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  • 1
    Electronic Resource
    Electronic Resource
    Evaluation of Crohn disease activity with magnetic resonance imaging (2000)
    Springer
    Abdominal imaging 25 (2000), S. 219-228 
    Details
    ISSN: 1432-0509
    Keywords: Key words: Magnetic resonance imaging—Crohn disease—Crohn disease activity.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The purpose of this study was to assess the accuracy of magnetic resonance imaging (MRI) in evaluating Crohn disease (CD) activity. The intestinal inflammatory activity is usually present in patients under pharmacologic treatment, despite their clinical remission. Methods: Twenty patients with CD, all under pharmacologic treatment, were prospectively studied by MRI at 1.5 T as a periodic control. Positivity of three acute-phase reactants was considered an index of biologic activity (BA). T2-weighted, T2-weighted fat-suppressed turbo spin-echo, and breath-hold T1-weighted turbo field-echo sequences, before and after gadolinium intravenous injection, were obtained. A negative superparamagnetic contrast agent was orally administered. The following MRI parameters were qualitatively evaluated by three radiologists at the level of the affected bowel and compared with clinical data: wall thickness (WT), wall T2-weighted signal (T2W), wall contrast enhancement (WE), amount of fibrofatty proliferation (FP), and T2-weighted signal of fibrofatty proliferation on fat-suppressed images (T2FP). The κ coefficient of agreement was calculated. The Spearman rank correlation was used for the analysis of clinical and radiologic data. Results: Nineteen of 20 patients were in clinical remission (Crohn Disease Activity Index 〈 150). On the basis of laboratory tests, nine of 20 patients had biologically active disease. An excellent correlation was found between BA and WE, T2W, and T2FP (0.900, 0.927 and 0.961, respectively; p 〈 0.0001), and a lower correlation was found between BA and WT and between BA and FP (0.78 and 0.62). Excellent statistical correlation was also found between WE and T2W and between WE and T2FP (0.876 and 0.892). Conclusions: An excellent statistical correlation was found between biologically “active” disease and the following MRI parameters: wall gadolinium enhancement, wall hyperintensity on T2-weighted fat-suppressed images, and hyperintensity of fibrofatty proliferation on T2-weighted fat-suppressed images. Therefore, MRI can be valuable in assessing CD activity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002610000004
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  • 2
    Electronic Resource
    Electronic Resource
    Two mesalazine regimens in the prevention of the post-operative recurrence of Crohn's disease: a pragmatic, double-blind, randomized controlled trial (2003)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 17 (2003), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : The role of mesalazine in preventing the clinical recurrence of Crohn's disease after surgery has been shown in a meta-analysis of all published studies. No clear relationship, however, has been shown between dosage and response.Aim : To evaluate whether 4.0 g/day of mesalazine may offer therapeutic advantages over 2.4 g/day in the prevention of both endoscopic and clinical post-operative recurrence of Crohn's disease.Methods : The study was a double-blind, randomized, multi-centre, prospective, controlled clinical trial. Two hundred and six patients, submitted to first or second intestinal resection for Crohn's disease limited to the terminal ileum, with or without involvement of the caecum/ascending colon, were enrolled. Of these, 101 were randomly allocated to receive 4.0 g/day of mesalazine (Asacol, Giuliani SpA, Milan, Italy) and 105 to receive 2.4 g/day, starting 2 weeks after surgery. The primary outcome was endoscopic recurrence, at 12 months after surgery. Three different degrees of endoscopic recurrence were evaluated (endoscopic scores: 〉 0, 〉 1 and 〉 2). The secondary outcome was clinical recurrence, defined as a Crohn's disease activity index of more than 150 points or an increase in the Crohn's disease activity index of 100 points or more. For statistical analysis, chi-square, Wilcoxon and Cox regression model tests were used, when appropriate.Results : Eighty-four patients in the 4.0 g/day group and 81 patients in the 2.4 g/day group were evaluable by endoscopy. Endoscopic recurrence of 〉 0 was significantly higher in the 2.4 g/day group than in the 4.0 g/day group (62% vs. 46%; P 〈 0.04). No difference was observed between the two groups with regard to the other two endoscopic outcomes (〉 1 and 〉 2) or clinical recurrence.Conclusions : A 4.0 g/day regimen of mesalazine does not offer a clinically significant advantage over a 2.4 g/day regimen in the prevention of post-operative endoscopic and clinical recurrence of Crohn's disease at 1 year of follow-up.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2003.01462.x
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  • 3
    Electronic Resource
    Electronic Resource
    Short-chain fatty acid topical treatment in distal ulcerative colitis (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 9 (1995), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Some evidence indicates that short-chain fatty acid (SCFA) enemas are effective in the treatment of distal ulcerative colitis. Methods: In a randomized, double-blind, placebo-controlled study, we tested the efficacy of a 6-week course of topical SCFA (100 mL, twice daily enemas of sodium acetate 80 mmol/L, sodium propionate 30 mmol/L and sodium butyrate 40 mmol/L) in 40 patients with mild to moderate distal colitis. Clinical, endoscopic and histological data were collected at the beginning and end of the study. Results: Fourteen patients on SCFA improved (overall score 11.3 ± 2.0 vs. 7.4 ± 3.5) as compared to five in the placebo group (overall score 10.0 ± 1.9 vs. 8.9 ± 2.5). In the SCFA-treated group all parameters significantly improved except the number of bowel motions, whereas no significant changes were recorded in the control group. A statistically significant difference between the two treatment regimens, however, was observed only for intestinal bleeding (P 〈 0.05), urgency (P 〈 0.02) and the patient self-evaluation score (P 〈 0.05). This was probably due to the random inclusion of more patients with moderate disease into the SCFA-treated group, thus causing pre-trial differences between the two groups. Conclusion: the present study confirms that irrigation with SCFA enemas is effective in distal colitis, and may represent an alternative therapeutic tool in the treatment of the disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.1995.tb00386.x
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  • 4
    Electronic Resource
    Electronic Resource
    Oral mesalazine (5-aminosalicylic acid; Asacol) for the prevention of post-operative recurrence of Crohn's disease (1994)
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 8 (1994), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Methods: A multicentre randomized controlled trial was conducted to evaluate the efficacy of oral mesalazine (5-aminosalicylic acid) for the prevention of post-operative recurrence in 110 patients operated on for Crohn's disease by first intestinal resection. Patients were randomly allocated to receive 2.4 g/day of mesalazine, or no treatment at all. The protocol included colonoscopy with ileoscopy at 6 months and yearly thereafter. Recurrence was denned on the basis of endoscopic criteria and classified as mild or severe. Results: The demographic and pre-trial characteristics were very similar in the two groups of patients. The cumulative proportion of recurrence at 6, 12 and 24 months was significantly lower in the mesalazine group than in untreated group (P= 0.002). At 24 months the cumulative proportions of endoscopic recurrence were 0.52 + 0.12 (± S.E.M.) and 0.85 (±0.07), respectively. At the same time the cumulative proportions of symptomatic recurrence were 0.18 + 0.09 and 0.41 + 0.09 (P= 0.006). The cumulative proportions of the severe recurrence was also significantly lower in the mesalazine group (0.17±0.09 vs. 0.38±0.09; P= 0.021). Conclusions: The preliminary results of this study show that administration of oral mesalazine soon after surgery is effective in preventing post-operative endoscopic recurrence in Crohn's disease over a 2-year period. It is estimated that this treatment prevents 39% of all recurrences and 55% of the severe recurrences.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.1994.tb00158.x
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  • 5
    Electronic Resource
    Electronic Resource
    Infliximab in refractory pouchitis complicated by fistulae following ileo-anal pouch for ulcerative colitis (2003)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 17 (2003), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim:  To determine the efficacy of infliximab in the treatment of chronic refractory pouchitis complicated by fistulae following ileal pouch-anal anastomosis for ulcerative colitis.Methods:  This open study included seven patients (four females, three males) with chronic refractory pouchitis complicated by fistulae. Pouchitis was diagnosed by clinical, endoscopic and histological criteria. The sites of the fistulae were as follows: pouch-bladder in one, vaginal in three, perianal in two, and both vaginal and perianal in one. Extra-intestinal manifestations (erythema nodosum, arthralgia) were present in four patients. Crohn's disease was carefully excluded in all patients after re-evaluation of the history, re-examination of the original proctocolectomy specimen and examination of the proximal small bowel. All patients had been treated with antibiotics and three with steroids. Patients received infliximab, 5 mg/kg, at 0, 2 and 6 weeks. Azathioprine (2.5 mg/kg) was also started for all patients as bridge therapy. Clinical response was classified as complete, partial or no response. Fistulae closure was classified as complete (cessation of fistulae drainage and total closure of all fistulae), partial (a reduction in the number, size, drainage or discomfort associated with fistulae) or no closure. The pouchitis disease activity index and quality of life were also used as outcome measures.Results:  Clinically, all patients improved. At the 10-week follow-up, six of the seven patients had a complete clinical response, and five had complete fistulae closure. At the 10-week follow-up, the median pouchitis disease activity index decreased from 12 (baseline) (range, 10–15) to 5 (range, 3–8); the median quality of life decreased from 37 points (range, 33–40) to 14 (range, 9–18). Erythema nodosum and arthralgia showed complete remission soon after the first infusion of infliximab.Conclusions:  These preliminary results indicate that infliximab may be recommended for the treatment of refractory pouchitis complicated by fistulae following ileal pouch-anal anastomosis for ulcerative colitis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2003.01535.x
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  • 6
    Electronic Resource
    Electronic Resource
    Biological agents in the treatment of Crohn's disease (2002)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 16 (2002), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The main aim of the management of Crohn's disease is to reduce inflammation. Current approaches with corticosteroids, immunosuppressive agents, mesalazine and antibiotics have limited therapeutic benefit for many patients. Considerable progress has been made with regard to our knowledge of the basic mechanisms of the disease, which is associated with immunological imbalance characterized by an excess of pro-inflammatory cytokines.Recent advances in bio-technology have led to the development of many new therapeutic agents, so-called biological agents, which selectively target single key processes involved in the pathogenesis of the disease. A growing number of biological agents are under investigation in both randomized controlled trials and uncontrolled studies. The aim of this review is to provide the clinician with an insight into the randomized controlled trials published in the literature on the use of biological agents in the treatment of Crohn's disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2002.01319.x
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  • 7
    Electronic Resource
    Electronic Resource
    Characterization of the mucins produced by normal human colonocytes in primary culture (1996)
    Springer
    International journal of colorectal disease 11 (1996), S. 76-83 
    Details
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Des cellules caliciformes matures remplies de mucine prêtes à la sécrétion constituent environ 1/3 de toutes les cellules dans des cultures primaires de colonocytes humains. Au cours de l'étude présente, les mucines produites par des cultures de colonocytes humains ont été typisées par des méthodes histochimiques, par liaison à la lectin et à des anti-corps monoclonaux. Deux anti-corps monoclonaux et trois types de lectin Dolichos biflorus (DBA), Helix pomatio (HPA) et Arachis hypogea (PNA) susceptibles de reconnaïtre les épitopes ou les haptènes d'hydrate de carbone caractéristiques de différentes phases de la maturation des glycoprotéines des mucines ont été emplyés. Les réactivités à ces substances ont été testéees à la fois sur des cultures de colonocytes et sur des segments de tissu muqueux coliques normaux. Les résultats montrent que les mucines produites en culture sont glycosylées dans les formes matures car elles présentent la même réactivité aux lectins et aux anti-corps des mucines tels que mesurés dans des segments de tissue de muqueuse colique normale. De plus, on a démontré que les colonocytes humains cultivés ne produisent pas de mucine réactive au PNA qui sont caractéristiques des tumeurs. Etant donné que les colonocytes humains cultivés conservent l'expression d'une différenciation des fonctions pour au moins trois jours, ils peuvent constituer un modèle utile pour étudier le métabolisme de la fonction et de la régulation des mucines coliques chez le sujet sain et pathologique.
    Notes: Abstract Mature goblet cells filled with mucin ready for secretion represent about one third of the cells in primary cultures of human colonocytes. In the present study characterization of the mucins produced by cultured human colonocytes was made by histochemical methods by lectin and monoclonal antibody binding. Two monoclonal antibodies and three lectinsDolichos biflorus (DBA),Helix pomatia (HPA) andArachis hypogea (PNA) recognizing epitopes or sugar haptens characteristic of different stages of mucin glycoprotein maturation, were employed. The reacivity to these probes was tested both on cultured colonocytes and on tissue sections of the normal colon mucosa. The results show that the mucins produced in culture are glycosylated to the mature form, as they show the same reactivity to lectins and antibodies of the mucins expressed in tissue sections of the normal colon mucosa. In addition, it is demonstrated that cultured human colonocytes do not express mucins reactive to PNA, which are characteristic of tumors. Since the cultured colonocytes maintain the expression of differentiated functions for at least three days, they may offer a useful model to study metabolism, function and regulation of colon mucins in health and disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00342464
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  • 8
    Electronic Resource
    Electronic Resource
    Metabolism of large bowel mucosa in health and disease (1991)
    Springer
    International journal of colorectal disease 6 (1991), S. 127-132 
    Details
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Conclusions Attitudes to colonic mucosal diseases have changed since the knowledge that the microflora act by its metabolites on the metabolic activity of the colonocytes, thereby influencing their functions and growth. The primary actions of the flora are twofold. They produce first metabolites which act as energy-producing substrates for the colonocytes, and second substances which may interfere with the enzymatic activities of the mucosa. Study of the action of microfloral metabolites on colonocyte metabolism and of the consequences following surgery offer an opportunity to obtain further information on the pathogenesis and therapy of large bowel diseases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00300209
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  • 9
    Electronic Resource
    Electronic Resource
    Human colonocytes in primary culture: a model to study epithelial growth, metabolism and differentiation (1994)
    Springer
    International journal of colorectal disease 9 (1994), S. 13-22 
    Details
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Le but de ce travail a été d'établir un modèle in vitro permettant d'étudier les fonctions normales et pathologiques de l'épithélium colique. Nous avons isolé des cryptes coliques par une digestion protéolytique douce et par une dissection mécanique de matériel biopsique prélevé au cours de colonoscopies. Les cryptes dépourvues de tissu conjonctif, placées en milieu de culture, se fixent rapidement sur le substrat et forment des colonies qui renferment plus de 95% de cellules épithéliales. L'histochimie et la caractérisation ultrastructurelle des colonies ont montré la présence de cellules d'absorbtion et de cellules secrétoires présentant un haut degré de différentiation. La prolifération active survient le plus souvent durant les premières 24 heures et diminue progressivement par la suite. Les cellules survivent et maintiennent les caractéristiques de différentiation durant au moins 3 jours en culture. Cette méthode peut être utilisée pour étudier les fonctions normales de l'épithélium colique. Elles peuvent aussi être utilisées pour investiger les facteurs nocifs et protecteurs dans des situations pathologiques telles que les maladies inflammatoires de l'intestin et les tumeurs colorectales.
    Notes: Abstract The purpose of this work was to set up an in vitro model for the study of normal and pathological functions of the colonic epithelium. We have isolated colonic crypts by mild proteolytic digestion and mechanical dissociation of human biopsy material obtained during colonoscopy. The crypts, free of connective tissue, when placed in culture rapidly attached to the substrate and formed colonies containing over 95% of epithelial cells. Histochemical and ultrastructural characterization of the colonies showed the presence of both absorptive and secretory cells, exhibiting a high degree of differentiation. Proliferative activity occurred mostly during the first 24 h and progressively declined thereafter. The cells survived and maintained differential characteristics for at least three days in culture. This method can be used to study normal functions of the colonic epithelium. It may also be employed to investigate both noxious and protective factors in pathological conditions such as inflammatory bowel disease and colorectal neoplasia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00304294
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  • 10
    Electronic Resource
    Electronic Resource
    Characterization of the mucins produced by normal human colonocytes in primary culture (1996)
    Springer
    International journal of colorectal disease 11 (1996), S. 76-83 
    Details
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé. Des cellules caliciformes matures remplies de mucine prêtes à la sécrétion constituent environ 1/3 de toutes les cellules dans des cultures primaires de colonocytes humains. Au cours de l'étude présente, les mucines produites par des cultures de colonocytes humains ont été typisées par des méthodes histochimiques, par liaison à la lectin et à des anti-corps monoclonaux. Deux anti-corps monoclonaux et trois types de lectin (Dolichos biflorus (DBA), Helix pomatio (HPA) et Arachis hypogea (PNA) susceptibles de reconnaïtre les épitopes ou les haptènes d'hydrate de carbone caractéristiques de différentes phases de la maturation des glycoprotéines des mucines ont été employés. Les réactivités à ces substances ont été testéees à la fois sur des cultures de colonocytes et sur des segments de tissu muqueux coliques normaux. Les résultats montrent que les mucines produites en culture sont glycosylées dans les formes matures car elles présentent la même réactivité aux lectins et aux anti-corps des mucines tels que mesurés dans des segments de tissu de muqueuse colique normale. De plus, on a démontré que les colonocytes humains cultivés ne produisent pas de mucine réactive au PNA qui sont caractéristiques des tumeurs. Etant donné que les colonocytes humains cultivés conservent l'expression d'une différenciation des fonctions pour au moins trois jours, ils peuvent constituer un modèle utile pour étudier le métabolisme de la fonction et de la régulation des mucines coliques chez le sujet sain et pathologique.
    Notes: Abstract. Mature goblet cells filled with mucin ready for secretion represent about one third of the cells in primary cultures of human colonocytes. In the present study characterization of the mucins produced by cultured human colonocytes was made by histochemical methods by lectin and monoclonal antibody binding. Two monoclonal antibodies and three lectins (Dolichos biflorus (DBA), Helix pomatia (HPA) and Arachis hypogea (PNA) recognizing epitopes or sugar haptens characteristic of different stages of mucin glycoprotein maturation, were employed. The reactivity to these probes was tested both on cultured colonocytes and on tissue sections of the normal colon mucosa. The results show that the mucins produced in culture are glycosylated to the mature form, as they show the same reactivity to lectins and antibodies of the mucins expressed in tissue sections of the normal colon mucosa. In addition, it is demonstrated that cultured human colonocytes do not express mucins reactive to PNA, which are characteristic of tumors. Since the cultured colonocytes maintain the expression of differentiated functions for at least three days, they may offer a useful model to study metabolism, function and regulation of colon mucins in health and disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003840050025
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