title: Clinical course of distal ulcerative colitis in relation to appendiceal orifice inflammation status.
abstract: BACKGROUND
  Although appendiceal orifice inflammation (AOI) is frequently observed as a skip lesion of ulcerative colitis (UC), its clinical significance is not clearly understood. We aimed to evaluate whether AOI is associated with the clinical course of UC.
  
  
  METHODS
  Ninety-four patients with newly diagnosed distal UC were prospectively enrolled at the Asan Medical Center between March 1996 and October 2002. Clinical features and colonoscopic findings during the follow-up period were analyzed in relation to initial AOI status.
  
  
  RESULTS
  Forty-eight patients were found to be initially AOI-positive and 46 to be initially AOI-negative. We found no difference in the baseline demographics and clinical characteristics between these two groups. The median follow-up periods for AOI-positive and AOI-negative groups were 45 and 41 months, respectively. Clinical remission was achieved in all patients of each group. The cumulative risk of relapse at 1, 3, and 5 years after remission was 31.2%, 59.8%, and 69.2%, respectively, in the AOI-positive group and 17.4%, 46.5%, and 67.2%, respectively, in the AOI-negative group (P = 0.124). The cumulative risk of proximal disease extension at 1, 3, and 5 years after diagnosis was 17.9%, 24.9%, and 44.5%, respectively, in the AOI-positive group and 9.8%, 21.5%, and 43.9%, respectively, in the AOI-negative group (P = 0.522). Proctocolectomy was performed in no patients in the AOI-positive group and in 1 patient in the AOI-negative group. No mortalities were observed in either group.
  
  
  CONCLUSIONS
  In patients with distal UC, AOI may have no prognostic implications in terms of remission, relapse, or proximal disease extension.
authors.affiliation: Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Jeong-Sik
authors.initials: JS
authors.lastname: Byeon
authors.forename: Suk-Kyun
authors.initials: SK
authors.lastname: Yang
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Myung
authors.forename: Seung Il
authors.initials: SI
authors.lastname: Pyo
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Park
authors.forename: Young Min
authors.initials: YM
authors.lastname: Kim
authors.forename: Yun Jung
authors.initials: YJ
authors.lastname: Lee
authors.forename: Seong Soo
authors.initials: SS
authors.lastname: Hong
authors.forename: Kyu-Jong
authors.initials: KJ
authors.lastname: Kim
authors.forename: Gin Hyug
authors.initials: GH
authors.lastname: Lee
authors.forename: Hwoon-Yong
authors.initials: HY
authors.lastname: Jung
authors.forename: Weon-Seon
authors.initials: WS
authors.lastname: Hong
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Young Il
authors.initials: YI
authors.lastname: Min
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001064:Appendicitis / Q000150:complications* / Q000473:pathology / Q000628:therapy; D003093:Colitis, Ulcerative / Q000150:complications* / Q000473:pathology* / Q000628:therapy; D003113:Colonoscopy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012074:Remission Induction; D012720:Severity of Illness Index; D013997:Time Factors