摘要:

PURPOSE:The aim of this study was to assess whether systemic proinflammatory cytokines (IL‐6), anti‐inflammatory cytokines (IL‐4, IL‐10), acute phase proteins (C‐reactive protein), or granulocyte elastase are valuable indicators for determining the degree of surgical trauma after openvs.laparoscopic‐assisted resections in Crohn's disease.METHOD:Eleven patients in each group (open and laparoscopic‐assisted surgery) were matched for indication, surgical procedure, and Crohn's disease activity index. Serum IL‐4, IL‐6, and IL‐10 were measured using enzyme‐linked immunosorbent assay. Serum C‐reactive protein was determined by immunoturbidimetric assay. Plasma granulocyte elastase was determined by immunoactivation immunoassay. Blood was sampled preoperatively, six hours after the operation, and at postoperative Days 1 to 5.RESULTS:IL‐4 was not detectable in any sample analyzed. Serum IL‐6 and IL‐10 levels peaked postoperatively in both groups without significant differences between laparoscopic‐assisted (185.6±54.1 pg/ml and 112.1±19.4 pg/ml, respectively; mean ± standard error of the mean) and open surgery (431.1±240.4 pg/ml and 196.7±56.5pg/ml, respectively). Serum C‐reactive protein levels also rose postoperatively, with a peak on the second day, but showed similar values after laparoscopic‐assisted (107.1±12.1 mg/l) and open (128.3±17.5 mg/l) surgery. Plasma granulocyte elastase levels peaked on the first and second postoperative day and were found elevated almost throughout the five‐day observation period. Comparison between the groups revealed significantly (P<0.02) lower values after laparoscopic‐assisted (Day 1, 46.5±8.9 &mgr;g/l; Day 2, 41.9±5.9 &mgr;g/l) when compared with open surgery (Day 1, 89.7±13.8 &mgr;g/l; Day 2, 91.4±14).CONCLUSIONS:Serum IL‐6 and IL‐10 may not be ideal measures for evaluation of the degree of tissue trauma in laparoscopic‐assisted and open resections in Crohn's disease, probably because of interference with disease‐specific cytokine interactions. In contrast, granulocyte elastase has to be considered a strong marker discriminating the different severity of surgical trauma induced by laparoscopic‐assistedvs.open resection in Crohn's disease.

ISSN:0012-3706    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

PURPOSE:Many data suggest in irritable bowel syndrome a generalized smooth‐muscle disorder, but data are scant concerning anal waves in patients with irritable bowel syndrome. The aim of the present study was first to propose a new method of anal pressure‐wave analysis and second to apply this method to patients with irritable bowel syndrome.METHODS:Spectral analysis was used in 20 healthy controls and 60 patients with irritable bowel syndrome to investigate anal pressure waves at rest during a standard anorectal test and during a maintained 12‐ml anal distention.RESULTS:Adaptation of the anal canal to maintained distention was similar in the two groups of subjects. Using a cluster analysis, three groups of anal waves were defined (in cycles per minute): ultra slow waves (0.9‐3.3), slow waves (3.8‐16.4), and simple waves (16.9‐23). In the resting state only simple waves were found less prevalent in patients with irritable bowel syndrome. During maintained distention, ultra slow waves increase in both groups, but slow waves increase in patients with irritable bowel syndrome and simple waves decrease in controls.CONCLUSIONS:Characterization of anal pressure waves is a simple procedure that is easy to perform in outpatients. Anal pressure waves of patients with irritable bowel syndrome have altered organization and respond differently to distention as compared with controls.

ISSN:0012-3706    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

&NA;Inflammatory involvement of the inferior mesenteric vein complicating sigmoid diverticulitis resulted in septic thrombophlebitis and the presence of gas within the inferior mesenteric vein. Gas within the mesenteric and portal veins is an infrequent and relatively nonfatal complication of diverticulitis and can be recognized readily on CT scan.

ISSN:0012-3706    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

&NA;This case report describes a patient who was previously prescribed alendronate (Fosamax®) and presented with postoperative hypophosphatemia and hypocalcemic tetany after bowel preparation with Fleet® Phospho®‐Soda. This report suggests that patients taking bone metabolism regulators may not be able to respond appropriately to hypocalcemic stressors.

ISSN:0012-3706    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

PURPOSE:This study was undertaken to demonstrate that quinolones may cause acute colitis resembling penicillin‐induced hemorrhagic colitis.METHODS:We reviewed the medical records of patients with acute colitis in our institutes. Twenty‐eight patients with acute hemorrhagic colitis in which no pathogenic microorganisms were identified were the subjects of this study. Pseudomembranous colitis caused byClostridium difficilewas excluded. Ulcerative colitis, Crohn's disease, and radiation proctocolitis were also excluded.RESULTS:Among these patients, 25 had a history of recent administration of penicillin derivatives. The remaining three patients had never been given any penicillin derivatives, but had ingested quinolones approximately four weeks before the developing colitis had been identified.Klebsiella oxytocawas also isolated in these three patients.CONCLUSIONS:Quinolones may cause acute hemorrhagic colitis. The time interval from antibiotic ingestion to onset of the condition may be much longer in quinolones than in penicillin derivatives.

ISSN:0012-3706    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

&NA;The use of mesh repairs in parastomal hernias has recently been the subject of controversy. We describe a modified Thorlakson technique that incorporates an incomplete circumferential mesh to reinforce the fascial repair. In this preliminary report five cases have been operated on without any serious complications. A comprehensive literature review found that a total of 72 cases have been reported by various authors. Failure rates caused by recurrence or meshrelated sepsis amounted to 8.3 percent. In comparison with results for stoma relocations and nonprostheticin‐situfascial repairs, mesh repairs have the lowest recurrence rates.

ISSN:0012-3706    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1999

数据来源: OVID