维生素B12和叶酸对血液透析患者血浆同型半胱氨酸的影响

心血管疾病(CVD)是慢性肾功能衰竭血液透析(HD)患者常见并发症和主要死因之一。近年发现,高同型半胱氨酸(homocysteine,Hcy)血症是导致CVD的重要危险因素[1,2]。因此,研究HD患者高Hcy血症发病情况及防治措施十分必     

口服叶酸及维生素B_(12)对围绝经期妇女同型半胱氨酸的影响

围绝经期妇女心血管疾病发生率增高，同型半胱氨酸（homocysteine，Hcy）水平升高与心血管疾病密切相关，为了解围绝经期妇女Hcy的变化及处理措施，从而减少心血管疾病的发生，我院近年对其进行了观察，报道如下。     

维生素B12和叶酸干预对绝经后骨质疏松症妇女的骨代谢及同型半胱氨酸水平的影响

目的观察叶酸和维生素B12对绝经后骨质疏松症妇女的骨代谢及同型半胱氨酸水平的影响。方法 80例绝经后骨质疏松症妇女参加研究。所有参与者随机接受叶酸和维生素B12(n=40)或安慰剂(n=40)治疗。在干预前的基线及干预后3个月和6个月,测量两组患者血清同型半胱氨酸、维生素B12和骨代谢标志物的水平。结果治疗前,两组患者血清同型半胱氨酸、维生素B12和骨代谢标志物水平比较差异无统计学意义(P0.05)。治疗后,两组患者同型半胱氨酸均下降,但比较差异无统计学意义(P0.05)。6个月后各组间血清维生素B12、骨钙素、CTX的变化均有显著改变且差异有统计学意义(P0.05)。结论绝经后骨质疏松症妇女补充叶酸和维生素B12可以一定程度改善同型半胱氨酸及骨代谢指标水平。     

Budd-Chiari综合征病人肝静脉血Hcy浓度与其血浆叶酸、维生素B12水平相关性的研究

目的探讨Budd—Chiari综合征肝静脉血Hcy浓度与其血浆叶酸、维生素B22水平的相关性。方法应用高效液相色谱分析法测定46例Budd—Chiari综合征病人的肝静脉血及肘静脉血Hcy的含量，化学发光法测定其肘静脉血的叶酸、维生素B12的含量。25例健康志愿者作正常对照，22例缩窄性心包炎病人作类比对照，SPSS6．0版本统计软件对其数据进行统计学处理。结果（1）Budd—Chiari综合征病人肝静脉血Hcy浓度明显高于其自身肘静脉血（P〈0．01）和对照组（P〈0．005），血清叶酸、维生素B12浓度均明显低于对照组（P〈0．05）；（2）Budd—Chiari综合征病人血浆Hcy水平与叶酸、维生素B12平呈负相关（r值分别为-0．6254和-0．3963）；（3）肝静脉血Hcy的水平与其狭窄程度呈正相关。结论局部高Hcy血症是Budd—Chiari综合征发病的独立危险因素之一。     

维生素D、维生素B12和同型半胱氨酸水平与绝经后女性骨密度的相关性研究

目的探索绝经后非骨质疏松症和骨质疏松症女性患者高半胱氨酸、维生素D、维生素B_(12)和骨密度(bone mineral density,BMD)之间的关系。方法选取2017年8～12月在我院就诊的138名女性作为研究对象,根据骨密度将绝经后女性分为骨质疏松组(n=58)和非骨质疏松组(n=80)。记录两组患者的体质量指数(body mass index,BMI)、年龄、腰围等一般资料,检测腰椎L_(1～4)前后位、左侧股骨近端的BMD,测定血清同型半胱氨酸、维生素B_(12)、维生素D、碱性磷酸酶、钙、磷水平。分析两组患者不同指标的差异以及高半胱氨酸、维生素D、维生素B_(12)和BMD之间的相关性。结果两组患者的年龄、BMI、腰围、同型半胱氨酸、维生素D、维生素B_(12)、腰椎L_(1～4)和左股骨颈骨密度比较差异有统计学意义(P均0.05);Rho相关性和回归分析表明,同型半胱氨酸与维生素D和B_(12)在绝经后非骨质疏松症和同型半胱氨酸与维生素B_(12)在绝经后骨质疏松症女性中呈显著负相关。结论高水平同型半胱氨酸可以通过绝经后非骨质疏松症患者维生素D水平和绝经后骨质疏松症女性维生素B_(12)水平预测。     

结合倾向性评分探究血清叶酸、维生素B12及同型半胱氨酸与勃起功能障碍的关系

目的 探究血清叶酸(Folic Acid,FA)、维生素B12(Vitamin B12,B12)及同型半胱氨酸(Homocysteine,HCY)与勃起功能障碍(Erectile dysfunction,ED)的关系以及上述指标的内在联系.方法 连续纳入2020年10月至2021年10月于我科就诊并符合纳入排除标准的初...     

维持性血液透析患者血浆同型半胱氨酸和血清脑钠肽检测的临床意义

目的：探讨维持性血液透析（maintenance hemodialysis,MHD）患者血浆同型半胱氨酸（homocysteine,Hcy）和血清脑钠肽（brain natriuretic peptide,BNP）水平与心血管疾病（cardiovascular disease,CVD）之间的关系。方法将95例 MHD患者分为心血管疾病组（CVD组）55例和无心血管疾病组（NCVD组）40例;另选30名健康对照者（健康对照组）,检测各组血浆 Hcy、血清BNP、血肌酐（SCr）、血糖（glucose,GLU）、血白蛋白（albumin,Alb）、血脂并进行比较。结果 MHD患者血浆 Hcy [（26.89＆#177;10.12）μmol/L]明显高于健康对照组[（8.05＆#177;2.53）μmol/L]（P〈0.01）;血清 BNP [（1275.02＆#177;1123.94）pg/ml]显著高于对照组[（57.82＆#177;34.61）pg/ml]（P〈0.01）;其中 CVD 组血浆 Hcy[（31.73＆#177;10.18）μmol/L]高于 NCVD 组[（20.24＆#177;5.01）μmol/L]（P〈0.01）;血清 BNP [（1957.49＆#177;1001.83）pg/ml]高于 NCVD组[（336.61＆#177;308.22）pg/ml]（P〈0.01）。以健康对照组血浆 Hcy 均数＋2倍标准差（x＋2s）（13.11μmol/L）为95%可信度上限,超过此值确定为高同型半胱氨酸血症（Hyperhomocysteinemia,HHcy）。95例 MHD患者 HHcy发生率为87.37%（83/95）;其中CVD组 HHcy占94.55%（52/55）,NCVD 组占77.50%（31/40）,均明显高于正常对照组6.67%（2/30）（均 P〈0.01）。CVD 组和 NCVD 组 SCr、GLU、Alb 及血脂比较,差异无统计学意义（P〉0.05）。CVD组血浆 Hcy与 SCr、Alb呈正相关（r=0.380、0.354,P〈0.01）,NCVD组血浆 HcyA与BNP、SCr、Alb呈正相关（r=0.341、0.337、0.389,P〈0.05）,血清 BNP 与 Hcy、SCr 呈正相关（r=0.341、0.389,P〈0.05）;血浆 Hcy、血清BNP与其余各血生化指标间无相关性（P〉0.05）。结论血浆 Hcy、血清BNP水平可作为 MHD患者CVD危险因素的预测指标。     

叶酸及维生素 B12联合应用对老年慢性肾衰血透患者 Hcy 的影响

目的观察外源性补充叶酸及维生素 B12对老年慢性肾衰血透患者血浆同型半胱氨酸（ Hcy）水平的影响。方法选取本院肾内科2012年10月～2014年10月收治的老年慢性肾衰血透患者,随机分为HD治疗组与对照组（每组48例）。 HD治疗组给予叶酸及维生素 B12治疗,治疗前及治疗8周后于早晨空腹采集肘静脉血液分别检测叶酸、维生素B12及同型半胱氨酸（ Hcy）水平;HD对照组不给予上述药物治疗,亦于入组时及8周后同上检测血浆叶酸、维生素B12及同型半胱氨酸（ Hcy）水平。同时选取48例健康人群作为健康对照组。比较三组检测结果及治疗组治疗前后各指标水平的变化。结果 HD治疗组及HD对照组入组时的血浆Hcy水平明显高于健康对照组,差异具有统计学意义（ P ＜0．05）,叶酸及维生素B12水平三组比较差异无统计学意义（ P ＞0．05）;HD治疗组患者治疗后的血浆 Hcy水平明显低于治疗前,且叶酸及维生素B12水平高于治疗前,差异具有统计学意义（ P ＜0．05）。结论老年慢性肾衰血透患者均存在较高血浆Hcy水平,患者服用叶酸以及维生素 B12可降低血浆 Hcy水平,可能减少心脑血管并发症发生,提高患者生活质量,值得临床应用推广。     

不同通量透析对维持血液透析患者叶酸、维生素B12等贫血相关指标的影响及其与贫血的关系研究

目的 探讨不同通量透析对维持血液透析(MHD)患者叶酸、维生素B12及其他贫血相关指标水平的影响及其与贫血的关系.方法 将本院血液透析中心进行维持透析的69例患者随机分为高通量透析组(HFHD组)和低通量透析组(LFHD组),观察两组患者入组时及治疗1年后血清叶酸、维生素B12、C-反应蛋白(CRP)、甲状旁腺素(PTH)等指标变化情况,并分析上述指标变化与贫血之间的关系.结果 经过治疗,两组平均Hb水平均有明显增加,和治疗前比较差异均有统计学意义(P＜0.05);LFHD组治疗前后其他指标均无明显变化(P＞0.05);HFHD组患者叶酸、维生素B12、Hct水平和初始值比较均明显增加(P＜0.05),CRP、PTH水平以及EPO使用量均明显下降(P＜0.05),和LFHD组比较差异均有统计学意义(P＜0.05).HFHD组叶酸、维生素B12、CRP以及PTH等4个指标的变化与贫血是否达标有明显的相关性(r =0.370 ～0.448,P＜0.05),HFHD组上述指标的变化与贫血相关性不强(r=0.017 ～0.241,P＞0.05).结论 高通量透析可以降低维持血液透析患者体内毒素水平,提高叶酸、维生素B12等造血原料营养物质水平,比低通量透析更加利于改善患者贫血状态.     

维生素B_（12）对急性脑梗死伴高同型半胱氨酸血症患者的治疗作用

目的探讨维生素B12对急性脑梗死伴高同型半胱氨酸血症的治疗作用。方法收集2010年7月～2011年3月在笔者所在医院神经内科住院的急性脑梗死伴高同型半胱氨酸血症患者60例,随机分为对照组及维生素B12治疗组,采用ELISA法,波长450nm在酶标仪上测定治疗前后血浆同型半胱氨酸的水平,同时检测两组日常生活能力量表（巴氏指数）。结果维生素B12治疗组治疗前后血浆同型半胱氨酸血症水平有统计学意义（P〈0.01）,与对照组治疗后比较也有显着差异（P〈0.01）,治疗组和对照组巴氏指数在治疗前后比较无统计学意义（P〉0.05）。结论维生素B12能有效降低急性脑梗死伴高同型半胱氨酸血症患者血浆的同型半胱氨酸水平,但对急性期脑梗死不能改善患者日常生活能力。     

Relation of homocysteine, folate, and vitamin B12 to bone mineral density of postmenopausal women

Genetic hyperhomocysteinemia is associated with skeletal abnormalities and osteoporosis. We tested whether levels of homocysteine and critical co-enzymes of homocysteine metabolism, such as vitamin B₁₂ and folate, are related to lumbar spine bone mineral density (BMD) measured by DEXA in 161 postmenopausal women. Folate but not homocysteine or vitamin B₁₂, was lower in osteoporotic than normal women (7.2 ± 0.9 ng/L vs 11.4 ± 0.7 ng/L, P < 0.003). Folate, but not homocysteine or vitamin B₁₂, was independently related to BMD (r = 0.254, P < 0.011). BMD progressively increased from the lowest to the highest folate quartile (1.025 ± 0.03 g/cm² vs 1.15 ± 0.03 g/cm², P < 0.01) even when covaried for weight, which was the only other variable related to BMD. The present data suggest a major association between folate and bone mineralization.     

赖氨肌醇维B12口服溶液中赖氨酸与维生素B12含量测定

目的建立赖氨肌醇维B12口服溶液中赖氨酸与维生素B12含量测定方法。方法采用电位滴定法测口服液中盐酸赖氨酸含量;高效液相色谱法测定维生素B12的含量,色谱条件为C18柱,以乙腈-0．05mol／L磷酸二氢钠（16：84）用磷酸调节pH=3．3为流动相,流速1mL／min,检测波长210nm。结果电位滴定法测定口服液中盐酸赖氨酸的回归方程为V=0．1055G-0．3425,r=0．9996。精密度试验的RSD％为0．44％,溶液稳定性试验的RSD％为0．59％,低中高三个浓度的平均回收率分别为99．54％、100．08％、99．71％,3批样品含量测定分别为100．72％、99．45％和99．76％;测定维生素B12的回归方程为A=0．8407C-0．0425,r=0．9998,精密度试验RSD为0．99％,溶液稳定性试验RSD为1．08％,最低检出限与定量限分别是0．12μg／mL和0．40μg／mL,低中高三个浓度平均回收率分别是98．20％、99．00％和99．07％,对3批样品的检测结果分别是100．81％、99．43％、98．25％。结论本研究测定盐酸赖氨酸和维生素B12的方法均准确可行,可用于本口服液的质量控制。     

Prevalence of Iron, Folate, and Vitamin B12 Deficiency Anemia After Laparoscopic Roux-en-Y Gastric Bypass

Background One of the most common bariatric operations is the laparoscopic Roux-en-Y gastric bypass (LRYGBP) in which the gastric capacity is restricted and the absorption by the small intestine is reduced. The objective of this study was to evaluate the incidence of iron, folate, and vitamin B12 deficiency anemia in patients undergoing LRYGBP. Patients and methods Clinical records of 30 patients who underwent LRYGBP between July 2003 and January 2005 and had a minimum follow up of 24 months at our outpatient clinic were included. Multivitamin supplementation was prescribed to all patients. The complete blood cell count, plasma iron, total iron-binding capacity, transferrin saturation, serum folate, and cobalamin levels before surgery, 6 months, 1, 2, and 3 years after the surgery were analyzed. Results There were 25 women (83.4%) and five men (16.6%) with ages from 21 to 56 years. Before surgery, two patients (6.6%) presented ferropenic anemia. Iron deficiency was seen in 40 and 54.5% 2 and 3 years after surgery, respectively. Cobalamin deficiency was observed in 33.3% at 2 years and in 27.2% at 3 years. At 2-year follow-up, 46.6% of the patients had already developed anemia and 63.6% at 3 years. Folate deficiency was not observed in any patient. Conclusion Our routine scheme of vitamin supplementation is not sufficient to prevent iron and vitamin B12 deficiencies in most patients.     

Plasma homocysteine after laparoscopic Roux-en-Y gastric bypass increases in the early postoperative phase but decreases in the long-term follow-up. A retrospective analysis

BackgroundHomocysteine is an important independent risk factor for predicting cardiovascular disease (CVD). However, changes in the homocysteine levels after bariatric surgery remain controversial.ObjectivesModeling differences in homocysteine after bariatric surgery.SettingUniversity Hospital, Austria.MethodsSeven hundred eight consecutive bariatric surgery patients (78% female, 22% male, mean body mass index 41 kg/m² preoperatively) underwent laparoscopic long-limb Roux-en-Y gastric bypass in a 6-year period and were retrospectively evaluated for changes in their preoperative homocysteine levels, at 3, 6, 9, 12, 18, 24, 36, 48, 60, and 72 months postoperatively. Furthermore, a postal and telephone screening for postoperative CVD with a follow-up of 71% was conducted.ResultsHyperhomocysteinemia was present in 11.8% preoperatively (normal range: <15 μmol/L). The median plasma homocysteine level was 10.4 preoperatively, 12.1 at 3, 11.2 at 6, 10.0 at 9, 9.8 at 12, 8.9 at 18, 8.7 at 24, 8.6 at 36, 9.1 at 48, 9.8 at 60, and 10.0 μmol/L at 72 months postoperatively. After subdividing the study population in morbidly obese (n = 509, body mass index 40–50 kg/m²) and super-obese (n = 199, body mass index >50 kg/m²) patients, the short-term increase into homocysteine levels remained. Overall, newly onset CVD risk was 4.2%. After subdividing the CVD risk into risk for myocardial infarction, stroke, and risk for deep vein thrombosis/pulmonary embolism the distribution was as follows: .2% myocardial infarction, .59% stroke, and 2.97% deep vein thrombosis/pulmonary embolism (median 36 [interquartile range 36–48] mo postoperatively).ConclusionLaparoscopic Roux-en-Y gastric bypass leads to increased homocysteine levels in the early postoperative period. However, there was no relationship between increased homocysteine levels and CVD event onset.     

Vitamin B12 deficiency following restorative proctocolectomy.

OBJECTIVE: Restorative proctocolectomy (RP) involves terminal ileal resection and formation of a small bowel reservoir that predisposes to bacterial overgrowth. It was anticipated that these patients would be at risk of vitamin B12 deficiency. METHOD: Vitamin B12 levels were measured sequentially in 171 patients who underwent RP. Prospective results were obtained from all 20 patients undergoing pouch formation after the commencement of the study. Further results were obtained retrospectively from case notes and computerized laboratory records of the 151 patients who underwent RP prior to the commencement of the study and these were correlated with the results of follow-up samples taken prospectively from the same patients after the commencement of the study. The median age of the patients was 40 years (range: 13-67) and the median duration of follow up was 5.4 years (range: 1-12). Patients with an abnormally low serum B12 level underwent both a Schilling and a hydrogen breath test. Eight of these patients were then treated with oral vitamin B12. RESULTS: Abnormally low serum B12 levels were found in 25% of patients. Forty per cent of our patient group had three or more sequential B12 measurements and of these, 66% showed steadily declining B12 levels. Ninety-four per cent of patients with low B12 had a normal Schilling test and were negative for bacterial overgrowth. CONCLUSION: Subnormal vitamin B12 levels develop in almost one-quarter of patients after pouch surgery. The exact mechanism for B12 deficiency in these patients is uncertain. In the majority of patients undergoing RP, vitamin B12 levels fall on sequential measurement. Serum B12 levels should be measured during follow up and pouch patients with subnormal B12 levels, should see them successfully restored to a normal value after treatment with oral B12 replacement therapy.     

Current concept of pathophysiological understanding and natural course of ulcerative colitis

Introduction According to the current paradigm both ulcerative colitis (UC) and Crohns disease (CD) result from a complex interplay of genetic susceptibility factors, environmental factors, alterations of the physiological intestinal flora and a defective regulation of the intestinal immune system.Discussion The objective of this review is to give an overview of these factors and mechanisms, including genetic, environmental and microbial factors, with special alterations of relevant cellular components of the intestinal immune system such as T cells, macrophages and epithelial cells will then be addressed. In addition, the most relevant animal model systems that have contributed to our current pathogenetic understanding will be introduced. Clinically, the natural course of UC with special reference to the risk of colorectal cancer will be addressed.Conclusion The elucidation of pathomechanisms at the level of the intestinal immune system provides the potential for novel, effective treatment strategies. Best surgical management of patients with UC, however, still remains a challenge.     

微生态制剂对溃疡性结肠炎的治疗效果及作用机制研究

目的探讨微生态制剂对溃疡性结肠炎（UC）的治疗效果及其作用机制。方法前瞻性入组2007年5月至2010年6月间新乡医学院第一附属医院收治的60例UC患者。按随机数字表法分为金双歧组、畅美组和联合组（金双歧联合畅美）,每组各20例。分别予以金双歧2．0g口服、2次／d,畅美1．0g口服、3次／d,及两种药物联合应用,疗程为24个月。治疗前及治疗后24个月对各组患者进行临床症状评分、内镜分级评分以及结肠炎性反应评分;并通过免疫组织化学染色和酶联免疫双抗体夹心法分别检测结肠黏膜及血清中的白细胞介素IO（IL-10）含量。结果联合组患者治疗后24个月,临床症状评分（12．5±2．1比2．3±0．8,P=O．016）、内镜分级评分（3．02±0．17比0．25±0．13,P=O．032）和炎性反应评分（2．63±0．19比0．77±0．16,P=O．028）均显著优于治疗前;而金双歧组和畅美组治疗前后各项评分的差异均无统计学意义（均P〉O．05）。联合组患者治疗24个月时,IL．10在结肠黏膜中的阳性表达率[85％（17／20）比55％（11／20）,P=O．038]和在血清中的表达水平f（17．4±2．2）ng／L比（12．8±2．2）ng／L,P=O．015]均显著高于治疗前;而金双歧组和畅美组治疗前后IL．10表达水平的差异均无统计学意义（均P〉O．05）。结论金双歧联合畅美治疗UC疗效肯定,其治疗作用可能与促进IL-10表达升高有关。     

B族维生素对大鼠糖尿病神经病理性痛的效应

目的 探讨B族维生素(维生素B1、B6、B12)对大鼠糖尿病神经病理性痛(DNP)的效应.方法 雄性SD大鼠104只,体重200～230 g,随机分为13组(n=8):正常对照组(C组),DNP组,DNP+生理盐水组(NS组),DNP+维生素B110、33、100 mg/kg组(B1 10组、B133组、B1100组),DNP+维生素B610、33、100 mg,kg组(B610组、B633组、B6100)组),DNP+维生素B120.5、1.5、4.5 mg/kg组(B120.5组、B12 1.5组、B124.5组),DNP+维生素B1 10/B6 33/B12 1.5 mg,kg组(VBC组).除C组外,其余各组均采用腹腔注射链唑霉素75 mg/kg 的方法制备DNP模型,于注射链唑霉素前2 d、注射后14 d时测定机械缩足阈值(MWT)和热缩足潜伏期(TWL),MWT和TWL均低于基础值的85%为DNP模型制备成功.注射链唑霉素后14 d时腹腔注射相应剂量和种类的B族维生素或生理盐水,1次/d,连续2周,并于B族维生寨给药1、3、7、14 d时测定MWT和TWL,最后1次测定痛阈后处死大鼠,测定脊髓背角和背根神经节(DRG)磷酸化cAMP反应元件结合蛋白(p-CREB)的表达水平.结果 与C组相比,其余各组MWT降低,TWL缩短,脊髓背角和DRG p-CREB表达上调(P<0.05);与DNP组比较,各B族维生素组MWT升高,TWL延长,脊髓背角和DRG p-CREB表达下调,且呈剂量依赖性(P<0.05);与B110组、B633组、B121.5组比较,VBC组MWT升高,TWL延长,脊髓背角和DRG p-CREB表达下调(P<0.05).结论 B族维生素可减轻大鼠DNP,呈剂量依赖性,其机制可能与抑制脊髓背角和DRG CREB 的磷酸化有关.     

绝经后妇女血维生素B12、叶酸水平与骨密度相关性的初步研究

目的探讨绝经后妇女血维生素B12、叶酸水平与骨密度的相关性。方法应用双能X线骨密度仪测定受试者腰椎及股骨骨密度,按1994年WHO标准将其分为3组,即骨质疏松组、骨量减少组及骨量正常组;采取空腹静脉血进行维生素B12、叶酸的集中检测;并分别进行维生素B12、叶酸与不同部位骨密度的相关性分析。结果①骨质疏松组的血维生素B12的水平(512.55±209.85)pg/ml,低于骨量减少组(551.29±237.71)pg/ml和骨量正常组(565.71±189.03)pg/ml。②骨质疏松组的血叶酸的水平(11.27±6.04)pg/ml,低于骨量减少组(13.18±6.14)pg/ml和骨量正常组(11.9±3.73)pg/ml。③绝经后妇女血维生素B12的水平与全髋BMD呈正相关(r=0.25,P<0.01),与股骨颈BMD呈正相关(r=0.212,P<0.05),与股骨干BMD呈正相关(r=0.257,P<0.01),与股骨大转子BMD呈正相关(r=0.239,P<0.05);血维生素B12的水平与L1~L4BMD无相关性(r=0.141,P>0.05)。④绝经后妇女血叶酸的水平与全髋BMD、股骨颈BMD、股骨干BMD、股骨大转子BMD和L1~L4BMD均无相关(r分别为0.005,0.021,0.017,-0.021和0.078,P>0.05)。结论绝经后妇女血维生素B12的水平的缺乏可能是骨质疏松发生的一个重要风险因素,叶酸的缺乏并非骨质疏松发生的风险因素。     

Discontinuous appendiceal involvement in ulcerative colitis: Pathology and clinical correlation

Continuous mucosal involvement from the rectum proximally is one of the hallmarks of ulcerative colitis. However, recent pathologic series report appendiceal ulcerative colitis in the presence of a histologically normal cecum, representing a "skip" lesion. The clinical significance of this rinding has not been established. Eighty patients, 54 males and 26 females, average age 37.9 years (range 14 to 82 years) who underwent proctocolectomy for ulcerative colitis from January 1990 to September 1995 were examined to determine the rate of discontinuous appendiceal involvement. Excluded were 12 patients with prior appendectomy and 11 with fibrotic obliteration of the appendiceal lumen. Of the remaining 57 patients, seven (12.3%) had clear appendiceal involvement in the presence of a histologically normal cecum. These seven patients clinically were indistinguishable from the 50 patients without skip involvement of the appendix in terms of age at surgery, pretreatment medications, type of surgery, interval from diagnosis to definitive procedure, complications, functional results, and clinical course. Discontinuous appendiceal involvement was found in 12.3% of patients undergoing proctocolectomy for ulcerative colitis, and clinically these patients behave as those without this feature.