presented in this work: (1) a novel manometer and a force sensor array that measure force per cm of axial length generated by the migrating motor complex, (2) a biaxial test apparatus and method for characterizing the biomechanical properties of the duodenum, jejunum, and ileum, (3) a novel in vitro device and protocol designed to measure the energy required to overcome the self-adhesivity of the mucosa, and (4) a novel tribometer that measures the in vivo coefficient of friction between the mucus membrane and the robot surface. The four devices are tested on a single porcine model to validate the approach and protocols. Mean force readings per cm of axial length of intestine that occurred over a 15?min interval in vivo were 1.34?±?0.14 and 1.18?±?0.22?N cm(-1) in the middle and distal regions, respectively. Based on the biaxial stress/stretch tests, the tissue behaves anisotropically with the circumferential direction being more compliant than the axial direction. The mean work per unit area for mucoseparation of the small bowel is 0.08?±?0.03 mJ cm(-2). The total energy to overcome mucoadhesion over the entire length of the porcine small bowel is approximately 0.55?J. The mean in vivo coefficient of friction (COF) of a curved 6.97 cm(2) polycarbonate sled on live mucosa traveling at 1?mm s(-1) is 0.016?±?0.002. This is slightly lower than the COF on excised tissue, given the same input parameters. We have initiated a comprehensive program and suite of test devices and protocols for mechanically characterizing the small bowel for in vivo mobility. Results show that each of the four protocols and associated test devices has successfully gathered preliminary data to confirm the validity of our test approach. PMID:22010745

Terry, Benjamin S; Lyle, Allison B; Schoen, Jonathan A; Rentschler, Mark E

2011-09-01

357

Bioactivation of the nasal toxicant 2,6-dichlorobenzonitrile: an assessment of metabolic activity in human nasal mucosa and identification of indicators of exposure and potential toxicity.  

Science.gov (United States)

The herbicide 2,6-dichlorobenzonitrile (DCBN) is a potent nasal toxicant in rodents; however, it is not known whether DCBN causes similar nasal toxicity in humans. The tissue-selective toxicity of DCBN in mouse nasal mucosa is largely dependent on target tissue bioactivation by CYP2A5. The human orthologues of CYP2A5, CYP2A6 and CYP2A13, are both expressed in nasal mucosa and are capable of activating DCBN. In this study, we directly determined the ability of human nasal mucosa to bioactivate DCBN. We also tested the suitability of a glutathione conjugate of DCBN (GS-DCBN) or its derivatives as biomarkers of DCBN exposure and nasal toxicity in mouse models. We found that human fetal nasal mucosa microsomes catalyze the formation of GS-DCBN, with a Km value comparable to that of adult mouse nasal mucosa microsomes. The activity of the human nasal mucosa microsomes was inhibited by 8-methoxypsoralen, a known CYP2A inhibitor. GS-DCBN and its metabolites were detected in the nasal mucosa and nasal-wash fluid obtained from DCBN-treated mice, in amounts that increased with escalations in DCBN dose, and they were all still detectable at 24 h after a DCBN treatment (at 10 mg/kg). Further studies in Cyp2a5-null mice indicated that GS-DCBN and its metabolites in nasal-wash fluid were generated in the nasal mucosa, rather than in other organs. Thus, our data indicate for the first time that the human nasal mucosa is capable of bioactivating DCBN and that GS-DCBN and its metabolites in nasal-wash fluid may collectively serve as indicators of DCBN exposure and potential nasal toxicity in humans. PMID:23360412

Xie, Fang; D'Agostino, Jaime; Zhou, Xin; Ding, Xinxin

2013-03-18

358

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.)

1983-03-01

359

Taste buds in the palatal mucosa of snakes  

Directory of Open Access Journals (Sweden)

Full Text Available An examination of the oral mucosa ofCrotalus and several Scolecophidia revealed the presence of taste buds. The taste buds in these two divergent groups of snakes are similar in appearance, and correspond to previous descriptions of gustatory organs in other reptiles. Few taste buds were present in any specimen, and these were restricted to the palatal mucosa adjacent to the ducts to the vomeronasal organ. Taste buds were not found in some of the scolecophidians examined.

Perrin Wilson

2011-10-01

360

Cytomorphometric analysis for Metal Bracket Effects on Human Buccal Mucosa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Objective: To find out effect of metal brackets on the epithelial cells of the buccal mucosa as compared to normal mucosa without any brackets. Patients and Methods: Oral mucosal smears were obtained for patients visited for orthodontic treatment using a cytobrush. The study group consisted of P1: patients with no brackets, P2: 60 days after placement of metal brackets, P3: 30 days after removal of brackets. 30 individuals of both sexes who are undergoing fixed appliance theropy with bonded b...

2010-01-01

 
 
 
 
361

Alterations in the laryngeal mucosa after exposure to asbestos.  

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The laryngeal mucosa of 195 workers in an asbestos cement factory (Salonit Anhovo, Yugoslavia) and in a control group was examined. The factory manufactures asbestos cement products containing about 13% of asbestos (8% amosite, 12% crocidolite, and 80% chrysotile) of different provenance. Alterations in the laryngeal mucosa were more frequent in the factory workers than in the control group. The changes, mostly consistent with chronic laryngitis, were closely related to the degree of workplac...

Kambic, V.; Radsel, Z.; Gale, N.

1989-01-01

362

Somatostatin binding in normal and malignant human gastrointestinal mucosa.  

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Somatostatin is a regulatory peptide implicated in the control of cellular proliferation in epithelial tissues and this regulation may occur directly via membrane bound receptor activation. The aim of this study was to investigate somatostatin binding in human gastrointestinal cancer and normal mucosa. Plasma membranes were prepared from specimens of tumour and normal mucosa from 51 patients undergoing surgical resection for malignancy (28 gastric, 23 colorectal). Using a competitive displace...

Miller, G. V.; Farmery, S. M.; Woodhouse, L. F.; Primrose, J. N.

1992-01-01

363

A Strange Case of Left Bowel Ischemia after Right Hernioplasty  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

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

2010-01-01

364

Uretroplastia con mucosa oral en estenosis de uretra anterior / Buccal mucosa urethroplasty in anterior urethral structures  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Los injertos de mucosa oral pueden ser utilizados para la reparación satisfactoria de estenosis de uretra péndula y bulbar. Material y métodos: Presentamos nuestra experiencia con injertos de mucosa oral en 8 pacientes. La longitud del injerto fue entre 4 y 16 cm. Se han realizado tres uretroplastia [...] s en uretra péndula, dos en uretra bulbar y tres panuretrales. El seguimiento ha sido entre 36 y 60 meses. Resultados: No se han observado recurrencias. Un paciente refirió parestesias en el labio inferior durante seis meses. Abstract in english Buccal mucosal graft can be used for succesfull repair in both pendulous and bulbar strictures. Material and methods: We present our experience with buccal mucosal graft repair in 8 patients with onlay patch that varies from 4 to 16 cm. in length. Three pendulous, two bulbar and three panurethral st [...] rictures were repaired. These patients were observed for 36 to 60 months. Results: No stricture recurrences were observed. Only one patient had lower lip paresthesia for six months.

Roca Edreira, A.; Aguilera Tubet, C.; García-Montesinos Perea, B.M.; García Montesinos, M.; Hernández Rodríguez, R..

365

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.

366

Small bowel intussusception causing a postoperative bowel obstruction following laparoscopic low anterior resection in an adult  

Science.gov (United States)

Adult intussusception usually presents with nonspecific symptoms such as abdominal pain, bloating, nausea, vomiting, and a change in bowel habits. Although postoperative intussusception has been described in the pediatric population, there has been little description of it in the adult population. Postoperative intussusception has unique challenges, as hydrostatic reduction may compromise bowel anastomoses. Surgery is the universal treatment in these patients. In adults, delay in diagnosis and definitive treatment may be a direct result of common symptomatology between postoperative ileus and intussusception. We present a case of an adult patient who underwent laparoscopic low anterior resection for rectal cancer and developed a small bowel intussusception causing obstruction requiring surgery. To our knowledge, this is the first report of a small bowel intussusception masquerading as a postoperative ileus in an adult. While most postoperative delayed bowel function is attributed to ileus, abscess formation, or anastomotic leak, other uncommon etiologies, including intussusception, may occur and are important to include in the differential diagnosis.

Hussain, Ahmad S.; Warrier, Rajalakshmi

2014-01-01

367

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2004-12-01

368

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.

369

Primary mucosa-associated lymphoid tissue lymphoma of the breast: a case report  

International Nuclear Information System (INIS)

A primary mucosa-associated lymphoid tissue lymphoma (MALT lymphoma) of the breast is extremely rare. We report a case of a MALT lymphoma of the breast that presented as a palpable left breast mass in a 37-year-old woman. A physical examination revealed a large firm, and fixed mass in the left inner breast. Mammograms showed a large, isodense mass in the lower inner quadrant of the left breast and an enlarged lymph node in the axilla. A sonogram demonstrated a 5 cm sized, oval, circumscribed, and heterogeneously hypoechoic mass with posterior acoustic enhancement. A surgical biopsy was performed, and the pathology revealed a MALT lymphoma

2007-11-01

370

A mucosa oral na hanseníase: um estudo clínico e histopatológico The oral mucosa in leprosy: a clinical and histopathological study  

Digital Repository Infrastructure Vision for European Research (DRIVER)

INTRODUÇÃO: a anseníase multibacilar pode causar comprometimento da mucosa oral, com ou sem lesões aparentes. Há poucos estudos que tratam deste assunto na era da multidrogaterapia. OBJETIVO: Verificar a freqüência do comprometimento da mucosa oral em pacientes de hanseníase multibacilar. CASUÍSTICA E MÉTODOS: Foi realizado um estudo transversal em vinte pacientes de hanseníase multibacilar, não-tratados, atendidos consecutivamente em Dracena, São Paulo, entre o período de 2000 ...

2006-01-01

371

Ileo-colonic intussusception secondary to small-bowel lipomatosis: a case report.  

Science.gov (United States)

Intestinal lipomatosis is a rare disease with an incidence at autopsy ranging from 0.04% to 4.5%. Because the lipomas are diffusely distributed in the intestine, most patients are symptom-free, and invasive intervention is not advised by most doctors. Here, we describe a case with intussusception due to small-bowel lipomatosis. Partial small bowel resection and anastomosis were performed because the intestinal wall was on the verge of perforation. This case indicates that regular follow-up is necessary and endoscopic treatment should be considered to avoid surgical procedures if the lipoma is large enough to cause intestinal obstruction. PMID:24587685

Gao, Peng-Ji; Chen, Lei; Wang, Fu-Shun; Zhu, Ji-Ye

2014-02-28

372

Small bowel obstruction and perforation secondary to primary enterolithiasis in a patient with jejunal diverticulosis.  

Science.gov (United States)

We describe a rare case of small bowel obstruction and perforation secondary to a primary enterolith in an 84-year-old female patient with jejunal diverticulosis. She underwent an emergency laparotomy, small bowel resection and primary anastomosis. Multiple jejunal diverticula and a large stone were identified at the time of operation. Analysis of the stone demonstrated mainly faecal material consistent with a true primary enterolith. A literature search of Medline and PubMed revealed three cases similar to the one described. The pathogenesis and management of enterolithiasis in jejunal diverticular disease is considered. PMID:24626387

Chaudhery, Baber; Newman, Peter Alexander; Kelly, Michael Denis

2014-01-01

373

Analysis of IL12B gene variants in inflammatory bowel disease  

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IL12B encodes the p40 subunit of IL-12, which is also part of IL-23. Recent genome-wide association studies identified IL12B and IL23R as susceptibility genes for inflammatory bowel disease (IBD). However, the phenotypic effects and potential gene-gene interactions of IL12B variants are largely unknown

Glas, Ju?rgen; Seiderer, Julia; Wagner, Johanna; Olszak, Torsten; Fries, Christoph; Tillack, Cornelia; Friedrich, Matthias; Beigel, Florian; Stallhofer, Johannes; Steib, Christian; Wetzke, Martin; Go?ke, Burkhard; Ochsenku?hn, Thomas; Diegelmann, Julia; Czamara, Darina

2012-01-01

374

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: English Abstract in spanish 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 ra [...] tas 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. Abstract in english 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 experime [...] nt 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.

Yorgancilar, E; Deveci, E; Deveci, S.

375

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

376

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 the other methods of investigation this study requires no bowel preparation, is noninvasive and has excellent diagnostic accuracy

1997-12-01

377

Effects of smoking on edentulous alveolar ridge mucosa  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction Tobacco use is an important risk factor for advanced histopathological findings on edentulous alveolar ridge mucosa. The aim of this study was to examine the effects of smoking on histopathological findings on edentulous alveolar ridge mucosa. Material and methods The experimental group consisted of 48 patients (29 smokers and 19 nonsmokers. The mean age of smokers was 42.6 and of nonsmokers 48.7 years. The anamnesis included the following data: age, sex, diseases and toxic habits-cigarette smoking. Biopsy samples were taken from the edentulous alveolar ridge mucosa without gross signs of symptoms. Results The mean number of cigarettes smoked per day was 11.5±7. The results of ?² test proved that there were no statistically significant differences (p>0.05 in histopathological findings on the alveolar ridge mucosa. The mean duration of smoking was 12.7± 5 years. Hyperkeratosis was established in 76.92% of smokers who smoked longer than 15 years. The mean-age at which smokers began smoking was 27.3±8 years and there were no statistically significant differences in histopathological findings on the alveolar ridge mucosa correlated with the beginning of smoking. Conclusion On the basis of our research we conclude that smokers who have been smoking for 15 years are at risk for developing histopathological changes of the alveolar ridge mucosa, but there were no statistically significant differences in histopathological findings on the alveolar ridge mucosa correlated with the number of cigarettes per day and the beginning of smoking. .

Markovi? Dubravka

2005-01-01

378

How do SSRIs help patients with irritable bowel syndrome?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

379

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

380

[Migraine and irritable bowel syndrome].  

Science.gov (United States)

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

Mulak, Agata; Paradowski, Leszek

2005-01-01

 
 
 
 
381

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 antige...

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

2000-01-01

382

Transient small bowel angioedema due to intravenous iodinated contrast media  

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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...

2012-01-01

383

The role of fecal calprotectin in investigating inflammatory bowel diseases  

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INTRODUCTION: Invasive and non-invasive tests can be used to evaluate the activity of inflammatory bowel diseases. OBJECTIVE: The aim of the present study was to investigate the role of fecal calprotectin in evaluating inflammatory bowel disease activity and the correlation of fecal calprotectin with the erythrocyte sedimentation rate and C reactive protein values in inflammatory bowel disease. METHOD: Sixty-five patients affected with inflammatory bowel disease were enrolled. Twenty outpatie...

Mustafa Erbayrak; Cansel Turkay; Elife Eraslan; Hulya Cetinkaya; Benan Kasapoglu; Mehmet Bektas

2009-01-01

384

Laparoscopic management of small bowel obstruction with associated intestinal ischemia  

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Obstruction is the most common surgical disorder of the small bowel. Complete small bowel obstruction (SBO) is usually treated surgically because bowel strangulation cannot be excluded with certainty. Acute SBO has been previously considered a relative contraindication for laparoscopic management especially due to the laparotomy conversion rate. We present a case of SBO for which laparoscopic management resulted in earlier return of bowel function, shorter hospital stay, faster overall recove...

Narh-martey, P.; Bello, A.; Orr, D.; Galdyn, I.

2012-01-01

385

Gynaecological consultation in patients with the irritable bowel syndrome.  

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A 12 month follow up study to assess the impact of symptoms suggestive of irritable bowel syndrome in women presenting to gynaecology clinics with pelvic pain is reported. Of 71 women 37 (52%) had symptoms suggestive of irritable bowel syndrome at presentation. A firm gynaecological diagnosis was reached in only three (8%) women positive for irritable bowel syndrome compared with 15 (44%) without (p = 0.002). After 12 months 24 (65%) women with irritable bowel syndrome were still symptomatic ...

Prior, A.; Whorwell, P. J.

1989-01-01

386

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

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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

387

Is microscopic colitis a missed diagnosis in diarrhea-predominant Irritable Bowel Syndrome?  

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  • BACKGROUND: There are controversies about the importance of biopsies of normal colon mucosa in the investigation of patients with diarrhea predominant irritable bowel syndrome (IBS. On the other hand, microscopic colitis may bemissed based on normal colonoscopy and laboratory examination in this group of patients
  • METHODS: The study took place in Alzahra and Noor hospitals and Poursina Hakim Research Institute, from 2002 to 2004. Eligible patients were those suffering from diarrhea for at least 4 weeks. A total of 138 patients were included in the study after meeting Rome criteria (II with normal CBC, ESR, stool examination and no endoscopic abnormality.
  • RESULTS: The histologic findings in 138 patients with diarrhea predominant IBS with mean age of 34.7 years (female 55.1% and male 44.9% were as follows: 10 patients (7.2% had collagenous colitis and 3 patients (2.2% were compatible with lymphocytic colitis. No significant diagnostic histologic findings were seen in the rest of patients. Collagenouscolitis was detected in 13% of right colon biopsies and in 10% of sigmoid and transverse colon biopsies. Nocturnal diarrhea was found in 30% of collagenous colitis patients.
  • CONCLUSIONS: Total colonoscopy and multiple biopsies in diarrhea predominant IBS patients are necessary for earlydiagnosis of microscopic colitis.
  • KEY WORDS: Irritable bowel syndrome, microscopic colitis, colonoscopy, biopsy, diarrhea.

Hamid Tavakoli

2008-08-01

388

MALT lymphoma of the small bowel with protein-losing enteropathy.  

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Mucosa-associated lymphoid tissue (MALT) lymphoma usually arises from chronic inflammation. We herein report a case of small intestinal MALT lymphoma with protein-losing enteropathy (PLE). A 73-year-old woman presented with lower leg edema and severe hypoalbuminemia. She had a medical history of pylorus-preserving pancreaticoduodenectomy with Billroth II reconstruction. Oral and anal route double-balloon enteroscopies revealed irregular nodular mucosal lesions with erosion extending from the jejunum to terminal ileum. Histopathological evaluation of the biopsied mucosa showed proliferation of small-to-medium-sized lambda light chain-restricted B cells. Plasmacytic differentiation and lymphoepithelial lesions were present, leading to the diagnosis of MALT lymphoma. Tc-99m albumin scintigraphy indicated tracer exudation in the small bowel, suggesting the presence of PLE. Combination immunochemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) regimen improved both MALT lymphoma and PLE, whereas rituximab monotherapy was not successful. This case is considered to be common type of MALT lymphoma at an uncommon site and is distinct from immunoproliferative small intestinal disease (IPSID). To our knowledge, this is the first case of non-IPSID-type small intestinal MALT lymphoma complicated by PLE. Gastrointestinal reconstruction may be responsible for underlying chronic inflammation via small intestinal bacterial overgrowth. PMID:24395281

Tsukamoto, Ayato; Nakamura, Fumihiko; Nannya, Yasuhito; Kobayashi, Yuka; Shibahara, Junji; Ichikawa, Motoshi; Fukayama, Masashi; Koike, Kazuhiko; Kurokawa, Mineo

2014-02-01

389

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

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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

390

Quadruple immunosuppression in a pig model of small bowel transplantation.  

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Rejection remains a major obstacle to successful small bowel transplantation in humans, irrespective of the immunosuppressants. Previous large animal studies have not used quadruple immunosuppression (with high-dose intravenous cyclosporine A [CSA]) for induction, followed by triple immunosuppression for maintenance therapy. Nor have immunosuppressive doses been comparable to clinical solid organ transplants. We studied, in 78 nonrelated outbred pigs, the effect of quadruple immunosuppression (including horse anti-pig thymocyte globulin [ATG] and high-dose intravenous CSA) on the incidence and severity of rejection in the early, critical posttransplant period. Group A (n = 19) pigs were nonimmunosuppressed. Group B (n = 20) received quadruple immunosuppression: pig ATG (10 mg/kg/day x 10 days), intravenous CSA (3.0 mg/kg/day), prednisolone (2 mg/kg/day), and azathioprine (2.5 mg/kg/day); prednisolone and azathioprine were each reduced by 50% on posttransplant Days 8 and 15. Trough CSA levels were > or = 400 ng/ml for the first 7 days posttransplant, > 200 ng/ml thereafter. Recipient pigs underwent resection of large and small bowel; orthotopic transplants (proximal duodenojejunostomy, distal ileostomy) were done with systemic vein drainage. We developed a scoring system (no, mild, moderate, severe rejection) to grade the extent of both interstitial and vascular rejection: biopsies were obtained daily from the ileostomy. Rejection-free graft survival at posttransplant Days 7, 10, and 14 was 32, 26, and 16% in the nonimmunosuppressed group versus 95, 90, and 85% in the immunosuppressed group (P < 0.0001). Rejection grades were significantly better over the whole observation period in immunosuppressed pigs: interstitial rejection was not present in up to 67% of all daily biopsy specimens. Rejection was present in all specimens of nonimmunosuppressed pigs. Vascular rejection was uncommon (incidence < 10%) in both groups. Isolated vascular rejection without interstitial rejection was not found. Graft-versus-host reaction was noted in both groups in the skin only; liver and native bowel were not involved. We conclude that quadruple immunosuppression with pig ATG and high-dose intravenous CSA for induction effectively prevents moderate and severe rejection in this model. Since clinical transplant complications (rejection, lymphomas) have persisted under FK 506 treatment, our immunosuppressive regimen should be considered an alternative for bowel transplantation in humans to prevent early rejection. PMID:8769976

Gruessner, R W; Fasola, C; Fryer, J; Nakhleh, R E; Kim, S; Gruessner, A C; Beebe, D; Moon, C; Troppmann, C; Najarian, J S

1996-02-15

391

Irritable bowel syndrome: focus on otilonium bromide.  

Science.gov (United States)

Irritable bowel syndrome is a prevalent and chronic disorder, characterized by recurrent abdominal pain/discomfort, bloating and altered bowel habits. This condition affects an estimated 10-15% of the population worldwide and impacts heavily on a patient's daily life and ability to work, as well as healthcare resource utilization. Drug therapy aimed at correcting the primary symptoms of diarrhea/constipation/bloating may have little effect on abdominal pain, which results from visceral hypersensitivity. Smooth muscle relaxants or antispasmodics decrease the tone and contractility of intestinal smooth muscle, effectively managing abdominal pain. Otilonium bromide has been widely used worldwide and has been found to be safe and well tolerated, and superior to placebo for the reduction of symptoms and the prevention of symptom relapse in patients with irritable bowel syndrome. PMID:24417261

Boeckxstaens, Guy; Clavé, Pere; Corazziari, Enrico S; Tack, Jan

2014-02-01

392

Inflammatory bowel disease and celiac disease: overlaps in the pathology and genetics, and their potential drug targets.  

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Inflammatory bowel disease, which covers Crohn's disease and ulcerative colitis, and celiac disease are both inflammatory diseases of the intestinal tract. In both diseases an antigen activates several inflammatory pathways, which cause extensive damage to the intestinal mucosa and lead to increased permeability of the intestinal epithelium. The causative antigen in inflammatory bowel disease is the microflora in the intestinal lumen, facilitated by an impaired innate immune system that is unable to halt the invasion of microbes into the lamina propria. These provoke T helper 1 and T helper 17 responses in Crohn's disease and a T helper 2 response in ulcerative colitis. Pro-inflammatory cytokines and interleukins produced in these processes lead to impairment of tight junctions and increased permeability of the intestinal epithelial lining. In celiac disease, inflammation is caused by dietary gluten, a peptide present in wheat, barley and rye. In genetically predisposed people, gliadin peptides (derivatives of gluten) are presented on the Human Leukocyte Antigen DQ2 or DQ-8 molecules of antigen-presenting cells to T helper cells. This provokes a T helper 1 response, which leads to the production of pro-inflammatory cytokines and subsequent damage to, and increased permeability of the intestinal epithelium. We describe the details and overlaps in the pathomechanism and genetics of inflammatory bowel disease and celiac disease, and discuss potential drug targets for intervention. PMID:19519468

Festen, Eleonora A M; Szperl, Agata M; Weersma, Rinse K; Wijmenga, Cisca; Wapenaar, Martin C

2009-06-01

393

A prospective study of differences in duodenum compared to remaining small bowel motion between radiation treatments: Implications for radiation dose escalation in carcinoma of the pancreas  

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Full Text Available Abstract Purpose As a foundation for a dose escalation trial, we sought to characterize duodenal and non-duodenal small bowel organ motion between fractions of pancreatic radiation therapy. Patients and methods Nine patients (4 women, 5 men undergoing radiation therapy were enrolled in this prospective study. The patients had up to four weekly CT scans performed during their course of radiation therapy. Pancreas, duodenum and non-duodenal small bowel were then contoured for each CT scan. On the initial scan, a four-field plan was generated to fully cover the pancreas. This plan was registered to each subsequent CT scan. Dose-volume histogram (DVH analyses were performed for the duodenum, non-duodenal small bowel, large bowel, and pancreas. Results With significant individual variation, the volume of duodenum receiving at least 80% of the prescribed dose was consistently greater than the remaining small bowel. In the patient with the largest inter-fraction variation, the fractional volume of non-duodenal small bowel irradiated to at least the 80% isodose line ranged from 1% to 20%. In the patient with the largest inter-fraction variation, the fractional volume of duodenum irradiated to at least the 80% isodose line ranged from 30% to 100%. Conclusion The volume of small bowel irradiated during four-field pancreatic radiation therapy changes substantially between fractions. This suggests dose escalation may be possible. However, dose limits to the duodenum should be stricter than for other segments of small bowel.

Wahab Sasha H

2006-09-01

394

Colon vs small bowel rejection after total bowel transplantation in a pig model.  

Science.gov (United States)

With the advent of FK 506, small bowel transplantation has become clinically feasible. Both clinically and experimentally, jejunal and ileal biopsies are used for early diagnosis of rejection. More recently, the colon, in addition to the small bowel, has been transplanted to decrease the high incidence of diarrhea after small bowel transplantation. A Bishop-Koop ileostomy allows biopsies on a regular basis, but the diagnosis of rejection remains a problem after takedown of the ileostomy. Rejection of the ileum is more frequent and more severe than rejection of the jejunum or the colon. Colon biopsy after ileostomy takedown would not rule out rejection of the ileum. PMID:8959844

Nakhleh, R E; Gruessner, A C; Pirenne, J; Benedetti, E; Troppmann, C; Gruessner, R W

1996-01-01

395

Multiple myelomatosis: an unusual cause of small bowel intussusception.  

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A 55 year old woman with multiple myeloma presented with a pathological fracture of the right neck of femur. Following internal fixation, and during subsequent radiotherapy, she developed small bowel obstruction. Laparotomy revealed an intussusception about a small bowel myeloma deposit. This is a previously unreported cause of small bowel intussusception.

Hill, S. A.; Yudelman, P. L.

1986-01-01

396

Early Gallium-67 abdominal imaging: pitfalls due to bowel activity  

International Nuclear Information System (INIS)

In gallium scanning for abdominal inflammatory disease, early imaging has been advocated so physiological activity within the bowel will not be confused with pathologic uptake. The normal physiologic pattern of bowel uptake is not desribed in the literature. Our study was undertaken to evaluate the frequency and patterns of gallium-67 bowel activity which may occur when early imaging is performed

1981-01-01

397

Multidetector CT Findings of Bowel Transection in Blunt Abdominal Trauma  

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Objective 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. Materials and Methods 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. Results 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. Conclusion 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; Hong, Hye-Suk; Park, Mee Hyun; Ha, Hong Il; Yang, Ik; Lee, Yul; Jung, Ah Young; Hwang, Ji-Young

2013-01-01

398

Oral mucosa and therapy of recurrent aphthous stomatitis.  

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Oral mucosa is one of the specific surfaces of the human body, which is permanently exposed to external factors related with food intake, breathing and speaking processes, which can lead to the onset of some problems. Disorders of the oral mucosa are a group of diseases, affecting, in the course of life, the majority of the population. Many of the oral mucosa ailments are manifested by lesions. Recurrent aphthous stomatitis (RAS) is the most common of these diseases. Despite much clinical and research attention, its causes remain poorly understood and treatment is only symptomatic. RAS is reported to affect up to 25% of the population worldwide. Topical or systemic therapy (corticosteroids, antiseptics, anti-inflamatory drugs, immunomodulating agents, etc.) can be used for treatment of RAS-associated symptoms. In general, topical therapy should be preferred due to the smaller drug load of the organism. In both cases, the active substance has to be in suitable dosage form. Recently, besides the conventional ways of application (rinses), the main disadvantage of which is the short time of resistance in the oral cavity, mucoadhesive dosage forms are used. The aim of this article is to give a theoretical overview of the oral mucosa topic and its most frequent disease - recurrent aphthous stomatitis in terms of various types of the disease classification, diagnosis and therapy, and in terms of the usage of various types of active substances and medical forms.Keywords: oral mucosa recurrent aphthous stomatitis therapy mucoadhesive dosage forms. PMID:23578262

Landová, Hana; Dan?k, Zden?k; Gajdziok, Jan; Vetchý, David; Stembírek, Jan

2013-01-01

399

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

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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 en