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At least 829 records · Page 46Linked to original sources
PubMed2006

Diagnostic yield of advanced colorectal neoplasia at colonoscopy, according to indications: an investigation from the Korean Association for the Study of Intestinal Diseases (KASID).

BACKGROUND AND STUDY AIMS: The factors that more accurately predict the detection of colorectal cancers and adenomas at colonoscopy are different. We conducted a prospective multicenter study to evaluate which indications were most closely associated with advanced colorectal neoplasm (CRN), including colorectal cancer, in a group of patients undergoing colonoscopy. PATIENTS AND METHODS: The 17 468 patients were enrolled in this study between July 2003 and March 2004, from 11 tertiary medical centers in Korea. They were recruited according to 11 itemized colonoscopic indications. The term "advanced adenoma" refers here to tubular adenomas of diameter of 11 mm or more, or to tubulovillous, villous, or severely dysplastic adenomas, irrespective of their size. Cancer was defined as the invasion of malignant cells beyond the muscularis mucosa. Advanced CRN was defined as advanced adenoma or invasive cancer. RESULTS: Advanced CRN was found in 1227/17 307 patients (1176 advanced adenomas plus 51 carcinomas, 7.1 %). According to univariate and multivariate analysis, the factors associated with advanced CRN included age >60 years (odds ratio (OR) 2.1, 95 % confidence interval (CI) 1.8 - 2.4, P < 0.0001), male gender (OR 2.1, 95 %CI 1.7 - 2.7, P < 0.0001), referral for colonoscopy from primary care physician (OR 3.1, 95 %CI 2.5 - 3.7, P < 0.0001), and several other indications (OR 1.8, 95 %CI 1.5 - 2.3, P < 0.001). The yield of colonoscopy for advanced CRN was lower (2.2 %) than expected in patients with iron-deficiency anemia (OR 0.5, 95 %CI 0.2 - 0.9, P = 0.03). CONCLUSIONS: Age, gender, and referral for colonoscopy from primary care physician constituted important independent predictors of advanced CRN in patients undergoing colonoscopy.

Adenoma↗
PubMedDate not supplied

[Chronic inflammatory intestinal disease and nephritis].

An 11 year old CD-patient developed an interstitial nephritis and acute kidney failure following treatment with Mesalazine (5-ASA) and Salazosulfapyridine (SASP). After removal of the medication and treatment with hemofiltration and prednisone there was only an incomplete recovery of the renal function (creatinine-clearance 34 ml/1,73 m2/min). It is thought that an hyperergic-allergic reaction due to SASP and 5-ASA causes interstitial nephritis in inflammatory bowel disease (IBD). This reaction can be induced by re-exposition too. On the other hand IBD can be associated with glomerulonephritis. This could be a not very well known extraintestinal manifestation in IBD caused by immune-complexes in serum and glomerula. A rapid histological verification of the renal disease is necessary for successful treatment. In both renal manifestations chronic courses are possible. These observations should not lead to avoid SASP/5-ASA in treatment of IBD, but renal function should be routinely investigated.

Acute Kidney Injury↗
PubMed1997

Echovirus type 22 outbreak associated with gastro-intestinal disease in a neonatal intensive care unit.

An echovirus type 22 outbreak involving 19 neonatal intensive care unit (NICU) patients during the months of October and November 1992 is reported. Twelve infants presented with diarrhea, 7 of whom had bloody stools and x-ray findings compatible with early stages of necrotizing enterocolitis, while one infant demonstrated characteristic pneumatosis intestinalis. Outbreaks of echovirus type 22 infection in premature infants have rarely been reported. The possibility of Echovirus 22 infection should be considered in neonatal gastrointestinal disease associated with features of necrotizing enterocolitis.

Antibodies, Viral↗
PubMedDate not supplied

[Immunologic aspects of chronic inflammatory intestinal diseases].

Aetiology as well as pathogenesis of Crohn's disease and ulcerative colitis are unclear as yet. Recent studies suggest that a transmissible factor present in Crohn's disease lymph nodes produces lymphoma and immune complex glomerulonephritis in nu/nu mice. Furthermore, sera of those patients contain an antibody, that recognizes an "antigen(s)" in the murine lymphoma and glomerular immune complexes. In ulcerative colitis a disease-specific colonic tissue bound antibody directed against specific antigens of colonic mucosa from patients with ulcerative colitis but not from patients with Crohn's disease and normal colon has been found. Contrary to earlier reports up to date knowledge gives no indication for a primary immunological defect of functions of the cell mediated immunity or unspecific immune system, although impairment of some immunological parameters appears due to the disease, both in Crohn's disease and in ulcerative colitis. This holds true for peripheral blood mononuclear cells. Results obtained with mononuclear cells isolated from the gut are highly controversial and at present do not allow final conclusions.

Basement Membrane↗
PubMed1986

[Adjuvant therapy with elemental diet in chronic inflammatory intestinal diseases. Comparative study].

26 in-patients (17 with Crohn's disease, 9 with ulcerative colitis) were given high-molecular (diet 1; 12 patients) or low-molecular (diet 2; 14 patients) elemental diets (6.3-12.6 MJ) additional to drug treatment previously given as out-patients. The activity index fell on both diets (on diet 1 from 253 to 83; diet 2 from 259 to 86), stool frequency decreased (on diet 1 from 7.1 to 0.9 per day; diet 2 from 5.6 to 2.0 per day), as did blood sedimentation rate (diet 1 from 57/80 to 30/51 mm; diet 2 from 56/80 to 23/45 mm). Body-weight, total protein, albumin and red blood corpuscles were not changed significantly. There was no significant difference between the two diet groups. The results raise the question of whether low-molecular elemental diet enriches the treatment of chronic inflammatory disease.

Adolescent↗
PubMed1985

[Successful acute treatment of chronic inflammatory intestinal diseases with oral 5-aminosalicylic acid].

The effectiveness of oral 5-aminosalicylic acid (0.5 g t.i.d.) and of salazosulfapyridine (1.0 g t.i.d.) was compared in a randomized controlled study in two groups with 30 patients each with ulcerative colitis and with Crohn's disease. Persistent complaints within the first 5 days were treated with additional methyl-prednisolone (40 mg/d initially). After treatment for 8 weeks patients with ulcerative colitis showed morphologic remissions in 60% of the 5-aminosalicylic acid group and in 53% of the salazosulfapyridine group. Clinical improvement was achieved in 86% in both groups. Clinical improvement in Crohn's disease was seen in 87% of patients of the 5-aminosalicylic acid group and in 80% of the salazosulfapyridine group. This was evidenced by the significant fall (P = 0,0001) of the mean activity index. Additional steroid medication was nearly equal in both treatment groups. There were no side effects during treatment with 5-aminosalicylic acid. In contrast, salazosulfapyridine had to be withdrawn in four patients due to signs of intolerance. 5-Aminosalicylic acid can thus be considered a valuable alternative to conventional treatment on the basis of equal effectiveness as salazosulfapyridine and lack of undesirable side effects.

Adolescent↗
PubMed1991

Chicken egg antibodies for prophylaxis and therapy of infectious intestinal diseases. V. In vivo studies on protective effects against Escherichia coli diarrhea in pigs.

A field study and a controlled infection trial showed the protective effect of egg yolk lyophilisate and whole egg lyophilisate against enterotoxic E. coli germs. The lyophilisates were gained from eggs of hens immunized against pilus antigen of porcine-enterotoxic E. coli. In a first field study using egg yolk antibodies, 92% of 299 diarrhea affected piglets were cured. In a further field study diarrhea affected piglets were cured after 3 days by application of egg yolk lyophilisate from immunized hens. Piglets treated only with egg yolk of not immunized hens showed no signs of recovery. The infection trial showed, that whole egg lyophilisate of immunized hens was as successful as a common antibiotic therapy in curing piglets, orally infected with 5 x 10(10) E. coli/feeding and animal. The present data show that chicken egg antibodies can be used for treatment of infectious diarrheal diseases in young animals. So far they represent a good alternative to the common used antibiotic therapy.

Animals↗
PubMed1974

Hyperphagia in intestinal disease.

Six patients with hyperphagia (ingestion of 5-11 000 Kcals/day) associated with severe malabsorption and steatorrhoea are described. The cause of the malabsorption was coeliac disease in three patients, Crohn's disease with ileal resection in two, and carcinoma of the pancreas in one patient. There was no evidence of neurological or endocrine disease (apart from mild diabetes mellitus in the patient with carcinoma of the pancreas) but three patients suffered from severe depression. This association may be commoner than previously realized and be revealed in patients with steatorrhoea of unexplained severity by careful dietary assessment. Its detection has therapeutic implications since restriction of caloric and fat intake decreased steatorrhoea without weight loss in several of the patients described.

Adult↗
PubMedDate not supplied

Adhesion molecules in inflammatory and neoplastic intestinal diseases.

Adhesion molecules participate in a broad variety of biological processes, i.e. tumor progression and inflammation, through their involvement in cell-to-cell interactions and immunoinflammatory cell migration. This review describes the basic properties of adhesion molecules with reference to inflammatory bowel disease and colorectal carcinoma. Accumulating data suggest that adhesion molecules could be pathogenetically pertinent to other gastrointestinal disorders such as celiac disease (nontropical sprue) and gastroduodenal ulcer. Future therapeutic approaches in inflammatory and malignant disorders may possibly be development of principles targeting adhesion molecules.

Cell Adhesion Molecules↗
PubMed1985

Effects of bile and bile salts on growth and membrane lipid uptake by Giardia lamblia. Possible implications for pathogenesis of intestinal disease.

We have shown previously that ox and pig bile accelerate in vitro growth of Giardia lamblia. We have now investigated the possible mechanisms by which mammalian biles promote parasite growth. Growth effects of (a) ox, pig, guinea pig, and human biles, (b) pure bile salts, and (c) egg and soybean lecithins were studied in the presence of a lecithin-containing growth medium. Individually, dilute native bile and pure sodium taurocholate (TC), glycocholate (GC), and taurodeoxycholate (TDC) promoted parasite growth; growth was most marked with biles of high phospholipid content, with biles enriched in more hydrophobic bile salts (ox approximately equal to human greater than pig greater than guinea pig) and with micellar concentrations of GC and submicellar concentrations of TC and TDC. By measuring uptake of radiolabeled biliary lipids from bile and bile salt-supplemented growth medium, we showed that the parasite consumed bile lipids, with the rank order lecithin greater than bile salts. Apparent net uptake of cholesterol was considered to be due to exchange, since net loss of cholesterol from the growth medium was not detected. Although bile and bile salt-stimulated parasite growth was associated with enhanced lecithin uptake, reduction in generation time was observed at low bile and bile salt concentrations when lecithin uptake was similar to bile free controls. Thus, bile salts may stimulate Giardia growth initially by a mechanism independent of enhanced membrane phospholipid uptake. However, since Giardia has no capacity to synthesize membrane lipid, biliary lecithin may be a major source of phospholipid for growth of this parasite.

Animals↗