No abstract available.
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Antimetabolites/therapeutic use ; Azathioprine/therapeutic use ; Chronic Disease ; Colitis, Ulcerative/diagnosis/*therapy ; Hemoglobins/analysis ; Humans ; Mesalamine/therapeutic use ; Recurrence ; Risk Factors

Solitary rectal ulcer syndrome (SRUS) is a rare, benign disorder in children that usually presents with rectal bleeding, constipation, mucous discharge, prolonged straining, tenesmus, lower abdominal pain, and localized pain in the perineal area. The underlying etiology is not well understood, but it is secondary to ischemic changes and trauma in the rectum associated with paradoxical contraction of the pelvic floor and the external anal sphincter muscles; rectal prolapse has also been implicated in the pathogenesis. This syndrome is diagnosed based on clinical symptoms and endoscopic and histological findings, but SRUS often goes unrecognized or is easily confused with other diseases such as inflammatory bowel disease, amoebiasis, malignancy, and other causes of rectal bleeding such as a juvenile polyps. SRUS should be suspected in patients experiencing rectal discharge of blood and mucus in addition to previous disorders of evacuation. We herein report six pediatric cases with SRUS.
Adolescent ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Anti-Ulcer Agents/therapeutic use ; Child ; Colonoscopy ; Female ; Gastrointestinal Hemorrhage/*diagnosis ; Humans ; Male ; Mesalamine/therapeutic use ; Rectal Diseases/*diagnosis/drug therapy ; Steroids/therapeutic use ; Sucralfate/therapeutic use ; Syndrome ; Ulcer/*diagnosis/drug therapy

The risk of developing colorectal cancer is increased in patients with inflammatory bowel disease. Surveillance colonoscopy has not been shown to prolong survival and rates of interval cancer are reported to be high. Continuing colonic inflammation has been shown to be important in the development of colorectal cancer and therefore anti-inflammatory agents such as the 5-aminosalicylates and immunomodulators have been considered as potential chemopreventive agents. This review focuses on various chemopreventive agents that have been clearly shown to reduce the risk of colorectal adenoma and cancer in the patients with inflammatory bowel disease.
Anti-Inflammatory Agents/therapeutic use ; Chemoprevention ; Colorectal Neoplasms/*complications/*prevention & control ; Folic Acid/therapeutic use ; Immunosuppressive Agents/therapeutic use ; Inflammatory Bowel Diseases/*complications/drug therapy ; Mesalamine/therapeutic use ; Ursodeoxycholic Acid/therapeutic use

OBJECTIVETo develop a colon position pulsatile capsule drug delivery system of which the lag-time is controlled by a plug tablet mainly made of konjac glucomannan and evaluate its release profile in vitro.

METHODImpermeable capsule body was prepared by filling method, the plug tablet was pressed by direct compression, and the rapid-disintegrable drug tablets was made by wet granulation. The pulsatile capsules were prepared by putting the drug tablet into the impermeable body and sealed it with the plug tablet The factors affecting the lag-time were investigated by dissolution testing.

RESULTThe formulation of the rapid-disintegrable drug tablets influenced the pulsatile release of the drug, the composition of the plug tablet significantly influenced the lag-time; the lag-time was extended with the higher viscosity of HPMC and the increased proportion of konjac glucomannan.

CONCLUSIONThe pulsatile capsule with a suitable lag-time and colon position characteristics can be achieved by adjusting the composition of the plug tablet.

Capsules ; chemistry ; Colonic Diseases ; drug therapy ; Drug Delivery Systems ; instrumentation ; Humans ; Mannans ; chemistry ; Mesalamine ; pharmacokinetics ; therapeutic use ; Technology, Pharmaceutical

OBJECTIVETo observe the clinical effects of Qingchang Huashi Recipe (QHR) for treating active ulcerative colitis (UC) patients of inner-accumulation of damp-heat syndrome (IADHS), and to evaluate its safety.

METHODSUsing a central random system, 60 patients with mild-to-moderately initial onset or relapsed active UC of IADHS were assigned to the test group (30 cases) and the control group (30 cases). Patients in the test group took QHR (Rhizoma Coptidis 6 g, Radix Scutellariae 10 g, Radix Pulsatillae 10 g, Radix Aucklandiae 10 g, parched Radix Angelicae sinensis 10 g, Radix Paeoniae alba 20 g, Cortex Cinnamomi 3 g, Radix Glycyrrhizae 6 g, and so on), 1 dose each time, decocted twice, mixed to 300 mL, taken in two portions. The components were modified according to the condition of illness. Enema of Guanchang Recipe (GCR) was combined (Cortex Phellodendri 30 g, Radix Sophorae flavescentis 10 g, Radix Sanguisorbae 30 g, Rhizoma bletillae 9 g, Radix notoginseng 3 g, Xilei powder 1.5 g), decocted twice, mixed and concentrated to 120 mL, applied before sleep every evening, with an interval of 12 days after 12 successive days). Those in the control group took Mesalazine Enteric-coated Tablet (MECT, 0.25 g/tablet), 1 g each time, 4 times daily. The therapeutic course for all was 8 weeks. The symptom integral, the colonoscopic results, the pathological efficacy, and the remission rate were compared between the two groups. The medication safety was monitored.

RESULTSBy the end of the treatment the improvement of symptoms was superior in the test group to that of the control group (P<0.05). The colonoscopic and pathological results were improved in the two groups, but with no statistical difference (P>0.05). There was no statistical difference in the mucosal healing rate (50.0% vs 43.3%) and the remission rate (36.7% vs 30.0%) between the two groups. Only 1 patient of the control group had moderate increase of ALT during the whole test.

CONCLUSIONSQHR was effective and safe in treating active UC patients of IADHS. Besides, its effect on improving the symptoms was better than that of MECT.

Adult ; Colitis, Ulcerative ; diagnosis ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Mesalamine ; therapeutic use ; Middle Aged ; Phytotherapy ; methods ; Treatment Outcome

OBJECTIVETo study the clinical features and treatment of pediatric Crohn's disease (CD).

METHODSClinical data of 10 children with active CD diagnosed between 2005 and 2013 were retrospectively reviewed.

RESULTSAbdominal pain, diarrhea, and bloody stools were the most common symptoms in these patients, usually accompanied by different degrees of growth retardation and nutritional disorders. Fever was the main extraintestinal manifestation. Enteroscopy showed discontinuous and segmental mucosal hyperaemia and erosion, cobblestone appearance and mucosal ulceration. Abdominal ultrasound revealed uneven and segmental thickening of the intestinal wall. The pathological esamination showed many lymphocytes, eosinophils and plasma cells infiltrating into the lamina propria and partial atrophy of mucosal gland. C-reactive protein (CRP) level was significantly lower in the remission stage than in the acute stage and the recurrence stage (P<0.05). The erythrocyte sedimentation rate (ESR) was significantly lower in the remission stage than in the recurrence stage (P<0.05). Among mild cases identified by the pediatric Crohn's disease activity index (PCDAI) in the early stage of disease, the induced remission rate and maintained remission rate were 100% and 67%, respectively, with oral 5-aminosalicylic acid (5-ASA) and adrenocortical hormone. Among moderate and severe cases identified by the PCDAI, the partial remission rate was 100% with 5-ASA and adrenocortical hormone, but the maintained remission rate was not so good and the recurrence rate of disease was high.

CONCLUSIONSPediatric CD has no specific clinical manifestations and laboratory test results. ESR and CRP can be used as the markers for evaluating the disease progression. 5-ASA has certain efficacy in inducing and maintaining remission of pediatric CD. There is a certain correlation between treatment outcome and the PCDAI score in the early stage of disease.

Adolescent ; Child ; Child, Preschool ; Colonoscopy ; Crohn Disease ; diagnosis ; drug therapy ; pathology ; Female ; Humans ; Male ; Mesalamine ; therapeutic use ; Prednisone ; therapeutic use ; Prognosis

The inverse correlation of appendectomy and ulcerative colitis is well known, but the effect of appendectomy on the clinical course of ulcerative colitis remains unclear. Although the majority of opinions were negative for the therapeutic advantage of appendectomy in patients with ulcerative colitis, advocates for positive effect of appendectomy have been proposed in a few case reports and a prospective study from Western countries. We herein report a case of ulcerative colitis who experienced clinical remission after appendectomy for acute appendicitis. The patient was 35 year old male and had been managed with immunosuppressant before appendectomy. The very acute change in clinical course and a long period of remission after appendectomy highly suggest the therapeutic effect of appendectomy for ulcerative colitis.
6-Mercaptopurine/therapeutic use ; Adult ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; *Appendectomy ; Colitis, Ulcerative/*diagnosis/drug therapy/surgery ; Colonoscopy ; Humans ; Immunosuppressive Agents/therapeutic use ; Male ; Mesalamine/therapeutic use ; Tomography, X-Ray Computed ; Treatment Outcome

Erythema nodosum is the most common form of septal panniculitis and the most frequent skin manifestation associated with inflammatory bowel disease, affecting up to 15% of Crohn's disease patients. Since the development of erythema nodosum is closely related with a variety of disorders and condition, it can serve as an important early sign of systemic disease. Here, we present the occurrence of erythema nodosum as an early sign of Cronh's disease in a 16-year-old woman.
Adolescent ; Anti-Inflammatory Agents/therapeutic use ; Azathioprine/therapeutic use ; Colonoscopy ; Crohn Disease/complications/*diagnosis/drug therapy ; Erythema Nodosum/complications/*diagnosis/pathology ; Female ; Humans ; Mesalamine/therapeutic use ; Prednisolone/therapeutic use ; Skin/pathology

OBJECTIVE: To explore the effects of novaferon on dextran sulfate sodium (DSS)-induced colitis and expression of TNF-α in mice and to evaluate the efficacy of novaferon on ulcerative colitis and the possible mechanisms. METHODS: A total of 70 BALB/C mice [weight (20.0±2.0) g, 8-week years old, female, pathogen free] were randomly divided into 7 groups: a normal group, a model group, a mesalazine treatment group, a prednisone treatment group, a low-dose novaferon group, a middle-dose novaferon group and a high-dose novaferon group (10 mice per group). The normal group-mice were given distilled water. The ulcerative colitis model was established by treated the mice with 4% DSS for 7 continuous days. At the 8th day, the mice in the all of drug treatment groups were injected corresponding drugs (i.p.). During the experiment, the general situation, daily weight, stool trait and occult blood were recorded, and the mice were killed on the 14th day. The disease activity index (DAI), colon length, histological scores were assessed. Immunohistochemistry was used to measure the expression of TNF-α in colonic mucosa. RESULTS: 1) The mice treated with DSS solution showed diarrhea, mucous stool and bloody stool, and the DAI score increased gradually. The mesalazine, predinison and nofaferon could ameliorate the general situation of the mice, reduce the DAI and histological scores, and reverse the decrease in the colon length. 2) Compared with the model group, the DAI scores were significantly decreased in the novaferon groups (at low, middle or high dose), the mesalazine group or the prednisone group (all P<0.01), but there was no difference among the mesalazine group, the prednisone group and the low-dose novaferon group (all P>0.05). The efficacy of novaferon in the middle-dose group and the high-dose group are better than that in the mesalazine group, the prednisone group and the low-dose novaferon group (all P<0.01). The efficacy of novaferon showed a dose-dependent manner. 3) The injury of colonic mucosa was relatively mild in the novaferon groups (at low-dose, middle-dose or high-dose), the mesalazine group and the prednisone group, and there were partial glands and less inflammatory cells. Compared with the model group, there was statistics difference (all P<0.05). The tissue injury was significantly alleviated, and the DAI score was decreased in the high-dose novaferon group compared the middle-dose novaferon group (P<0.05), but there was no significant difference between the low-dose novaferon group and the middle-dose novaferon group or between the mesalazine group and the prednisone group (both P>0.05). 4) The TNF-α expression was significantly down-regulated in the novaferon groups (at low-dose, middle-dose or high-dose), the mesalazine group and the prednisone group compared with model group (all P<0.01); but there was no significant difference between the mesalazine group and the prednisone group (P>0.05); the decrease of TNF-α expression by novaferon displayed a dose-dependent manner. Compared with the mesalazine group or the prednisone group, the TNF-α expression in novaferon groups at all dosages was dramatically reduced (all P<0.01). CONCLUSION Novaferon can improve the DAI scores and colonic tissue injury in ulcerative colitis induced by DSS in mice, and down-regulate the TNF-α expression in dose-dependent manner.
Animals ; Colitis, Ulcerative ; chemically induced ; drug therapy ; Dextran Sulfate ; adverse effects ; Female ; Interferons ; therapeutic use ; Intestinal Mucosa ; drug effects ; Mesalamine ; therapeutic use ; Mice ; Mice, Inbred BALB C ; Prednisone ; therapeutic use ; Recombinant Proteins ; therapeutic use ; Tumor Necrosis Factor-alpha ; genetics ; metabolism

Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) with uncertain etiopathogenesis. CD can involve any site of gastrointestinal tract from the mouth to anus and is associated with serious complications such as bowel strictures, perforations, and fistula formation. The incidence and prevalence rates of CD in Korea are still lower than those of Western countries, but have been rapidly increasing during the past decades. Although there are no definitive curative modalities for CD, various medical and surgical therapies are currently applied for diverse clinical situations of CD. However, a lot of decisions on the management of CD are made depending on the personal experiences and personal dicision of physicians. To suggest preferable approaches to diverse problems of CD and to minimize the variations according to physicians, guidelines for the management of CD are needed. Therefore, IBD Study Group of the Korean Association for the Study of the Intestinal Diseases has set out to develop the guidelines for the management of CD in Korea. These guidelines were developed using the adaptation methods and encompass the treatment of inflammatory disease, stricturing disease, and penetrating disease. The guidelines also cover the indication of surgery, prevention of recurrence after surgery, and CD in pregnancy and lactation. These are the first Korean guidelines for the management of CD and the update with further scientific data and evidences is needed.
6-Mercaptopurine/analogs & derivatives/therapeutic use ; Anti-Inflammatory Agents/therapeutic use ; Antibodies, Monoclonal/therapeutic use ; Antimetabolites, Antineoplastic/therapeutic use ; Budesonide/therapeutic use ; Crohn Disease/*drug therapy/pathology ; Databases, Factual ; Female ; Fistula/therapy ; Humans ; Intestinal Perforation/surgery/therapy ; Male ; Mesalamine/therapeutic use ; Methotrexate/therapeutic use ; Prednisolone/therapeutic use ; Pregnancy ; Recurrence ; Risk Factors ; Severity of Illness Index ; Sulfasalazine/therapeutic use