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Biomedical subjects

V Binder

Publications and source records attributed to V Binder.

At least 55 records · Page 3Linked to original sources
PubMed1991

Colonic epithelial dysplasia or carcinoma in a regional group of patients with ulcerative colitis of more than 15 years duration.

Colonoscopic screening for neoplasia was performed in a regional group of ulcerative colitis patients with a disease duration of greater than or equal to 15 years. A total of 121 patients, aged less than 80 years, were invited to participate, of whom 100 (83%) accepted colonoscopy, including biopsies in 15 standard locations of the entire colon, plus additional biopsies from all visible lesions. Unequivocal dysplasia was found in one patient with extensive colitis and a disease duration of 31 years. A polyp with highly differentiated adenocarcinoma was found in the sigmoid colon of a patient with intermittent rectum involvement, 37 years after the ulcerative colitis diagnosis had been made. Biopsy specimens from the remaining 98 patients showed no signs of dysplasia or cancer. Thus the frequency of pre-malignant or malignant changes is very low compared with the results of similar studies, and the rationale for general colonoscopic surveillance programmes for such patients is open to question.

Adenocarcinoma↗
PubMed1991

Granulomas of the appendix: is it Crohn's disease?

An epidemiologic study was performed 1) to estimate the occurrence of epithelioid granulomas in the appendix wall among patients in whom an appendectomy had been performed, 2) to identify patients with granulomas in the appendix who had symptoms and history compatible with Crohn's disease, and 3) to estimate the long-term prognosis. Within a 5-year period 6051 patients in Copenhagen County underwent appendectomy. Six patients (0.1%) had epithelioid granulomas of the appendix (0.2 per 10(5) inhabitants per year). Follow-up of the six patients for 9-11 years (median, 9.5 years) showed that all had been free of gastrointestinal symptoms since the operation. Among the 373 patients diagnosed as having Crohn's disease in Copenhagen County between 1962 and 1987, 3 patients had their disease initially confined to the appendix. Follow-up in these patients showed no recurrence within a median of 6 years (range, 4-7 years). Patients with epithelioid granulomas of the appendix have an excellent long-term prognosis, which could be explained by the fact that the condition seems to be unrelated to Crohn's disease.

Adolescent↗
PubMed1991

Prevalence of hepatobiliary dysfunction in a regional group of patients with chronic inflammatory bowel disease.

A regional group of outpatients with chronic inflammatory bowel disease (ulcerative colitis, n = 396, and Crohn's disease, n = 125) was biochemically screened to estimate the prevalence of hepatobiliary dysfunction. Among the 396 patients with ulcerative colitis, 69 (17%; 95% confidence limits, 14-22%) had at least 1 abnormal laboratory value. Serum bilirubin was elevated in 5%, alkaline phosphatases in 8%, aspartate aminotransferases in 4%, and alanine aminotransferases in 8% of the patients. Two per cent had decreased plasma coagulation factors (2.7 and 10) and serum albumin. Further diagnositc evaluation consisting of ultrasonography, liver biopsy, and endoscopic retrograde cholangiography was performed in patients who had biochemical values more than twice the upper normal limit in two consecutive blood tests within a fortnight. Six patients (1%) fulfilled this criterion. Three patients had primary sclerosing cholangitis, of whom two were primarily diagnosed; one patient had cholangiocarcinoma also primarily diagnosed; and two patients were found to have alcoholic hepatic damage. Among the 125 patients with Crohn's disease, 38 (30%; 95% confidence limits, 23-38%) had at least 1 abnormal laboratory value. Serum bilirubin was elevated in 2%, alkaline phosphatases in 18%, asparetate aminotransferases in 3%, and alanine aminotransferases in 10% of the patients. One per cent had decreased plasma coagulation factors (2.7 and 10) and serum albumin concentrations. Three patients (2%) fulfilled the criteria for further evaluation as described above. One patient appeared to have epithelioid granuloma in the liver and one patient had alcoholic liver disease, whereas one patient refused further examination.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Incidence and prevalence of ulcerative colitis in Copenhagen county from 1962 to 1987.

The incidence of ulcerative colitis was estimated during the period 1962 to 1987 in the county of Copenhagen. Within this area of approximately 550,000 inhabitants, 1161 patients were diagnosed. The mean annual incidence for the period was 8.1 per 10(5) inhabitants. There were significant increases in incidence in the early 1970s and in the early 1980s, both of which were followed by significant decreases. A bimodal age distribution was found in men, with incidence peaks in young adult life and late in life. In women a peak incidence was found in the young adult age group. The interval from onset of symptoms to diagnosis in terms of years remained unchanged over the period, with a median of 1 year (range, 0-37 years). The extent of disease at diagnosis was total colon in 18% of the patients, a substantial part of the colon in 36%, and distal colon in 44%--with no changes during the study period. The distribution of different localizations did not differ among age groups except for a tendency towards more extensive disease in young patients, below 20 years of age. The disease activity in the 1st year was fulminant in 9.1% of the cases, moderate to high in 70.7%, and low in 20.2%, with a tendency towards higher activity in patients diagnosed late in the study period. The prevalence of ulcerative colitis increased steadily during the study period, reaching a value at the end of the study (31 December 1987) of 161 per 10(5) inhabitants.

Adult↗
PubMed1990

Clinical evidence supporting the radical scavenger mechanism of 5-aminosalicylic acid.

5-Aminosalicylic acid, the therapeutically active metabolite of sulfasalazine, was exposed to oxygen-derived free radicals produced by the Fenton reaction in vitro, and several metabolites were detected and characterized by high performance liquid chromatography and ultraviolet spectrophotometry. The majority of these metabolites were present in methanolic extracts of feces samples from sulfasalazine-treated patients with inflammatory bowel disease but not in rheumatoid arthritis patients with normal bowel function. The presence of these metabolites, which have not been demonstrated in vivo before, provides evidence of an interaction between 5-aminosalicylic acid and oxygen-derived free radicals in sulfasalazine-treated patients with inflammatory bowel disease. Since the concentration of lipid peroxides, which is dependent on the release of oxygen-derived free radicals, was significantly increased in pretreatment rectal biopsies of the patients, and further was normalized concomitantly with a significant improvement in disease activity over the 5-wk treatment period, an important role of the radical scavenger mechanism of 5-aminosalicylic acid in sulfasalazine therapy of chronic inflammatory bowel disease is strongly suggested.

Adult↗
PubMed1990

Lifelong control with inflammatory bowel disease patients.

The benefits and the burden of a lifelong control scheme for patients with chronic inflammatory bowel disease are discussed. The benefits cover physical, psychologic, and social conditions. Valuable scientific gains can be yielded secondarily from the data collection.

Adaptation, Psychological↗
PubMed1989

Low-dose cyclosporin for Crohn's disease: implications for clinical trials.

Cyclosporin is a potent immunosuppressant, which has gained recent interest as a possible treatment for Crohn's disease. Chronic nephrotoxicity, however, has recently been demonstrated as a result of early treatment with high initial cyclosporin doses. We report the effect of a 3-month treatment with low-dose cyclosporin (5-7.5 mg kg-1 day-1) in 11 chronically active, therapy-resistant Crohn's disease patients. Eight of the 11 patients (72%) improved according to a clinical grading score and the Dutch Activity Index whereas 9/11 (82%) improved according to the Crohn's Disease Activity Index (P less than 0.05) after 1 month. Three patients were withdrawn despite clinical improvement. One developed arterial hypertension, one dropped out and one required surgical treatment due to a small bowel stricture. Five patients (45%) completed the treatment period with improved clinical scores. After tapering-off, two patients (18%) were better at follow-up. No serious side-effects were encountered and it is concluded that low-dose cyclosporin treatment should be further investigated in Crohn's disease.

Adult↗
PubMed1989

Elemental diet: a therapeutic approach in chronic inflammatory bowel disease.

The therapeutic effect of an elemental diet (Pepti 2000) and blended normal diet (placebo) was investigated in 43 out-patients with chronic inflammatory bowel disease (IBD); 24 with ulcerative colitis (UC) and 19 with Crohn's disease (CD), in a mild to moderate state of disease activity. A pilot study on healthy volunteers was executed to investigate palatability of the two diets. The patients were randomized in a double-blind study to the two diet regimes for 14 d. A simultaneous determination of laboratory data including plasma C3c split product and urinary excretion of 51Cr-EDTA was carried out together with a careful registration of the clinical symptoms and signs. No significant effect on the stage of clinical activity was seen in CD. A significant effect on clinical activity was obtained in both UC groups. The clinical improvement was primarily due to a decrease in number of bowel movements both in the elemental diet group and in the group of patients on the blended normal diet. The gross appearance of rectal mucosa did not improve during the study period in the Pepti 2000 or in the placebo group. The concentration of complement split products in plasma remained unchanged. 51Cr-EDTA excretion, as an expression of a leaky bowel mucosa, also remained unchanged. It was concluded that an effect on inflammation could not be demonstrated even if both diets seem to have a beneficial effect on the stage of clinical activity, especially diarrhoea, in patients with UC.

Adult↗
PubMed1989

Incidence of colonic cancer in inflammatory bowel disease.

In a cohort of 783 regional patients with ulcerative colitis treated in specialized clinics from the onset of the disease, the intestinal cancer risk was estimated. Seven patients developed colonic cancer from 4 to 44 years after onset of disease (median, 14 years). Eighteen years after onset of the disease the calculated risk was 1.4% (0.7-2.8%). After completing this follow-up study a new study was carried out with colonoscopy of all long-standing cases (greater than or equal to 15 years) of ulcerative colitis which had not been operated on. Of 100 patients examined, 2 showed epithelial dysplasia, and 98 did not. In a similar cohort of 185 patients with Crohn's disease, 1 showed small-bowel cancer. This gives a calculated risk of 0.6% (0.1-3.1%) at 10 years after the disease onset.

Cohort Studies↗
PubMed1988

Epidemiology, course and socio-economic influence of inflammatory bowel disease.

Based on the literature and on our own experience from a follow-up study of all inflammatory bowel disease patients in a defined population, the epidemiology, course and social economic aspects of the diseases are discussed. The incidence of ulcerative colitis has shown geographical differences with a stable incidence in Stockholm, Cardiff, the United Kingdom and Copenhagen compared to a remarkable increase in incidence in Iceland, Faroe islands, Norway, Scotland and North Tees since 1970. For Crohn's disease there has been an overall increase in incidence in all studies with a tendency towards a plateau in recent years in some areas. The prevalence of ulcerative colitis in 1978 was 117/10(5) and for Crohn's disease 34/10(5) in Copenhagen county. The survival of the patients did not differ from that of the background except for a small excess mortality in elderly men with ulcerative colitis within the first 2 years with the disease. 10% of patients with ulcerative colitis were colectomized within 1 year and 23% within 10 years. 55% of patients with Crohn's disease were operated on within 10 years, 11% two or more times. The number of patients in complete remission for 10 years after the initial attack is practically zero. 90% of patients with ulcerative colitis and about 80% with Crohn's disease have full work capacity. The risk of intestinal cancer is 1.4% in ulcerative colitis after 18 years (e.g. twice the risk in the background population) and is markedly lower than in previous reports. In Crohn's disease no increased risk of cancer was found.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Prognosis and quality of life in patients with ulcerative colitis and Crohn's disease.

The prognosis of a disease depends on individual social and medical factors. Prognosis for a group of patients on a well-defined treatment regimen will provide useful information only if patient material is suitable. In such studies normal survival of patients with ulcerative colitis and Crohn's disease has been reported. The price for good survival seems to be early surgical treatment in medical treatment failures. The quality of life (family relations, marriage, social activities and employment) did not differ significantly from a control group.

Colitis, Ulcerative↗
PubMed1987

CEA and carbohydrate antigens in normal and neoplastic colon mucosa. An immunohistochemical study.

Antibodies raised against tumour-associated antigens have been assessed for tumour selectivity using an indirect immunohistochemical peroxidase staining of formalin-fixed, paraffin-embedded tissue from colon carcinomas, colon polyps and normal mucosa. The following antibodies were used: 1) Unabsorbed polyclonal antibody to carcinoembryonic antigen (poly-CEA). 2) Monoclonal antibodies to CEA (mabs 3851 and 27). 3) Monoclonal antibodies to protein-bound carbohydrates (mabs C 216 and C 242) or to lipid- and protein-bound carbohydrates (C 50 and 19-9). These antibodies had been produced by hybridization of lymphocytes from mice, immunized with colon carcinoma cell lines or colon cancer tissue. All antibodies were used in one concentration only, preselected by initial titration experiments. No antibody was completely tumour-specific, but four antibodies, mabs 3851, 27, C 216 and C 242, showed statistically significant tumour selectivity. Using these antibodies, respectively 19, 19, 19, and 18 of 20 colon cancer were stained compared with 3, 4, 4, and 8 of 15 specimens of colon mucosa from normal controls. An increased frequency of staining was also noted in dysplastic polyps (statistically significant using mabs 3851 and C 216) and in dysplastic mucosa adjacent to a tumour (statistically significant using mabs 3851 and 27). The staining frequency of normal colon mucosa in cases of colon cancer did not differ from that in the normal controls. Poly-CEA and the anti-ganglioside mabs C 50 and 19-9 revealed no tumour selectivity. A pronounced goblet cell staining was seen using C 50, C 242 and 19-9.

Antibodies, Monoclonal↗
PubMed1987

Life prospects and quality of life in patients with Crohn's disease.

A regional prevalence group of 106 patients with Crohn's disease were interviewed about their familial, social, and professional conditions. The results were compared with results from similar interviews of an age and sex matched control group of 75 previously healthy patients admitted to the hospital for acute diseases of less than 28 days' duration. An equal percentage of the patients and the controls were married (67% vs 71%) and had become parents (68% vs 79%). The number of children was slightly lower among Crohn's disease patients. The occurrence of familial problems and sexual problems did not differ among patients and controls. The intake of sedatives was low in both groups and no difference was found in alcohol and tobacco intake between patients and controls. A combined score for social activities comprising cultural, sporting, educational and private social arrangements showed that about one-third of patients and controls had high social activity and about half of both groups had moderately high social activity. A similar physical activity score showed no difference between the two groups. The socioeconomic level of the Crohn's disease patients was slightly, but significantly higher than that of the controls. Sixty five per cent of Crohn's disease patients were employed, 64% of controls; 6% and 7% respectively unemployed. Three per cent of Crohn's disease patients had disablement pension. Of Crohn's disease patients employed, a higher percentage (77%) had remained in the same job for more than five years (64% of controls). The number of sick leave days during previous year was less than 11 in 72/69% of patients and controls. In spite of these objectively good results 54% of patients with Crohn's disease felt exacerbations of their disease strained their professional and personal life. During the previous year 23% reported decreased working capacity and 21% reported decreased leisure activities, compared with their own expectations.

Adult↗