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Elastic band ligation of hemorrhoids:Flexible gastroscope or rigid proctoscope?

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World Journal of Gastroenterology 2007年第4期13卷 585-587页

作者： M cazemier RJF Felt-Bersma MA Cuesta CJJ Mulder Department of Gastroenterology and Hepatology VU University Medical Center Amsterdam The Netherlands Department of Gastrointestinal Surgery VU University Medical Center Amsterdam The Netherlands Department of Gastroenterology and Hepatology VU University Medical Center.Amsterdam The Netherlands

AIM： To compare dgid proctoscope and flexible endoscope for elastic band ligation of internal hemorrhoids. METHODS： Patients between 18 and 80 years old, with chronic complaints （blood loss, pain, itching or prolapse） of internal hemorrhoids of grade 1-91, were randomized to elastic band ligation by rigid proctoscope or flexible endoscope （preloaded with 7 bands）. Patients were retreated every 6 wk until the cessation of complaints. Evaluation by three-dimensional anal endosonography was performed. RESULTS： Forty-one patients were included （median age 52.0, range 27-79 years, 20 men）. Nineteen patients were treated with a rigid proctoscope and twenty two with a flexible endoscope. Twenty-nine patients had grade I hemorrhoids, 9 patients had grade 11 hemorrhoids and 3 patients had grade 91 hemorrhoids. All patients needed a minimum of 1 treatment and a maximum of 3 treatments. A median of 4.0 bands was used in the rigid proctoscope group and a median of 6.0 bands was used in the flexible endoscope group （P 〈 0.05）. Pain after ligation tended to be more frequent in patients treated with the flexible endoscope （first treatment： 3 vs 20 patients, P 〈 0.05）. Three- dimensional endosonography showed no sphincter defects or alterations in submucosal thickness. CONCLUSION： Both techniques are easy to perform, well tolerated and have a good and fast effect. It is easier to perform more ligations with the flexible endoscope. Additional advantages of the flexible scope are the maneuverability and photographic documentation. However, treatment with the flexible endoscope might be more painful and is more expensive.

关键词： Hemorrhoids Barron ligation Rigid scope Endoscope Anal endosonography

Retrospective analysis of old-age colitis in the Dutch inflammatory bowel disease population

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World Journal of Gastroenterology 2008年第20期14卷 3183-3187页

作者： Muhammed Hadithi Marcel cazemier Gerrit A Meijer Elisabeth Bloemena Richel J Felt-Bersma Chris J Mulder Stephan GM Meuwissen Amado Salvador Pea Adriaan A van Bodegraven Department of Gastroenterology VUmcUniversity Medical Center Department of Pathology VUmc University MedicalCenter

AIM： To describe the characteristics of Dutch patients with *** bowel disease （IBD） first diagnosed above 60 years of age-a disease also known as old-age colitis （OAC） and to highlight a condition that has a similar appearance to IBD, namely segmen- tal colitis associated with diverticular disease （SCAD）. METHODS： A retrospective longitudinal survey of patient demographic and clinical characteristics, disease characteristics, diagnostic methods, management and course of disease was performed. The median follow-up period was 10 years. RESULTS： Of a total of 1100 IBD patients attending the Department of Gastroenterology, 59 （50） [median age 82 years （range 64-101）; 25 male （42%）] were identified. These patients were diagnosed with ulcerative colitis （n = 37, 61%）, Crohn＇s disease （n = 14, 24%）, and indeterminate colitis （n = 8, 15%）. Remission was induced in 40 （68%） patients within a median interval of 6 mo （range 1-21） and immunosuppressive therapy was well tolerated. Histological evaluation based on many biopsy samples and the course of the disease led to other diagnosis, namely SCAD instead of IBD in five （8%） patients. CONCLUSION： OAC is not an infrequent problem for the gastroenterologist, and should be considered in the evaluation of older patients with clinical features suggestive of IBD. Extra awareness and extensive biopsy sampling are required in order to avoid an erroneous diagnosis purely based on histological mimicry of changes seen in SCAD, when diagnosing IBD in the presence of diverticulosis coli.

关键词： Inflammatory bowel disease Old-age colitis Segmental colitis

肛门外括约肌的萎缩和缺损检查:三维肛门超声内镜与肛内磁共振成像检查的比较

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世界核心医学期刊文摘（胃肠病学分册） 2006年第8期2卷 4-5页

作者： cazemier M. Terra M. P. Stoker J. 陈云茹(译) 史敏(校) VU Medical Center De Boelelaan 1117 1007 MB Amsterdam Netherlands 不详

PURPOSE: Using endoanalmagnetic resonance imaging, atrophy of the external anal sphincter can be established. This aspect has not been thoroughly investigated using three-dimensional anal endosonography. The purpose of this study was to compare prospectively three-dimensional anal endosonography to magnetic resonance imaging in the detection of atrophy and defects of the external anal sphincter in patients with fecal incontinence. In addition, we compared both techniques for anal sphincter thickness and length measurements. MATERIALS AND METHODS: Patients with fecal incontinence underwent three-dimensio-nal anal endosonography and magnetic resonance imaging. Images of both endoluminal techniques were evaluated for atrophy and defects of the external anal sphincter. External anal sphincter atrophy scoring with three-dimensional anal endosonography depended on the distinction of the external anal sphincter and its reflectivity. External anal sphincter atrophy scoring with magnetic resonance imaging depended on the amount of muscle and the presence of fat replacement. Atrophy score was defined as none, moderate, and severe. A defect was defined at anal endosonography by a hypoechogenic zone and at magnetic resonance imaging as a discontinuity of the sphincteric ring and/or scar tissue. Differences between three-dimensional anal endosonography and magnetic resonance imaging for the detection of external anal sphincter atrophy and defects were calculated. In addition, we compared external anal sphincter thickness and length measurements in three-dimensional anal endosonography and magnetic resonance imaging. RESULTS: Eighteen patients were included (median age, 58 years; range, 27- 80; 15 women). Three-dimensional anal endosonography and magnetic resonance imaging did not significantly differ for the detection of external anal sphincter atrophy (P = 0.25) and defects (P = 0.38). Three-dimensional anal endosonography demonstrated atrophy in 16 patients, magnetic resonance

关键词：磁共振成像检查肛门外括约肌超声内镜肛内三维缺损大便失禁前瞻性比较肌萎缩测量技术

月桂酰乳酰乳酸钠对感染亚临床产气荚膜梭菌肉鸡生产性能和肠道健康的影响

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饲料博览 2011年第2期21卷 34-34页

作者： Lensing M Vander K J D Fabri T cazemier a Else A J

产气荚膜梭菌属革兰氏阳性菌,是一种家禽肠道致病菌。由于产气荚膜梭菌亚临床感染常导致肠黏膜损害,降低营养物质的消化,降低生产性能,应采取一种有效的措施控制产气荚膜梭菌的过度生长。为此,本文旨在研究月桂酰乳酰乳酸钠作为一种饲... 详细信息

产气荚膜梭菌属革兰氏阳性菌,是一种家禽肠道致病菌。由于产气荚膜梭菌亚临床感染常导致肠黏膜损害,降低营养物质的消化,降低生产性能,应采取一种有效的措施控制产气荚膜梭菌的过度生长。为此,本文旨在研究月桂酰乳酰乳酸钠作为一种饲料添加剂防止产气荚膜梭菌在肉鸡肠道内定植(LauL)的药效测定。首先,将月桂酰乳酰乳酸钠与感染产气荚膜梭菌肉鸡的月桂酸单体甘油二脂(MDG)和月桂酸游离脂肪酸(LauL)相比,产气荚膜梭菌损害度16分的结果表明,MDG和LauL两者都有降低损害程度的效果。考虑到体增重和死亡率,LauL比MDG更有效。因此,剂量反应研究目的是确定最佳LauL添加量。试验结果表明,LauL的剂量高于15%,对损害度和死亡率起到预期的积极作用。不添加任何剂量的LauL,生长性能较好。在第3次试验中,将LauL的效果与限制肠道内细菌活性的商业化产品(Aromabiotic波尔60)或限制球虫病的细菌(化学抗球虫药,Clinacox)相比。该产品并没有减少损害的数目和严重程度,且对生产性能无影响。因此,尽管在试验1和试验2中,高于0.15%剂量的LauL产生了显著的作用效果,但是添加月桂酰乳酰乳酸钠并不能降低产气荚膜梭菌在肉鸡体内的定植,故在试验3中并未产生效果。但为进一步研讨月桂酰乳酰乳酸钠作为潜在的添加剂对减少肉鸡产气荚膜梭菌激发的免疫反应的研究,提供了科学依据。

关键词：产气荚膜梭菌月桂酰乳酰乳酸钠肠道健康肉鸡

月桂酰乳酰乳酸钠对感染亚临床产气荚膜梭菌肉鸡生产性能和肠道健康的影响

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饲料博览 2010年第12期20卷 49-49页

作者： Lensing M Van der Klis J D Fabri T cazemier a Else A J

产气荚膜梭茵属革兰氏阳性菌，是一种家禽肠道致病菌。由于产气荚膜梭菌亚临床感染常导致肠黏膜损害，降低营养物质的消化，降低生产性能，应采取一种有效的措施控制产气荚膜梭茵的过度生长。

关键词：产气荚膜梭菌肉鸡生产性能亚临床感染肠道健康乳酸钠月桂酰革兰氏阳性菌肠道致病菌