[SURGICAL TREATMENT OF ULCERATIVE COLITIS IN COPENHAGEN'S MUNICIPAL HOSPITALS].
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Explore the source record for details and available documents.
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BACKGROUND: Mesalazine as the treatment standard for ulcerative colitis can be applied in different galenical preparations. AIM: A novel formulation of mesalazine pellets with delayed and prolonged release characteristics was compared with conventional Eudragit L-coated tablets. Furthermore, the effect of mesalazine dose escalation on nonresponders was evaluated in both treatment groups. METHODS: A total of 233 patients with mild to moderately active ulcerative colitis were randomized to receive either mesalazine (1.5 g/day in three doses) as pellets (n = 115) or tablets (n = 118) for 8 weeks. At insufficient response, the dose was increased to 3.0 g. RESULTS: The clinical remission rate (clinical activity index < or = 4) for pellets was 67% vs. 68% for tablets which statistically proved to be not inferior (significance level alpha = 2.5%). In patients without dose increase, the remission rate was 47% (pellets) vs. 42% (tablets). Endoscopic improvement was observed in 80% (pellets) vs. 83% (tablets), and histological improvement in 48% (pellets) vs. 52% (tablets) of patients. CONCLUSIONS: Mesalazine pellets are as effective as tablets in the treatment of mild to moderately active ulcerative colitis. Dose escalation to 3.0 g/day is a valid option for nonresponders to a starting dose of 1.5 g/day.
BACKGROUND: Sulfasalazine is accepted therapy for active ulcerative colitis, but side-effects and intolerance are common. Balsalazide is an azo-bonded pro-drug which also releases 5-aminosalicylic acid into the colon, but uses an inert carrier molecule. AIM: To compare the safety and efficacy of sul- fasalazine, 3 g, with balsalazide, 6.75 g, in the initial daily treatment of mild to moderate ulcerative colitis. METHODS: A randomized, multicentre, double-blind, parallel group study was performed, with a treatment duration of 8 weeks. Patients on previous maintenance treatment were excluded. The trial medication was the sole treatment for the colitis. Efficacy was assessed by patient diaries, symptom assessment, sigmoidoscopic appearance and histology. RESULTS: Fifty patients were recruited: 26 allocated to the balsalazide group and 24 to the sulfasalazine group. More patients withdrew due to adverse events in the sulfasalazine group (nine patients vs. one patient in the balsalazide group, P=0.004). Improvement occurred in both groups, with a tendency to a faster response with balsalazide. Of the patients taking balsalazide, 61% achieved clinical and sigmoidoscopic remission. CONCLUSIONS: Balsalazide, 6.75 g, is effective as the sole treatment for patients with mild to moderately active ulcerative colitis, with significantly fewer withdrawals due to side-effects than in a similar group of patients taking sulfasalazine, 3 g.
OBJECTIVE: To establish a model of ulcerative colitis in mice. METHODS: The mice were given 5% dextran sulfate sodium (DSS) solution freely for 7 consecutive days after which distilled water was given in stead for another 10 d, to complete one cycle of whole treatment plan that consisted of 4 such cycles. The symptoms were observed daily. At the end of the first and the fourth cycle respectively, the mice were killed for examining the whole colon under anatomic microscopy and serial tissue sections were prepared for histological observation. RESULTS: The symptoms observed in the mice including hematochezia diarrhea and loss of the body weight were similar to those of ulcerative colitis patients. Histological examination revealed infiltration of neutrocytophilia and lymphocythemia, with loss of integrity of the colon mucosa in the gland. CONCLUSION: This mouse model of ulcerative colitis can be easily induced and readily applied in various studies of ulcerative colitis.
In seven patients with longstanding ulcerative colitis, multiple mucosal biopsies taken at colonoscopy were assessed for DNA content and histological dysplasia. DNA analyses were performed using flow cytometric analyses in biopsies and microspectrophotometry in imprint slides prepared from the biopsies. Abnormal aneuploid DNA content was detected in five of the patients in eight separate locations in the colon. There was good conformity between the two methods in the detection of aneuploidy. Both methods of DNA analysis are considered to be applicable in mucosal biopsies from patients with ulcerative colitis. In two patients with significant low grade dysplasia in association with macroscopical lesions (DALMs), there was a relationship with aneuploid DNA pattern found by flow cytometric or microspectrophotometric analyses. Indefinite changes, probably dysplastic were found in three other patients and two of those also displayed aneuploidy, although only once in the same biopsy location. In five locations aneuploidy was detected without concomitant dysplasia. DNA-aneuploidy seems therefore to appear earlier than dysplasia and may be an early marker of malignant transformation of the mucosa in ulcerative colitis. Prospective trials are needed before the clinical significance of early findings of aneuploidy can be determined.
PURPOSE: Although coexistence of Takayasu's arteritis with ulcerative colitis is often reported, all these cases have been in patients whose colons were in situ. The aim of the present study was to describe a patient who developed Takayasu's arteritis after total proctocolectomy for ulcerative colitis. METHODS: The clinical course of a 42-year-old female who developed Takayasu's arteritis after total proctocolectomy for ulcerative colitis is described and the literature reviewed. RESULTS: Symptomatic arteritis developed in the left carotid artery four months after total proctocolectomy with ileal J-pouch-anal anastomosis for ulcerative colitis. Peristomal pyoderma gangrenosum, multiple ulcers in the oral cavity, and leakage at the ileoanal anastomosis were observed simultaneously. High-dose therapy with steroids proved effective for the arteritis, pyoderma gangrenosum, and multiple oral ulcers. We finally excised the ileal pouch with anus because of the intractable leakage three years after the occurrence of Takayasu's arteritis. CONCLUSIONS: This patient illustrates the possibility that Takayasu's arteritis is an extraintestinal complication of ulcerative colitis even after surgical removal of the colon.
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