Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085693 (acute appendicitis)
 3,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There is increasing evidence to suggest that the potent neutrophil chemoattractant interleukin-8 (IL-8) has an important role in the pathogenesis of inflammatory bowel disease. IL-8 mediates its actions via two cell surface receptors, CXCR1 and CXCR2. This paper describes the distribution of these IL-8 receptors in the normal gastrointestinal tract and how this is modified in ulcerative colitis (UC). Paraffin-embedded colonic resection specimens were stained with monoclonal antibodies directed against CXCR1 and CXCR2 in ten cases of total UC, 16 cases of appendicitis, and 11 histologically normal sections. A semiquantitative scale of 0-4 was used to assess the proportion and intensity of positively stained cells within certain defined areas of tissue. A comparative assessment was made of the distribution of various cell populations. Dual immunostaining was used to confirm the phenotype of positively staining cells. In the histologically normal colon, the antibody against CXCR1 stained a subpopulation of macrophages deep to the epithelium and germinal centre lymphocytes. A similar pattern of staining was seen in acute appendicitis, with in addition some positively stained neutrophil polymorphs. In UC, there was up-regulation of CXCR1, with a striking increase in positively stained macrophages throughout the mucosa and of B and T lymphocytes outside the germinal centre areas. There was also intense up-regulation of CXCR1 expression by the luminal epithelium, reflected in the epithelial staining score (mean+/-SE=1.8+/-0.44 for UC cases, vs. 0.23+/-0.16 for controls and 0.25+/-0.14 for acute appendicitis). CXCR2 was only expressed on a small population of lamina propria mononuclear cells and crypt epithelial cells, with no significant differences observed between the groups. These results suggest that IL-8 may, through CXCR1, have a role beyond neutrophil recruitment in mediating the immune response in UC and that this is not merely a consequence of the acute inflammation seen in UC.
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PMID:Distribution of the interleukin-8 receptors, CXCR1 and CXCR2, in inflamed gut tissue. 1111 72

Appendiceal involvement in ulcerative colitis may occur in the setting of either diffuse or distal disease, and is usually diagnosed incidentally at the time of proctocolectomy. The present patient had a rare case of 'ulcerative appendicitis' occurring on a background of clinically quiescent ulcerative colitis, and presented with the signs and symptoms of acute appendicitis.
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PMID:Ulcerative colitis of the appendix ('ulcerative appendicitis') mimicking acute appendicitis. 1126 74

Patients with ulcerative colitis (UC) have a less frequent prior history of appendectomy than the general population. The aim of the present investigation was to elucidate histological and immunological characteristics of the appendix in UC and to assess the effect of appendectomy on the disease. Nine subjects with mildly active UC were treated by surgical appendectomy. In four subjects, the histological findings of the appendix were compatible with ulcerative appendicitis. CD3+CD4+CD25+, CD3+CD4+CD45RO+, and CD3+CD8+CD45RO+ appendiceal mononuclear cells were significantly higher in UC than in acute appendicitis and in normal appendix. There was a trend towards higher mRNA transcripts of IFN-gamma in the appendix of UC than those in other two groups. Clinical activity index decreased significantly four weeks after the appendectomy, although the effect was transient. The appendix is a site of involvement in UC, where mononuclear cells are presumed to be at a state of basal activation.
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PMID:Histological and immunological features of appendix in patients with ulcerative colitis. 1264 97

The etiology of ulcerative colitis (UC) is not known. Recent studies support a primary role of the appendix in the pathogenesis of UC, however phenotypical studies of proliferating cells in the appendix have not been reported. We report phenotypical studies of lymphocytes and of proliferating subpopulations in the appendix of patients with inflammatory bowel disease and of controls. Surgical samples of the appendix were obtained from 5 patients with colon cancer, 5 with acute appendicitis, 12 with UC and 7 with Crohn's disease (CD). Frozen sections were cut from fixed samples, and immunostained with lymphocyte markers and anti-Ki-67 antibodies. The number of Ki-67(+) proliferating cells, CD19, and CD138 cells was significantly higher in the appendix of patients with UC than in controls, patients with acute appendicitis, and patients with CD. Immunohistological double staining revealed significant proliferation of CD3, CD19, and CD138 cells in the appendix of patients with UC. The proportions of Ki-67(+) cells in CD3, CD19, and CD138 cells were significantly higher in both total UC patients and patients in remission-stage UC, than in controls, patients with acute appendicitis, and patients with CD. Lamina propria cells in the appendix of patients with UC showed augmented proliferation with increased numbers of CD19 and CD138 cells. The number of CD3 cells was not significantly increased, but the proportion of proliferating CD3 cells was increased. An increased proportion of Ki-67(+) cells in CD19 and CD138 cells represents proliferation of immature plasma cells in the appendix of patients with UC, and proliferation of such immature plasma cells was seen in both active- and remission-stage UC. Proliferation of immature plasma cells in the appendix of patients with UC suggests a primary role of humoral immune responses in the pathogenesis of UC.
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PMID:Significance of increased proliferation of immature plasma cells in the appendix of patients with ulcerative colitis. 1570 31

Recent reports have demonstrated a negative association between appendectomy and ulcerative colitis. Many retrospective studies have shown that appendectomy appears to be protective against ulcerative colitis. Although the function of appendix is not known, all these studies have suggested that alterations in mucosal immune responses leading to appendicitis or resulting from appendectomy may negatively affect the pathogenic mechanisms of ulcerative colitis. Herein, we report a 45-year-old man who was diagnosed as severe ulcerative colitis 2 years ago. Colonoscopy revealed a feature of pancolitis. He has been treated with several courses of corticosteroids over 2 years. However, dosage of steroid was not tapered down because of the recurrence of symptoms. He was admitted with a diagnosis of acute appendicitis, and underwent appendectomy. Two months after the appendectomy, clinical symptoms and colonoscopic findings improved gradually. Two years after the appendectomy, the patient improved without the recurrences of symptoms, and is stably treated with sulfasalazine alone.
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PMID:[Clinical improvement of severe ulcerative colitis after incidental appendectomy: a case report]. 1680 55

Appendectomy is associated with a reduced risk of developing ulcerative colitis (UC). In addition, there may be appendicular involvement in UC in patients with extensive or even left-sided disease. However, no data are available on the incidence, clinical presentation and outcome of acute appendicitis in patients previously diagnosed with UC. The impact of appendectomy in this subset of patients also remains to be determined. We describe 2 cases of acute appendicitis in the setting of inactive extensive ulcerative colitis and compare their histologic features with those of the surgical specimens of 2 further UC patients colectomized for refractory and extensive disease.
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PMID:[Acute appendicitis in inactive extensive ulcerative colitis]. 1733 13

Although the appendiceal orifice is routinely identified during a total colonoscopic examination, there are only a few reports in the English literature describing abnormalities in this region. Many recent case reports have described endoscopic features of various appendiceal pathologies. In order to increase the awareness as well as facilitate the recognition of these uncommon encounters a review of the literature on the endoscopic features of various appendiceal problems is provided. The most frequently reported abnormalities are related to appendiceal neoplasms or intussusception. Interesting observations and new features of appendiceal regional abnormalities in acute appendicitis and ulcerative colitis are being described. Importance of appendiceal involvement in ulcerative colitis is of interest in particular. This may have impact on the disease prognosis and management. The knowledge of the emerging role of colonoscopy in the diagnosis and management of complicated appendicitis might encourage a more aggressive non-operative approach in some of these cases. Recognition of rare entities requires knowledge of their endoscopic appearance. Awareness of these new developments is essential for all endoscopists performing routine colonoscopic examination. In order to detect any abnormality, the appendiceal orifice should be carefully inspected during all routine colonoscopic examinations. This systematic approach may eventually result in more frequent pre-operative diagnosis of appendiceal problems.
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PMID:Diseases of the appendix recognized during colonoscopy. 1986 90

The inverse correlation of appendectomy and ulcerative colitis is well known, but the effect of appendectomy on the clinical course of ulcerative colitis remains unclear. Although the majority of opinions were negative for the therapeutic advantage of appendectomy in patients with ulcerative colitis, advocates for positive effect of appendectomy have been proposed in a few case reports and a prospective study from Western countries. We herein report a case of ulcerative colitis who experienced clinical remission after appendectomy for acute appendicitis. The patient was 35 year old male and had been managed with immunosuppressant before appendectomy. The very acute change in clinical course and a long period of remission after appendectomy highly suggest the therapeutic effect of appendectomy for ulcerative colitis.
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PMID:[Remission of ulcerative colitis after appendectomy: a case report]. 2084 11

Complications due to diagnostic colonoscopy are uncommon and acute appendicitis is a very rare complication of colonoscopy. This poses a diagnostic challenge as the presentation of appendicitis is similar to that of other complications of colonoscopy such as perforation or postpolypectomy syndrome. It is hypothesized that postcolonoscopy appendicitis might be associated with obstruction of the appendiceal lumen with fecal matter during colonoscopy. None of the previous reports in the literature have described findings of appendicitis after colonoscopy in a patient with active ulcerative colitis. We present a case of a 28 year-old man with active ulcerative colitis who underwent colonoscopy and subsequently developed acute appendicitis.
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PMID:Postcolonoscopy appendicitis in a patient with active ulcerative colitis. 2116 Sep 39

Fas-mediated induction of apoptosis is a major factor in the selection of lymphocytes and downregulation of immunological processes. In the present study, we have assessed endothelial Fas-ligand (FasL) expression in normal human ileum, appendix, and colon, and compared the expression levels with that in inflammatory bowel disease and in acute appendicitis. In a normal appendix, endothelial FasL levels were constant in almost half of the mucosal vessels; but, in the normal ileum and colon, endothelial FasL was practically restricted to areas in close proximity to lymphatic follicles, and was expressed mainly in the submucosal aspect of the follicles in the vessels with high endothelium. In samples from subjects with either Crohn's disease or ulcerative colitis, the extent of endothelial FasL expression was elevated in the submucosa and associated with an elevated number of lymphoid follicles. In inflammatory bowel disease, ulcers and areas with a high density of mononuclear cells expressing FasL also showed an elevated density of blood vessels with endothelial FasL expression. Although the function of endothelial FasL remains unclear, such a specific expression pattern suggests that endothelial FasL expression has a role in the regulation of lymphocyte access to the peripheral lymphoid tissues, including the intestinal mucosa.
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PMID:Endothelial Fas-Ligand in Inflammatory Bowel Diseases and in Acute Appendicitis. 2637 30


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