International journal of colorectal disease
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Int J Colorectal Dis · Sep 2003
Case ReportsNeutropenic enterocolitis: is it possible to break vicious circle between neutropenia and the bowel wall inflammation by surgery?
Neutropenic enterocolitis is a devastating bowel wall inflammation in patients with protracted neutropenia. The approach for diagnosis and treatment is still controversial, and it is difficult and challenging to decide on what should be the next step in the management. ⋯ Retrospective analysis of the long-term follow-up of our patient suggests that defunctioning the colon by ileostomy breaks the vicious circle between neutropenia and bowel wall inflammation, and an early surgical intervention could be considered as an adjunctive approach to the conservative management of persistent cases.
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Int J Colorectal Dis · Jul 2003
Clinical TrialA pilot study of irinotecan (CPT-11) as single-agent therapy in patients with locally advanced or metastatic esophageal carcinoma.
This study assessed the efficacy and safety of irinotecan (CPT-11) in the treatment of patients with unresectable esophageal carcinoma. ⋯ CPT-11 as single-agent therapy is modestly effective against squamous cell cancer of the esophagus.
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Int J Colorectal Dis · Jan 2003
Comparative StudyResponsiveness of intestinal epithelial cell lines to lipopolysaccharide is correlated with Toll-like receptor 4 but not Toll-like receptor 2 or CD14 expression.
Luminal bacteria have been implicated in the pathogenesis of inflammatory bowel diseases. Exposure of intestinal epithelial cells (IEC) to bacterial components potentially initiates intestinal inflammation by release of chemokines and recruitment of inflammatory cells. We analyzed receptor expression and signaling pathways involved in activation of human primary IEC and carcinoma-derived cell lines by lipopolysaccharide (LPS). ⋯ Responsiveness of IEC lines to LPS is positively correlated with TLR 4 expression. Strategies targeting TLR 4 expression or TLR 4 mediated signaling may antagonize IEC activation by LPS.
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Int J Colorectal Dis · Jan 2003
Comparative StudyThe effect of obesity on the results of Karydakis technique for the management of chronic pilonidal sinus.
Body mass index (BMI) was assessed as an objective indicator of obesity to determine whether it has an effect on the results of the Karydakis technique for managing chronic pilonidal sinus. ⋯ These findings show that (a) the Karydakis procedure for managing chronic pilonidal sinus in obese patients is easy to perform, has a fast healing time, short hospital stay, rapid return to work, and a low recurrence rate, (b) the results are similar between nonobese and obese patients, with no recurrence seen in these patients, and (c) complications occur in patients with a BMI greater than 30; in such patients a dietary regimen before operation is advisable, and inserting a suction drain during operation is recommended to avoid seroma formation.
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Int J Colorectal Dis · Jan 2003
Comparative StudyPostoperative peridural analgesia increases the strength of colonic contractions without impairing anastomotic healing in rats.
Peridural analgesia (PDA) is a common treatment in postoperative management after abdominal surgery to shorten postoperative ileus and to permit early postoperative nutrition. There are conflicting opinions on the effect of early peristalsis on healing of colonic anastomoses. ⋯ Postoperative PDA with ropivacaine increases the strength of colonic contractions. The increase in phasic contractions suggests a better propulsive bowel function. The significantly higher amount of collagen I in the anastomosis of animals in the PDA group supports the idea that healing of colonic anastomoses is improved rather than diminished by PDA.