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  • 1
    ISSN: 1530-0358
    Keywords: Ileal reservoir ; Kock continent ileostomy ; Pouchitis ; Ulcerative colitis ; Crohn's disease ; Familial adenomatous polyposis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: This study was undertaken to assess the electron microscopic and microbiologic findings in tissue biopsy samples from patients with pouchitis and to compare them with findings in patients with normal pouches, conventional ileostomies, and normal ileum. METHODS: Tissue samples were obtained from 78 patients: 23 patients with normal pouches endoscopically and histologically (Group 1), 12 patients with endoscopic and histologic evidence of inflammation (pouchitis) (Group 2), 14 patients who had either endoscopic or histologic evidence of inflammation but not both (Group 3), 20 patients with conventional ileostomies (Group 4), and 9 patients without ileostomies from whom biopsy samples of normal ileum were obtained (Group 5). RESULTS: The mean total aerobic facultative counts in the biopsy samples from the pouchitis patients were significantly higher when compared with biopsy samples from Groups 4 and 5 ( P 〈0.05). There were no significant differences in the mean anaerobic counts among the five groups. Positive cultures were obtained in 90 percent of patients with pouches compared with 69 percent of patients with conventional ileostomies or normal ileum ( P 〈0.05). Intramural bacteria were observed on electron microscopy in biopsy specimens of 47 percent patients with pouches compared with 14 percent of patients with conventional ileostomies or normal ileum ( P 〈0.05). However, the proportion of patients with positive cultures or intramural bacteria was not increased in the pouchitis group compared with the normal pouch group. CONCLUSION: These data suggest that intramural aerobic facultative bacterial counts are elevated in patients with pouchitis and may play a role in the pathogenesis of pouchitis.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Diseases of the colon & rectum 33 (1990), S. 869-873 
    ISSN: 1530-0358
    Keywords: Crohn's disease ; Pregnancy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Seventy-eight pregnancies in 50 patients were reviewed to evaluate the effects of Crohn's disease on the outcome of pregnancy and the influence of the pregnancy on the course of Crohn's disease. Overall, 21 pregnancies (27 percent) had abnormal outcomes including spontaneous abortions (9), infants small for gestational age (6), premature infants (5), and infants who developed respiratory distress (1). Eight (50 percent) patients with active disease compared with 13 (21 percent) patients with inactive disease at conception had abnormal outcomes (P 〈0.05). During pregnancy 15 (55 percent) with active disease and 6 (12 percent) with inactive disease had an abnormal outcome (P 〈0.001). Neither medical nor surgical treatment, independent of disease activity, appeared to affect the outcome adversely. Eighteen of 73 (25 percent) patients with quiescent or mild disease relapsed, and seven of 16 patients with some disease activity improved (44 percent). Of 34 patients on medication, nine relapsed (27 percent), and of 39 patients not on medication, nine relapsed (24 percent) (P=N.S.). These results suggest that the outcome of pregnancy is not adversely affected by Crohn's disease. However, patients with active disease at conception and/or during the pregnancy have poorer outcomes independent of the use of medication or requirement of surgery. Neither pregnancy nor medications taken affect the course of the disease.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1530-0358
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1530-0358
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    International journal of colorectal disease 6 (1991), S. 29-32 
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Bien que l'étude scintigraphique de la vidange des poches pelviennes ait été utilisée pour évaluer la fonction du néorectum chez les patients qui ont subi une colectomie ou une proctectomie muqueuse et une anastomose iléo-anale avec réservoir, les études précédentes n'ont pas étudié la valeur de ce test pour mesurer le volume de la poche et sa vidange. Cette étude a donc été entreprise pour déterminer: (1) la valeur de la méthode chez les patients avec un résultat fonctionnel stable: (2) si une vidange fractionnée est corrélée avec le volume de la poche. 10 patients ayant un résultat fonctionnel stable ont eu à deux reprises à une semaine d'intervalle une scintigraphie au technecium 99. Le volume moyen des selles artifielles instillées était de 338±104 CC. La différence moyenne de volume instillé entre le premier et le deuxième scan était de 78±26 CC et la différence moyenne absolue du pourcentage évacué était de 12±9%. Cette différence entre les deux examens n'était pas statistiquement significative (p〉0.05). Il n'y avait pas de corrélation significative entre le volume des selles artificielles instillées dans la poche pelvienne et la fraction spontanément évacuée (r=-0.1). Le résultat suggère que la scintigraphie au technécium 99 de la vidange d'une poche pelvienne est valable chez les patients qui ont un résultat fonctionnel stable. La quantité de matières évacuée est indépendante du volume de la poche.
    Notes: Abstract Although scintigraphic pelvic pouch emptying scans have been used to evaluate neorectal function in patients who have undergone colectomy, mucosal proctectomy, and ileoanal pouch anastomosis, previous reports have not documented the reliability of this test in measuring pouch volume and emptying. Thus, this study was undertaken to determine: (1) the reliability of this test in patients with stable functional results and, (2) whether the emptying fraction correlates with the volume of the pouch. Ten patients who had stable functional results had 99m Tc-sulphur colloid pouch emptying scans performed on two occasions, one week apart. The average volume of artificial stool that was instilled was 338±104 cc. The mean difference in the volume instilled between the initial and repeat scans was 78±26 cc and the mean absolute difference in the percentage evacuated was 12±9 percent. These inter-test differences were not statistically significant (p〉0.05). There was no correlation between the volume of artificial stool instilled into the pelvic pouch and the fraction spontaneously emptied (r=-0.1). Our results suggest that the 99m Tc-sulphur colloid pelvic pouch emptying scan is reliable in patients with stable functional results. Pouch emptying fraction is independent of pouch volume.
    Type of Medium: Electronic Resource
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