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      Ultrasonographic Evaluation of Bowel Wall Thickness and Intramural Blood Flow in Ulcerative Colitis

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          Abstract

          Aim. This study aimed at assessing Doppler ultrasonographic findings of gut wall vessels and thickness in active and quiescent ulcerative colitis. Methods. Fifty patients with ulcerative colitis were studied using transabdominal grayscale and Doppler sonography of sigmoid, distal and middle parts of descending colon in different stages of the disease. Thickness of colon wall in the most involved site, number of color signals in each box, resistive index (RI), and pulsatility index (PI) were evaluated. Results. The median thickness of the colon wall in the most involved sites was 4.3 mm in acute phase and 4.4 mm in the inactive phase ( P = 0.47). The median number of the color signals in the active phase at the most involved site, distal part of descending colon and sigmoid was higher than that of the color signals in the inactive phase ( P = 0.0001). In the most involved site, the PI and RI were undetectable in the inactive phase. The median PI was 1.4 in the mild phase, 1.3 in the moderate phase, and 1.1 in the severe phase ( P = 0.002). Conclusion. In contrast to the colon wall thickness, increased intramural blood flow reflected the clinical severity in ulcerative colitis patients.

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          Most cited references28

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          Cortisone in ulcerative colitis; final report on a therapeutic trial.

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            Multiple pathogenic roles of microvasculature in inflammatory bowel disease: a Jack of all trades.

            The etiology of Crohn's disease and ulcerative colitis, the two major forms of inflammatory bowel disease (IBD), is still largely unknown. However, it is now clear that the abnormalities underlying pathogenesis of intestinal inflammation are not restricted to those mediated by classic immune cells but also involve nonimmune cells. In particular, advances in vascular biology have outlined a central and multifaceted pathogenic role for the microcirculation in the initiation and perpetuation of IBD. The microcirculation and its endothelial lining play a crucial role in mucosal immune homeostasis through tight regulation of the nature and magnitude of leukocyte migration from the intravascular to the interstitial space. Chronically inflamed IBD microvessels display significant alterations in microvascular physiology and function compared with vessels from healthy and uninvolved IBD intestine. The investigation into human IBD has demonstrated how endothelial activation present in chronically inflamed IBD microvessels results in a functional phenotype that also includes leakiness, chemokine and cytokine expression, procoagulant activity, and angiogenesis. This review contemplates the newly uncovered contribution of intestinal microcirculation to pathogenesis and maintenance of chronic intestinal inflammation. In particular, we assess the multiple roles of the microvascular endothelium in innate immunity, leukocyte recruitment, coagulation and perfusion, and immune-driven angiogenesis in IBD.
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              Effects of exercise on mesenteric blood flow in man.

              M Qamar, A READ (1987)
              Transcutaneous Doppler ultrasound was used to assess the effects of exercise on both fasting and postprandial superior mesenteric artery blood flow. After treadmill exercise (speed 5 km/h, gradient 20%, duration 15 min) in 16 subjects, superior mesenteric artery blood flow decreased by 43% immediately after the end of the exercise and by 29% at five minutes and 24% at 10 minutes postexercise. The superior mesenteric artery blood flow response to a combination of a treadmill exercise and a liquid meal in 15 volunteers was significantly smaller at five minutes from the end of the stimuli, than the response to the meal alone (15 controls) (635 +/- 51 ml/min v 846 +/- 72 ml/min) (p less than 0.025), but not different at any other time. Thus exercise reduces mesenteric blood flow in both the fasting and postprandial state in normal subjects.
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                Author and article information

                Journal
                ISRN Gastroenterol
                ISRN Gastroenterol
                ISRN.GASTROENTEROLOGY
                ISRN Gastroenterology
                International Scholarly Research Network
                2090-4398
                2090-4401
                2012
                9 May 2012
                : 2012
                : 370495
                Affiliations
                1Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz 51656-65811, Iran
                2Liver and Gastroenterology Diseases Research Center, Tabriz University of Medical Sciences, Tabriz 51656-65811, Iran
                3Department of Radiology, Tabriz University of Medical Sciences, Tabriz 51656-65811, Iran
                4Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz 51656-65811, Iran
                5Students Research Committee, Tabriz University of Medical Sciences, Tabriz 51656-65811, Iran
                Author notes

                Academic Editors: A. Nakajima, A. A. te Velde, and A. Weimann

                Article
                10.5402/2012/370495
                3357539
                22649739
                064a52a6-2304-40bc-a82f-e4907571447f
                Copyright © 2012 Abolhassan Shakeri Bavil et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 January 2012
                : 21 February 2012
                Categories
                Clinical Study

                Gastroenterology & Hepatology
                Gastroenterology & Hepatology

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