No abstract available.

The current paradigm holds that ulcerative colitis occurs in genetically predisposed individuals because of dysregulated immune responses against intraluminal bacterial antigens. Recently, numerous new genes have been identified as involved in the genetic susceptibility to ulcerative colitis, including IL-23R, MST1, IL-12B (p40), NKX2-3, and STAT3. Experimental studies of ulcerative colitis point to an excessive T-cell response to antigenic stimulus resulting in damage to host intestinal tissue. The T-cell response in ulcerative colitis appears to be TH2 dominant (IL-5, IL-13) and mediated by specialized cells, such as NK T-cells. The characterization of these novel genes and immunologic basis should lead to the identification of therapeutic agents and a better clinical assessment of phenotype and prognosis in patients with ulcerative colitis.
Antigens, Bacterial ; Colitis, Ulcerative ; Genetic Predisposition to Disease ; Humans ; Phenotype ; Prognosis ; T-Lymphocytes ; Ulcer

No abstract availble.
Aged ; Chronic Disease ; Colonoscopy ; *Enema ; Female ; Humans ; Proctitis/*drug therapy/pathology ; Radiation Injuries/*drug therapy/pathology ; Sucralfate/*administration & dosage

Colonic diverticular disease is the common conditions in industrialized and westernized countries, but it is relatively rare in areas such as Asia. Colonic diverticula are asymptomatic in most cases, only 10-25% develop diverticulitis and 1% finally gets surgery. The location of colonic diverticulitis are significantly different in Western countries and Asia. Left-sided diverticulitis is common in Western countries, while in Asians, right-sided diverticulitis is more prevalent. A CT scans is commonly used to diagnose diverticulitis and its complication such as abscess, obstruction, fistula and perforation. It also has been used in percutaneous drainage of diverticular abscess and predicting the success of medical therapy. After resolution of clinical attack of diverticulitis, colonoscopy can be performed to exclude colon cancer. The current therapeutic approaches for colonic diverticulitis are relieving symptoms and preventing complications. Uncomplicated diverticulitis is successfully treated with antibiotics, bowel rest and pain control, while complicated diverticulitis require surgical consultation. Treatment strategy of recurrent diverticulitis depends on age and comorbid diseases as well as the frequency and severity of subsequent attacks.
Abscess ; Anti-Bacterial Agents ; Asia ; Asian Continental Ancestry Group ; Colon* ; Colonic Neoplasms ; Colonoscopy ; Diagnosis* ; Diverticulitis* ; Diverticulitis, Colonic ; Diverticulum, Colon ; Drainage ; Fistula ; Humans ; Tomography, X-Ray Computed

No abstract available.
Abscess/*diagnosis/microbiology ; Anti-Bacterial Agents/therapeutic use ; Cephalosporins/therapeutic use ; Gastroscopy ; Humans ; Klebsiella Infections/*drug therapy ; Klebsiella pneumoniae/*isolation & purification ; Male ; Middle Aged ; Stomach Diseases/*diagnosis/microbiology ; Tomography, X-Ray Computed

No abstract available.
Adult ; Colonic Diseases/*diagnosis/etiology/surgery ; Colonoscopy ; Humans ; Intussusception/*diagnosis/etiology/surgery ; Lipoma/complications/*diagnosis/pathology ; Male ; Tomography, X-Ray Computed

Esophagogastroduodenoscopy for cancer screening was performed in a 55-year-old woman as part of a health screening program, and revealed a depressed lesion approximately 20 mm in diameter in the lesser curvature of the mid-gastric body. Several biopsy specimens were collected as the lesion resembled early gastric cancer; however, histopathologic evaluation revealed chronic active gastritis with an ulcer and amorphous eosinophilic material deposition. Congo red staining identified amyloid proteins, and apple-green birefringence was shown using polarized light microscopy. Immunohistochemical staining revealed the presence of kappa and lambda chain-positive plasma cells. There was no evidence of underlying plasma cell dyscrasia or amyloid deposition in other segments of the gastrointestinal tract. Echocardiography and computed tomography of the chest, abdomen, and pelvis did not show any significant findings. Thus, the patient was diagnosed with localized gastric amyloidosis with kappa and lambda light chain coexpression.
Abdomen ; Amyloidogenic Proteins ; Amyloidosis* ; Biopsy ; Birefringence ; Congo Red ; Early Detection of Cancer ; Echocardiography ; Endoscopy, Digestive System ; Eosinophils ; Female ; Gastritis ; Gastrointestinal Tract ; Humans ; Mass Screening ; Microscopy, Polarization ; Middle Aged ; Paraproteinemias ; Pelvis ; Plaque, Amyloid ; Plasma Cells ; Stomach Neoplasms ; Thorax ; Ulcer

Clinical manifestations of Salmonella infection are variable such as enterocolitis, bacteremia, enteric fever, focal infection and asymptomatic carrier status. Among these presentations, enterocolitis is the most common clinical manifestation and can be diagnosed by the use of fecal specimens. Patients with severe infectious colitis are at increased risk of developing a colon perforation after colonoscopy due to colon trauma. We report a case of a 31-year-old woman with transverse colon perforation after colonoscopy that was diagnosed with enterocolitis caused by infection with non-typhoidal group D Salmonella.
Adult ; Bacteremia ; Colitis ; Colon ; Colon, Transverse ; Colonoscopy ; Enterocolitis ; Female ; Focal Infection ; Humans ; Megacolon, Toxic ; Salmonella ; Salmonella Infections ; Typhoid Fever

Gastrointestinal stroma tumors (GISTs) are CD117- positive primary mesenchymal tumors of the gastrointestinal tract and are noted to have a possible non-random association with neurofibromatosis-1 (NF-1, Von Recklinghausen disease). We report a case of a duodenal GIST presenting with gastrointestinal bleeding in a 74-year-old female, and this condition was accompanied with NF-1. A upper gastrointestinal endoscopy and abdominal computed tomography scan revealed several submucosal tumors in the duodenum, jejunum and ileum. Histological and immunohistochemical studies on the surgical resection specimen revealed gastrointestinal stromal tumors of an uncommitted type. The patient was treated with local excision of the tumors and is now in a favorable state.
Aged ; Duodenum ; Endoscopy, Gastrointestinal ; Female ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Hemorrhage* ; Humans ; Ileum ; Jejunum

BACKGROUND: We examined global gene expression profiles of peripheral blood mononuclear cells (PBMCs) in patients with ulcerative colitis (UC), and tested whether the identified genes with the altered expression might be associated with susceptibility to UC. METHODS: PBMCs from 8 UC and 8 normal healthy (NH) volunteers were collected, and total RNAs were subjected to the human 8.0K cDNA chip for the microarray analysis. Real time-PCR (RT-PCR) was performed to verify the results of microarray. One hundred forty UC patients and 300 NH controls were recruited for single nucleotide polymorphism (SNP) analysis. RESULTS: Twenty-five immune function-related genes with over 2-fold expression were identified. Of these genes, two chemokines, namely, CXCL1 and CCL20, were selected because of their potential importance in the evocation of host innate and adaptive immunity. Four SNPs were identified in the promoter and coding regions of CXCL1, while there was no significant difference between all patients with UC and controls in their polymorphisms, except minor association at g.57A< G (rs2071425, p=0.02). On the other hand, among three novel and one known SNPs identified in the promoter region of CCL20, g.-1,706 G< A (p=0.000000055), g.-1,458 G< A (p=0.0048), and g.-962C< A (p=0.0006) were found to be significantly associated with the susceptibility of UC. CONCLUSION: Altered gene expression in mononuclear cells may contribute to IBD pathogenesis. Although the findings need to be confirmed in other populations with larger numbers of patients, the current results demonstrated that polymorphisms in the promoter region of CCL20 are positively associated with the development of UC.
Adaptive Immunity ; Chemokines ; Clinical Coding ; Colitis, Ulcerative* ; Crohn Disease ; DNA, Complementary ; Gene Expression ; Hand ; Humans ; Inflammatory Bowel Diseases ; Microarray Analysis ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic* ; RNA ; Transcriptome ; Ulcer* ; Volunteers