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At least 19 recordsLinked to original sources

The pathogenesis rectal stricture. II. Experimental salmonellosis and ischemic proctitis.

Experimentally induced oral Salmonella typhimurium infection in pigs resulted in a severe, prolonged enterocolitis with ulcerative proctitis a constant feature. Healed lesions were annular cicatricial ulcers in the part of the rectum affected with rectal strictures. Strictures indistinguishable from the naturally occurring lesion were produced by injecting chlorpromazine into the cranial hemorrhoidal artery of three pigs. Dye injected into the cranial hemorrhoidal artery perfused the entire rectum in normal pigs, but in pigs with either rectal stricture or salmonella proctitis the dye halted at the cranial margin of the transverse mucosal defect. The predilection of rectal stricture and its proposed precursor, salmonella ulcerative proctitis, for the middle third of the rectum was attributed to a normally precarious arterial supply which renders the rectum unusually susceptible to ischemic injury and decreases its reparative capacity.

Animals

Persistence of proctitis in 2 cases of clindamycin-associated colitis.

Two cases of persisting proctitis after an episode of clindamycin-associated colitis are reported. Both patients had fulminant colitis and required emergency operation. Severe proctitis persisted in the rectal stumps until their removal 8 months after the initial diagnosis of colitis was made. Persisting proctitis has not previously been described in clindamycin-associated colitis.

Adult

Immunoglobulin E in rectal mucosa of patients with proctitis.

Rectal-biopsy specimens were obtained from a group of patients with proctitis in different stages of activity. Large numbers of brightly fluorescent IgE-producing cells were demonstrated in rectal-biopsy specimens taken from these patients during disease activity and clinical remission. An immediate hypersensitivity reaction is suggested as one of the mechanisms involved in the pathogenesis of proctitis.

Biopsy

Herpesvirus hominis (type 1) proctitis.

Herpes proctitis from Herpesvirus hominis type 1 is probably an underrecognized cause of rectal pain and inflammation. Extreme anal pain and a purulent rectal discharge in a heterosexual man led to the appropriate diagnosis. Clinicians should be more aware of herpes as a cause of proctitis.

Herpes Simplex

Superimposed traumatic and gonococcal proctitis: report of two cases.

Two men sought treatment at an emergency room with apparent gonococcal proctitis. Further evaluation after failure of antibiotic therapy in both patients revealed that rectal damage resulting from the patients' sexual habits had resulted in a severe traumatic proctitis. The discovery of several organisms, including Neisseria gonorrhoeae and two nonpathogenic amebas, was probably only incidental. Two points are emphasized: the importance of obtaining a complete sexual history for every patient treated for venereal disease, and the inherent complications associated with anorectal manipulation.

Adult

Disodium cromoglycate in the treatment of chronic proctitis.

The effect of topical disodium cromoglycate (DSCG) has been examined in 30 patients with chronic active proctitis using a double-blind crossover trial. Each treatment period was four weeks and patients were given DSCG 200 mg by enema twice daily and 100 mg orally three times each day. Twenty-six patients completed the trial successfully, 14 responded to DSCG treatment, two improved with placebo, and 10 responded to neither. Patients who responded to DSCG had significantly more eosinophils in their rectal biopsies than those who failed to respond and in some instances the counts were very high. The findings support the hypothesis than an allergic reaction is important in the pathogenesis of proctitis.

Adolescent

Immunohistochemical changes in morphologically involved and uninvolved colonic mucosa of patients with idiopathic proctitis.

Alterations in secretory component, IgA, IgG, and IgM were studied by immunofluorescent techniques in mucosal biopsy specimens obtained at colonoscopy from inflamed and grossly uninvolved colonic mucosa from 12 patients with idiopathic proctitis. Parotid-salivary secretory component and IgA and serum immunoglobulins were also investigated. Decreased secretory IgA was observed in the epithelium of all grossly involved rectal mucosa and in 40% of proximal normal mucosa. Salivary secretory IgA was not diminished. These observations suggest that a local immune defect may be pathogenetically related to idiopathic proctitis.

Adult

Comparative analysis of systemic immunological parameters in ulcerative colitis and idiopathic proctitis: effects of sulfasalazine in vivo and in vitro.

Comparative analysis of the systemic immunity revealed similarities between ulcerative colitis and idiopathic proctitis. In the active stage of both diseases, circulating complement receptor positive cells were increased whereas T-cell percentages and lymphocyte functions were decreased. In severe forms of ulcerative colitis and idiopathic proctitis circulating EAC-phagocytosing esterase positive cells, indicative of activated monocytes, were demonstrated. Successful treatment with salicylazosulfapyridine (SASP) reversed these immunological changes. Incubation of SASP and its metabolites with leucocytes from patients and control subjects, in concentrations similar to those demonstrated in sera from patients treated with SASP, did not alter the immunological changes.

Adult

Methylene blue dye spraying method in patients with ulcerative proctitis: a comparative study with morphological findings and functional capacity of the rectal epithelium.

Methylene Blue dye spraying method is currently used in the endoscopic assessment of the colonic mucosa of patients with chronic ulcerative proctocolitis. We have assessed the validity of this method in the evaluation of the functional capacity of the rectal mucosa in 17 patients with ulcerative proctitis and in 5 normal subjects. The ionic transmucosal fluxes of Na+ and K+ and the potential difference were used as parameters of the mucosal function. Our results indicate that methylene blue dye spraying method can be useful in the functional assessment of the rectal epithelium, especially for differentiating normal subjects and patients with mild ulcerative proctitis.

Adolescent

Idiopathic proctitis. I. The morphology of proximal colonic mucosa and its clinical significance.

A group of 31 patients with idiopathic proctitis were colonoscoped while they were symptomatic. Multiple mucosal biopsies were taken from the transverse, descending, and sigmoid colon and from the rectum. While visualization by colonoscopy revealed abnormalities limited to the most distal 18-20 cm of the colon, microscopic abnormalities were frequently seen in more proximal locations. Analysis of clinicopathological data indicates that there is good correlation between the extent of microscopic mucosal abnormalities and the clinical course. Patients with abnormalities limited to the rectum generally responded well to conventional treatment while patients with more proximal involvement were refractory to such therapy.

Adult

Syphilitic proctitis.

Two adult male homosexuals with syphilitic proctitis and without any detectable anal lesions are reported. There was no history or evidence of an external primary chancre in either patient. Of note, one had extensive rectal involvement of the first 20 cm and the other had multiple sites involved. One patient developed severe rectal bleeding following biopsy and a Jarisch-Herxheimer reaction after the first penicillin injection. Salient features of the literature are reviewed and discussed.

Adult

The prognosis of idiopathic proctitis.

Follow-up studies of 2 groups of patients with idiopathic proctitis show that the survival rate is little affected by the disease. The cumulative probability of extension of the inflammation to the descending colon above the left iliac crest was about 5% at 5 years and 12% at 10 years. Corresponding figures for extension to the hepatic flexure were about 4% at 5 years and 6% at 10 years. The probability of radical surgical treatment was 3--5%.

Adolescent

The treatment of gonococcal proctitis. An evaluation of 173 patients treated with 4 g of spectinomycin.

A group of 1,533 homosexual males were examined in 1976 for gonorrhea at the Skin Clinic of the Boston Dispensary. This examination included a rectal culture. There were 213 males with positive rectal cultures: an infection rate of 13.7%. Of these, 173 were treated with 4 g of spectinomycin hydrochloride, intramuscularly, and 127 (73.4%) returned in one week for a posttreatment examination and culture. All who returned had a negative culture. Four grams of intramuscular spectinomycin hydrochloride appears to be effective in the treatment of gonococcal proctitis.

Adolescent