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Query: UMLS:C0009324 (ulcerative colitis)
 17,300 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Being informed is not only a patient's right, it is also important in order to improve compliance and management. Apart from verbal consultations, informative material is often produced without prior analysis of what patients consider important to know. Patient information needs were defined in order to plan future educational programmes. A 44-item questionnaire was given to 100 Inflammatory Bowel Disease (IBD) out-patients (50 Crohn's Disease (CD) and 50 Ulcerative Colitis (UC). Sixty-two per cent of those with UC and 78% of those with CD consider themselves insufficiently informed about their disease. CU and CD patients indicated different priorities concerning areas where further information is requested: CD patient needs were aetiology, diet, symptoms, history, new treatments, risks deriving from treatment, cancer risk and consequences on work. UC patients indicated a different priority order: risk of cancer, new treatments, symptoms, psychological and diet factors and aetiology. The media preferred by patients were: specifically prepared books (73%), video-cassettes (20%) and leaflets (25%). Ninety per cent think that educational material prepared according to their needs could be very useful; however 35% think that knowledge of the possible severity of their disease might increase their anxiety.
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PMID:What do patients want to know about their inflammatory bowel disease? 148 77

In patients with ulcerative colitis, epidemiological work has suggested an association between low folate status and an increased risk of colonic neoplasia. The aim of the present study was to determine if experimental folate deficiency increases the likelihood of developing neoplasia in rats treated with the carcinogen dimethylhydrazine. Weanling male Sprague-Dawley rats were fed with an amino acid-defined diet containing either 8 or 0 mg/kg folic acid. After 5 weeks of defined diet, weekly s.c. injections of dimethylhydrazine (20 mg/kg) were administered to both groups. Serum, whole blood, liver, and colonic folate concentrations at the time of sacrifice were significantly lower in folate-depleted animals (P less than 0.001). There were significant differences in the incidence of colonic neoplasia between the two groups after 20 weeks of dimethylhydrazine exposure: folate-deficient rats had a greater incidence of dysplasia (6 of 7 versus 2 of 7 animals; P less than 0.05) and carcinoma (6 of 7 versus 1 of 7 animals; P less than 0.01). Furthermore, a significantly greater proportion of folate-replete rats than folate-deficient rats were free of neoplastic lesions (5 of 7 versus 0 of 7 animals; P less than 0.05). These results suggest that, in this animal model, folate deficiency increases the risk of malignancy when there is an underlying predisposition to colorectal cancer.
Cancer Res 1992 Sep 15
PMID:Folate deficiency enhances the development of colonic neoplasia in dimethylhydrazine-treated rats. 151 55

Samples of colorectal mucosa from patients with Crohn's disease, ulcerative colitis and cancer were analyzed by means of flow cytometry. S- and G2-phase fractions were determined and mean values were calculated for different groups of patients. Almost identical results were obtained for inflamed and normal appearing mucosa from patients with Crohn's disease as well as inflamed mucosa from patients with ulcerative colitis. The mean S- and G2-phase fractions in normal appearing mucosa from cancer patients, however, were significantly higher. This seems to be due to the fact that patients with Crohn's disease are between 15 and 45 years old, while cancer patients are mostly over 45. A detailed analysis of the S- and G2-phase fractions in different age groups revealed a slight, but significant increase in colorectal proliferation between 25 and 75 years.
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PMID:Flow cytometric analysis of colorectal mucosa from patients with Crohn's disease, ulcerative colitis and cancer. 152 71

Colorectal cancer screening in ulcerative colitis patients is a commonly accepted practice whose parameters are based on convention and not necessarily on the epidemiology of disease. This review summarizes previously published data from a single university-based surveillance program to estimate important screening parameters. The hazard rate (annual risk) of developing cancer was found to rise exponentially with disease duration and to be approximately 2% at 20 yr of disease and nearly 8% at 30 yr of disease. Older age at symptom onset was a significant risk factor for neoplasia. The lead time between the development of low-grade dysplasia and high-grade dysplasia or cancer was approximately 3 yr. Efficient scheduling of tests (maximum benefit for a given cost) implied that the screening test interval should be inversely proportional to the square root of the hazard rate. As the hazard rate increased with duration of disease, the screening interval should shorten accordingly. An historical cohort study demonstrated that the parameters used in our program were not associated with the anticipated result of reduced colorectal cancer mortality. A surveillance program should be tested that uses a more sensitive criterion for a positive test.
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PMID:Recommendations for colorectal cancer screening in ulcerative colitis: a review of research from a single university-based surveillance program. 153 Nov 63

Localized giant pseudopolyposis is a rare complication in patients with ulcerative colitis which progresses to a huge intramural polypoid mass. Our case described here is a 30-yr-old female with chronic ulcerative colitis who developed localized giant pseudopolyposis with unexpected infiltrating adenocarcinoma. This case is one of an unusual form of cancer presentation in ulcerative colitis, and it indicates that we should be aware of the possibility of occult adenocarcinoma inside a large pseudopolyposis with no superficial dysplasia.
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PMID:Occult cancer in localized giant pseudopolyposis. 153 78

This study was performed to determine the correlation of tumor ras and c-myc oncogene expression with clinical and prognostic variables in patients prone to develop colorectal cancer. One hundred eighteen patients with colorectal cancer were studied; mean age was 40 years. Fifty-three were young patients (age 40 or less), 49 had ulcerative colitis, and 16 had multiple polyposis coli. Immunoperoxidase stains of paraffin-embedded cancer sections were performed for the c-myc and ras proteins. ras staining was found to correlate with Dukes stage and prognosis. Patients with tumors negative for ras protein stain had an actuarial five-year survival of 61 percent versus 44 percent for those tumors with a positive stain (P less than 0.05). This correlation was not seen with the c-myc stain. Positive ras oncogene stain appears to be a useful indicator of advanced stage and poor prognosis in colorectal cancer occurring in cancer-prone patients.
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PMID:ras and c-myc protein expression in colorectal carcinoma. Study of cancer-prone patients. 156 93

A 62-year-old man with a 20-year history of chronic ulcerative colitis and a 9-year history of primary sclerosing cholangitis (PSC) underwent orthotopic liver transplantation because of symptoms related to PSC and cholangiographic features compatible with a biliary neoplasm. Study of the excised liver revealed papillary mucosal lesions in the common hepatic duct and the right and left hepatic ducts as well as cholangiectases and other features typically associated with PSC. The papillary lesions consisted of abundant fibrovascular stroma covered by biliary epithelium with low-grade and high-grade dysplasia. Some periductal glands were also dysplastic. These features distinguished papillary dysplasia from classic biliary papillomatosis. Only one focus of microinvasion was found; there were no metastases. Among 60 cases of PSC in whom the entire liver could be studied after orthotopic liver transplantation, this was the only instance of unequivocal dysplasia. However, in one specimen, papillary hyperplasia was found. Detailed macroscopic and microscopic rereview of 23 livers from our patients with the longest history of PSC (range, 5-24 years) failed to reveal any additional cases with dysplasia. It is concluded that (a) papillary mucosal lesions in PSC may represent papillary dysplasia without invasion; (b) these lesions may evolve from papillary hyperplasia; (c) the process may be largely, if not entirely, in situ; and (d) the prevalence of dysplasia and carcinoma of bile ducts may be less than the 7%-9% reported in the literature for malignancies associated with PSC.
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PMID:Papillary bile duct dysplasia in primary sclerosing cholangitis. 158 34

The malignancy risk in Crohn's disease is less than that of ulcerative colitis, although it has not been so well studied. The possibility of an early detection of malignant changes during the long term follow-up of the patients induces to look for parameters which might be helpful in this respect. In the second surgical clinic of the Hospital Clinico in Madrid, the pathological findings of 11 patients with the diagnosis of Crohn's disease have been analyzed and correlated with the clinical findings. The evaluation of the degree of dysplasia was done on 15 samples obtained by endoscopy and compared with the findings of the surgical specimens in 6 operated patients. The degree of dysplasia increases with age of the patients and years of evolution of the disease with a significant correlation (p less than 0.001) between negative dysplasia and positive dysplasia grade I.
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PMID:[Correlation between dysplasia and malignization risk of Crohn disease]. 159 62

DNA ploidy and S-phase fractions were assessed by flow cytometry in colonic biopsy specimens from 28 patients with ulcerative colitis and 51 with Crohn's disease. Whereas only diploid DNA histograms were found in Crohn's disease and control subjects, three patients with ulcerative colitis exhibited DNA aneuploidy. In one case, aneuploidy was associated with low grade dysplasia. S-phase fractions were higher in ulcerative colitis (mean (SD) 17.8 (7.7)%) than in Crohn's disease (13.1 (4.6)%) or control subjects (14.2 (4.6)%), but did not correlate with either disease activity or duration in any group. In this study, aneuploidy was associated exclusively with ulcerative colitis, even in the absence of dysplasia. In view of the epidemiological differences in malignant colonic transformation between ulcerative colitis and Crohn's disease, this study suggests that flow cytometry may help to identify individuals with an increased cancer risk in ulcerative colitis.
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PMID:DNA aneuploidy in Crohn's disease and ulcerative colitis: results of a comparative flow cytometric study. 161 84

This article summarizes the data concerning cancer risk in chronic inflammatory bowel disease. Cancer risk of ulcerative colitis and Crohn's disease is highly dependent on the duration of the disease, extent of bowel inflammation, and probably also of the age at onset of the disease. Cancer development follows the dysplasia-carcinoma-sequence. Diagnosis of premalignant changes is the basis for follow-up studies in ulcerative colitis as suggested here.
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PMID:[Risk of cancer in chronic inflammatory bowel diseases]. 162 13


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