Ulcerative Colitis: Hasegawa M

Ando T, Takahashi H, Watanabe O, Maeda O, Ishiguro K, Ishikawa D, Hasegawa M, Ohmiya N, Niwa Y, Goto H. · Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan. · World J Gastroenterol. · Pubmed #17551998 links to  free full text

Abstract: Ulcerative colitis (UC) is a chronic inflammatory bowel disorder characterized by exacerbations and remissions. The degree of inflammation as assessed by conventional colonoscopy is a reliable parameter of disease activity. However, even when conventional colonoscopy suggests remission and normal mucosal findings, microscopic abnormalities may persist, and relapse may occur later. Patients with long-standing, extensive ulcerative colitis have an increased risk of developing colorectal cancer. Ulcerative colitis-associated colorectal cancer is characterized by an early age at onset, poorly differentiated tumor cells, mucinous carcinoma, and multiple lesions. Early detection of dysplasia and colitic cancer is thus a prerequisite for survival. A relatively new method, magnifying chromoscopy, is thought to be useful for the early detection and diagnosis of dysplasia and colitic cancer, as well as the prediction of relapse.

Watanabe O, Ando T, Maeda O, Hasegawa M, Ishikawa D, Ishiguro K, Ohmiya N, Niwa Y, Goto H. · Department of Gastroenterology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan. · J Gastroenterol Hepatol. · Pubmed #19120913 No free full text.

Abstract: BACKGROUND: Confocal endomicroscopy is a new technology that provides microscopic images of cellular morphology in the gastrointestinal tract in vivo. In particular, confocal microendoscopy allows histological diagnosis during the endoscopic examination. We examined patients with ulcerative colitis (UC) using confocal endoscopy and investigated the features of confocal endomicroscopic images of inflamed and non-inflamed rectal mucosa. METHODS: Seventeen patients with UC, 12 in the active phase and 5 in the non-active phase, and 14 non-UC control patients who had colon polyps or colon cancer underwent colonoscopy, during which fluorescence images of the rectal mucosa were obtained with confocal endomicroscopy. Histological findings of rectal biopsy specimens were compared with the microendoscopic images. RESULTS: Confocal microendoscopy allowed observation of cellular and subcellular structures. The crypts of normal colonic mucosa were small, round and regularly arranged, and the crypt lumens of the colonic glands were small and round. The crypts of colonic mucosa in non-active UC were small, round and slightly irregular in arrangement and the crypt lumens of the colonic glands were small and round. Inflammatory cells and capillaries were visible in the lamina propria. The crypts of colonic mucosa in active UC were large, variously shaped and irregular in arrangement. The crypt lumens of the colonic glands were large and the crypt structure could not be recognized in some areas. Numerous inflammatory cells and capillaries were visible in the lamina propria. CONCLUSIONS: Images taken with the confocal microendoscope provided information that was equivalent to conventional histology, and improve our understanding of the differences in rectal tissues (crypts, capillaries and inflammatory cells) between normal controls and active and non-active UC patients during ongoing endoscopy.

Ando T, Watanabe O, Nobata K, Ishiguro K, Maeda O, Ishikawa D, Hasegawa M, Kondo S, Kato T, Ohmiya N, Niwa Y, Goto H. · Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan. · Digestion. · Pubmed #18577851 No free full text.

Abstract: BACKGROUND/AIMS: Ulcerative colitis (UC) mainly affects the colon and rectum, whereas the chronic inflammatory process in Crohn's disease (CD) can affect any part of the gastrointestinal tract. Recently, however, upper gastrointestinal lesions have been reported in UC patients. In this study, we investigated the immunological status of the stomach in UC or CD patients. METHODS: 26 patients each with UC, CD or functional dyspepsia (FD) underwent diagnostic upper gastrointestinal endoscopy, and biopsy specimens were obtained from the gastric antrum.The contents of interleukin (IL)-6 and IL-8 in the organ culture supernatants of antral mucosal tissues were measured with enzyme-linked immunosorbent assay. RESULTS: Endoscopically abnormal findings in the stomach were more frequent in CD than in UC or FD patients. Mononuclear cell infiltration and IL-6 production in the gastric antrum did not significantly differ between UC and FD patients, but were higher in those with CD. There was no significant difference in neutrophil infiltration or IL-8 production between UC, CD, and FD patients. CONCLUSIONS: UC patients did not show the immunological abnormalities in the stomach seen in CD patients.

Nozue T, Kobayashi A, Takagi Y, Okabe H, Hasegawa M. · Department of Pediatrics, Showa University Toyosu Hospital, Tokyo, Japan. · Pediatr Int. · Pubmed #10881587 No free full text.

Abstract: BACKGROUND: We determined whether magnetic resonance imaging (MRI) could determine the activity and site of involvement in ulcerative colitis. METHODS: Colonoscopy, double-contrast barium enema and gadodiamide-enhanced MRI were performed prospectively in six patients with ulcerative colitis, including three females aged 10-22 years, both in the active and the remission stages. RESULTS: Characteristic findings of MRI in the active stage of ulcerative colitis were loss of haustral markings and thickening and contrast enhancement of the colonic wall. In five of six patients, the site of disease distribution determined by MRI was in accordance with that determined by colonoscopy. CONCLUSIONS: Gadodiamide-enhanced MRI is a safe and useful method of determining disease activity and extent in patients with ulcerative colitis.