Inflammatory Bowel Diseases: Proceedings of the International Symposium on Inflammatory Bowel Diseases, Jerusalem September 7–9, 1981

310 Pages·1982·12.133 MB·English

by  John H. Yardley M.D., Stanley R. Hamilton M.D. (auth.), Daniel Rachmilewitz M.D. (eds.)

INFLAMMATORY BOWEL DISEASES
DEVELOPMENTS IN GASTROENTEROLOGY
VOLUME 3
Also in this series:
1. Peiia AS, Weterman IT, Booth CC, Strober W, eds: Recent advances
in Crohn's disease
ISBN 90-247-2475-9
2. Motta PM, Didio LJA, eds: Basic and clinical hepatology, 1981.
ISBN 90-247-2404-x
series ISBN 90-247-2441-4
INFLAMMATORY BOWEL
DISEASES
Proceedings of the International Symposium on Inflammatory Bowel
Diseases, Jerusalem September 7-9, 1981
edited by
Daniel Rachmilewitz
Hadassah University Hospital,
Jerusalem, ISRAEL
1982
MARTINUS NIJHOFF PUBLISHERS
THE HAGUE / BOSTON / LONDON
Distributors
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for all other countries
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I.ibrar~: of ('ong:rt'!'I"i ('alalugin,l!; in Publi('atioll nata
International Symposium on Inflammatory Bowel Di
seases (1981 : Jerusalem)
In fl.ammatory bowel diseases.
(Developments in gastroenterology; v. 3)
1. Intestines--Inflammation--Congresses.
2. Enteritis, Regional--Congresses. 3. Ulcerative
co.litis--Congresses. I. Rachmilewitz, Daniel.
II. Title. III. Series. [DNLM: 1. Crohn disease
--Congresses. 2. Colitis, Ulcerative--Congresses.
Wl DE997VYB v. 3 / WI 522 159i 1981]
RC862.E5157 1981 616.3'4 82-2118
ISBN-13:978-94-009-7516-3 AACR2
ISBN-13:978-94-009-7S16-3 e-ISBN-13:978-94-009-7S14-9
DOl: 1O.1007/978-94-009-7S14-9
Copyright © 1982 by Martinus Nijhoff Publishers, The Hague.
Softcover reprint of the hardcover 1st edition 1982
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted in any form or by any means, mechanical, photocopying, recording, or otherwise,
without the prior written permission of the publishers,
Martinus Nijhoff Publishers, P.O.Box 566,2501 CN The Hague, The Netherlands.
v
PREFACE
An international symposium on inflammatory bowel diseases was held
in Jerusalem on September 7th-9th, 1981. The symposium was sponsored
by the Hebrew University-Hadassah Medical SchooL and the Israeli
Gastroenterological Society. The idea was to bring together leading
workers in the field, to invite all those interested to present their new
work on IBD and thus to enable exchange of information and cross
fertilization needed to improve our understanding and handling of these
diseases.
The symposium was organized into four panels devoted to state of
the art reviews. presentation of new findings and approaches on the follow
ing topics: New pathological concepts. etiology. pathogenesis and
management of IBD. In addition. 89 abstracts were presented as posters
during the symposium. all of which were published in the book of abstracts.
The concluding panel outlined new directions for future research on IBD.
We owe our gratitude to Drs. J. B. Kirsner, G. L. Gitnick and
C. E. Rubin, members of the Organizing Committee, without whose
encouragement and help the symposium could not have taken place. The
Organizing Committee owes a considerable debt of gratitude to all the
contributors who presented their work in a clear and concise manner,
to all those who presented posters and to all the participants who came
from 27 countries. Their stimulating presentations and discussions con
tributed to the success of the meeting.
The keen interest which was shown in the symposium has led many
to ask about a future meeting to take place in a similar framework. We hope
that we shall be able to arrange a second International Symposium on
Inflammatory Bowel Diseases to take place in Jerusalem in September. 1984.
Henry D. Janowitz. M. D.
Daniel Rachmilewitz. M. D.
VII
LIST OF CONTRIBUTORS
John Alexander-Williams, M. D. Sherwood L. Gorbach, M. D.
Consultant Surgeon Professor of Medicine
The General Hospital Tufts University School of Medicine
Birmingham, England New England Medical Center Hospital
Boston, Massachusetts
David H. Alpers, M. D.
Professor of Medicine Henry D. Janowitz, M. D.
Washington University Clinical Professor of Medicine
School of Medicine Mount Sinai School of Medicine
St. Louis, Missouri of the City University of New York
New York
Marvin E. Ament, M. D
Professor of Pediatrics Martin F. Kagnoff, M. D.
University of California, Associate Professor of Medicine
Los Angeles School of Medicine University of California, San Diego
Los Angeles, California San Diego, California
Kiron M. Das, M. D., Ph. D. Joseph B. Kirsner, M. D., Ph. D.
Associate Professor of Medicine Louis Block Distinguished Service
Albert Einstein College of Professor of Medicine
Medicine The Division of the Biological Sciences
New York and The Pritzker School of Medicine
Chicago, Illinois
Irwin M. Gelernt, M. D.
Associate Professor of Surgery Richard B. McConnel, M. D.
Mount Sinai School of Medicine Consultant Physician
of the City University of Broadgreen Hospital
New York, Liverpool, England
New York
Albert 1. Mendeloff, M. D.
Tuvia Gilat, M. D. Professor of Medicine
Associate Professor of Medicine The Johns Hopkins University
Tel-Aviv University, School of Medicine,
Tel Aviv, Israel Baltimore, Maryland
Gary L. Gitnick, M. D. Andrew Onderdonk, Ph. D.
Professor of Medicine Director, Diagnostic Services
University of California, Tufts University
Los Angeles School of Medicine School of Veterinary Medicine,
Los Angeles, California Boston, Massachusetts
Harvey Goldman, M. D. Sidney F. Phillips, M. D. ,
Professor of Pathology Professor of Medicine
Harvard Medical School, Mayo Medical School,
Boston, Massachusetts Rochester, Minnesota
VIII
Daniel Rachmilewitz. M. D. Roy G. Shorter. M. D .•
Associate Professor of Medicine Section of Tissue and Organ
Hebrew University-Hadassah Transplant.
Medical School. Mayo Clinic.
Jerusalem. Israel Rochester. Minnesota
Irwin H. Rosenberg. M. D. John W. Singleton. M. D .•
Professor of Medicine Associate Professor of Medicine
The University of Chicago University of Colorado Medical
Pritzker School of Medicine Center.
Chicago. Illinois Denver. Colorado
Cyrus E. Rubin. M. D. Guido N. J. Tytgat. M. D .•
Professor of Medicine Professor of Medicine
University of Washington. University of Amsterdam Medical
Seattle. Washington School.
Amsterdam. The Netherlands
David B. Sachar. M. D.
Professor of Medicine. John H. Yardley. M. D.
Mount Sinai School of Medicine Professor of Pathology
of the City University of The Johns Hopkins University
New York. School of Medicine.
New York. New York Baltimore. Maryland
IX
CONTENTS
Preface v
List of contributors VII
New pathological concepts
1. Pathologic aspects of diagnosis, pathogenesis, and etiology of
idiopathic inflammatory bowel disease; J.H. Yardley, S.R. Hamilton. 3
2. Epithelioid granuloma and related histologic features which may
differentiate Crohn's disease from ulcerative colitis in rectal
biopsies; C.M. Surawicz, C.E. Rubin. 19
3. Dysplasia and carcinoma in inflammatory bowel disease; H. Goldman. 27
4. Athymic nude mice in studies of Crohn's disease; K.M. Das,
I. Valenzuela, S. Bagchi, S.E. Williams. 41
Etiology 57
5. Inflammatory bowel disease - The search for an etiology; M. Kagnoff. 59
6. Idiopathic inflammatory bowel disease (IBD): a review of immuno-
logical mechanisms; R.G. Shorter. 68
7. Ulcerative colitis: an autoimmune disease?; K.M. Das, Y. Kadono,
T. Nagai. 80
8. Bacterial etiology of inflammatory bowel disease; S.L. Gorbach. 96
9. Cytotoxic inducers in Crohn's disease and ulcerative colitis;
G.L. Gitnick. 110
10. Animal models for human inflammatory bowel diseases; A.B. Onderdonk. 126
Pathogenesis 135
11. Newer concepts of IBD epidemiology; A.I. Mendeloff. 137
12. Epidemiology of inflammatory bowel disease. State of the art and
etiologic inferences; T. Gilat, A. Grossman, Y. Bujanover, P. Rozen. 143
13. Genetics and inflammatory bowel disease; R.B. McConnell. 152
14. Possible role of prostanoids as mediators in the pathogenesis of
inflammatory bowel disease; D. Rachmilewitz, A.J. Treves,
M. Ligumsky, P. Sharon, A. Zifroni, F. Karmeli. 161
15. Prostaglandins and the mode of action of sulphasalazine in ulcera-
tive colitis: two-opposing viewpoints; J.R.S. Hoult, P.K. Moore. 174
x
16. Pathogenesis of diarrhea in inflammatory bowel disease;
S.F. Phillips. 190
17. psychiatric illness and inflammatory bowel disease; D.H. Alpers. 204
Management 213
18. Introduction; H.D. Janowitz. 215
19. Colonoscopy in inflammatory bowel disease; G.N. Tijtgat,
S. Meuwissen, K. Huibregtse, J.F.W.M. Bartelsman. 217
20. Drug therapy of inflammatory bowel disease; J.W. Singleton. 235
21. Total parenteral nutrition (TPN) in inflammatory bowel disease;
I.H. Rosenberg. 244
22. Ulcerative colitis and Crohn's disease in children; M.E. Ament. 254
23. Surgical management; J. Alexander-Williams. 269
New directions for future research 283
24. Inflammatory bowel disease - New directions for future research;
J.B. Kirsner. 285
25. New directions for medical research in inflammatory bowel disease;
D.B. Sachar. 291
26. New directions for future research: surgical/clinical;
J. Alexander-Williams. 301
A. New Pathological Concepts