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At least 1,261 records · Page 70Linked to original sources
PubMed1990

A new manifestation of seminal fluid hypersensitivity.

An immediate hypersensitivity reaction to seminal fluid is an uncommon but well recognized condition. We describe a young woman who developed haemorrhagic proctitis, arthralgia and urticaria on honeymoon. Investigations suggested an immune complex (type III) hypersensitivity. It subsequently became clear that her symptoms were temporally related to sexual intercourse. After 8 hours she developed nasal congestion and urticaria followed by migratory arthralgia and periorbital oedema. Over the ensuing 24 hours she had diarrhoea, occasionally with blood. She became breathless and had evidence of a restrictive ventilatory defect. These symptoms improved over 4-5 days. Further in vitro investigations were inconclusive but intradermal skin testing with seminal plasma led to recurrence of all her symptoms. Symptoms ceased with condom usage, and the condition abated over 2 years. This patient is unique in that seminal fluid hypersensitivity appears to have produced a type III immune response.

Adult↗
PubMed1989

Topical salicylate therapy (4-ASA and 5-ASA enemas).

Topical therapy with amino salicylate enemas is the treatment of choice for proctitis, proctosigmoiditis, and left-sided ulcerative colitis. Adjunctive sulfasalazine therapy is often required. Relapse rates of 80 per cent can be expected within 3 months of discontinuing therapy.

Administration, Topical↗
PubMed1989

[Autopsy results in surgical-radiotherapeutic treatment of bladder carcinoma--conclusions for optimal radiologic therapy].

With 282 autopsied patients with bladder carcinoma, that were treated by combined operation and radiotherapy, conclusions are given for tendency in tumor spreading as well as for complications and late-effects of radiotherapy. In 24.5% of the cases tumor tissue was found within the bladder and in 30.5% of the cases within the minor pelvis. Metastases were found in 24.1% in iliac lymph-nodes, in 21.3% of the autopsy cases in abdominal lymph-nodes. Liver, lungs, bones, and kidneys are main organs for hematological metastasizing. Little or undifferentiated carcinomas and squamous cell carcinomas show a greater tendency to metastasize than highly and medium-differentiated ureteral carcinomas. The least radiotherapeutical complications and late-effects were found in a fractionation with daily 1.5 Gy and a total dose of 60 Gy (necrotising urocystitis 17.9%, proctitis 3.6%).

Carcinoma↗
PubMed1989

[Anteroposterior rectopexy for disorders of rectal stasis: clinical and radiologic results. Value of digital subtraction rectography. Apropos of 30 cases].

We report the results of 30 antero-posterior rectopexies (APR) for rectal kinetic disorders with descending perineum syndrome. All patients were investigated by digital subtraction defecography and ano-rectal manometry. The associated surgical procedures were: sphincterotomy (n = 13) for outlet obstruction demonstrated by anal manometry or balloon expulsion test: hypertonic sphincter (n = 7), narrow fibrous sphincter (n = 6); 10 cases of prolapsectomy with extended anterior mucosectomy to reduce anterior rectal prolapse; 2 sigmoidectomy for dolichosigmoid. Best results (mean follow-up: 12 months, 3-26) were observed for ano-rectal or pelvic pain and rectal bleeding, which were cured in more than 80% of cases. Faecal incontinence (n = 5) was cured in all cases. Although normalisation of bowel movements and easier defecation were observed in 78% of cases, improvement in the dyschezic syndrome was differently perceived by the patients. Postoperative investigation demonstrated the probable cause of surgical failures (23%): impairment of rectal sensitivity (n = 2), anismus (n = 3), motor constipation (n = 4), with dolichosigmoid (n = 3). Severe perineal deficiency was also noted in 4 cases. Solitary ulcer (n = 6), anterior proctitis (n = 8), were cured within 2 months. Postoperative defecography showed correction of rectal intussusception without impairment of anterior rectal motility during defecation. These results confirm the efficacy of ARP for treatment of rectal intussusception or anterior rectocele. This functional rectopexy avoids the rectal "sling effect" of standard rectopexy which usually increases rectal dysfunction. Nevertheless, ARP alone seems to be insufficient when the associated functional or organic disorders implicated in rectal dysfunction are not also corrected, essentially outlet obstruction and dolichosigmoid.

Adult↗
PubMed1989

Clinical patterns and treatment complications of 1000 cases of carcinoma of the uterine cervix.

One thousand consecutive cases of carcinoma of the uterine cervix treated in the General Hospital Kuala Lumpur between January 1977 to December 1979 were studied. Epidemiological breakdown by race, age, parity, occupation, stage and histology of the disease were obtained. Treatment complications in survivors available for follow-up were analysed. The Chinese had the highest incidence, followed by the Indians and the Malays. Ninety six percent were squamous cell cancers, the remaining were adenocarcinomas. Eighty percent of patients were seen at an advanced stage (Stage IIB-IV). Late radiation complications were mainly proctitis, cystitis and fistula; (5%, 7.2% and 1.4% respectively). These figures are comparable to many centres but the incidence of cystitis is relatively higher. This is believed to be related to irradiation techniques in these cases.

Adult↗
PubMed1989

[Chlamydia infections in dermatology].

The serovares D-K of Chlamydia trachomatis (CT) are associated with inclusion conjunctivits, non-gonoccoccal urethritis (NGU), post-gonoccoccal urethritis (PGU), epididymitis, and ensuing male infertility. CT can be isolated from testicular tissue, in sexually acquired reactive arthritis (SARA) and in proctitis. Female partner infection primarily involves the cervix with ascending infection and ensuing infertility. Asymptomatic CT infection of the urogenital tract does not only present epidemiological problems, but also calls for smear examination in the asympotomatic partner. Double infection with CT and Neisseria gonorrhoeae is not necessarily followed by PGU. Incomplete detection of CT must be taken into account especially after application of penicillin and in the isolation procedures from sperm. The serovares L1-L3 are the infectious agents in venereal lymphogranuloma. Tetracyclines and erythromycin are usually recommended as the therapy of choice in CT infection. Sulfonamides should be applied with caution, since resistent CT isolates have been made known. There is still further clinical study required regarding the efficacy of quinolines in urogenital infections with chlamydiae.

Chlamydia Infections↗
PubMed1989

Comparative clinical results of ileal-pouch anal anastomosis and ileorectal anastomosis in ulcerative colitis.

The aim of the study was to compare the results of ileal-pouch anal anastomosis (IAA) and total abdominal colectomy with ileorectal anastomosis (IRA) in the treatment of ulcerative colitis. The number of patients included in the comparative trial was 104 (IAA) and 197 (IRA), respectively. No clear advantage of IRA over IAA was seen: postoperative mortality and morbidity were about the same; functional results as shown by the frequency of stools and daytime continence were virtually equal. A factor favoring IAA was, among others, recurrence of proctitis after IRA which is more difficult to treat than the pouchitis occurring after IAA and is associated with a higher rate of secondary permanent end ileostomy; besides, IRA entails the risk of cancer developing in the rectal stump, while at the same time it is difficult to follow up these patients closely enough. IRA is indicated only if the diagnosis of ulcerative colitis is in doubt; if the patient is more than 60 years of age; and if IAA proves technically too difficult, IAA is usually preferable, however, if there is any doubt as to whether the patient is suffering from ulcerative colitis or Crohn's disease, ileorectostomy is preferred which does not preclude IAA at a later date in case of need.

Anal Canal↗
PubMed1989

Transrectal ultrasound in monitoring response to treatment of prostate disease.

Transrectal ultrasound provides a safe method for repeated assessments of the prostate gland in the follow-up of prostatic cancer. Changes in the echo pattern of the gland may be observed following treatment, but these may be difficult to interpret. The capsule may be restored; the tumor may appear smaller, and in some cases, ultrasound identification of the tumor may become impossible. The total gland volume decreases with chemotherapy and hormonal manipulation (subcapsular orchidectomy or drug-induced). The volume generally decreases after radiotherapy but may show a transient increase if there is some associated radiation proctitis. The rate of decrease of total prostatic volume has not been established as a reliable indicator of the subsequent prognosis. Future studies should assess whether sequential measurements of the tumor volume rather than the total prostatic volume may be a more useful guide to prognosis.

Humans↗
PubMed1989

[Results of intensive radiotherapy of bladder cancer following transurethral tumor resection].

During the period from 1977 to 1984 173 patients with a bladder carcinoma were exposed a combined operative-radiological therapy. It includes the transurethral tumor resection and the percutaneous high voltage irradiation after an interval of six weeks. After individual irradiation planning--since 1981 by means of CT--pendulum technique has been applied exclusively for careful treatment of risk organs. The total target dose (= 80% isodose) was 56 Gy with daily application of 1.8 Gy. We attained a 5-years-healing of 27%, obviously the first two years therapy beginning were deciding for fate (2-years-survival 45%). Among infiltration grade and histological type also the primary tumor localization had prognostic relevance. In locally advanced bladder carcinoma with invasion into the environment the radiotherapy gives chance for permanent healing. Acute passing side-reactions during intensive therapy, mainly as cystitis, we recorded in 2/3 of the patients. Only with the combined occurrence of cystitis and proctitis we had to record chronic effects in 2.5% of the cases for a period of more than 5 years.

Aged↗
PubMed1989

About radiotherapy--Part II. Side effects and staff protection.

Special side effects which relate to specific areas are discussed. Head and neck radiation produces acute problems related to swallowing, dry mouth, sore throat and thickened saliva which all require medication. Alteration of taste may last for months after radiation is completed. Radiation to lungs may cause worsening breathlessness and coughing which may necessitate interruption of treatment. Radiation to pelvis and abdomen result in nausea and diarrhoea which usually respond to treatment. Proctitis, vaginal discharge and urinary problems all need attention. With cranial radiation, hair loss is a major problem and unlike chemotherapy induced alopecia, there is poor recovery. Patients must be informed that their condition will improve when radiation ceases, and not attribute all symptoms to underlying disease. Protection in this country is in line with international standards and strict adherence protects the work force. Patients with radioactive sources in situ e.g. radium or implants such as gold seeds, iridium wires, or being treated by radioactive iodine all require special nursing and are nursed in a protected ward. Staff wear film badges to detect radiation absorbed. If in doubt about safety measures contact superiors or radiophysics department of hospital. Patients already isolated from visitors must not be neglected and nurses must observe instructions and then proceed with safety.

Abdomen↗
PubMed1988

Herpesvirus infections (cytomegalovirus, herpes simplex virus, varicella-zoster virus). How to use ganciclovir (DHPG) and acyclovir.

Herpes viruses (HSV, CMV, VZ) are very frequent in AIDS patients and often exist in a chronic or progressive form. Clinically evident CMV retinitis occurs in approximately 10 per cent of AIDS patients but can be effectively treated with a new nucleoside analogue DHPG (Gancyclovir). Perianal ulcers, proctitis, and other clinical syndromes caused by HSV can be effectively treated with acyclovir (ACV) and HSV recurrences can be prevented by daily administration of ACV. Zoster in a young adult may be the first indication of immunodeficiency due to HIV. Because VZV is less susceptible to ACV than HSV, intravenous ACV or high-dose oral therapy is required to achieve inhibitory blood levels.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Current status of drug therapy for inflammatory bowel disease.

Both topical steroids and sulfasalazine are useful for patients with ulcerative proctitis and distal colitis. For patients with more extensive ulcerative colitis with moderate symptoms, prednisone and/or sulfasalazine will result in improvement in about 80% of patients. Parenteral corticosteroids or ACTH should be used in the setting of severe colitis and antibiotics added if the patient appears toxic. Sulfasalazine is of proven efficacy as maintenance therapy in ulcerative colitis. Prednisone and sulfasalazine are useful in Crohn's disease, although the latter is of limited use in patients with ileitis alone. Immunosuppressive agents such as azathioprine and 6-mercaptopurine may be especially helpful in Crohn's patients refractory to other drugs or dependent on high doses of steroids. Azathioprine is of proven usefulness as maintenance treatment of Crohn's disease. Metronidazole is as effective as sulfasalazine in Crohn's disease involving the colon and has an important role in severe perineal disease. New forms of steroid enemas and topical and oral forms of 5-aminosalicylate based on sulfasalazine should be available soon for patients with both ulcerative colitis and Crohn's disease.

Adrenal Cortex Hormones↗
PubMed1987

Medical treatment of inflammatory bowel disease: new therapies, new drugs.

Ulcerative colitis, ulcerative proctitis and Crohn's disease are chronic inflammatory conditions that affect the gastrointestinal tract. Conventional treatment has stressed the role of anti-inflammatory agents to suppress the inflammatory response. New compounds that can deliver 5-aminosalicylic acid to the colon have recently been released in Canada. Metronidazole and azathioprine may also be of benefit in Crohn's disease. Therapy with cyclosporine and clonidine should be based on the results of further clinical trials. The use of nutritional support as primary therapy in Crohn's disease appears promising. At present, both pharmacologic and nutritional therapies should be considered in the treatment of inflammatory bowel disease.

Aminosalicylic Acids↗
PubMed1989

External cobalt 60 irradiation alone for stage IIB carcinoma of the uterine cervix.

From 1964 to 1980, 97 patients with Stage IIb carcinoma of cervix uteri were treated by external 60Co irradiation alone. Of these 97 patients, 94 (96.9%) had squamous cell carcinoma. The parametrial extension of the lesion almost reached the pelvic wall in 73.2% and vaginal extension reached to the upper half of vaginal in 24.7% of the patients. A tumor dose of 60 Gy was given to the whole pelvis by a four field technic (opposing parallel AP and lateral portals) in 6-8 weeks. A booster dose of 10 Gy was delivered to the cervix by a pair of reduced opposing parallel AP portals or a perineal portal in a week. The doses delivered were equivalent to the Time-Dose-Fractionation (TDF) value of 110-130 at the center of pelvis and 90-110 in the whole pelvis. The 5-year survival rate for all 97 patients was 56.7%. It was 59.8% when those who died of other diseases were excluded. The prognosis of patients without residual tumor on the cervix and/or vagina was better than that with residual tumor (p less than 0.01). Thirty-seven patients died of cancer (23 died of recurrence, 8 of distant metastases, 2 of both, and 4 were lost before the fifth year). Of these 37 patients, 97.3% died within 3 years after initial treatment. During the radiation treatment, reactions were moderate. Late complications included 19 (19.6%) with mild cystitis and 16 (16.5%) with mild proctitis, 2 (2.7%) developed recto-vaginal fistula. These results were slightly poorer than those using intracavitary and external irradiation or the combination of preoperative irradiation plus surgery. Yet, for patients with extensions nearing the pelvic wall or with contra-indications to surgery or intracavitary radiotherapy, external irradiation alone is still of value.

Adenocarcinoma↗
PubMedDate not supplied

Transcatheter embolization for treatment of acute lower gastrointestinal bleeding.

Treatment of lower gastrointestinal bleeding was attempted in 13 patients by selective embolization of branches of the mesenteric arteries with Gelfoam. Bleeding was adequately controlled in 11 patients with active bleeding during the examination. One patient improved after embolization but bleeding recurred within 24 hours and in another patient the catheterization was unsuccessful. Five patients with diverticular hemorrhage were embolized in the right colic artery four times, and once in the middle colic artery. Three patients had embolization of the ileocolic artery because of hemorrhage from cecal angiodysplasia, post appendectomy, and leukemia infiltration. Three patients had the superior hemorrhoidal artery embolized because of bleeding from unspecific proctitis, infiltration of the rectum from a carcinoma of the bladder, and transendoscopic polypectomy. One patient was septic and bled from jejunal ulcers. Ischemic changes with infarction of the large bowel developed in two patients and were treated by partial semi-elective colectomy, three and four days after embolization. Four other patients developed pain and fever after embolization. Transcatheter embolization of branches of mesenteric arteries is an effective way to control acute lower gastrointestinal bleeding, but still has a significant rate of complications that must be seriously weighed against the advantages of operation.

Adult↗
PubMed1988

Colitis in calves: natural and experimental infection with a verotoxin-producing strain of Escherichia coli O111:NM.

Verotoxin-producing Escherichia coli O111:NM were isolated from two five week old Holstein calves with dysentery. On necropsy both calves had pseudomembranous ileitis, mucohemorrhagic colitis and proctitis. Large numbers of E. coli O111:NM were isolated from the colon and lesions typical of attaching-and-effacing E. coli were evident. The isolates from both calves had identical biochemical reactions and antimicrobial resistance patterns. Oral inoculation of a four day old colostrum deprived calf with 1 x 10(10) organisms of E. coli O111:NM produced a mild, focal colitis with typical attachment and effacement lesions. We conclude that the strain of E. coli O111:NM isolated from the clinical cases has the ability to produce colitis characterized by attachment and effacement of the colonic mucosa.

Animals↗
PubMed1986

Chromium 51-ethylenediaminetetraacetate test: a useful test in the assessment of inflammatory bowel disease.

We evaluated the usefulness of urinary excretion values in assessing mucosal damage in inflammatory bowel disease after administration of chromium 51-labeled EDTA either orally or rectally. In the oral study, 19 controls, 18 patients with Crohn's disease, and 13 patients with ulcerative colitis were given 100 microCi 51Cr-EDTA by mouth. The amount of 51Cr-EDTA in a 24-hour urine collection was expressed as a percentage of the ingested dose. The patients with Crohn's disease of the small bowel excreted 6.3% +/- 4.3%, which was significantly (P less than 0.001) higher than the percentage in patients with ulcerative colitis (1.7% +/- 1.1%) and controls (1.4% +/- 0.6%). In the enema study, 19 patients with ulcerative colitis, two with Crohn's disease, two with radiation colitis, and four controls (spastic colitis, lactose intolerance) were given 100 microCi 51Cr-EDTA by retention enema. The patients with active colonic inflammation excreted 8.4% +/- 3.9% of the dose given by enema, which was significantly (P less than 0.01) higher than in other controls (1.9% +/- 0.91%) or patients with inactive colitis (2.2% +/- 1.9%). The 51Cr-EDTA excretion test is a safe, inexpensive test useful in evaluating patients with inflammatory bowel disease. It can be given orally to screen patients with abdominal complaints who are suspected of having Crohn's disease involving the small intestine, and when given by enema it provides additional objective assessment of idiopathic ulcerative colitis or proctitis.

Administration, Oral↗
PubMed1987

[Combination of bilateral pelvic lymphadenectomy, permanent iodine-125 implantation and percutaneous irradiation of localized prostate carcinoma. 1: Methods and results].

Since the beginning of 1981, 32 patients at an age of 52 to 72 years who suffered from a locally confined adenocarcinoma of the prostate were treated by permanent implantation of iodine-125 seeds at the Urologic and Radiotherapeutic Hospital of the University of Erlangen. 25 patients were evaluated after a median observation period of 30 months. The first group consisting of 19 patients was submitted to a combined percutaneous and interstitial treatment, the other six patients were initially treated only by interstitial therapy because of severe complications observed in the meantime. After bilateral pelvic staging lymphadenectomy, permanent iodine-125 seeds were implanted into the patients of stage T1, T2, early T3, and pN0-1, in case of microscopic lymph node manifestation without capsular perforation also into patients of stage pN2 and pN4. Eight weeks later the patients received a moving beam irradiation with 10 MV photons at the linear accelerator. The centre of the prostate was faded out by a specially constructed H absorber in such a way that the prescribed target dose of 36 Gy in four weeks to the 90%-isodose was only applied to a spherical surface around the implant. One patient died perioperatively from an embolism due to phlebothrombosis of the thigh. 22 out of the other 24 patients are in complete remission, one patient had a local recurrence in the right seminal vesicle which appeared 28 months after primary therapy, and one patient developed skeletal metastases. The objective side effects and late complications of our combined treatment are considerable with respect to their incidence as well as their severity: a slight or medium radioproctitis was found after a latent period of one to two years in 28% (5/18) of cases, after a latent time of about 1 1/2 to two years another 28% (5/18) developed subsequently to a proctitis an urethral stricture and an ulcer situated on the anterior rectum wall facing the prostate, and four patients presented finally a prostato-rectal fistula.

Aged↗