Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0699790 (colon cancer)
 28,837 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic parastomal ulcers in patients with ileostomy or colostomy stomas are unusual. Previous reports have implicated infections, fistulas, recurrent inflammatory bowel disease (IBD), pyoderma gangrenosum, and trauma. Over the past 8 years we have evaluated 10 cases of such refractory parastomal ulcers that occurred at a mean of 11 years after stomal surgery. Eight patients had had an ileostomy for IBD while two had undergone colostomy for colon cancer. Five patients with IBD were diagnosed as having pyoderma gangrenosum ulcerations. They required systemic treatment for a mean of 25 weeks to effect ulcer healing. The other five patients had either parastomal ulcers on the basis of dermatoses (contact dermatitis, eczema, or bullous pemphigoid) or contact ulcers due to face-plate pressure and parastomal dermatitis. These patients received topical treatment with healing of ulcers in a mean of 4 weeks. We conclude that parastomal ulcers occurring in patients without IBD or IBD patients without classic pyoderma gangrenosum require early dermatologic evaluation as they respond relatively quickly to appropriate local therapy.
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PMID:Refractory parastomal ulcers: a multidisciplinary approach. 197 85

Many patients who present with acute or chronic diarrhea do not have an important organic disease. Most have functional diarrhea. The history, clinical examination, and initial laboratory studies should lead to a provisional diagnosis with respect to organic or functional origin and help define whether the disease affects the small or large intestine. Specific studies are then obtained to define organic causes. The most common causes of acute diarrhea are infections and drugs, while the most common causes of chronic diarrhea are inflammatory bowel disease, malabsorption, parasitic infections, carcinoma of the large bowel, and metabolic diseases. Clinicians should remember that patients with functional diarrhea are as prone to other severe disease as the rest of the population and avoid allowing the functional problem to mask other signs.
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PMID:Diagnosis and therapy of acute and chronic diarrhea. 231 56

Monoclonal antibody (MAb) B72.3 reactive with the high-molecular-weight (Mr greater than 10(6) tumor-associated glycoprotein (TAG)-72 is being increasingly utilized in vivo and in vitro for a variety of purposes in colon cancer patients. Recent evidence has suggested that the TAG-72 antigen expression may be enhanced in inflammatory bowel disease, particularly ulcerative colitis (Thor et al., 1986a: Cancer Res., 46, 3118-3124). We have utilized 117 paraffin-embedded formalin-fixed colonic specimens from 56 ulcerative colitis patients which demonstrate a spectrum of epithelial abnormalities (reactive atypia, dysplasia, and carcinoma) as well as 11 inflammatory controls to evaluate TAG-72 expression. Our selected patient population all had pan-colitis and demonstrated a generally increasing incidence of dysplasia or carcinoma with duration of disease (20% at 0 to 10 years, 50% at 11 to 20 years, 59% at 21 to 30 years, and 100% at more than 31 years). TAG-72 expression was similar in the control and non-dysplastic colonic epithelia, and increased with low- or high-grade dysplasia as well as carcinomatous lesions (mean cellular reactivities 23.7%, 26.5%, 36.7%, 70% and 84.3%, respectively). Epithelium with low-grade dysplasia exhibited a focal perinuclear, superficial crypt staining (when present). High-grade dysplastic epithelium showed pancytoplasmic, pan-cryptic reactivity. Invasive disease showed cytoplasmic as well as extracellular mucin staining. Biopsies from patients with active disease showed significantly more immunoreactive cells for TAG-72 than patients with quiescent disease. For any given biopsy specimen the percentage of cells reactive did not always correlate with the degree of dysplasia. TAG-72 expression in quiescent disease generally increased with duration of disease, in contrast to active disease which showed no correlation between MAb B72.3 staining and duration of disease. The frequent expression of TAG-72 in actively inflamed colonic mucosa (ulcerative colitis and other colitides) may limit the clinical utility of this antigen for detecting colon cancer in ulcerative colitis patients by serological assay or in vivo radiolocalization techniques. The tendency for TAG-72 expression to correlate with disease duration in patients with quiescent disease and to increase with more severe degrees of dysplasia suggests that the expression of this gene product correlates with the dysplasia-to-carcinoma sequence.
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PMID:Tumor-associated glycoprotein (TAG-72) expression in ulcerative colitis. 265 25

We compared the rectal microflora of 16 patients with surgically excluded colorectum with 16 healthy controls. The cause of diversion was inflammatory bowel disease (n = 10), colon cancer (n = 3), miscellaneous (n = 3). Six patients had a diversion colitis. In the excluded colorectum, the total bacterial count was only slightly lower than controls but the variety of the flora was significantly reduced. This reduction was confined to strict anaerobes, mainly the genus Eubacterium and Bifidobacterium. Among aerobes, enterobacteria were more often isolated than in controls. This altered microflora of excluded colorectum could be involved in the mucosal damage observed in some cases.
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PMID:Impaired bacterial flora in human excluded colon. 276 6

Patients with total long-standing mucosal ulcerative colitis are at an increased risk of developing carcinoma of the colon or rectum. Recently it has been suggested that cytological examination of the colon may play an important role in the examination of these patients. The present study was undertaken in order to determine the malignancy/severe dysplasia rate in our patients and to examine the role of cytology in comparison with mucosal biopsy in the detection of mucosal abnormality. Three patients had severe dysplasia in the absence of active inflammation (7.1%). Fifty-four patients were examined concurrently by histology and cytological brushing and at least seven specimens were obtained from each patient. Cytological examination detected active mucosal inflammation more often than histological examination at all sites in the colon. There was good agreement between the cytologists' evaluation, routine histopathological examination and endoscopic evaluation of the colorectal mucosa, although the latter tended to underestimate the degree of active inflammation. It was concluded that, since there was no real improvement in sampling by brush cytology, there may be little advantage in supplementing routine biopsy with brush cytology in patients with long-standing inflammatory bowel disease.
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PMID:Colonoscopy, mucosal biopsy and brush cytology in the assessment of patients with colorectal inflammatory bowel disease. 281 78

Hyperplastic colonic polyps are generally regarded as being of little or no clinical consequence. Recently, however, hyperplastic polyps have been found to share numerous functional similarities with colorectal carcinoma. To determine whether the presence of an isolated left-sided colonic hyperplastic (metaplastic) polyp could serve as a marker for more proximal synchronous adenomatous colonic polyps, we retrospectively analyzed all consecutive colonoscopic polypectomies performed over an 18-month period at two medical centers. It is the policy at both institutions to remove or biopsy all polyps, regardless of size. Indications for colonoscopy included known or previous colonic polyps or carcinoma, hemoccult positive stool, lower gastrointestinal bleeding, iron deficiency anemia, abnormal barium enema, inflammatory bowel disease, abdominal pain, and family history of colon cancer. The location of adenomatous polyps and hyperplastic polyps was recorded and compared. One hundred sixty-three of 845 consecutive patients (19.3%) had at least one colonic polyp. The prevalence of adenomatous polyps alone was 10.3%, hyperplastic polyps 9%, and both types 1.9%. The prevalence rate for an adenomatous polyp in patients without a hyperplastic polyp was 15%. In contrast, among patients with a hyperplastic polyp, 49% had a synchronous adenomatous polyp. Only 3.4% of patients had an adenomatous polyp proximal to the splenic flexure when no polyps were present in the left colon. Conversely, among the 29 patients in whom an isolated hyperplastic polyp was found in the left colon, there was a 32.5% prevalence of adenomatous polyps in the proximal colon (p less than 0.01). The results of this study suggest that left-sided hyperplastic colonic polyps (generally within the reach of a screening sigmoidoscopy) serve as a marker for neoplastic polyps.
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PMID:Hyperplastic colonic polyps as a marker for adenomatous colonic polyps. 291 17

A simple test for collagenase activity was performed on colonic mucosa specimens of 35 patients with inflammatory bowel disease, 7 patients with carcinoma of the colon, 3 with benign polyps, and 34 normal subjects. Increased collagenase activity was present in 94.2% of the specimens taken from the inflamed mucosa and 71.4% of those obtained from colonic carcinoma, as compared to 8.8% of the control group.
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PMID:Collagenase activity in colonic mucosa during inflammatory bowel disease. 303 75

Until a medical cure for ulcerative colitis is available, it is up to the surgeon to provide a solution. With the wealth of experience now available, the operation of ileal pouch with anal anastomosis must be considered as an option in treating the young or well-motivated patient. Screening of families in whom polyposis coli has been found can prevent colon cancer developing. For this group of patients, who may be totally asymptomatic, to be able to offer a reconstructive operation may make it easier for such patients to accept colectomy. The value of consultation between medical and surgical gastroenterologists in order to time surgery is vital, and an exact histologic diagnosis in inflammatory bowel disease may prevent the potential disaster of constructing an ileal pouch in a patient with Crohn's disease. The construction of a pouch is not difficult, being made up of several familiar surgical steps in an unfamiliar setting. However, it is a long operation, frequently taking more than 4 hours, and mucosal protectomy can be rather awkward. For these reasons and the problems with patient counseling, we believe ileal pouch with anal anastomosis operations should be performed at referral centers. We still have to decide on the best type of pouch to use, but it is encouraging that better antibiotics, safer anesthesia, and new techniques such as the intraluminal bypass tube and rectal sleeve dissection have helped to make this operation more successful for a greater number of patients.
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PMID:Ulcerative colitis and polyposis coli. Surgical options. 305 62

The impact of the pre-operative nutritional and clinical state on post-operative morbidity and mortality is not fully known and the effect of total parenteral nutrition (TPN) on the postoperative complication rate has not been established. We have investigated the effects of postoperative TPN on the complication rate in 92 patients after major colorectal surgery for carcinoma of the large bowel or inflammatory bowel disease in a controlled, randomised study. The complication rate was analysed against seven commonly used nutritional (biochemical and anthropometric) variables and against the diagnosis, clinical inflammatory activity and presence of pre-operative septic complication. Patients were randomly allocated to postoperative TPN or conventional fluid and electrolyte support. The results show no correlation between the complication rate and the nutritional and clinical state of the patients as assessed pre-operatively. The complication rate was not significantly reduced by postoperative TPN. This study indicates that biochemical and anthropometric nutritional variables do not identify patients at risk to develop postoperative complications. The presence of pre-operative complications showed a marginal correlation with postoperative morbidity, in agreement with previous experience. The result of this study obviates the use of TPN in routine postoperative care.
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PMID:Postoperative complications in colorectal surgery in relation to preoperative clinical and nutritional state and postoperative nutritional treatment. 311 97

The sample population in this initial case control study of the adenosine diphosphate ribosyl transferase (ADPRT) response of inflammatory bowel disease patients included: 23 patients with ulcerative colitis (UC)-active and inactive, 13 patients with Crohn's disease (CD)-active and inactive, 14 first degree relatives of UC and CD patients, and 19 age-matched controls. Adenosine diphosphate ribosyl transferase activity was determined after one hour incubation with 1% plasma (the constitutive value) or with 1% plasma and 100 microM H2O2 (the activated value) with the resulting difference designated as the induced value. Statistically significant decrease in ADPRT activity was found for the constitutive, activated and induced values in human mononuclear leucocytes of UC and CD patients, compared with controls. The values in the first degree relatives of UC and CD patients were not significantly different from either the control or disease populations, indicating an intermediate ADPRT response. These results may be related to the nature of the immunological response of IBD patients and comparable with similar findings in other diseases with known DNA repair deficiencies--for example, colon cancer.
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PMID:Hydrogen peroxide induced adenosine diphosphate ribosyl transferase (ADPRT) response in patients with inflammatory bowel disease. 314 30


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