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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Basing on comprehensive clinical investigations of 50 patients with colon dysfunction, relevant somatic and psychological aspects have been analysed. Colon dysfunction in shown to attend neurotic and personality disorders, to be in some cases a somatoform manifestation of endogenic depression. The majority of the patients had psychogenic neurotic affections closely related to colon dysfunction which is considered a psychosomatic pathology.
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PMID:[Psychosomatic correlations in patients with functional disorders of the colon]. 180 12

One hundred twenty-eight small flat adenomas (SFAs) were collected from 101 patients, and the clinicopathologic features were investigated. There were 91 adenomas with mild atypia, 20 with moderate atypia, and 17 with severe atypia. SFAs were found more often in males than in females, with a ratio of 3.4:1, and the malignancy rate in females (31.8 percent) was higher than in males (9.3 percent). About 38 percent of the patients had a history of colorectal carcinoma, and 65 percent had a history of colorectal neoplasms. Of 37 patients whose family history was traced, 21 had cancer families. SFAs were prone to be found in patients with a history of colorectal neoplasms and a cancer family. Malignancy rate increased with increasing size. The overall malignancy rate was 13.3 percent, which was considerably higher than that of ordinary small polypoid adenomas (2.8 percent). SFAs were situated more proximally (30.9 percent) than ordinary adenomas; however, there was no relationship between site and malignancy. All the lesions showed tubular adenomas, and there was no villous feature. A central depression was noted in 20 lesions, more frequently in adenomas with higher atypia. All but one adenoma with severe atypia showed a component of lower atypia, supporting the adenoma-carcinoma sequence.
Dis Colon Rectum 1991 Nov
PMID:Clinicopathologic features of the flat adenoma. 193 77

Three hundred thirteen patients with signs of depression or spontaneous or evoked pain of coccygeal area were studied over six months. One hundred eighty (58 percent) had no spontaneous pain, 87 (28 percent) had moderate pain, and 46 (15 percent) a severe coccygodynia leading to consultation. In four of the latter group, no other sign of depression was found. Seventy-nine percent of the patients with spontaneous pain and 66 percent without spontaneous pain had coccygeal pain evoked by rectal digital examination (RDE). Seventy-one percent of the patients with spontaneous pain and 56 percent without spontaneous pain had paracoccygeal pain evoked by RDE. Among severely depressed patients (Group III), 76 percent had an evoked pain and 80 percent a coccygeal pain--either spontaneous or evoked. In 178 (57 percent), all signs disappeared when treated with various antidepressants in seven visits and within six months. Seven (2 percent) were failures; 44 (14 percent) were lost during follow-up; 84 (27 percent) did not return after the first consultation. After treatment in five patients was stopped, all signs recurred together and disappeared when adapted treatment was administered again. In 120 consecutive patients who had colonic roentgenologic examination and no depressive sign, two had coccygeal and muscular pain at rectal touch. A highly significant correlation was found between the following parameters: evoked pain and depressive status in noncoccygodynic patients, coccygodynia and evoked pain, coccygeal and paracoccygeal muscular pain. Severity of coccygodynia was not correlated with the number of depressive signs. Sex, age, and treatment efficiency were not correlated. The mechanism of depressive pain is discussed. RDE-evoked pain is proposed as an "objective" diagnostic sign for masked depression and as a means of evolution control. The frequency of the disease and efficiency of treatment are stressed.
Dis Colon Rectum 1988 Mar
PMID:Spontaneous and evoked coccygeal pain in depression. 334 77

A study, comprising dissection and microscopic examination of the pectinate area with special consideration to anal glands, was performed in 29 cadavers varying from fully mature neonatal deaths to 52 years of age. At the junction of the anal canal proper with the rectal neck, an "anorectal sinus" (a submucosal anal circumferential depression) was identified in 18 specimens; in 6 specimens, the anorectal sinus was replaced by a fibroepithelial band ("anorectal band"); in 5 specimens, the anorectal sinus was absent, and in 3 of the 5 specimens only scattered epithelial cells ("epithelial debris" of the anorectal sinus) were detected. These findings suggest that the anorectal sinus is an embryonic vestige which results from hindgut "invagination" by the proctodeum. Its persistence or partial obliteration would result in the formation of tubular structures which are considered by investigators as anal glands. The sinus may be completely obliterated or may leave behind a submucosal "anorectal band" or scattered "epithelial debris." Evidence in favor of this new concept is put forward. The role of anorectal sinus, anorectal band, and epithelial debris in the genesis of some idiopathic anal lesions is discussed.
Dis Colon Rectum 1980 Apr
PMID:A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. X. Anorectal sinus and band: anatomic nature and surgical significance. 737 70

Camptothecin and some of its derivatives, all inhibitors of topoisomerase I, have been found to inhibit growth and induce regression of human colon carcinoma xenografts in nude mice. Some clinical trials of these compounds have been already completed, many more are being held. The mother compound, camptothecin, which is water insoluble, has been administered orally in a Phase I clinical trial. Main toxicity encountered has been diarrhea with minimal leukocytopenia. Camptothecin is now in Phase 2 clinical trials. 9-Aminocamptothecin, a water-insoluble derivative, is now in Phase I trials. Topotecan and iridotecan, two water-soluble derivatives, have undergone Phase I trials, showing mostly intestinal toxicity, followed by bone marrow depression.
Dis Colon Rectum 1994 Feb
PMID:New perspectives in colon cancer chemotherapy. 831 2

A study was undertaken to assess the evaluation and treatment of chronic intractable rectal pain. Sixty consecutive patients, 23 males and 37 females with a mean age of 69 (range, 29-87) years and a mean length of symptoms of 4.5 years, were evaluated by questionnaire, office examination, anal manometry, electromyography, cinedefecography, and pudendal nerve study. In all cases, organic abdominopelvic and anorectal etiologies for the pain were excluded by extensive radiologic and endoscopic evaluation. All patients had failed conservative and medical therapy. Ninety-five percent of patients had one or more associated factors: constipation or dyschezia (57 percent), prior pelvic surgery (43 percent), prior anal surgery (32 percent), prior spinal surgery (8 percent), irritable bowel syndrome (10 percent), or psychiatric disorders (depression or anxiety; 25 percent). Possible etiologies for the pain included levator spasm or anismus in 62 percent, coccygodynia in 8 percent, and pudendal neuropathy in 24 percent of patients. Therapy for pain control included electrogalvanic stimulation (EGS) in 29, biofeedback (BF) in 14, and steroid caudal block (SCB) in 11 patients. Pain control was assessed by an independent observer at a mean of 15 (range, 2-36) months after completion of therapy. Continued successful pain relief was classified by patients as good or excellent after EGS in 38 percent, after BF in 43 percent, and after SCB in 18 percent; overall success was reported by 47 percent of patients. The presence of levator spasm, coccygodynia, or pudendal neuropathy did not influence outcome. The routine use of physiologic investigation of rectal pain may not be justifiable. Moreover, more than half of the patients were refractory to all three therapeutic options used in this study.
Dis Colon Rectum 1993 Feb
PMID:Evaluation and treatment of chronic intractable rectal pain--a frustrating endeavor. 1185 48

This prospective study was undertaken to assess personality differences among patients with chronic pelvic floor disorders. Sixty patients (43 females and 17 males) of a mean age of 58 (range, 33-87) years with fecal incontinence (n = 19), constipation (n = 30), or levator spasm (n = 11) had a mean duration of symptoms of 35 (range, 2-50) years. The Minnesota Multiphasic Personality Inventory (MMPI) was utilized for psychologic assessment for all patients prior to treatment. Mean scores for scales 1 (hypochondriasis), 2 (depression), and 3 (hysteria) were significantly elevated for the levator spasm group (71, 75, and 73, respectively). A similar pattern was seen for the constipation group, where the mean scores for scales 1 and 2 were significantly elevated (70 and 74, respectively) with a moderate elevation on scale 3 (68). The hypochondriasis (1), depression (2), and hysteria (3) scales are referred to as the "neurotic triad," and profile patterns such as these indicate that these subjects may manifest their psychologic distress as physical symptoms. By contrast, the fecal incontinence patients were within the normal range on all scales. The information from these MMPI profiles can be used to understand the personality and emotional composition of these patients to assist in their evaluation and treatment.
Dis Colon Rectum 1993 Jun
PMID:MMPI assessment of patients with functional bowel disorders. 850 Mar 78

There remains some reluctance among physicians to refer patients for restorative proctocolectomy (RP). They argue that their patients would be worse off with a pouch because of the attendant problems of urgency and frequent bowel actions. The aim of this study was to compare quality of life in patients who had undergone RP with that of patients with ulcerative colitis on long-term medical treatment. A detailed questionnaire and the Hospital Anxiety and Depression (HAD) test were completed by 103 patients who had undergone RP and by 95 patients with ulcerative colitis on medical treatment and in remission attending a gastroenterology clinic. Patients with a pouch had a greater frequency of bowel action [five times per 24 hours (range, 4-7) vs. two times per 24 hours (range, 1-3); P < 0.001] but less urgency of defecation [12/103 (11.7 percent) vs. 69/95 (72.6 percent); P < 0.001] than patients with medically treated colitis. Efficiency of evacuation, discrimination between flatus and feces, use of perianal pads, and perianal soreness were similar. Use of antidiarrheal medication was more common in the pouch group [53 of 103 patients (51.5 percent) vs. 3 of 95 patients (3.2 percent); P < 0.05], whereas use of topical steroids was more common in medically treated patients [40 of 95 patients (47.1 percent) vs. 9 of 103 patients (8.7 percent); P < 0.05]. Limitation of social activity and HAD scores were significantly higher in medically treated patients. Quality of life for patients with a pouch appears to be as good as that for patients with medically treated colitis.
Dis Colon Rectum 1993 Jun
PMID:Quality of life after restorative proctocolectomy with a pelvic ileal reservoir compares favorably with that of patients with medically treated colitis. 850 Mar 77

Reactions to diagnosis, coping strategies, and anxiety and depression were prospectively studied in 139 consecutive, newly diagnosed gastrointestinal cancer patients. The reactions varied between diagnoses (colon, rectum, gastric, pancreatic and biliary) and states of illness (cured non-cured). Colon and rectal cancer patients, most of whom were potentially cured, had a more confrontational attitude towards their diagnosis, reported more 'Fighting Spirit' and less 'Anxious Preoccupation' and 'Hopeless/Helplessness'. Non-cured patients reported higher levels of intrusive thoughts and avoidance of aversive thoughts than cured patients. The overall levels of anxiety and depression were low, although higher levels were seen for non-cured patients. On the Hospital Anxiety and Depression scale (HAD), a total of 17% were scored as 'doubtful cases' or 'cases' on the anxiety scale and 21% on the depression scale. Thus, pancreatic/biliary cancer patients, most of which are non-cured, and to some extent those with gastric cancer are more vulnerable to psychological distress in connection with the diagnosis than are colorectal cancer patients.
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PMID:Psychological reactions in newly diagnosed gastrointestinal cancer patients. 948 86

We report a rare case of colon cancer in which a depressed-type tumor only 5 mm in diameter invaded the submucosal layer and produced intermediate lymph node metastasis. A 47-year-old male received a total colonoscopy for a depressed-type lesion with marginal elevation in the sigmoid colon. The lesion measured 5 mm in diameter. On chromoendoscopic examination, the depression was clearly demarcated and an irregular pit pattern was identified in the demarcated area by magnification suggesting invasion of the submucosal layer requiring surgery. Laparoscopic-assisted sigmoidectomy was performed and the resected specimen demonstrated well-differentiated adenocarcinoma. The depth of invasion was only 900 microm. There was no lymphovascular invasion although not only paracolic, but also intermediate lymph node metastasis was detected. There have been some reports about small depressed-type colorectal cancer invading the submucosal layer; however, intermediate LN metastasis is very rare in submucosal colorectal cancer. In this case, there were two noteworthy points: 1) despite the small size, submucosal invasion could be estimated preoperatively, therefore, a successful lymph node dissection was performed by laparoscopic surgery; and 2) although this depressed-type cancer invaded the submucosal layer only 900 microm and there was no lymphovascular invasion, intermediate lymph node metastasis was detected.
Dis Colon Rectum 2007 May
PMID:Minute depressed-type submucosal invasive cancer-5 mm in diameter with intermediate lymph-node metastasis: report of a case. 1729 20


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