Abnormal Epithelial Cells in Ulcerative Colitis

Boddington, Michael M.; Truelove, S. C.

doi:10.1136/bmj.1.4979.1318

Cited by 37 publications

(8 citation statements)

References 7 publications

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“…During the first and second days the cells that advance over the floor of a lesion are flattened in form before becoming hypertrophied, and this feature of regenerating epithelium is very well exemplified by most of the simple epithelia referred to here. Findings similar to those in experimental lesions are found in human pathological material; they are common in healing peptic ulcers and have been noted by Counsel1 (1955) in the ileum and Boddington & Truelove (1956) in the rectum during reparative phases in ulcerative colitis. Such an attempt to cover as much of a lesion as quickly as possible in the early stages of repair was regarded by earlier workers, e.g.…”

Section: ( I ) Epithelial Reactionssupporting

confidence: 77%

The Cytology of Wound Healing of Body Surfaces in Mammals

Johnson¹,

McMinn²

1960

Biological Reviews

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SUMMARY The cytological aspects of the repair of wounds with loss of substance in the skin, cornea and a number of mucous, serous and synovial membranes in mammals (laboratory animals and man) have been reviewed. It is emphasized that, as in the last century, the majority of studies of wound healing continue to be carried out on skin, and the need for examining repair processes in other organs is stressed. While most of the evidence indicates that epithelium regenerates from old epithelium at the wound margin, the surfaces of serous and synovial membranes are probably repaired by metaplasia of underlying connective tissue cells, assisted by the implantation of islands of surface cells that have desquamated from adjacent surfaces. The epithelia of the gall‐bladder and urinary bladder (in the cat) display abundant evidence of mitosis in migrating cells. Mitosis in spreading cells has also been observed in ileal and rectal epithelium. While migration remains a primary factor in epithelial repair, the role of mitosis has possibly been underestimated in the past. The origin of the connective tissue cells of granulation tissue remains an enigma. There is evidence suggesting that the fibrocytes of the dermis do not proliferate, and that new connective tissue cells are haematogenous in origin. The endothelial (vascular and lymphatic) elements of granulation tissue originate by budding from pre‐existing vessels. There is doubt whether mitosis occurs in such endothelial cells. In the repair of mucous membranes in the alimentary tract, new gland formation is observed regularly in the stomach, duodenum and ileum in all the species that have been investigated, including man. The colon and rectum appear to exhibit less regenerative capacity than higher levels of the alimentary tract, for there is no consistent evidence for new gland formation in these viscera. No universally applicable explanation is yet forthcoming for the accumulation of glycogen that can be detected histochemically in many, but not all, of the regenerating epithelia that have so far been studied. Among the urgent items on which cytological research might be prosecuted in the future are: the possible role of metaplasia of connective tissue cells in the production of new epithelium, mitosis in migrating epithelium, the factors regulating the initiation and cessation of mitosis, the problem of the origin of new connective tissue cells, and the causes of contraction. Compared with the number of purely morphological studies, histochemistry and autoradiography have not often been wedded to the problems of repair, while the whole field of wound healing at the cellular level awaits study with the electron microscope.

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Section: ( I ) Epithelial Reactionssupporting

confidence: 77%

The Cytology of Wound Healing of Body Surfaces in Mammals

Johnson¹,

McMinn²

1960

Biological Reviews

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“…Therefore, care should be taken whenever cytological examination is performed in adnoma. In contrast, such very atypical cells as reported previously by Galambos et al (1956) and Boddington and Truelove (1956) appeared infrequently in ulcerative colitis in this series, while a great many of neutrophils together with multinucleated giant cells or plasma cells were characteristic of the active stage of ulcerative colitis (Watanabe et al 1977). Bemvenuti et al (1974) reported that 4 cases of cancer associated with ulcerative colitis were correctly diagnosed cytologically.…”

Section: Resultscontrasting

confidence: 48%

Cytological Diagnosis of Cancer of the Colon and Rectum

Watanabe

1978

Tohoku J. Exp. Med.

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of Cancer of the Colon and Rectum Tohoku J. exp. Med., 1978, 124(2), 169-176-Results of cytological examination in 120 cases of colon and rectum cancer during the 11-year period ending in 1968 prior to the practical use of fibercolonoscope were first studied.At that time, quite favorable results were obtained in cancer of the lower colon and the rectum, but the results were not so satisfactory in cancer of the right side of the colon. After 1969 when the fibercolonoscope was introduced into the clinical practice, the range of cytological diagnosis under direct vision was at once expanded to the entire colon. Consequently, diagnosis by the cytological method in 140 cases of cancer of the colon and rectum experienced in 6-year period between 1969 and 1974 revealed favorable results.The results of the cytological diagnosis in cancer of the right side of the colon, previously not always favorable, improved markedly after the introduction of the cytological method under direct vision through fibercolonoscope.When early cancer of the colon and rectum is defined as in early gastric cancer, 40 lesions in 36 patients were detected during the past 19 years. The rate of positive result in cases of early cancer obtained by various diagnostic methods was 83% by the cytological method, 78% by biopsy and 91% by polypectomy.In cases in which both biopsy and cytological method were used, one or both frequently gave positive results. These results would indicate the possibility of correct diagnosis in many cases through the combined use of the cytological method and biopsy, without polypectomy. cytological diagnosis; cancer of the colon and rectum Diagnosis of cancer of the colon and rectum is usually made by x-ray examina tion, proctosigmoidoscopy, biopsy and exfoliative cytology. In recent years, a newly developed fibercolonoscope has opened the possibility of direct observation as well as the possibility of cytological study under direct vision through an endoscope in lesions beyond the reach of proctosigmoidoscope.Since 1958 we have made the cytological studies at the Third Department of Internal Medicine, Tohoku University Hospital, for the purpose of detection of cancer of the colon and rectum in its early stage, using various cell sampling methods such as rectal swabbings, modified colon brush method, colonic lavage, and recently, biopsy-smear method under direct vision through the fibercolonoscope (Yamagata et al. 1961;Watanabe 1972). The purpose of this paper is to summarize our experiences and conclusions from these investigations during a 19-year period.

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“…In a previous study (Boddington and Truelove, 1956) it was found that the colonic epithelial cells are frequently abnormal in ulcerative colitis. Compared with normal colonic epithelial cells, many of those seen in active ulcerative colitis are much enlarged, with big nuclei having nucleoli and a disturbed chromatin pattern.…”

Section: And 2 Cytological Findingsmentioning

confidence: 92%

“…from the anal margin, by means of an improved version of a special colonic biopsy instrument (Truelove et al, 1955). Specimens were taken for cytological examination by the Papanicolaou technique by means of a special instrument described previously (Boddington and Truelove, 1956).…”

Section: Present Investigationmentioning

confidence: 99%

Treatment of Ulcerative Colitis with Local Hydrocortisone Hemisuccinate Sodium

Truelove¹

1957

BMJ

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TOXIC EFFECTS OF IPRONIAZID BRrrsHMEDICAL JOURNAL within 36 hours. He continued on the same dose of iproniazid for a further five months, during which time he showed signs of increasing restlessness, euphoria, insomnia, and other mild toxic effects. He died in coma after an acute illness characterized by fever, coarse tremor, hallucinations, and " auditory delusions." At necropsy the brain showed that death was due to haemorrhagic encephalitis; since no other cause was apparent this was believed to be due to the toxic effect of iproniazid. The toxic manifestations of the central nervous system caused by pethidine and iproniazid are similar: cerebral excitation, confusion, restlessness, and muscle twitchings are common to both. It is difficult to decide whether in our own and Mitchell's case cerebral symptoms were caused by the simple additive effect of the two drugs or by a more complex inhibition of the enzyme-detoxicating system in the liver. The problem, however, is of theoretical interest. It is of practical importance that the two drugs become incompatible once a certain level of iproniazid is reached in the tissues. This may take up to four weeks.The response to chlorpromazine was remarkable and perhaps a life-saving measure in our patient. Barbituirates commonly invoked in the treatment of cerebral excitation did not help, and in larger doses could have done actual harm if, as we have suggested, the liver detoxicating system was affected by iproniazid.Although the pharmacological action on the heart is not yet clearly established, the improvement in this case and in others still under observation suggests that iproniazid is a promising drug in the treatment of angina. Patients with decubital angina, however, need heavy sedation with morphine analogues and barbiturates; potentiation with iproniazid may give rise to toxic cerebral reactions as in our patient. It is because of such therapeutic implications that this case is reported. Summary A case of decubital angina treated with iproniazid is reported. Although the frequency of the attacks diminished, occasional pethidine injections were still needed for the relief of pain. During the fifth week of iproniazid treatment these injections were followed by signs of severe cerebral irritation and excitement which responded dramatically to chlorpromazine. Either the simple additive effect of the two drugs or more complex interference with the normal detoxication of pethidine in the liver by iproniazid is believed to have caused toxic cerebral damage. It is suggested that pethidine should be used with caution in patients on iproniazid treatment.ADDENDUM.-Since this paper was submitted a different complication of iproniazid treatment has been encountered in a 63-year-old man suffering from incapacitating angina of effort. On a dose of 50 mg. twice daily, much improvement resulted. One month later, while still on the same dose, he complained of difficulty of micturition and giddiness, and his blood pressure had fallen from 140/80 to 110/ 75. Iproniazid was disconti...

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Abnormal Epithelial Cells in Ulcerative Colitis

Abstract: Sister Houle for her active co-operation.

Cited by 37 publications

References 7 publications

The Cytology of Wound Healing of Body Surfaces in Mammals

The Cytology of Wound Healing of Body Surfaces in Mammals

Cytological Diagnosis of Cancer of the Colon and Rectum

Treatment of Ulcerative Colitis with Local Hydrocortisone Hemisuccinate Sodium

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