bluuebunny/crossref_metadata_2025_split huggingface dataset:
ACCEPTABILITY OF VIRTUAL COLONOSCOPY AS A COMMUNITY BASED CRC SCREENING TEST IN ASYMPTOMATIC AVERAGE RISK SUBJECTS
Authors: Edwards JT , Foster NM , Wood CJ , Mendelson RM , Forbes GM 
Published: January 2004

Objectives  The acceptability of virtual colonoscopy (VC) in an average risk colorectal cancer (CRC) screening population is unknown. Our aims were to (1) assess acceptability of VC and (2) compare this with colonoscopy (CY), in a community based screening programme.Methods  Randomly selected asymptomatic average risk subjects aged 50–54 or 65–69 years were invited to participate in a VC based CRC screening programme. Virtual colonoscopy involved a sodium picosulfate (picolax) based bowel preparation, hyoscine butylbromide (buscopan) injection, rectal insertion of Foley's catheter, inflation of the bowel by CO2 and supine and prone CT scans. Of 174 (M:F 91:83) subjects who have completed screening by VC, 43 had a positive VC and underwent CY on the same day. CY subjects received a mean sedation of midazolam 3.4 mg, pethidine 59 mg. All participants completed questionnaires following their procedure (s).Results Visual analogue scale questionnaire results (median scores). (0 = most favourable, 100 = least favourable)

Pain
Tolerated
General satisfaction
Level of embarrassment
How likely to do again

All VC n = 174
16
11
6
7
5

VC and CY n = 43

VC
17
17
7.5
5
4

CY
4
5
2.5
2
2

Was procedure better, worse or similar to expected?

Better (%)
Similar (%)
Worse (%)

All VC n = 174
50
43
7

CY n = 43
88
9
3

VC
CY
No preference

Preferred procedure (n = 43)
7
14
22

Conclusion  VC is a highly acceptable screening test. The vast majority of subjects would readily have either VC or CY again.
DIFFERENTIAL DIAGNOSIS OF INTESTINAL BEHCET'S DISEASE and CROHN'S DISEASE BY COLONOSCOPIC FINDINGS
Authors: Kim TI , Kim WH , Lee J‐H , Lee CR , Kang JK , Lim JK 
Published: January 2004

Both Crohn's disease and intestinal Behçet's disease can cause nonspecific ulcerative lesion in any part of the intestine. The differential diagnosis between these two diseases is often difficult due to lack of pathognomic findings. The aims of this study were to investigate the colonoscopic findings and to find valuable parameters in differentiation between Crohn's disease and Behçet's disease.Methods  From August 1989 to June 2000, 183 patients were diagnosed as Crohn's disease (82) or intestinal Behçet's disease (101). We evaluated endoscopic features of 170 patients (100 patients with Intestinal Behçet's disease and 70 patients with Crohn's disease) who had ulcerative lesions on colonoscopy. Classification and regression tree method was used for the differentiation of two diseases by colonoscopic findings.Results  The distribution of lesions was divided into 3 types; focal (single or multiple), segmental, and diffuse. Most (93%) of the lesions in intestinal Behçet's disease distributed focally, in contrast many (70%) of the lesions in Crohn's disease showed segmental or diffuse distribution. The shape of ulcer was commonly round/oval (68%) or irregular (24%) in intestinal Behçet's disease while longitudinal (49%) or irregular (30%) in Crohn's disease. The ulcer in intestinal Behçet's disease tended to deeper, and more discrete than that in Crohn's disease. Stricture, inflammatory polyp, and perianal lesion were more common in Crohn's disease. Statistically these characteristics could make a tree structured classification rule as follows (Hit ratio: 91.9%).Round/oval  Intestinal Behçet's diseaseUlcer Irregular Focal distribution Intestinal Behçet's diseaseSegmental or diffuse distribution Crohn's diseaseLongitudinal  Crohn's diseaseConclusion  The shape of ulcer and distribution of lesions were the two most distinguishable endoscopic features. Round/oval ulcer was the characteristics in intestinal Behçet's disease, and longitudinal ulcer was that in Crohn's disease. When the ulcer was irregular, focal distribution suggested intestinal Behçet's disease, while segmental or diffuse distribution suggested Crohn's disease.
DIFFERENTIAL EXPRESSION OF ZONA OCCLUDEN‐1 PROTEIN and ITS ALPHA SPLICE ISOFORMS IN CROHN'S DISEASE and ULCERATIVE COLITIS
Authors: Ooi Choon Jin , Ng Han Seong , Podolsky Daniel K 
Published: January 2004

Introduction and aims  Tight junctions (TJ) are critical in sustaining the epithelial barrier. We investigated the regulation of major TJ proteins in IBD, the MAGUK (membrane associated guanylate kinase) cytoplasmic proteins, Zona occluden (ZO)‐1 and ZO‐2. Two isoforms of TJ protein ZO‐1 exist as a result from alternative RNA splicing and they differ by an internal 80‐amino acid domain termed motif‐α. ZO‐1 a– is expressed in structurally dynamic junctions whereas ZO‐1 α+ is expressed in less dynamic cells; perhaps this differentiation may correlate with the differences in junction plasticity, but the role of these different isoforms have never been studied in IBD.Methods  Mucosal biopsies were obtained from patients with Crohn's disease (CD), and ulcerative colitis (UC) undergoing colonoscopies. Colonoscopic biopsies were taken from macroscopically ‘involved’ (I) and ‘not involved’ (NI) areas avoiding ulcerated areas. Control specimens were obtained from patients undergoing colonoscopies with no history or endoscopic evidence of inflammatory or infective processes. TJ proteins were evaluated by immunoblotting, and mRNAs encoding these TJ proteins were assessed by RT–PCR and Northern blotting. Cellular localization of TJ proteins was defined by immunofluorescence (IF). β‐Actin proteins were used as internal controls. A total of 40 patients were studied; 10 normal, 16 UC and 14 CD patients.Results  Immunoblotting revealed down‐regulation of ZO‐1, and ZO‐2 in IBD tissues. In addition, RT–PCR showed that ZO‐1α+ isoform predominated in the normal tissue while the ZO‐1α– isoform was increased in disease. Our results show that both isoforms exists in normal intestinal tissue, with the ZO‐1α– consisting 14% (SD 0.05) of total ZO‐1. However, the proportion of ZO‐1α–/total ZO‐1 increased to 29% (P < 0.05) in uninvolved CD tissues, 40% (P < 0.01) in inflamed CD tissues and 46% (P < 0.001) in inflamed UC tissues. Northern blots employing DNA probes encoding both splice variants of ZO‐1 documented a decrease in steady state RNA in diseased tissues. IF showed ZO‐1 localized to dense granules on apical surfaces in normals, but was more cytoplasmic in distribution in IBD tissues.Conclusion  Alteration in ZO‐1 expression may be specific changes to CD and UC. This is the first study to show up‐regulation of the ZO‐1α– in inflamed tissues in CD and UC. It is however, unclear if these changes are the primary event to leading to breakdown in barrier function or mere secondary manifestations to inflammation.
DOES THE CYTOSKELETON OF INTESTINAL EPITHHELIAL CELLS FUNCTION AS A CELLULAR ALARM TO IDENTIFY THE E. COLI INFECTION
Authors: Li Zhe , Elliott Elizabeth , Gunning Peter , O'Loughlin Edward 
Published: January 2004

Intestinal epithelial cells play an important role in regulating host immunity in response to intestinal infection. Pathogenic bacteria (EPEC and EHEC) cause profound cytoskeletal rearrangement in intestinal epithelial cells during attachment or invasion. Rearrangement of cytoskeletal proteins could be a signal to up‐regulate host defence response.Aims  To determine the role of actin cytoskeleton and microtubles in IL‐8 mRNA response to E. coli infection.Methods  T84 cell monolayers in 6‐well plates were infected with HB101, EPEC and EHEC (105 CFU/well) and compared with uninfected control at 3, 6 and 12 h post infection. Control and infected monolayers were treated with nocodazole (Noc, microtubule disrupter, 30 mm), taxol (Tax, microtubule stabiliser, 10 mm), cytochalasin D (CytoD, actin depolymeriser, 100 nm) and Jasplakinolide (Jasp, actin polymeriser, stabilise actin filaments, 1 mm) and studied 6 h post infection. IL‐8 gene expression was measured by semiquantitative RT–PCR in control and uninfected monolayers with and without drug treatment and IL8 protein secretion by ELISA. The morphology of F‐actin and β‐tubulin was examined by FITC‐phaloidin staining (FAS), immunohistochemistry and confocal microscopy.Results  IL‐8 mRNA and IL‐8 were increased by infection with all bacterial strains at 3 and 6 h but both IL‐8 mRNA and IL‐8 in EHEC and EPEC infection were decreased compared with control and HB101 at 12 h. Disruption of microfilaments by Noc increased IL‐8 (2.7 fold) while preservation of microfilaments by Tax inhibited IL8 response (0.5 fold) to HB101 infection only. CytoD decreased (0.1–0.5 fold) IL8 expression at all time points in all infections while stabilising actin by Jasp markedly increased the IL8 response (2–6 fold) in control, HB101, EHEC and EPEC at 3 and 6 h. CytoD inhibited Noc‐induced IL8 gene expression. Confocal microscopy demonstrated that CytoD and Noc caused major morphological damage to the actin and β‐tubulin by 6 h. Similar changes were also observed in EPEC and EHEC infection at 12 h but not HB101. Jasp preserved actin stress filaments in both EPEC and EHEC.Conclusions  Disruption of microtubules and exogenous rearrangement of actin by pathogenic organism may be primary stimuli to up‐regulate proinflammatory cytokine gene expression. Preservation of actin filaments is required for this response and may be necessary for signal transduction to the nucleus.
DOSE‐DEPENDENT EFFECT OF LUMINAL BUTYRATE ON EPITHELIAL PROLIFERATION IN THE DISTAL COLON OF RATS
Authors: Sengupta S , Tjandra JJ , Gibson PR 
Published: January 2004

Butyrate, a major product of bacterial fermentation of dietary fibre, is trophic to the colonic epithelium, when deprived of dietary fibre or faecal stream. However, the dose–response relationship of butyrate to this trophic effect is not known. The mechanism of this effect is still debated and how it relates to the antitumorigenic action of butyrate is unclear.Aim  To characterise the dose–response relationship of the effect of butyrate delivered topically to the distal colon on fibre‐deprived atrophic colonic epithelium in rats.Methods  Sixty‐four male Sprague–Dawley rats were maintained on a fibre‐free AIN 93G diet for 3 weeks to induce mucosal atrophy in the colon. The rats then underwent laparotomy for colonic intubation, in which a polyethylene tube was positioned at the proximal end of the distal colon via a caecotomy. After recovering from surgery, they were randomly divided into five groups, which were given for 4 days twice daily infusions of 0.5 mL butyrate at doses of 0, 10, 20, 40 or 80 mm (at which complete reversal of atrophy has been previously observed). Prior to sacrifice, the rats were injected intraperitoneally with vincristine to induce mitotic arrest. Crypt column heights and mitotic arrests were quantified by light microscopy.Results  All treatment groups were healthy and stress‐free. The mucosa of vehicle‐infused rats was atrophic (mean 38 cells/crypt). Effects of twice daily infusions of butyrate were first observed on cell proliferation (number of mitotic arrests per crypt column) at 10 mm, and increased linearly to 80 mm. Crypt column height increased linearly from 20 mm to 80 mm, at which a mean of 45 cells/crypt were observed (the number usually observed in chow‐fed healthy rats). The mitotic index (number of mitotic arrests per 100 crypt cells) also increased linearly from 10 mm.Conclusions  Butyrate's trophic effect showed a linear dose–dependent relationship. Although a maximal effect was not convincingly demonstrated, the results indicate that very small amounts of butyrate are required to affect epithelial proliferation. Since much higher luminal delivery is required to suppress tumorigenesis in this model, the mechanism by which butyrate exerts its trophic and antitumorigenic effects are likely to be different.
EFFECT OF PROBIOTICS ON TH1 and TH2 CYTOKINES: RELEVANCE TO PATHOGENESIS and TREATMENT OF ULCERATIVE COLITIS
Authors: Cayzer Catherine , Patel Kalpana , Wang Xin , Florin Timothy 
Published: January 2004

Ulcerative colitis (UC) mucosa is associated with a cytokine imbalance with predominance of Th2 cytokines vs. Th1. A probiotic cocktail maintains remission in patients with pouchitis (Gionchetti, 2000). In addition, probiotics have similar efficacy to mesasal in maintaining remission in UC (Rembacken, 1999). This efficacy may be due to the ability of these organisms to modulate the immune response of the host. Mice fed Lactobacillus casei produce higher levels of the Th1 cytokines, IFNγ and IL‐2, and lower levels of the Th‐2 cytokines, IL‐4, IL‐5 and IL‐6 (Matsuzaki, 2000).Hypothesis  Probiotocs may work in UC/pouchitis by up‐regulation of Th1 vs. Th2 cytokines to so restore immunological balance.Study design  Five healthy, 5 UC, 5 CD subjects; not on immunosuppression. Trial two different probiotics (Lactobacillus paracasei LAFTI ™L26, and Bifidobacterium lactis LAFTI ™B94) sequentially and randomly with 2 weeks washout. Draw blood at time 0, 2 weeks post probiotic, 4 weeks (2 weeks post washout) and 6 weeks (2 weeks post second probiotic) for PBMC. Measure by ELISA cytokines in stimulated and unstimulated 44 h cultures. Stimulate PBMC with B94, L26, or other bacterial antigens.Results  There are preliminary Th1 (TNFα, IFNγ) and Th2 (IL‐4, IL‐10) data for feeding B94, but TNFa data only for L26, for n = 2 healthy subjects. Baseline (0 week), for TNFa, unstimulated was 371 pg/mL and stimulated was for gram positive (gm+) antigens 2166 pg/mL and for gram negative (gm–) antigens 1022 pg/mL. For IFNγ, baseline stimulated and unstimulated levels were negligible. For IL‐4, baseline levels in unstimulated and stimulated cultures were low (< 100 pg/mL). With B94 (2 weeks), TNFα increased in both unstimulated (923 pg/mL) and stimulated PBMC, 4588 pg/mL (gm+), 3040 pg/mL (gm–), and significant IFNg was detected in gm+ stimulated cultures (> 1000 pg/mL), but not in unstimulated or gm– stimulated cultures. IL‐4 was down‐regulated to undetectable levels. Levels of IL‐10 varied. With L26 (week 6) there were increased levels of TNFα in unstimulated cultures (517 pg/mL) but decreased levels in stimulated cultures, 1751 pg/mL (gm +), 940 pg/mL (gm–).Conclusion  The preliminary data for B94 but not L26 support the hypothesis that probiotics may prevent relapse of UC or pouchitis by effecting up‐regulation of Th1 vs. Th2 cytokines. The Gionchetti probiotic cocktail that was used to prevent pouchitis, contained both bifidobacteria and lactobacilli. It is not known which probiotic effected that treatment, but these preliminary data indicate probiotic effects on the immune system, which are diverse.
EPIDEMIOLOGY OF IRRITABLE BOWEL SYNDROME IN AN ASIAN URBAN SOCIETY
Authors: Gwee Kok Ann , Wai Chun Tao , Wong Mee Lian , Png Damian Cj 
Published: January 2004

Background  Based on limited studies, it has been suggested that there is a lower prevalence of IBS among Asians and that there is male predominance in patients consulting for IBS. On the other hand, we have previously reported that in our hospital based clinic the prevalence and demography of IBS are similar to those of western series.Aim  To study the epidemiology of IBS in an urban Asian population.Method  A validated bowel symptom questionnaire was administered by trained interviewers first to a proportional age‐, sex‐ and race‐stratified random sample of 3000 residents in Singapore. IBS was defined using the Rome II criteria.Results  In the community survey, the response rate was 78.2% (n = 2276, 1143 males and 1133 females). The age, sex and racial distribution of our respondents were similar to the general population and there was no significant difference between respondents and nonrespondents by type of household. The prevalence of IBS was 12.2%. The prevalence of IBS was higher in women than men (14.1 vs. 10.3%, P = 0.006), the younger age group (13.8% in those aged 40 years or less vs. 10.8% in those aged more than 40 years, P = 0.034). IBS subjects appeared to be more prone to abdominal surgery 7.2% IBS subjects vs. 2.9% non‐IBS subjects, P = 0.0004. The predominant bowel habits among community IBS subjects were constipation 47.1%, diarrhoea 44.4%. There was no difference in prevalence of IBS among different educational background.Conclusion  The prevalence and demography of IBS in our Asian urban society is similar to the west with higher prevalence among women and younger age groups.
EVALUATION OF IRRITABLE BOWEL SYNDROME USING ‘EXCLUSION CRITERIA’
Authors: Jafri Wasim , Jafri Nadim , Malooni Mahesh , Shah Hasnain , Hamid Saeed , Ahmed Ashfaq 
Published: January 2004

Aims  To estimate the occurrence of IBS in patients who were evaluated for organic bowel problems in a tertiary care university hospital.Methods  Seven hundred and seventy case records were retrieved from the medical records department who were evaluated for organic bowel problems. Data were fed into forms especially designed fulfilling the Manning and Rome 11 criteria for the diagnosis of IBS. Patients under went through history and physical along with comprehensive laboratory evaluation including CBC, ESR, LFTs, BUN, Creatinine, Electrolytes, Stool detailed report, Abdominal Ultrasound, Pelvic Ultrasound in females where indicated, Flexible sigmoidoscopy and or full colonoscopy, upper GI endoscopy, CT scan of the abdomen where indicated. ERCP was also performed in evaluation of cases in special circumstances.Results  Seventy‐six patients (9.87%) fulfilled the diagnostic criteria for Irritable bowel syndrome. Abdominal pain was present in 75% of the cases, lower abdomen was the most frequent site in 68% of cases, and epigastric discomfort or pain was seen in 30%. Character of the pain was spasmodic in 50% of cases and the radiation was mostly to either side into the flanks. Pain and bloating were aggravated post–prandially. There was no special relationship to the type of food. Passage of flatus relieved bloating and pain in 30% of cases. Gas distribution was towards head in 8% and chest in 4% of cases. Stools were loose in 68% and hard, lumpy or straw shaped in the rest. Frequency of stooling was as low as 2/week to 10/day. Abdominal examination revealed epigastric tenderness in 14.7% and lower abdominal tenderness was found in 27.63%. Hemoglobin was normal in all except in 2 cases, which was due to excessive menstrual losses. ESR, LFTs, Bun, Creatinine, Electrolytes were normal in all cases. Stool detailed report was essentially normal in all, except cysts of Blastocystis Hominis were seen in 14% of cases. Flexible Sigmoidoscopy/and or Colonoscopy were normal in all cases except the presence of Hemorrhoids in 9%. Rectal biopsy was also normal in all cases. EGD revealed antral gastritis in 50% patients, which was positive for Helicobacter pylori in 62%. Anxiety and depression were significant in 28.9% of cases.Conclusions  This study confirms that IBS is a common occurrence in a tertiary care Gastroenterology Center where mostly exclusion criteria is used for the diagnosis of IBS. This is to emphasize that the symptomatology of IBS is fairly consistent and characteristic and should be given weightage for the diagnosis of IBS. Exclusion criteria should be reserved for more difficult cases especially with the alarm symptoms.
ACUTE APOPTOTIC RESPONSE INDUCED BY THE COLON CARCINOGEN AOM IS DEPENDENT ON P53 GENE and NOT THE APC GENE
Authors: Hu Y , Le Leu R , Martin J , Young GP 
Published: January 2004

Background/objective  Apoptosis is disordered in tumourigensis, however, the importance of apoptosis in relation to DNA damage created at the time of initiation by genotoxic carcinogens, i.e. the acute apoptotic response to genotoxic carcinogens (AARGC), has hardly been explored. p53 and APC are tumor suppressor genes known to be altered frequently in colon cancer, however, it remains unclear whether AARGC is dependent on the function of p53 or APC. p53 –/–, p53 ± and APCMin/+ mice provide an excellent model to test the biological significance of AARGC in colon in terms of its ability to delete genetically damaged cells that might progress to cancer. Thus, we have tested the hypothesis that p53 and APC play a critical role in AARGC, by studying AARGC in p53+/– , p53 –/– mice and APCMin/+0.Methods  p53 knockout mice were produced by breeding male p53+/– with female C57BL/J mice or interbreeding p53+/– mice. APCMin/+ mice were produced by breeding male APCMin/+ mice with female C57BL/J mice. Mice geno‐typing were confirmed by PCR. At 10–12 weeks age, 44 mice were given a single subcutaneous azoxymethane (AOM 10 mg/kg) injection to induce AARGC, and killed 6 h later (the time of the maximal response). There were eight p53–/– mice, 11 p53+/– mice, nine p53+/+mice, 12 APCMin/+ mice, and six APC+/+ mice. Three p53–/– mice, four p53+/– mice, seven p53+/+ mice, two APCMin/+, and six APC+/+ mice without AOM injection were used as controls. Apoptosis in colon was measured by classic morphological H & E criteria.Results  In p53+/+ mice, AOM induced a significant increase in apoptosis (4.70 ± 0.35, SEM, apoptotic cells per crypt column) in the distal colon, located almost exclusively in the proliferative compartment. In comparison to the pattern of apoptosis observed in the p53+/+ mice, the apoptotic response of p53–/– mice was almost nonexistent (0.12 ± 0.06) while in p53+/– mice it was significantly suppressed by approximately 50% (2.26 ± 0.28); P < 0.01. In contrast to the importance of p53 gene on AARGC, absence of the APC gene had no obvious effect on AARGC: APCMin/+ mice (5.07 ± 0.30) and APC+/+ (5.50 ± 0.33); P > 0.05.Conclusion  p53 function appears to be critically important for carcinogen‐induced apoptosis in colon, while APC homeostasis appears not to be involved in this type of apoptosis. The loss of just one allele of p53, interferes with its function. Further studies are required to determine whether defective AARGC in p53 knockout mice puts them at increased risk of subsequent events in tumorigensis, and whether AARGC can be regulated by known protective agents.