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Biomedical subjects

C N Bernstein

Publications and source records attributed to C N Bernstein.

86 records · Page 5Linked to original sources

Rectal substance P concentrations are increased in ulcerative colitis but not in Crohn's disease.

Substance P, a neurotransmitter found in colonic mucosa, can alter gut immunologic, vascular, and motor phenomena. Thus, it may have an important role in the pathogenesis of ulcerative colitis (UC) and Crohn's disease (CD). By radioimmunoassay of the extracts of endoscopically obtained rectal mucosal biopsies in affected patients, we evaluated mucosal substance P levels. Non-inflammatory bowel disease patients undergoing lower endoscopies and biopsies served as controls. There were significantly increased concentrations of substance P in patients with UC, compared with controls (p < 0.05) and compared with patients with CD (p < 0.005). The mucosal levels in CD patients were significantly lower than in controls (p < 0.05). Patients with active rectal CD had lower levels than patients with no evidence of active rectal disease. For the CD and UC patients, there was a strongly positive correlation between rectal mucosal substance P concentrations and total histologic inflammation scores (r = 0.7, p = 0.001). A strong correlation existed for rectal mucosal substance P concentrations and mucosal mononuclear cell scores (r = 0.7, p = 0.001) and for rectal mucosal substance P concentrations and the combined scores of mucosal neutrophils and eosinophils (r = 0.7, p = 0.002). In conclusion, the rectal mucosal substance P concentrations in patients with UC and CD are significantly different. Thus, substance P may have a different role in the pathogenesis of each of these entities. It is possible that the elevated concentrations in patients with UC are contributing to the increased inflammation seen in these patients. Alternatively, measured mucosal substance P levels may simply reflect the end result of the different inflammatory processes in UC and CD, rather than the cause. It is possible that the inflammatory cells are contributing to the measured concentrations.

Adult↗

Pneumocystis carinii pneumonia in patients with ulcerative colitis treated with corticosteroids.

Today, Pneumocystis carinii pneumonia (PCP) is typically associated with AIDS. However, in the pre-AIDS era, PCP was known to be associated with various immunodeficiency states, malignancies, and immunosuppressive therapy, particularly the use of corticosteroids. PCP has been reported to occur during immuno-suppressive therapy of some chronic inflammatory states, but it has never been reported in patients with inflammatory bowel disease. We report two patients with ulcerative colitis who developed PCP during high-dose corticosteroid therapy, and review the literature regarding non-AIDS PCP. PCP should thus be added to the list of bronchopulmonary complications in inflammatory bowel disease. This report should give gastroenterologists further impetus to limit immunosuppressive therapy to its minimal effective dose.

Adult↗

Active idiopathic ulcerative colitis in a patient with ongoing HIV-related immunodepression.

It is suspected that immune mechanisms are important in the pathogenesis of ulcerative colitis. The following is a case report of a patient with human immunodeficiency virus-related immunodeficiency whose ulcerative colitis ran a course independent of the depression of his peripheral CD4 cells. Thus, peripheral CD4 cells may have little role in the pathogenesis of ulcerative colitis.

Adult↗

Multifocal gastric neoplasia after recurrent laser therapy for the watermelon stomach.

Repeated laser therapy has become an accepted therapeutic approach in the treatment of watermelon stomach, and to date no important negative sequelae have been reported. The case of a patient who underwent repeated sessions of neodymium: yttrium aluminum garnet (Nd:YAG) laser therapy over a five-year period for the treatment of the watermelon stomach is presented. Postlaser therapy the patient developed deep ulcerations that would heal; however, he ultimately developed a nodular antrum. Random biopsies of antral nodules revealed carcinoma-in-situ. A Billroth I gastrectomy revealed two foci of carcinoma-in-situ/high grade dysplasia and multiple foci of lower grades of dysplasia. This case suggests a possible association between use of laser therapy and development of gastric neoplasia.

Aged↗

Diagnostic potential for cancer via 1H magnetic resonance spectroscopy of colon tissue.

Specimens of colon tissue were examined by 1H MRS (360 MHz) in order to determine the usefulness of rat colon (n = 44) as a model for human colon (n = 60), particularly for the characterization of preneoplastic lesions. Human tissue was characterized by 1H MRS as a precursor to in vivo studies. For both tissues, resonances from mobile lipids were not characteristic of pure mucosa, but correlated with the presence of submucosa. The mean intensities of the resonances at 3.2 and 3.4 ppm (assigned mainly to choline-containing compounds and taurine, respectively) of rat mucosa compared to those of human mucosa, and of rat tumours compared to human tumours, were not significantly different, while both resonances were significantly more intense in rat tumours compared to rat mucosa. The spectra of premalignant lesions in rat colon have features between those due to tumours and normal tissue. We conclude that rat colon is a useful model for human colon in 1H MR spectroscopic studies. MR spectra from human colon control tissue and tumours were classified with 100% accuracy using multivariate analysis.

Animals↗