[Treatment of functional colonic diseases and colonic diverticulosis. Comparative effects of bran and Kaologeais using a crossover method].
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Colon sonography enables imaging of the colon from the beginning of the rectosigmoid transition up to the cecum. Colon sonographic investigations in 29 patients (normal findings n = 15, ulcerative colitis n = 6, Crohn's disease n = 8) with a finding verified by coloscopy and biopsy show that acute ulcerative colitis and florid Crohn's disease lead to different sonographic alterations. Formation of haustra can no longer be detected in the two diseases. In Crohn's disease, the typical sonographically discernible wall layering has been abolished, and the wall is markedly thickened. In contrast to this, the wall layering is preserved in acute ulcerative colitis and the wall is only moderately thickened. The results show that differential diagnosis of acute inflammatory diseases of the large intestine is possible using colon sonography.
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Generally two types of ultrasonic colon examination method are carried out. One is extracorporeal ultrasonographic examination (US). And another is endoscopic ultrasonographic examination (EUS). US is technically easy but is difficult to take good image of colon diseases. EUS can give us good and sufficient informations. But it is technically difficult and gives much trouble to patients. During usual endoscopy, we have tried extracorporeal ultrasonic examination by filling de-aired water around the diseased colon area. With this new method, we could easily identify the disease and got much better picture than usual US. And this new method gave almost no trouble and pain to examinees in comparison with EUS.
Small intestinal obstruction without colonic dilation can be the mode of presentation in a variety of colonic diseases, including carcinoma, diverticulitis, and colitis. Plain abdominal roentgenograms may lead the unwary physician into errors of diagnosis and treatment by suggesting primary small bowel disease. Barium enema examination of the colon will keep the wary physician out of such traps. We describe five patients with small bowel obstruction who had a variety of colonic diseases diagnosed by barium contrast studies. If the reason for intestinal obstruction is not apparent and the need for emergency surgery is not compelling, we recommend an immediate contrast study of the colon to aid in evaluating possible colonic pathology.
BACKGROUND & AIMS: Colonic mucins secreted by goblet cells protect the colon by preventing the attachment of enteric pathogens to the epithelium. Entamoeba histolytica overcomes this protective barrier and causes ulcerations, allowing the parasite to disseminate to the liver and form abscesses. An in vitro model is used to study the interaction between E. histolytica and colonic mucins. METHODS: Secretory mucins from the colonic adenocarcinoma cell line LS174T were collected and their functions assessed by their ability to inhibit amebic adherence to target cells and killing. The cytoprotective effect of mucus against E. histolytica cytolysis of LS174T monolayers was studied at 37 degrees C. RESULTS: Sepharose 4B column chromatography, metabolic labeling with [3H]glucosamine, cesium chloride density gradient centrifugation, and amino acid and carbohydrate compositional analysis revealed that LS174T cell mucins were typical of native colonic mucins. Mucin O-linked oligosaccharides bound to and inhibited the adherence of amebae to Chinese hamster ovary cells. E. histolytica killing of Chinese hamster ovary cell monolayers occurred rapidly, whereas killing of LS174T monolayers with an intact mucus layer was significantly retarded. CONCLUSIONS: Our results show that colonic mucins serve as the first line of host defense against amebic invasion and provide a useful model to study pathogen-mucin interactions.
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Spastic colon disease is a syndrome consisting of abdominal pain and abnormal bowel function associated with thickening of the circular muscle layer of the colon. The condition may be related to changes in intraluminal pressure associated with a lifelong low residue diet. Radiologic features include thickening, crowding, irregularity, and distortion of the interhaustral folds of the sigmoid colon, which in the past have been incorrectly considered to be manifestations of acute diverticulitis. Spastic colon disease leads to diverticulosis which develops because of mucosal herniations through the weakened colonic wall. When a diverticulum perforates, acute diverticulitis ensues. Depending on how the subsequent inflammatory response is contained, a mural abscess, colonic narrowing or obstruction, an intra-abdominal abscess, or a fistula may occur and be demonstrated on barium enema examination.
The colon is a frequent site of gastrointestinal complications in patients with HIV infection, and these colonic disorders increase in frequency as immunodeficiency worsens. The most common clinical manifestations of colonic disease in AIDS are diarrhea, lower gastrointestinal bleeding, and abdominal pain. Toxic megacolon, intussuseption, typhlitis, idiopathic colonic ulcer, and pneumatosis intestinalis also have been described. In the HIV-infected patient with preserved immunity, the most common cause of colitis is bacterial, but as the degree of immunodeficiency worsens, opportunistic pathogens (CMV, protozoa, mycobacteria, fungi) and neoplasms become more frequent. The frequent use of antibiotics, chemotherapeutic agents, and frequent hospitalization increase the susceptibility to cf2Clostridium difficule cf1colitis. Endoscopy plays an integral role in the management of many colonic disorders in AIDS.
For non-malignant colon diseases the indications for preventive measures can be of tumorous and non-tumorous nature. In case of ulcerative colitis and Crohn's colitis local and systemic complications may demand a colectomy. The operative procedures in this case are proctomucosectomy with ileumpouch or ileorectostomy , if continence can be preserved. Mucosal proctectomy with ileumpouch will prevent the obligatory malignant change in familial adenomatosis. The preventive resection in diverticulitis bewares of the complication of the progressive phlegmonous infection of the colonic wall.
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There were examined 27 patients with inflammatory diseases of colon. In cases of the nonspecific ulcerative colitis and Crohn's disease of colon the thyroid gland insufficiency occurs in variant of the thriiodinethyronine low contents syndrome, causing the necessity of the substitution therapy conduction in postoperative period.