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Query: UMLS:C0010346 (
Crohn's disease
)
21,615
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The prevalence of herpesvirus DNA was examined in inflammatory bowel disease tissue. DNA was extracted from resection and biopsy specimens of the large intestine from patients with ulcerative colitis (n = 21), patients with
Crohn's disease
(n = 29), and patients with noninflammatory
bowel disease
(controls) (n = 21). The nested polymerase chain reaction was used to detect viral DNA using primer pairs specific for either cytomegalovirus (CMV), herpes simplex virus 1 (HSV1), human herpesvirus 6 (HHV6), varicella zoster virus (VZV), or Epstein Barr virus (EBV). HSV1 and VZV DNA were not detected in any of tissue samples. There was a high prevalence of CMV (81%), HHV6 (76%), and EBV (76%) DNA in ulcerative colitis tissue compared to
Crohn's disease
tissues (CMV 66%, HHV6 45%, EBV 55%). Control tissue had a relatively low frequency of CMV (29%) and EBV (19%) DNA but a prevalence of HHV6 DNA similar to that of ulcerative colitis (86%). However, the simultaneous presence of HHV6 and CMV and/or EBV DNA in ulcerative colitis tissue (76%) was much greater than in either
Crohn's disease
tissues (38%) or control tissue (29%) (P < 0.05). There was a low prevalence of CMV, HHV6, and EBV DNA in peripheral blood mononuclear cells from all patient groups. CMV and EBV are capable of reactivating HHV6: the high prevalence of coexistent HHV6 infection with either or both of these two viruses in ulcerative colitis tissue suggests that they may play a synergistic role in the pathogenesis of this disease.
...
PMID:Detection of herpesvirus DNA in the large intestine of patients with ulcerative colitis and Crohn's disease using the nested polymerase chain reaction. 128 31
1. The incidence of gallstones in patients with
Crohn's disease
is increased compared with that in healthy control subjects. This is in part due to reduced terminal ileal bile salt absorption and consequent increased cholesterol saturation in bile. The aim of this study was to evaluate gallbladder contractility, a second important factor in the pathogenesis of gallstones, in
Crohn's disease
. 2. Thirty patients with
Crohn's disease
and no known biliary tract disease and nine healthy control subjects were studied. After an overnight fast, gallbladder volume was determined by real-time ultrasonography before and 10, 20, 30, 40, and 50 min after ingestion of a standard liquid fatty meal. 3. Compared with healthy control subjects, patients with
Crohn's disease
had similar fasting gallbladder volumes (control, 18.7 +/- 2.3 ml;
Crohn's disease
, 18.2 +/- 2.3 ml). Percentage emptying was significantly impaired at 30, 40 and 50 min in patients with
Crohn's disease
compared with control subjects. Patients with
Crohn's disease
limited to the small bowel had gallbladder contractility that was comparable with that of control subjects, whereas in those with large-
bowel disease
, minimum residual gallbladder volume was significantly smaller than in control subjects. Patients with both large- and small-bowel
Crohn's disease
demonstrated the most marked abnormalities, with gallbladder volumes significantly larger than those of control subjects at 30, 40 and 50 min. Likewise, patients with
Crohn's disease
who had undergone previous bowel resection had impaired emptying at 30, 40 and 50 min.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Impaired fatty-meal-stimulated gallbladder contractility in patients with Crohn's disease. 133 39
Colono-ileoscopy was performed on 11 patients after ileocolic resection for
Crohn's disease
, to observe development of recurrent anastomotic inflammation and its relationship to mucosal phospholipase A2 (EC 3.1.1.4) activity. Ileal inflammation appeared soon after surgery in eight cases but in none of nine controls with noninflammatory
bowel disease
. The ileal inflammation was more severe 1-3 cm above than greater than 5 cm above the ileocolic junction (p less than 0.05), whereas the postanastomotic colonic mucosa remained unchanged. Ileal phospholipase A2 activity in the mucosa was equally raised at the two ileal sites (p less than 0.01 and less than 0.02), irrespective of the presence or absence of inflammation. In colonic postanastomotic mucosa the phospholipase A2 activity was the same as in the controls. Further followup showed preanastomotic ileal inflammation at both investigated levels in all patients with
Crohn's disease
but still with greater severity close to the mucosal junction (p less than 0.05). The study indicates that recurrent inflammation in
Crohn's disease
is initiated in the terminal ileum close to the ileocolic junction. Progression of severity is accompanied by greater proximal involvement. The increase in mucosal phospholipase A2 activity, which precedes endoscopically detectable inflammation, implies a role for this enzyme in
Crohn's disease
.
...
PMID:Initiation of anastomotic recurrence of Crohn's disease after ileocolic resection. Onset proximal to the junction and preceded by increased phospholipase A2 activity. 143 52
Enterovesical fistulas usually result from diverticulitis,
Crohn's disease
, or colorectal cancer. A perforated Meckel's diverticulum can also result in an vesico-diverticulum fistula, as noted in three previously reported cases. In all three cases, bladder or
bowel disease
was associated with the fistula. Herein, the authors describe a previously healthy, 23-year-old man who presented with an enterovesical fistula. Exploratory laparotomy revealed a vesico-diverticular fistula resulting from a perforated Meckel's diverticulum. Pathologic examination revealed that the diverticulum did not contain ectopic gastric or pancreatic tissue and that the perforation was secondary to an enterolith. The patient underwent a diverticulectomy and had an uneventful postoperative course. Unlike any of the three previously reported cases, the authors' patient had no coexisting bowel or bladder disease occurring with his vesico-diverticular fistula. To the authors' knowledge, this is only the third reported case of a vesico-diverticular fistula resulting from a perforated Meckel's diverticulum that did not contain ectopic tissue. It represents the first case where the perforation was secondary to an enterolith.
...
PMID:Vesico-diverticular fistula: a rare complication of Meckel's diverticulum. 145 9
Suspected risk factors for adenocarcinoma of the small bowel in
Crohn's disease
include surgically excluded small bowel loops, chronic fistulous disease, and male sex. Review of all seven University of Chicago cases failed to confirm any suspected risk factor. A case-control study was performed to identify possible alternatives. Each case was matched to four randomly selected controls from an inflammatory bowel disease registry matched for year of birth, sex, and confirmed small bowel
Crohn's disease
. Three factors were significantly associated with the development of cancer: (1) Four cancers developed in the jejunum, and jejunal
Crohn's disease
was associated with the development of cancer [odds ratio (OR) 8.0, 95% confidence interval (CI) 1.6-39.3]. (2) There was an association between the development of cancer and occupations known to be associated with an increased colorectal cancer risk (OR 20.3, CI 2.7-150.5). Three cases (a chemist with exposure to halogenated aromatic compounds and aliphatic amines, a pipefitter with exposure to asbestos, and a machinist with exposures to cutting oils, solvents, and abrasives) and one of 28 controls (a fireman with multiple hazardous exposures) had an occupational risk factor. (3) Among medications taken for at least six months, only 6-mercaptopurine use was associated with cancer (OR 10.8, CI 1.1-108.7). In conclusion, proximal small
bowel disease
, 6-mercaptopurine use, and hazardous occupations are associated with cancer of the small bowel in patients with
Crohn's disease
and can be added to the list of suspected risk factors.
...
PMID:Risk factors for small bowel cancer in Crohn's disease. 149 40
Functional abdominal pain may often be sonographically attributed to the colon. Typically a segment of the colon is painful at direct palpation, but the wall is not thickened. The contractions between the haustra are often marked. The haustra are clearly outlined and cast acoustic shadows. If the patient also experiences spontaneous pain in this region, functional colonic pain, explained as spasms of the muscle coat, may be assumed. Clinically there are often other symptoms of the irritable
bowel disease
or a spastic constipation. In daily practice functional colonic pain is as frequent as dyspepsia. Differential diagnosis includes intestinal (peptic ulcer,
Crohn's disease
, appendicitis, diverticulitis, colon cancer) and extraintestinal diseases (e.g. of the gallbladder, pancreas and female adnexes).
...
PMID:[Functional colonic pain. An important clinical and sonographic differential diagnosis]. 150 37
Amyloidosis is a rare but serious complication of inflammatory bowel disease (IBD), especially
Crohn's disease
(CD). It occurred in 15 of our 1709 patients with CD (0.9%) (706 with ileocolitis, 310 with colitis, and 693 with enteritis), but in only 1 of our 1341 patients with ulcerative colitis (UC) (0.07%), admitted to The Mount Sinai Hospital between 1960 and 1985. Eleven of the patients with CD who had amyloidosis had ileocolitis, 2 colitis, and 2 ileitis; these figures represent a frequency within each group of 1.6%, 0.6%, and 0.3%, respectively. Amyloidosis was thus associated 4.4 times more often with CD of the colon than with pure small
bowel disease
. We have added to this group of 15 patients the 5 cases of CD that were originally reported by Werther et al in 1960, plus another 4 (2 with UC and 2 with CD) who have been seen since 1985, making a total of 25 patients in this series, 22 with CD and 3 with UC. There was a striking male preponderance, 16 of 22, among patients with CD, although 2 of the 3 patients with UC were female. Amyloid disease was diagnosed at a mean age of 40 years, 15 years (range, 1-42) after the onset of CD. Six major forms of amyloidosis occurred: nephropathy,
enteropathy
, cardiomyopathy, hepatosplenomegaly, thyroid mass, and generalized amyloidosis. Renal disease with proteinurea and/or renal insufficiency occurred in 18 of the 22 patients with CD and in all 3 with UC. Nephropathy was by far the most common lethal manifestation of IBD-associated amyloidosis in this series. Nephrotic syndrome developed in 15 patients with CD and was accompanied by renal failure, the major contributor to mortality, in 10 of the 13 patients who died. Amyloidosis may be associated with suppurative or other extraintestinal manifestations of IBD. Fifteen of the 22 patients with CD who had amyloidosis also had suppurative complications of their
bowel disease
, although the other 7 had no recognizable suppuration. Extraintestinal manifestations were also common in this series, occurring in 12 of 22 patients with CD and in 2 of the 3 patients with UC; 6 of the 18 patients with nephrotic syndrome also had arthritis. However, there is no evidence that patients with IBD with amyloidosis have extraintestinal manifestations more frequently than do IBD patients without amyloidosis. Earlier reports of amyloid associated with IBD came from autopsy series. In recent years, biopsy has allowed diagnosis to be made during life.(ABSTRACT TRUNCATED AT 400 WORDS)
...
PMID:Amyloidosis and inflammatory bowel disease. A 50-year experience with 25 patients. 152 2
We show the results of a retrospective study carried out during ten years (1978-1987), in Catalonia in the provinces of Barcelona and Gerona. The aim of the study was to evaluate the incidence and prevalence of inflammatory chronic
bowel disease
in our country, its clinical aspects, management and long term survival. An epidemiological inquiry was sent to all the hospitals and gastroenterologists of Catalonia. Nine hundred and seventy six answers were received from 20 Hospitals and four specialists. All of them were revised by the Research Committee, and 761 were validated for their inclusion in the study. The prevalence of the disease was similar both in Barcelona (19 per 100,000) and Gerona (18 per 100,000). The incidence of ulcerative colitis increased during the study, from 0.4 in 1978 to 0.8 in 1987, with a peak of maximum incidence (1.0 per 100,000) in 1985. In the same way, an increase in the incidence of
Crohn's disease
from 0.2 to 0.7 per 100,000, was observed. The mean incidence per year was 0.6 and 0.4 respectively, similar to the incidence observed in other Spanish regions during the same period of time. Finally we show the most important clinical and therapeutic aspects as well as the survival data.
...
PMID:[Chronic inflammatory intestinal disease in Catalonia (Barcelona and Gerona)]. 154 40
Ultrasound examinations were performed in 36 patients with
Crohn's disease
, 28 with ulcerative colitis, and 50 with no
bowel disease
. The pathological findings were classified into three types and compared with the radiographic and/or colonoscopic findings.
Crohn's disease
and ulcerative colitis could be detected by ultrasonography with a sensitivity of 86% and 89%, respectively. The ultrasonographic features correlated with the radiographic/colonoscopic findings and with disease activity, but did not help much in making a differential diagnosis, although the location of the pathologic changes was helpful to some extent. In conclusion, ultrasonography can serve as a useful alternative diagnostic procedure that permits us to obtain information about transmural changes in inflammatory bowel disease.
...
PMID:Ultrasonographic assessment of inflammatory bowel disease. 144 69
The etiology of ulcerative colitis (UC) and
Crohn's disease
(CD) remains enigmatic. Infiltrating intestinal macrophages are capable of producing the proinflammatory cytokines tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), and interleukin-6 (IL-6). We investigated the presence of IL-6, TNF-alpha and IL-1 beta mRNA transcripts in inflammatory bowel disease (IBD), normal, and other inflammatory intestinal specimens utilizing the polymerase chain reaction (PCR). TNF-alpha mRNA levels did not very between inflammatory bowel disease and control specimens. IL-1 beta mRNA levels were highest in active UC and noninflammatory
bowel disease
inflammatory specimens while IL-6 mRNA levels were highest in active IBD specimens. Infiltrating T cells, macrophages, and B cells were identified as sources of IL-6 protein in inflammatory bowel disease specimens by immunofluorescent staining. IL-6 transcripts were elevated only in active inflammatory bowel disease specimens, suggesting that IL-6-mediated immune processes are ongoing in the inflammatory mucosal environment of CD and UC.
...
PMID:Tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-6 expression in inflammatory bowel disease. 158 85
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