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At least 1,189 records · Page 66Linked to original sources
PubMed1992

[Prevention of postoperative ischemic colitis in aorto-iliac vascular reconstruction].

In consecutive series with 1740 aorto-iliac reconstructions (1970-1989) 32 patients (1.8%) with postoperative ischemic colitis have been registered. In a retrospective follow-up (1970-1983, group I, n = 1121) the incidence of this postoperative complication (ischemic colitis grade C) reached to 0.7%. In a further prospective follow-up (group II, 1984-1989, n = 619) the operative procedure was influenced by: 1) intraoperative stump pressure in the inferior mesenteric artery, 2) by the penile brachial index (PBI), 3) pre- and postoperative rectoscopy, and 4) measurement of perfusion in branches in the inferior mesenteric artery. The frequency of ischemic colitis could not be reduced. Grade C colitis reached to 1.3%. Rectosigmoidoscopy as a routine method before and after operation caused an remarkable decrease of the time interval between operation and diagnosis of ischemic colitis in group II (from 11 days to 24/48 h). As a result the mortality rate of transmural colon necrosis (grade C) could be reduced from 50% (group I) to 13.6% (group II). The IMA stump pressure alone (limit of 40 mm Hg) doesn't help to decide if reimplantation of the IMA necessary. The stump pressure with Doppler ultrasound flow registration in the branches of the IMA gains a greater sensitivity by a "two vessel clamping" (infrarenal aorta and digital compression of the SMA) (sensitivity 100%). During the last 230 surgical interventions the incidence of ischemic colitis ranged 0.9%.

Anastomosis, Surgical↗
PubMed2004

Effect of hyperbaric oxygen on experimental acute distal colitis.

It has been demonstrated that hyperbaric oxygen (HBO) is useful as an adjunctive therapy for Crohn's disease. However, its effects on ulcerative colitis have not been investigated. In the present study, HBO was tested for acetic acid-induced colitis, and antioxidant systems were evaluated to clarify its possible mode of action. Thirty-six Sprague-Dawley rats were randomly divided into three groups: sham control (Group I), colitis induced by acetic acid without any therapy (Group II), colitis induced by acetic acid and treated with HBO (Group III). HBO was given for 5 days, 2 sessions per day at 2.5-fold absolute atmosphere pressure (ATA) for a period of 90 min in rats in which colitis had been induced (Group III). Rats were sacrificed on the 5th day after the procedure. Superoxide dismutase (SOD), malondialdehyde (MDA) and glutathione peroxidase (GSH Px) activity were measured in the intestinal tissue and erythrocyte lysate. MDA and GSH Px were also determined in the plasma. Whereas MDA levels in erythrocyte, plasma and intestinal tissue were decreased, the levels of GSH Px and SOD were significantly increased in Group III as compared to those of Group II. The results of our study suggest that hyperbaric oxygen therapy has beneficial effects on the course of experimental distal colitis and that antioxidant systems may be involved in its mode of action.

Acetic Acid↗
PubMed1992

Fish oil fatty acid supplementation in active ulcerative colitis: a double-blind, placebo-controlled, crossover study.

Arachidonic acid metabolites formed by both the cyclooxygenase and lipoxygenase pathways may contribute to the clinical diarrhea and colitis of inflammatory bowel disease. Patients with active ulcerative colitis have increased levels of leukotriene B4 in their rectal mucosa, and these levels tend to correlate with severity of the disease. In this study, we evaluated the efficacy of ingestion of fish oil n-3-omega-fatty acids, inhibitors of leukotriene synthesis, in the treatment of ulcerative colitis. Eleven patients with ulcerative colitis of mild to moderate severity were studied in a 8-month, double-blind, placebo-controlled, crossover trial of dietary supplementation with fish oil, which provided about 4.2 g of omega-3- fatty acids per day. A disease activity index based on patient symptoms and sigmoidoscopic appearance was used to assess efficacy. Mucosal leukotriene B4 production was measured by radioimmunoassay. Mean disease activity index declined 56% for patients receiving fish oil and 4% for patients on placebo (p less than 0.05). There were no statistically significant differences in histopathologic scores or colonic mucosal leukotriene B4 levels. All patients tolerated fish oil ingestion and showed no alteration in routine blood studies. No patient worsened; anti-inflammatory drugs could be reduced or eliminated in eight patients (72%) while receiving fish oil. We conclude that fish oil dietary supplementation results in clinical improvement of active mild to moderate ulcerative colitis but is not associated with significant reduction in mucosal leukotriene B4 production, compared with placebo therapy. Further studies are needed to elucidate the mechanism of action and optimal dose and duration of fish oil supplementation in ulcerative colitis.

Adult↗
PubMed2004

[A case of reactivated tuberculous colitis after 9 months of anti-tuberculous therapy].

Tuberculous colitis, an important extra-pulmonary tuberculosis, is still prevalent in the developing countries and has been resurging in the Western world. The duration and dose of anti-tuberculous therapy have not yet been clarified in the tuberculous colitis. We experienced a case of tuberculous colitis, which relapsed after 9 months of therapy. A 28-year-old man presented with hematochezia and was diagnosed as tuberculous colitis on the basis of colonoscopic findings. He was treated with anti-tuberculous agents for 9 months successfully. Three months later, however, he complained of hematochezia again, suggesting the relapse of tuberculous colitis. He had taken anti-tuberculous therapy for another 15 months and showed no evidence of relapse. Although anti-tuberculous therapy is efficient for tuberculous colitis, rare cases of reactivation should be reminded.

Adult↗
PubMed1992

[Morphological and immunohistochemical quantitative analysis of dysplasia in ulcerative colitis. 1. Histological mapping specimen and morphological quantitative analysis].

Mapping specimens of 6 cases of ulcerative colitis included adenocarcinoma invaded into submucosa (invasive carcinoma) were made and Index value of Nucleus-Gland (ING) of invasive carcinoma, severe and moderate dysplasia in ulcerative colitis was measured and compared with one another. Large intestinal carcinoma invaded into submucosa, colonic adenoma and normal mucosa were examined as the control. Spatial relations of invasive carcinoma and dysplasia in ulcerative colitis were also examined. Severe and moderate dysplasia as well as large intestinal carcinoma invaded into submucosa showed significantly higher values of ING than adenoma (P less than 0.01). Invasive carcinoma and severe dysplasia of ulcerative colitis showed significantly higher values of ING than moderate dysplasia (P less than 0.01). Severe dysplasia was located around the portion of of invasive carcinoma of ulcerative colitis. Severe dysplasia falls into the same category with invasive carcinoma of ulcerative colitis because of the same value of ING and spatial translation each other. Moderate dysplasia was defined as borderline lesion because of the mean value of ING between severe dysplasia and adenoma.

Adenocarcinoma↗
PubMed2005

[Intestinal complications in ulcerative colitis].

Although cases of severe intestinal complications such as massive hemorrhaging, perforation, stricture and obstruction occur in some instances of ulcerative colitis, these are relatively infrequent in comparison to Crohn's disease. Many cases with such severe intestinal complications require surgery, sometimes acute surgical emergency, instead of medication as these can be less effective in terms of improvement of the disease. Cytomegalovirus infections, which are at times associated with intractable ulcerative colitis, has recently been considered an etiologic factor in the exacerbation and intractability of ulcerative colitis. Furthermore, colitic cancer, an important complication of ulcerative colitis, may occur at high incidence in patients experiencing long term courses of chronically active or frequently relapsing ulcerative colitis, and thus must be considered and managed appropriately. For the prevention of complications of ulcerative colitis, rapid induction of remission and long-term remission maintenance is essential, in addition to the emphasis in avoiding chronic administration of large doses of steroids.

Colitis, Ulcerative↗
PubMed2005

Development of dextran sulfate sodium-induced colitis is aggravated in mice genetically deficient for complement C5.

The complement system is a potent effector of innate immunity. To elucidate the pathophysiological role of the complement system in inflammatory bowel disease (IBD), we evaluated the development of dextran sulfate sodium (DSS)-induced colitis in genetically complement C5-deficient mice. We used DBA2/J mice, which are genetically deficient in complement C5. DBA1/J mice have a normal complement system, and were used as controls. Experimental colitis was induced by the oral administration of 3.5% (w/v) DSS in their drinking water for 10 days. On day 10, all mice were sacrificed and their colons were collected. The development of colitis was assessed by the histological score, disease activity index, myeloperoxidase (MPO) activity, and macroscopic changes of the colon. Body weight loss was more apparent in the DBA2/J mice than in control DBA1/J mice. The colon length was shorter in the DBA2/J mice than in DBA1/J mice. The disease activity index, histological colitis score, and MPO activity were all significantly higher in the DBA2/J mice than in DBA1/J mice. Microscopically, mucosal edema, cellular infiltration and disruption of the epithelium were much more severe in the DBA2/J mice than in DBA1/J mice. The development of DSS colitis was aggravated in genetically C5-deficient DBA2/J mice. These findings suggest that the complement system might play a protective role in the development of DSS-induced experimental colitis.

Animals↗
PubMed2006

Effect of a novel water-soluble vitamin E derivative as a cure for TNBS-induced colitis in rats.

Lipid peroxidation mediated by oxygen free radicals plays an important role in the pathogenesis of inflammatory bowel disease (IBD). Vitamin E is a lipid-soluble antioxidant and is generally considered to protect against lipid peroxidation of the cell membrane and to scavenge singlet oxygen and superoxide anion radical. Therefore, vitamin E or its derivatives are expected to have particular application for patients suffering from IBD. The aim of this study was to investigate the antioxidative effects of the water-soluble vitamin E derivative, 2-(alpha-D-glucopyranosyl)methyl-2,5,7,8-tetra-methylchroman-6-ol(TMG), on the therapy of experimental colitis in rats. Colitis was induced in male Wistar rats weighing 200 g using an enema of trinitrobenzene sulfonic acid (TNBS) dissolved in 50% ethanol; TMG dissolved in physiological saline was injected intra-peritoneally every day from 24 h after the enema of TNBS. The damage score, wet weight of the colon, and increase in body weight were estimated 1 week after the enema of TNBS. Thiobarbituric acid-reactive substances (TBA-RS), an index of lipid peroxidation, and tissue-associated myeloperoxidase (MPO) activity in the colonic mucosa were measured 1 week after the induction of colitis. As a result, increase in body weight was inhibited by the induction of colitis, although the inhibition was reduced in the group treated with TMG. The damage score, wet weight, TBA-RS and MPO activity were increased significantly in the colitis group; however, they were inhibited by the administration of TMG. These results suggest that TMG is effective for the treatment of colitis in rats induced by TNBS. In the future, TMG could be a new therapeutic agent for IBD.

Animals↗
PubMed2006

[Tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) in children with ulcerative colitis].

UNLABELLED: The analysis of bibliography referring to the role of haemostasis disturbances in pathogenesis of ulcerative colitis in children revealed considerable discrepancies in the obtained findings of the study and some controversies in their interpretation. The aim of the study was the assessment of tissue plasminogen activator (t-PA) and its inhibitor (PAI-1) in children with ulcerative colitis. MATERIAL AND METHODS: The 22 children with ulcerative colitis were included in our investigation, there were 7 girls and 15 boys whose mean age was 15, 55 (+/- 3.0) years. The reference group was made up of 22 children suffering from celiac disease covering the period of full compensation in the range of similar age and sex. Blood was drawn from the cubital vein in the morning with minimal stasis into a tube containing 3.2% sodium citrate at the ratio of 1:10. The levels of t-PA and PAI-1 were measured with ELISA. RESULTS: In children with ulcerative colitis and in the control group we found out similar concentration of antigen tissue plasminogen activator (t-PA:Ag). In the group of children with ulcerative colitis under investigation a mean concentration of antigen inhibitor plasminogen activator (PAI-1:Ag) was statistically higher. CONCLUSIONS: Elevation of PAI-1:Ag concentration in plasma of the children suffering from ulcerative colitis may confirm the participation of PAI-1 in inflammatory reaction of disease- induced changes in colon mucosa.

Adolescent↗
PubMedDate not supplied

Effect of soluble fiber or fructooligosaccharide supplementation upon trinitrobenzenesulphonic acid induced colitis in rats.

PURPOSE: To evaluate the effect of soluble fiber or fructooligosaccharide (FOS) supplementation upon trinitrobenzene sulphonic acid (TNBS)-induced colitis in rats. METHODS: 64 Wistar rats were given water, soluble fiber or FOS intragastrically during 14 days prior to colitis induction with TNBS (n=48) or rectal enema with water (n=16; control group). On the 7th or 14th day following colitis induction the rats were weighed and euthanized in order to determine the colon weight/length ratio and macroscopic and microscopic scores. RESULTS: On the 7th day following colitis induction the body weight had decreased significantly, the colon weight/length ratio had increased and macroscopic and microscopic colon lesions were observed. On the 14th day following colitis induction no difference in body weight was observed, in spite of the persistence of macroscopic and microscopic lesions and increased colon weight/length ratio. Supplementation with soluble fiber or FOS did not revert colon lesions or any of the study parameters. Supplementation with FOS, but not with fiber, was associated with increased colon weight/length ratio on the 14th day. CONCLUSION: Supplementation with soluble fiber or FOS produced no significant impact on TNBS-induced colitis in rats.

Administration, Oral↗
PubMed2006

[A clinical trial of rosiglitazone and 5-aminosalicylate combination for ulcerative colitis].

OBJECTIVE: To investigate the therapeutic effects of the combination of rosiglitazone, which is peroxisome proliferators-activated receptor gamma (PPARgamma) ligands used to treat type 2 diabetes mellitus, and aminosalicylate on mildly or moderately active ulcerative colitis and on relevant cytokine expressions. METHODS: According to the national guideline of China for diagnosis and treatment of the inflammatory bowel disease (IBD), 42 patients with mild, moderately active ulcerative colitis were selected from the outpatient clinic of West China Hospital from July to November, 2004. Patients with infectious colitis, amoebiasis, or cardiac, renal or hepatic failure were excluded, as well as those who had received corticosteroid or immunosuppressant treatment within the last month. Following a quasi-randomization principle, patients were allocated alternatively into the treatment group with rosiglitazone 4 mg/d plus 5-aminosalicylic acid (5-ASA) 2 g/d or sulfasalazine 3 g/d and the control group with 5-ASA or sulfasalazine alone for 4 weeks. Clinical and histological changes were evaluated weekly by the Mayo scoring system for assessment of the activity of ulcerative colitis and the Truelove-Richards' grading system, respectively. PPARgamma and nuclear factor (NF)-kappaB p65 expressions in colonic mucosa were investigated before and after the treatment. RESULTS: Mayo scores decreased 4.01 in treatment group and 3.48 in control group respectively, with a remission rate 71.4% in treatment group and 57.1% in control group respectively. Along with the improvement of the Mayo score, the histological grade improvement was more significant in treatment group than in control group (P < 0.05). PPARgamma expression was higher, and NF-kappaB p65 positive rate was lower in treatment group than in control group after the treatment, and there was a good negative correlation between PPARgamma and NF-kappaB. CONCLUSIONS: Combined treatment with rosiglitazone and 5-ASA achieved better therapeutic effect than 5-ASA alone without any side effects. The PPARgamma expression was lower in active ulcerative colitis. Rosiglitazone alleviate colonic inflammation probably the through blockade of NF-kappaB, which can be a novel approach to the ulcerative colitis treatment.

Adolescent↗
PubMed1991

[Distribution of cells containing different IgG and IgA subclasses in the colonic mucosa in childhood ulcerative colitis and Crohn disease].

The distribution of cells containing various subclasses of IgG and IgA were studied in the rectal and colonic mucosa from 14 paediatric patients with ulcerative colitis and four patients with Crohn's disease, as well as, from rectal biopsy specimens of 10 control subjects using monoclonal antibodies and the peroxidase method. The number of IgG3-containing cells in both the colonic and rectal mucosae of untreated patients with ulcerative colitis was significantly increased compared to controls. In the children with ulcerative colitis the number of IgG4 cells in the colonic mucosa was also significantly increased. In the rectal mucosa of patients with ulcerative colitis the percentage of IgG2 cells was decreased compared to the controls (22% versus 27%). In the great majority of specimens (in 37 out of 40) the number of IgA1 cells was higher than that of IgA2. The number of IgA1 cells in the rectal and colonic specimens of untreated patients with ulcerative colitis was slightly higher than that in the rectal specimens of controls. Authors speculate on the basis of their results that the observed IgG3 response in the patients with ulcerative colitis may be specific to the disease.

Adolescent↗
PubMed1989

The endorectal ileal pullthrough procedure in patients with ulcerative colitis and familial polyposis with carcinoma.

Since 1977, 196 patients (177 with ulcerative colitis and 19 with familial polyposis) have undergone colectomy, mucosal proctectomy and endorectal ileal pull-through with or without an ileal reservoir (PTR) at UCLA Medical Center. Fourteen of the patients (7.1 per cent) had carcinoma of the colon or rectum at the time of operation; 12 had colitis and two, polyposis. Another 40 patients had mucosal dysplasia. Only five of the 14 patients with carcinoma were diagnosed before operation despite close surveillance by gastroenterologists. The mean duration of colitis before the diagnosis of carcinoma was made was 17 years; the mean age that the carcinoma was identified was 38 years. Eleven of the 12 patients with colitis had universal involvement. Two patients with colitis and carcinoma who underwent colectomy and PTR died a mean of 30.5 months postoperatively of metastatic disease. Twelve patients with carcinoma (ten with colitis and two with polyposis) are alive a mean of 29 months postcolectomy and PTR; two of these have received chemotherapy. The low mortality (0.4 per cent) and good clinical results after colectomy and the PTR procedure and the unexpectedly high incidence of carcinoma and mucosal dysplasia among patients referred for operation suggest that surgical treatment should be considered at an earlier stage than the current general practice, particularly in patients at high risk (mucosal dysplasia, pancolitis and duration of more than ten years).

Adenocarcinoma↗
PubMed1979

Cancer in universal and left-sided ulcerative colitis: factors determining risk.

A retrospective study of 267 patients with ulcerative colitis admitted to The Mount Sinai Hospital during the period 1960--1976 revealed 26 (9.7%) with adenocarcinoma of the colon. Twenty-one cases of colorectal cancer were observed among 158 patients with universal colitis (13%), and 5 occurred among 109 patients with left-sided disease (5%). Patients with left-sided disease tended to develop cancer at least a decade later than patients with universal disease. The median duration from onset of colitis to diagnosis of cancer was 20 yr for those with universal colitis, and 32 yr for those with left-sided colitis. The decade incidence of colorectal carcinoma increased from 0.4% in the first decade to 7.4% in the second, 15.9% in the third, and 52.6% in the fourth decade of follow-up. The estimated cumulative probability of developing cancer reached 34% at 30 yr and 64% at 40 yr. Cancer risk was positively correlated with duration and anatomic extent of colitis, but did not appear to be increased by early age at onset of disease.

Adenocarcinoma↗
PubMed1984

Ulcerative colitis: why is the mortality from cardiovascular disease reduced?

A recent mortality study of patients with ulcerative colitis showed significant deficits in deaths from cardiovascular disease and from respiratory disease in males. The reasons for the observed deficits have been examined by studying the risk factors in a consecutive series of 103 patients with ulcerative colitis using matched controls. The patients and controls were assessed for age, sex, social class, alcohol and tobacco consumption. Height, weight and blood pressure were recorded and fasting blood samples were taken for serum lipid estimation. Patients with ulcerative colitis had significantly lower systolic and diastolic blood pressures and the changes were particularly marked in patients with extensive colitis and after panproctocolectomy. After matching for age, sex and social class the patients with ulcerative colitis smoked significantly less than controls. Serum lipid measurements were similar in both groups. The lower blood pressure may be related to sodium and water depletion particularly in ileostomy patients and those with extensive colitis.

Adult↗
PubMed1983

[Clinical spectrum of amebic colitis].

We present six cases to illustrate the protean clinical and sigmoidoscopic features of the amebic colitis. Three cases presented with a clinical picture resembling ulcerative colitis. In one fatal case, diverticular disease, ischemic colitis and toxic megacolon of uncertain origin were considered before arriving at the proper diagnosis. Two cases were believed to have pseudomembranous colitis on sigmoidoscopic examination. Given the multiple expressions of this entity, amebic colitis should be considered a diagnostic possibility in any protracted inflammatory condition of the colon. From the cases summarized here, it is evident that the clinical and endoscopic features of amebic colitis are variable and may often mimic other illnesses.

Adult↗
PubMed1981

Extended management of chronic ulcerative colitis and the problem of carcinoma.

Patients with ulcerative colitis provide a significant challenge to the primary care physician for a variety of reasons. Ulcerative colitis can be a severe or even fulminating disease or can be chronic, indolent, and therapeutically unresponsive. Patients afflicted with ulcerative colitis are often young, mobile, may have a suboptimal compliance with various forms of therapy, and may be lost to followup. Assessment of the individual therapeutic response as well as its relationship to the overall prognosis for a given patient may be difficult. Steroid side effects may also complicate the picture, leaving the patient the difficult alternative of total proctocolectomy with permanent ileostomy. Added to these factors is the recognition that under 50 per cent of patients with ulcerative colitis will undergo surgery and the remainder will be at increased risk for the subsequent development of colonic carcinoma. Although there has been much recent emphasis on adequate and cost-effective surveillance techniques to detect early carcinoma of the colon in ulcerative colitis, clarification of the value of colonoscopy and the definition of dysplasia are relatively recent developments. That the medical literature is often confusing only adds to the complexity and clinical challenge. Finally, although the cancer problem has been dominant, the challenge to the clinician is to try to assist the patient afflicted with ulcerative colitis to attain a meaningful and productive role in society.

Chronic Disease↗
PubMed1995

Detection of herpesvirus DNA in cottontop tamarins: no association with colitis.

Colitis occurs spontaneously in the cottontop tamarin; it shares similar clinical, endoscopic and histological features with, and has a similar response to treatment as, human ulcerative colitis. An association between human ulcerative colitis and the presence of DNA from multiple herpesviruses (human herpesvirus 6 (HHV-6), cytomegalovirus (CMV) and Epstein-Barr virus (EBV) in the colon has been described. Intestinal herpesvirus infection may be involved in the pathogenesis of this condition. In a pilot study, coded full thickness colonic specimens from 27 cottontop tamarins were examined for the presence of HHV-6, CMV and EBV DNA using the nested polymerase chain reaction. The sections represented a spectrum of disease activity ranging from histologically normal bowel to severe colitis. A low prevalence of DNA from these viruses was found, which bore no relation to the presence of inflammation. Although these herpesviruses may have a pathogenetic role in human ulcerative colitis, they are not associated with colitis in this animal model.

Animals↗