Akishige Obata

New treatment of ulcerative colitis with K-76

The complement inhibitor K-76 (Otsuka Pharmaceutical Co., Osaka, Japan) was clinically evaluated as a new drug for treatment of active stage ulcerative colitis (UC). As monotherapy, K-76 proved effective in four of five cases. Furthermore, in patients with active stage UC that continued despite administration of corticosteroid hormone and salicylazosulphapyridine (so-called refractory UC), concomitant administration of K-76 was effective in seven of 21 cases. Thus, we believe that the multifunctional agent K-76 will provide clinicians with a new therapeutic approach to inflammatory bowel diseases, including UC and Crohns disease.

Clinical and prognostic features of rectal sparing in ulcerative colitis

Thirty patients with ulcerative colitis who had been followed clinically for more than 5 years were studied. Patients with total or left-sided colitis were investigated to evaluate the significance of rectal sparing in the prognosis of the disease. Patients were divided into two groups, one with complete or relative sparing of the rectum and the other with homogeneous lesions ranging from the rectum to the proximal colon based on endoscopic findings. The administration of topical corticosteroids seemed to have little effect on rectal sparing. However, the relapse index was significantly higher in patients with rectal sparing. The intractability index, representing the ratio of the duration of the active stage to the investigation period, was also higher, though not significantly so, in this group. The results suggest that rectal sparing may give information about intractability or a tendency to relapse.

Multifunctional effects of anticomplementary agent K-76 on carrageenan-induced colitis in the rabbit

In this study the effect of K‐76. a sesquiterpcne compound with anticomplementary activity isolated from a fungus culture, on carrageenan‐induced colitis was studied from biochemical, histological and immunohistopathological aspects. K‐76 suppressed epithelial cell loss, crypt abscess formation, inflammatory cell infiltration, mucosal atrophy, and ulceration. Immunohistochcmical examination ofthe colonic mucosa showed that the number of IgG‐ and IgM‐positive plasma cells and the staining intensity for IgG and C3 were increased in carrageenan‐induced colitis, but these changes were inhibited by K‐76. Besides, serum mucoprotcin concentrations and CH50 levels were lower in the animals treated with carrageenan alone. K‐76 exerted multifunctional activity, although its mechanisms of action remain obscure.

DISTRIBUTION AND ANTI-INFLAMMATORY EFFECT OF MESALAZINE ON CARRAGEENAN-INDUCED COLITIS IN THE RABBIT

1. A controlled‐release preparation of mesalazine microgranules (PentasaR; Ferring AS, Vanlose, Denmark) releases the active ingredient over a wide area from the small intestine to the rectum and is consequently expected to bring about therapeutic benefits to patients with ulcerative colitis and Crohns disease.

Immunoglobulin-containing cells in the colonic mucosa of rabbits with carrageenan-induced colitis

Immunohistochemical analysis of immunocompetent cells in the colonic mucosa was performed with carrageenan-induced experimental colitis in rabbits. Colitis was induced by seven months of oral administration of λ-degraded carrageenan following immunization with the same substances containing Freunds complete adjuvant. In the colonic mucosa with colitis, IgG- and IgM-containing cells were significantly increased in number (IgG: 540±94/mm2 in experimental group,vs. 120±54/mm2 in control,P<.05, IgM: 55.0±19.7/mm2 in experimental group,vs. 6.7±2.4/mm2 in control,P<.05). There was no significant increase of IgA-containing cells either in number or in proportion to the total mononuclear cells. These changes, induced by carrageenan in rabbits, had resembled those in human ulcerative colitis well. These observations suggested an impairment of the IgA-regualted local immune system and an abnormality in the differentiation process of immunoglobulin-secreting cells.

A Study on Atypical Endoscopic Findings of Ulcerative Colitis: Longitudinal Ulcers, Mucosal Bridges and Red Spots

Abstract: One hundred and twenty‐one ulcerative colitis patients diagnosed during the period of 1984 to 1988 were examined endoscopically on repeated occasions. Forty‐six patients had total colitis, 56 had left‐sided colitis, 15 had proctitis, and 4 were postoperative patients. When classified according to their macroscopic findings, 28 of the patients had the polyposis type of this disease, 88 had the atrophic type, and 5 had the mixed type. Longitudinal ulcers were found in 9 patients, occuring usually in the sigmoid colon. There was no pathological evidence of ischemic changes in these 9 patients. Mucosal bridges were found in 13 of the patients with total colitis, occurring somewhere from the cecum to the rectum. The mucosal bridges tended to be present during the mildly active stage of the disease. Red spots, which sometimes looked like vascular spiders, were found in 10 patients. The spots tended to appear before the disease went into the inactive stage. Histological observation showed regenerating vessels, sometimes with intramucosal bleeding; therefore the spots seemed to be intractable changes.

The leading cord method of colonofiberscopy

Although the colonofiberscope has undergone various modifications and improvements, the insertion principle remains unchanged; that is pushing and rotation and the elasticity of the scope itself are inevitable. It often is difficult to maintain proper balance among these dynamic factors; imbalance prevents deep insertion. Over-elongation of the scope leads to insertion failure, particularly if there are adhesions of the sigmoid colon, overextension of the colon, or transverse colon ptosis. Our “leading cord” method is an excellent aid to colonofiberscopy. It can be inserted from the clamp hole of a conventional fiberscope and hardened to straighten the scope, thereby permitting deep insertion. With this technique the region from the rectum to the descending colon, as well as a ptosed transverse colon, can be straightened. Our clinical experience indicates that the rate of successful insertions in colonofiberscopy will be increased considerably with this complementary device.