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Biomedical subjects

J B Kirsner

Publications and source records attributed to J B Kirsner.

At least 55 records · Page 3Linked to original sources
PubMed1981

The irritable bowel syndrome. A clinical review and ethical considerations.

The irritable bowel syndrome (IBS) is clinically characterized by a wide variety of symptoms, including dyspepsia, flatulence, nausea, cramping abdominal pain, constipation and/or diarrhea, and nonspecific symptoms, probably reflecting autonomic nervous system overreactivity. Physiologically, the colonic motor abnormality is characterized by an altered slow-wave rhythm, quantitative differences from normal in the repetitive contraction pattern of the rectosigmoid area, and increased colonic muscle responsiveness to hormones such as cholecystokinin and pentagastrin. The diagnosis of IBS involves practical and ethical considerations as well as the need for decisive reassurance of the patient through judicious examination. Treatment of IBS requires a thoughtful and sensitive approach to the patient, recognition of IBS as an important clinical problem, regularization of bowel function, relief of the abdominal discomfort, and intelligent emotional support.

Attitude of Health Personnel↗
PubMed1981

Crohn's ileitis and ileocolitis: a study of the anatomical distribution of recurrence.

The records were reviewed of 56 consecutive patients with Crohn's disease (CD) who had had an ileocolonic anastomosis formed during surgical resection for Crohn's ileitis or ileocolitis. Twenty-seven patients (48%) were found to have radiological, pathological, or surgical evidence of recurrent CD. Of 24 patients with a diagnosis of Crohn's ileitis at initial surgery, 9 were found to have recurrent disease proximal to the anastomotic site. Of 32 patients with ileocolitis, 11 had recurrent disease proximal and distal to the anastomosis. Contrary to many prior reports, recurrent CD is not always located proximally to a surgical anastomosis. The distribution of recurrent CD tends to be a statistically significant function of the initial anatomical location with proximal recurrence found most often in Crohn's ileitis, while proximal and distal recurrence is associated with Crohn's ileocolitis (X2 = 4.5 P less than 0.05).

Adolescent↗
PubMed1981

Ileostomy in ulcerative colitis. A questionnaire study of 1,803 patients.

A questionnaire regarding details of their illness, social, educational and religious background and various aspects of rehabilitation since surgery was completed by 1,803 persons who underwent ileostomy for ulcerative colitis between 1930 and 1970. The majority of participants were operated on since 1960, reported an above-average education, lived in metropolitan areas, had surgery performed as a single stage proctocolectomy, and were chronically ill for an average of almost 7 years from the onset of disease to ileostomy. An unexplained high incidence of Jewish patients was noted; in addition, Jewish patients comprised almost half of those who had a family history of inflammatory bowel disease. Although some participants reported major postoperative problems including unfavorable alterations in stomal structure and function, bowel obstruction, delayed perineal healing and nephrolithiasis, most patients were satisfied with life with an ileostomy, presently maintaining their health, employment, marriage and sexuality.

Adolescent↗
PubMed1980

Crohn's disease and adenocarcinoma of the bowel.

We present six cases of cancer associated with Crohn's disease and stress the importance of the earlier age of onset than spontaneously arising small-bowel carcinoma, the long period of latency from the time of diagnosis of Crohn's disease to that of carcinoma, and the generally poor prognosis. We emphasize, furthermore, the frequent association with fistulas and the predisposition of bypassed or excluded segments of bowel to undergo malignant transformation. The occurrence of carcinoma in an excluded rectal stump has not previously been reported and stresses the necessity of resecting, rather than excluding, segments of bowel involved with Crohn's disease. These tumors are often not readily apparent by radiographic or endoscopic examination and in fact, may be discovered only after microscopic examination of resected or biopsied tissue.

Adenocarcinoma↗
PubMed1980

Current medical and surgical opinions on important therapeutic issues in inflammatory bowel disease. A special 1979 survey.

A survey was made in 1979 of 31 gastroenterologists and 25 surgeons on currently important medical and surgical therapeutic issues in inflammatory bowel disease. Opinions about issues such as intractability, indications for surgery in ulcerative colitis and Crohn's disease, the approach to various medical and surgical complications, and bowel malignancy were more concordant than might have been anticipated.

Attitude of Health Personnel↗
PubMed1979

Inflammatory tissue reaction in rabbit bowel injected with Crohn's homogenates.

Homogenates from the terminal ileum of a patient with Crohn's disease with granulomas were prepared as snap-frozen or fresh and were injected into the ascending colonic walls of New Zealand white rabbits. Control animals were injected with 1 per cent bovine serum albumin alone. The rabbit bowel was examined after 1 year, and lesions were noted in each of the rabbits injected with Crohn's disease homogenate, irrespective of the type of tissue preparation. The observed lesions were diffuse and occurred both at the injection site and in the terminal ileum. These changes were not noted in the control group. This work confirms earlier results in the same animal model and suggests that either fresh or snap-frozen homogenates will produce the intestinal lesion but that bovine albumin alone will not.

Animals↗