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PubMed1984

Carcinoma of the prostate treated by pelvic node dissection, iodine-125 seed implant and external irradiation: a study of rectal complications.

The University of Missouri-Columbia protocol for localised cancer of the prostate calls for pelvic node dissection, 10000 cGy at the periphery of the prostate from 125I and 4000 cGy in 20 fractions to the whole pelvis using supervoltage X-ray therapy. Rectal complications were studied in 104 patients; acute and chronic reactions were defined. During external irradiation 54% did not develop diarrhoea, 43% had mild diarrhoea and 3% had severe diarrhoea. In the chronic stage 77% did not have diarrhoea, 12% had delayed, non-distressing rectal bleeding which did not need specific treatment or needed only simple treatment, 7% had prolonged distressing proctitis and 4% had rectal ulceration or recto-urethral fistula necessitating colostomy. Each of the four patients who had colostomy had an additional aetiological factor (arterial disease, pelvic inflammation, additional radiation, pelvic malignancy or second operation). None of the patients entered in the combined brachytherapy and teletherapy programme, and in whom 0.5 cm space was maintained between the closest seed and the rectal mucosa, developed prolonged proctitis.

Brachytherapy↗
PubMed2003

[Ulcerative colitis with segmental involvement].

INTRODUCTION: Ulcerative colitis is a chronic inflammatory disease affecting areas of the colon or the full length. From the endoscopic point of view, ulcerative colitis presents lesions that stretch continuously from the rectum to variable colon segments, a characteristic that is of great value when distinguishing it from Crohn's disease. Continuous involvement, without healthy patches, justifies ending endoscopic exploration once the distal end of the lesion has been reached. OBJECTIVE: To retrospectively study the frequency of segmental lesions in the colonoscopies performed in patients with ulcerative colitis. METHODS: Diagnosis of ulcerative colitis and proctitis was established by clinical, endoscopic, histologic, analytical, and radiological criteria. The indication and number of endoscopies was made on the basis of the clinical criteria of diagnosis, acute episodes, refractoriness or dysplasia screening. The extent of the examination also depended on clinical criteria: the severity of the episode, tolerance to colonoscopy or the degree of cleansing. RESULTS: A total of 155 coloscopies were performed. In 113 colonoscopies (73%) the distal end of the lesion was reached and in 70 (45%) the cecum was reached. Of the 80 patients, 27 (33%) presented ulcerative proctitis at diagnosis. Nine of the 80 patients (11.3%) biopsies were performed in healthy colonic patches, which confirmed histological normality. Six of the 9 patients were receiving no treatment. In all patients except two, the cecum was reached in one or more of the colonoscopies. The distribution of the segmental lesions varied but these were mainly found in the periappendicular region and in the cecum in 6 of the 7 patients in whom the cecum was reached. Of the 80 patients, endoscopic evidence of rectal sparing was found in 5 (6.3%); of these, 4 were receiving systemic or topical treatment. Histological analysis confirmed the absence of inflammatory lesions in these patients. The only patient who was not receiving treatment presented microscopic lesions compatible with ulcerative colitis. CONCLUSIONS: Endoscopic segmental lesions in ulcerative colitis were present in 11.3% of patients. Segmental lesions were most frequently found in the cecum and periappendicular region. Endoscopic and histologic evidence of rectal sparing may be the result of systemic or topical treatment.

Adolescent↗
PubMed2002

Complications following permanent prostate brachytherapy.

OBJECTIVES: The acute and chronic complications of permanent prostate brachytherapy are discussed. MATERIALS AND METHODS: Review of literature for the complications associated with iodine-125 (125I) and palladium-103 (103Pd) prostate brachytherapy. Acute complications included urinary retention, changes in the International Prostate Symptom Score (IPSS) and need for TURP. Chronic morbidity included permanent urinary symptoms, incontinence, radiation proctitis and erectile dysfunction. RESULTS: Urinary retention occurred in 1.5-22% of the patients postimplant. Acute urinary symptoms increased by over 100% 1 month after the procedure. By 12 months, the symptoms were either back to baseline or slightly elevated in over 90% of the patients. Significant obstructive symptoms or persistent urinary retention necessitating TURP occurred in 0-8.7%. Urinary incontinence was found in 0-19% treated by implant without associated TURP, in 0-85% for those who had a TURP prior to the implant and in 0-17% for those who had the TURP subsequent to the implant. Potency rates ranged from 34% to 86% 1-6 years postimplant. Radiation proctitis was found in 0.5-21.4%, with significant injury (fistula) occurring in 1-2.4%. CONCLUSIONS: The data from this report suggests that permanent prostate brachytherapy can be accomplished with minimal short- and long-term morbidity. Attention to detail as well as an appreciation to the causative factors for the morbidity will help reduce treatment-related side effects.

Brachytherapy↗
PubMed2003

Fractionated perineal high-dose-rate temporary brachytherapy combined with external beam radiation in the treatment of localized prostate cancer: is lymph node sampling necessary?

PURPOSE: To study the influence of imaging based nodal staging and local dose escalation by a high-dose-rate brachytherapy (HDR-BT) boost in the treatment of locally confined prostate cancer in terms of prostate specific antigen (PSA) recurrence-free survival (biochemical non-evidence of disease (bNED)), treatment toxicity and prognostic variables. PATIENTS AND METHODS: The prospectively recorded files of 144 men aged in a median of 68 years with a mean follow-up of 8 years (60-171 months) receiving curatively intended, transrectal ultrasound guided high-dose-rate 192-iridium-brachytherapy (HDR-BT) combined with external beam radiation therapy (EBRT) for locally confined prostate cancer were analyzed. T-stages were defined by digital rectal investigation and transrectal sonography (TRUS), nodal staging was performed with computed tomography(CT)/magnetic resonance imaging (MRI) (UICC/AJCR 1992). Twenty-nine patients (20.1%) had T1b-T2a tumors, and 115 patients had T2b-T3 tumors. Median initial PSA (iPSA) was 12.15 ng x mL(-1) (mean 25.61 ng x mL(-1)). The total planned dose applied by external beam radiation was 50 Gy in the pelvis, and 40 Gy in the prostate by in-field-dose modification by individual compensators. The perineal, TRUS guided HDR-BT was delivered in two fractions of 15 Gy each. The target of BT boost was the peripheral zone of the prostate. RESULTS: The overall survival was 71.5% and that of the disease free survival 82.6%. Freedom from distant metastases in T3 stage was 91.3%, whereas for G3 lesions, it was 88.23%. The bNED rate was 72.9%. Regarding treatment related late toxicity according to the EORTC/RTOG score, we observed grade 1, 2, 3 proctitis in 9.72%, 6.94%, 4.10% as well as grade 1, 2, 3 cystitis in 12.5%, 4.16%, 2.08%, respectively. Grade 4 and 5 proctitis or cystitis were not registered. CONCLUSION: The minimum 5-year and mean 8-year results confirm that local dose escalation by TRUS guided perineal HDR-BT and complementary external beam radiation of the pelvic lymphatics has curative potential in men with locally confined high-risk prostate cancer, although surgical staging results in the literature suggest a high probabilityof microscopic nodal involvements at the level of 25.61 ng x mL(-1) mean PSA. The influence of additional short-term (< 6 months) hormonal ablation on the treatment results could not be stated.

Aged↗
PubMed1997

Review article: insurance risks for patients with ulcerative colitis or Crohn's disease.

Prospective population-based studies have allowed a re-evaluation of the risks of insuring patients with ulcerative colitis or Crohn's disease. Life expectancy, the risk of cancer and working capacity are very much better than previously recognised and are normal for many patients. Three population-based studies in ulcerative colitis have shown a mortality similar to or slightly less than the general population except in the first year after diagnosis, whilst two have shown a slightly higher mortality (standardized mortality ratio, SMR = 1.4), except for those with proctitis. In Crohn's disease, two population-based studies have also shown an increased mortality (SMR = 1.4), which is similar to that of unskilled manual labourers (SMR = 1.43) from all causes of death. Three other studies have shown no increase in overall mortality, except in the first 5 years after diagnosis, in those with proximal small intestinal disease and in some patients needing multiple operations. Insurance risks should be evaluated on an individual basis, after details of the extent and pattern of disease have been obtained. Although the 'standard life' in insurance terms differs from that of the general population, because people who seek life assurance are self-selected from a more affluent section of society, many patients can be identified who have a particularly good prognosis. These include patients with ulcerative proctitis, those with left-sided colitis in extended remission (> 12 months), and patients more than 30 years old with localized ileal or ileocaecal Crohn's disease that has responded to treatment. From the published data, it is difficult to justify increasing the insurance premium in such patients.

Activities of Daily Living↗
PubMed1991

Frequency and spectrum of microorganisms isolated from biopsy specimens in chronic colitis.

In 109 patients with chronic diarrhea colonic biopsies were examined for the presence of specific microorganisms. A positive result was obtained in 48% of patients with ulcerative colitis, 50% with Crohn's disease, 21% with non-specific colitis and 36% with non-specific proctitis. Chlamydiae were found most frequently in all groups. Obligate enteropathogenic bacteria were isolated in only three cases of nonspecific colitis. Of the facultatively enteropathogenic organisms Klebsiella and Pseudomonas aeruginosa were isolated in 31% and 24%, respectively, of patients with ulcerative colitis, in 21% and 7% of patients with Crohn's disease, and in 10% and 6% of patients with non-specific colitis. Whereas chlamydial proctitis is a well-known disease, the results of this study point also to a possible pathogenic role of chlamydiae in the proximal colon. Facultatively enteropathogenic organisms causing acute diarrhea might have aetiologic relevance in some cases of chronic non-specific colitis.

Adolescent↗
PubMed2005

Hyperthermia combined with radiation in treatment of locally advanced prostate cancer is associated with a favourable toxicity profile.

PURPOSE: Hyperthermia is used to treat several pelvic tumours. An important step in establishing a broader role for hyperthermia in treatment of prostate cancer is verification of an acceptable toxicity profile. In this report, short- and long-term toxicity profiles of a completed phase II trial of transrectal ultrasound hyperthermia combined with radiation in treatment of locally advanced prostate cancer are presented. METHODS AND MATERIALS: Thirty-seven patients enrolled on a phase II study of external beam radiation +/- androgen suppression with two transrectal ultrasound hyperthermia treatments were assessed for short- and long-term toxicity. Prostatic and anterior rectal wall temperatures were monitored. Rectal wall temperatures were limited to 40 degrees C (19 patients), 41 degrees C (three patients) and 42 degrees C (15 patients). Univariate logistic regression was used to estimate the log hazard of developing NCI CTC Grade 2 toxicity based on temperature parameters. Hazard ratios, 95% confidence intervals, p-values for statistical significance of each parameter and proportion of variability explained for each of the parameters were calculated. RESULTS: Median follow-up was 42 months. Both short- and long-term GI toxicity were limited to grade 2 or less. Acute grade 2 proctitis was greater for patients with allowable rectal wall temperature of >40 degrees C. Eleven of 18 patients in this group had acute grade 2 proctitis vs three of 19 patients with rectal wall temperatures limited to 40 degrees C (p = 0.004). Long-term grade 2 GI and GU toxicity occurred in 5% and 19% of patients. No late grade 3 or greater toxicity occurred. Late GI and GU toxicity were not associated with the allowable rectal wall temperature. CONCLUSION: Transrectal ultrasound hyperthermia combined with radiation for treatment of advanced clinically localized prostate cancer is safe and well tolerated.

Aged↗
PubMed1998

Incidence of HIV and sexually transmitted diseases (STD) in a cohort of HIV-negative men who have sex with men (MSM).

OBJECTIVE: To determine the prevalence of sexually transmitted diseases (STD) and incidence of and risk factors for STD, including HIV-1, among a cohort of HIV-negative men who have sex with men (MSM). SETTING: Seattle, Washington, United States. PARTICIPANTS: Prospective cohort of 578 HIV-negative MSM in which risk factors for acquiring a STD over 12 months follow-up were evaluated using a cumulative incidence analysis. MAIN OUTCOME MEASURES: Baseline tests obtained were: herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) Western blots, hepatitis B, and syphilis serologies; anorectal and pharyngeal Neisseria gonorrhoeae (GC) cultures; first-catch urine for leukocyte esterase (LE) and Chlamydia trachomatis (CT) ligase chain reaction (LCR). Men with a positive urine LE had urethral GC cultures obtained. The following outcomes were measured over 12 months follow-up: incident symptomatic bacterial STD (urethritis, proctitis, epididymitis), HSV-1 and HSV-2 seroconversion, and HIV-1 seroconversion. The 31 incident cases of STD (men with bacterial STD) were compared with those 489 men without symptomatic bacterial STD or seroconversion to HSV-1, HSV-2 or HIV-1 infection. RESULTS: Bacterial STD were found in nine participants at enrollment; there were two cases of nonchlamydial urethritis, two cases of nonchlamydial epididymitis, and five cases of asymptomatic GC infection. At enrollment, HSV-2 antibodies were detected in 149 (26.0%) of 572 men and prior hepatitis B infection in 145 (34.8%) of 417 unvaccinated men. During the 1-year of follow-up, 31 men (5.7/100 person-years) had 34 episodes of a symptomatic bacterial STD syndrome (urethritis, epididymitis or proctitis). Urethritis was the most common STD syndrome, detected in 29 men, of whom 10 had GC and 19 had nongonococcal urethritis. In the 1-year of follow-up, five participants seroconverted to HIV-1 (1.3/100 person-years), four to HSV-2 (1.0/100 person-years), and seven to HSV-1 (4.3/100 person-years). Unprotected insertive anal sex [odds ratio (OR) 2.6; 95% confidence interval (CI) 1.2-5.6]; and nitrite inhalant ('poppers') use (OR, 2.3; 95% CI, 1.0-5.0) were independently associated with incident STD. CONCLUSIONS: STD and HIV infection continue to be acquired even in a city with an overall low bacterial STD prevalence and among educated MSM receiving regular HIV screening and risk-reduction. Urethritis was the most common STD detected, and public health messages aimed at MSM need to emphasize safe insertive as well as receptive sexual practices.

Cohort Studies↗
PubMed1986

Erythrocytic sedimentation rate as a measure of clinical activity in inflammatory bowel disease.

To assess the reliability of the erythrocytic sedimentation rate (ESR) as a measure of clinical activity in inflammatory bowel disease, we analyzed the correlations of ESR with a global assessment of clinical activity in 77 patients with varying extents of Crohn's disease and ulcerative colitis. Analysis of all 141 ESR determinations in all 77 patients showed a highly significant correlation between mean ESR and clinical activity score (r = 0.54, p less than 0.001). Analysis of 133 ESR determinations in these 77 patients when their disease activity was either mild, moderate, or severe showed some significant differences among certain disease categories. The highest mean ESRs were in patients with the most extensive colon involvement (Crohn's colitis 40.7 +/- 3.3, universal ulcerative colitis 31.0 +/- 3.9), whereas the lowest mean ESRs were in patients with the most limited disease (ulcerative proctitis and proctosigmoiditis 19.2 +/- 2.1). The rate of increase in ESR with progressively increasing clinical activity from mild to moderate was the same in all disease categories, with the exception of Crohn's disease limited to the small bowel (ileitis or jejunoileitis), in which the ESR was relatively unchanged in a small sample of patients. By the time clinical activity became severe, however, patients in all disease categories manifested similarly high ESRs, with the exception of ulcerative proctitis in which the ESR remained low in the single patient tested.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Sedimentation↗
PubMed1999

Pancreatitis in ulcerative colitis: a case report of improved stricture of the main pancreatic duct.

We present one case with pancreatitis that synchronized with manifestations of ulcerative colitis, in which an improvement of stricture of the main pancreatic duct was observed. A 27-year-old man, having a history of nonalcoholic acute pancreatitis, complained of anal bleeding and pain in the epigastric region. The treatment for pancreatitis relieved the pain and decreased the serum levels of pancreatic enzymes to within normal ranges. Colonoscopy and histopathologic examination revealed ulcerative colitis in the rectum, and treatment with steroid enema made proctitis quiescent. Endoscopic retrograde pancreatography demonstrated a remarkable and short stricture of the main pancreatic duct, which improved at follow-up pancreatography. In a 20-month follow-up period, active proctitis relapsed with a episode of recurrent pancreatitis once, and without pancreatitis once.

Acute Disease↗
PubMedDate not supplied

Lymphogranuloma venereum in human immunodeficiency virus-infected individuals in New York City.

Lymphogranuloma venereum (LGV), or chlamydial proctitis, is a classic sexually transmitted disease with prominent gastrointestinal manifestations. The disease has received little attention in recent years, especially in relation to human immunodeficiency virus (HIV) infection. However, outbreaks of LGV have been reported in several large cities in Europe and the United States over the past few years, occurring in both HIV-infected and -uninfected individuals, and the reports have been largely limited to the sexually transmitted disease literature. We recently diagnosed four cases of chlamydial proctitis in HIV-infected individuals, who had different clinical presentations but very similar endoscopic and histopathologic features, as well as prompt and complete response to therapy. It is important for gastroenterologists to recognize that LGV may be reemerging as a relevant clinical entity, because of its similarity to inflammatory bowel diseases and its response to treatment with antibiotics.

Adult↗
PubMed1996

Progression of ulcerative proctosigmoiditis: incidence and factors influencing progression.

OBJECTIVE: To assess the changing distribution of disease within the large bowel in patients presenting with ulcerative proctitis or proctosigmoiditis. To evaluate the influence of clinical exacerbations, smoking, parity and family history in disease extension. DESIGN: Retrospective single-centre study in a university hospital. METHODS: Case records of patients presenting over a 40-year period were examined to evaluate the clinical course and disease distribution from initial presentation to final follow-up. For each patient whose disease extended to the more proximal colon, an age- and sex-matched control patient was identified whose disease remained confined to the original site. Patients completed a questionnaire to provide information on family history, smoking and parity. The differences in clinical exacerbations, family history, smoking and parity were then compared between the two groups. RESULTS: Among 145 patients presenting with proctitis or proctosigmoiditis followed prospectively for a median period of 10.9 years, the disease extended in 53 patients. Using actuarial methods the disease progressed beyond the rectosigmoid area in 16% of patients at 5 years and 31% at 10 years. Among the patients whose disease progressed, progression was preceded in 68% of cases by a clinical exacerbation of the colitis. When patients whose disease progressed were compared with those whose disease remained confined to the original site, no differences were detected in the number of clinical exacerbations, smoking habit, family history or parity. CONCLUSIONS: The factors that are associated with the extension of colitis are probably different from those that predisposed an individual to develop inflammatory bowel disease initially.

Adult↗
PubMed1995

Comparison of budesonide and 5-aminosalicylic acid enemas in active distal ulcerative colitis.

BACKGROUND: Budesonide is a new corticosteroid with high topical anti-inflammatory activity but little systemic effect. The aim of the present study was to compare the efficacy and safety of budesonide enema (2 mg/100 mL) and 5-ASA enema (mesalazine 1 g/100 mL) given for 4 weeks in the treatment of active distal ulcerative colitis and proctitis. METHODS: Ninety-seven patients were studied in a multicentre single-blind randomized group-comparative trial. The primary efficacy variables were endoscopy and histopathology scores obtained at 0, 2 and 4 weeks. Clinical symptoms were the secondary efficacy variables. Haematology, chemistry and adverse events were the safety variables. RESULTS: Budesonide and 5-ASA enemas both resulted in a significant improvement in endoscopy and histopathology scores but no difference could be demonstrated between the two treatment groups. There was also a significant improvement of symptoms (number of bowel movements per day, quality of stools, presence of blood and mucus, and state of well-being) within both groups but no difference between the two treatment groups. The clinical remission rate at 4 weeks was, however, 38% for patients treated with budesonide enema but 60% for those treated with 5-ASA enema (P = 0.03). No adverse events attributed to the study drugs were recorded in either of the groups. CONCLUSIONS: Budesonide enema 2 mg/100 mL appears to be as efficient and well-tolerated as 5-ASA enema in the treatment of active distal ulcerative colitis and proctitis.

Adult↗
PubMedDate not supplied

Rectal resection in the dog. A new surgical approach and the evaluation of its effect on fecal continence.

Thirteen healthy mixed breed dogs (6 female and 7 male) underwent rectal transection and resection of 0 to 6 cm using a dorsal approach. Rectoanal sphincter pressure studies were performed preoperatively and 6 weeks after surgery using a double balloon manometer device. Sphincter pressure profiles were altered in the 6 cm resection dogs. Clinical observations of defecation and degree of continence were made over a 10 week period postoperatively. The transection only and 4 cm resection dogs defecated normally. All dogs in the 6 cm resection group involving the peritoneal reflection were incontinent but retained some normal posturing behavior. Surgical complications included minor infection in two dogs, rectocutaneous fecal leakage in four dogs, breakdown of the anastomotic site in four dogs, and incontinence in all of the dogs that underwent 6 cm resections. Barium enemas were performed on the rectums postmortem to ascertain the degree of stricturing induced by the surgery. The index of stenosis measured did not correlate well with the extent of straining in each group. Histopathologic findings on dogs in the transection only and 4 cm resection groups without dehiscence showed mild granulomatous proctitis with normal myenteric plexi seen. Dogs suffering dehiscence had suppurative proctitis, necrosis, and obliteration of the myenteric plexi.

Anastomosis, Surgical↗
PubMed1982

Comparison of the composition of faecal fluid in Crohn's disease and ulcerative colitis.

We determined the ionic composition of faecal fluid from 13 patients with Crohn's disease limited to the colon, 10 with diffuse ulcerative colitis, and eight with ulcerative proctitis. The Crohn's and colitis groups had similar proportions of colon surface involved radiographically and similar 24 hour faecal weights. However, Crohn's patients' faecal fluid had arithmetically lower mean sodium and statistically lower mean chloride (34.8 mmol/l +/- 16.2 SD vs. 53.1 mmol/l +/- 23.1 SD) and higher potassium (49.2 mmol/l +/- 20.2 SD vs. 33.0 mmol/l +/- 13.8 SD) concentrations (p less than 0.05 for each) and much higher osmolality (487.1 mOsmol/kg +/- 87.1 SD vs. 341.1 mOsmol/kg +/- 88.9 SD, p less than 0.001). Separation of these patients using the faecal osmotic gap agreed with the clinical classification in 86% of cases. The diarrhoea of proctitis patients had a nearly normal ionic composition which was clearly distinguishable from that of diffuse colitis. These results suggest differences in the composition and perhaps the pathogenesis of the diarrhoea of Crohn's and ulcerative colitis. The composition of fluid may prove a useful, non-invasive method for classifying patients with inflammatory bowel disease and, in ulcerative colitis, determining the extent of the inflammatory process.

Chlorides↗
PubMed1990

Ulcerative colitis: one disease or two? (Quantitative histological differences between distal and extensive disease).

Cell counts and measurements of mucosal architecture were made on rectal biopsies from nine patients with total colitis, eight with left sided colitis, 15 with distal colitis, and 11 with proctitis. The mean total lamina propria cell count in proctitis and distal colitis approached twice that of extensive left sided and total colitis (p less than 0.001) and in distal proctocolitis the cell numbers are further increased in the chronic over the acute phase. This difference was not explained by age, duration, activity, or treatment. The predominantly increased lymphoid and mononuclear cell infiltrate in distal proctocolitis indicates a different pattern of immune response, suggesting a separate process from extensive colitis or a more intense reaction resulting in localisation of disease.

Adolescent↗
PubMed1994

Incidence of inflammatory bowel disease in northern France (1988-1990).

There were no data concerning the incidence of inflammatory bowel disease (IBD) in France. The aim of this study was to investigate the incidence of Crohn's disease and ulcerative colitis in northern France. This prospective population based study was realised through the gastroenterologists of the region Nord-Pas de Calais and the Somme Department. Each gastroenterologist referred patients consulting for the first time with clinical symptoms compatible with IBD. Data were collected by an interviewer practitioner present at the gastroenterologist's consulting room. Two independent expert gastroenterologists assessed each case in a blind manner and made a final diagnosis of Crohn's disease, ulcerative colitis, ulcerative proctitis, or unclassifiable chronic colitis. From 1988 to 1990, 1291 cases of IBD were recorded: 674 (52%) Crohn's disease, 466 (36%) ulcerative colitis including 162 proctitis (35%), and 151 (12%) unclassifiable chronic colitis. The mean annual incidence was 4.9 per 100,000 for Crohn's disease and 3.2 for ulcerative colitis. The sex ratio F/M was 1.3 for Crohn's disease and 0.8 for ulcerative colitis. The highest age specific incidence rate for Crohn's disease was between 20 and 29 years: 13.1 for women and 9.8 for men. The highest age specific incidence rate for ulcerative colitis was between 20 and 39 years: 5.5 for women and 6.5 for men. This first French prospective study has shown an incidence rate for Crohn's disease comparable with that seen in north European studies but lower than that seen for ulcerative colitis. These results could be related to the different environmental factors or the genetic background of the population studied, or both.

Adolescent↗
PubMed2007

Incidental rectal mucosa obtained via transrectal ultrasound-guided prostatic core biopsies.

A retrospective review was conducted of material from 782 transrectal ultrasound-guided prostatic core biopsies to determine whether incidental pieces of rectal mucosa obtained in this manner could harbor clinically significant rectal pathology or incur artifacts that cause diagnostic difficulty. Material from 114 biopsies (14.6%) showed rectal mucosa, and material from 19 (16.7%) showed rectal pathology, including a hyper-plastic polyp in 1, changes consistent with ulcerative proctitis in 8, focal active proctitis in 7, and granulomas in 3. The original pathologist overlooked the hyperplastic polyp. In 1 specimen, rectal lymphocytes and plasma cells that were displaced over prostatic tissue closely mimicked prostatic adenocarcinoma (Gleason score 5). Conversely, in another specimen, prostatic adenocarcinoma (Gleason score 5) that was displaced near rectal mucosa closely mimicked a rectal lymphoid aggregate. Incidental rectal mucosa obtained via transrectal ultrasound-guided prostatic core biopsies occasionally harbors clinically significant rectal pathology and rarely incurs artifacts that cause diagnostic difficulty.

Adenocarcinoma↗