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Volume 69 - 2006 - Fasc.3 - Original articles

Pulmonary function tests, high-resolutıon computed tomography findings and inflammatory bowel disease

Aim : The association between inflammatory bowel disease and pulmonary involvement has not been clearly established. The aim of this prospective study was to define the features of pulmonary function tests and high resolution computed tomography in inflammatory bowel disease patients and the relation between these and disease activity. Method : Fifty-two patients with inflammatory bowel disease (20 with Crohn's disease and 32 with ulcerative colitis) were enrolled. The standard pulmonary function tests and thorax high resolution computed tomography findings were investigated with respect to inflammatory bowel disease activity. Crohn's disease activity index and the Rachmilewitz endoscopic activity index for ulcerative colitis were used to assess disease activity. Medications used and smoking status were also documented. Results : Among the patients with ulcerative colitis, 6.25% had an obstructive and/or restrictive ventilatory defect compared with 25% of the patients with Crohn's disease. Fifty percent of the patients with ulcerative colitis and 60% of the patients with Crohn's disease showed abnormal findings in high resolution com- puted tomography. Pulmonary function tests and high resolution computed tomography abnormalities did not differ significantly between Crohn's disease and ulcerative colitis. No significant dif- ference related to inflammatory bowel disease activity was found (P > 0.05). Conclusion : Findings of high resolution computed tomography and the pulmonary function tests did not differ between ulcerative colitis and Crohn's disease. Bowel disease activity did not seem to affect these measurements. (Acta gastroenterol. belg., 2006, 69, 255- 260).

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Bile duct cannulation for ERCP therapy : success rates for techniques and devices at a single institution

Background and study aims : Deep bile duct cannulation is the first step in carrying out ERCP biliary interventions. Although many special techniques have been described, there is a lack of reports that describe all methods employed to cannulate in a sin- gle series. This is a prospective study about the way in which can- nulation was achieved in an ordinary ERCP workload. Patients and methods : From January 2002 to June 2004, all patients who underwent ERCP with accessible and intact papilla and no gastroduodenal surgical alterations were included. Cannulation either with a 5.5 french tapered, triple lumen sphinc- terotome (5.5 Fr-S), loaded with a 0.035 inch hydrophilic tip guidewire, or with a 3 french tapered, double lumen sphinctero- tome (3 Fr-S), plus a 0.025 inch guidewire, was considered stan- dard cannulation (SC). Other methods and devices were consid- ered to be alternative methods. Results : Of the 199 patients, SC succeeded in 150 (75.4%). Initial cannulation was achieved in 78/100 with the 3 Fr-S, and in 59/96 (61.4%) with the 5.5 Fr-S, (p = 0.01). Alternative methods used to reach a final 98% success rate were any type of precut (23 patients, 11.5%), cannulation above a pancreatic placed guidewire (11, 5.5%), above a pancreatic stent (7, 3.5%), utiliza- tion of two devices at the same time (3, 1.5%), and papillectomy (1, 0.5%). In 4 (2%) patients, cannulation failed. Conclusions : In almost a quarter of the patients (45, 22.6%) in this series, cannulation had to be performed by alternative meth- ods. A 3 Fr-S is a very useful tool for gaining access to the bile duct. (Acta gastroenterol. belg., 2006, 69, 261-267).

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The effects of Gingko biloba, vitamin E and melatonin on bacterial translocation in thioacetamide-induced fulminant hepatic failure in rats

Background and study aims : Bacterial translocation (BT) has been implicated in the development of infectious complications in many serious clinical conditions such as fulminant hepatic failure (FHF). We aimed to investigate the effects of Gingko biloba (GB), vitamin E (Vit E) and melatonin on intestinal oxidative damage and BT in thioacetamide (TAA)-induced FHF in rats. Materials and methods : A total of 42 rats were divided into five groups. Group 1 (n = 8) was the control group. Group 2 (n = 10) was the TAA group, in which rats received 350 mg/kg TAA daily by the intraperitoneal (ip) route for 3 days. Oral 100 mg/kg GB per day was administered to group 3 (n = 8), oral 200 mg/kg Vit E per day to group 4 (n = 8) and ip 3 mg/kg melatonin per day to group 5 (n = 8) 48 h prior to the first TAA injection and was con- tinued for 5 consecutive days. Results : When compared with the control group, serious hepat- ic and intestinal oxidative damage, increased Escherichia coli counts in ileal aspirates and high BT frequencies were observed in the TAA group (all p < 0.0001). Only GB treatment attenuated hepatic oxidative damage (p < 0.0001). There was no difference in intestinal oxidative damage, E. coli counts in ileal aspirates and BT frequency between TAA and the other antioxidant treatment groups (p > 0.05). Conclusion : Our results suggest that intestinal oxidative dam- age plays a major role in the development of BT by disrupting the barrier function of intestinal mucosa. (Acta gastroenterol. belg., 2006, 69, 268-275).

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