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At least 217 records · Page 12Linked to original sources
PubMed2000

Preliminary clinical observations on the use of piroxicam in the management of rectal tubulopapillary polyps.

Rectal tubulopapillary polyps were diagnosed in eight dogs following proctoscopy and mucosal pinch biopsy. Histological examination of the pinch biopsies revealed evidence of malignant transformation in three of the cases. The remaining cases were diagnosed as benign polyps. Inflammatory changes were observed in four cases. Seven dogs were treated with piroxicam suppositories and one with oral piroxicam. All dogs were re-examined after four to six weeks of piroxicam therapy and the extent of haematochezia, tenesmus and faecal mucus production was reduced in all cases. The owners of seven of the dogs considered the improvement in clinical signs to be good or excellent. Cases with and without evidence of inflammation responded equally well. This finding supports the hypothesis that piroxicam has an antineoplastic effect due to apoptosis and alteration in the cell cycle. Medical management with piroxicam may provide a non-invasive treatment option for dogs with rectal polyp formation in which surgical treatment is likely to be associated with complications such as incontinence, infection and wound breakdown, or where the owner declines such treatment.

Animals↗
PubMed1978

Histiocytic ulcerative colitis in a Boxer dog.

A 2-year-old male Boxer dog had passed loose faeces mixed with fresh blood and mucus for 8 months. Tenesmus after defaecation was a feature. Colitis was diagnosed from the proctoscopic appearance of the recto-colonic mucosa and confirmed from a biopsy. The disorder proved unresponsive to sulphasalazine therapy, but oral chloramphenicol, betamethasone and prednisolone enemas administered over a 6-week period produced a satisfactory clinical improvement, which persisted for a further 3 weeks without treatment. However, follow-up proctoscopy showed only a marginal improvement in the appearance of the mucosa and appeared to exacerbate further bloody diarrhoea, which persisted. The dog was destroyed and histiocytic ulcerative colitis confirmed at autopsy.

Animals↗
PubMed1980

Giardiosis and colitis in a dog.

An 18-month-old Cavalier King Charles Spaniel with recurrent diarrhoea for 2 months had signs suggesting dysfunction of small and large bowel. No helminth ova, protozoa or fat were found on faecal examination. Proctoscopy, barium enema examination and colonic biopsy revealed mucosal colitis. Biopsied small intestine was histologically normal but Giardia trophozoites were numerous in fluid aspirated from the duodenum. Absorption of d-xylose was normal. Giardiosis and idiopathic colitis were diagnosed. Clinical signs abated after 2 courses of metronidazole administration.

Animals↗
PubMed1980

Colonoscopic polypectomy in children.

Five children presenting with chronic and intermittent rectal bleeding were diagnosed as having colorectal polyps by fibreoptic colonoscopy performed under sedation. Three of the children had had barium-enema films reported on as normal. Eight polyps were seen, of which six were proximal to the sigmoid colon. All were removed endoscopically (one by proctoscopy, one by snare-intussusception) without complication. Colonoscopic polypectomy is a safe and efficient procedure in children, and colonoscopy may be regarded as first-line management in those with rectal bleeding.

Adolescent↗
PubMed1979

Chronic immune colitis in rabbits.

A chronic colitis has been induced in rabbits having many of the histological features of human ulcerative colitis. Animals were first immunised with the common enterobacterial antigen of Kunin and haemagglutinating antibodies demonstrated in high titre. An immune complex colitis was then established by the injection of soluble immune complexes following mild irritation of the rectum with dilute formalin as previously described. The rabbits developed an acute colitis within the first week but, in contrast with unsensitised rabbits, the inflammation persisted and was still present at six months as assessed by proctoscopy and rectal biopsy. Kunin-sensitised rabbits receiving intravenous saline, antigen, or antibody alone did not develop a chronic colitis. It is suggested that hypersensitivity to colonic bacterial antigens may be one mechanism whereby an acute colitis becomes chronic.

Animals↗
PubMed1997

Rectal cell proliferation and colon cancer risk in patients with hypergastrinaemia.

BACKGROUND: The influence of gastrin on the colonic mucosa is still uncertain. Some authors have suggested a stimulating effect on the growth of normal and malignant colonic epithelium, while others have shown no association between gastrin and neoplastic development. AIMS: To evaluate the effect of gastrin on colorectal cell proliferation, patients with chronic endogenous hypergastrinaemia underwent proctoscopy. Biopsy specimens were taken in order to study rectal cell kinetics. PATIENTS AND CONTROLS: Ten patients with chronic autoimmune gastritis (CAG), six patients with Zollinger-Ellison syndrome (ZES), and 16 hospital controls took part in this study. Patients with CAG and ZES had basal serum gastrin concentrations significantly higher than controls (p < 0.001). METHODS: Immunohistochemistry was performed on 3 microns sections of rectal biopsy specimens incubated with 5'-bromodeoxyuridine. RESULTS: The percentage of proliferating cells in the entire crypts (overall labelling index) was similar in all the groups. However, the labelling frequency in the upper two fifths of the glands (phi h value) was significantly higher in patients with CAG or ZES compared with controls (p < 0.01 in both patient groups versus controls). CONCLUSIONS: Endogenous hypergastrinaemia is associated with rectal cell proliferation defects, similar to those observed in conditions at high risk for colon cancer. The effect of the increased serum concentrations of gastrin on the colorectal mucosa after treatment with drugs inhibiting gastric acid secretion should be investigated.

Adult↗
PubMed1979

Comparison of anal and rectal swabs in the diagnosis of anorectal gonorrhoea in women.

Among 228 women with gonorrhoea (confirmed by culture), swabs taken blindly from the anal canal gave positive results in 26.3% and those taken from the rectum under direct vision in 27.6%. Swabs from both sites gave positive results in 23.2% of patients, from the anal canal alone in 3.1%, and from the rectum alone in 4.4%. Thus, culuture of anal canal swabs seems to give as reliable results as rectal swabs when proctoscopy cannot be carried out.

Anal Canal↗
PubMed1985

Chlamydial proctitis?

Chlamydia trachomatis was isolated from 21 (7%) of 309 specimens obtained in October 1982 from the rectum of homosexual men undergoing proctoscopy. During the same period Neisseria gonorrhoeae was isolated from 12 (3%) of 454 specimens obtained similarly. The clinical features of patients infected with each of these micro-organisms were compared with those of an uninfected group of homosexual men. No characteristic diagnostic features were noted in the infected men.

Adult↗
PubMed1987

Sigmoidoscopy--a necessary procedure in the routine investigation of homosexual men?

In a study to assess the value of sigmoidoscopy in the routine investigation of homosexual men, this procedure was undertaken on 1118 men who attended a sexually transmitted diseases clinic as "new" or "return new" patients. Serious rectal disease was not identified in any of the 557 men who were symptomless at the initial attendance. Though the extent of the proctitis diagnosed in 166 men would not have been defined, 99% (465) of 470 anorectal lesions would have been identified if proctoscopy alone had been performed. It is concluded that sigmoidoscopy does not have a role in the routine investigation of homosexual men.

Diagnostic Tests, Routine↗
PubMed1994

Rectal spirochaetosis in homosexual men: the association with sexual practices, HIV infection and enteric flora.

OBJECTIVE: To determine the prevalence of rectal spirochaetosis in homosexual men attending a sexually transmissible diseases clinic and investigate the association between their presence and sexual practices, HIV infection and enteric flora. DESIGN: The study included 144 male homosexual subjects who each completed a questionnaire, underwent physical examination, proctoscopy and investigations for STD and HIV screening, rectal biopsies and collection of faecal samples. SETTING: The Sexual Health Centre, Sydney Hospital, Sydney, Australia. RESULTS: Spirochaetes were detected in 39% of the rectal biopsies, using histological criteria. Logistic regression analysis showed that rectal spirochaetosis was significantly associated with: oral-anal contact. (P < 0.05, OR 3.45, 95% CI 1.48-8.05); detection of 3-5 different non-pathogenic protozoa in faeces (P < 0.01, OR 11.68, 95% C.I. 2.33-58) and a positive HIV antibody test (P < 0.01) OR 4.48, 95% C.I. 1.28-15.72). CONCLUSIONS: These findings indicate that rectal spirochaetosis is relatively common in homosexual men. The association with non-pathogenic protozoa is most likely attributable to the common mode of transmission viz oral-anal contact. However it is difficult to determine whether the association with HIV infection is cause or effect because of the limitations in the study design. Further information is required to determine the clinical significance of infection with these organisms.

Adult↗
PubMedDate not supplied

MR imaging of cervical carcinoma: a practical staging approach.

Cervical carcinoma is the third most common gynecologic malignancy and is typically seen in younger women, often with serious consequences. The International Federation of Gynecology and Obstetrics (FIGO) staging system provides worldwide epidemiologic and treatment response statistics. However, there are significant inaccuracies in the FIGO staging system, and magnetic resonance (MR) imaging, although not included in that system, is now widely accepted as optimal for evaluation of important prognostic factors such as lesion volume and metastatic lymph node involvement that will help determine the treatment strategy. MR imaging examination obviates the use of invasive procedures such as cystoscopy and proctoscopy, especially when there is no evidence of local extension. Brachytherapy and external beam therapy are optimized with MR imaging evaluation of the shape and direction of lesion growth. In general, T2-weighted MR imaging more clearly delineates cervical carcinoma and is preferred for evaluation of the lymph nodes. Dynamic gadolinium-enhanced T1-weighted imaging may help identify smaller tumors, detect or confirm invasion of adjacent organs, and identify fistulous tracts. MR imaging staging, when available, is invaluable for identifying important prognostic factors and optimizing treatment strategies.

Female↗
PubMed1984

Small colonic polyps: a reappraisal of their significance.

With the advent of fiberoptic endoscopy and modern radiographic techniques, the majority of detected polyps are less than 1 cm. During a seven-month period, we studied 140 patients who had radiographically demonstrated colonic polyps that were confirmed by pathologic study. Tissue specimens were obtained by proctoscopy, colonoscopy, or surgery. There were 222 polyps of which 144 (65%) were 1 cm or less in size, with the preponderance (80%) of these being adenomatous. Of the 82 polyps that ranged in size from 6-10 mm, 68 (83%) were adenomas, including one carcinoma and five villous adenomas. Forty-seven (72%) of the diminutive polyps (less than or equal to 5 mm) were adenomatous, including two with atypia. Our results correspond to those of several recent endoscopic studies, reporting that a small colonic polyp is most likely to be adenomatous, and that it possesses the potential for growth and malignant transformation. The detection of small polyps during barium enema examination is thus warranted, particularly in the proximal colon where the majority are adenomatous. The clinical management of polyps is becoming more aggressive, and the removal of even small lesions (less than or equal to 5 mm) is now performed if they are found incidentally during colonoscopy.

Adenoma↗
PubMed1992

Incidental finding of rectal carcinoma during transrectal US for prostatic diseases.

During transrectal ultrasound (TRUS), rectal carcinoma was an incidental finding in seven patients among a series of 5,000 TRUS examinations. TRUS was performed in seven patients with symptoms characteristic of prostatic diseases. All seven patients underwent examination by at least one physician before TRUS and, except for abnormal prostatic findings, no tumors were detected during digital rectal examination (DRE). The tumors were clearly visualized with TRUS and were easily palpated during DREs performed after TRUS. They were large and were located mainly along the posterior and lateral walls of the rectum. All the tumors were diagnosed by means of proctoscopy; the biopsy findings were positive, and the pathologic staging indicated advanced disease: adenocarcinoma of the rectum with a minimum grade of Dukes C. It is recommended that, in addition to evaluation of scans obtained in the transverse plane, the multiplane transducer be used to evaluate the longitudinal plane of the rectum for detection of possible undiscovered tumors.

Adenocarcinoma↗
PubMed1996

Invasive cervical carcinoma: role of MR imaging in pretreatment work-up--cost minimization and diagnostic efficacy analysis.

PURPOSE: To examine the cost and efficacy of diagnostic work-up in patients with invasive cervical cancer. MATERIALS AND METHODS: In 246 patients with invasive cervical cancer, all diagnostic tests performed before treatment were recorded. Patients were divided into two groups: those who underwent magnetic resonance (MR) imaging as the initial study (n = 105) and those who did not (n = 141). A list of 1995 Medicare global payments was used to measure cost. Bayesian analysis (likelihood ratios derived from a literature search) was performed for bladder, rectal, parameterial, and nodal involvement in stage Ib disease. RESULTS: Significantly fewer procedures and fewer invasive studies were performed in the MR imaging group. Net cost savings for the MR imaging group was $401 for all patients and $449 for patients with stage Ib disease. For stage Ib disease, the 0% pretest probability of bladder or rectal invasion does not justify the routine use of barium enema examination, cystoscopy, or proctoscopy. The increase in predictive values for parameterial and nodal disease was highest for MR imaging when tumor size was at least 2 cm. CONCLUSION: Guidelines for the pretreatment work-up of clinical stage Ib cervical cancer need revision. MR imaging should be used as an adjunct to clinical evaluation.

Adenocarcinoma↗
PubMed2000

Malignant melanoma of the anorectal area. Report of two cases.

BACKGROUND/AIMS: Primary anorectal melanoma is a very rare malignant tumor with no more than 300 cases reported in the literature. METHODS: Two cases of anorectal melanoma are reported herein. RESULTS: Both patients, aged 44 and 74 years, presented at the outpatient department with anal bleeding, one after being treated for 3 months with antihemorrhoidal drugs. The diagnosis was established with proctoscopy and biopsy, and a palliative abdominoperineal resection in the presence of lymph node metastases was performed followed by chemotherapy with vindesine. Although the procedures were not curative, both patients had an uneventful postoperative recovery, and lived 4 years and 21 months, respectively, without bleeding problems albeit with the inconvenience of a colostomy. CONCLUSIONS: For the time being there is no convincing proof of the value of either types of proposed surgical management. We agree with those who believe that abdominal perineal resection has an advantage regarding the prognosis and quality of life.

Adult↗
PubMed2005

Utilization of diagnostic studies in the pretreatment evaluation of invasive cervical cancer in the United States: results of intergroup protocol ACRIN 6651/GOG 183.

PURPOSE: To review the current utilization of diagnostic tests prescribed by the International Federation of Gynecology and Obstetrics (FIGO) clinical staging guidelines in the pretreatment work-up of invasive cervical cancer, and to compare the data with those of previous patterns of care studies. PATIENTS AND METHODS: This interdisciplinary American College of Radiology Imaging Network/Gynecologic Oncology Group prospective clinical trial was conducted between March 1, 2000, and November 11, 2002. Twenty-five participating institutions, all from the United States, enrolled a total of 208 patients. Only patients scheduled for surgery with biopsy-confirmed cervical cancer of clinical FIGO stage IB or higher were eligible. The patterns of care data analysis was based on 197 patients who met all inclusion criteria. The conventional FIGO-recommended tests used for pre-enrollment FIGO clinical stage classification were at the discretion of the treating physician; overall frequency of use was tabulated for each test. RESULTS: Use of cystoscopy (8.1%) and sigmoidoscopy or proctoscopy (8.6%) was significantly lower than in 1988 to 1989 (P < .0001 in each instance). Intravenous urography was used in only 1% of patients as compared with 42% in 1988 to 1989 and 91% in 1983. No patient included in the data analysis had barium enema or lymphangiography. Only 26.9% of patients had examination under anesthesia for FIGO clinical staging. CONCLUSION: There is a large discrepancy between the diagnostic tests recommended by FIGO and the actual tests used for cervical cancer staging, suggesting a need to reassess the relevance of the FIGO guidelines to current clinical practice in the United States.

Adult↗
PubMed2006

The potential of restaging in the prediction of pathologic response after preoperative chemoradiotherapy for rectal cancer.

BACKGROUND: We performed this study to prospectively evaluate the postchemoradiotherapy performance of transrectal ultrasonography (TRUS), pelvic computed tomography (CT) scan and magnetic resonance imaging (MRI), and endoscopic biopsies for predicting the pathologic complete response of rectal cancer patients. METHODS: Four weeks after completion of preoperative chemoradiotherapy, 46 consecutive patients with mid to low rectal cancer were prospectively evaluated by proctoscopy, TRUS, and pelvic CT scan and MRI. On the basis of T and N status, patients were classified as T0 or T1-4 and N-negative or N-positive. For each staging modality used, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. Findings were compared with the pathologic tumor-node-metastasis stage. RESULTS: On histopathologic analysis, 12 patients had pT0 and 34 had pT1-4 lesions; out of 45 assessable patients, 9 were N-positive. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in predicting T status (T0 vs. T >or=1) were 77%, 33%, 74%, 36%, and 64%, respectively, for TRUS; 100%, 0%, 74%, not assessable, and 74% for CT; and 100%, 0%, 77%, not assessable, and 77% for MRI. The corresponding figures in predicting N status (N-negative vs. N-positive) were, respectively, 37%, 67%, 21%, 81%, and 61% for TRUS; 78%, 58%, 32%, 91%, and 62% for CT; and 33%, 74%, 25%, 81%, and 65% for MRI. CONCLUSIONS: Current rectal cancer staging modalities after chemoradiotherapy allow good prediction of node-negative cases, although none of them is able to predict the pathologic complete response on the rectal wall.

Adenocarcinoma↗
PubMed1999

PCR detection of Epstein-Barr virus, herpes simplex virus and human papillomavirus from the anal mucosa in HIV-seropositive and HIV-seronegative homosexual men.

This study aimed to examine the prevalence of the Epstein-Barr virus (EBV), herpes simplex virus (HSV) and human papillomavirus (HPV) in the anal and oral mucosa of homosexual men with and without HIV infection and to correlate these findings to CD4+ count and anal cytology. Anal and oral cell samples from 20 HIV-infected and 14 non-infected homosexual men attending the STD clinic at Sahlgrenska University Hospital, Goteborg were examined for EBV, HSV and HPV by the polymerase chain reaction (PCR) technique. Proctoscopy was performed in all patients and swabs for cytology were taken. EBV was demonstrated in 32% (6/19) of anal cell samples from the HIV-positive group but in none from 13 HIV-negative men. Asymptomatic shedding of HSV type 2 from the anus was detected in 3 of 19 HIV-positive men, all with low CD4+ counts and abnormal cytology. No patient in the HIV-negative group shed HSV from the anus. HPV was demonstrated in 16 of 17 anal cell samples in the HIV-infected group and in 7 of 13 HIV-negative men. More than one HPV type was detected in 7 HIV-infected men. Five (29%) of 17 HIV-positive patients exhibited abnormal cytology whereas none did so in the HIV-negative group. Those with abnormal cytology all had CD4+ counts below 0.35 and were infected with multiple HPV types including HPV 16/18. In conclusion, our results demonstrate an enhanced expression of HPV as well as EBV from the anus in HTV-infected homosexual men. In this small number of patients EBV was not related to low CD4+ count or to abnormal cytology.

AIDS-Related Opportunistic Infections↗