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1

Delayed ischemic gangrene change of distal limb despite optimal decompressed colostomy constructed in obstructed sigmoid colon cancer: a case report.  

PubMed

Creating blow-hole colostomy for decompression could provide a time-saving and efficient surgical procedure for a severely debilitated case with a completely obstructed colorectal cancer. Complications are reported as prolapse, retraction, and paracolostomal abscess. However, complication with an ischemic distal limb has not been reported. We report a case of critical intra-abdominal disease after decompressed colostomy for relieving malignant sigmoid colon obstruction; a potential fatal condition should be alerted. A 76-year-old male visited our emergency department for symptoms related to obstructed sigmoid colon tumor with foul-odor vomitus containing fecal-like materials. An emergent blow-hole colostomy proximal to an obstructed sigmoid lesion was created, and resolution of complete colon obstruction was pursued. Unfortunately, extensive abdominal painful distention with board-like abdomen and sudden onset of high fever with leukocytopenia developed subsequently. Such surgical abdomen rendered a secondary laparotomy with resection of the sigmoid tumor along with an ischemic colon segment located proximally up to the previously created colostomy. Eventually, the patient had an uneventful postoperative hospital stay. In the present article, we have described an emergent condition of sudden onset of distal limb ischemia after blow-hole colostomy and concluded that despite the decompressed colostomy would resolve acute malignant colon obstruction efficiently; impending ischemic bowel may progress with a possible irreversible peritonitis. Any patient, who undergoes a decompressed colostomy without resection of the obstructed lesion, should be monitored with leukocyte count and abdominal condition survey frequently. PMID:16521237

Huang, Wen-Shih; Liu, Kuang-Wen; Lin, Paul Y; Hsieh, Ching-Chuan; Wang, Jeng-Yi

2006-02-14

2

Colouterine fistula caused by diverticulitis of the sigmoid colon.  

PubMed

Colouterine fistula is an extremely rare condition because the uterus is a thick, muscular organ. Here, we present a case of a colouterine fistula secondary to colonic diverticulitis. An 81-year-old woman was referred to the emergency department with abdominal pain and vaginal discharge. Computed tomography showed a myometrial abscess cavity in the uterus adherent to the thick sigmoid wall. Upon contrast injection via the cervical os for fistulography, we observed spillage of the contrast into the sigmoid colon via the uterine fundus. Inflammatory adhesion of the distal sigmoid colon to the posterior wall of the uterus was found during surgery. The colon was dissected off the uterus. Resection of the sigmoid colon, primary anastomosis, and repair of the fistula tract of the uterus were performed. The postoperative course was uneventful. This case represents an unusual type of diverticulitis complication and illustrates diagnostic procedures and surgical management for a colouterine fistula. PMID:23346512

Choi, Pyong Wha

2012-12-01

3

Volvulus of the transverse and sigmoid colon.  

PubMed

A case of transverse and sigmoid-colon volvulus and a discussion of the probable mechanism of large-bowel volvulus (LBV) in children and its management is presented. A 5-year-old male with cerebral palsy presented with transverse-colon and subsequently sigmoid volvulus. The child underwent resection of the involved segments with primary colocolic and colorectal anastomosis, respectively. The recovery was uneventful. LBV in children is due to congenital anomalous or absent ligamentous fixation of the colon. Constipation is probably the result of the volvulus. Resection of the involved segment and primary anastomosis is the definitive treatment. PMID:11057559

Samuel, M; Boddy, S A; Capps, S

2000-01-01

4

Migrated biliary plastic stent causing double sigmoid colon perforation  

PubMed Central

A female patient was admitted to our hospital with sigmoid colon perforation caused by migrated biliary plastic stent, which was placed 2 months ago for the treatment of choledocholithiasis. The patient underwent sigmoid colon resection with primary anastomosis and was discharged on seventh postoperative day in good general condition. PMID:25487372

Konstantinidis, Christos; Varsos, Panagiotis; Kympouris, Sotirios; Volteas, Spyridon

2014-01-01

5

Peristalsis in the rabbit distal colon  

PubMed Central

1. The motility of the distal colon of the rabbit has been examined by the conventional Trendelenburg method and by an isometric, isovolumic modification of this method. 2. The colon shows a range of movements, and tetrodotoxin and cold-storage have been used in an attempt to differentiate between myogenic and neurally integrated activities. 3. The observable myogenic movements are pendulum movements, `tone rings' and `tone waves'; the last of these can be weakly propulsive. The rabbit colon also shows a neurally organized and powerfully propulsive movement which corresponds to the peristaltic wave. 4. The implication of a role for nervous structures in the propulsive activity of the rabbit distal colon is at variance with the view of Lee (1960). 5. The myenteric reflex arc in the colon has been examined pharmacologically. Cholinergic neural transmission has been implicated at the ganglionic-synaptic and neuroeffector junctions, but additional noncholinergic mechanisms of chemical transmission have not been excluded. PMID:4400587

Mackenna, B. R.; McKirdy, H. C.

1972-01-01

6

Perforated diverticulitis of the sigmoid colon causing a subcutaneous emphysema  

PubMed Central

INTRODUCTION Although diverticular disease of the colon is frequent, perforated diverticulitis causing subcutaneous emphysema is a uncommon entity. We wish to present this extremely rare case of perforated colonic diverticulum in the subcutaneous tissue, which is the first one that we have encountered in our practice, along with the accompanying diagnostic and therapeutic issues and a review of the literature. PRESENTATION OF CASE We report the case of an 83-year-old man who admitted to the emergency room due to an abdominal subcutaneous emphysema. Physical examination revealed a severe subcutaneous emphysema especially in the left iliac fossa and abdominal pain. An urgent contrast enhanced abdominal CT scan showed multiple diverticula in the sigmoid colon and multiple air bubbles in the subcutaneous tissue. The exploratory laparotomy identified a perforation of diverticular in subcutaneous tissue. Forty centimeters of colon were resected. The subcutaneous emphysema resolved without specific treatment. The postoperative period was uncomplicated. DISCUSSION Subcutaneous emphysema of anterior abdomen wall is an obvious physical sign but its etiology is complex to determine and may be potentially lethal. The pathophysiological mechanism involved is the emergence of a pressure gradient between the peritoneum and surrounding structures, causing rupture of the anterior abdominal wall, allowing gas from a perforation to diffuse along tissue planes. CONCLUSION This physical sign may be of especial value in elderly patient groups amongst whom perforation may be less clinically obvious. General surgeons should bear in mind this rare complication of colonic diverticulosis. PMID:25437673

Kassir, Radwan; Abboud, Karine; Dubois, Joelle; Baccot, Sylviane; Debs, Tarek; Favre, Jean-Pierre; Gugenheim, Jean; Gastaldi, Pauline; Amor, Imed Ben; Tiffet, Olivier

2014-01-01

7

Volvulus of Sigmoid Colon During Full Term Pregnancy with Rectovaginal Fistula: A Case Report  

PubMed Central

Intestinal obstruction due to sigmoid colon volvulus during pregnancy is a rare complication but associated with significant fetomaternal mortality. We describe a case of sigmoid volvulus in a patient with 37 wk pregnancy causing huge dilation of left colon. Patient developed rectovaginal fistula following nonmedical method to relieve distention by inserting stick as told by patient. PMID:25478399

Gautam, Shefali; Prakash, Ravi; Sidhartha, Kanishka; Shashikant

2014-01-01

8

The "human visceral homunculus" to pain evoked in the oesophagus, stomach, duodenum and sigmoid colon.  

PubMed

The oesophagus, stomach, duodenum and sigmoid colon were electrically stimulated in 12 healthy volunteers with a thin nasal endoscope. The painful cortical evoked potentials (EPs) were recorded from 64 surface electrodes. The early EPs with latencies < 200 ms were studied and the corresponding dipole sources were calculated. The electrical current intensities needed to evoke pain were highest in the stomach and duodenum, compared to the other segments (F = 7.8; P < 0.001; post hoc analysis P < 0.05). The EP latencies after stimulation of the stomach and sigmoid colon were shorter compared with those to stimulation of the oesophagus and duodenum (all P values < 0.001). The EP amplitudes were higher to oesophagus stimulation (all P values < 0.001 except for the early positivity). The potential fields obtained after stimulation of the most distal segments (duodenum and sigmoid colon) were in general distributed more posteriorly compared to those recorded in the more proximal regions. The EP topographies to stimulation of all gut tracts were explained by a bilateral source in the second somatosensory (SII) area, by a dipole in the anterior cingulate cortex (ACC), and by a bilateral generator in the insular cortex. However, the position of the sources significantly changed depending on the stimulated gut tract. Moreover, while the SII and ACC sources were initially activated to oesophagus and stomach stimulation, the ACC and insular activities were the earliest ones after stimulation of the lower gut segments. The findings reflect differences in pathways and brain processing of visceral nociceptive inputs coming from either upper or lower gut and may improve our understanding of the brain-gut axis in health and disease. PMID:16676165

Drewes, Asbjørn Mohr; Dimcevski, Georg; Sami, Saber A K; Funch-Jensen, Peter; Huynh, Khiem Dinh; Le Pera, Domenica; Arendt-Nielsen, Lars; Valeriani, Massimiliano

2006-10-01

9

Perforated Sigmoid Colon Cancer within an Irreducible Inguinal Hernia: a Case Report  

PubMed Central

A perforated sigmoid colon cancer within an inguinal hernia is extremely rare. This unexpected finding is usually discovered during surgery and causes an unavoidable septic evolution. Here, we describe the case of an 84-year-old man who presented with fever, abdominal distension, and a painful, enlarged, left scrotum. A CT showed a left, incarcerated, inguinal hernia containing a perforated sigmoid adenocarcinoma (which was confirmed by histopathology). The possibility of an irreducible inguinal hernia in association with perforated sigmoid colon cancer should be considered in the array of diagnoses. A pre-operative CT scan would be helpful in facilitating an accurate diagnosis. PMID:20191071

Ko, Kai-Hsiung; Yu, Chih-Yung; Kao, Chien-Chang; Tsai, Shih-Hung; Huang, Guo-Shu

2010-01-01

10

Traditional serrated adenoma of the sigmoid colon with osseous metaplasia: a case report  

PubMed Central

Introduction Osseous metaplasia in the gastrointestinal tract is a rare phenomenon. Case presentation We present the case of a 62-year-old Hispanic man with two colonic polypoid lesions, one of which, upon resection and histopathological examination, was found to be a traditional serrated adenoma with a focus of stromal osseous metaplasia. Conclusions Our patient’s case is the third report of stromal osseous metaplasia in a traditional serrated adenoma of the sigmoid colon. PMID:22620280

2012-01-01

11

trans Fatty acid consumption and its association with distal colorectal cancer in the North Carolina Colon Cancer Study II  

Microsoft Academic Search

Recently, the potential health effects of trans-fatty acid consumption have raised concerns. A few studies have examined the risk of colorectal cancer with increasing consumption\\u000a of trans-fatty acids, but none investigated the risk of rectal cancer, which may have different risk factors than colon cancer. Our\\u000a objective was to explore the relationship between trans-fatty acid consumption and distal colorectal (sigmoid,

Lisa C. Vinikoor; Robert C. Millikan; Jessie A. Satia; Jane C. Schroeder; Christopher F. Martin; Joseph G. Ibrahim; Robert S. Sandler

2010-01-01

12

Characterization and autoradiographic localization of neurotensin binding sites in human sigmoid colon.  

PubMed

Radioiodinated neurotensin ((125)I-NT) was used to characterize and localize NT binding sites in normal human sigmoid colon. Specimens were obtained from patients (30-77 years old) undergoing resection for colon carcinoma. Specific binding of (125)I-NT to sigmoid circular muscle membranes was enhanced by o-phenanthroline (1 mM) but other peptidase inhibitors were ineffective. (125)I-NT bound to a high-affinity site of K(d) = 0.88 +/- 0.09 nM and B(max) = 4.03 +/- 0.66 fmol/mg of wet weight tissue (n = 14), although in the majority of patients another site, of low but variable affinity, could also be detected. Specific binding of 50 pM (125)I-NT was inhibited by NT(8-13) > NT > SR142948A > or = neuromedin N > or = SR48692, consistent with binding to the NT1 receptor. In autoradiographic studies, dense specific binding of (125)I-NT was seen over myenteric and submucosal ganglia, moderate binding over circular muscle, and sparse binding over longitudinal muscle and taenia coli. Levocabastine, which has affinity for the NT2 receptor, did not inhibit specific binding of (125)I-NT in membrane competition or autoradiographic studies. NT contracted sigmoid colon circular muscle strips with a pD(2) value of 6.8 +/- 0.2 nM (n = 25). The contractile responses to NT were significantly potentiated in the presence of tetrodotoxin (1 microM), indicating a neural component. Results from functional studies support actions for NT on both muscle and enteric neurons, consistent with the presence of NT receptors on circular muscle and ganglia of human sigmoid colon. The lack of inhibition by levocabastine suggests that the second binding site detected does not correspond to the NT2 receptor. PMID:11356931

Azriel, Y; Burcher, E

2001-06-01

13

Strangulation and Necrosis of an Epiploic Appendage of the Sigmoid Colon in a Right Inguinal Hernia  

PubMed Central

An epiploic appendage of the sigmoid colon is considered to be an unusual type of inguinal hernia content. The strangulation of a sigmoid colon appendage into a right inguinal hernia is exclusively rare. We present a case of an 81-year-old female patient with severe cardiovascular comorbidities who was urgently admitted after an episode of strangulation and subsequent spontaneous reduction of a right inguinal hernia. The condition of the patient was stable, and an urgent operation was not indicated for three days after admission. However, we had to operate because the hernia strangulation recurred. In the hernia sac, a free fatty body (a separated and saponified epiploic appendage of the colon) and a strangulated epiploic appendage of dolichosigmoid, with signs of necrosis, were found. Removal of the free fatty body and necrotic epiploic appendage and subsequent anterior-wall inguinal hernioplasty were successfully performed. In the world literature, this case may be the first report of a sigmoid epiploic appendage strangulation in a right inguinal hernia that is well documented by photography. PMID:24106635

Shiryajev, Yuri N.; Glebova, Anna V.; Chalenko, Marina V.

2013-01-01

14

Rupture of abdominal aortic aneurysm into sigmoid colon: A case report  

PubMed Central

Primary aorto-colic fistula is rarely reported in the literature. Although infrequently encountered, it is an important complication since it is usually fatal unless detected. Primary aorto-colic fistula is a spontaneous rupture of abdominal aortic aneurysm into the lumen of the adjacent colon loop. Here we report a case of primary aorto-colic fistula in a 54-year old male. The fistulated sigmoid colon was repaired by end-to-end anastomosis. Despite inotropic support, the patient died of sepsis and multiorgan failure on the first postoperative day. PMID:17167850

Aksoy, Murat; Yanar, Hakan; Taviloglu, Korhan; Ertekin, Cemalettin; Ayalp, Kemal; Yanar, Fatih; Guloglu, Recep; Kurtoglu, Mehmet

2006-01-01

15

Rupture of abdominal aortic aneurysm into sigmoid colon: a case report.  

PubMed

Primary aorto-colic fistula is rarely reported in the literature. Although infrequently encountered, it is an important complication since it is usually fatal unless detected. Primary aorto-colic fistula is a spontaneous rupture of abdominal aortic aneurysm into the lumen of the adjacent colon loop. Here we report a case of primary aorto-colic fistula in a 54-year old male. The fistulated sigmoid colon was repaired by end-to-end anastomosis. Despite inotropic support, the patient died of sepsis and multiorgan failure on the first postoperative day. PMID:17167850

Aksoy, Murat; Yanar, Hakan; Taviloglu, Korhan; Ertekin, Cemalettin; Ayalp, Kemal; Yanar, Fatih; Guloglu, Recep; Kurtoglu, Mehmet

2006-12-14

16

Solitary amyloidosis of the sigmoid colon featuring submucosal tumor caused hematochezia.  

PubMed

A previously a healthy 64-year-old woman complained of a two-week history of hemorrhaging upon defecation. The laboratory and urinalysis findings were normal, and no serum or urine M components were detectable on protein electrophoresis. An air contrast barium enema revealed an elevated lesion measuring -20 mm in diameter with a smooth surface and a depression in the sigmoid colon. Colonoscopy revealed a red colored and congested tumor. The exposed surface of the submucosal tumor (SMT) center was somewhat yellow in color and covered with fuzz. All other portions of the colon were normal. The endoscopy and double-contrast barium revealed a normal upper gastrointestinal tract and a normal small intestine, respectively. A histopathological evaluation of a biopsy specimen obtained from the SMT suggested amyloid deposition. However, the other biopsy specimens of the esophagus, stomach, duodenal bulb, second portion of the duodenum, terminal ileum and other portions of the colon demonstrated no amyloid deposition. Colonoscopic ultrasonography (US) revealed the hypoechoic, homogeneous SMT to be mainly localized within the submucosa. An endoscopic submucosal resection (EMR) of the solitary amyloidosis was performed and the immunohistopathology revealed the entire SMT to consist of amyloid light chain kappa amyloid deposition. We considered that the US followed by EMR contributed to the precise diagnosis of solitary amyloidosis and the treatment of hematochezia caused by a solitary area of amyloidosis within the sigmoid colon. PMID:24240791

Ogasawara, Naotaka; Kitagawa, Wataru; Obayashi, Konen; Itoh, Yoshitsugi; Noda, Hisatsugu; Funaki, Yasushi; Yokoi, Toyoharu; Sasaki, Makoto; Imai, Hirokazu; Kasugai, Kunio

2013-01-01

17

Penetrated sigmoid colon by air gun pellet could be life threatening: A case report  

PubMed Central

INTRODUCTION Air and paintball guns have been in existence for over 400 year. Although serious injury or death can result from the use of such guns, previous literature has not mentioned the issue of the penetration of the sigmoid colon by an air gun pellet. PRESENTATION OF CASE We report a rare case of a 44-year-old Caucasian woman referred to abdominal surgery after an accidental small wound had occurred in the lower left abdominal quadrant that was caused by an air gun pellet. The blood and biochemical analyses were normal but the CT scan revealed the presence of a foreign body – an air gun pellet in the left iliac region of the abdomen. Clinically, during the initial 24 h significant changes were not noticed. After 42 h, however, pain and local tenderness in the lower left abdominal quadrant was expressed. A laparotomy revealed a retained pellet in the wall of the sigmoid colon and a small leak with colonic content with consecutive local peritonitis also occurred. The foreign body was removed and the opening edges in the colon were excised and closed with the primary suture. DISCUSSION The hollow organs of the digestive tract, albeit very rarely penetrated by an air gun pellet, do not typically show all signs of an acute abdomen in the early posttraumatic phase. Such injuries can lead to a pronounced infection, which may cause septic shock if not appropriately treated. CONCLUSION For correct diagnosis, a careful approach and several daily clinical observations are required. PMID:25437671

Krasniqi, Avdyl S.; Hamza, Astrit R.; Zejnullahu, Valon A.; Sada, Fatos E.; Bicaj, Besnik X.

2014-01-01

18

An irreducible left scrotal hernia containing a sigmoid colon tumor (adenocarcinoma) – Case report  

PubMed Central

INTRODUCTION In relation to all inguinal hernias, large irreducible scrotal hernias are quite rare, while such hernias containing colon tumors in the sac have so far been described in fewer than 30 cases. PRESENTATION OF CASE A 61-year-old patient was admitted for a planned surgery because of a large irreducible left-sided scrotal hernia. Intraoperatively, a large tumor of the sigmoid colon was found in the hernial sac. In a histopathological examination it was diagnosed as adenocarcinoma. A palliative operation was performed and he was referred to further systemic and palliative treatment (because of numerous coexisting liver metastases). DISCUSSION Until now, only about 30 cases of colon tumor in inguinal hernia sac have been reported. CONCLUSION It should be remembered that even the most obvious preoperative diagnosis may be verified intraoperatively. PMID:24988210

Gna?, Jaros?aw; Bulsa, Marek; Czaja-Bulsa, Gra?yna

2014-01-01

19

Colon Visualization on 99mTc-HDP Whole-Body Bone Scan Due to Sigmoid Colon Cancer-Related Enterovesical Fistula.  

PubMed

An abnormally increased uptake of the bone-seeking agent is rarely observed in structures other than the bone and urinary track on bone scintigraphy. The general etiologies of soft tissue uptake can be explained by heterotopic ossification or dystrophic and metastatic calcification. We report a case of serendipitous visualization of the entire colon on bone scintigraphy. Diffuse colonic uptake was detected on the whole-body bone scan in a patient with biopsy-proven sigmoid colon cancer. Additional imaging studies clearly showed direct bladder invasion of the sigmoid colon cancer. Imaging findings with a brief review of the literature are presented in this article. PMID:25072927

Kim, Sung Hoon; Song, Bong-Il; Won, Kyoung Sook

2015-01-01

20

Early experiences with magnetic rings in resection of the distal colon.  

PubMed

We have developed an anastomosis technique for resection of the distal colon based on the principle of submucosal layer apposition. The anastomosis apparatus consists of two rings of Ertalyte (polyester-polyethyleneterephtalate) containing two magnetic rings of polymer bonded rare earth cobalt. For low anastomoses we developed a magnetic ring holder, protecting cap and hexagonal connecting rod. The working principle is based on progressive compression leading to necrosis of the intermediate mucosal and submucosal layers by increasing magnetic force while bowel healing takes place. After 7 to 17 days the magnets cut through and are propelled by peristalis out of the anastomotic region. From our initial series of five patients we performed three sigmoid resections and two low anterior resections. There were no postoperative complications. Sigmoidoscopic and radiological investigations two weeks postoperatively, showed no evidence of leakage or anastomotic narrowing. The technique and the special advantages of the apparatus are discussed. PMID:7366876

Jansen, A; Keeman, J N; Davies, G A; Klopper, P J

1980-01-01

21

Semi-automated segmentation of the sigmoid and descending colon for radiotherapy planning using the fast marching method  

NASA Astrophysics Data System (ADS)

A fast and accurate segmentation of organs at risk, such as the healthy colon, would be of benefit for planning of radiotherapy, in particular in an adaptive scenario. For the treatment of pelvic tumours, a great challenge is the segmentation of the most adjacent and sensitive parts of the gastrointestinal tract, the sigmoid and descending colon. We propose a semi-automated method to segment these bowel parts using the fast marching (FM) method. Standard 3D computed tomography (CT) image data obtained from routine radiotherapy planning were used. Our pre-processing steps distinguish the intestine, muscles and air from connective tissue. The core part of our method separates the sigmoid and descending colon from the muscles and other segments of the intestine. This is done by utilizing the ability of the FM method to compute a specified minimal energy functional integrated along a path, and thereby extracting the colon centre line between user-defined control points in the sigmoid and descending colon. Further, we reconstruct the tube-shaped geometry of the sigmoid and descending colon by fitting ellipsoids to points on the path and by adding adjacent voxels that are likely voxels belonging to these bowel parts. Our results were compared to manually outlined sigmoid and descending colon, and evaluated using the Dice coefficient (DC). Tests on 11 patients gave an average DC of 0.83 (±0.07) with little user interaction. We conclude that the proposed method makes it possible to fast and accurately segment the sigmoid and descending colon from routine CT image data.

Losnegård, Are; Bolstad Hysing, Liv; Muren, Ludvig Paul; Hodneland, Erlend; Lundervold, Arvid

2010-09-01

22

Migration of ingested sewing needle from within sigmoid colon to outside of the lumen  

PubMed Central

Foreign body ingestion is a frequently observed condition in children. However, migration of an ingested foreign body from the gastrointestinal tract toward any abdominal organ is extremely rare. We report herein a case of a 2-year-old female patient in whom an ingested sewing needle was palpable by rectal examination and was determined to have migrated from within the sigmoid colon to outside of the lumen. The needle was surgically removed. In cases of foreign body ingestion, both physical examination and radiological follow-up should be performed.

Cevizci, Mehmet Nuri; Demir, Muhammet; Demir, Berrin; Demir, Ilknur; Kilic, Omer

2014-01-01

23

Postoperative bacteriuria, pyuria and urinary tract infection in patients with an orthotopic sigmoid colon neobladder replacement.  

PubMed

The purpose of this study is to investigate the prevalence of postoperative bacteriuria, pyuria and urine culture in patients with an orthotopic sigmoid colon neobladder replacement. Urine samples for bacteriuria, pyuria and urine culture, if necessary, were collected at 1, 3, 6, 9 and 12 months after surgery and the presence of blood culture and antibiotic-resistant strains, and their treatments on positive urine culture cases were investigated. Of 209 for bacteriuria and 207 for pyuria urine samples with evaluable data, 95 (45.5%) were positive for bacteriuria and 76 (36.7%) had pyuria (10 or more white blood cells per high-power field). Totally, 30 bacteria were isolated from urine culture of urinary tract infection (UTI) and Klebisiella pneumoniae, Escherichia coli, Staphylococcos aureus and Enterococcus spp. strains were representatively isolated. The incidence of pyuria significantly decreased over time (P=0.041) but that of bacteriuria did not (P=0.107). In them, there were six bacteria (20.7%) with antibiotic-resistant strains. The antibiotics used for their treatments representatively were levofloxacin in five cases, tazobactam/piperacillin in three cases and sulfamethoxazole/trimethoprim and cefepime, meropenem in two cases, respectively. In conclusion, these findings suggest that physicians taking care of sigmoid colon neobladder patients need to be aware of these high ratios of bacteriuria, pyuria and UTI, including bacteremia. PMID:24169796

Shigemura, Katsumi; Tanaka, Kazushi; Arakawa, Soichi; Miyake, Hideaki; Fujisawa, Masato

2014-02-01

24

Relationship of cigarette smoking, alcohol use, and dietary habits with sigmoid colon adenomas.  

PubMed

The relationship between cigarette smoking, alcohol use, and dietary factors and the risk of adenomas of the sigmoid colon was examined in male self-defense officials who received a preretirement health examination at three Self-Defense Forces hospitals in Japan. In the comparison between 228 patients with sigmoid adenomas and 1484 control subjects with normal colonoscopy findings (> or = 60 cm from the anus), a clear dose-response relationship was observed between cigarette smoking and risk of adenoma. After adjustment for rank, body mass index, alcohol use, and physical activity as well as for hospital and survey season, the odds ratios (and 95% confidence intervals (CIs)) for the categories of 0, 1 to 399, 400 to 799, and 800 or more cigarette-years were 1.0, 2.1 (1.2 to 3.5), 2.8 (1.8 to 4.3), and 3.5 (2.1 to 5.8), respectively. Current alcohol drinkers tended to have an increased risk, but without a dose-response relation. Among four types of alcoholic beverages (shochu, sake, beer, and whiskey), only whiskey showed a weak association with risk of adenoma. None of the 13 dietary items studied (including meat and rice consumption) was measurably associated with adenoma risk. The present findings provide additional evidence that cigarette smoking is a risk factor for colon adenomas. It is inconclusive regarding alcohol intake's association with adenoma risk. PMID:8680611

Todoroki, I; Kono, S; Shinchi, K; Honjo, S; Sakurai, Y; Wakabayashi, K; Imanishi, K; Nishikawa, H; Ogawa, S; Katsurada, M

1995-11-01

25

A case of a mesenteric cyst in the sigmoid colon of a 3-year-old girl.  

PubMed

Mesenteric cysts are rare. In this paper we present a case of a mesenteric cyst in the sigmoid colon of a 3-year-old girl. On the first visit to our department, a smooth-surfaced soft mass approximately 15 cm in diameter was noticed in the right lower abdomen. Although the patient complained of lower abdominal pain, there was no tenderness or guarding. Laboratory tests indicated no abnormality except a slightly increased level of C-reactive protein (2.3 mg/dL). A plain abdominal X-ray film revealed displacement of colonic gas from the right lower abdomen, and abdominal ultrasonography and computed tomography revealed a smooth cystic mass measuring 9.5 x 8.7 x 4.7 cm that contained many internal septa. Because the patient had several symptoms, we performed a surgical operation under general anesthesia. We found a light-red cystic mass, 8.5 x 8.0 x 3.0 cm in size, in the mesentery of the sigmoid colon and surrounding the sigmoid colon, without adhesion to any other organ. We approached the cystic mass from the sigmoid colon and the mesentery of sigmoid colon and completely resected it without complications. The content of the cystic mass was a pale-yellow serous fluid. A cytological examination revealed mainly lymphocytes with reactive mesothelial cells. The resulting pathological diagnosis was a multi-lobular mesenteric cyst. Immunohistochemical staining with D2-40 antibody was positive value along the wall of the cyst, indicating that the cyst was derived from a lymphatic vessel. PMID:19915308

Iida, Shinya; Furukawa, Kiyonori; Terada, Yoshie; Sugisaki, Yuichi; Yoshimura, Kazuyasu; Tajiri, Takashi

2009-10-01

26

Mebeverine influences sodium ion transport in the distal colon.  

PubMed

The study was performed to check if the well-known intestinal spasmolytic effect of mebeverine is paralleled by any changes in intestinal transepithelial currents. The transepithelial potential difference related to ionic currents of the isolated rabbit distal colon wall was measured by means of Ussing's technique under control conditions and after gentle mechanical stimulation of intestinal epithelial surface by a flux from peristaltic pump and with and without of mebeverine in stimulation fluid. The transient hyperpolarization after mechanical stimulation was diminished after addition of mebeverine to the stimulation fluid when chloride transport was inhibited by bumetanide (BUME) but in the presence of amiloride (AMI), a sodium ion transport inhibitor, the drug did not influence the reaction. It was inferred that mebeverine was able to modulate transepithelial sodium ion transport and in this way to modify interaction between colonic wall and its contents during intestinal passage. PMID:17085870

Tyrakowski, Tomasz; M?odzik-Danielewicz, Natalia; Kurek, Weronika; Szaflarska-Pop?awska, Anna; Czerwionka-Szaflarska, Mieczys?awa; Kapa?a, Andrzej; Kopczy?ska, Ewa; Ho?y?ska, Iga; Kaczorowski, Piotr

2006-01-01

27

Cigarette smoking, alcohol use and adenomatous polyps of the sigmoid colon.  

PubMed

The relationship of adenomatous polyps of the sigmoid colon with cigarette smoking and alcohol use was investigated in male self-defense officials in Japan. In the comparison between 116 cases and 930 controls, total ethanol intake was not at all associated with the risk of adenomatous polyps, but cigarette smoking was strongly related to adenomatous polyps. After adjustment for total ethanol intake, body mass index and rank, odds ratios (and 95% confidence interval) for the categories of 0, 1-399, 400-799, and 800 or more cigarette-years were 1.0 (referent), 2.3 (1.1-4.6), 2.9 (1.5-5.4) and 3.2 (1.6-6.5), respectively. Among five alcoholic beverages (sake, shochu, beer, whiskey including brandy, and wine), only whiskey consumption was weakly related to the risk of adenomatous polyps. Because the present findings disagree with an earlier observation on self-defense officials, we examined the association with smoking and alcohol use separately for small (less than 5 mm) and large (greater than or equal to 5 mm) adenomas, combining data from these two studies. Cigarette smoking was more strongly associated with small adenomas while the positive association with certain alcoholic beverages were largely confined to large adenomas. These findings suggest that cigarette smoking and alcohol use may be linked with the development of adenoma at different stages of colon tumorigenesis. PMID:1399817

Honjo, S; Kono, S; Shinchi, K; Imanishi, K; Hirohata, T

1992-08-01

28

[A case of locally advanced sigmoid colon cancer treated with neoadjuvant chemoradiotherapy].  

PubMed

The patient was a 38-year-old woman who visited our hospital complaining of nausea and abdominal pain. A colonoscopy revealed an advanced cancer in the sigmoid colon. A computed tomography (CT) scan showed left hydronephrosis and lymph node metastasis to the left iliopsoas muscle and left ureter. No distant metastasis was found. Since the surgical margins were likely to be positive with a one-stage resection, 3 cycles of FOLFOX4 (folinic acid, fluorouracil, and oxaliplatin)were administered after creating a transverse loop colostomy. Although the tumor decreased in size, the surgical margins were still suspected to be positive. For further regional tumor control, radiotherapy (1.8 Gy/day for 25 days) to the medial region of the left iliac bone and oral UFT/LV (uracil and tegafur/Leucovorin)were administered. A partial response(PR)was determined in accordance with the Response Evaluation Criteria in Solid Tumors(RECIST). Sigmoidectomy with partial resection of the left ureter was performed by laparotomy. The histologic response was assessed as Grade 2 and all surgical margins were negative. Preoperative chemoradiotherapy may be an effective therapeutic option for locally advanced colon cancer resistant to conventional preoperative chemotherapy. PMID:25248907

Yoshitomi, Mami; Hashida, Hiroki; Nomura, Akinari; Ueda, Shugo; Terajima, Hiroaki; Osaki, Nobuhiro

2014-09-01

29

Design and evaluation of matrix base with sigmoidal release profile for colon-specific delivery using a combination of Eudragit and non-ionic cellulose ether polymers  

Microsoft Academic Search

A pH- and time-controlled drug delivery system with sigmoidal release profile was developed using Eudragit (L100 or S100)\\u000a in combination with hydroxy ethyl cellulose (HEC) or hydroxy propyl cellulose (HPC) for sigmoidal release of indomethacin\\u000a in the potential treatment of colon cancer. The effect of varying proportions of polymer type on sigmoidal release was evaluated.\\u000a The prepared tablets were also

Laila Fatima Ali Asghar; Sajeev Chandran

2011-01-01

30

Properties of submucosal venules in the rat distal colon  

PubMed Central

Background and Purpose Venules within the gut wall may have intrinsic mechanisms for maintaining the circulation even upon the intestinal wall distension. We aimed to explore spontaneous and nerve-mediated contractile activity of colonic venules. Experimental Approach Changes in the diameter of submucosal venules of the rat distal colon were measured using video microscopy. The innervation of the microvasculature was investigated using fluorescence immunohistochemistry. Key Results Submucosal venules exhibited spontaneous constrictions that were abolished by blockers of L-type Ca2+ channels (1??M nicardipine), Ca2+-ATPase (10??M cyclopiazonic acid), IP3 receptor (100??M 2-APB), Ca2+-activated Cl? channels (100??M DIDS) or store-operated Ca2+ entry channels (10??M SKF96365). Transmural nerve stimulation (TNS at 10?Hz) induced a phasic venular constriction that was blocked by phentolamine (1??M, ?-adrenoceptor antagonist) or sympathetic nerve depletion using guanethidine (10??M). Stimulation of primary afferent nerves with TNS (at 20?Hz) or capsaicin (100?nM) evoked a sustained venular dilatation that was attenuated by calcitonin gene-related peptide (CGRP) 8-37 (2??M), a CGRP receptor antagonist. Immunohistochemistry revealed sympathetic and primary afferent nerves running along submucosal venules. Conclusions and Implications Submucosal venules of the rat distal colon exhibit spontaneous constrictions that appear to primarily rely on Ca2+ release from sarcoplasmic reticulum and subsequent opening of Ca2+-activated Cl– channels that trigger Ca2+ influx through L-type Ca2+ channels. Venular contractility is modulated by sympathetic as well as CGRP-containing primary afferent nerves, suggesting that submucosal venules may play an active role in regulating the microcirculation of the digestive tract. PMID:23992146

Mitsui, Retsu; Miyamoto, Shun; Takano, Hiromichi; Hashitani, Hikaru

2013-01-01

31

[An example of metastasis to the iliopsoas muscle from sigmoid colon cancer].  

PubMed

Even though skeletal muscle, making up about 40% of body weight, is the largest organ in the human body, metastasis from malignant lesions is rare. Among reports of metastasis, those involving the iliopsoas muscle are numerous but few reports involve resection. Reported here is one example we experienced where metastasis developed in the iliopsoas muscle following colectomy, resection was then made possible by radiotherapy and chemotherapy. The case involved a 71-year- old male in which a Hartmann procedure was performed for sigmoid colon cancer. The pathology was Type 3 (8 × 7 cm, adenocarcinoma( mod), ss or more, ly1, v1, n0, ow(-), aw or ew(+), stage II). Upon additional sampling, thermal degredation of neoplastic cells was shown and outpatient oral UFT was performed. Five years following surgery, lymphoadenopathy was noted in the area of the left iliac artery upon US and CT. PET showed a probable metastasis to the left iliopsoas muscle. Early esophageal and stomach cancer were diagnosed by GFT. The esophageal cancer was located 30-32 cm from the incisors, unstained, Borrmann type 1, penetrating deeper than the muscularis propria. Biopsy revealed a diagnosis of tubular adenocarcinoma. ESD was performed for the esophageal cancer and one month later, a total gastrectomy D1+? was performed. During surgery, the iliopsoas muscle tumor was determined to be large and impossible to resect. Radiotherapy of 10MV X-ray, 8 fields, 65-70 Gy/26 times for 6 . 5 weeks was performed for residual tumor but had no effect on tumor size. Fifteen courses of FOLFOX+bevacizumab were then performed. The tumor was markedly reduced in size, unidentifiable upon CT but showed slight uptake on PET and resection of the suspected residual tumor was performed. Histologically, atypical cells were shown in scarred muscle and connective tissue, however, degradation by chemotherapy was high. Residual tumor at resection margins was found, findings consistent with metastasis form sigmoid colon cancer. Taking into account the age and condition of the patient following surgery, chemotherapy was changed to S-1. Currently, 5 months after resection, there has been no recurrence. PMID:22202360

Takada, Joji; Watanabe, Kenya; Kuraya, Daisuke; Kina, Masaya; Hayashi, Shunji; Hamada, Hiromi; Katsuk, Yoshio

2011-11-01

32

Sigmoid Volvulus  

PubMed Central

In sigmoid volvulus (SV), the sigmoid colon wraps around itself and its mesentery. SV accounts for 2% to 50% of all colonic obstructions and has an interesting geographic dispersion. SV generally affects adults, and it is more common in males. The etiology of SV is multifactorial and controversial; the main symptoms are abdominal pain, distention, and constipation, while the main signs are abdominal distention and tenderness. Routine laboratory findings are not pathognomonic: Plain abdominal X-ray radiographs show a dilated sigmoid colon and multiple small or large intestinal air-fluid levels, and abdominal CT and MRI demonstrate a whirled sigmoid mesentery. Flexible endoscopy shows a spiral sphincter-like twist of the mucosa. The diagnosis of SV is established by clinical, radiological, endoscopic, and sometimes operative findings. Although flexible endoscopic detorsion is advocated as the primary treatment choice, emergency surgery is required for patients who present with peritonitis, bowel gangrene, or perforation or for patients whose non-operative treatment is unsuccessful. Although emergency surgery includes various non-definitive or definitive procedures, resection with primary anastomosis is the most commonly recommended procedure. After a successful non-operative detorsion, elective sigmoid resection and anastomosis is recommended. The overall mortality is 10% to 50%, while the overall morbidity is 6% to 24%.

Atamanalp, S. Selcuk

2010-01-01

33

[A case of primary epiploic appendagitis of the sigmoid colon diagnosed by abdominal CT and managed conservatively].  

PubMed

A 40-year-old man presented to our department with left lower abdominal pain. Laboratory test showed slight leukocytosis and moderately elevated C-reactive protein (CRP). Computed tomography (CT) of the abdomen showed a typical fat density lesion adjacent to the sigmoid colon. The diagnosis of primary epiploic appendagitis of the sigmoid colon was established, and the patient was managed conservatively. Primary epiploic appendagitis is a self-limiting illness, and diagnosed by characteristic radiographic findings. Inaccurate diagnosis can lead to unnecessary treatments including surgical intervention. When we encounter a case of acute abdomen, we should consider the possibility of this disease to make accurate diagnosis and give proper treatment. PMID:22688104

Higashi, Yusuke; Ueda, Hiroyuki; Ohno, Atsushi; Boda, Tomoyuki; Fukuhara, Takayuki; Masuda, Hiromichi; Yamaguchi, Toshiki; Kamada, Koji; Hattori, Yoshihiro; Nakashima, Koichiro

2012-05-01

34

[A case of locally advanced sigmoid colon cancer curatively resected after neoadjuvant chemotherapy with FOLFIRI plus panitumumab].  

PubMed

A 72-year-old woman having abdominal pain and high fever was diagnosed with KRAS wild-type sigmoid colon cancer, invading the urinary bladder and uterus with a pelvic abscess. Considering the difficulty of curative resection, we first performed sigmoid colostomy and abscess drainage. Remarkable tumor regression was indicated by CT and colonoscopy after 1 course of FOLFIRI and 5 courses of FOLFIRI+panitumumab. Following an additional 2 courses of panitumumab, sigmoidectomy and partialcystectomy were performed. Six courses of FOLFIRI+panitumumab were administered postoperatively and no recurrence has been observed for 7 months. FOLFIRI+panitumumab may be an effective preoperative chemotherapy for patients with KRAS wild-type locally advanced colon cancer. PMID:23507607

Horioka, Kohei; Kaku, Keizo; Jimi, Sei-ichirou; Oohata, Yoshihiro; Kamei, Takafumi

2013-03-01

35

trans-Fatty Acid Consumption and its Association with Distal Colorectal Cancer in the North Carolina Colon Cancer Study II  

PubMed Central

Recently, the potential health effects of trans-fatty acid consumption have raised concerns. A few studies have examined the risk of colorectal cancer with increasing consumption of trans-fatty acids, but none investigated the risk of rectal cancer, which may have different risk factors than colon cancer. Our objective was to explore the relationship between trans-fatty acid consumption and distal colorectal (sigmoid, rectosigmoid, and rectal) cancer using a case-control study of Whites (n=1516) and African Americans (n=392) in North Carolina from 2001–2006. Matched cases and controls were interviewed about demographic information, lifestyle factors, and diet. White cases reported higher mean consumption of trans-fatty acid than White controls, but mean consumption was similar for African American cases and controls. Relative to the lowest quartile, the highest quartiles of energy-adjusted trans-fatty acid consumption were positively associated with distal colorectal cancer for Whites [adjusted ORs for the third and fourth quartiles, respectively: 1.54 (95%CI: 1.12, 2.13) and 1.45 (95%CI: 1.04, 2.03)]. Consumption was not associated with distal colorectal cancer in African Americans [adjusted ORs for the third and fourth quartiles: 0.98 (95%CI: 0.47, 2.05) and 0.87 (95%CI 0.42, 1.81)]. In conclusion, high consumption of trans-fatty acids was positively associated with distal colorectal cancer among Whites. PMID:19842051

Vinikoor, Lisa C; Millikan, Robert C; Satia, Jessie A; Schroeder, Jane C; Martin, Christopher F; Ibrahim, Joseph G.; Sandler, Robert S

2009-01-01

36

A case of a gastrointestinal stromal tumor with skeinoid fibers of the sigmoid colon.  

PubMed

An 80-year-old man was diagnosed with rectal cancer and underwent Hartmann's procedure. Although no tumors were identified during the preoperative examination, gross examination of the resected specimen incidentally revealed a submucosal tumor that was 9 mm in diameter at the oral side and located in the proximal stump of the specimen from the sigmoid colon. We suspected a concurrent gastrointestinal stromal tumor (GIST) and performed a histopathological examination. An L-shaped nodular lesion measuring 9 × 6 mm was histologically composed of a patternless proliferation of spindle cells intermingled with eosinophilic globules. Cellular atypia, prominent mitotic figures and necrotic foci were not observed in the nodule. The spindle cells were positive for CD34, CD117 and vimentin, but negative for CD56, smooth muscle actin and S-100 protein. MIB-1 positivity was estimated to be as low as approximately 1-2%. Electron microscopy showed a bundle of wool-like fibers with a periodicity of approximately 40 nm. We therefore considered the lesion to be a low-risk GIST with skeinoid fibers in the large intestine. Although numerous previous reports have reported skeinoid fibers in the stomach and small intestines, there have been only 9 cases (including the present case) of skeinoid fibers in the large intestine. PMID:25408627

Sumi, Tetsuo; Katsumata, Kenji; Shibuya, Makoto; Katayanagi, Sou; Iwasaki, Kenichi; Kasuya, Kazuhiko; Serizawa, Hiromi; Shimazu, Motohide; Tsuchida, Akihiko

2014-09-01

37

A Case of a Gastrointestinal Stromal Tumor with Skeinoid Fibers of the Sigmoid Colon  

PubMed Central

An 80-year-old man was diagnosed with rectal cancer and underwent Hartmann's procedure. Although no tumors were identified during the preoperative examination, gross examination of the resected specimen incidentally revealed a submucosal tumor that was 9 mm in diameter at the oral side and located in the proximal stump of the specimen from the sigmoid colon. We suspected a concurrent gastrointestinal stromal tumor (GIST) and performed a histopathological examination. An L-shaped nodular lesion measuring 9 × 6 mm was histologically composed of a patternless proliferation of spindle cells intermingled with eosinophilic globules. Cellular atypia, prominent mitotic figures and necrotic foci were not observed in the nodule. The spindle cells were positive for CD34, CD117 and vimentin, but negative for CD56, smooth muscle actin and S-100 protein. MIB-1 positivity was estimated to be as low as approximately 1–2%. Electron microscopy showed a bundle of wool-like fibers with a periodicity of approximately 40 nm. We therefore considered the lesion to be a low-risk GIST with skeinoid fibers in the large intestine. Although numerous previous reports have reported skeinoid fibers in the stomach and small intestines, there have been only 9 cases (including the present case) of skeinoid fibers in the large intestine. PMID:25408627

Sumi, Tetsuo; Katsumata, Kenji; Shibuya, Makoto; Katayanagi, Sou; Iwasaki, Kenichi; Kasuya, Kazuhiko; Serizawa, Hiromi; Shimazu, Motohide; Tsuchida, Akihiko

2014-01-01

38

Acquired hemophilia A with sigmoid colon cancer: successful treatment with rituximab followed by sigmoidectomy.  

PubMed

Acquired hemophilia A is a rare and potentially fatal condition of coagulopathy caused by autoantibodies against clotting factor VIII (factor VIII inhibitor). We report a case of a 63-year-old woman, who presented with a sudden onset of severe hemorrhagic tendency with exclusively prolonged activated partial thromboplastin time (APTT). She was diagnosed with acquired hemophilia A due to a decrease in factor VIII activity and a high titer of factor VIII inhibitor. Hemorrhage was well controlled by recombinant activated factor VII. Although the level of factor VIII inhibitor did not decline with prednisolone and cyclophosphamide, it became undetectable with rituximab. In parallel with controlling hemorrhage, malignancy, which may cause acquired hemophilia A, was searched for and sigmoid colon cancer was found. After the eradication of factor VIII inhibitor, surgical resection was performed uneventfully. Thereafter, acquired hemophilia A has been in complete remission without any additional therapy. The present case suggests the efficacy of rituximab for refractory acquired hemophilia A and the importance of the identification of underlying diseases that can cause acquired hemophilia A. PMID:19484333

Ichikawa, Satoshi; Kohata, Katsura; Okitsu, Yoko; Suzuki, Makiko; Nakajima, Shinji; Yamada, Minami F; Onishi, Yasushi; Yamamoto, Joji; Suzuki, Sozo; Ishizawa, Kenichi; Kameoka, Junichi; Harigae, Hideo

2009-07-01

39

Colorectal infantile myofibromatosis: an unusual cause of rectal prolapse and sigmoid colo-colonic intussusception: a case report  

PubMed Central

Background Infantile myofibromatosis is a rare mesenchymal disorder of infancy that can extensively involve the viscera including the gastrointestinal tract. Case presentation In this report, an exceptional case of infantile myofibromatosis is described in which rectal prolapse and sigmoid colo-colonic intussusception were the initial presentations of colorectal involvement in a 2-month-old premature female infant. Conclusion To the best of our knowledge, this is the first case reporting rectal prolapse and the second case documenting intussusception secondary to gastrointestinal involvement by infantile myofibromatosis. PMID:19077316

Dhall, Deepti; Frykman, Philip K; Wang, Hanlin L

2008-01-01

40

Differences in control of descending inhibition in the proximal and distal regions of rat colon.  

PubMed Central

1. Descending inhibition in the proximal and distal portions of rat colon was studied separately, in vitro. 2. In the proximal colon, localized distension with a small balloon caused three types of response (contraction; relaxation; relaxation, then contraction) of the circular muscle on the anal side of the distended region. 3. Distension caused descending relaxation of circular muscle in all segments of the proximal colon, although for this prostaglandin F2 alpha (PGF 2 alpha) was necessary in some segments to increase muscle tone. 4. Atropine and guanethidine did not inhibit this descending relaxation, but tetrodotoxin did. 5. Hexamethonium inhibited the descending relaxation in 14 of 17 preparations of proximal colon tested, but not in the others. 6. In the distal colon, distension consistently caused an increase in the tone of the circular muscles. Descending relaxation was observed only after development of higher tone. Atropine and guanethidine did not inhibit the relaxation, but tetrodotoxin did. 7. Hexamethonium did not inhibit the descending relaxation in most of the preparations of distal colon examined. 8. AF64A, an inhibitor of choline uptake, inhibited the response mediated by cholinergic neurons in vitro to electrical transmural stimulation of the longitudinal muscle of proximal colon. 9. Treatment of colonic preparations with AF64A in vitro resulted in inhibition of descending relaxation in those of proximal, but not those of distal, colon. 10. The participation of intrinsic cholinergic neurones in the descending neuronal pathway is strongly suggested by the results in the proximal colon, but less so in the distal colon. 11. The tone and spontaneous contractile activity of colonic circular muscles are discussed in relation to their neuronal control. PMID:2085703

Hata, F.; Kataoka, T.; Takeuchi, T.; Yagasaki, O.; Yamano, N.

1990-01-01

41

[A case of curatively resected sigmoid colon cancer after mFOLFOX6 plus panitumumab neoadjuvant chemotherapy].  

PubMed

A 54-year-old man with residual urine, abdominal pain, and a high fever was diagnosed with KRAS wild-type sigmoid colon cancer with urinary bladder invasion. Considering the difficulty of curative resection, we first performed an ileostomy. Remarkable tumor regression was indicated by computed tomography(CT)and colonoscopy after 3 courses of mFOLFOX6 plus panitumumab. A sigmoidectomy and partial cystectomy were performed with a curative intent. Six courses of XELOX adjuvant chemotherapy were administered, and no recurrence has been observed for 9 months. mFOLFOX6 plus panitumumab might be an effective preoperative chemotherapy for patients with locally advanced KRAS wild-type colon cancer. PMID:24743293

Yoshikawa, Kiyoshi; Kuwata, Hirofumi; Nakahata, Yoshikatsu

2014-03-01

42

Alcoholic beverages and adenomatous polyps of the sigmoid colon: a study of male self-defence officials in Japan.  

PubMed

The drinking habits of 86 men with adenomatous polyps of the sigmoid colon were compared to those of 1184 men with normal colonoscopy among middle-aged male self-defence officials. After adjustment for rank, smoking history and rice consumption, total ethanol intake was positively associated with the risk of adenomatous polyps. The odds ratio (OR) was 2.4 (95% confidence interval (CI) 1.0-5.5) for men consuming at least 60 ml of ethanol per day. Among five alcoholic beverages (shochu, beer, sake, whiskey and wine), both sake and beer showed a dose-response relationship with the risk of adenomatous polyps although the association with beer was less striking. Shochu was the largest source of ethanol intake in the study population, but there was virtually no association between shochu consumption and adenomatous polyps. Men drinking wine had a significantly increased risk, but these men were too few to examine the relation in detail. The findings suggest that the consumption of specific alcoholic beverages rather than ethanol itself is associated with an increased risk of adenomatous polyps of the sigmoid colon. PMID:2084011

Kono, S; Ikeda, N; Yanai, F; Shinchi, K; Imanishi, K

1990-12-01

43

Increasing butyrate concentration in the distal colon by accelerating intestinal transit  

PubMed Central

Background—Populations at low risk of colonic cancer consume large amounts of fibre and starch and pass acid, bulky stools. One short chain fatty acid (SCFA), butyrate, is the colon's main energy source and inhibits malignant transformation in vitro. ?Aim—To test the hypothesis that altering colonic transit rate alters colonic pH and the SCFA content of the stools. ?Patients—Thirteen healthy adults recruited by advertisement. ?Methods—Volunteers consumed, in turn, wheat bran, senna and loperamide, each for nine days with a two week washout period between study periods, dietary intake being unchanged. Before, and in the last four days of each intervention, whole gut transit time (WGTT), defaecation frequency, stool form, stool ?-glucuronidase activity, stool pH, stool SCFA concentrations and intracolonic pH (using a radiotelemetry capsule for continuous monitoring) were assessed. ?Results—WGTT decreased, stool output and frequency increased with wheat bran and senna, vice versa with loperamide. The pH was similar in the distal colon and stool. Distal colonic pH fell with wheat bran and senna and tended to increase with loperamide. Faecal SCFA concentrations, including butyrate, increased with senna and fell with loperamide. With wheat bran the changes were non-significant, possibly because of the short duration of the study. Baseline WGTT correlated with faecal SCFA concentration (r=?0.511, p=0.001), with faecal butyrate (r=?0.577, p<0.001) and with distal colonic pH (r=0.359, p=0.029). ?Conclusion—Bowel transit rate is a determinant of stool SCFA concentration including butyrate and distal colonic pH. This may explain the inter-relations between colonic cancer, dietary fibre intake, stool output, and stool pH. ?? Keywords: bowel cancer; colonic pH; fibre; intestinal transit; pH; short chain fatty acids PMID:9301506

Lewis, S; Heaton, K

1997-01-01

44

TRPV3, a thermosensitive channel is expressed in mouse distal colon epithelium  

SciTech Connect

The thermo-transient receptor potential (thermoTRP) subfamily is composed of channels that are important in nociception and thermo-sensing. Here, we show a selective expression of TRPV3 channel in the distal colon throughout the gastrointestinal tract. Expression analyses clearly revealed that TRPV3 mRNA and proteins were expressed in the superficial epithelial cells of the distal colon, but not in those of the stomach, duodenum or proximal colon. In a subset of primary epithelial cells cultured from the distal colon, carvacrol, an agonist for TRPV3, elevated cytosolic Ca{sup 2+}concentration in a concentration-dependent manner. This response was inhibited by ruthenium red, a TRPV channel antagonist. Organotypic culture supported that the carvacrol-responsive cells were present in superficial epithelial cells. Moreover, application of carvacrol evoked ATP release in primary colonic epithelial cells. We conclude that TRPV3 is present in absorptive cells in the distal colon and may be involved in a variety of cellular functions.

Ueda, Takashi, E-mail: tueda@med.nagoya-cu.ac.jp [Department of Neurobiology and Anatomy, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601 (Japan)] [Department of Neurobiology and Anatomy, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601 (Japan); Yamada, Takahiro, E-mail: yamada-taka@syd.odn.ne.jp [Department of Neurobiology and Anatomy, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601 (Japan)] [Department of Neurobiology and Anatomy, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601 (Japan); Ugawa, Shinya, E-mail: ugawa@med.nagoya-cu.ac.jp [Department of Neurobiology and Anatomy, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601 (Japan)] [Department of Neurobiology and Anatomy, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601 (Japan); Ishida, Yusuke, E-mail: y.ishida@med.nagoya-cu.ac.jp [Department of Neurobiology and Anatomy, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601 (Japan)] [Department of Neurobiology and Anatomy, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601 (Japan); Shimada, Shoichi, E-mail: sshimada@med.nagoya-cu.ac.jp [Department of Neurobiology and Anatomy, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601 (Japan)] [Department of Neurobiology and Anatomy, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601 (Japan)

2009-05-22

45

Synchronous Appearance of a High-Grade Neuroendocrine Carcinoma of the Ampulla Vater and Sigmoid Colon Adenocarcinoma  

PubMed Central

Neuroendocrine carcinoma is a relatively rare tumor and its coexistence with other primary cancers is very exceptional. We present a case of a 63-year-old woman with biliary obstruction due to a high-grade neuroendocrine carcinoma located in ampulla of Vater who was found to have a synchronous sigmoid colon adenocarcinoma while undergoing staging laparotomy and pancreas head resection. Medical history was significant only for basal cell skin cancer. Immunohistochemical examination revealed the concurrence of histologically proved neuroendocrine carcinoma (chromogranin A, synaptophysin, and CD56 were positive) and Stage II (T3, N0, and M0) according to the TNM staging classification of colorectal cancer. The coexistence of neuroendocrine tumors with either synchronous or metachronous unrelated cancer is increasingly recognized. The patients with neuroendocrine carcinoma should be evaluated for secondary primary malignancies. PMID:24368955

Cokmert, Suna; Demir, Lutfiye; Akder Sari, Aysegul; Kucukzeybek, Yuksel; Can, Alper; Akyol, Murat; Bayoglu, Ibrahim Vedat; Dirican, Ahmet; Erten, Cigdem; Tarhan, Mustafa Oktay

2013-01-01

46

Chicken or the leg: Sigmoid colon perforation by ingested poultry fibula proximal to an occult malignancy?  

PubMed Central

INTRODUCTION Colonic perforation by ingested foreign bodies is exceedingly rare, with the diagnosis made more challenging by patients infrequently recalling any inadvertent ingestion and the poor sensitivity of plain radiography. PRESENTATION OF CASE The presented case demonstrates that bony perforation of the large bowel might occur immediately proximal to an otherwise occult colonic malignancy. DISCUSSION Ingestion of foreign bodies is common and rarely results in colonic perforation. However, bony ingestion is not usually remembered and can be missed even with cross-sectional imaging. If present, consideration should be given to the presence of an adjacent concealed colon cancer. CONCLUSION The co-existence of separate pathology should be carefully assessed in these patients, since this has important implications for relevant investigations and appropriate surgical management. PMID:24060703

Terrace, J.D.; Samuel, J.; Robertson, J.H.; Wilson, R.G.; Anderson, D.N.

2013-01-01

47

Hypergastrinemia Is Associated with Increased Risk of Distal Colon Adenomas  

Microsoft Academic Search

Background\\/Aims:Helicobacter pylori infection is a recognized cause of hypergastrinemia, but the association of blood gastrin levels with colonic adenomas (CAs) is controversial. The aim of this study is to investigate if hypergastrinemia, H. pylori infection and\\/or cagA protein are risk factors for CAs. Methods: In this prospective case-control study, fasting serum samples from 78 consecutive patients with CAs and 78

Sotirios D. Georgopoulos; Dimitrios Polymeros; Konstantinos Triantafyllou; Charis Spiliadi; Andreas Mentis; Dimitrios G. Karamanolis; Spiros D. Ladas

2006-01-01

48

Intramural distribution of regulatory peptides in the sigmoid-recto-anal region of the human gut.  

PubMed Central

The distribution of regulatory peptides was studied in the separated mucosa, submucosa and muscularis externa taken at 10 sampling sites encompassing the whole human sigmoid colon (five sites), rectum (two sites), and anal canal (three sites). Consistently high concentrations of VIP were measured in the muscle layer at most sites (proximal sigmoid: 286 (16) pmol/g, upper rectum: 269 (17), a moderate decrease being found in the distal smooth sphincter (151 (30) pmol/g). Values are expressed as mean (SE). Conversely, substance P concentrations showed an obvious decline in the recto-anal muscle (mid sigmoid: 19 (2.0) pmol/g, distal rectum: 7.1 (1.3), upper anal canal: 1.6 (0.6)). Somatostatin was mainly present in the sigmoid mucosa and submucosa (37 (9.3) and 15 (3.5) pmol/g, respectively) and showed low, but consistent concentrations in the muscle (mid sigmoid: 2.2 (0.7) pmol/g, upper anal canal: 1.5 (0.8]. Starting in the distal sigmoid colon, a distinct peak of tissue NPY was revealed, which was most striking in the muscle (of mid sigmoid: 16 (3.9) pmol/g, upper rectum: 47 (7.8), anal sphincter: 58 (14)). Peptide YY was confined to the mucosa and showed an earlier peak (upper sigmoid: 709 (186) pmol/g, mid-distal sigmoid: 1965 (484)). A clear differential distribution of regulatory peptides was thus shown in the region studied. A possible role is suggested for NPY and VIP containing nerves in the effector control of the human internal anal sphincter. PMID:2454876

Ferri, G L; Adrian, T E; Allen, J M; Soimero, L; Cancellieri, A; Yeats, J C; Blank, M; Polak, J M; Bloom, S R

1988-01-01

49

[A case of locally advanced sigmoid colon cancer invading the bladder and seminal vesicle effectively treated with preoperative mFOLFOX6].  

PubMed

A 77-year-old male was admitted to our hospital complaining of dyschezia. Computed tomography (CT) and colonoscopy (CF) revealed a huge sigmoid colon cancer invading the bladder and seminal vesicle. Chemotherapy with mFOLFOX6 was initiated preoperatively, and the tumor shrunk markedly after seven courses of treatment. Pelvic exenteration with negative margins was carried out. The patient is still alive and disease-free 16 months after surgery. It was suggested that mFOLFOX6 may be useful for advanced colon cancer invading other organs when used as neoadjuvant chemotherapy. PMID:22189239

Hirayama, Kazuhisa; Hayashi, Tadataka; Nishiwaki, Yoshiro; Kamishima, Megumu; Furuhashi, Satoru; Fukushima, Hisataka; Nakata, Yuuki; Tamura, Hiroaki; Kanai, Toshikazu; Ikematsu, Yoshito; Mori, Hiroki; Ozawa, Takachika

2011-12-01

50

Rare cause of intestinal obstruction - submucous lipoma of the sigmoid colon.  

PubMed

The lipoma of the colon is a benign and rare tumor. Most lipomas are asymptomatic, their discovery being fortuitous. The diagnosis is ussualy easy by colonoscopy associated with biopsies. The abdominal CT scan also has its role in the diagnostic process and in the assesment of the tumoral extension.The treatment depends essentially on the clinical picture, on the size and location of the lipoma and involves endoscopic or surgical excision. We present the case of a 56 years old woman in which a random colonoscopic and than tomographic diagnosis of a sigmoidian lipoma was made 2 years ago when the patient presented with different symptoms, the submucosal lipoma being small sized at the time; the surgical treatment(sigmoidectomy including the tumor) was currently indicated by the sub-occlusive syndrome and haematochezia, due to the intraluminal proliferation of the tumor. PMID:24524487

Andrei, L S; Andrei, A C; Usurelu, D L; Puscasu, L I; Dima, C; Preda, E; Lupescu, I; Herlea, V; Popescu, I

2014-01-01

51

[Successful treatment of advanced sigmoid colon cancer with liver metastases with cetuximab monotherapy as first-line treatment-a case report].  

PubMed

The prognosis for patients diagnosed with advanced colorectal cancer with liver metastases is poor. Chemotherapy should be administered with caution in such patients because of complications due to severe liver dysfunction. We report here the successful management of a case of advanced sigmoid colon cancer, with icterus due to severe liver metastases, treated with cetuximab as first-line therapy. A 72-year-old man presented at our institution with complaints of severe general fatigue, tarry stools, and abdominal distention. He was diagnosed with advanced sigmoid colon cancer with multiple liver metastases. Clinical examination revealed the presence of ascites. The patient had an Eastern Cooperative Oncology Group(ECOG) performance status(PS)score of 3. A biopsy specimen of the primary tumor showed well-moderately differentiated adenocarcinoma without KRAS mutation. He was diagnosed with advanced sigmoid colon cancer with multiple hepatic metastases. Cetuximab monotherapy was initiated as first-line treatment. After 4 courses of cetuximab monotherapy, results of laboratory tests showed an improvement, and a computed tomography(CT)scan revealed a regression in the size of the liver metastases. Because the results of liver function tests and the ECOG PS scores improved, we initiated combination chemotherapy with 5-fluorouracil, Leucovorin, oxaliplatin(FOLFOX), and cetuximab. This regimen was well tolerated up to 14 courses, during which the only adverse reaction reported was a rash of grade 2 toxicity. Thereafter, disease progression in the form of liver metastases resulted in a change in the combination therapy to irinotecan and S-1(IRIS)as second-line chemotherapy. Thereafter, irinotecan and panitumumab were administered as third-line therapy. The patient continued chemotherapy on an outpatient basis; however, he died due to disease progression 18 months after his first visit. PMID:25131880

Harada, Kazuaki; Hatanaka, Kazuteru; Kinoshita, Kenji; Kawamoto, Yasuyuki; Yamato, Hiroaki; Ogawa, Koji; Yamamoto, Yoshiya; Naruse, Hirohito

2014-07-01

52

Patient age and duration of colonoscopy are predictors for adenoma detection in both proximal and distal colon  

PubMed Central

AIM: To investigate the relation of patient characteristics and procedural parameters to the endoscopic detection rate of colonic adenomas. Further to study, which factors may be capable to predict the localization of adenomatous lesions. METHODS: We used the data base of a prospective randomized colonoscopy study (The ColoCap trial) to identify patients being diagnosed with colon adenoma. Logistic regression analysis was conducted to reveal predictors for adenoma detection in the entire colon and also with respect to the proximal and distal part. Covariates including age, gender, duration of colonoscopy and comorbidities were defined to determine association between predictors and adenoma detection. RESULTS: Equal numbers of adenomas were detected in the proximal and distal side of the splenic flexure [126 (57%) vs 94 (43%), P = 0.104]. Simultaneous occurrence of adenomas in both sides of the colon was rare. The appearance of both proximal and distal adenoma was associated with increasing age (P = 0.008 and P = 0.024) and increasing duration of colonoscopy (P < 0.001 and P = 0.001). Male gender was a predictor for adenoma detection in the proximal colon (P = 0.008) but statistical significance was slightly missed with respect to the distal colon (P = 0.089). Alcohol abuse was found to be a predictor for the detection of distal adenoma (P = 0.041). CONCLUSION: Increasing age and longer duration of colonoscopy are factors with a strong impact on adenoma detection both in the proximal and distal colon. Since proximal adenomas occurred in absence of distal adenomas, complete colonoscopy should be performed for screening.

Klare, Peter; Ascher, Stefan; Hapfelmeier, Alexander; Wolf, Petra; Beitz, Analena; Schmid, Roland M; von Delius, Stefan

2015-01-01

53

Patient age and duration of colonoscopy are predictors for adenoma detection in both proximal and distal colon  

PubMed Central

AIM: To investigate the relation of patient characteristics and procedural parameters to the endoscopic detection rate of colonic adenomas. Further to study, which factors may be capable to predict the localization of adenomatous lesions. METHODS: We used the data base of a prospective randomized colonoscopy study (The ColoCap trial) to identify patients being diagnosed with colon adenoma. Logistic regression analysis was conducted to reveal predictors for adenoma detection in the entire colon and also with respect to the proximal and distal part. Covariates including age, gender, duration of colonoscopy and comorbidities were defined to determine association between predictors and adenoma detection. RESULTS: Equal numbers of adenomas were detected in the proximal and distal side of the splenic flexure [126 (57%) vs 94 (43%), P = 0.104]. Simultaneous occurrence of adenomas in both sides of the colon was rare. The appearance of both proximal and distal adenoma was associated with increasing age (P = 0.008 and P = 0.024) and increasing duration of colonoscopy (P < 0.001 and P = 0.001). Male gender was a predictor for adenoma detection in the proximal colon (P = 0.008) but statistical significance was slightly missed with respect to the distal colon (P = 0.089). Alcohol abuse was found to be a predictor for the detection of distal adenoma (P = 0.041). CONCLUSION: Increasing age and longer duration of colonoscopy are factors with a strong impact on adenoma detection both in the proximal and distal colon. Since proximal adenomas occurred in absence of distal adenomas, complete colonoscopy should be performed for screening. PMID:25593468

Klare, Peter; Ascher, Stefan; Hapfelmeier, Alexander; Wolf, Petra; Beitz, Analena; Schmid, Roland M; von Delius, Stefan

2015-01-01

54

Neurochemical characterization of extrinsic nerves in myenteric ganglia of the guinea pig distal colon.  

PubMed

Extrinsic nerves to the gut influence the absorption of water and electrolytes and expulsion of waste contents, largely via regulation of enteric neural circuits; they also contribute to control of blood flow. The distal colon is innervated by extrinsic sympathetic and parasympathetic efferent and spinal afferent neurons, via axons in colonic nerve trunks. In the present study, biotinamide tracing of colonic nerves was combined with immunohistochemical labeling for markers of sympathetic, parasympathetic, and spinal afferent neurons to quantify their relative contribution to the extrinsic innervation. Calcitonin gene-related peptide, vesicular acetylcholine transporter, and tyrosine hydroxylase, which selectively label spinal afferent, parasympathetic, and sympathetic axons, respectively, were detected immunohistochemically in 1?±?0.5% (n?=?7), 15?±?4.7% (n?=?6), and 24?±?4% (n?=?7) of biotinamide-labeled extrinsic axons in myenteric ganglia. Immunoreactivity for vasoactive intestinal polypeptide, nitric oxide synthase, somatostatin, and vesicular glutamate transporters 1 and 2 accounted for a combined maximum of 14% of biotinamide-labeled axons in myenteric ganglia. Thus, a maximum of 53% of biotinamide-labeled extrinsic axons in myenteric ganglia were labeled by antisera to one of these eight markers. Viscerofugal neurons were also labeled by biotinamide. They had distinct morphologies and spatial distributions that correlated closely with their immunoreactivity for nitric oxide synthase and choline acetyltransferase. As reported for the rectum, nearly half of all extrinsic nerve fibers to the distal colon lack the key immunohistochemical markers commonly used for their identification. Their abundance may therefore have been significantly underestimated in previous immunohistochemical studies. J. Comp. Neurol. 523:742-756, 2015. © 2014 Wiley Periodicals, Inc. PMID:25380190

Chen, Bao Nan; Sharrad, Dale F; Hibberd, Timothy J; Zagorodnyuk, Vladimir P; Costa, Marcello; Brookes, Simon J H

2015-04-01

55

A common cause of irritable bowel syndrome and diverticulitis: chronic distal colon distention from sedentary behavior and excessive dietary fiber.  

PubMed

A multidisciplinary analysis restricted to validated reports was applied to the cause and management of irritable bowel syndrome and diverticular formation and subsequent diverticulitis. There is evidence that they are linked - both caused by attenuation of gravitational aid to distal intestinal motility, resulting in damaging chronic intestinal distention. Both irritable bowel syndrome and diverticular formation and subsequent diverticulitis have worsened in recent years owing to excessive dietary fiber intake. Potential solutions include augmenting weight-bearing time, moderating dietary fiber consumption, stimulating distal colon evacuation through chemical means and developing pharmaceuticals to block the reflexive distal colon distention associated with fiber consumption. Amplified intestinal distention commenced when all classes of Renaissance Europeans became the first group in human history to wear shoes, which led to a sedentary lifestyle that moderates gravitational aid to colon motility and evacuation. PMID:23899281

Robbins, Steven E

2013-07-01

56

Prophylactic ureteral catheterization in colon surgery  

Microsoft Academic Search

PURPOSE: The preoperative placement of prophylactic ureteral catheters in operations of the distal colon is both commonplace and controversial. We assessed the frequency, safety, and effectiveness of their use over a five and one-half-year period in a teaching hospital. METHODS: The charts of 561 consecutive patients who underwent sigmoid or rectosigmoid colectomy from 1986 to 1991 were analyzed for age,

William N. Bothwell; Richard J. Bleicher; Thomas L. Dent

1994-01-01

57

Neural mechanisms of peristalsis in the isolated rabbit distal colon: a neuromechanical loop hypothesis  

PubMed Central

Propulsive contractions of circular muscle are largely responsible for the movements of content along the digestive tract. Mechanical and electrophysiological recordings of isolated colonic circular muscle have demonstrated that localized distension activates ascending and descending interneuronal pathways, evoking contraction orally and relaxation anally. These polarized enteric reflex pathways can theoretically be sequentially activated by the mechanical stimulation of the advancing contents. Here, we test the hypothesis that initiation and propagation of peristaltic contractions involves a neuromechanical loop; that is an initial gut distension activates local and oral reflex contraction and anal reflex relaxation, the subsequent movement of content then acts as new mechanical stimulus triggering sequentially reflex contractions/relaxations at each point of the gut resulting in a propulsive peristaltic contraction. In fluid filled isolated rabbit distal colon, we combined spatiotemporal mapping of gut diameter and intraluminal pressure with a new analytical method, allowing us to identify when and where active (neurally-driven) contraction or relaxation occurs. Our data indicate that gut dilation is associated with propagating peristaltic contractions, and that the associated level of dilation is greater than that preceding non-propagating contractions (2.7 ± 1.4 mm vs. 1.6 ± 1.2 mm; P < 0.0001). These propagating contractions lead to the formation of boluses that are propelled by oral active neurally driven contractions. The propelled boluses also activate neurally driven anal relaxations, in a diameter dependent manner. These data support the hypothesis that neural peristalsis is the consequence of the activation of a functional loop involving mechanical dilation which activates polarized enteric circuits. These produce propulsion of the bolus which activates further anally, polarized enteric circuits by distension, thus closing the neuromechanical loop. PMID:24795551

Dinning, Phil G.; Wiklendt, Lukasz; Omari, Taher; Arkwright, John W.; Spencer, Nick J.; Brookes, Simon J. H.; Costa, Marcello

2014-01-01

58

Opposite role played by GABAA and GABAB receptors in the modulation of peristaltic activity in mouse distal colon.  

PubMed

We investigated the role of GABA on intestinal motility using as model the murine distal colon. Effects induced by GABA receptors recruitment were examined in whole colonic segments and isolated circular muscle preparations to analyze their influence on peristaltic reflex and on spontaneous and neurally-evoked contractions. Using a modified Trendelenburg set-up, rhythmic peristaltic contractions were evoked by gradual distension of the colonic segments. Spontaneous and neurally-evoked mechanical activity of circular muscle strips were recorded in vitro as changes in isometric tension. GABA, at low concentrations (10-50 µM), potentiated peristaltic activity and the neural cholinergic contractions, whilst it, at higher concentrations (500 µM-1mM), had inhibitory effects. GABA excitatory effects were mimicked by muscimol, GABAA-receptor agonist, and prevented by bicuculline, GABAA-receptor antagonist, which per se reduced peristaltic activity and the cholinergic contractile responses. Inhibitory effects were mimicked by baclofen, GABAB-receptor agonist, and antagonized by phaclofen, GABAB-receptor antagonist and by hexamethonium, neural nicotinic receptor antagonist. Guanethidine was ineffective on GABA effects. Non-cholinergic responses were not affected by GABA agents. All drugs failed to affect the response to carbachol. Lastly, GABAC receptor agonist/antagonist had any effect on colonic motility. In conclusion, GABA in mouse distal colon is a modulator of peristaltic activity via the regulation of acetylcholine release from cholinergic neurons through interaction with GABAA or GABAB receptors. GABAA receptors are recruited at low GABA concentrations, increasing acetylcholine release and propulsive activity. At high GABA concentrations the activation of GABAB receptors overrides GABAA receptor effects, decreasing acetylcholine release and peristaltic activity. PMID:24642362

Auteri, Michelangelo; Zizzo, Maria Grazia; Mastropaolo, Mariangela; Serio, Rosa

2014-05-15

59

Functional changes in the rat distal colon after whole-body irradiation: dose-response and temporal relationships.  

PubMed

The aim of this study was to determine the acute radiation response of the rat distal colon by in vivo and in vitro measurements of the functions of the colon over a range of radiation doses. Rats received a whole-body irradiation of 2 to 12 Gy and were studied from 1 to 7 days after exposure. In vivo water and electrolyte absorption was measured by insertion of an agarose cylinder in the colon of anesthetized rats. In vitro transepithelial electrical parameters (potential difference, short-circuit current, transepithelial conductance) were measured in Ussing chambers in basal and agonist-stimulated conditions. In vivo and in vitro functional studies were completed by standard histological analyses. The majority of functional modifications appeared at 4 days after exposure. At this time, a dose-dependent decrease in absorption of water and sodium/chloride ions in the colon was noted. In contrast, a twofold increase in potassium secretion was observed for every radiation dose studied. The response to secretagogues was attenuated at doses >8 Gy. Modifications of basal transepithelial electrical parameters together with marked histological alterations were observed at 4 days with the higher doses (>/=10 Gy). In conclusion, these results show that functions of the colon are affected by irradiation and may contribute to diarrhea induced by ionizing radiation. PMID:10931691

Dublineau, I; Ksas, B; Griffiths, N M

2000-08-01

60

Genome-wide analysis of the rat colon reveals proximal-distal differences in histone modifications and proto-oncogene expression  

PubMed Central

Since disease susceptibility of the intestine exhibits an anatomical bias, we propose that the chromatin landscape, especially the site-specific epigenetic differences in histone modification patterns throughout the colonic longitudinal axis, contributes to the differential incidence of site-specific pathology. To test this hypothesis, we assessed the chromatin structure associated with gene expression profiles in the rat proximal and distal colon by globally correlating chromatin immunoprecipitation next-generation sequencing analysis (ChIP-Seq) with mRNA transcription (RNA-Seq) data. Crypts were isolated from the proximal and distal colonic regions from rats maintained on a semipurified diet, and mRNA gene expression profiles were generated by RNA-Seq. The remaining isolated crypts were formaldehyde-cross-linked and chromatin immunoprecipitated with antibodies against H3K4me3, H3K9me3, and RNA polymerase II. Globally, RNA-Seq results indicate that 9,866 genes were actively expressed, of which 540 genes were differentially expressed between the proximal and distal colon. Gene ontology analysis indicates that crypt location significantly affected both chromatin and transcriptional regulation of genes involved in enterocyte movement, lipid metabolism, lymphatic development, and immune cell trafficking. Gene function analysis indicates that the PI3-kinase signaling pathway was regulated in a site-specific manner, e.g., proto-oncogenes, JUN, FOS, and ATF, were upregulated in the distal colon. Middle and long noncoding RNAs (lncRNAs) were also detected in the colon, including select lncRNAs formerly only detected in the rat nervous system. In summary, distinct combinatorial patterns of histone modifications exist in the proximal versus distal colon. These site-specific differences may explain the differential effects of chemoprotective agents on cell transformation in the ascending (proximal) and descending (distal) colon. PMID:24151245

Triff, Karen; Konganti, Kranti; Gaddis, Sally; Zhou, Beiyan; Ivanov, Ivan

2013-01-01

61

Sigmoid volvulus treated by mini-incision.  

PubMed

Definitive surgical management of sigmoid volvulus is usually via a midline laparotomy or laparoscopy. We report our experience with a series of five consecutive cases over a 10-year period. All patients had definitive surgery via a left iliac fossa mini-incision after prior decompression. For four patients, it was the first episode of sigmoid volvulus and one patient had a recurrent sigmoid volvulus after previous sigmoid colectomy. The latter patient had pan colonic megacolon diagnosed at initial surgery. All five cases were surgically treated successfully via a mini-incision on the left iliac fossa. There were no instances of recurrence at a median follow-up duration of 95 months (range 7-132 months). A left iliac fossa mini-incision is sufficient for the definitive management of non-perforated sigmoid volvulus. Larger studies are warranted to draw definitive conclusions. PMID:25367827

Seow-En, I; Seow-Choen, F

2014-12-01

62

Age-Related Changes in Melatonin Release in the Murine Distal Colon  

PubMed Central

Constipation and fecal impaction are conditions of the bowel whose prevalence increases with age. Limited information is known about how these conditions manifest; however, functional deficits are likely to be due to changes in signaling within the bowel. This study investigated the effects of age on colonic mucosal melatonin (MEL) release and the consequences this had on colonic motility. Electrochemical measurements of MEL overflow demonstrated that both basal and mechanically stimulated MEL release decreased with age. The MEL/serotonin also decreased with increasing age, and the trend was similar to that of MEL overflow, suggestive that age-related changes were primarily due to a reduction in MEL levels. Levels of N-acetylserotonin and the N-acetylserotonin/serotonin ratio were reduced with age, providing an explanation for the reduction in MEL release. Decreases in colonic motility were observed in animals between 3 and 24 months old. Exogenous application of MEL could reverse this deficit in aged colon. In summary, we propose that the age-related decline in MEL release may be due to either decreases or alterations in mechanosensory channels and/or a loss in levels/activity of the N-acetyltransferase enzyme responsible for the synthesis of N-acetylserotonin. Decreases in MEL release may explain the decreases in colonic motility observed in 24 month old animals and could offer a new potential therapeutic treatment for age-related constipation. PMID:23631514

2013-01-01

63

Painful irritable bowel syndrome and sigmoid contractions.  

PubMed

Fifteen patients with abdominal pain compatible with the irritable bowel syndrome (IBS) were examined by barium enema and pressure recording. Strong circular contractions of the sigmoid colon and pressure recordings correlated with the characteristic pain in 13 of the 15 patients. In 15 control patients no pain occurred. It is concluded that pain and high pressure are caused by strong circular sigmoidal contractions. Such findings enable the radiologist to contribute to the diagnosis of IBS. PMID:2004507

Ritsema, G H; Thijn, C J

1991-02-01

64

Permeability of the proximal and distal rat colon crypt and surface epithelium to hydrophilic molecules  

Microsoft Academic Search

Our knowledge of the epithelial permeability of different sections of the colon as well as of the surface and crypt epithelium is patchy and contradictory. Therefore, movement of radiolabelled urea, mannitol and Cr-EDTA between the lumen and the plasma of rats was studied, and expressed as clearance. In experiments studying movement from the lumen to the plasma, only the clearance

Britt-Marie Fihn; Mats Jodal

2001-01-01

65

Role of the BK channel (KCa1.1) during activation of electrogenic K+ secretion in guinea pig distal colon  

PubMed Central

Secretagogues acting at a variety of receptor types activate electrogenic K+ secretion in guinea pig distal colon, often accompanied by Cl? secretion. Distinct blockers of KCa1.1 (BK, Kcnma1), iberiotoxin (IbTx), and paxilline inhibited the negative short-circuit current (Isc) associated with K+ secretion. Mucosal addition of IbTx inhibited epinephrine-activated Isc (epiIsc) and transepithelial conductance (epiGt) consistent with K+ secretion occurring via apical membrane KCa1.1. The concentration dependence of IbTx inhibition of epiIsc yielded an IC50 of 193 nM, with a maximal inhibition of 51%. Similarly, IbTx inhibited epiGt with an IC50 of 220 nM and maximal inhibition of 48%. Mucosally added paxilline (10 ?M) inhibited epiIsc and epiGt by ?50%. IbTx and paxilline also inhibited Isc activated by mucosal ATP, supporting apical KCa1.1 as a requirement for this K+ secretagogue. Responses to IbTx and paxilline indicated that a component of K+ secretion occurred during activation of Cl? secretion by prostaglandin-E2 and cholinergic stimulation. Analysis of KCa1.1? mRNA expression in distal colonic epithelial cells indicated the presence of the ZERO splice variant and three splice variants for the COOH terminus. The presence of the regulatory ?-subunits KCa?1 and KCa?4 also was demonstrated. Immunolocalization supported the presence of KCa1.1? in apical and basolateral membranes of surface and crypt cells. Together these results support a cellular mechanism for electrogenic K+ secretion involving apical membrane KCa1.1 during activation by several secretagogue types, but the observed K+ secretion likely required the activity of additional K+ channel types in the apical membrane. PMID:23064759

Zhang, Jin; Halm, Susan T.

2012-01-01

66

High-resolution time-of-flight mass spectrometry fingerprinting of metabolites from cecum and distal colon contents of rats fed resistant starch  

SciTech Connect

Time-of-flight mass spectrometry along with statistical analysis was utilized to study metabolic profiles among rats fed resistant starch (RS) diets. Fischer 344 rats were fed four starch diets consisting of 55 % (w/w, dbs) starch. A control starch diet consisting of corn starch was compared against three RS diets. The RS diets were high-amylose corn starch (HA7), HA7 chemically modified with octenyl succinic anhydride, and stearic-acid-complexed HA7 starch. A subgroup received antibiotic treatment to determine if perturbations in the gut microbiome were long lasting. A second subgroup was treated with azoxymethane (AOM), a carcinogen. At the end of the 8-week study, cecal and distal colon content samples were collected from the sacrificed rats. Metabolites were extracted from cecal and distal colon samples into acetonitrile. The extracts were then analyzed on an accurate-mass time-of-flight mass spectrometer to obtain their metabolic profile. The data were analyzed using partial least-squares discriminant analysis (PLS-DA). The PLS-DA analysis utilized a training set and verification set to classify samples within diet and treatment groups. PLS-DA could reliably differentiate the diet treatments for both cecal and distal colon samples. The PLS-DA analyses of the antibiotic and no antibiotic-treated subgroups were well classified for cecal samples and modestly separated for distal colon samples. PLS-DA analysis had limited success separating distal colon samples for rats given AOM from those not treated; the cecal samples from AOM had very poor classification. Mass spectrometry profiling coupled with PLS-DA can readily classify metabolite differences among rats given RS diets.

Anderson, Timothy J. [Ames Laboratory; Jones, Roger W. [Ames Laboratory; Ai, Yongfeng [Iowa State University; Houk, Robert S. [Ames Laboratory; Jane, Jay-lin [Iowa State University; Zhao, Yinsheng [Iowa State University; Birt, Diane F. [Iowa State University; McClelland, John F. [Ames Laboratory

2013-12-04

67

Low Salt Intake Down-regulates the Guanylin Signaling Pathway in Rat Distal Colon  

PubMed Central

Background & Aims Guanylin, an endogenous gastrointestinal peptide, causes the translocation of NaCl from interstitial fluid to the intestinal lumen. The aim of this study was to examine whether changes in dietary salt intake lead to compensatory changes in expression of the guanylin signaling pathway. Methods Rats received low-, normal-, or high-sodium diets for 1 week. Colonic guanylin expression was evaluated by Western and Northern blotting, rates of guanylin secretion by measuring biologically active guanylin released into the medium from colon explants, and expression of the guanylin receptor (C-type guanylate cyclase) by Northern blotting and bioassay. Results By every criterion, the low-salt diet reduced expression of guanylin to 30%–40% of the level found in control animals. Guanylin receptor expression was also decreased, although less dramatically and with a lower statistical significance. For both guanylin and guanylin receptor, the high-salt diet had no significant effect on expression. Conclusions The data support the hypothesis that the guanylin pathway is down-regulated as an adaptive response to salt restriction. PMID:8942754

LI, ZHIPING; KNOWLES, JOSHUA W.; GOYEAU, DOMINIQUE; PRABHAKAR, SUBHASH; SHORT, DOUGLAS B.; PERKINS, ASHLEY G.; GOY, MICHAEL F.

2009-01-01

68

Unusual presentation of sigmoid diverticulitis as an acute scrotum.  

PubMed

We report a case of inflammation of the spermatic cord and testicle resulting from a perforated diverticulum of the sigmoid colon. Management included sigmoid resection with diversion, right orchiectomy and débridement of the right groin. To our knowledge this is the first reported case of retroperitoneal necrotizing fasciitis presenting initially as an acute scrotum. PMID:3339751

Klutke, C G; Miles, B J; Obeid, F

1988-02-01

69

Sigmoid schwannoma: A rare case  

PubMed Central

Schwannomas are rare tumors derived from the cells of Schwann that form the neural sheath. When located in the gastrointestinal tract, they constitute together with leiomyoma, leiomyoblastoma, and leiomyosarcoma, the gastrointestinal stromal tumors (GIST). Peripheral nerve sheath tumors represent 2-6% GIST with most common location, the stomach and the small intestine. Schwannomas of the colon and rectum are extremely rare and radical excision with wide margins is mandatory, due to their tendency to recur locally and become malignant, if left untreated. In the present study, we report a rare case of a sigmoid schwannoma, which was successfully treated in our department and reviewed the literature. PMID:16124072

Fotiadis, Constantine I.; Kouerinis, Ilias A.; Papandreou, Ioannis; Zografos, George C.; Agapitos, George

2005-01-01

70

Activation of the umami taste receptor (T1R1/T1R3) initiates the peristaltic reflex and pellet propulsion in the distal colon.  

PubMed

Intraluminal nutrients in the gut affect the peristaltic reflex, although the mechanism is not well defined. Recent evidence supports the presence of taste receptors and their signaling components in enteroendocrine cells, although their function is unclear. This study aimed to determine if nutrients modify colonic motility through activation of taste receptors. Colonic sections were immunostained for the umami taste receptor T1R1/T1R3, which mediates the response to umami ligands, such as monosodium glutamate (MSG), in taste cells. Ascending contraction, descending relaxation, and calcitonin gene-related peptide release were measured in three-chamber flat-sheet preparations of rat colon in response to MSG alone or with inosine 5'-monophosphate (IMP). Velocity of artificial fecal pellet propulsion was measured by video recording in guinea pig distal colon. T1R1/T1R3 receptors were present in enteroendocrine cells of colonic sections from human, rat, mouse, and guinea pig. MSG initiated ascending contraction and descending relaxation components of the peristaltic reflex and calcitonin gene-related peptide release in flat-sheet preparations. IMP augmented the MSG-induced effects, suggesting activation of T1R1/T1R3 receptors. In T1R1(-/-) mice, mucosal stroking, but not MSG, elicited a peristaltic reflex. Intraluminal perfusion of MSG enhanced the velocity of artificial fecal pellet propulsion, which was also augmented by IMP. Propulsion was also increased by l-cysteine, but not l-tryptophan, supporting a role of T1R1/T1R3 receptors. We conclude that T1R1/T1R3 activation by luminal MSG or l-cysteine elicits a peristaltic reflex and CGRP release and increases the velocity of pellet propulsion in distal colon. This mechanism may explain how nutrients regulate colonic propulsion. PMID:25324508

Kendig, Derek M; Hurst, Norman R; Bradley, Zachary L; Mahavadi, Sunila; Kuemmerle, John F; Lyall, Vijay; DeSimone, John; Murthy, Karnam S; Grider, John R

2014-12-01

71

Localisation and activation of the neurokinin 1 receptor in the enteric nervous system of the mouse distal colon.  

PubMed

The substance P neurokinin 1 receptor (NK1R) regulates motility, secretion, inflammation and pain in the intestine. The distribution of the NK1R is a key determinant of the functional effects of substance P in the gut. Information regarding the distribution of NK1R in subtypes of mouse enteric neurons is lacking and is the focus of the present study. NK1R immunoreactivity (NK1R-IR) is examined in whole-mount preparations of the mouse distal colon by indirect immunofluorescence and confocal microscopy. The distribution of NK1R-IR within key functional neuronal subclasses was determined by using established neurochemical markers. NK1R-IR was expressed by a subpopulation of myenteric and submucosal neurons; it was mainly detected in large multipolar myenteric neurons and was colocalized with calcitonin gene-related peptide, neurofilament M, choline acetyltransferase and calretinin. The remaining NK1R-immunoreactive neurons were positive for nitric oxide synthase. NK1R was expressed by most of the submucosal neurons and was exclusively co-expressed with vasoactive intestinal peptide, with no overlap with choline acetyltransferase. Treatment with substance P resulted in the concentration-dependent internalisation of NK1R from the cell surface into endosome-like structures. Myenteric NK1R was mainly expressed by intrinsic primary afferent neurons, with minor expression by descending interneurons and inhibitory motor neurons. Submucosal NK1R was restricted to non-cholinergic secretomotor neurons. These findings highlight key differences in the neuronal distribution of NK1R-IR between the mouse, rat and guinea-pig, with important implications for the functional role of NK1R in regulating intestinal motility and secretion. PMID:24728885

Pelayo, Juan-Carlos; Veldhuis, Nicholas A; Eriksson, Emily M; Bunnett, Nigel W; Poole, Daniel P

2014-05-01

72

Pharmacological analysis of the effects of Bay K 8644 and organic calcium antagonists on the mouse isolated distal colon.  

PubMed Central

1. Bay K 8644 (10(-8) to 10(-6) M) induced concentration-related contractions of the longitudinal muscle of the mouse distal colon. The maximal responses were enhanced and the EC50 was lowered in the presence of tetrodotoxin (TTX; 1.5 x 10(-7) M). The responses were not affected by atropine (10(-7) M), mepyramine (2.5 x 10(-7) M), methysergide (5 x 10(-7) M), propranolol (10(-6) M), phentolamine (10(-6) M) or naloxone (4 x 10(-7) M). By contrast, the contractile responses were inhibited by Ca2+ entry blockers (verapamil, nifedipine) and abolished in Ca2+-free EGTA solution. These observations indicate that the contractile effects of Bay K 8644 are dependent on its ability to promote Ca2+ influx. 2. At 10(-4) M, Bay K 8644 provoked a slow relaxation of the preparation. Moreover, from 10(-5) M, Bay K 8644 markedly reduced the contractile responses to ACh and K+ depolarization. These inhibitory effects were comparable with those produced by nifedipine. Such data suggest that, at high concentrations, Bay K 8644 could act in part as a dihydropyridine Ca2+ channel antagonist. 3. Bay K 8644 (10(-9) M) preferentially enhanced, while nifedipine (10(-10) to 10(-8) M) as well as verapamil (3 x 10(-9) to 10(-6) M) preferentially inhibited, the tonic component of the contractile response evoked by K+ depolarizing solution. This may indicate that different populations of voltage-sensitive Ca2+ channels are involved in the biphasic response to K+ depolarization.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2463025

Fontaine, J.; Lebrun, P.

1988-01-01

73

Pharmacological analysis of the effects of Bay K 8644 and organic calcium antagonists on the mouse isolated distal colon.  

PubMed

1. Bay K 8644 (10(-8) to 10(-6) M) induced concentration-related contractions of the longitudinal muscle of the mouse distal colon. The maximal responses were enhanced and the EC50 was lowered in the presence of tetrodotoxin (TTX; 1.5 x 10(-7) M). The responses were not affected by atropine (10(-7) M), mepyramine (2.5 x 10(-7) M), methysergide (5 x 10(-7) M), propranolol (10(-6) M), phentolamine (10(-6) M) or naloxone (4 x 10(-7) M). By contrast, the contractile responses were inhibited by Ca2+ entry blockers (verapamil, nifedipine) and abolished in Ca2+-free EGTA solution. These observations indicate that the contractile effects of Bay K 8644 are dependent on its ability to promote Ca2+ influx. 2. At 10(-4) M, Bay K 8644 provoked a slow relaxation of the preparation. Moreover, from 10(-5) M, Bay K 8644 markedly reduced the contractile responses to ACh and K+ depolarization. These inhibitory effects were comparable with those produced by nifedipine. Such data suggest that, at high concentrations, Bay K 8644 could act in part as a dihydropyridine Ca2+ channel antagonist. 3. Bay K 8644 (10(-9) M) preferentially enhanced, while nifedipine (10(-10) to 10(-8) M) as well as verapamil (3 x 10(-9) to 10(-6) M) preferentially inhibited, the tonic component of the contractile response evoked by K+ depolarizing solution. This may indicate that different populations of voltage-sensitive Ca2+ channels are involved in the biphasic response to K+ depolarization. 4. The biphasic contractile activity induced by ACh was barely enhanced by Bay K 8644 (10-9M) and was less sensitive to Ca2+ entry blockers than the responses to KCl. These findings are discussed in terms of receptor-operated channels and mobilization of bound calcium. PMID:2463025

Fontaine, J; Lebrun, P

1988-08-01

74

Tumor suppressors miRNA-143 and miR-145 and predicted target proteins API5, ERK5, KRAS, and IRS-1 are differentially expressed in proximal and distal colon.  

PubMed

The colon differs regionally in local luminal environment, excretory function, and gene expression. Polycistronic miR-143 and miR-145 are down-regulated early in colon cancer. We asked if these miRNA might be differentially expressed in the proximal versus the distal colon, contributing to regional differences in protein expression. Primary transcripts and mature miR-143 and miR-145 were quantified by real-time PCR, putative targets were measured by Western blot, and DNA methylation was assessed by sequencing bisulfite treated DNA in proximal and distal normal colonic mucosa as well as colon cancers. Putative targets of these miRNA were assessed following transfection with miR-143 or miR-145. Mean expression of mature miR-143 and miR-145 was 2.0-fold (p<0.0001) and 1.8-fold (p=0.005) higher in the proximal colon compared to the distal colon, respectively. There were no differences in DNA methylation or primary transcript expression for these miRNAs by location. In agreement with increased expression of miR-143 and miR-145 in the proximal colon, predicted targets of these miRNA, API5, ERK5, KRAS, and IRS-1 that are cell cycle and survival regulators were lower in proximal colon compared to the distal colon. Transfection of HCA-7 colon cancer cells with miR-145 down-regulated IRS-1, and transfection of HT-29 colon cancer cells with miR-143 decreased K-RAS and ERK5. In conclusion, mIR-143 and miR-145 and predicted target proteins API5, ERK5, KRAS, and IRS-1 display regional differences in expression in the colon. We speculate that differences in these tumor suppressors might contribute to regional differences in normal colonic gene expression and modulate site-specific differences in malignant predisposition. PMID:25477374

Pekow, Joel; Meckel, Katherine; Dougherty, Urszula; Butun, Fatma; Mustafi, Reba; Lim, John; Crofton, Charis; Chen, Xindi; Joseph, Loren J; Bissonnette, Marc

2014-12-01

75

Effect of broad- and narrow-spectrum antimicrobials on Clostridium difficile and microbial diversity in a model of the distal colon  

PubMed Central

Vancomycin, metronidazole, and the bacteriocin lacticin 3147 are active against a wide range of bacterial species, including Clostridium difficile. We demonstrate that, in a human distal colon model, the addition of each of the three antimicrobials resulted in a significant decrease in numbers of C. difficile. However, their therapeutic use in the gastrointestinal tract may be compromised by their broad spectrum of activity, which would be expected to significantly impact on other members of the human gut microbiota. We used high-throughput pyrosequencing to compare the effect of each antimicrobial on the composition of the microbiota. All three treatments resulted in a decrease in the proportion of sequences assigned to the phyla Firmicutes and Bacteroidetes, with a corresponding increase in those assigned to members of the Proteobacteria. One possible means of avoiding such “collateral damage” would involve the application of a narrow-spectrum antimicrobial with specific anti-C. difficile activity. We tested this hypothesis using thuricin CD, a narrow-spectrum bacteriocin produced by Bacillus thuringiensis, which is active against C. difficile. The results demonstrated that this bacteriocin was equally effective at killing C. difficile in the distal colon model but had no significant impact on the composition of the microbiota. This offers the possibility of developing a targeted approach to eliminating C. difficile in the colon, without collateral damage. PMID:20616009

Rea, Mary C.; Dobson, Alleson; O'Sullivan, Orla; Crispie, Fiona; Fouhy, Fiona; Cotter, Paul D.; Shanahan, Fergus; Kiely, Barry; Hill, Colin; Ross, R. Paul

2011-01-01

76

Simultaneous intracellular recordings from longitudinal and circular muscle during the peristaltic reflex in guinea-pig distal colon  

PubMed Central

Simultaneous intracellular recordings were made from longitudinal muscle (LM) and circular muscle (CM) cells of guinea-pig distal colon during the peristaltic reflex. Spontaneous rhythmical depolarizations with superimposed action potentials (mean amplitude: 19 ± 2 mV) were regularly recorded from the LM (mean interval: 7 ± 1 s). In contrast, in the CM layer, spontaneous action potentials occurred with an irregular frequency. Although spontaneous action potentials in LM were rarely correlated in time with those in CM, spontaneous inhibitory junction potentials (sIJPs) were found to occur synchronously in both muscles (5 out of 27 animals; 19 %). Graded inflation of an intra-luminal balloon or mucosal stimulation oral to the recording electrodes elicited gradeable compound IJPs synchronously in both LM (mean amplitude: 6 ± 1 mV) and CM (mean amplitude: 9 ± 1 mV) (descending inhibitory reflex). Evoked IJPs were often followed by action potentials in both muscle layers. Mucosal stimuli applied anal to the recording electrodes elicited compound excitatory junction potentials (EJPs) synchronously in both muscles layers that were often associated with the generation of action potentials. In the LM, evoked EJP amplitudes ranged from 3 mV (subthreshold) to 31 mV (including the action potential) and in the CM from 4 mV (subthreshold) to 44 mV (including the action potential). Apamin (500 nM) reduced the evoked IJP in the CM by 55 % (from 11 ± 2 to 5 ± 1 mV), but caused no significant reduction in the LM layer (from 8 ± 1 to 6 ± 1 mV). Apamin-resistant IJPs in both muscle layers were likely to be due to nitric oxide, since they were abolished by l-NA (100 ?M). Atropine (1 ?M) abolished the ascending excitatory reflex in both muscles. Injection of neurobiotin into the LM and CM confirmed that simultaneous intracellular recordings were made from different muscle layers. In conclusion, during the peristaltic reflex, the LM and CM layers receive synchronous inhibitory neuromuscular inputs during descending inhibition and synchronous excitatory neuromuscular inputs during ascending excitation. No evidence was found to support reciprocal innervation. PMID:11410635

Spencer, Nick J; Smith, Terence K

2001-01-01

77

Colonic perforation resulting from ingested chicken bone revealing previously undiagnosed colonic adenocarcinoma: report of a case and review of literature.  

PubMed

An 86 year old male with a four-day history of nonspecific gastrointestinal symptoms was found on colonoscopy to have evidence of sigmoid colon obstruction and possible perforation. Emergent operative exploration revealed diffuse peritonitis, sigmoid perforation, adjacent dense adhesions, and a foreign body protruding through the perforated area. Pathologic examination showed the foreign body to be a sliver of bone consistent with chicken bone and the sigmoid subacute perforation to be associated distally with a circumferential ulcerated obstructing mass, microscopically seen to be transmurally infiltrating adenocarcinoma, signet-ring cell type. There was extensive acute and organizing peritonitis, 100% Escherichia coli was cultured from peritoneal fluid, and the patient died two days postoperatively with sepsis and hypotension. This appears to be the fifth reported case of colonic perforation resulting from foreign body perforation due to previously undiagnosed adenocarcinoma. The four previously reported cases were all deeply invasive adenocarcinoma of sigmoid colon, and the foreign bodies included three chicken/poultry bones and a metallic staple. These five cases are highly unusual examples of a potentially lethal malignant neoplasm being clinically revealed by a usually (but not always) innocuous event, the ingestion of a small foreign body. PMID:21333012

McGregor, Douglas H; Liu, Xiaoying; Ulusarac, Ozlem; Ponnuru, Kimberly D; Schnepp, Stephanie L

2011-01-01

78

[A case of advanced sigmoid colon cancer with metastases in the liver and the paraaortic lymph nodes successfully treated with 5-FU/l-LV and FOLFOX4 followed by S-1 leading to long-term complete response].  

PubMed

The patient was a 70-year-old woman with sigmoid colon cancer and metastases in the liver and the paraaortic lymph nodes. We performed sigmoidectomy along with lymph node dissection. The solitary hepatic metastasis was 3 cm in diameter; however, hepatectomy was not performed because metastases in the paraaortic lymph nodes persisted. The serum carcino embryonic antigen(CEA)level was above 200 ng/mL, both preoperatively and postoperatively. After surgery, chemo- therapy was initiated. Initially, weekly 5-fluorouracil and l / -Leucovorin(5-FU/l-LV)therapy was administered 4 times. Subsequently, 5-FU/folinic acid plus oxaliplatin(FOLFOX4)therapy was administered 12 times every 2 weeks. Thereafter, S-1 therapy(orally, 40 mg twice a day, 28 days, followed by 14 days of rest)was initiated. After 3 months of chemotherapy, serum CEA levels decreased rapidly to within the normal limit. Paraaortic lymph node metastases and the hepatic metastasis disappeared after 3 months and 11 months, respectively. S-1 therapy was continued for over 7 years. Currently, it has been over 1 year since the discontinuation of S-1 therapy, and complete response has been maintained for over 9 years since the surgery. PMID:24423964

Nagano, Ikuo; Yamada, Ikuo; Niwa, Masaki; Kanazawa, Hidetoshi; Sato, Taichi; Matsumoto, Naoki; Yoshinaka, Hisaaki

2014-01-01

79

Synchronous perforation of sigmoid diverticula: a rare presentation.  

PubMed

Diverticular disease affects more than 50% of the population over the age of 60 years in the west and becomes even more common as the population ages. Diverticulitis is one of the complications of diverticular disease and can culminate into colonic perforation. Though perforated diverticular disease is not uncommon, synchronous colonic perforations in diverticulitis is rare. Our patient was admitted with acute abdomen and exploratory laparotomy revealed two side-by-side perforations of the sigmoid colon. A Hartmann's procedure was performed. Macro- and microscopic evaluation confirmed the presence of two perforated sigmoid diverticula due to diverticulitis. Simultaneous perforation of two abreast sigmoid diverticula is uncommon; thus, a cautious surgeon should always take into account such a probable diagnosis. PMID:19562554

Andrabi, Syed Imran Hussain; Latif, Muhammad Usman; Ahmad, Jawad; Malik, Arshad Hussain; El-Hakeem, Ahmed A S

2009-05-01

80

Inducible loss of one Apc allele in Lrig1-expressing progenitor cells results in multiple distal colonic tumors with features of familial adenomatous polyposis.  

PubMed

Individuals with familial adenomatous polyposis (FAP) harbor a germline mutation in adenomatous polyposis coli (APC). The major clinical manifestation is development of multiple colonic tumors at a young age due to stochastic loss of the remaining APC allele. Extracolonic features, including periampullary tumors, gastric abnormalities, and congenital hypertrophy of the retinal pigment epithelium, may occur. The objective of this study was to develop a mouse model that simulates these features of FAP. We combined our Lrig1-CreERT2/+ mice with Apcfl/+ mice, eliminated one copy of Apc in leucine-rich repeats and immunoglobulin-like domains protein 1 (Lrig1)-positive (Lrig1(+)) progenitor cells with tamoxifen injection, and monitored tumor formation in the colon by colonoscopy and PET. Initial loss of one Apc allele in Lrig1(+) cells results in a predictable pattern of preneoplastic changes, culminating in multiple distal colonic tumors within 50 days of induction, as well as the extracolonic manifestations of FAP mentioned above. We show that tumor formation can be monitored by noninvasive PET imaging. This inducible stem cell-driven model recapitulates features of FAP and offers a tractable platform on which therapeutic interventions can be monitored over time by colonoscopy and noninvasive imaging. PMID:24833705

Powell, Anne E; Vlacich, Gregory; Zhao, Zhen-Yang; McKinley, Eliot T; Washington, M Kay; Manning, H Charles; Coffey, Robert J

2014-07-01

81

An exploration of the microrheological environment around the distal ileal villi and proximal colonic mucosa of the possum (Trichosurus vulpecula)  

PubMed Central

Multiple particle-tracking techniques were used to quantify the thermally driven motion of ensembles of naked polystyrene (0.5 µm diameter) microbeads in order to determine the microrheological characteristics around the gut mucosa. The microbeads were introduced into living ex vivo preparations of the wall of the terminal ileum and proximal colon of the brushtail possum (Trichosurus vulpecula). The fluid environment surrounding both the ileal villi and colonic mucosa was heterogeneous; probably comprising discrete viscoelastic regions suspended in a continuous Newtonian fluid of viscosity close to water. Neither the viscosity of the continuous phase, the elastic modulus (G’) nor the sizes of viscoelastic regions varied significantly between areas within 20 µm and areas more than 20 µm from the villous mucosa nor from the tip to the sides of the villous mucosa. The viscosity of the continuous phase at distances further than 20 µm from the colonic mucosa was greater than that at the same distance from the ileal villous mucosa. Furthermore, the estimated sizes of viscoelastic regions were significantly greater in the colon than in the ileum. These findings validate the sensitivity of the method and call into question previous hypotheses that a contiguous layer of mucus envelops all intestinal mucosa and restricts diffusive mass transfer. Our findings suggest that, in the terminal ileum and colon at least, mixing and mass transfer are governed by more complex dynamics than were previously assumed, perhaps with gel filtration by viscoelastic regions that are suspended in a Newtonian fluid. PMID:23389898

Lim, Y. F.; Williams, M. A. K.; Lentle, R. G.; Janssen, P. W. M.; Mansel, B. W.; Keen, S. A. J.; Chambers, P.

2013-01-01

82

Mechanosensory S-neurons rather than AH-neurons appear to generate a rhythmic motor pattern in guinea-pig distal colon.  

PubMed

Simultaneous intracellular recordings were made from myenteric neurons and circular muscle (CM) cells in isolated, stretched segments of guinea-pig distal colon. We have shown previously that maintained stretch generates a repetitive and coordinated discharge of ascending excitatory and descending inhibitory neuronal reflex pathways in the distal colon. In the presence of nifedipine (1-2 microm) to paralyse the muscle, simultaneous recordings were made from 25 pairs of AH (after-hyperpolarization)-neurons and CM cells separated by 100-500 microm. In all 25 AH-neurons, proximal process potentials (PPPs) were never recorded, even though at the same time, all recordings from neighbouring CM cells showed an ongoing discharge of inhibitory junction potentials (IJPs) anally, or excitatory junction potentials (EJPs) orally. In fact, 24 of 25 AH-neurons were totally silent, while in one AH-cell, some spontaneous fast excitatory postsynaptic potentials (FEPSPs) were recorded. All 10 electrically silent AH-cells that were injected with neurobiotin were found to be multipolar Dogiel type II neurons. In contrast, when recordings were made from myenteric S-neurons, two distinct electrical patterns of electrical activity were recorded. Recordings from 25 of 48 S-neurons showed spontaneous FEPSPs, the majority of which (22 of 25) showed periods when discrete clusters of FEPSPs (mean duration 88 ms) could be temporally correlated with the onset of EJPs or anal IJPs in the CM. Nine S-neurons were electrically quiescent. The second distinct electrical pattern in 14 S-neurons consisted of bursts, or prolonged trains of action potentials, which could be reduced to proximal process potentials (PPPs) in six of these 14 neurons during membrane hyperpolarization. Unlike FEPSPs, PPPs were resistant to a low Ca(2+)-high Mg(2+) solution and did not change in amplitude during hyperpolarizing pulses. Mechanosensory S-neurons were found to be uniaxonal or pseudounipolar filamentous neurons, with morphologies consistent with interneurons. No slow EPSPs were ever recorded from AH- or S-type neurons when IJPs or EJPs occurred in the CM. In summary, we have identified a population of mechanosensory S-neurons in the myenteric plexus of the distal colon which appear to be largely stretch sensitive, rather than muscle-tension sensitive, since they generate ongoing trains of action potentials in the presence of nifedipine. No evidence was found to suggest that in paralysed preparations, the repetitive firing in ascending excitatory or descending inhibitory nerve pathways was initiated by myenteric AH-neurons, or slow synaptic transmission. PMID:15146052

Spencer, Nick J; Smith, Terence K

2004-07-15

83

5-HT3 and 5-HT4 antagonists inhibit peristaltic contractions in guinea-pig distal colon by mechanisms independent of endogenous 5-HT.  

PubMed

Recent studies have shown that endogenous serotonin is not required for colonic peristalsis in vitro, nor gastrointestinal (GI) transit in vivo. However, antagonists of 5-Hydroxytryptamine (5-HT) receptors can inhibit peristalsis and GI-transit in mammals, including humans. This raises the question of how these antagonists inhibit GI-motility and transit, if depletion of endogenous 5-HT does not cause any significant inhibitory changes to either GI-motility or transit? We investigated the mechanism by which 5-HT3 and 5-HT4 antagonists inhibit distension-evoked peristaltic contractions in guinea-pig distal colon. In control animals, repetitive peristaltic contractions of the circular muscle were evoked in response to fixed fecal pellet distension. Distension-evoked peristaltic contractions were unaffected in animals with mucosa and submucosal plexus removed, that were also treated with reserpine (to deplete neuronal 5-HT). In control animals, peristaltic contractions were blocked temporarily by ondansetron (1-10 ?M) and SDZ-205-557 (1-10 ?M) in many animals. Interestingly, after this temporary blockade, and whilst in the continued presence of these antagonists, peristaltic contractions recovered, with characteristics no different from controls. Surprisingly, similar effects were seen in mucosa-free preparations, which had no detectable 5-HT, as detected by mass spectrometry. In summary, distension-evoked peristaltic reflex contractions of the circular muscle layer of the guinea-pig colon can be inhibited temporarily, or permanently, in the same preparation by selective 5-HT3 and 5-HT4 antagonists, depending on the concentration of the antagonists applied. These effects also occur in preparations that lack any detectable 5-HT. We suggest caution should be exercised when interpreting the effects of 5-HT3 and 5-HT4 antagonists; and the role of endogenous 5-HT, in the generation of distension-evoked colonic peristalsis. PMID:23935564

Sia, Tiong C; Whiting, Malcolm; Kyloh, Melinda; Nicholas, Sarah J; Oliver, John; Brookes, Simon J; Dinning, Phil G; Wattchow, David A; Spencer, Nick J

2013-01-01

84

5-HT3 and 5-HT4 antagonists inhibit peristaltic contractions in guinea-pig distal colon by mechanisms independent of endogenous 5-HT  

PubMed Central

Recent studies have shown that endogenous serotonin is not required for colonic peristalsis in vitro, nor gastrointestinal (GI) transit in vivo. However, antagonists of 5-Hydroxytryptamine (5-HT) receptors can inhibit peristalsis and GI-transit in mammals, including humans. This raises the question of how these antagonists inhibit GI-motility and transit, if depletion of endogenous 5-HT does not cause any significant inhibitory changes to either GI-motility or transit? We investigated the mechanism by which 5-HT3 and 5-HT4 antagonists inhibit distension-evoked peristaltic contractions in guinea-pig distal colon. In control animals, repetitive peristaltic contractions of the circular muscle were evoked in response to fixed fecal pellet distension. Distension-evoked peristaltic contractions were unaffected in animals with mucosa and submucosal plexus removed, that were also treated with reserpine (to deplete neuronal 5-HT). In control animals, peristaltic contractions were blocked temporarily by ondansetron (1–10 ?M) and SDZ-205–557 (1–10 ?M) in many animals. Interestingly, after this temporary blockade, and whilst in the continued presence of these antagonists, peristaltic contractions recovered, with characteristics no different from controls. Surprisingly, similar effects were seen in mucosa-free preparations, which had no detectable 5-HT, as detected by mass spectrometry. In summary, distension-evoked peristaltic reflex contractions of the circular muscle layer of the guinea-pig colon can be inhibited temporarily, or permanently, in the same preparation by selective 5-HT3 and 5-HT4 antagonists, depending on the concentration of the antagonists applied. These effects also occur in preparations that lack any detectable 5-HT. We suggest caution should be exercised when interpreting the effects of 5-HT3 and 5-HT4 antagonists; and the role of endogenous 5-HT, in the generation of distension-evoked colonic peristalsis. PMID:23935564

Sia, Tiong C.; Whiting, Malcolm; Kyloh, Melinda; Nicholas, Sarah J.; Oliver, John; Brookes, Simon J.; Dinning, Phil G.; Wattchow, David A.; Spencer, Nick J.

2013-01-01

85

The traditional anti-diarrheal remedy, Garcinia buchananii stem bark extract, inhibits propulsive motility and fast synaptic potentials in the guinea pig distal colon  

PubMed Central

Background Garcinia buchananii bark extract is a traditional African remedy for diarrhea, dysentery, abdominal discomfort and pain. We investigated the mechanisms and efficacy of this extract using the guinea pig distal colon model of gastrointestinal motility. Methods Stem bark was collected from G. buchananii trees in their natural habitat of Karagwe, Tanzania. Bark was sun dried and ground into fine powder, which was suspended in Krebs to obtain an aqueous extract. Isolated guinea pig distal colon was used to determine the effect of the G. buchananii bark extract on fecal pellet propulsion. Intracellular recording was used to evaluate the extract action on evoked fast excitatory post-synaptic potentials (fEPSPs) in S- neurons of the myenteric plexus. Key Results G. buchananii bark extract inhibited pellet propulsion in a concentration-dependent manner, with an optimal concentration of ~10 mg powder ml?1. Interestingly, washout of the extract resulted in an increase in pellet propulsion to a level above basal activity. The extract reversibly reduced the amplitude of evoked fEPSPs in myenteric neurons. The extract’s inhibitory action on propulsive motility and fEPSPs was not affected by the opioid receptor antagonist, naloxone, or the alpha- 2 adrenoceptor antagonist, yohimbine. The extract inhibited pellet motility in the presence of gamma-aminobutyric acid (GABA), GABAA and GABAB receptor antagonists picrotoxin and phaclofen, respectively. However, phaclofen and picrotoxin inhibited recovery rebound of motility during washout. Conclusions & Inferences G. buchananii extract has the potential to provide an effective, non-opiate anti-diarrheal drug. Further studies are required to characterize bioactive components and elucidate the mechanisms of action, efficacy and safety. PMID:20718943

Balemba, Onesmo B.; Bhattarai, Yogesh; Stenkamp-Strahm, Chloe; Lesakit, Mellau S.B.; Mawe, Gary M.

2010-01-01

86

Unusual cause of right iliac fossa pain: sigmoid perforation due to ingested rabbit bone. Case report.  

PubMed

Disorders of an organ not usually found in the right iliac fossa, such as the sigmoid colon, are an uncommon cause of right iliac fossa pain. We present a case of right iliac fossa pain caused by a sigmoid perforation due to involuntary ingestion of a rabbit bone, and describe the main features of this condition. PMID:22018217

Iusco, D R; Jannaci, M; Grassi, A; Corazza, F; Virzì, S

2011-10-01

87

Patterns of propulsive motility in the human colon after abdominal operations.  

PubMed

Twenty patients about to undergo elective cholecystectomy who were not using laxatives or drugs known to affect gastrointestinal motility and who did not give a history of gastrointestinal disease were investigated in a prospective open study. Patients swallowed two capsules each containing four radio-opaque markers every 12 hours starting 48 hours before operation. The pattern of resolution of postoperative colonic paralysis was monitored by serial abdominal radiographs taken every 12 hours until motility had returned to the rectum/sigmoid colon. In all 17 patients who completed the study propulsive motility started significantly earlier in the right colon (mean 61 hours) than in any other part (p less than 0.01). The gradient of resolution of postoperative colonic paralysis was always from proximal to distal, adding to the accumulating body of experimental evidence that implicates the right colon to return to normal first. PMID:1352138

Tollesson, P O; Cassuto, J; Rimbäck, G

1992-04-01

88

Use of Nonsteroidal Antiinflammatory Drugs and Distal Large Bowel Cancer in Whites and African Americans  

PubMed Central

Despite the belief that the etiology of and risk factors for rectal cancer might differ from those for colon cancer, relatively few studies have examined rectal cancer in relation to use of nonsteroidal antiinflammatory drugs (NSAIDs). The authors evaluated the association between NSAIDs and distal large bowel cancer in African Americans and whites, using data from a population-based case-control study of 1,057 incident cases of adenocarcinoma of the sigmoid colon, rectosigmoid junction, and rectum and 1,019 controls from North Carolina (2001–2006). NSAID use was inversely associated with distal large bowel cancer in whites (odds ratio (OR)?=?0.60, 95% confidence interval (CI): 0.46, 0.79). The inverse association was evident for all types of NSAIDs but was slightly stronger with prescription NSAIDs, particularly selective cyclooxygenase 2 inhibitors (OR?=?0.38, 95% CI: 0.25, 0.56). Compared with whites, a relatively weak inverse association was found in African Americans (OR?=?0.87, 95% CI: 0.55, 1.40), although odds ratio heterogeneity by race could not be confirmed (P?=?0.21). In addition, the strength of the association with NSAIDs varied by tumor location, suggesting more potent effects for rectal and rectosigmoid cancers than for sigmoid cancer. The chemopreventive potential of NSAIDs might differ by population and by tumor characteristics. PMID:18945689

Martin, Christopher; Galanko, Joseph; Woosley, John T.; Schroeder, Jane C.; Keku, Temitope O.; Satia, Jessie A.; Halabi, Susan; Sandler, Robert S.

2008-01-01

89

beta-Adrenergic activation of electrogenic K+ and Cl- secretion in guinea pig distal colonic epithelium proceeds via separate cAMP signaling pathways.  

PubMed

Adrenergic stimulation of isolated guinea pig distal colonic mucosa produced transient Cl(-) and sustained K(+) secretion. Transient short-circuit current (I(sc)) depended on beta(2)-adrenergic receptors (beta(2)-AdrR), and sustained I(sc) relies on a beta(1)-AdrR/beta(2)-AdrR complex. Epinephrine (epi) increased cAMP content with a biphasic time course similar to changes in epi-activated I(sc) ((epi)I(sc)). Inhibition of transmembrane adenylyl cyclases (tmACs) reduced peak (epi)I(sc) and cAMP to near zero without decreasing sustained (epi)I(sc), consistent with cAMP from tmAC signaling for only Cl(-) secretion. Inhibition of soluble adenylyl cyclase (sAC) reduced sustained (epi)I(sc) and cAMP to near zero without decreasing peak (epi)I(sc) or cAMP, consistent with cAMP from sAC signaling for K(+) secretion. Sensitivity to phosphodiesterase (PDE) inhibitors and peptide YY (PYY) stimulation further supported separate signaling for the two components. PDE3 or PDE4 inhibitors enhanced peak (epi)I(sc) but not sustained (epi)I(sc), consistent with these PDEs as part of the beta(2)-AdrR signaling domain. PYY suppressed peak (epi)I(sc) in a pertussis toxin (PTx)-sensitive manner, supporting Galpha(i)-dependent inhibition of tmACs producing cAMP for Cl(-) secretion. Since PYY or PTx did not alter sustained (epi)I(sc), signaling for K(+) secretion occurred via a Galpha(i)-independent mechanism. Presence of multiple sAC variants in colonic epithelial cells was supported by domain-specific antibodies. Responses to specific activators and inhibitors suggested that protein kinase A was not involved in activating peak or sustained components of (epi)I(sc), but the cAMP-dependent guanine nucleotide exchange factor, Epac, may contribute. Thus beta-adrenergic activation of electrogenic Cl(-) and K(+) secretion, respectively, required tmAC- and sAC-dependent signaling pathways. PMID:20413718

Halm, Susan T; Zhang, Jin; Halm, Dan R

2010-07-01

90

Sigmoid diverticulitis: US findings  

PubMed Central

Acute diverticulitis (AD) results from inflammation of a colonic diverticulum. It is the most common cause of acute left lower-quadrant pain in adults and represents a common reason for acute hospitalization, as it affects over half of the population over 65 years with a prevalence that increases with age. Although 85% of colonic diverticulitis will recover with a nonoperative treatment, some patients may have complications such as abscesses, fistulas, obstruction, and /or perforation at presentation. For these reasons, different classifications were introduced through times to help clinicians to develop a correct diagnosis and guide the treatment and for the same reasons imaging is used in most cases both to realise a differential diagnosis and to guide the therapeutic management. US and CT are both usefull in diagnosis of diverticolitis, and their sensibility and specificity are similar. However CT scanning is essential for investigating complicated diverticular disease especially where there are diffuse signs and clinical suspicion of secondary peritonitis; instead in most uncomplicated cases the experienced sonographer may quickly confirm a diagnosis guided by the clinical signs. US is to be recommended in premenopausal women, and in young people to reduce dose exposure. PMID:23902791

2013-01-01

91

Membrane Protein Profiling of Human Colon Reveals Distinct Regional Differences *  

PubMed Central

The colonic epithelium is a highly dynamic system important for the regulation of ion and water homeostasis via absorption and secretion and for the maintenance of a protective barrier between the outer milieu and the inside of the body. These processes are known to gradually change along the length of the colon, although a complete characterization at the protein level is lacking. We therefore analyzed the membrane proteome of isolated human (n = 4) colonic epithelial cells from biopsies obtained via routine colonoscopy for four segments along the large intestine: ascending, transverse, descending, and sigmoid colon. Label-free quantitative proteomic analyses using high-resolution mass spectrometry were performed on enriched membrane proteins. The results showed a stable level for the majority of membrane proteins but a distinct decrease in proteins associated with bacterial sensing, cation transport, and O-glycosylation in the proximal to distal regions. In contrast, proteins involved in microbial defense and anion transport showed an opposing gradient and increased toward the distal end. The gradient of ion-transporter proteins could be directly related to previously observed ion transport activities. All individual glycosyltransferases required for the O-glycosylation of the major colonic mucin MUC2 were observed and correlated with the known glycosylation variation along the colon axis. This is the first comprehensive quantitative dataset of membrane protein abundance along the human colon and will add to the knowledge of the physiological function of the different regions of the colonic mucosa. Mass spectrometry data have been deposited to the ProteomeXchange with the identifier PXD000987. PMID:24889196

van der Post, Sjoerd; Hansson, Gunnar C.

2014-01-01

92

A Rare Case Presentation of a Perforated Giant Sigmoid Diverticulum  

PubMed Central

Giant sigmoid diverticulum (GSD) is a rare complication of diverticulosis. These lesions arise from herniations of the mucosa through the muscle wall which progressively enlarge with colonic gas to become large air-filled cysts evident on plain X-ray and CT scans. We present a rare case of a 72-year-old female presenting with abdominal distention, abdominal tenderness, and fever who developed a type 1 giant sigmoid diverticulum (pseudodiverticulum) that subsequently formed an intra-abdominal abscess and an accompanying type 2 diverticulum as well. The patient was treated with surgical resection of the diverticulum with a primary anastomosis and abscess drainage. The patient's postoperative course was uneventful. This case helps to support the need for the consideration of GSD in patients aged 60 and older with a history of diverticulosis and presenting with abdominal discomfort and distension. PMID:24288544

Kam, Jennifer C.; Doraiswamy, Vikram; Spira, Robert S.

2013-01-01

93

Diagnosis of a sigmoid volvulus in pregnancy: ultrasonography and magnetic resonance imaging findings  

PubMed Central

Sigmoid volvulus complicating pregnancy is a rare, non-obstetric cause of abdominal pain that requires prompt surgical intervention (decompression) to avoid intestinal ischemia and perforation. We report the case of a 31-week pregnant woman with abdominal pain and subsequent development of constipation. Preoperative diagnosis was achieved using magnetic resonance imaging and ultrasonography: the large bowel distension and a typical whirl sign - near a sigmoid colon transition point - suggested the diagnosis of sigmoid volvulus. The decision to refer the patient for emergency laparotomy was adopted without any ionizing radiation exposure, and the pre-operative diagnosis was confirmed after surgery. Imaging features of sigmoid volvulus and differential diagnosis from other non-obstetric abdominal emergencies in pregnancy are discussed in our report, with special emphasis on the diagnostic capabilities of ultrasonography and magnetic resonance imaging. PMID:24967020

Palmucci, Stefano; Lanza, Maria Letizia; Gulino, Fabrizio; Scilletta, Beniamino; Ettorre, Giovanni Carlo

2014-01-01

94

An unusual zoonosis: liver abscess secondary to asymptomatic colonic foreign body.  

PubMed

A liver abscess may arise following any insult to gut integrity allowing portal drainage of bacteria to hepatocytes. Foreign bodies such as bones, toothpicks and items of stationery have previously been implicated in compromising gut epithelium. Here we present the case of a 57 year old man suffering from a left liver abscess. This was defined on CT which incidentally also identified a chicken bone protruding through the wall of the distal sigmoid colon. Whilst unwell with upper abdominal pain and sepsis, the presumed source of portal sepsis within the colon remained asymptomatic throughout. Following percutaneous drainage, the liver abscess resolved but the chicken bone had not passed at two months, necessitating atraumatic removal at colonoscopy. A high rate of incidental diagnoses suggests that unidentified foreign bodies may be vastly under recognised in cases of hepatic sepsis. Thus, identification of the precise mechanism of the liver insult demands thorough consideration; foreign body should be considered in all cases. PMID:21113288

Gundara, Justin S; Harrison, Richard

2010-01-01

95

An Unusual Zoonosis: Liver Abscess Secondary to Asymptomatic Colonic Foreign Body  

PubMed Central

A liver abscess may arise following any insult to gut integrity allowing portal drainage of bacteria to hepatocytes. Foreign bodies such as bones, toothpicks and items of stationery have previously been implicated in compromising gut epithelium. Here we present the case of a 57 year old man suffering from a left liver abscess. This was defined on CT which incidentally also identified a chicken bone protruding through the wall of the distal sigmoid colon. Whilst unwell with upper abdominal pain and sepsis, the presumed source of portal sepsis within the colon remained asymptomatic throughout. Following percutaneous drainage, the liver abscess resolved but the chicken bone had not passed at two months, necessitating atraumatic removal at colonoscopy. A high rate of incidental diagnoses suggests that unidentified foreign bodies may be vastly under recognised in cases of hepatic sepsis. Thus, identification of the precise mechanism of the liver insult demands thorough consideration; foreign body should be considered in all cases. PMID:21113288

Gundara, Justin S.; Harrison, Richard

2010-01-01

96

Perforated sigmoid diverticulitis in a lumbar hernia after iliac crest bone graft - a case report  

PubMed Central

Background The combination of perforated diverticulitis in a lumbar hernia constitutes an extremely rare condition. Case presentation We report a case of a 66 year old Caucasian woman presenting with perforated sigmoid diverticulitis localized in a lumbar hernia following iliac crest bone graft performed 18 years ago. Emergency treatment consisted of laparoscopic peritoneal lavage. Elective sigmoid resection was scheduled four months later. At the same time a laparoscopic hernia repair with a biologic mesh graft was performed. Conclusion This case shows a very seldom clinical presentation of lumbar hernia. Secondary colonic resection and concurrent hernia repair with a biologic implant have proven useful in treating this rare condition. PMID:25051974

2014-01-01

97

Late recurrence of sigmoid carcinoma mimicking primary vulvar cancer: case report and review of the literature  

PubMed Central

Objective To demonstrate a unique case report about late and isolated vulvar metastasis of sigmoid adeno-carcinoma with review of the literature. Material-method 57 year old postmenopausal patient with prior sigmoid colon cancer history was admitted with isolated vulvar mass. Immunohistochemistry (IHC) and KRAS gen mutation analysis following surgery were performed to discriminate the metastasis from a vulvar primary malignancy. Further imaging techniques were also performed to exclude additional tumours. Results Immunohistochemistry (IHC) and KRAS gene mutation analysis revealed isolated metastasis of the colonic adeno-carcinoma in the vulva. Conclusion Isolated and late occurring vulvar metastasis of colonic origin is very unusual. Careful evaluation and IHC is useful for such cases. PMID:22949946

Pabuccu, Emre; Tolunay, Harun Egemen; Kocbulut, Evren; Task?n, Salih; Ortac, F?rat; Sertcelik, Ayse; Sasmaz, Aysegul; Savas, Berna

2012-01-01

98

Colonic abscess induced by India ink tattooing.  

PubMed

Endoscopic tattooing with India ink is generally regarded as a safe procedure that enables ready identification of endoluminal cancer from the serosal surface. However, significant complications have been reported, including local inflammatory pseudotumor formation, peritonitis, rectus muscle abscess, small bowel infarction, and phlegmonous gastritis. Although the mechanism of complication is not completely understood, it may be related to the chemical compounds contained in the ink solution and enteric or extraenteric bacterial inoculation by injection needle or the ink itself. Authors encountered a case of a 60-year-old man with a resectable sigmoid colon cancer which was tattooed with India ink for subsequent localization in the intraoperative setting. During the laparoscopic operation, the proximal and distal margin of the lesion appeared edematous with bluish color. The distal resection margin was extended approximately 5 cm more than expected because of long extent of edematous mucosa. Histologic examination of the edematous tattooing area revealed an ink abscess spreading laterally above the muscularis propria. Although tattooing is widely used and relatively safe, the presented case indicates the risk of infection or inflammation by tattooing. PMID:25073671

Bang, Chang Seok; Kim, Yeon Soo; Baik, Gwang Ho; Han, Sang Hak

2014-07-01

99

Multiple Mineralocorticoid Response Elements Localized in Different Introns Regulate Intermediate Conductance K+ (Kcnn4) Channel Expression in the Rat Distal Colon  

PubMed Central

An elevated plasma aldosterone and an increased expression of the intermediate conductance K+ (IK/Kcnn4) channels are linked in colon. This observation suggests that the expression of Kcnn4 gene is controlled through the action of aldosterone on its cognate receptor (i.e., mineralocorticoid receptor; MR). In order to establish this, we performed chromatin immunoprecipitation (ChIP) assay to identify the MR response elements (MREs) in a region that spanned 20 kb upstream and 10 kb downstream of the presumed transcription start site (TSS) using chromatin from the colonic epithelial cells of normal and aldosterone-treated rats. MREs were immunoprecipitated in an approximately 5 kb region that spanned the first and second introns in the aldosterone rats. These regions were individually cloned in luciferase-expression vector lacking enhancer activity. These clones were tested for enhancer activity in vitro by transfecting in HEK293T and CaCo2 cells with MR and aldosterone treatment. At least four regions were found to be responsive to the MR and aldosterone. Two regions were identified to contain MREs using bioinformatics tools. These clones lost their enhancer activity after mutation of the presumptive MREs, and thus, established the functionality of the MREs. The third and fourth clones did not contain any bioinformatically obvious MREs. Further, they lost their activity upon additional sub-cloning, which suggest cooperativity between the regions that were separated upon sub-cloning. These results demonstrate the presence of intronic MREs in Kcnn4 and suggest a highly cooperative interaction between multiple intronic response elements. PMID:24901797

O’Hara, Bryan; de la Rosa, Diego Alvarez; Rajendran, Vazhaikkurichi M.

2014-01-01

100

Contractile effect of short-chain fatty acids on the isolated colon of the rat.  

PubMed Central

The contractile effect of short-chain fatty acids on proximal, middle and distal segments of the rat colon was studied in vitro. A single contraction of the longitudinal muscle of the everted preparation of the middle and distal but not the proximal colon was induced by mucosal application of propionate, butyrate or valerate. Sigmoid dose-responses were observed between contraction and log dose of propionate, butyrate and valerate. The threshold concentration of short-chain fatty acids was between 0.02 and 0.04 mM. A maximal contraction was induced with 0.1 mM-propionate, butyrate and valerate. While acetate (up to 10 mM) and lactate (up to 30 mM) had no contractile effect at all. Serosal application of short-chain fatty acids was without effect, while the contractile response with up to 10 mM-propionate was abolished in both the middle and distal colon by scraping away the mucosa. Cumulative addition of short-chain fatty acids to the organ bath (without wash-out of the first dose) caused adaptation of the contractile response; thus, the effect of propionate (1 mM) was abolished by prior addition of acetate (10 mM) or lactate (30 mM) or propionate (1 mM) or butyrate (1 mM) or valerate (1 mM). The contractile effect of propionate was also inhibited by atropine (1 microM), procaine (0.4 mM) and tetrodotoxin (3 microM); was unaffected by hexamethonium (0.1 mM) and enhanced by eserine (10 nM). The results suggest that short-chain fatty acids, which are normal constituents of the colon, have the ability to stimulate colonic contractions, probably via an enteric reflex involving local sensory and cholinergic nerves. PMID:2867220

Yajima, T

1985-01-01

101

The use of pedicled transplants of sigmoid or other parts of the intestinal tract for vaginal construction.  

PubMed Central

The use of transplants from different parts of the intestinal tract for vaginal construction is surveyed and the special value of sigmoid colon for this purpose is demonstrated by the results obtained in 7 patients treated by the author. PMID:6638845

Goligher, J. C.

1983-01-01

102

The localisation of cancer in the sigmoid, rectum or rectosigmoid junction using endoscopy or radiology—What is the most accurate method?  

PubMed Central

Introduction There is a difference in approach between colon and rectal cancer. Aim Evaluate the methods of localisation: endoscopy and radiology. Materials and methods Patients with cancer in the sigmoid or rectum diagnosed with endoscopy, were included. Patients underwent additional radiological examinations. The resection specimen served as the gold standard. A tumour surrounded by serosa was considered a sigmoid cancer, surrounded by perirectal fat, than it was rectal cancer. If the frontal edge of the tumour showed serosa and the dorsal plane perirectal fat than the tumour was located in the “rectosigmoid”. Results A total of 182 cancers were diagnosed. Of the 128 cancers with gold standard, endoscopy had the correct localisation in 112 (87.5%), and radiology in 114 (90.5%) cases. Concordance between both techniques was present in 80%. In 28 cases there was discordance. Radiology located 10 sigmoidal cancers wrongly in the rectum. One rectal cancer was placed in the sigmoid. In 16 cases the endoscopic localisation wrongly was the sigmoid. Sensitivity and specificity for endoscopy in sigmoidal cancer is 100% and 77% respectively, for rectal cancer 77% and 100%. Sensitivity of radiology for cancer in the sigmoid and rectum are 80% and 98% respectively. Specificity for both cancers is 98% and 80% respectively. Conclusions The endoscopist and the radiologist should not be too overconfident with localisation of the tumour in cases of high rectal or low sigmoidal cancer. PMID:25436127

Flens, Marcel; Fransen, Gerwin; den Boer, Frank C.; van Bochove, Aart

2014-01-01

103

A novel mutation in the vascular Ehlers-Danlos syndrome: a case presenting with colonic perforations  

Microsoft Academic Search

A 15-year-old girl who had chronic constipation presented with peritonitis caused by sigmoid colon perforation. After her sigmoid colon was resected and an end colostomy performed, as there were no apparent causes for perforation, she was followed-up. After the second colonic perforation proximal to the end colostomy, as the pathologic findings revealed myopathic changes, the connective tissue disorders were evaluated.

Billur Demirogullari; Ramazan Karabulut; Arzu Demirtola; Bilge Karabulut; I. Hakki Gol; Cemalettin Aybay; Sofie Symoens; Kaan Sonmez; A. Can Basaklar; Nuri Kale

2006-01-01

104

Sigmoid perforation by compressed carbon dioxide.  

PubMed

Self-induced injuries of the bowel have various accidental mechanisms. This is a report of a 35-year-old patient with disruption of the recto-sigmoid junction caused by carbon dioxide (CO2) originating from a bottle of sparkling wine, which was introduced transanally for sexual stimulation. The patient underwent resection of the recto-sigmoid junction and primary anastomosis. The postoperative course was uneventful except for wound infection. The patient was discharged 12 days later. The physical backgrounds, the pathological pathways for perforation and diagnostic modalities including diagnostic pitfalls are critically discussed. PMID:15932178

Ikapischke, Matthias; Tepel, Juergen; Pai, Muhdra; Schulz, Tim

2005-03-01

105

Neurocomputing 62 (2004) 501506 Fuzzy sigmoid kernel for support  

E-print Network

-definite kernel in the support vector machines framework. The fuzzy sigmoid kernel allows lower computational cost the advantages of using the fuzzy-based sigmoid function presented in [8] as a non-PSD kernel matrix for SVM. WeNeurocomputing 62 (2004) 501­506 Letters Fuzzy sigmoid kernel for support vector classifiers G

Camps-Valls, Gustavo

106

Inverse relationship between moderate alcohol intake and rectal cancer: Analysis of the North Carolina Colon Cancer Study  

PubMed Central

Background The relationship between alcohol intake and rectal cancer is uncertain Objective We sought to evaluate whether alcohol consumption is associated with distal colorectal cancer and rectal cancer specifically. Design Data on alcohol intake were examined from the North Carolina Colon Cancer Study, a population-based case control study of distal colorectal cancer. Setting 33 counties in the central and eastern part of North Carolina Patients Cases had adenocarcinoma of the rectum, rectosigmoid, and sigmoid colon. Controls were frequency-matched on age, race, and gender. Interventions Demographic and dietary intake data were collected using a validated questionnaire. Main outcome measures Logistic regression was used to estimate odds ratios for the relationship between alcohol consumption and distal colorectal cancer. Results 1,033 cases and 1,011 controls participated. The odds ratio for rectal cancer comparing any vs. no alcohol intake was 0.73 (95% confidence interval 0.60, 0.90), adjusted for age, gender, race, smoking status, obesity, education, red meat intake, use of non-steroidal anti-inflammatory medications and family history of colorectal cancer. The odds ratio for moderate alcohol (?14 grams/day) was 0.66 (0.53, 0.82), while the odds ratio for heavy alcohol (>14 grams/day) was 0.93 (0.70, 1.23). Moderate beer and wine intakes were also inversely associated with distal colorectal cancer: odds ratios 0.76 (0.60, 0.96) and 0.69 (0.56, 0.86) respectively. Limitations This was a retrospective, observational study. Residual confounding is possible. Conclusions In this study, moderate alcohol intake (especially wine) was inversely associated with distal colorectal cancer. PMID:21654257

Crockett, Seth D.; Long, Millie D.; Dellon, Evan S.; Martin, Christopher F.; Galanko, Joseph A.; Sandler, Robert S.

2011-01-01

107

Colonic and anal metastases from pancreato-biliary malignancies  

PubMed Central

Pancreato-biliary malignancies often present with locally advanced or metastatic disease. Surgery is the mainstay of treatment although less than 20% of tumours are suitable for resection at presentation. Common sites for metastases are liver, lungs, lymph nodes and peritoneal cavity. Metastatic disease carries poor prognosis, with median survival of less than 3 mo. We report two cases where metastases from pancreato-biliary cancers were identified in the colon and anal canal. In both cases specific immunohistochemical staining was utilised in the diagnosis. In the first case, the presenting complaint was obstructive jaundice due to an ampullary tumour for which a pancreato-duodenectomy was carried out. However, the patient re-presented 4 wk later with an atypical anal fissure which was found to be metastatic deposit from the primary ampullary adenocarcinoma. In the second case, the patient presented with obstructive jaundice due to a biliary stricture. Subsequent imaging revealed sigmoid thickening, which was confirmed to be a metastatic deposit. Distal colonic and anorectal metastases from pancreato-biliary cancers are rare and can masquerade as primary colorectal tumours. The key to the diagnosis is the specific immunohistochemical profile of the intestinal lesion biopsies. PMID:24707155

Ejtehadi, Farshid; Chatzizacharias, Nikolaos A; Brais, Rebecca J; Hall, Nigel R; Godfrey, Edmund M; Huguet, Emmanuel; Praseedom, Raaj K; Jah, Asif

2014-01-01

108

Online Catalog for Filament-Sigmoid Correlation  

NASA Astrophysics Data System (ADS)

A new online catalog correlating H-alpha filaments with SXT sigmoids gives researchers, teachers and pre-college students the ability to access digital H-alpha images online that were previously available only at the physical location of the NSO at Sunspot, NM. This web-based catalog correlates SOHO's SXT sigmoids from 1993-1998 as described in a non-online catalog created by Zach Blehm under the direction of Richard Canfield, MSU-Bozeman, with H-alpha filament activity as described by Ivy Merriot under the direction of Alexei Pevtsov, NSO, and Petrus Martens, MSU-Bozeman. The H-alpha images were digitized from film archives of the Flare Patrol Telescope at Sunspot, NM. Use of the online catalog will be demonstrated at the poster site with critical comments encouraged.

Merriot, Ivy; Pevtsov, A.; Martens, P.

2007-05-01

109

Distal Convoluted Tubule  

PubMed Central

The distal convoluted tubule is the nephron segment that lies immediately downstream of the macula densa. Although short in length, the distal convoluted tubule plays a critical role in sodium, potassium, and divalent cation homeostasis. Recent genetic and physiologic studies have greatly expanded our understanding of how the distal convoluted tubule regulates these processes at the molecular level. This article provides an update on the distal convoluted tubule, highlighting concepts and pathophysiology relevant to clinical practice. PMID:24855283

Ellison, David H.

2014-01-01

110

Mean Field Theory for Sigmoid Belief Networks  

Microsoft Academic Search

We develop a mean eld theory for sigmoid belief networks based on ideas from statistical mechanics. Our mean eld theory provides a tractable approximation to the true probability dis-tribution in these networks; it also yields a lower bound on the likelihood of evidence. We demon-strate the utility of this framework on a benchmark problem in statistical pattern recognition|the classi cation

Lawrence K. Saul; Tommi Jaakkola; Michael I. Jordan

1996-01-01

111

Results using the biofragmentable anastomotic ring for colon anastomosis.  

PubMed

The Biofragmentable Anastomotic Ring (BAR) (Valtrac, Davis & Geck, Inc.) is a newly approved device intended for colonic anastomosis. We have used the device in 47 patients to date. These patients were studied to determine the effectiveness, uses and limitations of this new device. The BAR is similar in concept to the older Murphy "Button" used circa World War I, but it's constructed of polyglycolic acid rather than metal. Anastomosis is effected by placing the two bowel lumens over the device, tying the purse-string sutures snugly, and "clicking" the device closed. The BAR fragments and is passed 2 to 3 weeks postoperatively. The patients ranged from 14 to 82 years of age. Thirty-nine patients were operated on for cancer, four for diverticulitis, and four for colostomy closure. One transverse colectomy (THC), 15 left hemicolectomies (LHC), 23 sigmoid colectomies (SC), two low anterior resections (LAR), four colostomy closures, and two right hemicolectomies were performed. There were no anastomotic leaks and no complications. We found that because of the need to have access distally to "click" the device closed, BAR anastomosis after LAR is rarely feasible. Because of the small lumenal size of the distal ileum, the BAR is seldom usable for ileocolonic anastomosis after right hemicolectomy (RHC). The newly approved 25-mm BAR may change this. We found that the time required to perform an anastomosis with the BAR is equivalent to stapled techniques. At our hospital, the cost of the device is equivalent to one intestinal stapler. Since multiple staplers are used in most colon anastomotic techniques, there is a modest cost advantage for the BAR.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8214962

Wood, J S; Frost, D B

1993-10-01

112

The lingual distalizer system.  

PubMed

Class II molar relationships can be corrected by several methods. In previous systems, orthodontic forces have been applied to crowns and distal movement of the first molar has mainly been by tipping and a rotation of the crowns. A new Lingual Distalizer (LD) has recently been developed to distalize the maxillary molars without the drawbacks of previous appliances. The lingual distalizer is relatively easy to insert, is well-tolerated, does not require patient co-operation and is aesthetic. It distalizes molars without loss of anchorage and moves them with bodily translation. PMID:8942092

Carano, A; Testa, M; Siciliani, G

1996-10-01

113

A case report of a giant presacral cystic schwannoma with sigmoid megacolon.  

PubMed

Schwannomas are peripheral nerve sheath tumours with a slow growth rate. Giant sacral schwannoma with anterior cortex erosion and associated intrapelvic extension are uncommon. Though they tend to be large when initially found, most Giant schwannomas are clinically asymptomatic. The tumour appears heterogenous due to long standing degeneration. Herein, we present a case of a large purely cystic presacral schwannoma in a patient with poliomyelitis, which has displaced adjacent organs including urinary bladder and sigmoid colon, with an initial presentation of constipation. The tumour was partially excised and diagnosis was confirmed by histo-pathology and immunohistochemistry. PMID:22470633

Nyapathy, Vinay; Murthy, Umesh Krishna; Chintamani, Jaiger; Sridhar, Deepak Yedagudde

2009-01-01

114

Fast Learning by Bounding Likelihoods in Sigmoid Type Belief Networks  

E-print Network

Sigmoid type belief networks, a class of probabilistic neural networks, provide a natural framework for compactly representing probabilistic information in a variety of unsupervised and supervised learning problems. ...

Jaakkola, Tommi S.

1996-02-09

115

FIP bias in a sigmoidal active region  

NASA Astrophysics Data System (ADS)

We investigate first ionization potential (FIP) bias levels in an anemone active region (AR) - coronal hole (CH) complex using an abundance map derived from Hinode/EIS spectra. The detailed, spatially resolved abundance map has a large field of view covering 359'' × 485''. Plasma with high FIP bias, or coronal abundances, is concentrated at the footpoints of the AR loops whereas the surrounding CH has a low FIP bias, ~1, i.e. photospheric abundances. A channel of low FIP bias is located along the AR's main polarity inversion line containing a filament where ongoing flux cancellation is observed, indicating a bald patch magnetic topology characteristic of a sigmoid/flux rope configuration.

Baker, D.; Brooks, D. H.; Démoulin, P.; van Driel-Gesztelyi, Lidia; Green, L. M.; Steed, K.; Carlyle, J.

2014-01-01

116

Distal Radius Attachments of the Radiocarpal Ligaments: An Anatomical Study  

PubMed Central

Background?Understanding the anatomy of the ligaments of the distal radius aids in the surgical repair of ligamentous injuries and the prediction of intraarticular fracture patterns. Purposes?(1) to measure the horizontal and vertical distances of the origins of the radiocarpal ligaments from the most ulnar corner of the sigmoid notch and the joint line, respectively; and (2) to express them as a percentile of the total width of the bony distal radius. Methods?We dissected 8 cadaveric specimens and identified the dorsal radiocarpal, radioscaphocapitate, and the long and short radiolunate ligaments. Results?The dorsal radiocarpal ligament attached from the 16th to the 52nd percentile of the radial width. The radioscaphocapitate ligament attached around the radial styloid from the 86th percentile volarly to the 87th percentile dorsally. The long radiolunate ligament attached from the 59th to the 85th percentile, and the short radiolunate ligament attached from the 14th to the 41st percentile. Discussion?There was a positive correlation between the radial width and the horizontal distance of the ligaments from the sigmoid notch. These findings may aid individualized surgical repair or reconstruction adjusted to patient size and enable further standardized research on distal radial fractures and their relationship with radiocarpal ligaments. PMID:24436840

Zumstein, M. A.; Hasan, A. P.; McGuire, D. T.; Eng, Kevin; Bain, Gregory Ian

2013-01-01

117

Semiconstrained distal radioulnar joint prosthesis.  

PubMed

Distal radioulnar joint (DRUJ) problems can occur as a result of joint instability, abutment, or incongruity. The DRUJ is a weight-bearing joint; the ulnar head is frequently excised either totally or partially, and in some cases it is fused, because of degenerative, rheumatoid, or posttraumatic arthritis. Articles about these procedures report the ability to pronate and supinate, but they rarely discuss grip strength, and even less do they address lifting capacity. We report the long term results of the first 35 patients who underwent total DRUJ arthroplasty with the Aptis DRUJ prosthesis after 5 years follow-up. Surgical indications were all causes of dysfunctional DRUJ (degenerative, posttraumatic, autoimmune, congenital). We recorded data for patient demographics, range of motion (ROM), strength, and lifting capacity of the operated and of the nonoperated extremity. Pain and functional assessments were also recorded. The Aptis DRUJ prosthesis, a bipolar self-stabilizing DRUJ endoprosthesis that restores forearm function, consists of a semiconstained and modular implant designed to replace the function of the ulnar head, the sigmoid notch of the radius, and the triangular fibrocartilage ligaments. The surgical technique is presented in detail. The majority of the patients regained adequate ROM and improved their strength and lifting capacity to the operated side. Pain and activities of daily living were improved. Twelve patients experienced complications, most commonly being extensor carpi ulnaris (ECU) tendinitis, ectopic bone formation, bone resorption with stem loosening, low-grade infection, and need for ball replacement. The Aptis total DRUJ replacement prosthesis is an alternative to salvage procedures that enables a full range of motion as well as the ability to grip and lift weights encountered in daily living activities. PMID:24436788

Savvidou, Christiana; Murphy, Erin; Mailhot, Emilie; Jacob, Shushan; Scheker, Luis R

2013-02-01

118

Three cases of synchronous laparoscopic resection for gastric and colonic cancer.  

PubMed

Case 1 was an 84-year-old female who suffered from a superficial elevated lesion within depressed area (0 IIc+IIa) from the lesser curvature to the posterior wall at the middle corpus of the stomach and a depressed lesion with a circumferential embankment (type 2) at the sigmoid colon. Case 2 was a 70-year-old male who suffered from a superficial depressed lesion (0 IIc) at the lesser curvature of the gastric angle and a superficial elevated lesion (0 IIa) at the cecum. Case 3 was a 58-year-old male who suffered from a superficial depressed lesion (0 IIc) from the lesser curvature to the posterior wall at the middle corpus of the stomach, and an elevated lesion (type 1) and a depressed lesion with a circumferential embankment (type 2) at the sigmoid colon. In 3 cases, we first inserted 5 or 6 trocars and performed laparoscopic distal gastrectomy with groups 1 and 2 lymph node dissection according to the Japanese Classification of Gastric Carcinoma. Subsequently, in case 1, 1 additional port was inserted at the right lower quadrant for sigmoidectomy; in case 2, two trocars were added for ileocecal resection; and in case 3, one additional port was inserted at the median hypogastric region for sigmoidectomy. In cases 1 and 2, Billroth II reconstruction was performed using a laparoscopic linear stapling device (endo-GIA) and, in case 3, Roux-en-Y reconstruction was performed using endo-GIA, after distal gastrectomy. The double stapling technique using a conventional circular stapling device was performed after pulling out the specimen from the paraumbilical port after colectomy in case 1, whereas an end-to-end triangular suture using endo-GIA was used extracorporeally through the paraumbilical port in case 2 and the median hypogastric port in case 3. The operative durations of cases 1, 2, and 3 were 315, 340, and 495 minutes and the amounts of blood loss were 80, 300, and 440 mL, respectively. Except for the need to retain the drain until the tenth postoperative day because of serous discharge in case 1, no postoperative complications occurred. The postoperative commencement of oral feeding was on the fifth day in case 1 and on the third day in cases 2 and 3. All cases made a quick recovery and they were discharged from hospital on the nineteenth, thirteenth, and tenth day after operation, respectively. Double cancer patients with gastric and colonic carcinomas were thought to be very suitable for laparoscopic surgery because by avoiding a total median skin incision, there is less wound pain and quicker postoperation recovery. PMID:21150407

Nishikawa, Masahiro; Higashino, Masayuki; Tanimura, Shinya; Fukunaga, Yosuke; Tokuhara, Taigo

2010-12-01

119

Cooperative Roles of Colon and Anorectum During Spontaneous Defecation in Conscious Dogs  

Microsoft Academic Search

Colorectal motility during spontaneous defecation was investigated using force strain gauge transducers implanted in the proximal colon, distal colon, rectum, and anus in six dogs. One 24-hr recording and several defecation recordings were made in each dog. During 24-hr recordings, 29 giant contractions were observed in the distal colon. The giant contractions, which propagated to the rectum, accompanied evacuation more

Hiroshi Matsufuji; Jotaro Yokoyama; Takeshi Hirabayashi; Shuichi Watanabe; Kenji Sakurai

1998-01-01

120

Serum Sodium Levels in Sigmoid Volvulus  

PubMed Central

Objective Sigmoid volvulus (SV) is an uncommon type of large bowel obstruction. This study sought to determine serum sodium concentrations in patients with SV. Materials and Methods The records of 89 patients with SV and 40 patients with obstructive rectosigmoid cancer (ORC) were reviewed retrospectively Results The mean serum sodium concentrations in patients with SV and in those with ORC were 138.4±4.5 mEq/L and 137.7±3.2 mEq/L, respectively (t:0.7, P>0.05). The numbers of hyponatremic and hypernatremic patients were 13 vs. 4 and 1 vs. 0, respectively, in the SV and ORC groups (x2:0.5, P>0.05). Conclusion No cause-effect relationship was determined between serum sodium concentrations and SV.

Atamanalp, S. Selcuk; Keles, M. Sait; Ozturk, Gurkan; Ozogul, Bunyami; K?saoglu, Abdullah; Akbas, Ahmet

2009-01-01

121

Extended external hemipelvectomy for sigmoid adenocarcinoma treatment.  

PubMed

Surgery is the most effective way of treating a locally advanced colorectal carcinoma and an extended en bloc resection is necessary to achieve the best overall survival rate. In this rare case, a multi-visceral resection was performed along with the entire lower left limb and left iliac bone for a sigmoid carcinoma. The T4N0M0 (B3) tumor involved the left iliac vessels, left pelvic wall, small bowel and both rectus muscles, besides presenting with a skin fistula. A Hartmann colostomy was also performed. Chemotherapy was interrupted because of toxicity. The patient is free of disease after 38 months. There are very few cases that describe an extended hemipelvectomy as part of a colorectal carcinoma treatment. PMID:21181006

Reis, Rodrigo Ribas Dias dos; Schiavinatto, Luciane; Telles, Mário Luis; Moreira, Adriana Eliza Brasil; Mainardi, João Paulo Aguiar Jordão

2010-10-01

122

Review article: aminosalicylates for distal colitis.  

PubMed

About two-thirds of patients with ulcerative colitis have an inflammatory involvement distal to the splenic flexure and therefore may be effectively treated with topical treatment. This allows the delivery of the active drug directly to the site of inflammation, limiting the systemic absorption and the potential side effects. Topical aminosalicylate therapy is the most effective approach, provided that the formulation reaches the upper extent of the disease. Suppositories should be considered the treatment of choice for proctitis and distal sigmoiditis. A 1 g Pentasa-suppository once daily induces a quicker clinical and endoscopic remission and was better tolerated than a 500-mg suppository twice daily. Enemas, foams and gel, thanks to their proximal spread, should be the treatment of choice for proctosigmoiditis and left-sided colitis. Oral aminosalicylates are less effective than topical therapies for patients with active disease; however, a combination of oral and topical aminosalicylates can be successfully tried in refractory patients. Topical aminosalicylates also play an important role in the maintenance of remission, and the combination of oral plus rectal 5-aminosalicylate is superior to the single agent. Patients who prefer not to continue on long-term rectal therapy can be treated with oral aminosalicylates. PMID:16961744

Gionchetti, P; Rizzello, F; Morselli, C; Tambasco, R; Campieri, M

2006-10-01

123

Idiopathic distal radioulnar synostosis.  

PubMed

Radioulnar synostosis is rare, and exists in two forms: congenital and post-traumatic. The congenital form presents only in the proximal forearm, and the post-traumatic form may present anywhere along the radius and ulna. The only known aetiology for distal radioulnar synostosis is post-traumatic. We present a rare case of distal radioulnar synostosis with no previous history of trauma. PMID:23789710

Shoham, Yaron; Gurfinkel, Reuven; Sagi, Amiram

2014-02-01

124

A case of colon cancer incidentally detected by 18F-choline PET/CT.  

PubMed

A 65-year-old man had restaging of prostate cancer with an 18F-choline PET/CT, which revealed focal uptake in a thickened posterior wall of sigmoid colon. Biopsy demonstrated colon cancer. Incidental colorectal 18F-choline uptake should be further investigated with histological analysis. PMID:24097002

Calabria, Ferdinando F; Crusco, Sonia; Cicciò, Carmelo; Schillaci, Orazio

2013-12-01

125

Serum Potassium Levels in Sigmoid Volvulus  

PubMed Central

Objective: This study aimed to determine the serum potassium concentrations in patients with sigmoid volvulus (SV), which is a rare large bowel obstruction. Materials and Methods: The records of 86 patients with SV were reviewed retrospectively, while the records of 41 patients diagnosed with obstructive rectosigmoid cancer (ORC) were considered as the control group and as such, served as a source for comparison. Results: The analysis revealed a mean serum potassium concentration of 3.9 ± 0.6 mEq/L for the patients with SV, while the mean potassium concentration was 3.9 ± 0.5 mEq/L for the patients diagnosed with ORC (t:0.1, P>0.05). The number of hypokalemic and hyperkalemic patients identified in this study sample were 11 versus 5 patients and 1 versus 0 patients, respectively for the SV and ORC groups (x2 = 0.1 and 0.5, respectively with a P>0.05). Conclusions: No cause-and-effect relationship was observed between the serum potassium concentrations and SV. The serum potassium concentration is not pathognomonic for SV.

Atamanalp, S. Selcuk; Keles, M. Sait; Aydinli, Bulent

2009-01-01

126

Hinode XRT observations of a long-lasting coronal sigmoid  

NASA Astrophysics Data System (ADS)

Aims:Coronal sigmoids are important sources of eruptions into interplanetary space, and a handful of models have been proposed to explain their characteristic S shape. However, the coronal X-ray images available to date have generally not had sufficient resolution to distinguish between these models. The goal of the present investigation is to determine whether the new observations from Hinode can help us to make such a distinction. Methods: We present the first observations of a persistent coronal sigmoid obtained with the Hinode X-Ray Telescope (XRT). The excellent angular resolution of XRT (1 arcsec per pixel) and the sigmoid's location near disk center combined to provide an unprecedented view of the formation and eruption of this phenomenon. We compared the observed morphology with expectations inferred from two popular models of sigmoid formation, the bald-patch separatrix surface model and the kinking flux rope model. Results: The images during the pre-eruptive phase show that the overall S shape of the sigmoid comprises two separate J-shaped bundles of many loops. The straight sections of the two J patterns lie anti-parallel to one another in the middle of the S, on opposite sides of the magnetic polarity inversion line. The images during the eruptive phase reveal that, before any soft X-ray flaring begins, a diffuse linear structure almost as long as the sigmoid lifts off from the middle of the S. It shows slight clockwise rotation. The X-ray flare begins with the appearance of a sheared arcade of short loops, in the area centered between the two J-shaped patterns of the sigmoid. Conclusions: Taken together, the observational findings provide strong support for the bald-patch separatrix surface model for this sigmoid.

McKenzie, D. E.; Canfield, R. C.

2008-04-01

127

CT manifestations of infarcted epiploic appendages of the colon  

Microsoft Academic Search

Two patients presenting with acute onset of left lower abdominal pain due to infarcted epiploic appendages are the subject of this report. Computed tomography (CT) in both cases showed localized pericolic inflammatory changes corresponding to the location of infarcted epiploic appendages on the serosal aspect of the descending colon or sigmoid. The clinical and radiological findings of this entity are

G. M. Torres; P. L. Abbitt

1994-01-01

128

The distal biceps tendon.  

PubMed

Distal biceps tendon ruptures continue to be an important injury seen and treated by upper extremity surgeons. Since the mid-1980s, the emphasis has been placed on techniques that limit complications or improve initial tendon-to-bone fixation strength. Recently, basic science research has expanded the knowledge base regarding the biceps tendon structure, footprint anatomy, and biomechanics. Clinical data have further delineated the results of conservative and surgical management of both partial and complete tears in acute or chronic states. The current literature on the distal biceps tendon is described in detail. PMID:23474326

Schmidt, Christopher C; Jarrett, Claudius D; Brown, Brandon T

2013-04-01

129

Colon cancer  

MedlinePLUS

Colorectal cancer; Cancer - colon; Rectal cancer; Cancer - rectum; Adenocarcinoma - colon; Colon - adenocarcinoma ... In the United States, colorectal cancer is one of the leading causes of deaths due to cancer. Early diagnosis can often lead to a complete cure. Almost ...

130

Feasibility of radical sigmoid colectomy performed as natural orifice translumenal endoscopic surgery (NOTES) using transanal endoscopic microsurgery  

Microsoft Academic Search

Background  Natural orifice translumenal endoscopic surgery (NOTES), a recent development in the field of minimally invasive surgery,\\u000a may offer advantages over open and laparoscopic surgery. Most investigations to date have focused on small end-organ resections,\\u000a and none have described en bloc regional lymphadenectomy. This study aimed to describe a method of anal transcolonic sigmoid\\u000a colon resection.\\u000a \\u000a \\u000a \\u000a Methods  A fresh frozen then thawed

M. H. Whiteford; P. M. Denk; L. L. Swanström

2007-01-01

131

Colon cancer  

Microsoft Academic Search

Cancer of the colon is currently a leading cause of cancer-related death in the United States. Statistics indicate that mortality from cancer of the colon in males is second only to lung cancer; a similar situation exists among females for whom colonic cancer ranks second after cancer of the breast (Figure 1). Carcinoma of the colon has been characterized by

Edward Kassira; Linda Parent; George Vahouny

1976-01-01

132

More patients should undergo surgery after sigmoid volvulus  

PubMed Central

AIM: To assess the outcome of patients treated conservatively vs surgically during their first admission for sigmoid volvulus. METHODS: We conducted a retrospective study of 61 patients admitted to Aarhus University Hospital in Denmark between 1996 and 2011 for their first incidence of sigmoid volvulus. The condition was diagnosed by radiography, sigmoidoscopy or surgery. Patients treated with surgery underwent either a sigmoid resection or a percutaneous endoscopic colostomy (PEC). Conservatively treated patients were managed without surgery. Data was recorded into a Microsoft Access database and calculations were performed with Microsoft Excel. Kaplan-Meier plotting and Mantel-Cox (log-rank) testing were performed using GraphPad Prism software. Mortality was defined as death within 30 d after intervention or surgery. RESULTS: Among the total 61 patients, 4 underwent emergency surgery, 55 underwent endoscopy, 1 experienced resolution of the volvulus after contrast enema, and 1 died without treatment because of large bowel perforation. Following emergency treatment, 28 patients underwent sigmoid resection (semi-elective n = 18; elective n = 10). Two patients who were unfit for surgery underwent PEC and both died, 1 after 36 d and the other after 9 mo, respectively. The remaining 26 patients were managed conservatively without sigmoid resection. Patients treated conservatively on their first admission had a poorer survival rate than patients treated surgically on their first admission (95%CI: 3.67-14.37, P = 0.036). Sixty-three percent of the 26 conservatively treated patients had not experienced a recurrence 3 mo after treatment, but that number dropped to 24% 2 years after treatment. Eight of the 14 patients with recurrence after conservative treatment had surgery with no 30-d mortality. CONCLUSION: Surgically-treated sigmoid volvulus patients had a higher long-term survival rate than conservatively managed patients, indicating a benefit of surgical resection or PEC insertion if feasible.

Ifversen, Anne Kathrine Wewer; Kjaer, Daniel Willy

2014-01-01

133

Hinode/XRT Observations of a Coronal Sigmoid  

NASA Astrophysics Data System (ADS)

We present the first observations of an X-ray sigmoid made with the Hinode X-Ray Telescope, co-aligned with those of TRACE and SoHO/MDI. XRT's extraordinary angular resolution (1 arcsec/pixel) and the sigmoid's location near disk center combined to provide an unprecedented view of the formation and eruption of this phenomenon. XRT observed the sigmoid over several days, with cadences as high as 1 image per 10--30 seconds. The first motions associated with eruption of the sigmoid started at 0600UT on 12-Feb-2007; the first brightening of the ensuing X-ray arcade was seen at 0740UT. The images during the pre-eruptive phase, which ends with the onset of large-scale motions, show:

  • The overall S shape of the sigmoid is not defined by any single X-ray loop. Rather, many individual loops collectively comprise an S-shaped pattern.
  • The S shape is comprised of two separate J shapes, whose straight sections lie anti-parallel to one another in the middle of the S, on opposite sides of the magnetic polarity inversion line.
  • During the several-day span of the XRT observation, the S shape gradually becomes better defined.
The images during the eruptive phase show:
  • Approximately 100 minutes before any soft X-ray flaring begins, a diffuse linear structure, almost as long as the sigmoid, lifts off from the middle of the S. It shows slight clockwise rotation.
  • The X-ray flare begins with the appearance of a sheared arcade of short loops, in the area centered between the two J-shaped patterns of the sigmoid.
  • Within 16 hours of the start of the flare, no S shape remains.
Taken together, these features provide strong support for the Bald-Patch Separatrix Surface model of sigmoids put forth by Titov & Demoulin (1999).

McKenzie, David E.; Canfield, R. C.

2007-05-01

134

Hinode Observations of an Eruption from a Sigmoidal Active Region  

NASA Astrophysics Data System (ADS)

We analyse the evolution of a bipolar active region which produces an eruption during its decay phase. The soft X-ray arcade develops high shear over a time span of two days and transitions to sigmoidal shortly before the eruption. We propose that the continuous sigmoidal soft X-ray threads indicate that a flux rope has formed which is lying low in the solar atmosphere with a bald patch separatrix surface topology. The formation of the flux rope is driven by the photospheric evolution which is dominated by fragmentation of the main polarities, motion due to supergranular flows and cancellation at the polarity inversion line.

Green, L. M.; Wallace, A. J.; Kliem, B.

2012-08-01

135

Role of Damage Control Surgery in the Treatment of Hinchey III and IV Sigmoid Diverticulitis: A Tailored Strategy.  

PubMed

Many of the treatment strategies for sigmoid diverticulitis are actually focusing on nonoperative and minimally invasive approaches. The aim of this systematic review was to evaluate the actual role of damage control surgery (DCS) in the treatment of generalized peritonitis caused by perforated sigmoid diverticulitis.A literature search was performed in PubMed and Google Scholar for articles published from 1960 to July 2013. Comparative and noncomparative studies that included patients who underwent DCS for complicated diverticulitis were considered.Acute Physiology and Chronic Health Evaluation score, duration of open abdomen, intensive care unit length of stay, reoperation, bowel resection performed at first operation, fecal diversion, method, and timing of closure of abdominal wall were the main outcomes of interest.According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses algorithm for the literature search and review, 10 studies were included in this systematic review. DCS was exclusively performed in diverticulitis patients with septic shock or requiring vasopressors intraoperatively. Two surgical different approaches were highlighted: limited resection of the diseased colonic segment with or without stoma or reconstruction in situ, and laparoscopic washing and drainage without colonic resection.Despite the heterogeneity of patient groups, clinical settings, and interventions included in this review, DCS appears to be a promising strategy for the treatment of Hinchey III and IV diverticulitis, complicated by septic shock. A tailored approach to each patient seems to be appropriate. PMID:25437034

Cirocchi, Roberto; Arezzo, Alberto; Vettoretto, Nereo; Cavaliere, Davide; Farinella, Eriberto; Renzi, Claudio; Cannata, Gaspare; Desiderio, Jacopo; Farinacci, Federico; Barberini, Francesco; Trastulli, Stefano; Parisi, Amilcare; Fingerhut, Abe

2014-11-01

136

Recent advances in the management of distal ulcerative colitis  

PubMed Central

The most frequent localization of ulcerative colitis (UC) is the distal colon. In treating patients with active distal UC, efficacy and targeting of the drug to the distal colon are key priorities. Oral and rectal 5-aminosalicylic acid (5-ASA) preparations represent the first line therapy of mild-to-moderate distal UC for both induction and maintenance treatment. It has been reported that many UC patients are not adherent to therapy and that non-compliant patients had a 5-fold risk of experiencing a relapse. These findings led to the introduction of once-daily oral regimens of 5-ASA as better therapeutic options in clinical practice due to improved adherence. New formulations of mesalazine, including the multi-matrix delivery system, and mesalazine granules, which allow once-daily administration, have been developed. They have been demonstrated to be efficacious in inducing and maintaining remission in mild-to-moderate distal UC in large clinical trials. However, existing data for distal UC are rather insufficient to make a comparison between new and classical 5-ASA formulations. It seems that the new formulations are at least as effective as classical oral 5-ASA formulations. Other treatment options, in the case that 5-ASA therapy is not effective, include systemic corticosteroids, thiopurines (azathioprine or 6-mercaptopurine), cyclosporine, infliximab and surgery. The combination of a prompt diagnostic work-up, a correct therapeutic approach and an appropriate follow-up schedule is important in the management of patients with distal UC. This approach can shorten the duration of symptoms, induce a prolonged remission, improve patient’s quality of life, and optimize the use of health resources. PMID:21577295

Koutroubakis, Ioannis E

2010-01-01

137

Segmentation algorithm of colon based on multi-slice CT colonography  

NASA Astrophysics Data System (ADS)

CT colonography is a radiology test that looks at people's large intestines(colon). CT colonography can screen many options of colon cancer. This test is used to detect polyps or cancers of the colon. CT colonography is safe and reliable. It can be used if people are too sick to undergo other forms of colon cancer screening. In our research, we proposed a method for automatic segmentation of the colon from abdominal computed Tomography (CT) images. Our multistage detection method extracted colon and spited colon into different parts according to the colon anatomy information. We found that among the five segmented parts of the colon, sigmoid (20%) and rectum (50%) are more sensitive toward polyps and masses than the other three parts. Our research focused on detecting the colon by the individual diagnosis of sigmoid and rectum. We think it would make the rapid and easy diagnosis of colon in its earlier stage and help doctors for analysis of correct position of each part and detect the colon rectal cancer much easier.

Hu, Yizhong; Ahamed, Mohammed Shabbir; Takahashi, Eiji; Suzuki, Hidenobu; Kawata, Yoshiki; Niki, Noboru; Suzuki, Masahiro; Iinuma, Gen; Moriyama, Noriyuki

2012-02-01

138

Defining the role of subtotal colectomy in the treatment of carcinoma of the colon.  

PubMed Central

Seventy-two patients with colon cancer were treated by primary subtotal colectomy, including 23 patients with acute and subacute left colon obstruction. There were two operative deaths and no cases of disabling diarrhea. One death occurred in the group with colon obstruction. Other indications for subtotal colectomy included multiple polyps associated with the primary tumor (32), synchronous carcinomas (15), a previous transverse colostomy for obstruction (8), associated severe sigmoid diverticular disease (2), age less than 50 years with a positive family history (3), adherence of the sigmoid loop to a cecal tumor (2), and metachronous carcinoma (2). There were multiple indications in several patients. Subtotal colectomy has a defined role in a wide variety of clinical settings associated with colon cancer, including management of obstruction of the left and sigmoid colon, particularly if the proximal colon cannot be evaluated before operation by colonoscopy or barium enema. Segmental or regional colonic resections are appropriate if the entire colon can be evaluated before operation and no associated neoplasms are revealed. PMID:1998405

Brief, D K; Brener, B J; Goldenkranz, R; Alpert, J; Parsonnet, V; Ferrante, R; Huston, J; Eisenbud, D

1991-01-01

139

Hyperventilation, central autonomic control, and colonic tone in humans.  

PubMed Central

Symptoms attributable to hyperventilation are common among patients with the irritable bowel syndrome (IBS); indeed, some have suggested that hyperventilation may exacerbate the alimentary symptoms of IBS. Hyperventilation changes haemodynamic function through central and peripheral mechanisms; its effects on colonic motor function, however, are unknown. The aim of this study, therefore, was to assess the effects of hyperventilation on colonic tone and motility and on cardiovascular autonomic activity, and to discover if hypocapnia was critical to elicit the response. Phasic and tonic motility of the transverse and sigmoid colon, end tidal PCO2, pulse rate, and beat to beat pulse variability were assessed before, during, and after a five minute period of hypocapnic hyperventilation in 15 healthy volunteers; in seven other subjects, effects of both eucapnic and hypocapnic hyperventilation were evaluated. Hypocapnic but not eucapnic hyperventilation produced an increase in colonic tone and phasic contractility in the transverse and sigmoid regions and an increase in pulse rate and pulse interval variability. The findings are consistent with inhibition of sympathetic innervation to the colon or direct effects of hypocapnia on colonic smooth muscle, or both. These physiological gut responses suggest that some of the changes in colonic function are caused by altered brain or autonomic control mechanisms. PMID:7489935

Ford, M J; Camilleri, M J; Hanson, R B; Wiste, J A; Joyner, M J

1995-01-01

140

Morphometric study of the fibrosis and mast cell count in the circular colon musculature of chronic Chagas patients with and without megacolon.  

PubMed

A morphometric study of the circular colon musculature was performed, in which the mast cell count was determined and the connective fibrous tissue in this layer was measured. The objective was to gain better understanding of Chagas megacolon morphology and contribute towards the knowledge of fibrosis pathogenesis in Chagas megas. An evaluation was made of 15 distal sigmoid rings from Chagas patients with megacolon (MCC), 15 without megacolon (CSMC) and 15 non-Chagas patients (NC). The rings were fixed in formol, embedded in paraffin, and 7mm thick sections were cut and stained using Azan-Heidenhain and Giemsa. The mast cell count and fibrosis were greater in the MCC group than in the CSMC and NC groups (p< 0,05; Kruskal-Wallis test) and there was no significant difference between the latter two. The fibrosis and increased mast cell count in the colon musculature of the MCC group possibly indicates that there is a relationship between mastocytosis and fibrosis, as has already been demonstrated in other pathologies. PMID:12937722

Pinheiro, Simone Wanderley; Rua, Adilha Misson de Oliveira; Etchebehere, Renata Margarida; Cançado, Cristiane Gobbo; Chica, Javier Em lio Lazo; Lopes, Edison Reis; Adad, Sheila Jorge

2003-01-01

141

Distal femoral osteotomy.  

PubMed

Osteotomies around the knee are well-recognized treatments for unloading the affected compartment in cases of lower limb malalignment. There are few papers in the literature describing the outcomes of distal femoral osteotomy (DFO), as compared with the studies reporting on high tibial osteotomy (HTO), probably because valgus malalignment is less common than the varus one. There is still debate as to what the correct indication is and which surgical techniques lead to the best outcomes in performing a DFO. Besides, it is still controversial whether patellofemoral arthritis should be considered as a contraindication to performing a DFO, as well as in HTO. In this article, we will summarize the indications for DFO, the surgical techniques reported in the literature, and their outcomes. PMID:25142271

Rosso, Federica; Margheritini, Fabrizio

2014-12-01

142

Effect of chronic hypokalemia on H(+)-K(+)-ATPase expression in rat colon.  

PubMed

Although the kidney plays the major role in the regulation of systemic K+ homeostasis, the colon also participates substantively in K+ balance. The colon is capable of both K+ absorption and secretion, the magnitude of which can be modulated in response to dietary K+ intake. The H(+)-K(+)-adenosinetriphosphatase (H(+)-K(+)-ATPase) has been proposed as a possible mediator of K+ absorption in distal colon, but inhibitor profiles obtained in recent studies suggest that two, and perhaps more, distinct H(+)-K(+)-ATPase activities may be present in mammalian distal colon. We have developed highly specific probes for the catalytic alpha-subunits of colonic and gastric H(+)-K(+)-ATPase, alpha 1-Na(+)-K(+)-ATPase, and beta-actin, which were used in Northern analysis of total RNA from whole distal colon and stomach obtained from one of three experimental groups of rats: 1) controls, 2) chronic dietary K+ depletion, and 3) chronic metabolic acidosis. The probe for the colonic but not the gastric H(+)-K(+)-ATPase alpha-isoform hybridized to distal colon total RNA in all groups. A significant increase in colonic H(+)-K(+)-ATPase mRNA abundance was observed in response to chronic dietary K+ depletion but not to chronic metabolic acidosis. The alpha 1-isoform of Na(+)-K(+)-ATPase, which is also expressed in distal colon, did not respond consistently to either chronic dietary K+ depletion or chronic metabolic acidosis. The gastric probe did not hybridize to total RNA from distal colon but, as expected, hybridized to total stomach RNA. However, the abundance of gastric H(+)-K(+)-ATPase or Na(+)-K(+)-ATPase in stomach was not altered consistently by either chronic dietary K+ depletion or metabolic acidosis. Under the conditions of this study, it appears that the mRNA encoding the colonic alpha-isoform is upregulated by chronic dietary K+ restriction, a condition shown previously to increase K+ absorption in the distal colon. PMID:9039045

Codina, J; Pressley, T A; DuBose, T D

1997-01-01

143

Magnetohydrodynamic Simulation of a Sigmoid Eruption of Active Region 11283  

NASA Astrophysics Data System (ADS)

Current magnetohydrodynamic (MHD) simulations of the initiation of solar eruptions are still commonly carried out with idealized magnetic field models, whereas the realistic coronal field prior to eruptions can possibly be reconstructed from the observable photospheric field. Using a nonlinear force-free field extrapolation prior to a sigmoid eruption in AR 11283 as the initial condition in an MHD model, we successfully simulate the realistic initiation process of the eruption event, as is confirmed by a remarkable resemblance to the SDO/AIA observations. Analysis of the pre-eruption field reveals that the envelope flux of the sigmoidal core contains a coronal null and furthermore the flux rope is prone to a torus instability. Observations suggest that reconnection at the null cuts overlying tethers and likely triggers the torus instability of the flux rope, which results in the eruption. This kind of simulation demonstrates the capability of modeling the realistic solar eruptions to provide the initiation process.

Jiang, Chaowei; Feng, Xueshang; Wu, S. T.; Hu, Qiang

2013-07-01

144

MAGNETOHYDRODYNAMIC SIMULATION OF A SIGMOID ERUPTION OF ACTIVE REGION 11283  

SciTech Connect

Current magnetohydrodynamic (MHD) simulations of the initiation of solar eruptions are still commonly carried out with idealized magnetic field models, whereas the realistic coronal field prior to eruptions can possibly be reconstructed from the observable photospheric field. Using a nonlinear force-free field extrapolation prior to a sigmoid eruption in AR 11283 as the initial condition in an MHD model, we successfully simulate the realistic initiation process of the eruption event, as is confirmed by a remarkable resemblance to the SDO/AIA observations. Analysis of the pre-eruption field reveals that the envelope flux of the sigmoidal core contains a coronal null and furthermore the flux rope is prone to a torus instability. Observations suggest that reconnection at the null cuts overlying tethers and likely triggers the torus instability of the flux rope, which results in the eruption. This kind of simulation demonstrates the capability of modeling the realistic solar eruptions to provide the initiation process.

Jiang Chaowei; Feng Xueshang [SIGMA Weather Group, State Key Laboratory for Space Weather, Center for Space Science and Applied Research, Chinese Academy of Sciences, Beijing 100190 (China); Wu, S. T.; Hu Qiang, E-mail: cwjiang@spaceweather.ac.cn, E-mail: fengx@spaceweather.ac.cn, E-mail: wus@uah.edu, E-mail: qh0001@uah.edu [Center for Space Plasma and Aeronomic Research, The University of Alabama in Huntsville, Huntsville, AL 35899 (United States)

2013-07-10

145

Fiber type, meal frequency and colonic cytokinetics  

E-print Network

, pH, and cell proliferation throughout the large intestine; that effects of pH and concentrations of SCFAs on cell proliferation are found predominately in the cecum. Fecal bulking ability of the fibers may play a role in distal colonic cell...

Zhang, Jianhu

1993-01-01

146

Spontaneous Colon Perforations Associated with a Vascular Type of Ehlers-Danlos Syndrome  

PubMed Central

Ehlers-Danlos syndrome, vascular type (vEDS) (MIM #130050) is an autosomal dominant disorder caused by mutation in the type III collagen gene, COL3A1, leading to fragility of blood vessels, bowel and uterus that leads to spontaneous rupture. We report a previously undiagnosed vEDS patient with bowel complications. A 20-year-old female patient was referred to our hospital with abdominal pain. Computed tomography showed notable dilatation of the sigmoid colon with intraperitoneal fluid. Laparotomy revealed dilatation of the sigmoid colon, breakdown of serosa and muscularis propria of the sigmoid colon with impending perforation, and intra-abdominal hemorrhage caused by breakdown of the mesenterium. Resection of the sigmoid colon with Hartmann's pouch and an end colostomy were performed. Physical examination showed joint hypermobility, translucent skin with venous prominence and facial structure abnormalities. Genetic analysis using cDNA extracted from the patient's fibroblasts by reverse transcriptase polymerase chain reaction direct sequencing showed a missense mutation within the triple helix region of COL3A1 (c.2150 G>A; Gly717Asp). PMID:24932165

Yoneda, Akira; Okada, Kazuya; Okubo, Hitoshi; Matsuo, Mitsutoshi; Kishikawa, Hiroki; Naing, Banyar Than; Watanabe, Atsushi; Shimada, Takashi

2014-01-01

147

Distal ulna hook plate fixation for unstable distal ulna fracture associated with distal radius fracture.  

PubMed

The significance of distal ulna fractures is often undermined, which can result in inadequate treatment compared with fractures of the radius, the ulna's larger counterpart. However, little guidance exists in the current literature on how to manage distal ulna head or neck fractures and intra-articular ulna head fractures. Therefore, the purpose of this retrospective study was to evaluate the outcomes of distal ulna hook plate fixation for the treatment of an unstable distal ulna fracture associated with a distal radius fracture. Twenty-five patients with unstable distal ulna fractures who underwent stable fixation for an associated distal radius fracture were included in the study. All patients achieved satisfactory reduction and bony union. Average final motion was as follows: wrist flexion, 72° (range, 60°-85°); extension, 69° (range, 65°-80°); pronation, 77° (range, 55°-95°); supination, 82° (range, 65°-90°); ulnar deviation, 35° (range, 15°-50°); and radial deviation, 24° (range, 10°-40°). Average postoperative grip strength was 28 kg (range, 22-30 kg) and was 91% (range, 71%-100%) in the cases in which the dominant hand was injured and 80% (range, 65%-100%) in the cases in which the nondominant hand was injured. Average postoperative modified Mayo wrist score and Disabilities of the Arm, Shoulder and Hand score was 87 points (range, 65-100 points) and 14 points (range, 0-54 points), respectively. Chronic instability of the distal radioulnar joint was not encountered in any patient. Thus, the study demonstrated that distal ulna hook plate fixation for the treatment of unstable distal ulna fractures can achieve healing with good alignment, satisfactory function, and minimal transient morbidity. PMID:22955402

Lee, Sang Ki; Kim, Kap Jung; Park, Ju Sang; Choy, Won Sik

2012-09-01

148

Dynamic scanning defines a colonic defect in severe idiopathic constipation.  

PubMed

A technique is described in which a chemical stimulus applied to the mucosa of the right colon is used to assess colonic motor function. Peroral intubation of the right colon was achieved using a fine polyvinylchloride (PVC) tube. Bisacodyl was used to initiate colonic motor activity, and colonic transit was monitored using 99mTc-DPTA and a gamma camera. In normal subjects there was rapid movement of the radiopharmaceutical from the right colon to the rectum. In patients with severe idiopathic constipation, a spectrum of colonic abnormality was observed from slow transit involving the rectum and sigmoid only to slow transit involving the whole colon. The hepatic flexure to rectum transit time for the 'head of the isotope column' in normals ranged from 1-10 minutes (mean 5.3 minutes), whereas in patients the transit time was 14-25 minutes in four patients and radioisotope did not reach the rectum by two hours in three other patients (controls v patients, p less than 0.01). Patients also showed relatively impaired transport of the isotope 'mass'. This technique has shown that the normal colon is capable of rapid effective transport in response to a standard stimulus, and that patients with severe idiopathic constipation have a definable colonic motor disorder. PMID:3410334

Kamm, M A; Lennard-Jones, J E; Thompson, D G; Sobnack, R; Garvie, N W; Granowska, M

1988-08-01

149

Distal convoluted tubule.  

PubMed

The distal convoluted tubule (DCT) is a short nephron segment, interposed between the macula densa and collecting duct. Even though it is short, it plays a key role in regulating extracellular fluid volume and electrolyte homeostasis. DCT cells are rich in mitochondria, and possess the highest density of Na(+)/K(+)-ATPase along the nephron, where it is expressed on the highly amplified basolateral membranes. DCT cells are largely water impermeable, and reabsorb sodium and chloride across the apical membrane via electroneurtral pathways. Prominent among this is the thiazide-sensitive sodium chloride cotransporter, target of widely used diuretic drugs. These cells also play a key role in magnesium reabsorption, which occurs predominantly, via a transient receptor potential channel (TRPM6). Human genetic diseases in which DCT function is perturbed have provided critical insights into the physiological role of the DCT, and how transport is regulated. These include Familial Hyperkalemic Hypertension, the salt-wasting diseases Gitelman syndrome and EAST syndrome, and hereditary hypomagnesemias. The DCT is also established as an important target for the hormones angiotensin II and aldosterone; it also appears to respond to sympathetic-nerve stimulation and changes in plasma potassium. Here, we discuss what is currently known about DCT physiology. Early studies that determined transport rates of ions by the DCT are described, as are the channels and transporters expressed along the DCT with the advent of molecular cloning. Regulation of expression and activity of these channels and transporters is also described; particular emphasis is placed on the contribution of genetic forms of DCT dysregulation to our understanding. © 2015 American Physiological Society. Compr Physiol 5: 45-98, 2015. PMID:25589264

McCormick, James A; Ellison, David H

2015-01-01

150

Cathartic colon  

Microsoft Academic Search

Cathartic colon is not rare. Heilbrun reported 9 cases. We have seen 6 cases during the last 2 years. In 3 of these patients, a diagnosis of ulcerative colitis was made. Although a definite differential diagnosis from ulcerative colitis may be impossible on roentgen study, the changes described above should alert the radiologist to the possibility of cathartic colon. The

Richard H. Marshak; Arnold Gerson

1960-01-01

151

[Motility of the sigmoid in irritable bowel syndrome and colonic diverticulosis].  

PubMed

The results of pressure recording in patients with irritable bowel syndrome, diverticulosis and diverticulosis with pain were compared with the results in control subjects. The motility showed variable higher values in patients with irritable bowel syndrome. The motility was clearly higher in patients with diverticulosis and in patients with diverticulosis with pain. The patients with irritable bowel syndrome were younger than the patients in the two groups with diverticulosis. These findings are consistent with the hypothesis that the irritable bowel syndrome is an aetiologic factor in diverticulosis. PMID:2374631

Ritsema, G H; Thijn, C J; Smout, A J

1990-07-21

152

Atomic bomb survivors and the sigmoidal response model  

SciTech Connect

Epidemiological data on health effects of low-level radiation based on 40-yr followup studies of 75000 atomic bomb survivors and 35000 control people show that there were no measurable risks from low-level radiation in regard to noncancer diseases, genetic, teratogenic, and carcinogenic effects. However, seemingly sigmoidal responses of bomb radiation-induced cancers, which must have been caused by tumorigenic mutations contradict experimental results that mutations linearly increase with increase in radiation dose. An explanation is proposed for this superficial contradiction.

Kondo, S. [Kinki Univ. (Japan)

1994-12-31

153

Field Topology Analysis of a Long-lasting Coronal Sigmoid  

NASA Astrophysics Data System (ADS)

We present the first field topology analysis based on nonlinear force-free field (NLFFF) models of a long-lasting coronal sigmoid observed in 2007 February with the X-Ray Telescope on Hinode. The NLFFF models are built with the flux rope insertion method and give the three-dimensional coronal magnetic field as constrained by observed coronal loop structures and photospheric magnetograms. Based on these models, we have computed horizontal maps of the current and the squashing factor Q for 25 different heights in the corona for all six days of the evolution of the region. We use the squashing factor to quantify the degree of change of the field line linkage and to identify prominent quasi-separatrix layers (QSLs). We discuss the major properties of these QSL maps and devise a way to pick out important QSLs since our calculation cannot reach high values of Q. The complexity in the QSL maps reflects the high degree of fragmentation of the photospheric field. We find main QSLs and current concentrations that outline the flux rope cavity and that become characteristically S-shaped during the evolution of the sigmoid. We note that, although intermittent bald patches exist along the length of the sigmoid during its whole evolution, the flux rope remains stable for several days. However, shortly after the topology of the field exhibits hyperbolic flux tubes (HFT) on February 7 and February 12 the sigmoid loses equilibrium and produces two B-class flares and associated coronal mass ejections (CMEs). The location of the most elevated part of the HFT in our model coincides with the inferred locations of the two flares. Therefore, we suggest that the presence of an HFT in a coronal magnetic configuration may be an indication that the system is ready to erupt. We offer a scenario in which magnetic reconnection at the HFT drives the system toward the marginally stable state. Once this state is reached, loss of equilibrium occurs via the torus instability, producing a CME.

Savcheva, A. S.; van Ballegooijen, A. A.; DeLuca, E. E.

2012-01-01

154

Enzymatic Logic Gates with Noise-Reducing Sigmoid Response  

E-print Network

Biochemical computing is an emerging field of unconventional computing that attempts to process information with biomolecules and biological objects using digital logic. In this work we survey filtering in general, in biochemical computing, and summarize the experimental realization of an AND logic gate with sigmoid response in one of the inputs. The logic gate is realized with electrode-immobilized glucose-6-phosphate dehydrogenase enzyme that catalyzes a reaction corresponding to the Boolean AND functions. A kinetic model is also developed and used to evaluate the extent to which the performance of the experimentally realized logic gate is close to optimal.

Valber Pedrosa; Dmitriy Melnikov; Marcos Pita; Jan Halamek; Vladimir Privman; Aleksandr Simonian; Evgeny Katz

2009-12-23

155

Absence of transverse colon, persistent descending mesocolon, displaced small and large bowels: a rare congenital anomaly with a high risk of volvulus formation  

PubMed Central

Congenital anomalies such as positional anomalies of the right half of the colon are more common when compared to its left half. We report a rare case of congenital anomaly where the transverse colon was totally absent. Ascending colon continued as descending colon at the right colic flexure. Ascending and descending colons formed an inverted U shaped loop which was situated in the right half of the abdomen. The sigmoid colon began from the descending colon, on the right side of the midline and coursed to the left iliac fossa. The terminal part of ascending colon and entire descending colon had a persistent mesocolon. The jejunum and ileum were situated in the upper left part of the abdominal cavity. This anomaly can cause volvulus of the colon at any stage of life. Furthermore, the knowledge of this anomaly is very useful for radiologists, gastroenterologists and surgeons.

Shetty, Prakashchandra

2014-01-01

156

Pneumomediastinum caused by colonic diverticulitis perforation  

PubMed Central

A 59-year-old man presented with abdominal and left flank pain. The symptom had started 30 days before as an acute nephrolithiasis, which had worsened despite conservative management. The abdomen was slightly distended and tender over the lower abdomen, without signs of generalized peritoneal irritation. A computed tomography (CT) scan showed an abscess in left para-renal space up to the subphrenic space and an unexpected pneumomediastinum. An emergency operation was performed, which showed retroperitoneal diverticulitis perforation of the sigmoid descending junction with abscess formation. A segmental resection of the diseased colon and end-colostomy was performed (Hartmann's procedure). However, the patient's condition progressively deteriorated, and he died of sepsis and multi-organ failure on the 5th postoperative day. Although pneumomediastinum caused by colonic diverticulitis perforation is extremely rare, it could be a life-threatening condition in patients without signs of peritonitis because of delayed diagnosis. PMID:22066076

2011-01-01

157

Colon Adenocarcinoma  

MedlinePLUS

... or the surgeon creates a temporary or permanent colostomy (an opening in the abdomen where stool passes ... percent of colon cancer patients require a permanent colostomy. Surgery is performed either through a large abdominal ...

158

Plasma Composition in a Sigmoidal Anemone Active Region  

NASA Astrophysics Data System (ADS)

Using spectra obtained by the EUV Imaging Spectrometer (EIS) instrument onboard Hinode, we present a detailed spatially resolved abundance map of an active region (AR)-coronal hole (CH) complex that covers an area of 359'' × 485''. The abundance map provides first ionization potential (FIP) bias levels in various coronal structures within the large EIS field of view. Overall, FIP bias in the small, relatively young AR is 2-3. This modest FIP bias is a consequence of the age of the AR, its weak heating, and its partial reconnection with the surrounding CH. Plasma with a coronal composition is concentrated at AR loop footpoints, close to where fractionation is believed to take place in the chromosphere. In the AR, we found a moderate positive correlation of FIP bias with nonthermal velocity and magnetic flux density, both of which are also strongest at the AR loop footpoints. Pathways of slightly enhanced FIP bias are traced along some of the loops connecting opposite polarities within the AR. We interpret the traces of enhanced FIP bias along these loops to be the beginning of fractionated plasma mixing in the loops. Low FIP bias in a sigmoidal channel above the AR's main polarity inversion line, where ongoing flux cancellation is taking place, provides new evidence of a bald patch magnetic topology of a sigmoid/flux rope configuration.

Baker, D.; Brooks, D. H.; Démoulin, P.; van Driel-Gesztelyi, L.; Green, L. M.; Steed, K.; Carlyle, J.

2013-11-01

159

Cathartic colon  

Microsoft Academic Search

Cathartic colon is an infrequent and severe manifestation of chronic irritant laxative abuse. Little is known of its natural\\u000a history after cathartics are stopped. Previous reported cases have shown residual roentgen abnormalities on follow-up examinations.\\u000a A case is presented of cathartic colon caused by more than 70 years of laxative abuse that demonstrated complete reversal\\u000a of the roentgen changes four

William L. Campbell

1983-01-01

160

Nutrients and Risk of Colon Cancer  

PubMed Central

Dietary fats are thought to be important in the etiology of colon cancer. However, the evidence linking them is inconclusive. Studies on dietary protein, cholesterol and carbohydrate and the risk of colon cancer are also inconsistent. This study examined the association between dietary intake of protein, fats, cholesterol and carbohydrates, and the risk of colon cancer. Mailed questionnaires were completed by 1731 individuals with histologically confirmed cases of colon cancer and 3097 population controls between 1994 and 1997 in seven Canadian provinces. Measurements included socio-economic status, lifestyle habits and diet. A 69-item food frequency questionnaire was used to provide data on eating habits from two years before the study. Odds ratios (OR) and 95% confidence intervals (CI) were computed using unconditional logistic regression. The nutrients were categorized by quartiles based on the distributions among the controls. Intake of polyunsaturated fat, trans-fat and cholesterol were significantly associated with the risk of colon cancer; the ORs for the highest quartiles were 1.36 (95% CI, 1.02–1.80), 1.37 (95% CI, 1.10–1.71) and 1.42 (95% CI, 1.10–1.84), respectively. The association was stronger with proximal colon cancer (PCC). An increased risk was also observed with increasing intake of sucrose for both proximal and distal colon cancers; the ORs for the highest quartiles were 1.67 (95% CI, 1.22–2.29) for PCC and 1.58 (95% CI, 1.18–2.10) for distal colon cancer (DCC). An elevated risk of PCC was also found with increased lactose intake. Our findings provide evidence that a diet low in fat and sucrose could reduce the risk of various colon cancers. PMID:24281033

Hu, Jinfu; La Vecchia, Carlo; Negri, Eva; Mery, Les

2010-01-01

161

Locally recurrent penile apocrine carcinoma initially diagnosed as metastatic adenocarcinoma of colon  

PubMed Central

Apocrine carcinoma is a rare malignant adnexal neoplasm. The differential diagnosis between apocrine carcinoma and cutaneous metastasis is often difficult. Here, we report a case of locally recurrent penile apocrine carcinoma initially diagnosed as metastatic adenocarcinoma of the colon. A 75-year-old man with a history of surgical resection due to sigmoid colon cancer and penile metastasis two years prior to this study presented with a nodule at the left penile base. He underwent a wide local resection of the penile mass under a suggested preoperative diagnosis of extra-mammary Paget’s disease (EMPD) associated with previous sigmoid colon cancer. However, the previously and currently resected penile masses were identified as primary apocrine carcinoma upon hematoxylin and eosin (H&E) staining and immunohistochemical staining. Although the incidence is extremely rare, both clinicians and pathologists should be alert to the possibility of synchronous double primary apocrine carcinoma in cancer patients with malignant cutaneous lesions. PMID:24385708

Lee, Ok-Jun; Yun, Seok-Joong; Kim, Wun-Jae; Choi, Song-Yi; Lee, Ho-Chang; Song, Hyung-Geun; Lim, Sung-Nam; Lee, Ki-Hyeong; Kim, Seung-Taik

2013-01-01

162

Colonic spirochetosis is associated with colonic eosinophilia and irritable bowel syndrome in a general population in Sweden.  

PubMed

Irritable bowel syndrome (IBS) is a functional disorder defined by symptoms in the absence of overt pathology. Colonic spirochetosis (CS), defined by histologic observation of spirochetal strains of Brachyspira in colonic biopsies, is uncommon and considered of doubtful significance. We aimed to determine the prevalence of CS in the general population, identify subtle colon pathologies, and evaluate a link with symptoms of IBS. Colonoscopy was performed in 745 subjects (aged 19-70 years, mean age 51 years, 43% male) with biopsies (ileum and 4 colonic sites) from a random population sample, Stockholm, Sweden, who completed a validated questionnaire of gastrointestinal symptoms; IBS was identified by Rome III criteria. CS was identified by histology and immunohistochemistry. In a general population, 17 individuals (2.28%; 95% confidence interval, 1.2%-3.5%) were diagnosed as having CS by histology; 6 (35%) had IBS. CS was always present in the sigmoid colon, but only 14 rectal biopsies. Eosinophils were increased in colon biopsies in CS cases versus controls, in the transverse (P = .02), sigmoid colon (P = .001), and rectum (P = .0005) with subepithelial eosinophil clusters (P = .053). Lymphoid follicles (at any site) were present in 13 CS (P = .0003). There was a 3-fold increased risk of IBS in CS (odds ratio, 3.59; 95% confidence interval, 1.27-10.11; P = .015). Polyps and diverticular disease were similar in CS cases and controls. The prevalence of CS in a general population is 2% and associated with nonconstipating IBS. Colonic eosinophilia with lymphoid follicles may signify the presence of CS. PMID:25540866

Walker, Marjorie M; Talley, Nicholas J; Inganäs, Linn; Engstrand, Lars; Jones, Michael P; Nyhlin, Henry; Agréus, Lars; Kjellstrom, Lars; Öst, Åke; Andreasson, Anna

2015-02-01

163

Traumatic distal ulnar artery thrombosis.  

PubMed

This paper is about a posttraumatic distal ulnar artery thrombosis case that has occurred after a single blunt trauma. The ulnar artery thrombosis because of chronic trauma is a frequent condition (hypothenar hammer syndrome) but an ulnar artery thrombosis because of a single direct blunt trauma is rare. Our patient who has been affected by a single blunt trauma to his hand and developed ulnar artery thrombosis has been treated by resection of the thrombosed ulnar artery segment. This report shows that a single blunt trauma can cause distal ulnar artery thrombosis in the hand and it can be treated merely by thrombosed segment resection in suitable cases. PMID:25276455

Karaarslan, Ahmet A; Karaka?l?, Ahmet; Mayda, Aslan; Karc?, Tolga; Aycan, Hakan; Kobak, Senol

2014-01-01

164

Traumatic Distal Ulnar Artery Thrombosis  

PubMed Central

This paper is about a posttraumatic distal ulnar artery thrombosis case that has occurred after a single blunt trauma. The ulnar artery thrombosis because of chronic trauma is a frequent condition (hypothenar hammer syndrome) but an ulnar artery thrombosis because of a single direct blunt trauma is rare. Our patient who has been affected by a single blunt trauma to his hand and developed ulnar artery thrombosis has been treated by resection of the thrombosed ulnar artery segment. This report shows that a single blunt trauma can cause distal ulnar artery thrombosis in the hand and it can be treated merely by thrombosed segment resection in suitable cases. PMID:25276455

Karaarslan, Ahmet A.; Karaka?l?, Ahmet; Mayda, Aslan; Karc?, Tolga; Aycan, Hakan; Kobak, ?enol

2014-01-01

165

Preliminary Experience with a New Total Distal Radioulnar Joint Replacement  

PubMed Central

This study reports the intermediate-term results of four patients from a series eight patients who have had an insertion of a new complete distal radioulnar joint (DRUJ) prosthesis. A retrospective review was performed for all patients who underwent DRUJ joint replacement with the STABILITY Sigmoid Notch Total DRUJ System between the years of 2003 and 2008. To be included in this report, all patients had to have more than 24 months of follow-up and hand examination by the senior author. From the eight patients with this procedure, four patients met the inclusion criteria. These included one patient with painful posttraumatic arthritis, two patients with failed hemiarthroplasty, and one patient with a failed Sauvé–Kapandji procedure. Mean age at the time of surgery was 42.5 years (range: 35 to 51 years) and mean follow-up was 46 months (range: 36 to 66 months). Preoperative and postoperative assessment included range of motion, grip strength, visual analog pain scale, patient satisfaction, and radiographic evaluation. There was a successful replacement of the DRUJ in all four patients. Final range of motion showed mean pronation of 80 degrees (range: 60 to 90 degrees) and mean supination of 64 degrees (range: 45 to 90 degrees). Final grip strength on the operated extremity was 25.5?kg and averaged 73% of contralateral side. This was an improvement from preoperative grip strength of 14.5?kg visual analog pain scale decreased from 8 to 2.5 following surgery (scale: 1 to 10). Patient satisfaction was 100%. One patient returned to manual labor, one patient returned to office work, and two patients remained off work. Postoperative radiographs depict appropriate alignment of the DRUJ, and there have been no cases of subluxation or dislocation. Implant survival has been 100%. Total DRUJ joint replacement with sigmoid notch resurfacing and distal ulna replacement is an alternative to ulnar head resection in cases of DRUJ arthritis. Total DRUJ arthroplasty with this resurfacing design may provide a means of decreasing pain and restoring DRUJ stability and motion following severe trauma, failed hemiarthroplasty, or failed Sauvé–Kapandji procedure. More experience is needed with this implant to confirm these initial encouraging results. The level of evidence for this study is IV (therapeutic, case series). PMID:23904976

Ewald, Timothy J.; Skeete, Kshamata; Moran, Steven L.

2012-01-01

166

An observational study addressing the anatomic basis of mesosigmoidopexy as a rational treatment of non-gangrenous sigmoid volvulus.  

PubMed

Sigmoid volvulus is a common cause of bowel obstruction. We describe mesosigmoidopexy, an accepted surgical technique for the management of non-gangrenous sigmoid volvulus, and provide anatomic correlations supporting the therapy. Mesosigmoidopexy should be considered as a rational alternative to resection and anastomosis when operating on non-gangrenous sigmoid volvulus. PMID:22184737

Samuel, Jonathan C; Msiska, Nelson; Muyco, Arturo P; Cairns, Bruce A; Charles, Anthony G

2012-01-01

167

Epigenomic enhancer profiling defines a signature of colon cancer.  

PubMed

Cancer is characterized by gene expression aberrations. Studies have largely focused on coding sequences and promoters, even though distal regulatory elements play a central role in controlling transcription patterns. We used the histone mark H3K4me1 to analyze gain and loss of enhancer activity genome-wide in primary colon cancer lines relative to normal colon crypts. We identified thousands of variant enhancer loci (VELs) that comprise a signature that is robustly predictive of the in vivo colon cancer transcriptome. Furthermore, VELs are enriched in haplotype blocks containing colon cancer genetic risk variants, implicating these genomic regions in colon cancer pathogenesis. We propose that reproducible changes in the epigenome at enhancer elements drive a specific transcriptional program to promote colon carcinogenesis. PMID:22499810

Akhtar-Zaidi, Batool; Cowper-Sal-lari, Richard; Corradin, Olivia; Saiakhova, Alina; Bartels, Cynthia F; Balasubramanian, Dheepa; Myeroff, Lois; Lutterbaugh, James; Jarrar, Awad; Kalady, Matthew F; Willis, Joseph; Moore, Jason H; Tesar, Paul J; Laframboise, Thomas; Markowitz, Sanford; Lupien, Mathieu; Scacheri, Peter C

2012-05-11

168

Distal esophageal spasm: an update.  

PubMed

Distal esophageal spasm (DES) is an esophageal motility disorder that presents clinically with chest pain and/or dysphagia and is defined manometrically as simultaneous contractions in the distal (smooth muscle) esophagus in ?20% of wet swallows (and amplitude contraction of ?30 mmHg) alternating with normal peristalsis. With the introduction of high resolution esophageal pressure topography (EPT) in 2000, the definition of DES was modified. The Chicago classification proposed that the defining criteria for DES using EPT should be the presence of at least two premature contractions (distal latency<4.5 s) in a context of normal EGJ relaxation. The etiology of DES remains insufficiently understood, but evidence links nitric oxide (NO) deficiency as a culprit resulting in a disordered neural inhibition. GERD frequently coexists in DES, and its role in the pathogenesis of symptoms needs further evaluation. There is some evidence from small series that DES can progress to achalasia. Treatment remains challenging due in part to lack of randomized placebo-controlled trials. Current treatment agents include nitrates (both short and long acting), calcium-channel blockers, anticholinergic agents, 5-phosphodiesterase inhibitors, visceral analgesics (tricyclic agents or SSRI), and esophageal dilation. Acid suppression therapy is frequently used, but clinical outcome trials to support this approach are not available. Injection of botulinum toxin in the distal esophagus may be effective, but further data regarding the development of post-injection gastroesophageal reflux need to be assessed. Heller myotomy combined with fundoplication remains an alternative for the rare refractory patient. Preliminary studies suggest that the newly developed endoscopic technique of per oral endoscopic myotomy (POEM) may also be an alternative treatment modality. PMID:23892829

Achem, Sami R; Gerson, Lauren B

2013-09-01

169

Regional Mucosa-Associated Microbiota Determine Physiological Expression of TLR2 and TLR4 in Murine Colon  

PubMed Central

Many colonic mucosal genes that are highly regulated by microbial signals are differentially expressed along the rostral-caudal axis. This would suggest that differences in regional microbiota exist, particularly mucosa-associated microbes that are less likely to be transient. We therefore explored this possibility by examining the bacterial populations associated with the normal proximal and distal colonic mucosa in context of host Toll-like receptors (TLR) expression in C57BL/6J mice housed in specific pathogen-free (SPF) and germ-free (GF) environments. 16S rRNA gene-based terminal restriction fragment length polymorphism (T-RFLP) and clone library analysis revealed significant differences in the community structure and diversity of the mucosa-associated microbiota located in the distal colon compared to proximal colon and stool, the latter two clustering closely. Differential expression of colonic TLR2 and TLR4 along the proximal-distal axis was also found in SPF mice, but not in GF mice, suggesting that enteric microbes are essential in maintaining the regional expression of these TLRs. TLR2 is more highly expressed in proximal colon and decreases in a gradient to distal while TLR4 expression is highest in distal colon and a gradient of decreased expression to proximal colon is observed. After transfaunation in GF mice, both regional colonization of mucosa-associated microbes and expression of TLRs in the mouse colon were reestablished. In addition, exposure of the distal colon to cecal (proximal) microbiota induced TLR2 expression. These results demonstrate that regional colonic mucosa-associated microbiota determine the region-specific expression of TLR2 and TLR4. Conversely, region-specific host assembly rules are essential in determining the structure and function of mucosa-associated microbial populations. We believe this type of host-microbial mutualism is pivotal to the maintenance of intestinal and immune homeostasis. PMID:21042588

Wang, Yunwei; Devkota, Suzanne; Musch, Mark W.; Jabri, Bana; Nagler, Cathryn; Antonopoulos, Dionysios A.; Chervonsky, Alexander; Chang, Eugene B.

2010-01-01

170

Anorectal manometric abnormalities and colonic propulsive impairment in patients with severe chronic idiopathic constipation  

Microsoft Academic Search

Idiopathic chronic constipation is a frequent and disabling symptom, but its pathophysiological grounds are still poorly understood. In particular, there is little knowledge about the relationships between distal (anorectal area) and proximal (colonic area) motor abnormalities in this condition, especially concerning high-amplitude propagated colonic activity. For this purpose, we studied 25 patients complaining of severe idiopathic constipation and categorized them

Gabrio Bassotti; Giuseppe Chiarioni; Italo Vantini; Cesare Betti; Carla Fusaro; Maria Antonietta Pelli; Antonio Morelli

1994-01-01

171

Coincidental Colonization  

NSDL National Science Digital Library

In this game of chance, learners will discover how organisms colonized the Galápagos Islands, experiencing how chance plays a role in the successful dispersal of species to new areas. Each learner will be assigned an animal along with information about its special characteristics and what chance events they will need to colonize the island. The educator will randomly select popsicle sticks that each have one chance event written on it to simulate the unpredictability of nature and the needs of the new environment. If the popsicle stick event matches the next box on the learner's card, the learner's animal is one step closer to mirgating to the Galápagos Islands. This lesson plan includes educator resources, wrap-up suggestions, extension ideas, and is standards-based.

2011-08-25

172

Left-sided sacrospinous ligament suspension for treating recurrent sigmoid neovagina prolapse.  

PubMed

Numerous techniques for surgical creation of a neovagina have been described for treating Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. Sigmoid vaginoplasty is one well-described technique with satisfactory long-term outcomes. However, there are several case reports of subsequent prolapse of the sigmoid neovagina, which presents a unique challenge for surgical repair, as the associated mesentery can also be involved and is at risk during repair. We present a patient with MRKH syndrome and recurrent sigmoid neovagina prolapse who had undergone four prior attempts at repair. In all prior attempts, recurrence of her prolapse occurred within 3 months of the antecedent surgery. We describe the first report and successful long-term treatment of recurrent sigmoid neovagina prolapse using a left-sided sacrospinous ligament suspension. PMID:24832857

Swenson, Carolyn W; DeLancey, John O; Schimpf, Megan O

2014-11-01

173

In vivo imaging reveals sigmoidal growth kinetic of ?-amyloid plaques  

PubMed Central

A major neuropathological hallmark of Alzheimer’s disease is the deposition of amyloid plaques in the brains of affected individuals. Amyloid plaques mainly consist of fibrillar ?-amyloid, which is a cleavage product of the amyloid precursor protein. The amyloid-cascade-hypothesis postulates A? accumulation as the central event in initiating a toxic cascade leading to Alzheimer’s disease pathology and, ultimately, loss of cognitive function. We studied the kinetics of ?-amyloid deposition in Tg2576 mice, which overexpress human amyloid precursor protein with the Swedish mutation. Utilizing long-term two-photon imaging we were able to observe the entire kinetics of plaque growth in vivo. Essentially, we observed that plaque growth follows a sigmoid-shaped curve comprising a cubic growth phase, followed by saturation. In contrast, plaque density kinetics exhibited an asymptotic progression. Taking into account the fact that a critical concentration of A? is required to seed new plaques, we can propose the following kinetic model of ?-amyloid deposition in vivo. In the early cubic phase, plaque growth is not limited by A? concentration and plaque density increases very fast. During the transition phase, plaque density stabilizes whereas plaque volume increases strongly reflecting a robust growth of the plaques. In the late asymptotic phase, A? peptide production becomes rate-limiting for plaque growth. In conclusion, the present study offers a direct link between in vitro and in vivo studies facilitating the translation of A?-lowering strategies from laboratory models to patients. PMID:24678659

2014-01-01

174

On the Structure and Evolution of Complexity in Sigmoids: A Flux Emergence Model  

NASA Astrophysics Data System (ADS)

Sigmoids are structures with a forward or inverse S-shape, generally observed in the solar corona in soft X-ray emission. It is believed that the appearance of a sigmoid in an active region is an important factor in eruptive activity. The association of sigmoids with dynamic phenomena such as flares and coronal mass ejections (CMEs) make the study of sigmoids important. Recent observations of a coronal sigmoid, obtained with the X-Ray Telescope (XRT) on board Hinode, showed the formation and eruption phase with high spatial resolution. These observations revealed that the topological structure of the sigmoid is complex: it consists of many differently oriented loops that all together form two opposite J-like bundles or an overall S-shaped structure. A series of theoretical and numerical models have been proposed, over the past years, to explain the nature of sigmoids but there is no explanation on how the aforementioned complexity in sigmoids is built up. In this paper, we present a flux emergence model that leads to the formation of a sigmoid, whose structure and evolution of complexity are in good qualitative agreement with the recent observations. For the initial state of the experiment a twisted flux tube is placed below the photosphere. A density deficit along the axis of the tube makes the system buoyant in the middle and it adopts an ?-shape as it rises toward the outer atmosphere. During the evolution of the system, expanding field lines that touch the photosphere at bald-patches (BPs) form two seperatrix surfaces where dissipation is enhanced and current sheets are formed. Originally, each of the BP seperatrix surfaces has a J-like shape. Each one of the J's consist of reconnected field lines with different shapes and different relative orientation. The further dynamical evolution of the emerging flux tube results in the occurrence of many sites that resemble rotational discontinuities. Thus, additional current layers are formed inside the rising magnetized volume increasing the complexity of the system. The reconnected field lines along these layers form an overall S-shaped structure. The reconnection process continues to occur leading to the formation of another current concentration in the middle of the sigmoid where a flaring episode occurs. This central brightening is accompanied by the eruption of a flux rope from the central area of the sigmoid and the appearance of "post-flare" loops underneath the current structure.

Archontis, V.; Hood, A. W.; Savcheva, A.; Golub, L.; Deluca, E.

2009-02-01

175

Colonic perforation by a large gallstone: A rare case report  

PubMed Central

INTRODUCTION Herein we present the case of an 86-year-old woman with gallstone perforation of the sigmoid colon. PRESENTATION OF CASE An 86-year-old woman with known cholelithiasis presented to our office with one week of abdominal pain and nausea. X-rays taken at presentation demonstrated pneumobilia, and CT scan showed a 3.5 cm gallstone in the sigmoid colon. Medical management was unsuccessful in passing the stone, and a colonoscopy on day 4 was unsuccessful in incorporating the stone. Subsequent clinical deterioration prompted a laparotomy, where a perforation was discovered. A Hartmann's procedure was performed and the patient recovered after a complicated post-operative course. DISCUSSION Gallstone ileus is an uncommon, but medically important, cause of bowel obstruction. This presentation is considered a surgical emergency and thus prompt identification and removal is essential. Obstructions tend to occur in either the stomach or along the various segments of the small intestine but have been reported in the colon as well. CONCLUSION In cases of gallstones that manage to pass into the large intestine, it is prudent to attempt conservative measures for passage. Failure to do so should raise suspicion of a possible stricture, either benign or malignant, preventing its evacuation. Earlier surgical intervention should be considered in these cases. PMID:25498567

Halleran, Devin R.; Halleran, David R.

2014-01-01

176

Application of Quasi-Separatrix Layer Maps to Understanding the Structure and Evolution of Sigmoids  

NASA Astrophysics Data System (ADS)

We present some preliminary work in attempt to utilize Quasi-Separatrix Layer (QSL) maps for understanding the structure and evolution of sigmoids. We show sample QSL maps calculated at different heights above the photosphere and different times over the evolution of the quiescent sigmoid from February, 2007, observed with Hinode/XRT. The QSL maps use already existing static MHD models of the sigmoid, based on the flux rope insertion method. We give a short overview of the method used to set-up these maps. By comparing current distributions and the squashing factors at different height and cross sections over the sigmoid location we suggest the use of QSLs as tracers of surface and/or volumetric currents. We look at the distribution, structure, and concentration of QSLs in combination with the size and location of bald patches at different stages of the sigmoid development. We attempt to use this analysis to help us discriminate between the main scenarios for the formation and X-ray appearance of the S-like structure - flux emergence (or cancellation) and twisting foot point motions. This method may possibly shed some light on the pre-eruption configuration and eruption mechanism in sigmoids as well.

Savcheva, Antonia; DeLuca, E.; Van Ballegooijen, A.

2010-05-01

177

Associations of Red Meat, Fat, and Protein Intake With Distal Colorectal Cancer Risk  

PubMed Central

Studies have suggested that red and processed meat consumption elevate the risk of colon cancer; however, the relationship between red meat, as well as fat and protein, and distal colorectal cancer (CRC) specifically is not clear. We determined the risk of distal CRC associated with red and processed meat, fat, and protein intakes in Whites and African Americans. There were 945 cases (720 White, 225 African American) of distal CRC and 959 controls (800 White, 159 African American). We assessed dietary intake in the previous 12 mo. Multivariate logistic regression analyses were used to obtain odds ratios (OR) and 95% confidence intervals (95% CI). There was no association between total, saturated, or monounsaturated fat and distal CRC risk. In African Americans, the OR of distal CRC for the highest category of polyunsaturated fat intake was 0.28 (95% CI = 0.08–0.96). The percent of energy from protein was associated with a 47% risk reduction in Whites (Q4 OR = 0.53, 95% CI = 0.37–0.77). Red meat consumption in Whites was associated with a marginally significant risk reduction (Q4 OR = 0.66, 95% CI = 0.43–1.00). Our results do not support the hypotheses that fat, protein, and red meat increase the risk of distal CRC. PMID:20661817

Williams, Christina Dawn; Satia, Jessie A.; Adair, Linda S.; Stevens, June; Galanko, Joseph; Keku, Temitope O.; Sandler, Robert S.

2011-01-01

178

Colonic gallstone ileus: the rolling stones.  

PubMed

Gallstone ileus is a rare complication of cholelithiasis accounting for 1-4% of cases of intestinal obstruction with a predominance in the elderly population. Unfortunately, it has an insipid presentation and is associated with significant rates of morbidity and mortality. Controversy arises over the management of gallstone ileus, and while surgery remains the mainstay of treatment, the main point of contention surrounds the extent of surgery. We describe the case of an 85-year-old woman who presented with symptoms and signs of large bowel obstruction. Radiological evaluation revealed a 5?cm×3.5?cm gallstone impacted in the sigmoid colon. A laparoscopic-assisted enterolithotomy alone relieved the obstruction with minimal surgical insult and allowed for a swift and uneventful recovery. Our case emphasises the need for a high index of suspicion for the condition as well as highlighting the advantages of the use of laparoscopic surgery in an emergency setting. PMID:25323275

Heaney, Roisin Mary

2014-01-01

179

Sigmoidal equilibria and eruptive instabilities in laboratory magnetic flux ropes  

NASA Astrophysics Data System (ADS)

The Magnetic Reconnection Experiment (MRX) has recently been modified to study quasi-statically driven line-tied magnetic flux ropes in the context of storage-and-release eruptions in the corona. Detailed in situ magnetic measurements and supporting MHD simulations permit quantitative analysis of the plasma behavior. We find that the behavior of these flux ropes depends strongly on the properties of the applied potential magnetic field arcade. For example, when the arcade is aligned parallel to the flux rope footpoints, force free currents induced in the expanding rope modify the pressure and tension in the arcade, resulting in a confined, quiescent discharge with a saturated kink instability. When the arcade is obliquely aligned to the footpoints, on the other hand, a highly sigmoidal equilibrium forms that can dynamically erupt (see Fig. 1 and Fig. 2). To our knowledge, these storage-and-release eruptions are the first of their kind to be produced in the laboratory. A new 2D magnetic probe array is used to map out the internal structure of the flux ropes during both the storage and the release phases of the discharge. The kink instability and the torus instability are studied as candidate eruptive mechanisms--the latter by varying the vertical gradient of the potential field arcade. We also investigate magnetic reconnection events that accompany the eruptions. The long-term objective of this work is to use internal magnetic measurements of the flux rope structure to better understand the evolution and eruption of comparable structures in the corona. This research is supported by DoE Contract Number DE-AC02-09CH11466 and by the Center for Magnetic Self-Organization (CMSO). Qualitative sketches of flux ropes formed in (1) a parallel potential field arcade; and (2) an oblique potential field arcade. One-dimensional magnetic measurements from (1) a parallel arcade discharge that is confined; and (2) an oblique arcade discharge that erupts.

Myers, C. E.; Yamada, M.; Belova, E.; Ji, H.; Yoo, J.

2013-12-01

180

The beauty of stability: distal radioulnar joint stability in arthroscopic triangular fibrocartilage complex repair.  

PubMed

The triangular fibrocartilage complex (TFCC) has an important role in the stability of the distal radioulnar joint (DRUJ) stability. We designed a new method of TFCC tear repair that has satisfactory post-operative DRUJ stability. From May 2004 to August 2010, 14 patients who underwent this operation were reviewed. The average post-operative follow-up period was 8.2 months; 66.7% of the patients with TFCC tear in sigmoid notch had clinical DRUJ instability, while only 50% of tear in fovea and 16.7% of tear in base of ulnar styloid had clinical DRUJ instability. Transosseous suture via inside-outside technique was used for repair. At the final follow-up, all 14 patients have soft end point with < 5 mm translations of the DRUJ shown by the stress test. Based on this small sample with satisfactory outcome assessed by the Mayo modified wrist score and DRUJ stability, we recommend TFCC tear in sigmoid notch, which has a higher chance of DRUJ instability, to be repaired by transosseous suture. PMID:23413845

Tang, Chris; Fung, Boris; Chan, Rebecca; Fok, Margaret

2013-01-01

181

Alterations of Colonic Contractility in an Interleukin-10 Knockout Mouse Model of Inflammatory Bowel Disease  

PubMed Central

Background/Aims Inflammatory bowel disease is commonly accompanied by colonic dysmotility and causes changes in intestinal smooth muscle contractility. In this study, colonic smooth muscle contractility in a chronic inflammatory condition was investigated using smooth muscle tissues prepared from interleukin-10 knockout (IL-10?/?) mice. Methods Prepared smooth muscle sections were placed in an organ bath system. Cholinergic and nitrergic neuronal responses were observed using carbachol and electrical field stimulation with L-NG-nitroarginine methyl ester (L-NAME). The expression of interstitial cells of Cajal (ICC) networks, muscarinic receptors, neuronal nitric oxide synthase (nNOS) and inducible nitric oxide synthase (iNOS) was observed via immunofluorescent staining. Results The spontaneous contractility and expression of ICC networks in the proximal and distal colon was significantly decreased in IL-10?/? mice compared to IL-10+/+ mice. The contractility in response to carbachol was significantly decreased in the proximal colon of IL-10?/? mice compared to IL-10+/+ mice, but no significant difference was found in the distal colon. In addition, the expression of muscarinic receptor type 2 was reduced in the proximal colon of IL-10?/? mice. The nictric oxide-mediated relaxation after electrical field stimulation was significantly decreased in the proximal and distal colon of IL-10?/? mice. In inflamed colon, the expression of nNOS decreased, whereas the expression of iNOS increased. Conclusions These results suggest that damage to the ICC network and NOS system in the proximal and distal colon, as well as damage to the smooth muscle cholinergic receptor in the proximal colon may play an important role in the dysmotility of the inflamed colon. PMID:25537671

Park, Jae Hyung; Kwon, Joong Goo; Kim, Sun Joo; Song, Dae Kyu; Lee, Seok Guen; Kim, Eun Su; Cho, Kwang Bum; Jang, Byung Ik; Kim, Dae Hwan; Sin, Jeong-Im; Kim, Tae Wan; Song, In Hwan; Park, Kyung Sik

2015-01-01

182

Colonic tuberculosis masquerading as colon cancer  

PubMed Central

Isolated colonic tuberculosis (TB) is rare, and the symptoms are nonspecific making early diagnosis and management difficult. Although colonoscopy and biopsy is an important diagnostic modality, the features are variable and the distinction from other conditions of the colon, especially Crohn’s disease and cancer, may be impossible without surgical resection. We report a case of ascending colon TB which was mistaken for colonic cancer during colonoscopy, with non-specific results on biopsy. The diagnosis was finally made when the histopathology report was received. The diagnostic dilemma of colonic TB is discussed. PMID:24960138

Kumar, A; Patodia, M; Pandove, PK; Sharda, VK

2012-01-01

183

Colonic tuberculosis masquerading as colon cancer.  

PubMed

Isolated colonic tuberculosis (TB) is rare, and the symptoms are nonspecific making early diagnosis and management difficult. Although colonoscopy and biopsy is an important diagnostic modality, the features are variable and the distinction from other conditions of the colon, especially Crohn's disease and cancer, may be impossible without surgical resection. We report a case of ascending colon TB which was mistaken for colonic cancer during colonoscopy, with non-specific results on biopsy. The diagnosis was finally made when the histopathology report was received. The diagnostic dilemma of colonic TB is discussed. PMID:24960138

Kumar, A; Patodia, M; Pandove, Pk; Sharda, Vk

2012-01-01

184

Carcinoma of Colon: a rare cause of fever of unknown origin.  

PubMed

Fever of unknown origin (FUO) was originally defined as a body temperature greater than 38.3°C on several occasions longer than 3 weeks, with a diagnosis that remains unclear after 7 days of obligatory investigation. Only a few types of solid tumors have been associated with FUO. We described 2 patients who had recurrent fever but no other specific gastrointestinal symptoms where carcinoma of the colon was the only identifiable cause. In the first case, a mass arising from the sigmoid colon was found without any nodal metastasis, and the fever was resolved after three days of the surgical resection. In the second case, advanced adenocarcinoma was found in the ascending colon together with liver cirrhosis. Although it was not possible to surgically remove this tumor, prolonged fever in the patient was most likely due to the carcinoma. These cases indicate that clinicians should consider carcinoma of the colon in the differential diagnosis of patients with FUO. PMID:23359772

Dai, Wei; Chung, Kyu-Sung

2012-06-01

185

Totally Laparoscopic Distal Gastrectomy after Learning Curve Completion: Comparison with Laparoscopy-Assisted Distal Gastrectomy  

PubMed Central

Purpose The aims are to: (i) display the multidimensional learning curve of totally laparoscopic distal gastrectomy, and (ii) verify the feasibility of totally laparoscopic distal gastrectomy after learning curve completion by comparing it with laparoscopy-assisted distal gastrectomy. Materials and Methods From January 2005 to June 2012, 247 patients who underwent laparoscopy-assisted distal gastrectomy (n=136) and totally laparoscopic distal gastrectomy (n=111) for early gastric cancer were enrolled. Their clinicopathological characteristics and early surgical outcomes were analyzed. Analysis of the totally laparoscopic distal gastrectomy learning curve was conducted using the moving average method and the cumulative sum method on 180 patients who underwent totally laparoscopic distal gastrectomy. Results Our study indicated that experience with 40 and 20 totally laparoscopic distal gastrectomy cases, is required in order to achieve optimum proficiency by two surgeons. There were no remarkable differences in the clinicopathological characteristics between laparoscopy-assisted distal gastrectomy and totally laparoscopic distal gastrectomy groups. The two groups were comparable in terms of open conversion, combined resection, morbidities, reoperation rate, hospital stay and time to first flatus (P>0.05). However, totally laparoscopic distal gastrectomy had a significantly shorter mean operation time than laparoscopy-assisted distal gastrectomy (P<0.01). We also found that intra-abdominal abscess and overall complication rates were significantly higher before the learning curve than after the learning curve (P<0.05). Conclusions Experience with 20~40 cases of totally laparoscopic distal gastrectomy is required to complete the learning curve. The use of totally laparoscopic distal gastrectomy after learning curve completion is a feasible and timesaving method compared to laparoscopy-assisted distal gastrectomy. PMID:23610716

Kim, Han-Gil; Jeong, Sang-Ho; Lee, Young-Joon; Ha, Woo-Song; Choi, Sang-Kyung; Hong, Soon-Chan; Jung, Eun-Jung; Ju, Young-Tae; Jeong, Chi-Young; Park, Taejin

2013-01-01

186

Colonic angiosarcoma: A case report and review of literature  

PubMed Central

INTRODUCTION Angiosarcomas are rare tumours that arise from the vascular endothelium. They can occur anywhere in the body, mostly affecting the head and neck. Their occurrence in the gastrointestinal tract is quite rare with a few reported cases in medical literature. PRESENTATION OF CASE A 40-year-old man presented with metastatic sigmoid colon angiosarcoma, for which he was operated due to endoscopically uncontrollable massive tumour bleeding. The patient is presently still alive at 24 months after his first presentation. He is receiving palliative care. DISCUSSION This article presents a review of the literature on this rare clinical entity, emphasising the very aggressive behaviour and the poor outcome of this malignancy. We present, briefly, 17 reported cases on primary colonic angiosarcoma since 1949. CONCLUSION The role of chemotherapy and radiation is established neither in the adjuvant setting nor in metastatic disease. Surgery is the mainstay to treat localised colorectal angiosarcomas. PMID:23279809

Al Beteddini, Osama S.; Brenez, Daniel; Firket, Christophe; Algaba, Roberto; Tabech, Ahmad

2012-01-01

187

Enzyme-Based Logic: OR Gate with Double-Sigmoid Filter Response  

E-print Network

The first realization of a biomolecular OR gate function with double-sigmoid response (sigmoid in both inputs) is reported. Two chemical inputs activate the enzymatic gate processes resulting in the output signal: chromogen oxidation, which occurs when either one of the inputs or both are present (corresponding to the OR binary function), and can be optically detected. High-quality gate functioning in handling of sources of noise is enabled by "filtering" involving pH control with an added buffer. The resulting gate response is sigmoid in both inputs when proper system parameters are chosen, and the gate properties are theoretically analyzed within a model devised to evaluate its noise-handling properties.

Oleksandr Zavalov; Vera Bocharova; Vladimir Privman; Evgeny Katz

2013-05-07

188

Enzyme-Based Logic: OR Gate with Double-Sigmoid Filter Response  

E-print Network

The first realization of a biomolecular OR gate function with double-sigmoid response (sigmoid in both inputs) is reported. Two chemical inputs activate the enzymatic gate processes resulting in the output signal: chromogen oxidation, which occurs when either one of the inputs or both are present (corresponding to the OR binary function), and can be optically detected. High-quality gate functioning in handling of sources of noise is enabled by "filtering" involving pH control with an added buffer. The resulting gate response is sigmoid in both inputs when proper system parameters are chosen, and the gate properties are theoretically analyzed within a model devised to evaluate its noise-handling properties.

Zavalov, Oleksandr; Privman, Vladimir; Katz, Evgeny; 10.1021/jp305183d

2013-01-01

189

Yohkoh SXT and SOHO EIT Observations of Sigmoid-to-Arcade Evolution of Structures Associated with Halo Coronal Mass Ejections  

NASA Astrophysics Data System (ADS)

A subset of the solar-disk counterparts to halo coronal mass ejections (CMEs) displays an evolution in soft X-rays (SXR) that is characterized by a preflare S-shaped structure, dubbed a ``sigmoid,'' which evolves into a postflare cusp or arcade. We examine the morphological properties of the evolution of sigmoids into cusps and arcades for four such regions associated with SXR flares, using the Soft X-Ray Telescope (SXT) on the Yohkoh satellite and the EUV Imaging Telescope (EIT) on the Solar and Heliospheric Observatory (SOHO) satellite. Most of our EIT observations are with the 1.5 MK 195 Å Fe XII channel. At most, there is only a weak counterpart to the SXR sigmoid in the preflare 195 Å EUV images, indicating that the preflare sigmoid has a temperature greater than 1.5 MK. While more identifiable than in the 195 Å channel, a clear preflare sigmoid is also not observed in the 2.0 MK EIT 284 Å Fe XV channel. During the time of the flare, however, an EUV sigmoid brightens near the location of the SXR preflare sigmoid. Initially the SXR sigmoid lies along a magnetic neutral line. As the SXR flare progresses, new field lines appear with orientation normal to the neutral line and with footpoints rooted in regions of opposite polarity; these footpoints are different from those of the preflare sigmoid. The cusp structures in SXRs develop from these newly ignited field lines. In EIT images, the EUV sigmoid broadens as the flare progresses, forming an arcade beneath the SXR cusp. Our findings are consistent with a standard picture in which the origin of the flare and CME is caused by the eruption of a filament-like feature, with the stretching of field lines producing a cusp. We infer that the cusp-producing fields may be overlying the sigmoid fields in the preflare phase, but we do not directly observe such preflare overlying fields.

Sterling, Alphonse C.; Hudson, Hugh S.; Thompson, Barbara J.; Zarro, Dominic M.

2000-03-01

190

Intake of Polyunsaturated Fatty Acids and Distal Large Bowel Cancer Risk in Whites and African Americans  

PubMed Central

Long-chain ?-3 polyunsaturated fatty acids (PUFAs) may have antineoplastic properties in the colon. The authors examined the association between intakes of different PUFAs and distal large bowel cancer in a population-based case-control study of 1,503 whites (716 cases; 787 controls) and 369 African Americans (213 cases; 156 controls) in North Carolina (2001–2006). Unconditional logistic regression was used to estimate odds ratios and 95% confidence intervals for distal large bowel cancer risk in relation to quartiles of PUFA intake. Increased consumption of long-chain ?-3 PUFAs was associated with reduced risk of distal large bowel cancer in whites (multivariable odds ratios = 0.88 (95% confidence interval (CI): 0.63, 1.22), 0.69 (95% CI: 0.49, 0.98), and 0.49 (95% CI: 0.34, 0.71) for second, third, and highest vs. lowest quartile) (Ptrend < 0.01). Intake of individual eicosapentaenoic acids and docosahexaenoic acids was inversely related to distal large bowel cancer risk, whereas the ratio of ?-6 to long-chain ?-3 PUFAs was associated with increased risk of distal large bowel cancer in whites, but not among African Americans (Pinteraction < 0.05). Study results support the hypothesis that long-chain ?-3 PUFAs have beneficial effects in colorectal carcinogenesis. Whether or not the possible benefit of long-chain ?-3 PUFAs varies by race warrants further evaluation. PMID:20392864

Kim, Sangmi; Sandler, Dale P.; Galanko, Joseph; Martin, Christopher; Sandler, Robert S.

2010-01-01

191

Gonorrhoea of the sigmoid neovagina in a male-to-female transgender.  

PubMed

A 33-year-old male-to-female transgender consulted our outpatient clinic with perneovaginal bleeding during and following coitus. Four years before, she underwent a total laparoscopic sigmoid neovaginoplasty. Physical, histological and endoscopic examination revealed neither focus of active bleeding nor signs of active inflammation. A polymerase chain reaction test performed on a neovaginal swab showed gonococcal infection. Treatment consisted of 500?mg intramuscular ceftriaxone. Three weeks later, our patient reported resolution of symptoms, consistent with eradication of Gonococcus Neisseria demonstrated by a follow-up neovaginal swab polymerase chain reaction. To our knowledge, this is the first case report of gonococcal infection of the sigmoid neovagina. PMID:25060698

van der Sluis, Wouter B; Bouman, Mark-Bram; Gijs, Luk; van Bodegraven, Adriaan A

2014-07-23

192

Fabrication and Evaluation of a Noncompliant Molar Distalizing Appliance: Bonded Molar Distalizer  

PubMed Central

Objective Attempts to treat class II malocclusions without extraction in non-compliant patients have led to utilization of intraoral molar distalizing appliances. The purpose of this study was to investigate dental and skeletal effects of Bonded Molar Distalizer (BMD) which is a simple molar distalizing appliance. Materials and Methods Sixteen patients (12 girls, four boys) with bilateral half-cusp class II molar relationship, erupted permanent second molars and normal or vertical growth pattern were selected for bilateral distalization of maxillary molars via BMD. The screws were activated every other day, alternately. Lateral cephalograms and study models were obtained before treatment and after 11 weeks activation of the appliance. Results Significant amounts of molar distalization, molar distal tipping and anchorage loss were observed. The mean maxillary first molar distal movement was 1.22±0.936 mm with a distal tipping of 2.97±3.74 degrees in 11 weeks. The rate of distal movement was 0.48 mm per month. Reciprocal mesial movement of the first premolars was 2.26±1.12 mm with a mesial tipping of 4.25±3.12 degrees. Maxillary incisors moved 3.55±1.46 mm and tipped 9.87±5.03 degrees mesially. Lower anterior face height (LAFH) decreased 1.28±1.36 mm. Conclusion BMD is appropriate for distalizing maxillary molars, especially in patients with critical LAFH, although significant amounts of anchorage loss occur using this appliance. PMID:22457837

Sodagar, A.; Ahmad Akhoundi, M. S.; Rafighii, A.; Arab, S.

2011-01-01

193

Dural arteriovenous fistulas including the transverse and sigmoid sinuses: Results of treatment in 30 cases  

Microsoft Academic Search

Summary We report about the treatment and outcome of 30 patients with durai arteriovenous fistulas including the transverse and sigmoid sinuses treated between 1986 and 1995. All patients underwent panangiography for definitive diagnosis. The dAVF were supplied by the external carotid artery system alone (14 patients), both external and internal carotid systems (10 patients) or both anterior and posterior circulation

V. Olteanu-Nerbe; E. Uhl; H.-J. Steiger; T. Yousry; H.-J. Reulen

1997-01-01

194

PREDICTION OF CONTAMINANT ACCUMULATION BY FREE-LIVING ORGANISMS: APPLICATIONS OF A SIGMOIDAL MODEL  

Microsoft Academic Search

The accumulation of contaminants by free-living organisms has traditionally been de- termined with permutations of the deterministic model: Ct = Ce(1 - e -kt). However, studies uti- lizing a variety of species and exposure scenarios now suggest that significant deviations may occur from this classic form. In many cases noted to date, these deviations have involved a sigmoidal pat- tern

I. Lehr Brisbin; Michael C. Newman; Susan G. McDowell; Eric L. Peters

1990-01-01

195

Colonic mass movements in idiopathic chronic constipation.  

PubMed Central

As relatively little is known of human colonic motor activity either in health, or in pathological conditions, we investigated mass movements in 14 chronically constipated patients and 18 healthy volunteers. Mass movements were recorded from proximal and distal colon during 24 h (12 noon-12 noon) by a colonoscopically positioned multilumen manometric probe and low compliance infusion system. Patients and controls differed significantly in the number (mean 2.6 (0.7) v 6.1 (0.9) (SE), p = 0.02) and duration (mean 8.2 (1.6) v 14.1 (0.8) s, p = 0.04) of mass movements. The data suggest that one pathophysiological mechanism of constipation may be decreased propulsive activity. A circadian pattern, with a significant difference between day and night distribution, was documented in both groups. The patients reported decreased defecatory stimulus concomitant with the mass movements. Images Fig. 1 PMID:3197990

Bassotti, G; Gaburri, M; Imbimbo, B P; Rossi, L; Farroni, F; Pelli, M A; Morelli, A

1988-01-01

196

Benign hybrid perineurioma-schwannoma in the colon. A case report.  

PubMed

A 48-year-old man of Haitian descent presented with progressive constipation, hematochezia, and weight loss. Colonoscopy and computed tomography scan revealed an obstructing colonic mass, causing intussusception and pneumatosis of the descending/upper sigmoid colon and necessitating an emergency left hemicolectomy. Gross examination revealed a 4.9-cm obstructing mass in the sigmoid colon extending through the muscularis propria. Histologically, the lesional cells were bland, spindled, with tapered and often wavy nuclei set in a loose fibromyxoid stroma. Focally, the lesional cells displayed whorling or storiform growth pattern mixed with spindle wavy cells. In many areas, the cells had bipolar cytoplasmic processes. Immunohistochemistry revealed patchy positivity for epithelial membrane antigen, CD34, vimentin, diffuse positivity for S-100, and negativity for CD117, cytokeratin (AE1/AE3), ALK1, desmin, smooth muscle actin, neuronal nuclei antigen (NeuN), and neurofilament protein. The morphology and immunohistochemical findings were consistent with hybrid perineurioma-schwannoma. Electron microscopic examination revealed the characteristic features of perineuriomal and schwannomatous differentiation. Based upon the histopathology, immunophenotype, and ultrastructure, this tumor was classified as a benign hybrid perineurioma-schwannoma, a counterpart to the tumor described in the soft tissue. This is the first case report of hybrid perineurioma-schwannoma in the colon. PMID:17126257

Emanuel, Patrick; Pertsemlidis, David S; Gordon, Ronald; Xu, Ruliang

2006-12-01

197

Smoothelin expression in the gastrointestinal tract: implication in colonic inertia.  

PubMed

Colonic inertia is a frustrating motility disorder to patients, clinicians, and pathologists. The pathogenesis is largely unknown. The aims of this study were to: (1) characterize the expression of smoothelin, a novel smooth muscle-specific contractile protein expressed only by terminally differentiated smooth muscle cells, in the normal gastrointestinal (GI) tract; and (2) determine whether smoothelin is aberrantly expressed in patients with colonic inertia. A total of 57 resections of the normal GI tract (distal esophagus to left colon) were obtained from patients without GI motor dysfunction. Sixty-one colon resections were obtained from patients with a clinical diagnosis of colonic inertia. Smoothelin immunostaining was conducted on full-thickness tissue sections. In the nondysmotile controls, strong and diffuse cytoplasmic staining for smoothelin was observed in both the inner circular and outer longitudinal layers of the muscularis propria (MP) throughout the entire GI tract. The muscularis mucosae (MM) and muscular vessel walls were either completely negative or only patchily and weakly stained. The 1 exception to this pattern was observed in the distal esophagus, in which the MM was also diffusely and strongly stained. In cases with colonic inertia, a moderate to marked reduction of smoothelin immunoreactivity was observed in 15 of 61 (24.6%) colon resections, selectively seen in the outer layer of the MP. The data demonstrate that smoothelin is differentially expressed in the MP and MM of the normal GI tract and suggest that defective smoothelin expression may play a role in the pathogenesis of colonic inertia in a subset of patients. PMID:23060305

Chan, Owen T M; Chiles, Lauren; Levy, Mary; Zhai, Jing; Yerian, Lisa M; Xu, Haodong; Xiao, Shu-Yuan; Soffer, Edy E; Conklin, Jeffrey L; Dhall, Deepti; Kahn, Melissa E; Balzer, Bonnie L; Amin, Mahul B; Wang, Hanlin L

2013-10-01

198

Disorders of the distal biceps brachii tendon.  

PubMed

Pathologic conditions of the distal biceps brachii tendon are of clinical interest, with partial and complete tears being the most common. However, the anatomy of the distal biceps brachii tendon makes imaging of the distal tendon somewhat difficult. An innovation in patient positioning for magnetic resonance (MR) imaging of the distal biceps tendon was recently described in which the patient lies prone with the arm overhead, the elbow flexed to 90 degrees , and the forearm supinated, so that the thumb points superiorly. The acronym FABS (f lexed elbow, abducted shoulder, forearm supinated) has been used to describe this position. The FABS position creates tension in the tendon and minimizes its obliquity and rotation, resulting in a "true" longitudinal view of the tendon. MR imaging and, to a lesser extent, ultrasonography are useful in visualizing the distal tendon and in detecting other pathologic conditions in the cubital fossa. Partial tears are usually characterized by enlargement and abnormal contour of the tendon, along with abnormal intratendinous signal intensity. In complete tears, there is discontinuity and, if the bicipital aponeurosis is also disrupted, retraction. Imaging with FABS positioning can complement conventional MR imaging, especially in the axial plane, in the assessment of the distal biceps tendon. PMID:16160108

Chew, Michael L; Giuffrè, Bruno M

2005-01-01

199

Colon Adenomatous Polyps  

MedlinePLUS

... patients and CAP members only. Normal colon tissue. Definitions Colon: The section of the large intestine leading ... fat dairy products and nutritional supplements) and not smoking. If you are at high risk for developing ...

200

Film coatings for oral colon delivery.  

PubMed

Oral colon delivery is pursued through a number of formulation strategies with the aim of enabling effective and well-tolerated treatments for large bowel pathologies or enhancing the intestinal absorption of peptide and protein drugs. According to such strategies, coated dosage forms for colonic release may be provided with microbiota, pH, pressure or time-dependent polymeric films. Microbiota-activated coatings are mostly obtained from polysaccharides of natural origin mixed with insoluble structuring excipients. Alternatively, synthetic azo compounds have been employed, generally requiring organic solvents for use as spray-coating agents. On the other hand, pH-sensitive films show responsiveness to pH changes in the lower gut, such as the rise generally observed in the terminal ileum and distal colon or the slight acidification of caecal contents by bacterial fermentation products. Pressure-sensitive coatings are intended for rupturing because of the relatively elevated pressure that may affect solid dosage forms in the large bowel. Finally, time-dependent films are expected to undergo timed erosion, break-up or permeabilization processes irrespective of the aforementioned physiological variables. In this review, the differing films applied for colon delivery purposes are surveyed, and details on their composition, manufacturing and performance are reported. PMID:23727142

Maroni, Alessandra; Del Curto, Maria Dorly; Zema, Lucia; Foppoli, Anastasia; Gazzaniga, Andrea

2013-12-01

201

Colon cancer - Series (image)  

MedlinePLUS

Colon cancer is the third most common cancer in the United States. Risk factors include a diet low ... The treatment of colon cancer depends on the stage of the disease. Stage I cancer is limited to the inner lining of the colon; ...

202

Re-examining treatment strategies for sigmoid volvulus: An analysis of treatment and outcomes in Lilongwe, Malawi.  

PubMed

INTRODUCTION: Sigmoid volvulus is a common surgical emergency in many regions of the world, with significant morbidity and mortality. The aims of this study were to (a) summarize outcomes and (b) define a treatment algorithm for sigmoid volvulus in our setting. EXPERIMENTAL: Five year (2003-2008) retrospective review of sigmoid volvulus cases at Kamuzu Central Hospital, in Lilongwe, Malawi. RESULTS AND DISCUSSION: There were 239 cases of sigmoid volvulus identified. Cases were mostly seen in males (91.7%), with a median age of 50 (range 18-86). Gangrene was noted in 36.7% of cases. Mesosigmoidopexy (36%), Hartmann's procedure (33%), and resection and anastomosis (23%) were the most common procedures. There was seasonal variation with more cases seen in the harvest months of March and April. The major complications noted were recurrence (5 of 6 recurrences after mesosigmoidopexy / plasty) and anastomotic leakage after resection and anastomosis (2 in gangrenous, and 2 in non-gangrenous sigmoid volvulus). CONCLUSIONS: Gangrenous sigmoid volvulus is best managed with Hartmann's procedure. Non-gangrenous sigmoid volvulus is best managed with resection and anastomosis, unless there are risk factors for anastomotic leakage, in which case the surgeon should consider mesosigmoidopexy with non-absorbable suture. PMID:22570523

Samuel, Jonathan C; Akinkuotu, Adesola; Msiska, Nelson; Cairns, Bruce A; Muyco, Arturo P; Charles, Anthony G

2010-10-01

203

Association between CYP7A1 and the risk of proximal colon cancer in Japanese  

PubMed Central

Bile acids have long been implicated in the etiology of colorectal carcinogenesis by their genotoxicity as well as cytotoxicity. Cholesterol 7-alfa-hydroxylase (CYP7A1) is the rate-limiting enzyme that converts cholesterol into cholesterol 7-alfa-hydroxycholesterol in the first step of the classical pathway of bile acid synthesis. Recently, an association between a polymorphism (?204A>C, rs3808607) in CYP7A1 and proximal colon cancer/adenoma has been reported, which was not observed with distal colon or rectal cancer/adenoma. In this case-control study, we examined the association between haplotypes of CYP7A1 and proximal or distal colon/rectal cancer risk in a Japanese population. Subjects were 96 cases of proximal colon cancer, 357 of distal colon/rectal cancer and 961 age- and sex-matched non-cancer controls at Aichi Cancer Center. We examined five loci, including rs3808607, and evaluated the impact of haplotype on risk. In locus-specific analyses, we saw no association with rs3808607 for any site. Haplotype analyses revealed that the TAAGG haplotype was positively associated with proximal colon cancer [confounder-adjusted odds ratio: 1.72 (95% confidence interval: 1.10-2.71), p=0.018] but not with distal colon and rectal cancer combined. This association was consistently observed in analyses stratified by potential confounders. Our results indicate that CYP7A1 plays a role in the carcinogenesis of colorectal cancer specifically in the proximal colon. Confirmation of this association in other epidemiologic studies and biological evaluation of the TAAGG haplotype are warranted. PMID:21537451

Ito, Hidemi; Matsuo, Keitaro; Hosono, Satoyo; Watanabe, Miki; Kawase, Takakazu; Suzuki, Takeshi; Hirai, Takashi; Yatabe, Yasushi; Tanaka, Hideo; Tajima, Kazuo

2010-01-01

204

Effect of the dietary fibre content of lifelong diet on colonic cellular proliferation in the rat.  

PubMed Central

The effect of the fibre content of lifelong (18 months) diets on proximal and distal colonic cellular proliferation and short chain fatty acid (SCFA) content was investigated in 40 rats. Rats were fed a low fibre diet (17 g/kg non-starch polysaccharides NSP) or the stock diet (133 g/kg NSP). The higher fibre fed rats had increased caecal and colonic total contents (p < 0.001) and SCFAs than the low fibre fed rats (caecal SCFAs: higher fibre rats 96.4 (6.8) mumol/g wet weight v low fibre 22.7 (3.0): p < 0.001, colonic SCFAs: higher fibre 52.3 (3.1) mumol/g wet weight v low fibre 6.9 (2.2) mumol/g wet weight: p < 0.001). Cellular proliferation was increased in the proximal colon (bromodeoxyuridine labelling index, higher fibre 9.3 v low fibre 8.4 p < 0.05; flow cytometry, % cells in S phase higher fibre diet 7.9 v low fibre 6.9; p < 0.01) and there was a shift of proliferating cells to a higher region in each crypt. There was no significant difference in the percentage of cells in S phase in the distal colon of rats in both diet groups. The proliferative zone, however, was expanded in the distal colon of the higher fibre diet fed rats. This study indicates that long term higher fibre intake in rats is associated with a modest increase in cellular proliferation in the proximal colon but not the distal colon. PMID:1327981

Edwards, C A; Wilson, R G; Hanlon, L; Eastwood, M A

1992-01-01

205

Berberine reduces cAMP-induced chloride secretion in T84 human colonic carcinoma cells through inhibition of basolateral KCNQ1 channels  

Microsoft Academic Search

Berberine is a plant alkaloid with multiple pharmacological actions, including antidiarrhoeal activity and has been shown to inhibit Cl- secretion in distal colon. The aims of this study were to determine the molecular signalling mechanisms of action of berberine on Cl- secretion and the ion transporter targets. Monolayers of T84 human colonic carcinoma cells grown in permeable supports were placed

Rodrigo Alzamora; Fiona OMahony; Wing-Hung Ko; Tiffany Wai-Nga Yip; Derek Carter; Mustapha Irnaten; Brian J Harvey

2011-01-01

206

Partial rupture of the distal biceps tendon.  

PubMed

Partial rupture of the distal biceps tendon is a relatively rare event, and various degrees of partial tendon tears have been reported. In the current study four patients with partial atraumatic distal biceps tendon tears (mean age, 59 years; range, 40-82 years) are reported. In all four patients, a common clinical pattern emerged. Pain at the insertion of the distal biceps tendon in the radius unrelated to any traumatic event was the main symptom. In all patients the diagnosis was based on magnetic resonance imaging or computed tomography imaging. In three of four patients the partial rupture of the tendon caused a significant bursalike lesion. The typical appearance was a partially ruptured biceps tendon, with contrast enhancement signaling the degree of degeneration, tenosynovitis, and soft tissue swelling extending along the tendon semicircular to the proximal radius. In three patients, conservative treatment was successful. Only one patient needed surgery, with reinsertion of the tendon resulting in total functional recovery. PMID:10818980

Dürr, H R; Stäbler, A; Pfahler, M; Matzko, M; Refior, H J

2000-05-01

207

Osteochondritis of the Distal Tibial Epiphysis  

PubMed Central

Osteochondritis of the distal tibial epiphysis is a very rare entity. 9 cases have been described in 7 articles and 8 other cases have been mentioned in textbooks. This paper describes the 10th case of osteochondritis of the distal tibial epiphysis and summarizes the clinical and radiological presentations of the 9 other cases. The etiology of this entity is well debated in the literature. We believe that it results from a vascular abnormality in the distal tibial epiphysis associated with a mechanical stress (trauma, excessive overload, etc.). Since it is a self-limited disease, the prognosis is good and the younger the patient is the better the prognosis will be. In general, this entity responds well to conservative treatment. PMID:23193412

EL Hajj, Firass; Sebaaly, Amer; Kharrat, Khalil; Ghanem, Ismat

2012-01-01

208

Biochemical Filter with Sigmoidal Response: Increasing the Complexity of Biomolecular Logic  

E-print Network

The first realization of a designed, rather than natural, biochemical filter process is reported and analyzed as a promising network component for increasing the complexity of biomolecular logic systems. Key challenge in biochemical logic research has been achieving scalability for complex network designs. Various logic gates have been realized, but a "toolbox" of analog elements for interconnectivity and signal processing has remained elusive. Filters are important as network elements that allow control of noise in signal transmission and conversion. We report a versatile biochemical filtering mechanism designed to have sigmoidal response in combination with signal-conversion process. Horseradish peroxidase-catalyzed oxidation of chromogenic electron donor by hydrogen peroxide, was altered by adding ascorbate, allowing to selectively suppress the output signal, modifying the response from convex to sigmoidal. A kinetic model was developed for evaluation of the quality of filtering. The results offer improved capabilities for design of scalable biomolecular information processing systems.

Vladimir Privman; Jan Halamek; Mary A. Arugula; Dmitriy Melnikov; Vera Bocharova; Evgeny Katz

2010-09-13

209

Awake embolization of sigmoid sinus diverticulum causing pulsatile tinnitus: simultaneous confirmative diagnosis and treatment.  

PubMed

Sigmoid sinus diverticulum, a rare dural sinus anomaly, is regarded as one of the very rare causes of pulsatile tinnitus, and there have been only a few reports on their surgical or endovascular management. We describe a 31-year-old woman presenting with a three-year pulsatile tinnitus in her right ear. After finding the small bony defect in her right temporal bone on CT which was filled with contrast after enhancement, we confirmed the presence of sigmoid sinus diverticulum with the cerebral angiogram and embolized it with two detachable coils in awake status. Right after filling the two coils into the sac, thanks to her alert consciousness, she was able to refer the disappearance of her tinnitus. The operation was finished only with the detachment of the coils. PMID:22005703

Park, Y-H; Kwon, H-J

2011-09-01

210

The Ribbon-Like Hard X-Ray Emission in a Sigmoidal Solar Active Region  

E-print Network

Solar flare emissions at Halpha and EUV/UV wavelengths often appear in the form of two ribbons, which has been regarded as evidence for a typical configuration of solar magnetic reconnection. However, such a ribbon structure has rarely been observed in hard X-rays (HXRs), although it is expected as well. In this letter, we report a ribbon-like HXR source observed with the Reuven Ramaty High Energy Solar Spectroscopic Imager (RHESSI) at energies as high as 25-100 keV during the 2005 May 13 flare. For a qualitative understanding of this unusual HXR morphology, we also note that the source active region appeared in a conspicuous sigmoid shape before the eruption and changed to an arcade structure afterward as observed with the Transition Region and Coronal Explorer (TRACE) at 171 A. We suggest that the ribbon-like HXR structure is associated with the sigmoid-to-arcade transformation during this type of reconnection.

Chang Liu; Jeongwoo Lee; Dale E. Gary; Haimin Wang

2007-02-12

211

Efficient Digital Implementation of The Sigmoidal Function For Artificial Neural Network  

NASA Astrophysics Data System (ADS)

An efficient piecewise linear approximation of a nonlinear function (PLAN) is proposed. This uses simulink environment design to perform a direct transformation from X to Y, where X is the input and Y is the approximated sigmoidal output. This PLAN is then used within the outputs of an artificial neural network to perform the nonlinear approximation. In This paper, is proposed a method to implement in FPGA (Field Programmable Gate Array) circuits different approximation of the sigmoid function.. The major benefit of the proposed method resides in the possibility to design neural networks by means of predefined block systems created in System Generator environment and the possibility to create a higher level design tools used to implement neural networks in logical circuits.

Pratap, Rana; Subadra, M.

2011-10-01

212

Arteriovenous fistula between the ascending pharyngeal artery and the sigmoid sinus. Report of a case with spontaneous regression  

Microsoft Academic Search

An unusual case of arteriovenous communication between the ascending pharyngeal artery and the sigmoid sinus is described. The patient had pulsatile tinnitus and bruit over the left mastoid. The symptoms regressed spontaneously without therapy. This was documented by subsequent angiography.

M. Takahashi; Y. Gito; M. Kowada

1974-01-01

213

Endovascular Treatment of Transverse-Sigmoid Sinus Dural Arteriovenous Malformations Presenting as Pulsatile Tinnitus  

PubMed Central

Transverse-sigmoid sinus dural arteriovenous malformations (DAVM) are uncommon vascular lesions for which complete cure may be difficult to obtain. A wide variety of treatments for these lesions include observation, arterial compression, surgical resection, and endovascular embolization. We propose that transverse-sigmoid sinus DAVM can be completely cured by occluding the ipsilateral dural sinus with detachable balloon and Guglielmi detachable coils (GDC) coils before arterial feeder embolization with histoacryl. Three patients who presented with pulsatile tinnitus and normal magnetic resonance imaging (MRI) studies underwent angiography, which demonstrated transverse-sigmoid sinus DAVM. All three patients wer treated with retrograde transvenous sinus embolization with complete occlusion of the transverse-sigmoid sinus with detachable balloons and GDC coils with preservation of the vein of Labbé. Subsequently, the various feeders from the external carotid artery were embolized. The tentorial arteries arising from the ipsilateral internal carotid arteries were not embolized in any of the cases, which were still contributing to the DAVM. Complete cure with thrombosis of the tentorial branch of the internal carotid artery (ICA) was seen on follow-up angiogram 1 day after embolization in one patient and on 4-week and 6-week follow-up angiograms in the other two patients. Complete occlusion of the transverse sinus proximal to the vein of Labbé, in spite of incomplete arterial feeder embolization, can result in complete cure of the transversesinus dural AVF if adequate time is given for the remaining feeders to occlude, once the fistula is obliterated. ImagesFigure 1Figure 1p18-aFigure 2Figure 3 PMID:17167600

Shownkeen, Harish; Yoo, Kevin; Leonetti, John; Origitano, T.C.

2001-01-01

214

Position-dependent chemotactic response of slowly migrating cells in sigmoidal concentration profiles  

NASA Astrophysics Data System (ADS)

Characterizing the chemotactic motility of slowly migrating cells as a function of time is still challenging. In this paper, we use a microfluidic device for investigating the chemotactic activity of HFF-1 fibroblasts in a sigmoidal concentration profile of epidermal growth factor (EGF). Sigmoidal concentration profiles are very common in biological systems but, in contrast to linear gradients, are much less studied in microfluidic systems. We monitored cell migration for up to 10 hours and found that chemotaxis is strongest where the absolute EGF concentration is below 25 pM ( K D of EGF is 1 nM). Calculating the fraction of receptor occupancy ( FRO) at the front and rear of the cells showed that the chemotactic activity of HFF-1 cells scaled with the difference in FRO between both ends of the cell normalized by the average FRO av of the cell. Interestingly, the mean chemotactic index of the cells was found to be a function of the gradient at the starting position and did not change when cells were entering into other regions of the highly non-linear concentration profile. Our studies demonstrate the usefulness of stable sigmoidal concentration profiles produced in microfluidic channels for a detailed analysis of the chemotactic response of slowly migrating cells.

Renner, A.; Jaeger, M. S.; Lankenau, A.; Duschl, C.

2013-09-01

215

Comparison of Maxillary Molar Distalization with an Implant-Supported Distal Jet and a Traditional Tooth-Supported Distal Jet Appliance  

PubMed Central

Aim. To investigate and compare the efficiency of two appliances for molar distalization: the bone-anchored distal screw (DS) and the traditional tooth-supported distal jet (DJ) for molar distalization and anchorage loss. Methods. Tests (18 subjects) were treated with a DS and controls (18 subjects) were treated with a DJ. Lateral cephalograms were obtained before and at the end of molar distalization and were analysed. Shapiro Wilk test, unpaired t-test, and Wilcoxon rank-sum test were applied according to values distribution. The ? level was fixed at 0.05. Results. Maxillary first molars were successfully distalized into a Class I relationship in all patients. The mean molar distalization and treatment time were similar in both groups. The DS group exhibited a spontaneous distalization (2.1 ± 0.9?mm) of the first premolar with control of anchorage loss, distal tipping, extrusion, and skeletal changes. Conclusions. The DS is an adequate compliance-free distalizing appliance that can be used safely for the correction of Class II malocclusions. In comparison to the traditional DJ, the DS enables not only a good rate of molar distalization, but also a spontaneous distalization of the first premolars. PMID:25018770

Cozzani, Mauro; Pasini, Marco; Zallio, Francesco; Ritucci, Robert; Mutinelli, Sabrina; Mazzotta, Laura; Giuca, Maria Rita; Piras, Vincenzo

2014-01-01

216

Properties of cholinergic and non-cholinergic submucosal neurons along the mouse colon.  

PubMed

Submucosal neurons are vital regulators of water and electrolyte secretion and local blood flow in the gut. Due to the availability of transgenic models for enteric neuropathies, the mouse has emerged as the research model of choice, but much is still unknown about the murine submucosal plexus. The progeny of choline acetyltransferase (ChAT)-Cre × ROSA26(YFP) reporter mice, ChAT-Cre;R26R-yellow fluorescent protein (YFP) mice, express YFP in every neuron that has ever expressed ChAT. With the aid of the robust YFP staining in these mice, we correlated the neurochemistry, morphology and electrophysiology of submucosal neurons in distal colon. We also examined whether there are differences in neurochemistry along the colon and in neurally mediated vectorial ion transport between the proximal and distal colon. All YFP(+) submucosal neurons also contained ChAT. Two main neurochemical but not electrophysiological groups of neurons were identified: cholinergic (containing ChAT) or non-cholinergic. The vast majority of neurons in the middle and distal colon were non-cholinergic but contained vasoactive intestinal peptide. In the distal colon, non-cholinergic neurons had one or two axons, whereas the cholinergic neurons examined had only one axon. All submucosal neurons exhibited S-type electrophysiology, shown by the lack of long after-hyperpolarizing potentials following their action potentials and fast excitatory postsynaptic potentials (EPSPs). Fast EPSPs were predominantly nicotinic, and somatic action potentials were mediated by tetrodotoxin-resistant voltage-gated channels. The size of submucosal ganglia decreased but the proportion of cholinergic neurons increased distally along the colon. The distal colon had a significantly larger nicotinic ion transport response than the proximal colon. This work shows that the properties of murine submucosal neurons and their control of epithelial ion transport differ between colonic regions. There are several key differences between the murine submucous plexus and that of other animals, including a lack of conventional intrinsic sensory neurons, which suggests there is an incomplete neuronal circuitry within the murine submucous plexus. PMID:24344165

Foong, Jaime Pei Pei; Tough, Iain R; Cox, Helen M; Bornstein, Joel C

2014-02-15

217

Disturbed Colonic Motility Contributes to Anorectal Symptoms and Dysfunction After Radiotherapy for Carcinoma of the Prostate  

SciTech Connect

Purpose: To evaluate the role of colonic motility in the pathogenesis of anorectal symptoms and dysfunction after radiotherapy (RT) for carcinoma of the prostate. Patients and Methods: Thirty-eight patients, median age 71 (range, 50-81) years with localized prostate carcinoma randomized to one of two radiation dose schedules underwent colonic transit scintigraphy and assessment of anorectal symptoms (questionnaire), anorectal function (manometry), and anal sphincteric morphology (endoanal ultrasound) before and at 1 month and 1 year after RT. Results: Whole and distal colonic transit increased 1 month after RT, with faster distal colonic transit only persisting at 1 year. Frequency and urgency of defecation, fecal incontinence, and rectal bleeding increased 1 month after RT and persisted at 1 year. Basal anal pressures remained unchanged, but progressive reductions occurred in anal squeeze pressures and responses to increased intra-abdominal pressure. Rectal compliance decreased progressively in the patients, although no changes in anorectal sensory function ensued. Radiotherapy had no effect on the morphology of the internal and external anal sphincters. Distal colonic retention was weakly related to rectal compliance at 1 month, but both faster colonic transit and reduced rectal compliance were more frequent with increased fecal urgency. At 1 year, a weak inverse relationship existed between colonic half-clearance time and frequency of defecation, although both faster whole-colonic transit and reduced rectal compliance occurred more often with increased stool frequency. Conclusion: Colonic dysmotility contributes to anorectal dysfunction after RT for carcinoma of the prostate. This has implications for improving the management of anorectal radiation sequelae.

Yeoh, Eric K., E-mail: eric.yeoh@health.sa.gov.a [Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, SA (Australia); Bartholomeusz, Dylan L. [Department of Nuclear Medicine, Royal Adelaide Hospital, Adelaide, SA (Australia); Holloway, Richard H. [Department of Gastroenterology, Royal Adelaide Hospital, Adelaide, SA (Australia); Fraser, Robert J. [Gastrointestinal Investigation Unit, Repatriation General Hospital, Daw Park, SA (Australia); Botten, Rochelle; Di Matteo, Addolorata [Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, SA (Australia); Moore, James W. [Department of Colorectal Surgery, Royal Adelaide Hospital, Adelaide, SA (Australia); Schoeman, Mark N. [Department of Gastroenterology, Royal Adelaide Hospital, Adelaide, SA (Australia)

2010-11-01

218

Segmental colonic transit time  

Microsoft Academic Search

Mean segmental transit time of radiopaque markers through the right colon, left colon and rectosigmoid areas of adults and\\u000a children has been calculated from their distribution on consecutive plain films of the abdomen. Overall mean transit does\\u000a not differ significantly in the large bowel between adults and children. However, there are regional differences within the\\u000a colon in relation to age.

Pierre Arhan; Ghislain Devroede; Bertrand Jehannin; Michel Lanza; Claude Faverdin; Catherine Dornic; Bernard Persoz; Léon Tétreault; Bernard Perey; Denys Pellerin

1981-01-01

219

Early stage colon cancer  

PubMed Central

Evidence has now accumulated that colonoscopy and removal of polyps, especially during screening and surveillance programs, is effective in overall risk reduction for colon cancer. After resection of malignant pedunculated colon polyps or early stage colon cancers, long-term repeated surveillance programs can also lead to detection and removal of asymptomatic high risk advanced adenomas and new early stage metachronous cancers. Early stage colon cancer can be defined as disease that appears to have been completely resected with no subsequent evidence of involvement of adjacent organs, lymph nodes or distant sites. This differs from the clinical setting of an apparent “curative” resection later pathologically upstaged following detection of malignant cells extending into adjacent organs, peritoneum, lymph nodes or other distant sites, including liver. This highly selected early stage colon cancer group remains at high risk for subsequent colon polyps and metachronous colon cancer. Precise staging is important, not only for assessing the need for adjuvant chemotherapy, but also for patient selection for continued surveillance. With advanced stages of colon cancer and a more guarded outlook, repeated surveillance should be limited. In future, novel imaging technologies (e.g., confocal endomicroscopy), coupled with increased pathological recognition of high risk markers for lymph node involvement (e.g., “tumor budding”) should lead to improved staging and clinical care. PMID:24379564

Freeman, Hugh James

2013-01-01

220

Insulin and colon cancer  

Microsoft Academic Search

Some factors related to Westernization or industrialization increase risk of colon cancer. It is believed widely that this increase in risk is related to the direct effects of dietary fat and fiber in the colonic lumen. However, the fat and fiber hypotheses, at least as originally formulated, do not explain adequately many emerging findings from recent epidemiologic studies. An alternative

Edward Giovannucci

1995-01-01

221

A diagnostic dilemma following risk-reducing surgery for BRCA1 mutation – a case report of primary papillary serous carcinoma presenting as sigmoid cancer  

PubMed Central

Background Women that carry germ-line mutations for BRCA1 or BRCA2 genes are at an increased risk of developing breast, ovarian and peritoneal cancer. Primary peritoneal carcinoma is a rare tumour histologically identical to papillary serous ovarian carcinoma. Risk-reducing surgery in the form of mastectomy and oophorectomy in premenopausal women has been recommended to prevent breast and ovarian cancer occurrence and decrease the risk of developing primary peritoneal cancer. Case presentation We present a case report of a woman with a strong family history of breast cancer who underwent risk-reducing surgery in the form of bilateral salpingo-oophorectomy following a mastectomy for a right-sided breast tumour. Following the finding of a BRCA1 mutation, a prophylactic left-sided mastectomy was performed. After remaining well for twenty-seven years, she presented with rectal bleeding and altered bowel habit, and was found to have a secondary cancer of the sigmoid colon. She was finally diagnosed with primary papillary serous carcinoma of the peritoneum (PSCP). Conclusion PSCP can present many years after risk-reducing surgery and be difficult to detect. Surveillance remains the best course of management for patients with known BRCA mutations. PMID:17850658

Chand, Manish; Moore, Patrick J; Clarke, Andrew D; Nash, Guy F; Hickisk, Tamas

2007-01-01

222

Role of red meat and arachidonic acid in protein kinase C activation in rat colonic mucosa.  

PubMed

Two studies were conducted to investigate the role of meat and arachidonic acid in colonic signal transduction, particularly protein kinase C (PKC) activation. In Study 1, 26 male Wistar rats were fed a casein- or a beef-based diet for four weeks. PKC activity was measured from the proximal and distal colonic mucosa and diacylglycerol concentration from fecal samples. The beef diet significantly increased membrane PKC activity in the proximal and distal colon and cytosolic PKC in the distal colon. No differences were found in fecal diacylglycerol concentration for the rats maintained on the two diets. In Study 2, 57 male Wistar rats were divided into three dietary treatment groups: a control group, a group supplemented with arachidonic acid at 8 mg/day (an amount equivalent to that available from the beef diet in Study 1), and a group supplemented with fish oil at 166 mg/day. After a four-week supplementation period, 6 rats per group were used for colonic phospholipid fatty acid analysis and 13 rats per group were used for analysis of colonic prostaglandin E2 concentration, sphingomyelinase, and PKC activities. Supplementation of dietary arachidonic acid resulted in incorporation of arachidonic acid into colonic phosphatidylcholine, which was associated with an increase in mucosal prostaglandin E2 concentration compared with the fish oil group. However, arachidonate supplementation had no effect on sphingomyelinase or PKC activities. These data indicate that meat significantly increases colonic PKC activity, but this effect is probably not due to the arachidonic acid content of meat. PMID:9919617

Pajari, A M; Häkkänen, P; Duan, R D; Mutanen, M

1998-01-01

223

Formation of Torus-Unstable Flux Ropes and Electric Currents in Erupting Sigmoids  

NASA Astrophysics Data System (ADS)

We analyze the physical mechanisms that form a three-dimensional coronal flux rope and later cause its eruption. This is achieved by a zero-? magnetohydrodynamic (MHD) simulation of an initially potential, asymmetric bipolar field, which evolves by means of simultaneous slow magnetic field diffusion and sub-Alfvénic, line-tied shearing motions in the photosphere. As in similar models, flux-cancellation-driven photospheric reconnection in a bald-patch (BP) separatrix transforms the sheared arcades into a slowly rising and stable flux rope. A bifurcation from a BP to a quasi-separatrix layer (QSL) topology occurs later on in the evolution, while the flux rope keeps growing and slowly rising, now due to shear-driven coronal slip-running reconnection, which is of tether-cutting type and takes place in the QSL. As the flux rope reaches the altitude at which the decay index -?ln B/?ln z of the potential field exceeds ~3/2, it rapidly accelerates upward, while the overlying arcade eventually develops an inverse tear-drop shape, as observed in coronal mass ejections (CMEs). This transition to eruption is in accordance with the onset criterion of the torus instability. Thus, we find that photospheric flux-cancellation and tether-cutting coronal reconnection do not trigger CMEs in bipolar magnetic fields, but are key pre-eruptive mechanisms for flux ropes to build up and to rise to the critical height above the photosphere at which the torus instability causes the eruption. In order to interpret recent Hinode X-Ray Telescope observations of an erupting sigmoid, we produce simplified synthetic soft X-ray images from the distribution of the electric currents in the simulation. We find that a bright sigmoidal envelope is formed by pairs of J-shaped field lines in the pre-eruptive stage. These field lines form through the BP reconnection and merge later on into S-shaped loops through the tether-cutting reconnection. During the eruption, the central part of the sigmoid brightens due to the formation of a vertical current layer in the wake of the erupting flux rope. Slip-running reconnection in this layer yields the formation of flare loops. A rapid decrease of currents due to field line expansion, together with the increase of narrow currents in the reconnecting QSL, yields the sigmoid hooks to thin in the early stages of the eruption. Finally, a slightly rotating erupting loop-like feature (ELLF) detaches from the center of the sigmoid. Most of this ELLF is not associated with the erupting flux rope, but with a current shell that develops within expanding field lines above the rope. Only the short, curved end of the ELLF corresponds to a part of the flux rope. We argue that the features found in the simulation are generic for the formation and eruption of soft X-ray sigmoids.

Aulanier, G.; Török, T.; Démoulin, P.; DeLuca, E. E.

2010-01-01

224

Treatment of partial distal biceps tendon tears.  

PubMed

Partial rupture of the distal biceps tendon exhibits features similar to that of complete disruption, including acute antecubital pain, weakness of elbow flexion, and forearm supination, and differs only in the fact that the biceps tendon is still palpable in the partial rupture. There are 2 etiologies, first acute traumatic (such as a sudden eccentric contracture) and second, chronic degenerative tendon disease. For accurate diagnosis, a high index of suspicion must be employed. Initial investigations should include plain x-ray and a magnetic resonance scan. Partial tears <50% may be treated with nonoperative management or with surgical debridement of the surrounding synovitis. Tears >50% should be treated with division of the remaining tendon and surgical repair of the entire tendon as a single unit. Surgical endoscopy provides the ability to further quantify the extent of a distal biceps tear and to treat with debridement. This technique, however, should only be used in experienced hands. PMID:18703975

Bain, Gregory I; Johnson, Luke J; Turner, Perry C

2008-09-01

225

The Epidemiology of Distal Radius Fractures  

PubMed Central

Distal radius fractures are one of the most common types of fractures, accounting for around 25% of fractures in the pediatric population and up to 18% of all fractures in the elderly age group. Although the pediatric and elderly populations are at the greatest risk for this injury, distal radius fractures still have a significant impact on the health and well-being of young adults. Data from the past 40 years has documented a trend towards an overall increase in the prevalence of this injury. For the pediatric population, this increase can likely be attributed to a surge in sports related activities. The growth of the elderly population and a rise in the number of active elderly are directly responsible for the increase seen in this age group. Understanding the epidemiology of this fracture is an important step towards the improvement of the treatment strategies and preventative measures which target this debilitating injury. PMID:22554654

Nellans, Kate W.; Kowalski, Evan; Chung, Kevin C.

2012-01-01

226

Periosteal osteoid osteoma of the distal femur  

PubMed Central

Periosteal osteoid osteoma is extremely rare. The diagnosis is not always clear. We report a case of periosteal osteoid osteoma arising from the posterior surface of the right distal femur in a 21-year-old woman. After careful evaluation and excisional biopsy, histological examination confirmed the diagnosis of osteoid osteoma, showing the nidus, surrounding osteosclerosis, and catarrhal synovitis. The lesion was treated successfully with excision of the nidus. PMID:21808706

Amar, Mohammed Fahd; Almoubaker, Salma; Chbani, Badr; Chahbouni, Sanae; Marzouki, Amine; Amarti, Afaf; Boutayeb, Fawzi

2010-01-01

227

Fractures of Distal Radius: An Overview  

PubMed Central

Fractures of distal radius account for up to 20% of all fractures treated in emergency department. Initial assessment includes a history of mechanism of injury, associated injury and appropriate radiological evaluation. Treatment options include conservative management, internal fixation with pins, bridging and non-bridging external fixation, dorsal or volar plating with/without arthroscopy assistance. However, many questions regarding these fractures remain unanswered and good prospective randomized trials are needed.

Meena, Sanjay; Sharma, Pankaj; Sambharia, Abhishek Kumar; Dawar, Ashok

2014-01-01

228

Nonlinear Force-free Modeling of a Long-lasting Coronal Sigmoid  

NASA Astrophysics Data System (ADS)

A study of the magnetic configuration and evolution of a long-lasting quiescent coronal sigmoid is presented. The sigmoid was observed by Hinode/XRT and Transition Region and Coronal Explorer (TRACE) between 2007 February 6 and 12 when it finally erupted. We construct nonlinear force-free field models for several observations during this period, using the flux-rope insertion method. The high spatial and temporal resolution of the X-Ray Telescope (XRT) allows us to finely select best-fit models that match the observations. The modeling shows that a highly sheared field, consisting of a weakly twisted flux rope embedded in a potential field, very well describes the structure of the X-ray sigmoid. The flux rope reaches a stable equilibrium, but its axial flux is close to the stability limit of about 5 × 1020 Mx. The relative magnetic helicity increases with time from February 8 until just prior to the eruption on February 12. We study the spatial distribution of the torsion parameter ? in the vicinity of the flux rope, and find that it has a hollow-core distribution, i.e., electric currents are concentrated in a current layer at the boundary between the flux rope and its surroundings. The current layer is located near the bald patch separatrix surface (BPSS) of the magnetic configuration, and the X-ray emission appears to come from this current layer/BPSS, consistent with the Titov and Démoulin model. We find that the twist angle ? of the magnetic field increases with time to about 2? just prior to the eruption, but never reaches the value necessary for the kink instability.

Savcheva, Antonia; van Ballegooijen, Adriaan

2009-10-01

229

Proximal Tumors Are Associated with Greater Mortality in Colon Cancer  

PubMed Central

ABSTRACT BACKGROUND Colon cancer is the third leading cause of death from cancer in the United States. Recent studies report on increasing proportions of proximal cancers. The etiology behind this epidemiological trend is unclear, and its implication on survival outcomes is unknown. Further analysis of the impact of anatomic site of disease among a large multiethnic population will help facilitate research and education to improve colon cancer screening and treatment. OBJECTIVE To investigate the association between proximal tumor location and survival in patients with colon cancer. DESIGN AND PARTICIPANTS A large retrospective cohort study in the US utilizing the Surveillance, Epidemiology, and End Results (SEER) cancer registry analyzed survival outcomes of patients with colon cancer. Multivariable logistic regression analyses investigated sex-specific, race/ethnicity-specific, and anatomic site-specific disparities in survival. MAIN MEASURES Five-year survival outcomes from colon cancer. RESULTS Our study demonstrated significant disparities in survival by sex, race/ethnicity, and anatomic site. Across all time periods and among most cohorts, patients with proximal cancers had significantly worse survival outcomes. When compared to distal cancers, patients with proximal cancers were 13% less likely to survive 5 years (OR 0.87; 95% CI, 0.82–0.91). When compared to non-Hispanic whites, blacks were 30% less likely to survive 5 years (OR 0.70; 95% CI, 0.68–0.73). Stage-specific multivariable regression analysis of localized cancers demonstrated similar findings. CONCLUSIONS Significant race-specific, sex-specific, and anatomic site-specific disparities in colon cancer survival exist. Proximal cancers are associated with worse survival odds. These disparities may reflect differences in the genotype and phenotype of colon cancer among these groups. A modified risk assessment tool that incorporates these variations may be more effective in the early detection and treatment of colon cancer. PMID:20652758

2010-01-01

230

Distal Embolic Protection for Renal Arterial Interventions  

SciTech Connect

Distal or embolic protection has intuitive appeal for its potential to prevent embolization of materials generated during interventional procedures. Distal protection devices (DPDs) have been most widely used in the coronary and carotid vascular beds, where they have demonstrated the ability to trap embolic materials and, in some cases, to reduce complications. Given the frequency of chronic kidney disease in patients with renal artery stenosis undergoing stent placement, it is reasonable to propose that these devices may play an important role in limiting distal embolization in the renal vasculature. Careful review of the literature reveals that atheroembolization does occur during renal arterial interventions, although it often goes undetected. Early experience with DPDs in the renal arteries in patients with suitable anatomy suggests retrieval of embolic materials in approximately 71% of cases and renal functional improvement/stabilization in 98% of cases. The combination of platelet inhibition and a DPD may provide even greater benefit. Given the critical importance of renal functional preservation, it follows that everything that can be done to prevent atheroembolism should be undertaken including the use of DPDs when anatomically feasible. The data available at this time support a beneficial role for these devices.

Dubel, Gregory J., E-mail: gdubel@lifespan.org; Murphy, Timothy P. [Brown University Medical School, Department of Diagnostic Imaging, Division of Interventional Radiology (United States)

2008-01-15

231

Forearm and distal radius fractures in children.  

PubMed

Pediatric forearm and distal radius fractures are common injuries. Resultant deformities are usually a product of indirect trauma involving angular loading combined with rotational displacement. Fractures are classified by location, completeness, angular and rotational deformity, and fragment displacement. Successful outcomes are based on restoration of adequate pronation and supination and, to a lesser degree, acceptable cosmesis. When several important concepts are kept in mind, these goals are usually met with conservative treatment by reduction and immobilization. Greenstick fractures are reduced by rotating the forearm such that the palm is directed toward the fracture apex. Complete fractures are manipulated and reduced with traction and rotation; extremities are then immobilized in well-molded plaster casts until healing, which usually takes about 6 weeks. Radiographs should be obtained between 1 and 2 weeks after initial reduction to detect early angulation. In fractures in any level in children less than 9 years of age, complete displacement, 15 degrees of angulation, and 45 degrees of malrotation are acceptable. In children 9 years of age or older, 30 degrees of malrotation is acceptable, with 10 degrees of angulation for proximal fractures and 15 degrees for more distal fractures. Complete bayonet apposition is acceptable, especially for distal radius fractures, as long as angulation does not exceed 20 degrees and 2 years of growth remains. Operative intervention is used when the fracture is open and when acceptable alignment cannot be achieved or maintained. Single-bone intramedullary fixation has proven useful. PMID:9689186

Noonan, K J; Price, C T

1998-01-01

232

Immediate postoperative parastomal end sigmoid hernia resulting in evisceration and strangulation  

PubMed Central

Parastomal evisceration is a very rare complication occurring after stoma formation. We report the case of this complication which occurred within 3 days status post end sigmoid colostomy in a 69-year-old male who initially presented with perianal infection–severe necrotizing fasciitis. This case highlights the significance of the size of a stomatal aperture and should remind general surgeons of the one of dangerous complications indicated by a stomatal aperture that is just a centimeter larger than the accepted ideal size. PMID:24876516

Azouz, Vitali; Simmons, Jeremy D.; Abourjaily, Georges S.

2014-01-01

233

Formation and Eruption of an Active Region Sigmoid: NLFFF Modeling and MHD Simulation  

NASA Astrophysics Data System (ADS)

We present a magnetic analysis of the formation and eruption of an active region sigmoid in AR 11283 from 2011 September 4 to 6, which is jointly based on observations, static nonlinear force-free field (NLFFF) extrapolation and dynamic MHD simulation. A time sequence of NLFFF model's outputs are used to reproduce the evolution of the magnetic field of the region over three days leading to a X-class flare near the end of 2011 September 6. In the first day, a new bipolar emerges into the negative polarity of a pre-existing mature bipolar, forming a magnetic topology with a coronal null on the magnetic separatrix surface between the two flux system, while the field is still near potential at the end of the day. After then photospheric shearing and twisting build up non-potentiality in the embedded core region, with a flux rope (FR) formed there above the polarity inversion line by tether-cutting reconnection between the strongly sheared field lines. Within this duration, the core field has gained a magnetic free energy of ˜ 1032 erg. In this core a sigmoid is observed distinctly at 22:00 UT on September 6, closely before its eruption at 22:12 UT. Comparison of the SDO/AIA observations with coronal magnetic field suggests that the sigmoid is formed by emission due to enhanced current sheet along the BPSS (bald-patch separatrix surface, in which the field lines graze the line-tied photosphere at the neutral line) that separates the FR from the ambient flux. Quantitative inspection of the pre-eruption field on 22:00 UT suggests a mechanism for the eruption: tether cutting at the null triggers a torus instability of the FR--overlying field system. This pre-eruption NLFFF is then input into a time-dependent MHD model to simulate the fast magnetic evolution during eruption, which successfully reproduces the observations. The highly asymmetric magnetic environment along with the lateral location of the null leads to a strongly inclined non-radial direction of the eruption. The study of this kind provides important insights in a quantitative way to many open issues on the formation and eruption of sigmoidal FR.

Jiang, C.; Wu, S.; Feng, X.; Hu, Q.

2013-12-01

234

Use of a computer to evaluate sigmoidal curves in serology by a new procedure.  

PubMed

Serological standard curves are mostly sigmoidal in shape. Their transformation into straight lines by linear regression can be the source of serious error. Log/log or logit/log handling of the values can straighten the curve but only if their distribution is normal. A new way of calculating concentrations of antibody or antigen which leaves the standard curve unmanipulated is described. Computer programs for TI 59 (Texas Instruments) and--in BASIC--for a personal computer have been written and greatly facilitate routine work. PMID:7310137

Fey, H

1981-01-01

235

Clinical syndromes of arteriovenous malformations of the transverse-sigmoid sinus.  

PubMed Central

Arteriovenous malformations or fistulae shunting arterial blood from branches of the external and internal carotid and vertebral arteries into the transverse-sigmoid sinus may produce different clinical syndromes. The literature is reviewed with 96 patients including six personal cases. Usually these malformations have a congenital origin and only in 4% of the series was there a previous history of a severe head injury. Clinical groups are defined and the role of angiography assessed. Direct surgical approach with occlusion or removal of the vascular malformation is the treatment of choice. Possible methods of treatment by selective embolization are discussed. Images PMID:1097602

Obrador, S; Soto, M; Silvela, J

1975-01-01

236

On the partitioning capabilities of feedforward neural networks with sigmoid nodes.  

PubMed

In this letter, the capabilities of feedforward neural networks (FNNs) on the realization and approximation of functions of the form g: R(l) --> A, which partition the R(l) space into polyhedral sets, each one being assigned to one out of the c classes of A, are investigated. More specifically, a constructive proof is given for the fact that FNNs consisting of nodes having sigmoid output functions are capable of approximating any function g with arbitrary accuracy. Also, the capabilities of FNNs consisting of nodes having the hard limiter as output function are reviewed. In both cases, the two-class as well as the multiclass cases are considered. PMID:14511529

Koutroumbas, K

2003-10-01

237

Clinical, Endoscopic, and Histopathological Aspects of Sigmoid Actinomycosis; A Case Report and Literature Review  

PubMed Central

Actinomycosis is a rare and chronic infectious disease caused by a non-spore gram- positive, anaerobic bacterium that rarely infects the colon, in particular the left colon. A 53-year-old woman was referred to us due to chronic abdominal pain, bloating, a few episodes of bloody-mucous rectal discharge, and change of bowel habits. Her medical history and physical examination were unremarkable. Colonoscopy revealed a polypoid mass like lesion located 20 cm proximal to the anal verge above the rectosigmoid junction. Several biopsy samples were taken. Histopathological evaluation showed actinomycosis infection. Consequently the patient was treated with intravenous and then six months oral penicillin. Her complaints and colonic mass resolved totally. Diagnosis of colonic actinomycosis is not an easy task. It is advisable to keep this infection in mind among the differential diagnoses of unusual abdominal masses. Colonoscopy and histopathological examination can be the preferred modality for diagnosis of colonic actinomycosis infection.

Zamani, Farhad; Sohrabi, Masoudreza

2015-01-01

238

Distal hereditary motor neuropathy type II (distal HMN II): mapping of a locus to chromosome 12q24  

Microsoft Academic Search

The distal hereditary motor neuropathy (distal HMN) or the spinal form of Charcot-Marie-Tooth (CMT) disease is an exclusively motor disorder of the peripheral nerv- ous system. The disorder clinically resembles the her- editary motor and sensory neuropathies (HMSN) type I and type II or CMT type 1 and type 2. Distal HMN might also be related to the spinal muscular

Vincent Timmerman; Peter De Jonghe; Sandra Simokovic; Ann Löfgren; Joke Beuten; Eva Nelis; Chantal Ceuterick; Jean-Jacques Martin; Christine Van Broeckhoven

1996-01-01

239

Piroxicam decreases postirradiation colonic neoplasia in the rat  

SciTech Connect

This study evaluated the effects of the nonsteroidal antiinflammatory agent piroxicam on chronic radiation proctitis in the rat. Forty female Wistar rats received a 2250-cGy dose of irradiation to the distal 2 cm of the colon. Twenty received piroxicam 8.0 mg/kg orally 30 minutes before exposure and 24 hours after exposure; 20 rats served as irradiated controls. All animals were evaluated by colonoscopy 1 and 3 weeks postexposure and every third week until death or killing at 1 year. At killing, colons were removed for light microscopic examination. One year postirradiation results showed no differences in mortality, vascular changes, acute inflammation, colitis cystica profunda, or rectal stricture between the control and piroxicam-treated groups. However, at 1 year postirradiation the control group demonstrated neoplasia in 15 of 19 animals compared with eight of 20 animals in the piroxicam-treated group. The first endoscopic appearance of colonic neoplasm occurred at 15 weeks postirradiation in one control irradiated rat whereas the first evidence of endoscopic neoplasm in the piroxicam-treated group did not occur until 36 weeks postirradiation. Histologic examination documented a tendency toward a greater presence of adenocarcinomas in the control group compared with the piroxicam-treated group. The authors conclude that piroxicam treatment significantly decreased the incidence of colonic neoplasia in general as well as delayed the endoscopic appearance of colonic neoplasia in rats after pelvic irradiation. 41 references.

Northway, M.G.; Scobey, M.W.; Cassidy, K.T.; Geisinger, K.R. (Wake Forest Univ., Winston Salem, NC (USA))

1990-12-01

240

Identification of functionally distinct Na-HCO3 co-transporters in colon.  

PubMed

Na-HCO3 cotransport (NBC) regulates intracellular pH (pHi) and HCO3 secretion in rat colon. NBC has been characterized as a 5,5'-diisothiocyanato-2-2'-stilbene (DIDS)-sensitive transporter in several tissues, while the colonic NBC is sensitive to both amiloride and DIDS. In addition, the colonic NBC has been identified as critical for pHi regulation as it is activated by intravesicular acid pH. Molecular studies have identified several characteristically distinct NBC isoforms [i.e. electrogenic (NBCe) and electroneutral (NBCn)] that exhibit tissue specific expression. This study was initiated to establish the molecular identity and specific function of NBC isoforms in rat colon. Northern blot and reverse transcriptase PCR (RT-PCR) analyses revealed that electrogenic NBCe1B or NBCe1C (NBCe1B/C) isoform is predominantly expressed in proximal colon, while electroneutral NBCn1C or NBCn1D (NBCn1C/D) is expressed in both proximal and distal colon. Functional analyses revealed that amiloride-insensitive, electrogenic, pH gradient-dependent NBC activity is present only in basolateral membranes of proximal colon. In contrast, amiloride-sensitive, electroneutral, [H(+)]-dependent NBC activity is present in both proximal and distal colon. Both electrogenic and electroneutral NBC activities are saturable processes with an apparent Km for Na of 7.3 and 4.3 mM, respectively; and are DIDS-sensitive with apparent Ki of 8.9 and 263.8 µM, respectively. In addition to Na-H exchanger isoform-1 (NHE1), pHi acidification is regulated by a HCO3-dependent mechanism that is HOE694-insensitive in colonic crypt glands. We conclude from these data that electroneutral, amiloride-sensitive NBC is encoded by NBCn1C/D and is present in both proximal and distal colon, while NBCe1B/C encodes electrogenic, amiloride-insensitive Na-HCO3 cotransport in proximal colon. We also conclude that NBCn1C/D regulates HCO3-dependent HOE694-insensitive Na-HCO3 cotransport and plays a critical role in pHi regulation in colonic epithelial cells. PMID:23690961

Barmeyer, Christian; Ye, Jeff Huaqing; Soroka, Carol; Geibel, Peter; Hingsammer, Lukas M; Weitgasser, Laurence; Atway, Danny; Geibel, John P; Binder, Henry J; Rajendran, Vazhaikkurichi M

2013-01-01

241

Identification of Functionally Distinct Na-HCO3 Co-Transporters in Colon  

PubMed Central

Na-HCO3 cotransport (NBC) regulates intracellular pH (pHi) and HCO3 secretion in rat colon. NBC has been characterized as a 5,5?-diisothiocyanato-2-2?-stilbene (DIDS)-sensitive transporter in several tissues, while the colonic NBC is sensitive to both amiloride and DIDS. In addition, the colonic NBC has been identified as critical for pHi regulation as it is activated by intravesicular acid pH. Molecular studies have identified several characteristically distinct NBC isoforms [i.e. electrogenic (NBCe) and electroneutral (NBCn)] that exhibit tissue specific expression. This study was initiated to establish the molecular identity and specific function of NBC isoforms in rat colon. Northern blot and reverse transcriptase PCR (RT-PCR) analyses revealed that electrogenic NBCe1B or NBCe1C (NBCe1B/C) isoform is predominantly expressed in proximal colon, while electroneutral NBCn1C or NBCn1D (NBCn1C/D) is expressed in both proximal and distal colon. Functional analyses revealed that amiloride-insensitive, electrogenic, pH gradient-dependent NBC activity is present only in basolateral membranes of proximal colon. In contrast, amiloride-sensitive, electroneutral, [H+]-dependent NBC activity is present in both proximal and distal colon. Both electrogenic and electroneutral NBC activities are saturable processes with an apparent Km for Na of 7.3 and 4.3 mM, respectively; and are DIDS-sensitive with apparent Ki of 8.9 and 263.8 µM, respectively. In addition to Na-H exchanger isoform-1 (NHE1), pHi acidification is regulated by a HCO3-dependent mechanism that is HOE694-insensitive in colonic crypt glands. We conclude from these data that electroneutral, amiloride-sensitive NBC is encoded by NBCn1C/D and is present in both proximal and distal colon, while NBCe1B/C encodes electrogenic, amiloride-insensitive Na-HCO3 cotransport in proximal colon. We also conclude that NBCn1C/D regulates HCO3-dependent HOE694-insensitive Na-HCO3 cotransport and plays a critical role in pHi regulation in colonic epithelial cells. PMID:23690961

Barmeyer, Christian; Ye, Jeff Huaqing; Soroka, Carol; Geibel, Peter; Hingsammer, Lukas M.; Weitgasser, Laurence; Atway, Danny; Geibel, John P.; Binder, Henry J.; Rajendran, Vazhaikkurichi M.

2013-01-01

242

Enzyme-Based Logic Analysis of Biomarkers at Physiological Concentrations: AND Gate with Double-Sigmoid "Filter" Response  

E-print Network

We report the first realization of a biomolecular AND gate function with double-sigmoid response (sigmoid in both inputs). Two enzyme biomarker inputs activate the gate output signal which can then be used as indicating liver injury, but only when both of these inputs have elevated pathophysiological concentrations, effectively corresponding to logic-1 of the binary gate functioning. At lower, normal physiological concentrations, defined as logic-0 inputs, the liver-injury output levels are not obtained. High-quality gate functioning in handling of various sources of noise, on time scales of relevance to potential applications is enabled by utilizing "filtering" effected by a simple added biocatalytic process. The resulting gate response is sigmoid in both inputs when proper system parameters are chosen, and the gate properties are theoretically analyzed within a model devised to evaluate its noise-handling properties.

Halamek, Jan; Halamkova, Lenka; Korkmaz, Sevim; Privman, Vladimir; Katz, Evgeny; 10.1021/jp300447w

2013-01-01

243

Formation of current sheets and sigmoidal structure by the kink instability of a magnetic loop  

E-print Network

We study dynamical consequences of the kink instability of a twisted coronal flux rope, using the force-free coronal loop model by Titov & D\\'emoulin (1999) as the initial condition in ideal-MHD simulations. When a critical value of the twist is exceeded, the long-wavelength ($m=1$) kink mode develops. Analogous to the well-known cylindrical approximation, a helical current sheet is then formed at the interface with the surrounding medium. In contrast to the cylindrical case, upward-kinking loops form a second, vertical current sheet below the loop apex at the position of the hyperbolic flux tube (generalized X line) in the model. The current density is steepened in both sheets and eventually exceeds the current density in the loop (although the kink perturbation starts to saturate in our simulations without leading to a global eruption). The projection of the field lines that pass through the vertical current sheet shows an S shape whose sense agrees with the typical sense of transient sigmoidal (forward or reverse S-shaped) structures that brighten in soft X rays prior to coronal eruptions. The upward-kinked loop has the opposite S shape, leading to the conclusion that such sigmoids do not generally show the erupting loops themselves but indicate the formation of the vertical current sheet below them that is the central element of the standard flare model.

B. Kliem; V. S. Titov; T. Toeroek

2003-11-09

244

Max Millennium/Whole Sun Month Observations of a Sigmoid Region (AR 8668)  

NASA Astrophysics Data System (ADS)

We report on observations of a sigmoidal region AR 8668 obtained during the Whole Sun Month #3 campaign and Max Millennium Coordinated Observing Program #2. The observations pertain to the period 1999 August 16-17 during which several GOES B and C class flares occurred in AR 8668. Near simultaneous observations were obtained by SOHO (EIT 195 Angstroms/ and MDI full-disk magnetograms), TRACE 171 Angstroms/, Yohkoh SXT, Big Bear (H? ), and Mees (IVM vector magnetograms). The multi-wavelength nature of these data, combined with their overlapping spatial and temporal coverages, provide a unique opportunity to study the magnetic topology and flaring evolution of twisted flux structures associated with sigmoids. An objective of this study is to co-align images and magnetograms obtained before and during the observed flares, and compare the results with inferences from the topological model of Titov and Demoulin, A&A 351, 707 (1999). We will present examples of these coalignments and identify sites of magnetic energy release that are associated with topological features (e.g. separatrices) predicted by this model.

Zarro, D. M.; Canfield, R. C.; Nitta, N.; Myers, D. C.; Gregory, S. E.; Qiu, J.; Alexander, D.; Hudson, H. S.; Thompson, B. J.; LaBonte, B. J.

2000-05-01

245

Modified Sigmoid Function Based Gray Scale Image Contrast Enhancement Using Particle Swarm Optimization  

NASA Astrophysics Data System (ADS)

The main objective of an image enhancement is to improve eminence by maximizing the information content in the test image. Conventional contrast enhancement techniques either often fails to produce reasonable results for a broad variety of low-contrast and high contrast images, or cannot be automatically applied to different images, because they are parameters dependent. Hence this paper introduces a novel hybrid image enhancement approach by taking both the local and global information of an image. In the present work, sigmoid function is being modified on the basis of contrast of the images. The gray image enhancement problem is treated as nonlinear optimization problem with several constraints and solved by particle swarm optimization. The entropy and edge information is included in the objective function as quality measure of an image. The effectiveness of modified sigmoid function based enhancement over conventional methods namely linear contrast stretching, histogram equalization, and adaptive histogram equalization are better revealed by the enhanced images and further validated by statistical analysis of these images.

Verma, Harish Kumar; Pal, Sandeep

2015-01-01

246

A noninvasive scintigraphic assessment of the colonic transit of nondigestible solids in man  

SciTech Connect

A noninvasive, scintigraphic technique for quantifying large intestinal transit time that provides low radiation doses was developed. The scintigraphic large intestinal transit (SLIT) method uses a total of 100 microCi of 111In encapsulated in ten 2-cm nondigestible capsules, which are ingested after a 6-hr fast. Two hundred fifty microcuries of 99mTc-sulfur colloid were given to outline the gastrointestinal tract. Images were acquired at 4-hr intervals until all capsules were excreted. Normal volunteers (n = 10) consumed a standardized diet 2 days prior and during imaging. Segmental transit times were measured in the following: ascending, transverse, descending, recto-sigmoid colons; hepatic and splenic flexures. The radiation absorbed dose to the large intestine for the SLIT technique is less than half of that associated with other radiographic methods of colonic transit time measurement.

Stubbs, J.B.; Valenzuela, G.A.; Stubbs, C.C.; Croft, B.Y.; Teates, C.D.; Plankey, M.W.; McCallum, R.W. (Department of Nuclear Engineering, General Clinical Research Center, University of Virginia, Charlottesville (USA))

1991-07-01

247

A case of colonic pseudoobstruction related to bacterial overgrowth due to a sigmoidocecal fistula.  

PubMed

Colocolic fistulas are usually a complication of an inflammatory or neoplastic process. Development of these abnormal bowel communications may lead to bacterial overgrowth. We report on a 71-year-old man with a one-year history of recurrent abdominal distension and irregular bowel habits. Abdominal X-rays and computed tomography showed multiple air-fluid levels and loops of distended bowel without evidence of mechanical obstruction or diverticulitis. Colonoscopy showed a fistulous tract between the sigmoid colon and cecum. Results of a lactulose breath test showed high fasting breath CH4 levels, which were thought to be the result of intestinal bacterial overgrowth. The patient was diagnosed with a colonic pseudo-obstruction associated with bacterial overgrowth due to a sigmoidocecal fistula. We recommended surgical correction of the sigmoidocecal fistula; however, the patient requested medical treatment. After antibiotic therapy, the patient still had mild symptoms but no acute exacerbations. PMID:24561700

Chung, Kyoung Myeun; Lim, Seong Uk; Hong, Hyoung Ju; Park, Seon Young; Park, Chang Hwan; Kim, Hyun Soo; Choi, Sung Kyu; Rew, Jong Sun

2014-02-01

248

Ensemble classification of colon biopsy images based on information rich hybrid features.  

PubMed

In recent years, classification of colon biopsy images has become an active research area. Traditionally, colon cancer is diagnosed using microscopic analysis. However, the process is subjective and leads to considerable inter/intra observer variation. Therefore, reliable computer-aided colon cancer detection techniques are in high demand. In this paper, we propose a colon biopsy image classification system, called CBIC, which benefits from discriminatory capabilities of information rich hybrid feature spaces, and performance enhancement based on ensemble classification methodology. Normal and malignant colon biopsy images differ with each other in terms of the color distribution of different biological constituents. The colors of different constituents are sharp in normal images, whereas the colors diffuse with each other in malignant images. In order to exploit this variation, two feature types, namely color components based statistical moments (CCSM) and Haralick features have been proposed, which are color components based variants of their traditional counterparts. Moreover, in normal colon biopsy images, epithelial cells possess sharp and well-defined edges. Histogram of oriented gradients (HOG) based features have been employed to exploit this information. Different combinations of hybrid features have been constructed from HOG, CCSM, and Haralick features. The minimum Redundancy Maximum Relevance (mRMR) feature selection method has been employed to select meaningful features from individual and hybrid feature sets. Finally, an ensemble classifier based on majority voting has been proposed, which classifies colon biopsy images using the selected features. Linear, RBF, and sigmoid SVM have been employed as base classifiers. The proposed system has been tested on 174 colon biopsy images, and improved performance (=98.85%) has been observed compared to previously reported studies. Additionally, the use of mRMR method has been justified by comparing the performance of CBIC on original and reduced feature sets. PMID:24561346

Rathore, Saima; Hussain, Mutawarra; Aksam Iftikhar, Muhammad; Jalil, Abdul

2014-04-01

249

Colon cancer screening  

MedlinePLUS

... called a virtual colonoscopy . Other tests: Double-contrast barium enema is a special x-ray of the ... colon cancer: Colonoscopy every 10 years Double-contrast barium enema every 5 years Fecal occult blood test ( ...

250

Causes, Inheritance: Colon cancer  

NSDL National Science Digital Library

Familial colon cancer was long thought to be inherited; however a complete understanding of its causes awaited the discovery that specific genetic mutations confer a large increase in susceptibility to these types of cancers.

2009-12-26

251

Anatomic Reconstruction of the Distal Radioulnar Ligament for Posttraumatic Distal Radioulnar Joint Instability  

PubMed Central

Background To analyze clinical outcomes after anatomical reconstruction of distal radioulnar ligaments in patients with chronic post-traumatic instability of the distal radioulnar joint. Methods Anatomical reconstruction was performed in 16 patients with subluxation or dynamic instability of distal radioulnar joint following trauma. Osteotomy was performed simultaneously in 10 patients with radial malunion. The average follow-up period was 18.9 months. For clinical outcome assessment, we performed the anteroposterior stress test, measured the range of motion and grip strength, and performed radiological examination. For assessment of the pain and function, we used the Patient Rated Wrist Evaluation, the Disabilities of the Arm, Shoulder and Hand, and the Modified Mayo Wrist Score. Results Anteroposterior stress test performed at the last follow-up showed normal in 12 patients, mild laxity in 3, and residual subluxation in one. The average Patient Rated Wrist Evaluation was 9.1 for pain and 11.2 for function. The average Disabilities of the Arm, Shoulder and Hand score was 10.5. The average Modified Mayo Wrist Score was 92.8; there were 10 excellent, 5 good, and 1 poor case. The average grip strength improved from 69.7 1b to 80.9 1b. A revision osteotomy was performed on the patient with residual subluxation in order to obtain normal alignment of the joint. Conclusions Anatomical reconstruction of the distal radioulnar ligaments is recommended to restore distal radioulnar joint stability. In addition to ligament reconstruction, realignment of the distal radioulnar joint seems critical when the instability is combined with malunion of the radius. PMID:19885049

Seo, Kyu Nam; Kang, Hong Je

2009-01-01

252

Pulsatile tinnitus caused by an aneurysm of the transverse-sigmoid sinus: a new case report and review of literature.  

PubMed

A 28-year-old woman consulted for disabling pulsatile tinnitus. Clinical examination suggested a venous etiology. An aneurysm of the transverse-sigmoid sinus was identified on computed tomography angiography (CTA) and confirmed by digital subtraction angiography. Endovascular occlusion of the aneurysm with detachable coils permanently eliminated the bruit. Thus, this report is of a new case of pulsatile tinnitus caused by an aneurysm of the transverse-sigmoid sinus, with a focus on a literature review and etiopathophysiology. Embryological studies suggest that these aneurysms represent a partial remnant of the petrosquamous sinus. PMID:23025972

Lenck, Stephanie; Mosimann, Pascal John; Labeyrie, Marc-Antoine; Houdart, Emmanuel

2012-10-01

253

Surgical approaches to the distal radioulnar joint.  

PubMed

For the distal radioulnar joint (DRUJ) to be stable, not only do the articulating surfaces need to be congruent and well aligned but also the capsule and ligaments need to be mechanically and sensorially competent. According to recent investigations, ligaments should not be regarded as simple static structures maintaining articular alignment but as complex arrangements of collagen fibers containing mechanoreceptors, which are able to generate neural reflexes aiming at a more efficient and a more definitive muscular stabilization. By careful planning and meticulous execution of surgical incisions to approach the DRUJ, the nerve endings innervating the capsule and DRUJ ligaments may be safeguarded, thus preserving the proprioceptive function of the joint. PMID:20951897

Garcia-Elias, Marc; Hagert, Elisabet

2010-11-01

254

Distal Renal Tubular Acidosis and Calcium Nephrolithiasis  

NASA Astrophysics Data System (ADS)

Calcium stones are commonly encountered in patients with congenital distal renal tubular acidosis, a disease of renal acidification caused by mutations in either the vacuolar H+-ATPase (B1 or a4 subunit), anion exchanger-1, or carbonic anhydrase II. Based on the existing database, we present two hypotheses. First, heterozygotes with mutations in B1 subunit of H+-ATPase are not normal but may harbor biochemical abnormalities such as renal acidification defects, hypercalciuria, and hypocitraturia which can predispose them to kidney stone formation. Second, we propose at least two mechanisms by which mutant B1 subunit can impair H+-ATPase: defective pump assembly and defective pump activity.

Moe, Orson W.; Fuster, Daniel G.; Xie, Xiao-Song

2008-09-01

255

VSHOT Measurements of Distal II Dish Concentrators  

SciTech Connect

The Video Scanning Hartmann Optical Tester (VSHOT) is a laser ray-trace tool for measuring the slope error of solar concentrator mirrors. The VSHOT measurements made on two, 8.5-m diameter, Distal II dishes represent its first use on a concentrator installed and operating in the field. A number of valuable lessons were learned regarding the use of the VSHOT for outdoor testing. The two dishes were found to have overall figure-of-merit RMS slope errors from an ideal parabola of 2.99 and 3.18 milliradians. The VSHOT measurements compare well qualitatively with distant observer photographs made using a colored concentric ring target.

Jones, S.A.

1998-12-14

256

Revascularization options for terminal distal ischemia.  

PubMed

Direct arterial bypass remains the best option in patients with terminal ischemia of the hand, if there is an adequate distal target vessel. In situ bypass is the procedure of choice in patients who are candidates for arterial bypass. Venous arterialization offers an option in patients in whom there is not adequate arterial runoff in the hand. Venous arterialization should be avoided in patients with significant wounds and/or active infection. In selected patients, microvascular omental transfer can offer an option for revascularization of the ischemic hand. PMID:25455358

Pederson, William C

2015-02-01

257

Nizatidine enhances the gastrocolonic response and the colonic peristaltic reflex in humans.  

PubMed

Animal studies demonstrate that nizatidine, an H2-receptor inhibitor, may enhance colonic activity independent of its effect on acid secretion. The effect of nizatidine on human colonic motility is unknown. We evaluated the potential prokinetic property of nizatidine in 12 healthy subjects (10 men and 2 women, age 21-46 years). Each subject received either nizatidine (600 mg), famotidine (80 mg, a H2-receptor inhibitor used as a control), or a placebo, on separate days in randomized order at least 3 days apart. Following an overnight fast, a three-lumen catheter fitted with a stimulus balloon and two barostat bags was placed in the descending colon. The gastrocolonic response was tested by antral balloon inflation and the colonic peristaltic reflex was evaluated by colonic distension. Changes in colonic motility were assessed by volume changes in the barostat bags. Antral distension evoked volume-dependent increases in colonic motility, maximal at a 300-ml inflation, as demonstrated by a reduced bag volume. Nizatidine enhanced colonic motility in response to antral distension at 200 and 300 ml, compared with famotidine and placebo. Colonic distension evoked volume-dependent increases in colonic motility proximal to the stimulus balloon. Compared with famotidine and placebo, nizatidine enhanced the ascending and descending contractile limbs of the peristaltic reflex but did not affect relaxation distal to the balloon. In conclusion, nizatidine enhanced the gastrocolonic response and the colonic peristaltic reflex in healthy subjects. Further research on the prokinetic action of nizatidine in the colon may lead to novel treatments for idiopathic constipation. PMID:11561075

Sun, W M; Hasler, W L; Lien, H C; Montague, J; Owyang, C

2001-10-01

258

Phosphorylation of glucose in isolated rat hepatocytes. Sigmoidal kinetics explained by the activity of glucokinase alone  

PubMed Central

The conversion of glucose into glucose 6-phosphate in an extract of isolated rat hepatocytes incubated in the presence of MgATP was studied spectrophotometrically at 340nm and also by a radiochemical procedure based on the release of 3H from [2-3H]glucose. Both methods gave similar results. The glucose-saturation curve was sigmoidal and the shape of this curve was not influenced by the ionic composition of the incubation medium. The activity at 0.5mm-glucose was only 1–2% of Vmax., indicating a virtual absence of low-Km hexokinase in the preparation. The radiochemical method was also used for the determination of glucose phosphorylation by intact hepatocytes. The glucose-saturation curve was also markedly sigmoidal, but the s0.5 (substrate concentration at half-maximal velocity) and the Hill coefficient were larger than in extracts of hepatocytes. These two parameters became smaller when cells were incubated in a medium in which Na+ ions were replaced by K+ ions. The increased rate of phosphorylation at low glucose concentration in a K+ medium was accompanied by an increased rate of metabolite recycling between glucose and glucose 6-phosphate and also by an increased uptake of glucose. In both media phosphorylation of glucose was inhibited co-operatively by N-acetylglucosamine. Calculations indicate that this inhibition would reach 100% at saturation of the inhibitor, although at lower concentrations of N-acetylglucosamine it was smaller than expected from the known Ki of N-acetylglucosamine for glucokinase. The rate of phosphorylation of glucose was proportional to the amount of glucokinase in hepatocytes from newborn rats and in conditions such as starvation and diabetes in which the total amount of glucokinase in the liver is decreased. In the same conditions, glucose 6-phosphatase activity was either normal or increased. It is concluded that the phosphorylation of glucose in isolated hepatocytes follows sigmoidal kinetics, which can be explained by the activity of glucokinase alone with no participation of low-Km hexokinase or of glucose 6-phosphatase. PMID:213056

Bontemps, Françoise; Hue, Louis; Hers, Henri-Géry

1978-01-01

259

THE ISOLATION OF ESCHERICHIA COLI 0157:H7 FROM INTACT COLON SAMPLES OF SWINE AT A SWINE SLAUGHTER FACILITY  

Technology Transfer Automated Retrieval System (TEKTRAN)

The prevalence of Escherichia coli O157:H7 in pig feces was examined at a swine slaughter facility. Fecal samples recovered from the distal colon of 305 eviscerated pigs were enriched in brilliant green bile broth followed by anti-E. coli O157 immunomagnetic bead separation. Beads were plated onto s...

260

Biomechanical Comparison of Osteoporotic Distal Radius Fractures Fixed by Distal Locking Screws with Different Length  

PubMed Central

Objectives To evaluate the postoperative stability of osteoporotic distal radius fractures fixed with distal locking screws with different length. Methods A comminuted extra-articular dorsally unstable distal radius fracture, treated with volar locking plate system, was created. The 18 specimens were randomized into 3 groups based on distal locked screws with different length: Group A had unicortical screws with 50% length to the dorsal cortex. Group B had unicortical screws with 75% length to the dorsal cortex. Group C had bicortical screws. Axial compression and bending loads were imposed on the models before and after cycling testing as well as load to clinical and catastrophic failure. Results Minimum change in stiffness was observed before and after fatigue for all groups. The final stiffness to bending forces was statistically similar in all groups, but stiffness to axial compression was statistically significant different: Group A approached significance with respect to groups B and C (P?=?0.017, 0.009), whereas stiffness in group B and C was statistically similar (P?=?0.93). Load to clinical failure was significantly less for group A (456.54±78.59 N) compared with groups B (580.24±73.85 N) and C (591.07±38.40 N). Load to catastrophic failure was statistically similar between groups, but mean values for Group A were 18% less than means for Group C. Conclusions The volar locking plate system fixed with unicortical locking screws with at least 75% length not only produced early stability for osteoporotic distal radius fractures, but also avoided extensor tendon complications due to dorsal screw protrusion. PMID:25080094

Liu, Xiong; Wu, Wei-dong; Fang, Ya-feng; Zhang, Mei-chao; Huang, Wen-hua

2014-01-01

261

Ultrasound of colon diverticulitis.  

PubMed

Overall, the diagnosis of diverticulitis is more reliably made by computed tomography (CT) than by ultrasound (US). However, since US is often used as a first modality in acute abdomen, it is important to be aware of the US signs of diverticulitis. Besides, in not too obese patients, US may be superior to CT. US is most useful in early, uncomplicated diverticulitis. Daily, repeated US examinations in patients with diverticulitis have taught that diverticulitis, in the majority of cases, runs a predictable and benign course. Initially, there is local wall thickening of the colon with preservation of the US layer structure. Within the inflamed diverticulum, a fecolith is present, and the diverticulum is surrounded by hyperechoic, noncompressible tissue, which represents the inflamed mesentery and omentum 'sealing off' the imminent perforation. US follow-up shows evacuation of the fecolith to the colonic lumen, with or without the transient development of a small paracolic abscess, sometimes with disintegration of the fecolith. This process of spontaneous evacuation of pus and fecolith via local weakening of the colonic wall at the level of the original diverticular neck towards the colonic lumen takes place within 1 or 2 days, rarely longer. The residual inflammatory changes remain present for several days after the evacuation, and it is not uncommon to find an empty diverticulum at first presentation. If, in such cases, patients are specifically asked for their symptoms, they invariably declare that 'the worst pain is over'. Whenever diverticulitis takes a complicated course, CT is superior to US, especially in the detection of free air, fecal peritonitis and deeply located abscesses, and in general in obese patients. Finally, US, if necessary followed by CT, has an important role in the diagnosis of alternative conditions: ureterolithiasis, pyelonephritis, perforated peptic ulcer, appendicitis, Crohn's disease, epiploic appendagitis, gynecological conditions, colonic malignancy, pancreatitis, etc. Right-sided colonic diverticulitis in many respects differs from its left-sided cousin. Diverticula of the right colon are usually congenital, solitary, true diverticula containing all bowel wall layers. The fecoliths within these diverticula are larger and the diverticular neck is wider. There is no hypertrophy of the muscularis of the right colonic wall. My observations with US and CT in 110 patients with right colonic diverticulitis clearly show that it invariably has a favorable course and never leads to free perforation or large abscesses. Although relatively rare (left:right = 15:1), it is crucial to make a correct diagnosis since the clinical symptoms of acute right lower quadrant pain may lead to an unnecessary appendectomy or even right hemicolectomy. PMID:22572686

Puylaert, Julien B C M

2012-01-01

262

A case of ascending colon variceal bleeding treated with venous coil embolization  

PubMed Central

A 38-year-old female with a history of alcoholic liver cirrhosis visited our hospital with a massive hematochezia. An esophagogastroduodenoscopy did not demonstrate any bleeding source, and a colonoscopy showed a massive hemorrhage in the ascending colon but without an obvious focus. The source of the bleeding could not be found with a mesenteric artery angiography. We performed an enhanced abdominal computed tomography, which revealed a distal ascending colonic varix, and assumed that the varix was the source of the bleeding. We performed a venous coil embolization and histoacryl injection to obliterate the colon varix. The intervention appeared to be successful because the vital signs and hemoglobin laboratory data remained stable and because the hematochezia was no longer observed. We report here on a rare case of colonic variceal bleeding that was treated with venous coil embolization. PMID:23345957

Ko, Bong Suk; Kim, Woo Tae; Chang, Su Sun; Kim, Eun Hye; Lee, Seung Woo; Park, Won Seok; Kim, Yeon Soo; Nam, Soon Woo; Lee, Dong Soo; Kim, Ji Chang; Kang, Sang Bum

2013-01-01

263

Unraveling the genetics of distal hereditary motor neuronopathies  

Microsoft Academic Search

The hereditary motor neuronopathies (HMN [MIM 158590]) are heterogeneous group of disorders characterized by an exclusive\\u000a involvement of the motor part of the peripheral nervous system. They are usually subdivided in proximal HMN, i.e., the classical\\u000a spinal muscular atrophy syndromes and distal hereditary motor neuronopathies (distal HMN) that clinically resemble Charcot-Marie-Tooth\\u000a syndromes. In this review, we concentrate on distal HMN.

Joy Irobi; Ines Dierick; Albena Jordanova; Kristl G. Clayes; Peter De Jonghe; Vincent Timmerman

2006-01-01

264

Distalization of the patella during tibial callus distraction.  

PubMed

Consecutive distalization of the patella is described in two patients undergoing segmental transportation after high tibial corticotomy. Revision surgery with loosening and proximal reattachment of a portion of the patellar ligament bridging the callus distraction zone could re-establish the correct patellar position. Despite excellent callus formation after tibial corticotomy just below the tibial tuberositas, this procedure should be performed more distally as the fibers of the patellar tendon spread laterally and distally. PMID:9709862

Eingartner, C; Bretschneider, C; Badke, A; Weise, K

1998-01-01

265

A New SIR-Based Sigmoid Power Control Game in Cognitive Radio Networks  

PubMed Central

Interference resulting from Cognitive Radios (CRs) is the most important aspect of cognitive radio networks that leads to degradation in Quality of Service (QoS) in both primary and CR systems. Power control is one of the efficient techniques that can be used to reduce interference and satisfy the Signal-to-Interference Ratio (SIR) constraint among CRs. This paper proposes a new distributed power control algorithm based on game theory approach in cognitive radio networks. The proposal focuses on the channel status of cognitive radio users to improve system performance. A new cost function for SIR-based power control via a sigmoid weighting factor is introduced. The existence of Nash Equilibrium and convergence of the algorithm are also proved. The advantage of the proposed algorithm is the possibility to utilize and implement it in a distributed manner. Simulation results show considerable savings on Nash Equilibrium power compared to relevant algorithms while reduction in achieved SIR is insignificant. PMID:25286044

Al-Gumaei, Yousef Ali; Noordin, Kamarul Ariffin; Reza, Ahmed Wasif; Dimyati, Kaharudin

2014-01-01

266

Lemierre syndrome with thrombosis of sigmoid sinus following dental extraction: a case report  

PubMed Central

Lemierre syndrome is caused by an infection in the oropharyngeal region with subsequent thrombophlebitis in the internal jugular vein. The thrombus from the thrombophlebitis can invade other vital organs, such as liver, lungs, or joints, resulting in secondary infection, which further exacerbates the fatal prognosis of this syndrome. Lemierre syndrome, also called postanginal sepsis or necrobacillosis, was first reported by Dr. Lemierre in 1936. In his report, Lemierre mentioned that out of 20 patients who suffered from this syndrome, only two survived. He also stated that all of the 20 patients complained of infections in the palatine tonsils and developed sepsis and thrombophlebitis in the internal jugular vein. Once called a "forgotten disease," this syndrome showed a very high mortality rate until usage of antibiotics became prevalent. In this case report, the authors present a 71-year-old female patient who suffered from Lemierre syndrome with thrombosis extended to the right sigmoid sinus. PMID:24471023

Kim, Taeyun

2013-01-01

267

Lemierre syndrome with thrombosis of sigmoid sinus following dental extraction: a case report.  

PubMed

Lemierre syndrome is caused by an infection in the oropharyngeal region with subsequent thrombophlebitis in the internal jugular vein. The thrombus from the thrombophlebitis can invade other vital organs, such as liver, lungs, or joints, resulting in secondary infection, which further exacerbates the fatal prognosis of this syndrome. Lemierre syndrome, also called postanginal sepsis or necrobacillosis, was first reported by Dr. Lemierre in 1936. In his report, Lemierre mentioned that out of 20 patients who suffered from this syndrome, only two survived. He also stated that all of the 20 patients complained of infections in the palatine tonsils and developed sepsis and thrombophlebitis in the internal jugular vein. Once called a "forgotten disease," this syndrome showed a very high mortality rate until usage of antibiotics became prevalent. In this case report, the authors present a 71-year-old female patient who suffered from Lemierre syndrome with thrombosis extended to the right sigmoid sinus. PMID:24471023

Kim, Taeyun; Choi, Jin-Young

2013-04-01

268

Multiple, persistent gastropancreato-neuroendocrine tumours accompanying sigmoid bowel adenocarcinoma: A rare case report  

PubMed Central

Introduction Gastropancreato-neuroendocrine tumours (GETs) are rare, especially when they occur alongside colorectal adenocarcinoma. Furthermore, multiple GETs occurring within the small bowel are less frequent with only two cases described within the literature. Presentation of case A healthy 58-year old woman presented with severe gastrointestinal pain and faecal incontinence. Family history revealed consanguineous parents and a brother who had recently died of a gastric GET. First biopsy showed a sigmoid adenocarcinoma. Histology of the resected sigmoid revealed both adenocarcinoma and GET. After this, she presented with small bowel obstruction secondary to multiple ileal and jejunal GETs, also treated with resection. All imaging modalities gave no evidence of extra-intestinal metastasis. The patient received multiple operations and chemotherapy but died 18 months after the original presentation. Discussion A case of such persistent and multiple small bowel GET without extra-intestinal metastasis has yet to be reported within the literature. GETs are rare and typically asymptomatic with a small proportion giving the classical carcinoid syndrome. Surgery is usually reserved for smaller GETs with high five-year survival. Despite this, surgery and chemotherapy were performed and both proved to be ineffective. Furthermore, a genetic basis for GETs is supported in this case with her brother suffering a similar fatal tumour. Conclusion This case highlights a rare GET that has a likely underlying familial origin. It illustrates the non-specific presentation of these tumours and the importance of taking a thorough family history. It also demonstrates that these tumours can be fatal even in the absence of extra-intestinal metastasis.

Hotchen, Andrew James; Naidoo, Khimara; Lanzon-Miller, Sandro

2014-01-01

269

Formation of a Double-decker Magnetic Flux Rope in the Sigmoidal Solar Active Region 11520  

NASA Astrophysics Data System (ADS)

In this paper, we address the formation of a magnetic flux rope (MFR) that erupted on 2012 July 12 and caused a strong geomagnetic storm event on July 15. Through analyzing the long-term evolution of the associated active region observed by the Atmospheric Imaging Assembly and the Helioseismic and Magnetic Imager on board the Solar Dynamics Observatory, it is found that the twisted field of an MFR, indicated by a continuous S-shaped sigmoid, is built up from two groups of sheared arcades near the main polarity inversion line a half day before the eruption. The temperature within the twisted field and sheared arcades is higher than that of the ambient volume, suggesting that magnetic reconnection most likely works there. The driver behind the reconnection is attributed to shearing and converging motions at magnetic footpoints with velocities in the range of 0.1-0.6 km s-1. The rotation of the preceding sunspot also contributes to the MFR buildup. Extrapolated three-dimensional non-linear force-free field structures further reveal the locations of the reconnection to be in a bald-patch region and in a hyperbolic flux tube. About 2 hr before the eruption, indications of a second MFR in the form of an S-shaped hot channel are seen. It lies above the original MFR that continuously exists and includes a filament. The whole structure thus makes up a stable double-decker MFR system for hours prior to the eruption. Eventually, after entering the domain of instability, the high-lying MFR impulsively erupts to generate a fast coronal mass ejection and X-class flare; while the low-lying MFR remains behind and continuously maintains the sigmoidicity of the active region.

Cheng, X.; Ding, M. D.; Zhang, J.; Sun, X. D.; Guo, Y.; Wang, Y. M.; Kliem, B.; Deng, Y. Y.

2014-07-01

270

Distal Xq duplication and functional Xq disomy  

PubMed Central

Distal Xq duplications refer to chromosomal disorders resulting from involvement of the long arm of the X chromosome (Xq). Clinical manifestations widely vary depending on the gender of the patient and on the gene content of the duplicated segment. Prevalence of Xq duplications remains unknown. About 40 cases of Xq28 functional disomy due to cytogenetically visible rearrangements, and about 50 cases of cryptic duplications encompassing the MECP2 gene have been reported. The most frequently reported distal duplications involve the Xq28 segment and yield a recognisable phenotype including distinctive facial features (premature closure of the fontanels or ridged metopic suture, broad face with full cheeks, epicanthal folds, large ears, small and open mouth, ear anomalies, pointed nose, abnormal palate and facial hypotonia), major axial hypotonia, severe developmental delay, severe feeding difficulties, abnormal genitalia and proneness to infections. Xq duplications may be caused either by an intrachromosomal duplication or an unbalanced X/Y or X/autosome translocation. In XY males, structural X disomy always results in functional disomy. In females, failure of X chromosome dosage compensation could result from a variety of mechanisms, including an unfavourable pattern of inactivation, a breakpoint separating an X segment from the X-inactivation centre in cis, or a small ring chromosome. The MECP2 gene in Xq28 is the most important dosage-sensitive gene responsible for the abnormal phenotype in duplications of distal Xq. Diagnosis is based on clinical features and is confirmed by CGH array techniques. Differential diagnoses include Prader-Willi syndrome and Alpha thalassaemia-mental retardation, X linked (ATR-X). The recurrence risk is significant if a structural rearrangement is present in one of the parent, the most frequent situation being that of an intrachromosomal duplication inherited from the mother. Prenatal diagnosis is performed by cytogenetic testing including FISH and/or DNA quantification methods. Management is multi-specialist and only symptomatic, with special attention to prevention of malnutrition and recurrent infections. Educational and rehabilitation support should be offered to all patients. Disease name Xq duplications, Xq functional disomy PMID:19232094

Sanlaville, Damien; Schluth-Bolard, Caroline; Turleau, Catherine

2009-01-01

271

Differences in plasma gastrin, CEA, and CA 19-9 concentration in patients with proximal and distal colorectal cancer  

Microsoft Academic Search

Summary  \\u000a Aim. We investigated whether there are differences in plasma gastrin, as compared with carcinoembryonic antigen (CEA) and cancer\\u000a antigen (CA) 19-9 between patients with proximal and distal colorectal cancer. Gastrin concentration has also been analyzed,\\u000a dependent on the tumor stage, in order to evaluate the possible prognostic role of this measurement.\\u000a \\u000a \\u000a Methods. In 50 patients with colon cancer-fasting gastrin,

Grzegorz Bombski; Anita Gasiorowska; Daria Orszulak-Michalak; Beata Neneman; Justyna Kotynia; Janusz Strzelczyk; Adam Janiak; Ewa Malecka-Panas

2002-01-01

272

Medical expulsive therapy for distal ureteral stones.  

PubMed

Although minimally invasive treatments for ureteral stones are efficacious, they are not free of complications and are associated with high cost. Medical expulsive therapy (MET) has recently emerged as an alternative strategy for the initial management of small distal ureteral stones. A MEDLINE search was undertaken to evaluate all currently available data on efficacy and safety of MET therapy in such patients. The specific mechanism of action on the ureteral smooth muscle and the emerging evidence of the efficacy (defined as either an increase in expulsion rate or a decrease in time to expulsion) and low-risk profile suggest that alpha-adrenergic receptor antagonists (alpha-blockers) and calcium channel antagonists should be the initial medical treatment in patients amenable to conservative therapy. NSAIDs and anticholinergics have not shown efficacy as single agents or in combination with alpha-blockers or nifedipine. Corticosteroids may provide a small additive effect when combined with either alpha-blockers or nifedipine. PMID:19405549

Tzortzis, Vassilios; Mamoulakis, Charalampos; Rioja, Jorge; Gravas, Stavros; Michel, Martin C; de la Rosette, Jean J M C H

2009-01-01

273

Diet, lifestyle, and colon cancer.  

PubMed

Diet and lifestyle modification offers means of reducing risk of developing colon cancer. Current data suggest that consuming a Western style diet, that is, one high in meat, refined grains, and sugar and low in vegetables and fiber, may contribute to risk of colon cancer. There also are data to support a reduction in colon cancer risk from consuming high levels of calcium and folate. Energy balance and maintaining an appropriate body weight have been associated with a reduced risk of colon cancer. An important part of the energy balance equation is physical activity. High levels of physical activity have consistently been identified as being associated with a reduced risk of colon cancer. It is estimated that 13% of colon cancer can be attributed to being physically inactive, 12% of colon cancer can be attributed to eating a Western style diet, and 8% of colon cancer can be attributed to having a first degree relative with colorectal cancer. PMID:10950460

Slattery, M L

2000-07-01

274

ALDH as a Marker for Enriching Tumorigenic Human Colonic Stem Cells  

PubMed Central

Aldehyde dehydrogenase (ALDH) can be used as a marker to isolate, propagate, and track normal and cancerous human colon stem cells. To determine their tumorigenic potential, tissues obtained from proximal (normal counterpart) and distal (cancerous) colon of colon cancer patients are implanted into NODSCID mice. In parallel, ALDHhigh and ALDHlow cells are isolated via Florescence Associated Cell Sorting (FACS) after the dissociation of distal and proximal colon tissues into a single-cell suspension. Flow cytometry for ALDHhigh and ALDHlow cells is possible with the ALDEFLUOR assay. Following cell sorting, ALDH-enriched cells are tested for their tumorigenic potential in vivo as xenografts. Owing to cancer stem cell properties, ALDHhigh cells could be propagated in vivo by serial passaging of the human tissue as xenografts and in vitro as suspension cultures called sphere cultures. In this unit, all the above-mentioned methods to isolate and propagate colon cancer stem cells using ALDH as a stem cell marker are described in detail. PMID:22914954

Shenoy, Anitha; Butterworth, Elizabeth; Huang, Emina H.

2014-01-01

275

Mucosal origin and shedding of an early colonic tumor marker defined by Adnab-9 monoclonal antibody.  

PubMed

Recent attention has been drawn to the diagnostic potential of tests based on shed colonic tumor markers. Adnab-9 monoclonal antibody raised against neoplastic, potentially premalignant colonic adenomas recognizes a marker in colonic effluent or tissue which correlates with the presence of tumors or risk of colorectal cancer. The origin of this antigen and optimal collection of colonic effluent were investigated by enzyme-linked immunosorbent assay and Western blotting. Mean Adnab-9 binding in effluent samples from colorectal cancer patients even after resection is high as compared with that in normal subjects (P < 0.05). Effluent samples are best collected in the morning hours. Antigen proteolysis may be significant depending on the site and timing of effluent collection, but breakdown products are reactive. Tissue and effluent Adnab-9 binding at any one anatomic site of collection appear to correlate (r = 0.88, P = 0.01). The Adnab-9 antigen is constitutively expressed at low levels throughout the distal bowel and localized to the deepest regions of the mucosal crypts. Other than meconium, no significant levels of binding are found in other body fluids. This antigen is specific for the gastrointestinal tract, its binding in conveniently collected effluent samples correlates with tissue content, and the antigen is constitutively expressed in the crypts of the distal small bowel and colonic mucosa. PMID:8303203

Tobi, M; Elitsur, Y; Moyer, M P; Halline, A; Deutsch, M; Nochomovitz, L; Luk, G D

1993-12-01

276

Association of Dietary Quercetin with Reduced Risk of Proximal Colon Cancer  

PubMed Central

Quercetin is a flavonol that appears to be protective against several cancers, but its possible role in prevention of colorectal cancer is not yet well studied. We evaluated dietary intakes of quercetin and risk of colorectal cancer in a large case-control study conducted in Metropolitan Detroit, MI (n = 2664). The protective effects of quercetin intake, as assessed by food frequency questionnaire, were confined to risk of proximal colon cancer. Stratified analyses showed that the protective effects of quercetin on risk of proximal colon cancer were significant only when fruit intake or the Healthy Eating Index score were high, or when tea intake was low, with odds ratios (OR) for the highest versus the lowest quartile = 0.49, 0.44, and 0.51, respectively. Increased quercetin intake had no protective effects when tea intake was high. Interestingly, increased intake of quercetin was associated with increased risk of distal colon cancer when total fruit intake was low (OR for the highest versus the lowest quartile = 1.99). These results suggest that quercetin can have disparate effects on colon cancer risk depending on whether dietary intakes of fruit or tea are high, and that quercetin had protective effects only on proximal, not distal, colon cancer. PMID:22429001

Djuric, Zora; Severson, Richard K.; Kato, Ikuko

2012-01-01

277

Ion transport in proximal colon of the rat. Sodium depletion stimulates neutral sodium chloride absorption.  

PubMed Central

The model of sodium and chloride transport proposed for the colon is based on studies performed in the distal segment and tacitly assumes that ion transport is similar throughout the colon. In rat distal colon, neutral sodium-chloride absorption accounts for the major fraction of overall sodium absorption and aldosterone stimulates electrogenic, amiloride-sensitive sodium absorption. Since we have demonstrated qualitative differences in potassium transport in proximal and distal segments of rat colon, unidirectional 22Na and 36Cl fluxes were performed under short-circuit conditions across isolated proximal colon of control and sodium-depleted rats with secondary hyperaldosteronism. In the control group, net sodium absorption (JNanet) (7.4 +/- 0.5 mu eq/h . cm2) was greater than Isc (1.4 +/- 0.1 mu eq/h . cm2), and JClnet was 0 in Ringer solution. Residual flux (JR) was -5.2 +/- 0.5 mu eq/h . cm2 consistent with hydrogen ion secretion suggesting that neutral sodium absorption may represent sodium-hydrogen exchange. 1 mM mucosal amiloride, which inhibits sodium-hydrogen exchange in other epithelia, produced comparable decreases in JNanet and JR (4.1 +/- 0.6 and 3.2 +/- 0.6 mu eq/h . cm2, respectively) without a parallel fall in Isc. Sodium depletion stimulated JNanet, JClnet, and Isc by 7.0 +/- 1.4, 6.3 +/- 1.9, and 0.8 +/- 0.2 mu eq/h . cm2, respectively, and 1 mM amiloride markedly inhibited JNanet and JClnet by 6.0 +/- 1.1 and 4.0 +/- 1.6 mu eq/h . cm2, respectively, with only a minimal reduction in Isc. Conclusions: the predominant neutral sodium-absorptive mechanism in proximal colon is sodium-hydrogen exchange. Sodium depletion stimulates electroneutral chloride-dependent sodium absorption (most likely as a result of increasing sodium-hydrogen and chloride-bicarbonate exchanges), not electrogenic chloride-independent sodium transport. The model of ion transport in the proximal colon is distinct from that of the distal colon. PMID:2418060

Foster, E S; Budinger, M E; Hayslett, J P; Binder, H J

1986-01-01

278

Measurement of mucosal capillary hemoglobin oxygen saturation in the colon by reflectance spectrophotometry  

NASA Astrophysics Data System (ADS)

Advances in optical and computer technology have enabled the development of a device that utilizes white-light reflectance spectrophotometry to measure capillary hemoglobin saturation in intestinal mucosa during colonoscopy. Studies were performed using the colon oximeter in anesthetized animals and patients undergoing colonoscopy. Mucosal hemoglobin saturation in the normal colon (mean +/- S.D.) is 72% +/- 3.5%. In an animal model, ischemia via arterial ligation and hypoxemia via hypoxic ventilation each result in a decrease of over 40% in the mucosal saturation. In human patients with colon polyps, ischemia induced by epinephrine injection, stalk ligation using a loop, or clipping of the polyp stalk each result in a decrease of over 40% in the mucosal saturation (p<0.02). In contrast, saline injection does not decrease the mucosal saturation (p=N.S.). A patient who previously underwent partial colectomy with sacrifice of the inferior mesenteric artery had a saturation of 55% in the remaining sigmoid colon, with normal values in the superior mesenteric artery territory (p<0.05). A novel device for measuring capillary hemoglobin saturation in intestinal mucosa during colonoscopy is capable of providing reproducible measurements in normal patients and clearly detects dramatic decreases in saturation with ischemic and hypoxic insults.

Friedland, Shai; Benaron, David A.; Parachikov, Ilian H.; Soetikno, Roy

2003-06-01

279

Immunohistochemical detection of abnormal cell proliferation in colonic mucosa of subjects with polyps.  

PubMed Central

Previous studies have shown the presence of increased proliferation in the large bowel epithelium of those at high risk of developing colon cancer. An in vitro technique for labelling large bowel mucosa with the thymidine analogue bromodeoxyuridine (Brdu) was therefore developed and its ability to distinguish differences in mucosal proliferation between subjects with colorectal adenomas and normal controls was assessed. Sigmoid biopsy specimens from 15 subjects with polyps and 15 age and sex matched controls were labelled and the incorporated Brdu visualised with an immunohistochemical technique. Mean labelling index (LI) was significantly higher in those with polyps than in controls. Differences in the pattern of labelling in colonic crypts were compared by the generation of cumulative labelling distributions. Analysis showed a significant expansion of the proliferative compartment in the colon crypts of those with polyps. It is concluded that in vitro labelling with Brdu provides a useful method for the assessment of mucosal proliferation in subjects at high risk of developing colon cancer. Images PMID:2212066

Wilson, R G; Smith, A N; Bird, C C

1990-01-01

280

Pharmacologically Mediated Colon Ischemia  

Microsoft Academic Search

Colon ischemia (CI) is the most common form of ischemic injury of the gastrointestinal tract. Determining the precise incidence of CI is a challenging task, because of its often brief, mild nature, and frequent spontaneous resolution, as well as its misdiagnosis as other diseases. While many underlying disease conditions may predispose patients to CI, an important and possibly overlooked etiology

David J. Hass; Patricia Kozuch; Lawrence J. Brandt

2007-01-01

281

Colon Surgery Codes  

Cancer.gov

Colon C180–C189 (Except for M9727, 9733, 9741-9742, 9764-9809, 9832, 9840-9931, 9945-9946, 9950-9967, 9975-9992) Code removal/surgical ablation of single or multiple liver metastases under the data item Surgical Procedure/Other Site (NAACCR Item

282

Physiological and Functional Evaluation of the Transposed Human Pylorus as a Distal Sphincter  

PubMed Central

Background/Aims Studies evaluating the human pylorus as a sphincter are scanty and contradictory. Recently, we have shown technical feasibility of transposing the human pylorus for end-stage fecal incontinence. This unique cohort of patients provided us an opportunity to study the sphincter properties of the pylorus in its ectopic position. Methods Antro-pylorus transposition on end sigmoid colostomies (n = 3) and in the perineum (n = 15) was performed for various indications. Antro-pylorus was assessed functionally (digital examination, high resolution spatiotemporal manometry, barium retention studies and colonoscopy) and by imaging (doppler ultrasound, MRI and CT angiography) in its ectopic position. Results The median resting pressure of pylorus on colostomy was 30 mmHg (range 28-38). In benign group, median resting pressure in perineum was 12.5 mmHg (range 6-44) that increased to 21.5 mmHg (range 12-29) (P = 0.481) and 31 mmHg (range 16-77) (P = 0.034) on first and second follow-up, respectively. In malignant group, median post-operative pressures were 20 mmHg (range 14-36) and 21 mmHg (range 18-44) on first and second follow-up, respectively. A definite tone and gripping sensation were felt in all the patients on digital examination. On distal loopogram, performed through the diverting colostomies, barium was retained proximal to the neo-pyloric valve. Both perineal ultrasound and MRI showed viable transposed graft. CT angiography and color doppler studies confirmed vascular flow in the transposed position. Conclusions The human pyloric valve can function as a tonic sphincter when removed from the gastroduodenal continuity. PMID:22837874

Ghoshal, Uday C; Gupta, Vishal; Jauhari, Ramendra; Srivastava, Rajendra N; Misra, Asha; Kumar, Ashok; Kumar, Manoj

2012-01-01

283

Sonography of tears of the distal biceps tendon.  

PubMed

OBJECTIVE. The objective of this study was to describe the sonographic appearance of tears of the distal biceps brachii tendon. CONCLUSION. Sonography can reveal complete and partial tears of the distal biceps tendon, thus providing an alternative technique to MR imaging. PMID:11000169

Miller, T T; Adler, R S

2000-10-01

284

Carcinoma in situ of the glans penis and distal urethra.  

PubMed

A case is presented of erythroplasia of Queyrat involving the distal glans penis surrounding the urethral meatus. Therapy with topical 5-fluorouracil was followed by recurrence within 14 months. Treatment by excision utilizing the Mohs technique demonstrated carcinoma in situ of over 5 cm of the distal urethra. Plastic surgical reconstruction produced a cosmetically and functionally normal penis. PMID:3700824

Bernstein, G; Forgaard, D M; Miller, J E

1986-05-01

285

Patient with Sjogren's Syndrome and Distal Renal Tubular  

Microsoft Academic Search

Distal urinary acidification abnormalities may arise from transepithelial voltage defects, permeability defects, or proton-secretory defects, but tests to de- termine the cellular mechanisms underlying secre- tory abnormalities have not previously been re- ported. A patient with Sjogren's syndrome and distal renal tubular acidosis due to a secretory defect is described, whose kidney biopsy was examined by fluorescent immunocytochemistry with an

Eric P. Cohen; Bahar Bastani; Miriam R. Cohen; Stuart Kolner; Philip Hemken; Stephen L. Gluck; P. Hemkin

1992-01-01

286

Radiographic study of distal radial physeal closure in thoroughbred horses.  

PubMed

Monthly radiography was performed to study distal radial physeal closure in ten male and ten female Thoroughbred horses. The height, thoracic circumference and metacarpus circumference were also measured. Distal radial physeal closure time was sooner in females than males, and took 701 +/- 37 and 748 +/- 55 days respectively. PMID:9335091

Vulcano, L C; Mamprim, M J; Muniz, L M; Moreira, A F; Luna, S P

1997-01-01

287

Distal Prosodic Context Affects Word Segmentation and Lexical Processing  

ERIC Educational Resources Information Center

Three experiments investigated the role of distal (i.e., nonlocal) prosody in word segmentation and lexical processing. In Experiment 1, prosodic characteristics of the initial five syllables of eight-syllable sequences were manipulated; the final portions of these sequences were lexically ambiguous (e.g., "note bookworm", "notebook worm"). Distal

Dilley, Laura C.; McAuley, J. Devin

2008-01-01

288

Architectural Properties of Distal Forelimb Muscles in Horses, Equus caballus  

E-print Network

were measured for nine distal forelimb muscles. Physiological cross-sectional area (PCSAArchitectural Properties of Distal Forelimb Muscles in Horses, Equus caballus Nicholas A.T. Brown,1. To accurately and noninvasively predict muscle and joint contact forces, a detailed model of musculoskeletal

Meyers, Ron

289

Streptococcus Adherence and Colonization  

PubMed Central

Summary: Streptococci readily colonize mucosal tissues in the nasopharynx; the respiratory, gastrointestinal, and genitourinary tracts; and the skin. Each ecological niche presents a series of challenges to successful colonization with which streptococci have to contend. Some species exist in equilibrium with their host, neither stimulating nor submitting to immune defenses mounted against them. Most are either opportunistic or true pathogens responsible for diseases such as pharyngitis, tooth decay, necrotizing fasciitis, infective endocarditis, and meningitis. Part of the success of streptococci as colonizers is attributable to the spectrum of proteins expressed on their surfaces. Adhesins enable interactions with salivary, serum, and extracellular matrix components; host cells; and other microbes. This is the essential first step to colonization, the development of complex communities, and possible invasion of host tissues. The majority of streptococcal adhesins are anchored to the cell wall via a C-terminal LPxTz motif. Other proteins may be surface anchored through N-terminal lipid modifications, while the mechanism of cell wall associations for others remains unclear. Collectively, these surface-bound proteins provide Streptococcus species with a “coat of many colors,” enabling multiple intimate contacts and interplays between the bacterial cell and the host. In vitro and in vivo studies have demonstrated direct roles for many streptococcal adhesins as colonization or virulence factors, making them attractive targets for therapeutic and preventive strategies against streptococcal infections. There is, therefore, much focus on applying increasingly advanced molecular techniques to determine the precise structures and functions of these proteins, and their regulatory pathways, so that more targeted approaches can be developed. PMID:19721085

Nobbs, Angela H.; Lamont, Richard J.; Jenkinson, Howard F.

2009-01-01

290

Colonic motility and transit of digesta during hard and soft faeces formation in rabbits.  

PubMed

Rabbits produce hard and soft faeces in a circadian rhythm. This study was undertaken in order to examine the motor function of the colon in relation to the formation of these two types of faeces. Colonic motility was measured in unanaesthetized rabbits using strain-gauge transducers and simultaneous radiography. Three types of contractions were found in the rabbit proximal colon: haustral activity, segmental activity, and mass peristalsis. Distinctly different motor patterns were observed during the formation of hard and soft faeces. When hard faeces were produced, the motor activity of the proximal colon was enhanced. It consisted of segmental and haustral activity. The segmental contractions separated the digesta into faecal pellets and forced them slowly aborad, whereas the movements of the haustra carried the liquid contents back towards the caecum. When soft faeces were produced haustral and segmental activity was reduced and transfer of the digesta through the proximal colon was accelerated by mass movements. In contrast to the proximal colon, the motility of the distal colon was enhanced during the formation of soft faeces and decreased during the production of hard faeces. The results support the concept that hard faeces are chiefly produced by a separation of liquids and solids and by a retrograde transfer of liquid digesta rather than by an increased absorption of water. PMID:6875977

Ehrlein, H J; Reich, H; Schwinger, M

1983-05-01

291

Distal Deposits from a Cometary Impact Event  

NASA Astrophysics Data System (ADS)

The Gulf of Carpentaria contains an impact ejecta layer that is circa 1500 BP in age. We have found the following components of the layer in five cores: 1) quench textured impact spherules composed of magnetite and hematite, 2) white chlorinated hydrocarbons, 3) high-Si, low- Fe, low-K glass, 4) vesiculated quartz, 6) native Fe, 7) CrFeNiCl spherules, 8) native Fe-Ni spherules and 9) fragments of high-Mg and high-Ca pyroxene. The latter three materials are possible impactor fragments. The former are candidates for impact ejecta. Some of the magnetite spherules occur in rocks bearing hematite- and silica-replaced marine microfossils. The chlorinated hydrocarbons contain quench textured magnetite spherules and have twice as much Cl as polyvinyl chloride. A small fraction of the magnetite spherules are ablated and have elongated tektite-like shapes. These materials occur in layers with stratigraphic thicknesses between 6 and 20 cm. Each layer has a strong peak in magnetic susceptibility that coincides with the maximum concentration of impact ejecta. We use the high magnetic susceptibility of hematite to model a minimum thickness of the impact ejecta layer before it was reworked by bioturbation. We find that the impact ejecta layer was originally at least 10s to 100s of micrometers thick. These thicknesses, along with the typical 100-1000 micrometer diameters of the larger ejecta fragments are consistent with a distal source crater. Using an online modeling program (http://impact.ese.ic.ac.uk/) we have ruled out tsunami transport for the ejecta layer. This is consistent with the lack of graded bedding of the layer. The grain size distribution of the ejecta layer is most consistent with a thin layer deposited from the air and reworked by bioturbation. We can match our modeled initial layer thicknesses and ejecta sizes by a cometary impactor that broke up and produced a 12 km crater at the location of our 12 km wide Tabban crater candidate. Our five cores contain a distal impact ejecta layer; possibly derived from the Tabban crater candidate between 540 and 712 km away. Now that we have constrained the thickness and mode of deposition of the impact ejecta layer, we have the tools to date it with more precision in the near future.

Abbott, D. H.; Rodriguez, L. E.; Breger, D.

2011-12-01

292

The use of distal rhynchokinesis by birds feeding in water.  

PubMed

The use of distal rhynchokinesis, which consists of the movement of the distal part of the upper jaw with respect to the cranium, is well documented in long-billed shorebirds (Scolopacidae), commonly being associated with the deep probing feeding method. However, the functional and evolutionary significance of distal rhynchokinesis and other cranial kinesis is unclear. We report for the first time the use and occurrence of distal rhynchokinesis in wild long-billed shorebirds feeding on small prey items suspended in water. We tested whether prey size in captive dunlins Calidris alpina influences the occurrence of distal rhynchokinesis during feeding and also whether its use affects foraging efficiency. We found that wild dunlin, curlew sandpiper Calidris ferruginea, sanderling Calidris alba and little stint Calidris minuta commonly use distal rhynchokinesis to strike, capture and transport small prey items. Prey size influenced the occurrence of distal rhynchokinesis during the transport phase, with this type of cranial kinesis being more frequently used with larger prey. The rhynchokinesis protraction angle (a measure of bill tip elevation) during prey strike and transport was affected by prey size, and bill gape was modulated through the use of distal rhynchokinesis in relation to prey size. Finally, the use of distal rhynchokinesis throughout intra-oral prey transport was related to shorter transport times, which improved foraging efficiency. We conclude that distal rhynchokinesis is a mechanism that could contribute to the flexible feeding behaviour of long-distance migratory shorebirds, enhancing small prey profitability and so improving foraging efficiency, and may have played a role in the evolutionary radiation of Scolopacidae (Charadrii). PMID:17951416

Estrella, Sora M; Masero, José A

2007-11-01

293

Potassium currents in rat colonic smooth muscle cells and changes during development and aging  

Microsoft Academic Search

In a previous study on freshly isolated single smooth muscle cells from the circular layer of the rat distal colon, we reported that the L-type Ca2+ current density increased during development and gradually declined with further aging [ZI Xiong, N Sperelakis, N Noffsinger, C Fenoglio-Preiser (1993) Am J Physiol 265: C617–C625]. Since K+ current plays a key role in controlling

Zhiling Xiong; Nicholas Sperelakis; Amy Noffsinger; Cecilia Fenoglio-Preiser

1995-01-01

294

Colonic smooth muscle cells and colonic motility patterns as a target for irritable bowel syndrome therapy: mechanisms of action of otilonium bromide  

PubMed Central

Otilonium bromide (OB) is a spasmolytic compound of the family of quaternary ammonium derivatives and has been successfully used in the treatment of patients with irritable bowel syndrome (IBS) due to its specific pharmacodynamic effects on motility patterns in the human colon and the contractility of colonic smooth muscle cells. This article examines how. OB inhibits the main patterns of human sigmoid motility in vitro, which are spontaneous rhythmic phasic contractions, smooth muscle tone, contractions induced by stimulation of excitatory motor neurons and contractions induced by direct effect of excitatory neurotransmitters. It does this mainly by blocking calcium influx through L-type calcium channels and interfering with mobilization of cellular calcium required for smooth muscle contraction, thereby limiting excessive intestinal contractility and abdominal cramping. OB also inhibits T-type calcium channels and muscarinic responses. Finally, OB inhibits tachykinin receptors on smooth muscle and primary afferent neurons which may have the joint effect of reducing motility and abdominal pain. All these mechanisms mediate the therapeutic effects of OB in patients with IBS and might be useful in patients with other spastic colonic motility disorders such as diverticular disease. PMID:25057296

Rychter, Jakub; Espín, Francisco; Gallego, Diana; Vergara, Patri; Jiménez, Marcel

2014-01-01

295

Review article: problematic proctitis and distal colitis.  

PubMed

About two-thirds of patients with ulcerative colitis have an inflammatory involvement distal to the splenic flexure, and therefore may be effectively treated with topical treatment, allowing the delivery of the active drug directly to the site of inflammation and limiting systemic absorption and potential side-effects. Topical aminosalicylate therapy is the most effective approach, and most patients will benefit hugely, provided that the formulation reaches the upper extent of the disease. Therefore, the choice of topical preparation should be based on the proximal extent of the disease and on patient preference. Oral aminosalicylates are less effective than topical therapies; however, a combination of oral and topical aminosalicylates can be successful in refractory patients. Alternatives to aminosalicylates are the new glucocorticoids, budesonide and beclometasone dipropionate, either as enemas or oral formulations (only beclometasone dipropionate). A combination of oral or rectal new glucocorticoids with rectal aminosalicylates should be considered in patients refractory to either approach. When these measures fail, treatment with oral glucocorticoids is necessary. An intensive intravenous steroid regimen is also helpful for patients refractory to oral steroids. Alternative treatments include short-chain fatty acid enemas, nicotine enemas and patches, acetarsol suppositories, ciclosporin enemas and epidermal growth factor enemas. Several factors potentially having a negative impact on therapeutic response include concurrent enteric pathogens, coexistent irritable bowel syndrome, patient nonadherence to therapy, inadequate dosing and duration of therapy, and proximal progression of the disease. Surgical colectomy may be required in those rare patients refractory or intolerant to pharmacotherapy. PMID:15352902

Gionchetti, P; Rizzello, F; Morselli, C; Campieri, M

2004-10-01

296

Effect of Itopride Hydrochloride on the Ileal and Colonic Motility in Guinea Pig In Vitro  

PubMed Central

Purpose Itopride hydrochloride (itopride) inhibits acetylcholinesterase (AChE) and antagonizes dopamine D2 receptor, and has been used as a gastroprokinetic agent. However, its prokinetic effect on the small bowel or colon has not yet been thoroughly investigated. The aim of this study was to investigate the effects of itopride on motor functions of the ileum and colon in guinea pigs. Materials and Methods The distal ileum was excised and the activity of peristaltic contraction was determined by measuring the amplitude and propagation velocity of peristaltic contraction. The distal colon was removed and connected to the chamber containing Krebs-Henseleit solution (K-H solution). Artificial fecal matter was inserted into the oral side of the lumen, and moved toward the anal side by intraluminal perfusion via peristaltic pump. Colonic transit times were measured by the time required for the artificial feces to move a total length of 10 cm with 2-cm intervals. Results In the ileum, itopride accelerated peristaltic velocity at higher dosage (10-10-10-6 M) whereas neostigmine accelerated it only with a lower dosage (10-10-10-9 M). Dopamine (10-8 M) decelerated the velocity that was recovered by itopride infusion. Itopride and neostigmine significantly shortened colonic transit at a higher dosage (10-10-10-6 M). Dopamine (10-8 M) delayed colonic transit time that was also recovered after infusion of itopride. Conclusion Itopride has prokinetic effects on both the ileum and colon, which are regulated through inhibitory effects on AChE and antagonistic effects on dopamine D2 receptor. PMID:18581598

Lim, Hyun Chul; Kim, Young Gyun; Lim, Jung Hyun; Kim, Hee Sun

2008-01-01

297

Insights into Vibrio cholerae intestinal colonization from monitoring fluorescently labeled bacteria.  

PubMed

Vibrio cholerae, the agent of cholera, is a motile non-invasive pathogen that colonizes the small intestine (SI). Most of our knowledge of the processes required for V. cholerae intestinal colonization is derived from enumeration of wt and mutant V. cholerae recovered from orogastrically infected infant mice. There is limited knowledge of the distribution of V. cholerae within the SI, particularly its localization along the villous axis, or of the bacterial and host factors that account for this distribution. Here, using confocal and intravital two-photon microscopy to monitor the localization of fluorescently tagged V. cholerae strains, we uncovered unexpected and previously unrecognized features of V. cholerae intestinal colonization. Direct visualization of the pathogen within the intestine revealed that the majority of V. cholerae microcolonies attached to the intestinal epithelium arise from single cells, and that there are notable regiospecific aspects to V. cholerae localization and factors required for colonization. In the proximal SI, V. cholerae reside exclusively within the developing intestinal crypts, but they are not restricted to the crypts in the more distal SI. Unexpectedly, V. cholerae motility proved to be a regiospecific colonization factor that is critical for colonization of the proximal, but not the distal, SI. Furthermore, neither motility nor chemotaxis were required for proper V. cholerae distribution along the villous axis or in crypts, suggesting that yet undefined processes enable the pathogen to find its niches outside the intestinal lumen. Finally, our observations suggest that host mucins are a key factor limiting V. cholerae intestinal colonization, particularly in the proximal SI where there appears to be a more abundant mucus layer. Collectively, our findings demonstrate the potent capacity of direct pathogen visualization during infection to deepen our understanding of host pathogen interactions. PMID:25275396

Millet, Yves A; Alvarez, David; Ringgaard, Simon; von Andrian, Ulrich H; Davis, Brigid M; Waldor, Matthew K

2014-10-01

298

Insights into Vibrio cholerae Intestinal Colonization from Monitoring Fluorescently Labeled Bacteria  

PubMed Central

Vibrio cholerae, the agent of cholera, is a motile non-invasive pathogen that colonizes the small intestine (SI). Most of our knowledge of the processes required for V. cholerae intestinal colonization is derived from enumeration of wt and mutant V. cholerae recovered from orogastrically infected infant mice. There is limited knowledge of the distribution of V. cholerae within the SI, particularly its localization along the villous axis, or of the bacterial and host factors that account for this distribution. Here, using confocal and intravital two-photon microscopy to monitor the localization of fluorescently tagged V. cholerae strains, we uncovered unexpected and previously unrecognized features of V. cholerae intestinal colonization. Direct visualization of the pathogen within the intestine revealed that the majority of V. cholerae microcolonies attached to the intestinal epithelium arise from single cells, and that there are notable regiospecific aspects to V. cholerae localization and factors required for colonization. In the proximal SI, V. cholerae reside exclusively within the developing intestinal crypts, but they are not restricted to the crypts in the more distal SI. Unexpectedly, V. cholerae motility proved to be a regiospecific colonization factor that is critical for colonization of the proximal, but not the distal, SI. Furthermore, neither motility nor chemotaxis were required for proper V. cholerae distribution along the villous axis or in crypts, suggesting that yet undefined processes enable the pathogen to find its niches outside the intestinal lumen. Finally, our observations suggest that host mucins are a key factor limiting V. cholerae intestinal colonization, particularly in the proximal SI where there appears to be a more abundant mucus layer. Collectively, our findings demonstrate the potent capacity of direct pathogen visualization during infection to deepen our understanding of host pathogen interactions. PMID:25275396

Millet, Yves A.; Alvarez, David; Ringgaard, Simon; von Andrian, Ulrich H.; Davis, Brigid M.; Waldor, Matthew K.

2014-01-01

299

Colonic hypersensitivity is a major determinant of the efficacy of bloating treatment in constipation-predominant irritable bowel syndrome.  

PubMed

The pathophysiology of bloating is largely unknown, and many mechanisms have been proposed. An alteration of intestinal gas production may have a role in a subgroup of patients, but available data are conflicting. We have previously shown that hypersensitivity to colonic fermentation is associated with severe bloating in a subgroup of patients with low intestinal gas production. Accordingly, we evaluated whether modification of intestinal gas production improves bloating severity according to the presence of visceral hypersensitivity to colonic fermentation. Twenty-four IBS-C patients with severe bloating underwent intestinal gas production measurement by hydrogen breath test after lactulose, and a recto-sigmoid barostat test in order to evaluate sensitivity thresholds in a basal condition and after induction of colonic fermentation. The subjects were then randomly assigned to receive either rifaximin or placebo according to a double-blind, randomized, cross-over trial. Rifaximin induced an improvement of symptom severity. A post hoc analysis according to the presence of hypersensitivity to colonic fermentation shows that rifaximin induces a significant improvement in symptom severity only in normosensitive, hyperproducer patients. Modulation of colonic flora, in order to reduce fermentation, does not interfere with bloating severity in patients with visceral hypersensitivity, thus suggesting that in this subgroup of subjects gas production is not crucial for the onset of bloating. PMID:21161699

Di Stefano, Michele; Tana, Paola; Mengoli, Caterina; Miceli, Emanuela; Pagani, Elisabetta; Corazza, Gino Roberto

2011-10-01

300

How Much Colonic Redundancy Could Be Obtained by Splenic Flexure Mobilization in Laparoscopic Anterior or Low Anterior Resection?  

PubMed Central

Background and Objectives: Splenic flexure mobilization (SFM) is performed to ensure a tension free anastomosis with an adequate resection margin in laparoscopic anterior resection (AR) or low anterior resection (LAR). This retrospective study was performed to determine the amount of colonic redundancy that can be expected by SFM. Methods: Retrospective review of medical record for a total of 203 patients who underwent SFM during laparoscopic AR or LAR for the treatment of sigmoid colon or rectal cancer was performed. Results: The obtained redundancy of the colon by SFM was 27.81 ± 7.29 cm from the sacral promontory. The redundancy of the colon by SFM with high ligation of the inferior mesenteric vein (IMV) (29.54 ± 7.17 cm from the sacral promontory) was greater than that with low ligation of the IMV (24.94 ± 6.07 cm from the sacral promontory, P < 0.0001). It took about 9.82% of the total operation time to perform SFM. There was no intraoperative complication during SFM. Conclusions: SFM during laparoscopic AR or LAR is a safe and feasible option. Based on the result of this study, one can gain about 27.81 cm redundancy of the colon by SFM. PMID:25013364

Kye, Bong-Hyeon; Kim, Hyung-Jin; Kim, Hyun-Sil; Kim, Jun-Gi; Cho, Hyeon-Min

2014-01-01

301

Age and site of Colonic Neoplastic Lesions: Implications of screening in South Asia  

PubMed Central

Objective : To evaluate the Age of patients and the site of Colonic Neoplastic Lesions (CNL) and to determine the appropriate screening strategy for Colorectal Carcinoma (CRC) (sigmoidoscopy versus colonoscopy) in our population. Methods : This is a cross sectional study. Data of all patients more than 16 years of age who underwent full colonoscopic examination at the Aga Khan University hospital between January 2011 till December 2013 and were diagnosed to have CRC or advanced adenomas (defined as polyp more than 1 cm and/or having villous morphology on histology) was recorded. Lesions found distal to the splenic flexure were characterized as distal lesions and while lesions found between the splenic flexure and the cecum were characterized as proximal lesions. Results: During the study period colonic neoplastic lesions were found in 217 patients; 186 (85.7%) patients had CRC and 31(14.3%) patients had advanced adenomatous polyps. Mean age was 55.8±14 years and amongst them 72 (33.2%) patients were less than 50 years of age while 145 (66.8%) were more than 50 years. In 144 (66.4%) patients lesions were located in the distal colon, 65 (30%) had lesions in the proximal colon while in 8 (3.7%) patients the neoplastic lesions were found both in the proximal and distal colon. The predominant symptoms were bleeding per rectum in 39.6% of patients followed by weight loss in 31.8% of patients. Only 3 patients had familial syndromes with multiple polyps. When patients younger than 50 years of age were compared with patients more than 50 years there was no statistically significant difference between the site of neoplastic lesion as well as the presenting symptoms. (p value 0.85). Conclusion: Colonic Neoplastic Lesions presented at younger age in our study population and one third of the lesions were found in the right sided colon. Hence screening for CNLs should be implied at an earlier age preferably with colonoscopy. More population based data is required to further validate our results.

Hussain, Manzoor; Khalid, Abdullah Bin; Ahsan, Syed; Jafri, Wasim; Hamid, Saeed; Javed, Anam; Wahab, Sana

2014-01-01

302

Tentorial meningioma encroaching the transverse sinuses and sigmoid sinus junction area associated with dural arteriovenous fistulous malformation: a case report.  

PubMed Central

A 62-year-old woman was evaluated for tinnitis and headache. Magnetic resonance imaging and angiography revealed the coexistence of a tentorial tumor encroaching the junction of the right transverse-sigmoid sinuses, and dural arteriovenous fistulous malformation (AVFM) of the right transverse sinus. AVFM was not manipulated at all during the surgery. The pathology was fibroblastic meningioma. Postoperatively, the dural AVFM completely disappeared on follow-up angiography. The fistulas were occluded also after surgery, even though there was no manipulation of the AVFM. It is suggested that the right dominant transverse-sigmoid sinuses are partially occluded by tentorial meningioma, developing the dural arteriovenous fistula of the right transverse sinus. An acquired origin of the dural AVFM was suggested in this case. PMID:10485631

Chung, Y. G.; Lee, K. C.; Lee, H. K.; Lee, N. J.

1999-01-01

303

Tentorial meningioma encroaching the transverse sinuses and sigmoid sinus junction area associated with dural arteriovenous fistulous malformation: a case report.  

PubMed

A 62-year-old woman was evaluated for tinnitis and headache. Magnetic resonance imaging and angiography revealed the coexistence of a tentorial tumor encroaching the junction of the right transverse-sigmoid sinuses, and dural arteriovenous fistulous malformation (AVFM) of the right transverse sinus. AVFM was not manipulated at all during the surgery. The pathology was fibroblastic meningioma. Postoperatively, the dural AVFM completely disappeared on follow-up angiography. The fistulas were occluded also after surgery, even though there was no manipulation of the AVFM. It is suggested that the right dominant transverse-sigmoid sinuses are partially occluded by tentorial meningioma, developing the dural arteriovenous fistula of the right transverse sinus. An acquired origin of the dural AVFM was suggested in this case. PMID:10485631

Chung, Y G; Lee, K C; Lee, H K; Lee, N J

1999-08-01

304

Resection Interposition Arthroplasty for Failed Distal Ulna Resections  

PubMed Central

The major complications of distal ulna resection, the Darrach procedure, are radioulnar impingement and instability. High failure rates have been reported despite published modifications of the Darrach procedure. Several surgical techniques have been developed to treat this difficult problem and to mitigate the symptoms associated with painful convergence and impingement. No technique has demonstrated clinical superiority. Recently, implant arthroplasty of the distal ulna has been endorsed as an option for the management of the symptomatic patient with a failed distal ulna resection. However, there are concerns for implant longevity, especially in young, active adults. Resection interposition arthroplasty relies on interposition of an Achilles tendon allograft between the distal radius and the resected distal ulna. Although this technique does not restore normal mechanics of the distal radioulnar joint, it can prevent painful convergence of the radius on the ulna. Achilles allograft interposition arthroplasty is a safe and highly effective alternative for failed distal ulna resections, especially for young, active patients, in whom an implant or alternative procedure may not be appropriate. PMID:24436784

Papatheodorou, Loukia K.; Rubright, James H.; Kokkalis, Zinon T.; Sotereanos, Dean G.

2013-01-01

305

Colonic diverticula and hemorrhage  

Microsoft Academic Search

Summary  Approximately 17 per cent of 500 patients with diverticular disease had colonic hemorrhage. In most cases the bleeding was\\u000a mild, but it is potentially a lethal complication. In this series the associated mortality was 3.6 per cent. If the bleeding\\u000a site is readily identifiable it is reasonable to resect the involved area; if not, total abdominal colectomy with ileorectal\\u000a anastomosis

ANTHONY R.. GENNARO; George P. Rosemond

1973-01-01

306

Simulation of sigmoid structure and filament eruption of AR11283 using a three-dimensional data-driven magnetohydrodynamic model  

NASA Astrophysics Data System (ADS)

This paper describes an MHD simulation of an observed Sigmoid in AR 11283 from its formation to eruption. The Non-linear Force Free MHD model (Jiang and Feng, 2012) and the data-driven active region evolution model (Wu et al., 2006; Jiang et al. 2013) together with the SDO/HMI magnetograms are used. We show the successful simulation results of the eruption of a flux-rope structure.

Wu, S. T.; Jiang, Chaowei; Feng, Xueshang; Hu, Qiang; Liu, Yang

2014-01-01

307

Formation of current sheets and sigmoidal structure by the kink instability of a magnetic loop  

E-print Network

We study dynamical consequences of the kink instability of a twisted coronal flux rope, using the force-free coronal loop model by Titov & D\\'emoulin (1999) as the initial condition in ideal-MHD simulations. When a critical value of the twist is exceeded, the long-wavelength ($m=1$) kink mode develops. Analogous to the well-known cylindrical approximation, a helical current sheet is then formed at the interface with the surrounding medium. In contrast to the cylindrical case, upward-kinking loops form a second, vertical current sheet below the loop apex at the position of the hyperbolic flux tube (generalized X line) in the model. The current density is steepened in both sheets and eventually exceeds the current density in the loop (although the kink perturbation starts to saturate in our simulations without leading to a global eruption). The projection of the field lines that pass through the vertical current sheet shows an S shape whose sense agrees with the typical sense of transient sigmoidal (forward...

Kliem, B; Toeroek, T

2004-01-01

308

Comparative study of four sigmoid models of pressure-volume curve in acute lung injury  

PubMed Central

Background The pressure-volume curve of the respiratory system is a tool to monitor and set mechanical ventilation in acute lung injury. Mathematical models of the static pressure-volume curve of the respiratory system have been proposed to overcome the inter- and intra-observer variability derived from eye-fitting. However, different models have not been compared. Methods The goodness-of-fit and the values of derived parameters (upper asymptote, maximum compliance and points of maximum curvature) in four sigmoid models were compared, using pressure-volume data from 30 mechanically ventilated patients during the early phase of acute lung injury. Results All models showed an excellent goodness-of-fit (R2 always above 0.92). There were significant differences between the models in the parameters derived from the inspiratory limb, but not in those derived from the expiratory limb of the curve. The within-case standard deviations of the pressures at the points of maximum curvature ranged from 2.33 to 6.08 cmH2O. Conclusion There are substantial variabilities in relevant parameters obtained from the four different models of the static pressure-volume curve of the respiratory system. PMID:17300715

Albaiceta, Guillermo M; Garcia, Esteban; Taboada, Francisco

2007-01-01

309

Modelling suppressed muscle activation by means of an exponential sigmoid function: Validation and bounds.  

PubMed

The aim of this study was to establish how well a three-parameter sigmoid exponential function, DIFACT, follows experimentally obtained voluntary neural activation-angular velocity profiles and how robust it is to perturbed levels of maximal activation. Six male volunteers (age 26.3±2.73 years) were tested before and after an 8-session, 3-week training protocol. Torque-angular velocity (T-?) and experimental voluntary neural drive-angular velocity (%VA-?) datasets, obtained via the interpolated twitch technique, were determined from pre- and post-training testing sessions. Non-linear regression fits of the product of DIFACT and a Hill type tetanic torque function and of the DIFACT function only were performed on the pre- and post-training T-? and %VA-? datasets for three different values of the DIFACT upper bound, ?max, 100%, 95% & 90%. The determination coefficients, R(2), and the RMS of the fits were compared using a two way mixed ANOVA and results showed that there was no significant difference (p<0.05) due to changing ?max values indicating the DIFACT remains robust to changes in maximal activation. Mean R(2) values of 0.95 and 0.96 for pre- and post-training sessions show that the maximal voluntary torque function successfully reproduces the T-? raw dataset. PMID:25636854

Voukelatos, Dimitrios; Pain, Matthew Tg

2015-02-26

310

Difficult colon polypectomy  

PubMed Central

Colorectal cancer (CRC) is one of the leading causes of death from cancer in the world. We now know that 90% of CRC develop from adenomatous polyps. Polypectomy of colon adenomas leads to a significant reduction in the incidence of CRC. At present most of the polyps are removed endoscopically. The vast majority of colorectal polyps identified at colonoscopy are small and do not pose a significant challenge for resection to an appropriately trained and skilled endoscopist. Advanced polypectomy techniques are intended for the removal of difficult colon polyps. We have defined a “difficult polyp” as any lesion that due to its size, shape or location represents a challenge for the colonoscopist to remove. Although many “difficult polyps” will be an easy target for the advanced endoscopist, polyps that are larger than 15 mm, have a large pedicle, are flat and extended, are difficult to see or are located in the cecum or any angulated portion of the colon should be always considered difficult. Although very successful, advanced resection techniques can potentially cause serious, even life-threatening complications. Moreover, post polypectomy complications are more common in the presence of difficult polyps. Therefore, any endoscopist attempting advanced polypectomy techniques should be adequately supervised by an expert or have an excellent training in interventional endoscopy. This review describes several useful tips and tricks to deal with difficult polyps. PMID:22816006

Vormbrock, Klaus; Mönkemüller, Klaus

2012-01-01

311

Formation and Eruption of an Active Region Sigmoid. I. A Study by Nonlinear Force-free Field Modeling  

NASA Astrophysics Data System (ADS)

We present a comprehensive study of the formation and eruption of an active region (AR) sigmoid in AR 11283. To follow the quasi-static evolution of the coronal magnetic field, we reconstruct a time sequence of static fields using a recently developed nonlinear force-free field model constrained by vector magnetograms. A detailed analysis of the fields compared with observations suggests the following scenario for the evolution of the region. Initially, a new bipole emerges into the negative polarity of a preexisting bipolar AR, forming a null-point topology between the two flux systems. A weakly twisted flux rope (FR) is then built up slowly in the embedded core region, largely through flux cancellation, forming a bald patch separatrix surface (BPSS). The FR grows gradually until its axis runs into a torus instability (TI) domain, and the BPSS also develops a full S-shape. The combined effects of the TI-driven expansion of the FR and the line tying at the BP tear the FR into two parts with the upper portion freely expelled and the lower portion remaining behind the postflare arcades. This process dynamically perturbs the BPSS and results in the enhanced heating of the sigmoid and the rope. The accelerated expansion of the upper-portion rope strongly pushes its envelope flux near the null point and triggers breakout reconnection at the null, which further drives the eruption. We discuss the important implications of these results for the formation and disruption of the sigmoid region with an FR.

Jiang, Chaowei; Wu, S. T.; Feng, Xueshang; Hu, Qiang

2014-01-01

312

Laparoscopically assisted distal gastrectomy for early gastric cancer  

Microsoft Academic Search

Background  The purpose of this study was to compare clinical outcomes between laparoscopically assisted and open distal gastrectomy for\\u000a early gastric cancer.\\u000a \\u000a \\u000a \\u000a Methods  The records of 21 patients who underwent laparoscopically assisted distal gastrectomy (LG) for preoperative diagnosis of intramucosal\\u000a gastric carcinoma between January 1996 and August 1998 were reviewed and compared with those of 31 open distal gastrectomy\\u000a patients during the

S. Shimizu; A. Uchiyama; K. Mizumoto; T. Morisaki; K. Nakamura; H. Shimura; M. Tanaka

2000-01-01

313

Endovascular treatment of two concomitant causes of pulsatile tinnitus: sigmoid sinus stenosis and ipsilateral jugular bulb diverticulum. Case report and literature review.  

PubMed

We describe a rare case of highly invalidating pulsatile tinnitus associated with both stenosis of the sigmoid sinus and ipsilateral jugular bulb diverticulum. Both conditions were successfully treated by positioning a stent across the sigmoid sinus and jugular bulb. To our knowledge, the present clinical case represents the first report of such an approach. The therapeutic decision-making is discussed in relation to the etiopathologic hypothesis put forward. PMID:22065197

Signorelli, Francesco; Mahla, Kalid; Turjman, Francis

2012-01-01

314

The probiotic Escherichia coli Nissle 1917 inhibits propagating colonic contractions in the rat isolated large intestine.  

PubMed

The objective of this research was to test an in vitro motility model by investigating whether a probiotic that reduces diarrhea in humans would reduce motility in the rat colon in vitro. The probiotic Escherichia coli Nissle 1917 (EcN) the active ingredient in Mutaflor® was used as an example probiotic because it is effective for treating infectious diarrheal diseases. The effect of EcN on motility was compared in two colonic preparations. In distal colon segments EcN extract decreased the tension of spontaneous contractions by 74% and frequency by 46% compared with pre-treatment controls. In the whole large intestine the number of synchronized spontaneous propagating contractions decreased by 86% when EcN extract was applied externally and 69% when applied via the lumen compared with pre-treatment. From the inhibition produced by EcN extract in the distal colon segment a myogenic action was inferred and in the whole large intestine neural involvement was implicated. Both are consistent with its anti-diarrheal effect in humans. PMID:25415771

Dalziel, J E; Mohan, V; Peters, J; Anderson, R C; Gopal, P K; Roy, N C

2015-01-24

315

Fungal infection of the colon  

PubMed Central

Fungi are pathogens that commonly infect immunocompromised patients and can affect any organs of the body, including the colon. However, the literature provides limited details on colonic infections caused by fungi. This article is an intensive review of information available on the fungi that can cause colon infections. It uses a comparative style so that its conclusions may be accessible for clinical application. PMID:25364269

Praneenararat, Surat

2014-01-01

316

Distal Renal Tubular Acidosis in Infancy: A Bicarbonate Wasting State  

ERIC Educational Resources Information Center

Studied were three unrelated infants with distal renal tubular acidosis (a condition characterized by an inability to acidify the urine to minimal pH levels resulting in the loss of bicarbonates). (DB)

Rodriguez-Soriano, J.; And Others

1975-01-01

317

Distal Triceps Knotless Anatomic Footprint Repair: A New Technique  

PubMed Central

Distal triceps rupture is a rare injury causing significant disability. Several techniques for treating distal triceps ruptures have been described using bone tunnels or suture anchors. More recent techniques have focused on re-creating the anatomic footprint of the distal triceps tendon. However, the increasing numbers of anchors used increase the risk to the articular surface, and all earlier techniques require knot tying and bulky knots beneath the thin posterior elbow soft-tissue envelope. We describe a technique combining the use of bone tunnels and a single suture anchor to create a knotless anatomic footprint repair of the distal triceps. By using this technique, we are able to create a tension-band construct that self-reinforces the anatomic repair and is very low profile while significantly decreasing risk to the articular surface. PMID:25473618

Paci, James M.; Clark, Jonathan; Rizzi, Angelo

2014-01-01

318

Distal clavicle osteolysis following fixation with a synthetic ligament  

PubMed Central

We present a case of distal clavicle osteolysis following treatment of a chronic acromioclavicular joint dislocation with a synthetic ligament. The relevant literature is reviewed and discussed. PMID:22223960

Dearden, Paul M. C.; Ferran, Nicholas A.; Morris, Emyr W.

2011-01-01

319

Biomechanical Analysis of Distal Biceps Tendon Repair Methods  

Microsoft Academic Search

Background: The 1-incision and 2-incision techniques are commonly used methods to repair a distal biceps rupture, and they differ in the location of reinsertion of tendon into bone.Hypothesis: The native distal biceps brachii tendon inserts on the posterior-ulnar aspect of the bicipital tuberosity, which functions as a cam, increasing the tendon's moment arm during its principal action of forearm supination.

Jon Henry; Jeff Feinblatt; Christopher C. Kaeding; James Latshaw; Alan Litsky; Roman Sibel; Julie A. Stephens; Grant L. Jones

2007-01-01

320

Fracture separation of the distal humeral physis in the newborn.  

PubMed

Fracture separation of the distal humeral physis in the newborn is a rare injury. Two case reports are presented, both with a history of traumatic delivery and a clinical examination revealing swelling, hypermobility, and muffled crepitance about the elbow. Radiographs demonstrated posteromedial displacement of the distal humeral epiphysis with respect to the shaft. Closed reduction with splint immobilization is the most common form of treatment. PMID:6490887

Barrett, W P; Almquist, E A; Staheli, L T

1984-09-01

321

Perineal colostomy and electrostimulated gracilis “neosphincter” after abdomino-perineal resection of the colon and anorectum: a surgical experience and follow-up study in 47 cases  

Microsoft Academic Search

A series of 47 patients undergoing abdominoperineal resection of the distal colon and anorectum and construction of a continent perineal colostomy using electrostimulated gracilis muscle is described. External and implanted pulse generators have both been used. An analysis of complications and oncological data are reported. There was no operative mortality. The incidence of complications, divided into three classes, mild (62%),

E. Cavina; M. Seccia; G. Evangelista; M. Chiarugi; P. Buccianti; A. Tortora; A. Chirico

1990-01-01

322

Dextran Carrier Macromolecules for Colon-specific Delivery of 5-Aminosalicylic Acid  

PubMed Central

Present manuscript describes the sustained and targeted delivery of 5-aminosalicylic acid to the distal ileum and proximal colon, using dextran (40 kDa) as a carrier for targeting 5-aminosalicylic acid at the colonic site by attaching p-aminobenzoic acid and benzoic acid as linkers. Prepared conjugate were characterized by UV, HPLC, FT-IR, and 1H NMR. The degree of substitution was estimated by complete hydrolysis of conjugates in borate buffer and in vitro hydrolysis study of conjugates was performed in different biological media. It was observed that 5-aminosalicylic acid alone have produced high incidence of gastric ulcer with high ulcer index whereas lower ulcer index was found for the dextran conjugates of 5-aminosalicylic acid. The release pattern of conjugates in 3% w/v rat caecal content was confirmed the colon specificity of 5-aminosalicylic acid conjugates. PMID:24082343

Shrivastava, P. K.; Shrivastava, A.; Sinha, S. K.; Shrivastava, S. K.

2013-01-01

323

Endovascular Treatment for Ruptured Distal Anterior Inferior Cerebellar Artery Aneurysm  

PubMed Central

A 42-year-old woman presented with Hunt and Hess grade (HHG) III subarachnoid hemorrhage (SAH) caused by a ruptured left distal anterior inferior cerebellar artery (AICA) aneurysm. Computed tomography showed a thin SAH on the cerebellopontine angle cistern, and small vermian intracerebral hemorrhage and intraventricular hemorrhage in the fourth ventricle. Digital subtraction angiography revealed the aneurysm on the postmeatal segment of left distal AICA, a branching point of rostrolateral and caudomedial branch of the left distal AICA. Despite thin caliber, tortuous running course and far distal location, the AICA aneurysm was obliterated successfully with endovascular coils without compromising AICA flow. However, the patient developed left side sensorineural hearing loss postoperatively, in spite of definite patency of distal AICA on the final angiogram. She was discharged home without neurologic sequela except hearing loss and tinnitus. Endovascular treatment of distal AICA aneurysm, beyond the meatal loop, is feasible while preserving the AICA flow. However, because the cochlear hair cell is vulnerable to ischemia, unilateral hearing loss can occur, possibly caused by the temporary occlusion of AICA flow by microcatheter during endovascular treatment. PMID:24765609

Oh, Jae-Sang; Shim, Jai-Joon; Bae, Hack-Gun; Yoon, Il-Gyu

2014-01-01

324

Multiple Colon Polyposis  

PubMed Central

Introduction: Familial adenomatous polyposis (FAP) is a rare autosomal, dominant hereditary disease, which affects both sexes equally (1-10). FAP accounts for less than 1% of all colon cancers and is estimated to occur in one of 8,300 live births. It is characterized by numerous adenomas scattered throughout mucosa of the colon and rectum. Case Report: The patient is a 62 years old man, admitted at the Surgical Department of the General Hospital in Konjic on May 18 2010 with gastrointestinal problems including: hard stool, often splattered with fresh blood, irregular and that causes the patient a lot of problems. The final diagnosis was median laparatomy supra et infraumibilicalis. Exploratio cavi abdominalis. Colectomy totalis et ileo-recto anastomosis TT cum staypler (33Ch). Loop ileostomy. Drainage cavi abdominalis N I (uno). Early postoperative course was generally regular. Control laboratory findings show the reference value. After ten days of hospitalization, the patient was discharged on the home recovery, with practically given instructions for care and use of stoma bags. For the secondary surgery was planned ileostomy closure, and regular post-operative endoscopic control. Conclusion: Most of the listed surgical intervention in case of FAP treatment localized in the colon can be performed by open (classic), or laparoscopic methods. Duration of postoperative stay in the hospital depends on the patient’s general condition and the type of performed surgery. It is usually about 7 days. After hospital treatment, recovery at home is from 4-6 weeks. Patients can usually return to work or school 6-8 weeks after surgery. After surgery, patients lives will be completely normal. Sexual and social activities remain the same, while either procedure does not affect the ability of a man or woman to have offspring.

Buturovic, Sead

2014-01-01

325

SUNSPOT ROTATION, SIGMOIDAL FILAMENT, FLARE, AND CORONAL MASS EJECTION: THE EVENT ON 2000 FEBRUARY 10  

SciTech Connect

We find that a sunspot with positive polarity had an obvious counterclockwise rotation and resulted in the formation and eruption of an inverse S-shaped filament in NOAA Active Region 08858 from 2000 February 9 to 10. The sunspot had two umbrae which rotated around each other by 195 Degree-Sign within about 24 hr. The average rotation rate was nearly 8 Degree-Sign hr{sup -1}. The fastest rotation in the photosphere took place during 14:00 UT to 22:01 UT on February 9, with a rotation rate of nearly 16 Degree-Sign hr{sup -1}. The fastest rotation in the chromosphere and the corona took place during 15:28 UT to 19:00 UT on February 9, with a rotation rate of nearly 20 Degree-Sign hr{sup -1}. Interestingly, the rapid increase of the positive magnetic flux occurred only during the fastest rotation of the rotating sunspot, the bright loop-shaped structure, and the filament. During the sunspot rotation, the inverse S-shaped filament gradually formed in the EUV filament channel. The filament experienced two eruptions. In the first eruption, the filament rose quickly and then the filament loops carrying the cool and the hot material were seen to spiral counterclockwise into the sunspot. About 10 minutes later, the filament became active and finally erupted. The filament eruption was accompanied with a C-class flare and a halo coronal mass ejection. These results provide evidence that sunspot rotation plays an important role in the formation and eruption of the sigmoidal active-region filament.

Yan, X. L.; Qu, Z. Q.; Kong, D. F. [National Astronomical Observatories/Yunnan Astronomical Observatory, Chinese Academy of Sciences, Kunming, Yunnan 650011 (China); Xu, C. L. [Department of Mathematics, Yunnan Normal University, Kunming, Yunnan 650092 (China)

2012-07-20

326

[A case of severe enteritis induced by adjuvant chemotherapy for colon cancer].  

PubMed

A 77-year-old man underwent surgery for sigmoid colon cancer. He was diagnosed with Stage IIIa colon cancer; there- fore, we initiated oral administration of adjuvant chemotherapy comprising uracil/tegafur(UFT)plus Leucovorin(LV). However, chemotherapy was stopped after 21 days because of fatigue and diarrhea. He recovered after 3 weeks, and we administered the same regimen with a dose reduction. However, he again experienced fatigue and diarrhea after 20 days; therefore, chemotherapy was discontinued. Subsequently, he was hospitalized 8 times for conditions such as diarrhea, hypoalbuminemia, and fever. Computed tomography revealed thickening of the transverse colonic wall and colonoscopy revealed colitis, which we believe was induced by UFT plus LV. Twelve months after the last chemotherapy session, he was diagnosed with Clostridium difficile colitis. Therefore, we initiated the oral administration of vancomycin, which resulted in rapid recovery from colitis. However, he developed liver metastasis and died 29 months after the initiation of chemotherapy. We believe that this severe case of intractable colitis was caused by UFT plus LV. Therefore, we report this case with a review of the literature on enteritis induced by fluorouracil-based anticancer agents in Japan. PMID:24743369

Mukai, Shumpei; Endo, Shungo; Nakahara, Kenta; Takayanagi, Daisuke; Maeda, Chiyo; Takehara, Yusuke; Omoto, Tomokatsu; Wada, Yoko; Kida, Hiroyuki; Hidaka, Eiji; Ishida, Fumio; Tanaka, Jun-ichi; Kudo, Shin-ei

2014-04-01

327

Perforated colonic carcinoma presenting as epididymo-orchitis and Fournier's gangrene.  

PubMed

Epididymo-orchitis is a relatively common diagnosis in elderly men, often related to prostatic outflow obstruction. A 70-year-old man presented with a 4-day history of swelling and pain in the scrotum, fevers, dysuria and frequency. He had severe symptoms of prostatic hypertrophy. Physical examination and urine microscopy confirmed the diagnosis of left epididymo-orchitis and antimicrobial therapy was commenced. Subsequently, however, he developed severe necrotizing fasciitis (Fournier's gangrene) of the scrotum requiring surgical debridement, and at laparotomy, a perforated carcinoma of the sigmoid colon was found at the level of the left deep inguinal ring. Despite further radical surgery the gangrene extended, his condition deteriorated and he died. There has been no other similar case reported in the literature, and thus, although rare, intra-peritoneal causes of infection should be considered in patients with Fournier's gangrene. PMID:9315070

Gould, S W; Banwell, P; Glazer, G

1997-08-01

328

Early experience of the compression anastomosis ring (CARTM 27) in left-sided colon resection  

PubMed Central

AIM: To evaluate clinical validity of the compression anastomosis ring (CAR™ 27) anastomosis in left-sided colonic resection. METHODS: A non-randomized prospective data collection was performed for patients undergoing an elective left-sided colon resection, followed by an anastomosis using the CAR™ 27 between November 2009 and January 2011. Eligibility criteria of the use of the CAR™ 27 were anastomoses between the colon and at or above the intraperitoneal rectum. The primary short-term clinical endpoint, rate of anastomotic leakage, and other clinical outcomes, including intra- and postoperative complications, length of operation time and hospital stay, and the ring elimination time were evaluated. RESULTS: A total of 79 patients (male, 43; median age, 64 years) underwent an elective left-sided colon resection, followed by an anastomosis using the CAR™ 27. Colectomy was performed laparoscopically in 70 patients, in whom two patients converted to open procedure (2.9%). There was no surgical mortality. As an intraoperative complication, total disruption of the anastomosis occurred by premature enforced tension on the proximal segment of the anastomosis in one patient. The ring was removed and another new CAR™ 27 anastomosis was constructed. One patient with sigmoid colon cancer showed postoperative anastomotic leakage after 6 d postoperatively and temporary diverting ileostomy was performed. Exact date of expulsion of the ring could not be recorded because most patients were not aware that the ring had been expelled. No patients manifested clinical symptoms of anastomotic stricture. CONCLUSION: Short-term evaluation of the CAR™ 27 anastomosis in elective left colectomy suggested it to be a safe and efficacious alternative to the standard hand-sewn or stapling technique. PMID:22147979

Lee, Jung-Yeon; Woo, Jin-Hee; Choi, Hong-Jo; Park, Ki-Jae; Roh, Young-Hoon; Kim, Ki-Han; Lee, Hak-Yoon

2011-01-01

329

Associations between Trans Fatty Acid Consumption and Colon Cancer among Whites and African Americans in the North Carolina Colon Cancer Study I  

PubMed Central

Disparities in incidence and mortality rates of colon cancer exist between Whites and African Americans. Prior studies examined the association between trans fatty acid consumption and colorectal cancer, but none assessed this possible relationship within a large study population of African Americans and Whites. Using data from a population-based case-control study in North Carolina, we investigated this association with attention to possible racial differences. Cases and matched controls were queried on demographic characteristics, lifestyle factors, medical history, and diet. Cases reported higher daily consumption (grams/day) of trans fatty acids [mean 5.9 (SD 2.9) and median 5.5 (IQR 3.8-7.5)] compared to controls [mean 5.2 (SD 2.4) and median 4.7 (IQR 3.5-6.4)]. Energy-adjusted trans fatty acid consumption was not associated with colon cancer. Compared to participants in the lowest quartile of consumption, those in the highest quartile had an adjusted odds ratio of 1.01 (95% confidence interval 0.69, 1.49) for Whites and 0.99 (95% confidence interval 0.61, 1.62) for African Americans. No association was found between increased consumption of trans fatty acid and specific tumor location (proximal or distal colon). In conclusion, trans fatty acid consumption is not associated with colon cancer and does not contribute to disparities in colon cancer rates. PMID:19838914

Vinikoor, Lisa C; Satia, Jessie A; Schroeder, Jane C; Millikan, Robert C; Martin, Christopher F; Ibrahim, Joseph; Sandler, Robert S

2010-01-01

330

Lack of efficacy of blueberry in nutritional prevention of azoxymethane-initiated cancers of rat small intestine and colon  

PubMed Central

Background Blueberries may lower relative risk for cancers of the gastrointestinal tract. Previous work indicated an inhibitory effect of consumed blueberry (BB) on formation of aberrant crypt foci (ACF) in colons of male Fisher F344 rats (inbred strain). However, effects of BB on colon tumors and in both genders are unknown. Methods We examined efficacy of BB in inhibition of azoxymethane (AOM)-induced colon ACF and intestine tumors in male and female Sprague-Dawley rats (outbred strain). Pregnant rats were fed a diet with or without 10% BB powder; progeny were weaned to the same diet as their dam and received AOM as young adults. Results Male and female rats on control diet had similar numbers of ACF at 6 weeks after AOM administration. BB increased (P < 0.05) ACF numbers within the distal colon of female but not male rats. There was a significant (P < 0.05) diet by gender interaction with respect to total colon ACF number. Colon and duodenum tumor incidences were less in females than males at 17 weeks after AOM. BB tended (0.1 > P > 0.05) to reduce overall gastrointestinal tract tumor incidence in males, however, tumor incidence in females was unaffected (P > 0.1) by BB. There was a tendency (0.1 > P > 0.05) for fewer adenocarcinomas (relative to total of adenomatous polyps plus adenocarcinomas) in colons of female than male tumor-bearing rats; in small intestine, this gender difference was significant (P < 0.05). BB favored (P < 0.05) fewer adenocarcinomas and more adenomatous polyps (as a proportion of total tumor number) in female rat small intestine. Conclusion Results did not indicate robust cancer-preventive effects of BB. Blueberry influenced ACF occurrence in distal colon and tumor progression in duodenum, in gender-specific fashion. Data indicate the potential for slowing tumor progression (adenomatous polyp to adenocarcinoma) by BB. PMID:19758446

2009-01-01

331

Diets enriched with cereal brans or inulin modulate protein kinase C activity and isozyme expression in rat colonic mucosa.  

PubMed

The role of dietary fibres in colon carcinogenesis is controversial. To elucidate the mechanisms by which different dietary fibre sources may affect colonic tumour development, we studied the effects of diets enriched with cereal brans or inulin on protein kinase C (PKC) activity and isozyme expression in rat colon. Male Wistar rats (twelve per group) were fed one of the following AIN-93G-based diets (Reeves et al. 1993) for 4 weeks: a non-fibre high-fat diet or one of the four high-fat diets supplemented with either rye, oat or wheat bran or inulin at 100 g/kg diet. The fat concentration (20 g/100 g) and fatty acid composition of the non-fibre high-fat diet was designed to approximate that in a typical Western-type diet. In the proximal colon, rats fed the inulin diet had a significantly higher membrane PKC activity and a higher membrane PKC delta level than rats fed the non-fibre diet In the distal colon, rats fed the inulin and oat bran diets had a higher total PKC activity and a higher membrane PKC beta 2 level than rats fed the wheat-bran diet. Rats in the non-fibre and wheat-bran groups had the lowest concentrations of luminal diacylglycerol. In conclusion, feeding of wheat bran resulted in low distal PKC activity and expression of PKC beta 2, a PKC isozyme related to colonic cell proliferation and increased susceptibility for colon carcinogenesis, which may explain in part the protective effect of wheat bran against tumour development in a number of experimental colon cancer studies. The increase in PKC activity and PKC beta 2 expression by feeding inulin may be a drawback of inulin as a functional food. PMID:11177176

Pajari, A M; Oikarinen, S; Gråsten, S; Mutanen, M

2000-11-01

332

Comparison of Segmental Colon Transit Time With Total Energy Expenditure in Psychiatry Unit Patients.  

PubMed

Physical activity is associated with a reduced risk of colorectal cancer. We examined the colon transit time (CTT) according to the total energy expenditure (TEE) in psychiatry unit patients. The study participants included 67 adults, with a mean age of 49.8 years. The participants used an accelerometer for 7 days to measure their 1-week TEE. They took a capsule containing 20 radio-opaque markers for 3 days. On the 4th day and 7th day, a supine abdominal radiography was performed. According to the TEE of all study participants, the upper 30%, middle 30%, and lower 40% were classified into groups according to high (H), moderate (M), and low (L) physical activity. The mean total CTT was 52.0 hours. The segmental CTT for the right, left, and recto-sigmoid colon were 15.3 hours, 19.2 hours, and 17.4 hours. Total CTT in the H group was significantly shorter than that in the L group (p= .010). A comparison of the segmental CTT between the L, M, and H groups showed that the right CTT (p= .010) of the H group was significantly shorter than that of the M group. The left CTT of the M group (p= .028) and H group (p= .004) was significantly shorter than that of the L group. The recto-sigmoid CTT (p= .016) of the M group was significantly shorter than that of the L group. The study showed that moderate and high TEE was assisted with reduced CTT.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommerical-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. PMID:25181498

Kim, Yeon Soo; Song, Bong Kil; Lee, On; Kwon, Hyun Jin

2014-08-29

333

Pathways to Colonization  

NASA Technical Reports Server (NTRS)

The steps required for space colonization are many to grow from our current 3-person International Space Station, now under construction, to an infrastructure that can support hundreds and eventually thousands of people in space. This paper will summarize the author's findings from numerous studies and workshops on related subjects and identify some of the critical next steps toward space colonization. Findings will be drawn from the author s previous work on space colony design, space infrastructure workshops, and various studies that addressed space policy. In conclusion, this paper will note that significant progress has been made on space facility construction through the International Space Station program, and that significant efforts are needed in the development of new reusable Earth to Orbit transportation systems. The next key steps will include reusable in space transportation systems supported by in space propellant depots, the continued development of inflatable habitat and space elevator technologies, and the resolution of policy issues that will establish a future vision for space development.

Smitherman, David V., Jr.

2003-01-01

334

Treatment Option Overview (Colon Cancer)  

MedlinePLUS

... colon. The colon is part of the body’s digestive system . The digestive system removes and processes nutrients ( vitamins , minerals , carbohydrates , fats, ... pass waste material out of the body. The digestive system is made up of the esophagus , stomach , and ...

335

General Information about Colon Cancer  

MedlinePLUS

... colon. The colon is part of the body’s digestive system . The digestive system removes and processes nutrients ( vitamins , minerals , carbohydrates , fats, ... pass waste material out of the body. The digestive system is made up of the esophagus , stomach , and ...

336

Numerical ecology validates a biogeographical distribution and gender-based effect on mucosa-associated bacteria along the human colon.  

PubMed

We applied constrained ordination numerical ecology methods to data produced with a human intestinal tract-specific phylogenetic microarray (the Aus-HIT Chip) to examine the microbial diversity associated with matched biopsy tissue samples taken from the caecum, transverse colon, sigmoid colon and rectum of 10 healthy patients. Consistent with previous studies, the profiles revealed a marked intersubject variability; however, the numerical ecology methods of analysis allowed the subtraction of the subject effect from the data and revealed, for the first time, evidence of a longitudinal gradient for specific microbes along the colorectum. In particular, probes targeting Streptococcus and Enterococcus spp. produced strongest signals with caecal and transverse colon samples, with a gradual decline through to the rectum. Conversely, the analyses suggest that several members of the Enterobacteriaceae increase in relative abundance towards the rectum. These collective differences were substantiated by the multivariate analysis of quantitative PCR data. We were also able to identify differences in the microarray profiles, especially for the streptococci and Faecalibacterium prausnitzii, on the basis of gender. The results derived by these multivariate analyses are biologically intuitive and suggest that the biogeography of the colonic mucosa can be monitored for changes through cross-sectional and/or inception cohort studies. PMID:21124491

Aguirre de Cárcer, Daniel; Cuív, Páraic O; Wang, Tingting; Kang, Seungha; Worthley, Daniel; Whitehall, Vicki; Gordon, Iain; McSweeney, Chris; Leggett, Barbara; Morrison, Mark

2011-05-01

337

Coated capsules for drug targeting to proximal and distal part of human intestine.  

PubMed

Coated hard capsules are becoming increasingly important for a number of reasons such as administration of new active ingredients, oral vaccination, colon drug delivery or their use in preclinical and clinical trials. The independency of coating composition on capsules filling is the major advantage of this dosage form. In our study, two types of hard capsules (gelatin and hypromellose) were coated by non-aqueous solutions of Eudragit L and S 12.5, respectively, to achieve intestinal and distal ileic drug delivery. Gelatin hard capsules were coated with Eudragit film either directly or using hydroxypropyl cellulose sub-coating prior to the final coating. Hypromellose capsules were coated directly. Coated capsules were evaluated for coating thickness by optical microscope and for dissolution in different pH media. Gelatin capsules do not seem to be suitable for direct coating with Eudragit due to insufficient film adhesion to the smooth capsule surface and a brittleness of formed films. These problems can be solved by hydroxypropyl celullose interlayer application. Hypromellose hard capsules could be directly easily coated with both Eudragit solutions. Dissolution of caffeine from coated capsules showed the potency for enteric delivery in gelatin capsules with interlayer and Eudragit L film in 7.5 and 10.0% concentrations and in hypromellose capsules coated with EudragitL in 5-17.5% coating levels. Gelatine capsules with interlayer and 10% Eudragit S film and hypromellose capsules only with high coating level (20%) provided potential distal ileum targeting of incorporated drug. Eudragit S film sprayed onto hypromellose capsules surface was brittle especially in the junction zone between capsule cap and body. Better plasticity of Eudragit S coating could be probably achieved using a different plasticizer. PMID:20369797

Dvorácková, Katerina; Rabisková, Miloslava; Gajdziok, Jan; Vetchý, David; Muselík, Jan; Bernatoniene, Jurga; Bajerová, Martina; Drottnerová, Pavlína

2010-01-01

338

Type 2 Secretion Promotes Enterohemorrhagic Escherichia coli Adherence and Intestinal Colonization?  

PubMed Central

Enterohemorrhagic Escherichia coli (EHEC) is a noninvasive food-borne pathogen that colonizes the distal ileum and colon. Proteins encoded in the EHEC locus of enterocyte effacement (LEE) pathogenicity island are known to contribute to this pathogen's adherence to epithelial cells and intestinal colonization. The role of non-LEE-encoded proteins in these processes is not as clear. We found that the Z2053 gene (designated adfO here), a gene located in a cryptic EHEC prophage, exhibits similarity to adherence and/or colonization factor genes found in several other enteric pathogens. An EHEC adfO mutant exhibited marked reductions in adherence to HeLa cells and in the secretion of several proteins into the supernatant. YodA, one of these secreted proteins, was found to be a substrate of the EHEC pO157-encoded type 2 secretion system (T2SS). Both the T2SS and YodA proved to be essential for EHEC adherence to cultured HeLa cell monolayers. Using an infant rabbit model of infection, we found that the adfO mutation did not affect colonization but that the colonization of an etpC (T2SS) mutant was reduced ?5-fold. A strain deficient in YodA had a more severe colonization defect; however, this strain also exhibited a growth defect in vitro. Overall, our findings indicate that the pO157-encoded T2SS contributes to EHEC adherence and intestinal colonization and thus show that EHEC pathogenicity depends on type 2 secretion as well as type 3 secretion. PMID:18316380

Ho, Theresa D.; Davis, Brigid M.; Ritchie, Jennifer M.; Waldor, Matthew K.

2008-01-01

339

Prosthetic reconstruction for tumours of the distal tibia and fibula.  

PubMed

We have carried out prosthetic reconstruction in six patients with malignant or aggressively benign bone tumours of the distal tibia or fibula. The diagnoses were osteosarcoma in four patients, parosteal osteosarcoma in one and recurrent giant-cell tumour in one. Five tumours were in the distal tibia and one in the distal fibula. The mean duration of follow-up was 5.3 years (2.0 to 7.1). Reconstruction was achieved using custom-made, hinged prostheses which replaced the distal tibia and the ankle. The mean range of ankle movement after operation was 31 degrees and the joints were stable. The average functional score according to the system of the International Society of Limb Salvage was 24.2 and five of the patients had a good outcome. Complications occurred in two with wound infection and talar collapse. All patients were free from neoplastic disease at the latest follow-up. Prosthetic reconstruction may be used for the treatment of malignant tumours of the distal tibia and fibula in selected patients. PMID:10530840

Lee, S H; Kim, H S; Park, Y B; Rhie, T Y; Lee, H K

1999-09-01

340

Effect of distal interactions on O2 binding to heme.  

PubMed

This paper reports DFT-computed electronic ground states, Mössbauer isomer shifts, O-O and Fe-O vibration frequencies, and thermodynamics of O2 binding of heme models representing different distal (position E7) interactions, strictly validated against experimental data. Based on the results, the impact of specific types of distal interactions on oxyheme electronic structure can be systematized. Hydrogen bonding increases back-donation, O-O bond activation, and oxygen binding affinity. The heme side chains reduce isomer shifts by -0.06 mm/s due to electron withdrawal from iron, and distal hydrogen bonds can further reduce isomer shifts up to 0.07 mm/s. The O-O stretch vibration, the O-O distance, and the isomer shift possess substantial heuristic value in interpreting electronic structure, whereas other properties are less effective, based on computed correlation coefficients. Shorter Fe-O bond length does not correlate with O2 affinity, as hydrogen bonding elongates both Fe-O and O-O bonds by ~0.01-0.02 Å, contrary to the situation absent from distal hydrogen bonds and of potential relevance to ligand activation where distal interactions are involved. An ionic (Weiss-type) model of Fe-O bonding combined with electron withdrawal by hydrogen bonds is shown to robustly explain the structural, spectroscopic, and thermodynamic properties of the hemes. The identified correlations may be useful, e.g., for designing O2-activating catalysts or for diagnosing heme protein variants. PMID:23489162

Kepp, Kasper P; Dasmeh, Pouria

2013-04-11

341

Hybrid carotid stent for the management of a venous aneurysm of the sigmoid sinus treated by sole stenting.  

PubMed

We describe the case of a 59-year-old female presenting with a disabling pulsatile tinnitus caused by a venous aneurysm of the sigmoid sinus. This is the first successful case of sole stenting, using a closed-cell design in the central part of the stent, leading to the occlusion of the aneurysm and the cure of the tinnitus. Venous aneurysms of the dural sinuses are rare causes of pulsatile tinnitus and the sole stenting technique provides a simpler, safe, and effective approach. PMID:22534612

Santos-Franco, J A; Lee, A; Nava-Salgado, G; Zenteno, M; Vega-Montesinos, S; Pane-Pianese, C

2012-05-01

342

Continent colostomy: An experimental study in dogs  

Microsoft Academic Search

Summary  A method for constructing a continent colostomy has been tested in dogs. The sigmoid colon was divided and the distal end\\u000a closed. The proximal end was used for constructing the colostomy. Approximately 5 cm proximal to the colostomy, a short segment\\u000a of the sigmoid wall was intussuscepted into the bowel lumen and secured in position by use of electrocauterization and

N. G. Kock; S. Geroulanos; P. HAHNLOSER; H. Schauwecker; H. Säuberli

1974-01-01

343

Neurotensin expression and release in human colon cancers.  

PubMed Central

Neurotensin (NT), a distal gut peptide released by intraluminal fats, is trophic for normal small bowel and colonic mucosa. In addition, NT stimulates growth of certain colon cancers; the mechanism for this effect is not known. The purpose of this study was to determine whether human colon cancers (HCC) (1) express the mRNA for NT/neuromedin N (N), (2) produce NT peptide, and (3) express the mRNA for a functional NT receptor (NTR). RNA was extracted from four HCC cell lines in culture, nine HCC lines established in athymic nude mice, and from six HCC and adjacent normal mucosa from freshly resected operative specimens; the RNA was analyzed for NT/N mRNA by Northern hybridization with a complementary DNA probe. Neurotensin peptide content, NTR expression, and intracellular Ca++ ([Ca++]i) mobilization in response to NT were evaluated in three HCC cell lines (LoVo, HT29, HCT116). Neurotensin/N mRNA transcripts were identified in all four of the HCC cell lines and in one of nine HCC in nude mice. Neurotensin expression was found in two of six freshly resected HCC and in none of the six corresponding samples of normal mucosa. Neurotensin peptide was identified by RIA in LoVo, HT29, and HCT116. In addition, NTR mRNA was found in HT29 and HCT116. Neurotensin stimulated [Ca++]i mobilization in HCT116 (without serum) and in LoVo (with 0.25% serum). These findings demonstrate the presence of NT/N mRNA and NT peptide and the presence of a functional NTR in certain HCC. Neurotensin, a potent trophic factor for normal gut mucosa, may function as an autocrine growth factor in certain human colon cancers. Images FIG. 1. FIG. 4. PMID:1329682

Evers, B M; Ishizuka, J; Chung, D H; Townsend, C M; Thompson, J C

1992-01-01

344

Colonize, evade, flourish  

PubMed Central

Helicobacter pylori is an adapted gastric pathogen that colonizes the human stomach, causing severe gastritis and gastric cancer. A hallmark of infection is the ability of this organism to evade detection by the human immune system. H. pylori has evolved a number of features to achieve this, many of which involve glyco-conjugates including the lipopolysaccharide, peptidoglycan layer, glycoproteins, and glucosylated cholesterol. These major bacterial components possess unique features from those of other gram-negative organisms, including differences in structure, assembly, and modification. These defining characteristics of H. pylori glycobiology help the pathogen establish a long-lived infection by providing camouflage, modulating the host immune response, and promoting virulence mechanisms. In this way, glyco-conjugates are essential for H. pylori pathogenicity and survival, allowing it to carve out a niche in the formidable environment of the human stomach. PMID:23859890

Rubin, Erica J; Trent, M Stephen

2013-01-01

345

Reverse telescoping in distal skarns at Campiglia Marittima (Italy)  

NASA Astrophysics Data System (ADS)

Skarn deposits commonly results from the metasomatic alteration of a rock, usually carbonate-rich, by infiltration of hydrothermal fluids. Most carbonate-hosted skarn deposits show a direct spatial relationship with magmatic intrusions and an intimate relationship with porphyry copper deposits. Their primary mineralogical and geochemical features indicate metasomatism by high-temperature magmatic fluids. Conversely, many distal Pb-Zn-Ag skarns pose an important challenge because there is no apparent association with magmatic intrusions and external, meteoric and/or basinal fluids should become increasingly dominant with increasing distance from the igneous source. Nevertheless recent investigation of distal skarn deposits indicates that ore-forming fluids match the composition of proximal magmatic fluids in granitoid-related mineral deposits. Besides that metal producer (Pb, Zn, Ag, Cu, Fe, W, Sn), skarn deposits can be key to understanding fluid dynamics at the periphery of magmatic-hydrothermal systems, unraveling pathways to hidden ore deposits (e.g porphyry copper). In this scenario, research on distal skarns opens new perspectives for deep mineral exploration and/or modeling of intrusion centered geothermal systems, because they should represent the outer limit of the hydrothermal system dominated by magmatic aqueous fluids. Here we present exceptional evidences from a distal Pb-Zn-Ag skarn deposit in Campiglia Marittima, Italy, where the magma, after having released the metasomatic fluids, fled up chasing its own fluid stream and invading large pockets of the newly formed skarn bodies at shallower level. Detailed underground mapping and petrologic data indicate that, after the formation of a typical distal Pb-Zn-Ag skarn, the intrusion of the parent magma produced prograde reactions in the skarn silicates, mobilization of the Pb-Zn-Ag sulfides and precipitation of a new Cu-Fe sulfide assemblage. This is a very unusual case of reverse telescoping during which the early and shallower distal skarn ores were overprinted by higher temperature ore minerals typical of proximal skarn systems.

Vezzoni, Simone; Dini, Andrea; Rocchi, Sergio

2014-05-01

346

Urethral advancement technique for repair of distal hypospadias.  

PubMed

Eighty children with distal hypospadias were operated upon by this technique. It is a modification from the old Beck technique and is applicable only for distal types (coronal and subcoronal) with minimal chordae and rotation. The urethral meatus could be placed to the tip of the glans penis by mobilizing and advancing the urethra without constructing a neourethra. Children did not need catheterization or diversion. The average hospital stay was 2 days. Success rate was 98%. Children who developed fistulae were treated by simple closure of the defect. PMID:2318238

Wishahi, M M; Wishahy, M K; Kaddah, N

1990-01-01

347

Tool use and the distalization of the end-effector  

PubMed Central

We review recent neurophysiological data from macaques and humans suggesting that the use of tools extends the internal representation of the actor’s hand, and relate it to our modeling of the visual control of grasping. We introduce the idea that, in addition to extending the body schema to incorporate the tool, tool use involves distalization of the end-effector from hand to tool. Different tools extend the body schema in different ways, with a displaced visual target and a novel, task-specific processing of haptic feedback to the hand. This distalization is critical in order to exploit the unique functional capacities engendered by complex tools. PMID:19347356

Bonaiuto, James B.; Jacobs, Stéphane; Frey, Scott H.

2009-01-01

348

Tubularized incised plate urethroplasty for distal hypospadias: A literature review  

PubMed Central

The tubularized incised plate (TIP) urethroplasty or Snodgrass procedure has gained worldwide acceptance for distal hypospadias repair due to its low complication rate, good cosmetic result, and technical simplicity. As a result, several articles have been published concerning various aspects and subtle variations of this procedure. The aim of this review is to critically and systematically analyze the published complication rates of TIP repair for distal hypospadias in children. We also reviewed the surgical modifications that have been introduced to the original technique and discussed the potential impact on the final outcome of the Snodgrass procedure. PMID:19468401

Braga, Luis Henrique P.; Lorenzo, Armando J.; Salle, Joao L. Pippi

2008-01-01

349

Distal renal tubular acidosis in a cat with pyelonephritis.  

PubMed

A four-year-old castrated male domestic shorthair cat with recent onset of lethargy and depression was found to have hypokalaemia, low plasma bicarbonate concentration and a urine pH of 7. Subsequent findings of hyperchloraemic metabolic acidosis with failure to produce acid urine led to a diagnosis of distal renal tubular acidosis. Pyelonephritis associated with Escherichia coli infection of the urinary tract was also diagnosed. The urinary tract infection was eliminated by antibiotic treatment. For two years subsequently, the clinical effects of distal renal tubular acidosis have been controlled by oral administration of potassium bicarbonate, although some biochemical abnormalities have persisted. PMID:3529597

Watson, A D; Culvenor, J A; Middleton, D J; Rothwell, T L

1986-07-19

350

An Improved Electronic Colon Cleansing Method for Detection of Colonic Polyps by Virtual Colonoscopy  

Microsoft Academic Search

Electronic colon cleansing (ECC) aims to segment the colon lumen from a patient abdominal image acquired using an oral contrast agent for colonic material tagging, so that a virtual colon model can be constructed. Virtual colonoscopy (VC) provides fly-through navigation within the colon model, looking for polyps on the inner surface in a manner analogous to that of fiber optic

Zigang Wang; Zhengrong Liang; Xiang Li; Lihong Li; Bin Li; Daria Eremina; Hongbing Lu

2006-01-01

351

THE CONTRACTION OF OVERLYING CORONAL LOOP AND THE ROTATING MOTION OF A SIGMOID FILAMENT DURING ITS ERUPTION  

SciTech Connect

We present an observation of overlying coronal loop contraction and rotating motion of the sigmoid filament during its eruption on 2012 May 22 observed by the Solar Dynamics Observatory (SDO). Our results show that the twist can be transported into the filament from the lower atmosphere to the higher atmosphere. The successive contraction of the coronal loops was due to a suddenly reduced magnetic pressure underneath the filament, which was caused by the rising of the filament. Before the sigmoid filament eruption, there was a counterclockwise flow in the photosphere at the right feet of the filament and the contraction loops and a convergence flow at the left foot of the filament. The hot and cool materials have inverse motion along the filament before the filament eruption. Moreover, two coronal loops overlying the filament first experienced brightening, expansion, and contraction successively. At the beginning of the rising and rotation of the left part of the filament, the second coronal loop exhibited rapid contraction. The top of the second coronal loop also showed counterclockwise rotation during the contraction process. After the contraction of the second loop, the left part of the filament rotated counterclockwise and expanded toward the right of NOAA AR 11485. During the filament expansion, the right part of the filament also exhibited counterclockwise rotation like a tornado.

Yan, X. L.; Qu, Z. Q.; Xue, Z. K.; Deng, L. H.; Ma, L.; Kong, D. F. [National Astronomical Observatories/Yunnan Astronomical Observatory, Chinese Academy of Sciences, Kunming 650011 (China); Pan, G. M. [College of Mathematics Physics and Information Engineering, Jiaxing University, Jiaxing 314001 (China); Liu, J. H. [Key Laboratory of Solar Activity, National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012 (China)

2013-06-15

352

Increased induction of apoptosis by Propionibacterium freudenreichii TL133 in colonic mucosal crypts of human microbiota-associated rats treated with 1,2-dimethylhydrazine.  

PubMed

Propionibacterium freudenreichii, a food-grade bacterium able to kill colon cancer cell lines in vitro by apoptosis, may exert an anticarcinogenic effect in vivo. To assess this hypothesis, we administered daily 2 x 10(10) colony-forming units (CFU) of P. freudenreichii TL133 to human microbiota-associated (HMA) rats for 18 d. Either saline or 1,2-dimethylhydrazine (DMH) was also administered on days 13 and 17 and rats were killed on day 19. The levels of apoptosis and proliferation in the mid and distal colon were assessed by terminal deoxynucleotide transferase-mediated deoxyuridine triphosphate nick end labelling (TUNEL) and proliferating cell nuclear antigen (PCNA) immunolabelling, respectively. The administration of P. freudenreichii TL133 significantly increased the number of apoptotic cells in DMH-treated rats compared to those given DMH only (P < 0.01). Furthermore, propionibacteria were able to decrease the proliferation index in the distal colon after treatment with DMH (P < 0.01). Conversely, propionibacteria alone did not exert such an effect on healthy colonic mucosa. P. freudenreichii TL133 thus facilitated the elimination of damaged cells by apoptosis in the rat colon after genotoxic insult and may play a protective role against colon cancer. PMID:18466653

Lan, Annaïg; Bruneau, Aurélia; Bensaada, Martine; Philippe, Catherine; Bellaud, Pascale; Rabot, Sylvie; Jan, Gwénaël

2008-12-01

353

Enteric bacterial protein AvrA promotes colonic tumorigenesis and activates colonic beta-catenin signaling pathway  

PubMed Central

Salmonella infections can become chronic and increase the risk of cancer. The mechanisms by which specific Salmonella organisms contribute to cancer, however, are still unknown. Live and attenuated Salmonella are used as vectors to target cancer cells, but there have been no systematic studies of the oncogenic potential of chronic Salmonella infections in cancer models. AvrA, a pathogenic product of Salmonella, is inserted into host cells during infection and influences eukaryotic cell pathways. In the current study, we colonized mice with Salmonella AvrA-sufficient or AvrA-deficient Salmonella typhimirium strains and induced inflammation-associated colon cancer by azoxymethane/dextran sulfate sodium (AOM/DSS). We confirmed Salmonella persisted in the colon for up to 45 weeks. Salmonella was identified not only in epithelial cells on the colonic luminal surface and base of the crypts but also in invading tumors. Tumor incidence in the AvrA+infected group was 100% compared with 51.4% in the AOM/DSS group without bacterial gavage and 56.3% in mice infected with the AvrA- strain. Infection with AvrA+ strain also altered tumor distribution from the distal to proximal colon that might reflect changes in the microbiome. AvrA-expressing bacteria also upregulated beta-catenin signaling as assessed by decreased beta-catenin ubiquitination, increased nuclear beta-catenin and increased phosphorylated-beta-catenin (Ser552), a marker of proliferating stem-progenitor cells. Other ?-catenin targets increased by AvrA included Bmi1, a cancer stem cell marker, matrix metalloproteinase-7, and cyclin D1. In summary, AvrA-expressing Salmonella infection activates ?-catenin signals and enhances colonic tumorigenesis. Our findings provide important new mechanistic insights into how a bacterial protein targets proliferating stem-progenitor cells and contributes to cancer development. Our observations also raise a note of caution regarding the use of mutant Salmonella organisms as vectors for anti-cancer therapy. Finally, these studies could suggest biomarkers (such as AvrA level in gut) to assess cancer risk in susceptible individuals and infection-related dysregulation of ?-catenin signaling in cancer. PMID:24911876

Lu, R; Wu, S; Zhang, Y-g; Xia, Y; Liu, X; Zheng, Y; Chen, H; Schaefer, K L; Zhou, Z; Bissonnette, M; Li, L; Sun, J

2014-01-01

354

Enteric bacterial protein AvrA promotes colonic tumorigenesis and activates colonic beta-catenin signaling pathway.  

PubMed

Salmonella infections can become chronic and increase the risk of cancer. The mechanisms by which specific Salmonella organisms contribute to cancer, however, are still unknown. Live and attenuated Salmonella are used as vectors to target cancer cells, but there have been no systematic studies of the oncogenic potential of chronic Salmonella infections in cancer models. AvrA, a pathogenic product of Salmonella, is inserted into host cells during infection and influences eukaryotic cell pathways. In the current study, we colonized mice with Salmonella AvrA-sufficient or AvrA-deficient Salmonella typhimirium strains and induced inflammation-associated colon cancer by azoxymethane/dextran sulfate sodium (AOM/DSS). We confirmed Salmonella persisted in the colon for up to 45 weeks. Salmonella was identified not only in epithelial cells on the colonic luminal surface and base of the crypts but also in invading tumors. Tumor incidence in the AvrA+infected group was 100% compared with 51.4% in the AOM/DSS group without bacterial gavage and 56.3% in mice infected with the AvrA- strain. Infection with AvrA+ strain also altered tumor distribution from the distal to proximal colon that might reflect changes in the microbiome. AvrA-expressing bacteria also upregulated beta-catenin signaling as assessed by decreased beta-catenin ubiquitination, increased nuclear beta-catenin and increased phosphorylated-beta-catenin (Ser552), a marker of proliferating stem-progenitor cells. Other ?-catenin targets increased by AvrA included Bmi1, a cancer stem cell marker, matrix metalloproteinase-7, and cyclin D1. In summary, AvrA-expressing Salmonella infection activates ?-catenin signals and enhances colonic tumorigenesis. Our findings provide important new mechanistic insights into how a bacterial protein targets proliferating stem-progenitor cells and contributes to cancer development. Our observations also raise a note of caution regarding the use of mutant Salmonella organisms as vectors for anti-cancer therapy. Finally, these studies could suggest biomarkers (such as AvrA level in gut) to assess cancer risk in susceptible individuals and infection-related dysregulation of ?-catenin signaling in cancer. PMID:24911876

Lu, R; Wu, S; Zhang, Y-G; Xia, Y; Liu, X; Zheng, Y; Chen, H; Schaefer, K L; Zhou, Z; Bissonnette, M; Li, L; Sun, J

2014-01-01

355

Effect of Age on the Enteric Nervous System of the Human Colon  

PubMed Central

The effect of age on the anatomy and function of the human colon is incompletely understood. The prevalence of disorders in adults such as constipation increase with age but it is unclear if this is due to confounding factors or age-related structural defects. The aim of this study was to determine number and subtypes of enteric neurons and neuronal volumes in the human colon of different ages. Normal colon (descending and sigmoid) from 16 patients (9 male) was studied; ages 33–99. Antibodies to HuC/D, ChAT, nNOS, and PGP9.5 were used. Effect of age was determined by testing for linear trends using regression analysis. In the myenteric plexus, number of Hu-positive neurons declined with age (slope = ?1.3 neurons/mm/10yrs, p =0.03). The number of ChAT-positive neurons also declined with age (slope = ?1.1 neurons/mm/10yrs of age, p=0.02). The number of nNOS-positive neurons did not decline with age. As a result, the ratio of nNOS to Hu increased (slope= 0.03 per 10yrs of age, p=0.01). In the submucosal plexus, the number of neurons did not decline with age (slope = ? 0.3 neurons/mm/10 yrs, p =0.09). Volume of nerve fibers in the circular muscle and volume of neuronal structures in the myenteric plexus did not change with age. In conclusion, the number of neurons in the human colon declines with age with sparing of nNOS- positive neurons. This change was not accompanied by changes in total volume of neuronal structures suggesting compensatory changes in the remaining neurons. PMID:19220755

Bernard, Cheryl E.; Gibbons, Simon J.; Gomez-Pinilla, Pedro J.; Lurken, Matthew S.; Schmalz, Philip F.; Roeder, Jaime L.; Linden, David; Cima, Robert R.; Dozois, Eric J.; Larson, David W.; Camilleri, Michael; Zinsmeister, Alan R; Pozo, Maria J; Hicks, Gareth A.; Farrugia, Gianrico

2009-01-01

356

Isolated amyloidosis of the colon.  

PubMed

A 46-year-old man was seen with a 2-month history of crampy abdominal pain and recent onset of hematochezia. Colonoscopic examination revealed a semiannular mass lesion in the descending colon which was thought to represent a near-obstructing neoplasm. A partial colon resection was performed. Gross inspection revealed a segment of bowel with focally necrotic mucosa but no mass lesion. Microscopic examination revealed deposits of amyloid infiltrating the muscularis propria, submucosal vessel walls, and lamina propria, with focal ischemic necrosis of mucosa. Special stains were positive for light chains, indicating primary amyloidosis. Follow-up studies for multiple myeloma and inflammatory disorders gave negative results. A diagnosis of isolated amyloidosis of the colon was rendered. Two months after surgery, the patient had a recurrence of symptoms and colon biopsy specimens revealed amyloidosis. The patient was given colchicine, with subjective and objective improvement. The various types of amyloidosis are discussed. PMID:8932596

Threlkeld, C; Nguyen, T H

1996-03-01

357

Young Adults and Colon Cancer  

MedlinePLUS Videos and Cool Tools

... the decline in older Americans, but a new study finds incidence of the disease in younger adults may be on the rise. Researchers analyzed more than 230,000 cases of colon cancer covering a period of more ...

358

Gastric colonization with Candida albicans  

Microsoft Academic Search

We adapted a rat model of gastrointestinal candidiasis for studies of in vivo gastric colonization withCandida albicans. Whereas normal rats cleared a single intragastric inoculum of 5×106C. albicans from the stomach within 4 hours, rats pretreated with chloramphenicol and gentamicin achieved stable gastric colonization for at least 5 days after administration of this inoculum. We next used this model to

Ronald A. Greenfield; Wnedy A. Joyce

1993-01-01

359

Selenium, Folate, and Colon Cancer  

PubMed Central

Background Selenium is an essential trace element which has been implicated in cancer risk; however, study results have been inconsistent with regard to colon cancer. Our objectives were to 1) investigate the association between selenium and colon cancer 2) evaluate possible effect measure modifiers and 3) evaluate potential biases associated with the use of post-diagnostic serum selenium measures Methods The North Carolina Colon Cancer Study is a large population-based, case-control study of colon cancer in North Carolina between 1996 and 2000 (n=1,691). Nurses interviewed patients about diet and lifestyle and drew blood specimens which were used to measure serum selenium. Results Individuals who had both high serum selenium (>140 mcg/L) and high reported folate (>354 mcg/day), had a reduced relative risk of colon cancer (OR=0.5, 95% CI=0.4,0.8). The risk of colon cancer for those with high selenium and low folate was approximately equal to the risk among those with low selenium and low folate (OR=1.1, 95% CI=0.7,1.5) as was the risk for those with low selenium and high folate (OR=0.9, 95% CI=0.7–1.2). We did not find evidence of bias due to weight loss, stage at diagnosis, or time from diagnosis to selenium measurement. Conclusion High levels of serum selenium and reported folate jointly were associated with a substantially reduced risk of colon cancer. Folate status should be taken into account when evaluating the relation between selenium and colon cancer in future studies. Importantly, weight loss, stage at diagnosis, or time from diagnosis to blood draw did not appear to produce strong bias in our study. PMID:19235033

Connelly-Frost, Alexandra; Poole, Charles; Satia, Jessie A.; Kupper, Lawrence L.; Millikan, Robert C.; Sandler, Robert S.

2009-01-01

360

Endoscopic Distal Soft Tissue Procedure in Hallux Valgus Surgery  

Microsoft Academic Search

The distal soft tissue procedure is the basis of surgical hallux valgus correction. It involves release of the transverse metatarsal ligament, adductor hallucis, and lateral joint capsule, which permits the proximal phalanx to be realigned on the metatarsal head. The attenuated medial capsule is plicated after the medial bony prominence has been excised. We describe a new endoscopic approach for

Tun Hing Lui; Shek Ng; Kwok-bill Chan

2005-01-01

361

Functional outcome of arthroscopic assisted fixation of distal radius fractures  

PubMed Central

Background: Many studies in literature have supported the role of wrist arthroscopy as an adjunct to the stable fixation of unstable intraarticular distal radial fractures. This article focuses on the surgical technique, indications, advantages, and results using wrist arthroscopy to assess articular reduction and evaluates the treatment of carpal ligament injuries and triangular fibrocartilage complex (TFCC) injuries in conjunction with the stable fixation of distal radial fractures. Materials and Methods: We retrospectively evaluated 27 patients (16 males and 11 females), who underwent stable fixation of intraarticular distal radial fractures with arthroscopic evaluation of the articular reduction and repair of associated carpal injuries. As per the AO classification, they were 9 C 1, 12 C2, 2 C3, 3 B 1, and 1 B2 fractures. The final results were evaluated by modified Mayo wrist scoring system. The average age was 41 years (range: 18-68 years). The average followup was of 26 months (range 24-52 months). Results: Five patients needed modification of the reduction and fixation after arthroscopic joint evaluation. Associated ligament lesions found during the wrist arthroscopy were TFCC tears (n=17), scapholunate ligament injury (n=8), and luno-triquetral ligament injury (n=1). Five patients had combined injuries i.e. included TFCC tear, scapholunate and/or lunotriquetral ligament tear. There were 20 excellent, 3 good, and 4 fair results using this score. Conclusion: The radiocarpal and mid carpal arthroscopy is a useful adjunct to stable fixation of distal radial fractures. PMID:23798761

Khanchandani, Prakash; Badia, Alejandro

2013-01-01

362

Distal volcano-tectonic seismicity near Augustine Volcano  

USGS Publications Warehouse

Clustered earthquakes located 25 km northeast of Augustine Volcano occurred more frequently beginning about 8 months before the volcano?s explosive eruption in 2006. This increase in distal seismicity was contemporaneous with an increase in seismicity directly below the volcano?s vent. Furthermore, the distal seismicity intensified penecontemporaneously with signals in geodetic data that appear to reveal a transition from magmatic inflation of the volcano to dike injection. Focal mechanisms for five events within the distal cluster show strike-slip-fault movement. Directly above the earthquake cluster, shallow (<5 km deep) folds and faults mapped using multichannel seismic-reflection data strike northeast, parallel to the regional structural grain. About 10 km northeast of Augustine Volcano, however, the Augustine-Seldovia arch, an important trans-basin feature, strikes west and intersects the northeast-striking structural zone. We propose that the fault causing the distal earthquake cluster strikes northwest, subparallel to the arch, and is a right-lateral strike-slip fault. Future earthquake monitoring might show whether increasing activity in the remote cluster can aid in making eruption forecasts.

Fisher, Michael A.; Ruppert, Natalia A.; White, Randall A.; Sliter, Ray W.; Wong, Florence L.

2010-01-01

363

Comparison of internal and external fixation of distal radius fractures  

PubMed Central

Background and purpose There is no consensus on the difference in effects of internal fixation (IF) and external fixation (EF) on outcomes for the treatment of distal radius fractures. We performed a meta-analysis of randomized clinical studies. Methods We searched the literature and included studies that compared the effects of IF and EF on the treatment of distal radius fractures. Statistically, we pooled patient data using standard meta-analytic methods. For the continuous variables, the weighted mean difference (WMD) was used. For dichotomous data, the relative risk (RR) was calculated. Results 10 studies were eligible for data extraction. The pooled data showed that compared with EF, IF led to statistically significantly better Disabilities of the Arm, Shoulder, and Hand (DASH) scores at 12 months postoperatively, recovery of forearm supination at 3 months, and restoration of volar tilt and radial inclination. IF using volar locking plates resulted in better DASH scores than EF at 3 and 6 months, but the trend diminished over time; at 12 months postoperatively, the scores were not statistically significant. Compared with EF, IF led to fewer minor surgical complications. Interpretation For surgical treatment of distal radius fractures, IF yields better functional outcomes, forearm supination, restoration of anatomic volar tilt and radial inclination, and fewer minor complications. The patients who received IF using volar locking plates for the treatment of distal radius recovered more quickly than did patients who received EF. PMID:23594247

2013-01-01

364

Ovarian apoptosis after shock wave lithotripsy for distal ureteral stones.  

PubMed

The objective of this study is to identify any apoptotic effect of shock wave lithotripsy (SWL) for distal ureteral stones on ovarian tissue. Twenty-one female New Zealand White rabbits were divided into three groups of seven rabbits each: I (control), and II, III (treated and killed 14 and 28 days after SWL, respectively). The left distal ureteral segment of the anesthetized (ketamine HCl, 20 mg/kg) animals in groups II and III was exposed to 1,500 shock waves at 17 kV. Localization of the distal ureteral segments was achieved following contrast medium (Iohexol 300 mg of I/ml) injection. The animals were killed on day 14 or 28 after SWL, and the ovaries were removed. The follicle number with apoptotic changes in ovarian tissue was compared with control group. Apoptotic changes were determined by terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end-labeling (TUNEL) method. No increased apoptosis was detected in all groups. The mean number of TUNEL-positive follicle in groups I, II and III was 9.3 +/- 2.9, 8.1 +/- 2.6 and 8.7 +/- 2.9, respectively. There were no statistically significant differences among all groups regarding the number of TUNEL-positive follicle (P = 0.647). Also, no histomorphological change other than apoptosis was detected in the study groups. In conclusion, SWL treatment for distal ureteral stones does not induce apoptotic changes on ovarian tissue. PMID:19189090

Bayrak, Omer; Cimentepe, Ersin; Karatas, Omer Faruk; Aker, Aylin; Bayrak, Reyhan; Yildirim, Mehmet Erol; Unsal, Ali; Unal, Dogan

2009-04-01

365

Treatment of distal humerus fractures in adults: a historical perspective.  

PubMed

Nonsurgical treatment was the mainstay of management of distal humerus fractures for centuries and nonunions and malunions were common. The 19th century featured the recognition of distinct injury patterns. With advances in radiology, anesthesia, antisepsis, and hardware technology, surgical treatment is now generally preferred, yet loss of elbow joint mobility can still be a vexing problem. PMID:25442772

Kozánek, Michal; Bartoní?ek, Jan; Chase, Samantha M; Jupiter, Jesse B

2014-12-01

366

The effectiveness of distal soft tissue procedures in hallux valgus  

PubMed Central

Background Hallux valgus is a common disorder affecting mostly women population. Distal soft tissue procedure in the treatment of hallux valgus is one of the main operative techniques described. The aim of this study is to evaluate the outcomes of McBride’s distal soft tissue procedure in hallux valgus cases. Materials and methods This study includes 30 patients (27 women) having 31 hallux valgus, who were treated between 1999 and 2004. Modified McBride’s distal soft tissue procedure was carried out in all cases. Pain status of the cases was recorded by using VAS, clinical assessment described by Bonney and Macnab, and American Orthopaedic Foot and Ankle Society’s (AOFAS) score at the last follow up. Results The mean hallux valgus and intermetatarsal angles decreased from 31.4° and 13.8° to 13.5° and 10.5°, respectively, with an average follow-up period of 54.4 months. AOFAS’s score displayed significant improvement from 57 to 87. The mean VAS showed a significant decrease from 8.75 preoperatively to 2.1 at the last follow-up. According to Bonney and Macnab criteria, only one case was accepted as poor result due to 5° hallux varus. Conclusions McBride’s distal soft tissue procedure yields high rate of satisfaction for mild to moderate hallux valgus with no bony complications related to osteotomy. PMID:19384606

Ozturk, Hasan; Agus, Haluk; Altay, Taskin; Hancerli, Ozgur

2008-01-01

367

Distal phalanx fracture in adults: Seymour-type fracture.  

PubMed

Seymour's fracture is an extra-articular, transverse, physeal, and juxta-epiphyseal open fracture of the distal phalanx seen in childhood. In this study, we present 10 adult cases of fractures localized to the metaphyseal region, 1-2 mm distal to the insertion of the extensor tendon. Mean age was 38 years. Four patients were treated conservatively with a mallet finger splint. Closed reduction and osteosynthesis with Kirschner wires (K-wires) was performed in three of the patients. Three of the patients had open fractures in whom closed reduction could not be performed. They underwent open reduction and osteosynthesis with K-wires. We recommend that extra-articular distal phalanx fractures mimicking mallet finger in adults are called Seymour-type fracture to establish a common language among clinicians to define this type of fracture. These fractures generally occur by hyperflexion of the distal phalanx and can be treated by conservative or surgical methods. The outcomes of conservative and surgical management of Seymour-type fractures depend on the appropriate reduction as well as efficient physical therapy. PMID:24194615

Ugurlar, M; Saka, G; Saglam, N; Milcan, A; Kurtulmus, T; Akp?nar, F

2014-03-01

368

[Distal revascularization in diabetic patients with chronic limb ischemia].  

PubMed

Diabetes mellitus is an independent risk factor for peripheral artery disease. Life expectancy is 41 months for diabetic patients with an ischemic ulcer. The characteristics of diabetic arteriopathy make its treatment more difficult than in non-diabetic patients. Few data are available about the surgical treatment of arteriopathy in diabetic patients (including angioplasty or bypass), especially in case of distal arteriopathy. The choice of the procedure depends on multiple factors such as the disease localization, its extent, distal blood flow and vascular disease-related surgical risk. The principal aim of revascularisation is to restore direct flow to the foot in order to ensure wound healing and limb salvage. With percutaneous endoluminal angioplasty, limb salvage can be achieved in more than 80 % of patients at 1-3 years. The percutaneous procedure is less invasive than open surgery, there are fewer complications, and morbidity and mortality rates are reduced; moreover, a second procedure remains possible in the future. With bypass surgery, the rate of limb salvage exceeds 80 % at five years. Nevertheless, peri-operative mortality reaches 3 % and arterial anatomy, patient-related risks factors or venous graft availability may be limitations. New endovascular techniques especially designed for the distal arteries of the lower limbs enable very distal revascularization with morbidity and mortality rates lower than with surgery. PMID:25596672

Courtois, M-C; Sapoval, M; Del Giudice, C; Ducloux, R; Mirault, T; Messas, E

2015-02-01

369

Krüppel-Like Factor 5 Mediates Transmissible Murine Colonic Hyperplasia Caused by Citrobacter rodentium Infection  

PubMed Central

Background & Aims Krüppel-like factor 5 (KLF5) is a transcription factor that is highly expressed in proliferating crypt cells of the intestinal epithelium. KLF5 has a pro-proliferative effect in vitro and is induced by mitogenic and stress stimuli. To determine whether KLF5 is involved in mediating proliferative responses to intestinal stressors in vivo, we examined its function in a mouse model of transmissible murine colonic hyperplasia (TMCH), which is triggered by colonization of the mouse colon by the bacterial pathogen, Citrobacter rodentium. Methods Heterozygous Klf5 knockout (Klf5+/?) mice were generated from embryonic stem cells carrying an insertional disruption of the Klf5 gene. Klf5+/? mice or wild-type (WT) littermates were infected with C. rodentium by oral gavage. At various time points post-infection (p.i.), mice were sacrificed and distal colons harvested. Colonic crypt heights were determined morphometrically from sections stained with hematoxylin and eosin. Frozen tissues were stained by immunofluorescence using antibodies against Klf5 and the proliferation marker, Ki67, to determine Klf5 expression and numbers of proliferating cells per crypt. Results Infection of WT mice with C. rodentium resulted in a 2-fold increase in colonic crypt heights at 14 days p.i. and was accompanied by a 1.7-fold increase in Klf5 expression. Infection of Klf5+/? mice showed an attenuated induction of Klf5 expression, and hyperproliferative responses to C. rodentium were reduced in the Klf5+/? animals as compared to WT littermates. Conclusion Our study demonstrates that Klf5 is a key mediator of crypt cell proliferation in the colon in response to pathogenic bacterial infection. PMID:18395082

McConnell, Beth B.; Klapproth, Jan-Michael A.; Sasaki, Maiko; Nandan, Mandayam O.; Yang, Vincent W.

2008-01-01

370

Posterior interosseous nerve incarceration with endobutton repair of distal biceps.  

PubMed

Distal biceps ruptures are uncommon injuries that comprise approximately 3% of all biceps pathology. This injury is most commonly seen in 40- to 60-year-old men, and the mechanism of injury involves a forceful extension movement to a flexed elbow. Without surgical intervention, patients are left with measurable weakness in elbow flexion and supination as well as a cosmetic deformity that often leaves them dissatisfied. Consequently, early surgical repair is advocated for physically active individuals. A variety of surgical approaches and fixation devices are currently used for distal biceps repair. The single-incision cortical button repair for distal biceps avulsions has become popular since Bain introduced the technique in 2000. The advantage of the cortical button biceps repair technique is the significantly higher failure strength than either the 2-incision technique or the suture anchor repair. The initial repair strength of the cortical button technique allows immediate active elbow range of motion and accelerated rehabilitation. Additionally, the single-incision anterior approach is less invasive than the 2-incision biceps repair and results in a lower incidence of heterotopic ossification. One disadvantage of this approach, however, is the risk of injury to the posterior interosseous nerve. The authors report a case in which the posterior interosseous nerve was incarcerated between the cortical button and the radius during acute distal biceps repair, resulting in complete posterior interosseus nerve palsy. This case report details the surgery leading to the nerve palsy and the subsequent nerve exploration that identified the cause of the nerve palsy. Recommendations are made on how to avoid this complication during distal biceps tendon repairs. [Orthopedics. 2015; 38(1):e68-e71.]. PMID:25611423

Van den Bogaerde, James; Shin, Edward

2015-01-01

371

Indolent infection in nonunion of the distal femur.  

PubMed

In the treatment of nonunions of the distal femur, infection should be excluded. However, it is difficult to determine whether the nonunion is infected or not with negative history and signs of infection. The purpose of this study was to investigate indolent infection as a cause of presumptive aseptic distal femur nonunion. All presumptive aseptic distal femur nonunions treated from 1998 to 2008 were retrospectively reviewed. Any patient with suspected of having an infection clinically was excluded. Multiple tissue cultures were performed at the nonunion site. The main outcomes were to analyze the rate of positive cultures in presumptive aseptic distal femur nonunion and to compare the rate of secondary surgery in positive and negative culture groups. Of the 22 patients, 3 (13.6 %) had positive culture results. The organisms cultured were Staphylococcus aureus, Staphylococcus epidermidis, and Enterobacter cloacae. The overall rate of infection was 9.1 % (2/22), and one patient underwent a secondary procedure. In the open fracture group, 2 of 10 patients (20 %) had positive cultures; all developed infection. In the closed fracture group, 1 of 12 patients (8.3 %) had positive culture results, but Infection did not occur in the patient with a 3-week intravenous antibiotic treatment. The postoperative infection rate was 67 % (2/3) in patients with positive intraoperative cultures, while 0 % (0/18) in the group with negative intraoperative cultures (p < 0.001). The presence of indolent infection can be verified in patients with presumptive aseptic nonunion of distal femoral fractures by obtaining intraoperative biopsy tissue cultures. Positive intraoperative culture results were related with postoperative infection. PMID:25189289

Kim, Ji Wan; Byun, Seong-Eun; Oh, Hyoung Keun; Kim, Jung Jae

2014-09-01

372

Utility of the Cortical Thickness of the Distal Radius as a Predictor of Distal-Radius Bone Density  

PubMed Central

Background Bone density is an important factor in the management of fractures of the distal radius. Objectives The aim of this study was to establish whether standard anteroposterior (AP) radiographs would provide the attending physician with a prediction of bone density. Patients and Methods Six pairs of human cadaveric radii were harvested. The mean donor age was 74 years. Standardized AP radiographs were taken of the radii. The outside diameter and the inside diameter of the cortical shell at the metaphyseal / diaphyseal junction were measured and their ratio was calculated. Dual-energy x-ray absorptiometry (DXA) was used to obtain the bone mineral density (BMD) of the distal parts of the radii. The correlation of the BMD values with these ratios was studied. Results The mean BMD was 0.559 (SD = 0.236) g / cm2. The mean outside diameter/inside diameter ratio was 1.24 (SD = 0.013); the ratio significantly correlated with the total BMD (P = 0.001; R2 = 0.710). In the BMD subregions, the correlation was also significant. Conclusions The outside diameter/inside diameter ratio at the metaphyseal/diaphyseal junction of the distal radius on AP radiographs is suitable for use as a predictor of distal-radius bone density. Further studies should be performed, and clinical utility evaluated. PMID:24396783

Rausch, Sascha; Klos, Kajetan; Gras, Florian; Skulev, Hristo Kostov; Popp, Albrecht; Hofmann, Gunther Olaf; Mückley, Thomas

2013-01-01

373

Rebamipide promotes healing of colonic ulceration through enhanced epithelial restitution  

PubMed Central

AIM: To investigate the efficacy of rebamipide in a rat model of colitis and restitution of intestinal epithelial cells in vitro. METHODS: Acute colitis was induced with trinitrobenzene sulfonic acid (TNBS) in male Wistar rats. Rats received intrarectal rebamipide treatment daily starting on day 7 and were sacrificed on day 14 after TNBS administration. The distal colon was removed to evaluate the various parameters of inflammation. Moreover, wound healing assays were used to determine the enhanced restitution of rat intestinal epithelial (RIE) cells treated with rebamipide. RESULTS: Intracolonic administration of rebamipide accelerated TNBS-induced ulcer healing. Increases in the wet weight of the colon after TNBS administration were significantly inhibited by rebamipide. The wound assay revealed that rebamipide enhanced the migration of RIE cells through phosphorylation of extracellular signal-regulated kinase (ERK) and activation of Rho kinase. CONCLUSION: Rebamipide enema healed intestinal injury by enhancing restitution of RIE cells, via ERK activation. Rebamipide might be a novel therapeutic approach for inflammatory bowel disease. PMID:21987622

Takagi, Tomohisa; Naito, Yuji; Uchiyama, Kazuhiko; Okuda, Toshimitsu; Mizushima, Katsura; Suzuki, Takahiro; Handa, Osamu; Ishikawa, Takeshi; Yagi, Nobuaki; Kokura, Satoshi; Ichikawa, Hiroshi; Yoshikawa, Toshikazu

2011-01-01

374

Compensation for distal impairments of grasping in adults with hemiparesis.  

PubMed

Previous studies have shown that patients with arm and hand paresis following stroke recruit an additional degree of freedom (the trunk) to transport the hand during reaching and use alternative strategies for grasping. The few studies of grasping parameters of the impaired hand have been case studies mainly focusing on describing grasping in the presence of particular impairments such as hemi-neglect or optic ataxia and have not focussed on the role of the trunk in prehension. We hypothesized that the trunk movement not only ensures the transport of the hand to the object, but it also assists in orienting the hand for grasping when distal deficits are present. Nineteen patients with chronic hemiparesis and seven healthy subjects participated in the study. Patients had sustained a stroke of non-traumatic origin 6-82 months previously (31+/-22 months) and had mild or moderate to severe arm paresis. Using a whole hand grasp, subjects reached and grasped a cylinder (35 mm) that was placed sagittally (T1) or at a 45 degrees angle to the sagittal midline in the ipsilateral workspace (T2), both at about 90% arm's length (10 trials per target). Eight infrared emitting diodes were placed on bony landmarks of the hand, arm and trunk and kinematic data were recorded by an optical motion analysis system (Optotrak) for 2-5 s at 120 Hz. Hand position and orientation were recorded by a Fastrack Polhemus system. Our results show that during goal-directed prehension tasks, individuals with hemiparesis oriented the hand more frontally for grasping and used more trunk anterior displacement or rotation to transport the hand to the target compared to healthy subjects. Despite these changes, the major characteristics of reaching and grasping such as grip aperture size, temporal coordination between hand transport and aperture formation and the relative timing of grip aperture were largely preserved. For patients with more severe distal impairments, the amount of trunk displacement was also correlated with a more frontal hand orientation for grasping. Furthermore, in healthy subjects and patients without distal impairments, the trunk movement was mostly related to proximal arm movements while in those with distal impairments, trunk movement was related to both proximal and distal arm movements. Data support the hypothesis that the trunk movement is used to assist both arm transport and hand orientation for grasping when distal deficits are present. PMID:14985899

Michaelsen, Stella M; Jacobs, Stéphane; Roby-Brami, Agnès; Levin, Mindy F

2004-07-01

375

Removal of an entrapped large metallic dilator from the sigmoid neovagina in a male-to-female transsexual using a laparoscopic approach  

PubMed Central

Introduction To describe the role of laparoscopy for removal of entrapped vaginal metallic dilator (20 cm in length and 3.5 cm in diameter) in a case of male-to-female transsexual. Presentation of the case The patient was a 24-year old male-to-female transsexual, presented with entrapment and upward migration of the vaginal metallic dilator 1 week before admission. She underwent gender reassignment surgery with sigmoid vaginoplasty 8 month before admission. After 3-port transperitoneal laparoscopic abdominopelvic exploration, through an incision over the sigmoid vagina the dilator was extracted. The sigmoid vagina was repaired with free-hand intracorporeal laparoscopic suturing and knot-tying techniques in two layers and the dilator was removed by extending the site of umbilical port. The operative time was 70 min. Discussion Up to 60% of rectosigmoidal or vaginal foreign bodies can be extracted transanally or transvaginally with adequate sedation. When surgical exploration is indicated, a longitudinal laparatomy is performed to extract the foreign body. To reduce the associated morbidity of an open procedure in our patient, we performed a laparoscopic approach for complete abdominal exploration for possible presence of intestinal or sigmoidal injuries together with removal of this large metalic dilator. Conclusion Laparoscopic approaches in cases of neovaginal foreign body are useful when the endovaginal approaches have failed, especially in transsexual patients, to prevent another major open surgery. PMID:22504480

Aminsharifi, A.; Afsar, F.; Jafari, M.; Tourchi, A.

2012-01-01

376

DIFFERENTIAL ENVIRONMENTAL SPATIAL PATTERNING (ESP) RECREATES PROXIMAL-DISTAL AXIAL PATTRENS IN EMBRYONIC  

E-print Network

DIFFERENTIAL ENVIRONMENTAL SPATIAL PATTERNING (ESP) RECREATES PROXIMAL-DISTAL AXIAL PATTRENS- ferential Environmental Spatial Patterning, ESP) technique as an in vitro means to generate developmentally relevant differ- entiation patterns. We demonstrated that ESP could emulate proximal-distal differentiation

Voldman, Joel

377

An in vitro rat model of colonic motility to determine the effect of ?-casomorphin-5 on propagating contractions.  

PubMed

Beta-casomorphin-5 (?CM-5) is a milk-derived bioactive peptide that slows gastro-intestinal transit (GIT) in vivo and blocks the peristaltic reflex in the guinea pig colon in vitro. We wanted to establish an in vitro model system in which effects of dairy-derived substances containing opioid peptides on intestinal motility can be assessed and used to predict in vivo outcomes. Because ?CM-5 is an opioid agonist that acts on enteric neurons, we used this substance to compare two different isolated colonic tissue preparations to determine which would more closely mimic the in vivo response previously reported in the literature. We compared and characterized the effects of ?CM-5 on spontaneous contractions in isolated segments of distal colon (1 cm length) compared with propagating contractions along the isolated intact large intestine (22 cm length). In short segments of distal colon, ?CM-5 increased the tension and frequency of spontaneous contractions in a concentration-dependent manner. At 20 ?M ?CM-5 tension increased by 71 ± 17% and the frequency doubled (n = 9), effects inhibited by naloxone (n = 7) and therefore mediated by opioid receptors. In contrast 20 ?M ?CM-5 disrupted propagating contractions in the large intestine preparation. At 20 ?M ?CM-5 reduced the proportion of contractions initiated in the proximal colon reaching the rectum by 83 ± 11% (n = 5) and this effect was also inhibited by naloxone, consistent with altered GIT reported in vivo. Our results demonstrate that the isolated whole large intestine provides an ideal preparation that mimics the reduced propagation of GIT in vivo in response to an opioid agonist, whereas short colon segments did not. The findings of the current study reveal that preserving large segments of intact large intestine, and hence intact enteric neural circuitry provides an ideal in vitro model to investigate the effect of opioid receptor modulators on intestinal transit. PMID:25093576

Dalziel, J E; Spencer, N J; Dunstan, K E; Lynch, A T; Haggarty, N W; Gopal, P K; Roy, N C

2014-11-01

378

Drug-related segmental colitis: Angiographic findings  

Microsoft Academic Search

We report a case of drug-related segmental colitis in a 70-year-old woman with no thromboembolic risk factor. Mesenteric angiography showed multiple stenoses and occlusions of the distal arterial circulation in the sigmoid and descending colon. These observations support the hypothesis of an ischemic origin for this type of colitis.

B. Morin; V. L. Oliva; L. Lalonde; B. Panzini; F. Bourdon

1995-01-01

379

Drug-related segmental colitis: angiographic findings.  

PubMed

We report a case of drug-related segmental colitis in a 70-year-old woman with no thromboembolic risk factor. Mesenteric angiography showed multiple stenoses and occlusions of the distal arterial circulation in the sigmoid and descending colon. These observations support the hypothesis of an ischemic origin for this type of colitis. PMID:8580747

Morin, B; Oliva, V L; Lalonde, L; Panzini, B; Bourdon, F

1995-01-01

380

An examination of nerve-mediated, hyoscine-resistant excitation of the guinea-pig colon  

PubMed Central

1. The mechanical and electrical activity of the smooth muscle of the distal colon of the guinea-pig has been recorded in experiments designed to determine the nature of the nerve-mediated excitation of the muscle. 2. The spontaneous contractions of the colon, normally observed in vitro, were similarly antagonized by hyoscine or tetrodotoxin. However, neither drug caused complete cessation of the spontaneous activity. 3. The contractile responses of the colon to repetitive stimulation of intramural nerve fibres were of two types, a primary contraction which occurred within 1 sec of the beginning of stimulation and a secondary contraction which occurred after stimulation. The primary contraction was blocked by hyoscine, usually revealing an inhibitory response to stimulation, but the secondary contraction persisted. Similar primary contractions were observed in response to stimulation of the pelvic and sometimes of the periarterial nerves. 4. An initial relaxation during, and a secondary contraction after, stimulation were sometimes obtained when the periarterial nerves were stimulated. Propranolol completely blocked both the initial relaxation and the secondary contraction in response to sympathetic stimulation but did not affect either the relaxation or the secondary contraction in response to transmural stimulation. 5. The direct effects of noradrenaline and adenosine triphosphate on the mechanical activity of the colon were studied. Both drugs caused a relaxation of the colon. Washout of either drug after a short exposure was followed by a period of increased activity. Especially in preparations of low tone, the initial relaxation and the secondary contraction in response to transmural stimulation could be mimicked by the application and washout of either noradrenaline or adenosine triphosphate. 6. Two types of potential change were evoked in the muscle cells of the colon, either separately or in combination, when the intramural nerve fibres were stimulated: excitatory junction potentials (EJPs), which were blocked by hyoscine, and inhibitory junction potentials (IJPs). When the membrane potential recovered following an IJP, it was common to observe action potentials in muscle cells that were initially quiescent. A similar secondary firing of action potentials was initiated by hyperpolarizing the muscle cells with anodal current pulses in the presence of tetrodotoxin in sufficient concentration to block nerve-mediated responses. 7. The results reported in this paper lead to the conclusion that the muscle cells of the distal colon of the guinea-pig are influenced by three sets of nerves: cholinergic excitatory, adrenergic inhibitory and intrinsic inhibitory fibres releasing a non-adrenergic transmitter substance. The secondary non-cholinergic excitation arises from a non-specific reaction of the muscle cells to a preceding inhibition. PMID:5499747

Furness, J. B.

1970-01-01

381

Dietary fibre and colonic neoplasia.  

PubMed Central

Dietary plant fibre, or plantix, is thought to play a significant role in the pathogenesis of colon cancer in humans. It is a complex polymeric substance that has several distinct components resistant to hydrolysis by the digestive enzymes of humans. These components include cellulose, hemicelluloses, pectins, lignin, gums, mucilages and, in certain instances, algal polysaccharides. These polymers have different physicochemical properties, and recent evidence from experimental studies in animals treated with carcinogens suggests that some may exert protective effects in the intestine and others may enhance colon carcinogenesis. This review synthesizes information on the chemical composition, methods of analysis and physicochemical properties of dietary plant fibre and reviews available studies examining the role of fibre in colonic neoplasia in animals and humans. PMID:466603

Freeman, H J

1979-01-01

382

Bacterial oncogenesis in the colon  

PubMed Central

The human colon plays host to a diverse and metabolically complex community of microorganisms. While the colonic microbiome has been suggested to contribute to the development of colorectal cancer (CRC), a definitive link has not been made. The role in which the colon microflora could contribute to the initiation and/or progression of CRC is explored in this review. Potential mechanisms of bacterial oncogenesis are presented, along with lines of evidence derived from animal models of microbially induced CRC. Particular focus is given to the oncogenic capabilities of enterotoxigenic Bacteroides fragilis. Recent progress in defining the microbiome of CRC in the human population is evaluated, and the future challenges of linking specific etiologic agents to CRC are emphasized. PMID:23534358

Dejea, Christine; Wick, Elizabeth; Sears, Cynthia L

2013-01-01

383

Increased Colonic Luminal Synthesis of Butyric Acid Is Associated with Lowered Colonic Cell Proliferation in Piglets12  

PubMed Central

Butyrate inhibits colonic cell proliferation in vitro but reportedly has an opposite effect in vivo. Because lactulose feeding decreases cecal cell proliferation, an effect attenuated by prefeeding inulin, we hypothesized that lactulose feeding would decrease colonic luminal synthesis of butyrate, and that prefeeding and cofeeding inulin would prevent this effect. Piglets (n = 31) were catheterized and randomly assigned to 1 of 4 groups: Control formula (C); control formula + lactulose (L); control formula + lactulose + inulin (L + I); and control formula + inulin (I). At 6 and 7 d postsurgery, the rate of cecal synthesis of butyrate, cecal cell proliferation and apoptosis, and cecal and distal colon butyrate concentration were measured. In groups C, L, L + I, and I, the rates of synthesis of butyrate (mean ± SEM) were 10.6 ± 3.2, 23.3 ± 4.5, 12.4 ± 3.6, and 14.6 ± 4.0 ?mol/min, respectively (Group Effect, P = 0.1; C vs. L, P = 0.03; L vs. L + I, P = 0.06). The cecal butyrate concentrations did not differ among the 4 groups and were 8.7 ± 3.2, 2.4 ± 0.8, 3.4 ± 1.9, and 2.0 ± 0.7 ?mol/g dry wt, respectively. The total cecal cell proliferation index was higher in C than in L (P = 0.008) or I (P = 0.026) and was higher in L + I than in L (P = 0.013) or I (P = 0.046). The increased supply of butyrate to the cecum was associated with decreased cell proliferation, but cecal butyrate concentration did not reflect synthesis. PMID:16365060

Kien, C. Lawrence; Schmitz-Brown, Mary; Solley, Travis; Sun, Dayong; Frankel, Wendy L.

2006-01-01

384

Osteomyelitis Caused by Candida glabrata in the Distal Phalanx  

PubMed Central

Osteomyelitis caused by Candida glabrata is rare and its optimal treatment is unknown. Here we report a case of osteomyelitis caused by C. glabrata in the distal phalanx in a 54-year-old woman. Despite partial resection of the nail and administering a 1-month course of antibiotics for paronychia, the local swelling remained and an osteolytic lesion was found. C. glabrata osteomyelitis of the distal phalanx was later diagnosed after curettage. Thereafter, the patient was treated with antifungal agents for 3 months. The infection eventually resolved, and radiological healing of the osteolytic lesion was achieved. Antifungal susceptibility testing should be performed in the case of osteomyelitis caused by nonalbicans Candida species, due to their resistance to fluconazole. PMID:25215255

Hibino, Naohito; Sairyo, Koichi; Yoshioka, Shinji; Yamano, Masahiro; Henmi, Tatsuhiko

2014-01-01

385

[Distal reconstructions under critical lower limb ischemia in elderly patients].  

PubMed

Performong reconstructive operations on arteriae is the only way to avoid limb amputation in patients with critical limb ischemia. Whereas reconstructive manipulations on distal arteriae, especially in patients older then 75 years, are often entailed by thrombotic complications. High peripheric vessel resistance is considered to be the crucial factor of the bypass thrombosis. The conducted study demonstrated the efficacy of the use of vena saphena magna collateral tributaries as bypass unload collectors. Femoral distal autovenous in situ reconstruction decreases vessel resistance. Due to the arterial reconstruction with bypass unload using unligated autovenous tributaries the cumulative bypass patency was 75,1% a year after the procedure. 5-year cumulative bypass patency was 53,8%. 5 - year lethality was 28,6%. PMID:19156077

Dibirov, M D; Dibirov, A A; Gadzhimuradov, R U; Tereshchenko, S A; Soboleva, S R; Ramazanova, Iu I; Bazhenov, M S

2009-01-01

386

[The pendulis appliance: a palatal miniscrew supported molar distalization device].  

PubMed

The maxillary molar distalization is a valuable therapeutic option in some clinical cases. Its biomechanics is challenging and difficult to obtain. Historically, various devices have been described offering successful solutions to this problem such as the Hilgers Pendulum Appliance (1992) and variants linked to mini screws which recently have shown interesting clinical potential. This article presents a new Pendulum variant using a miniscrew, the "pendulis". It follows the original concept (titanium-molybdenum alloy distalization springs and polymethyl-methacrylate pellet) but dental support is replaced by a single palatal miniscrew (median adults, para-median in children) to which the device is fixed by means of a metal welded cap easily positioned and removable by the practitioner. This allows for better control of the oral hygiene and completely controlled extraoral activation. Fabrication steps are described and instruction of use is illustrated with clinical documentation. PMID:25158749

Nappée-Miévilly, Magali; Nappée, François-Joseph; Kerbrat, Jean-Baptiste; Goudot, Patrick

2014-09-01

387

Scintisplenoportography in assessing patency of distal splenorenal shunts  

SciTech Connect

Scintisplenoportography was performed on 33 occasions in 28 cirrhotic patients who had bled from esophagogastric varices. In 17 cases scintisplenoportography was carried out after a retroperitoneal distal splenorenal shunt procedure and in the remaining 16 instances in patients without any surgical shunt. In four patients scintisplenoportography was performed before and after a surgical shunt procedure, and in one case, before and after the shunt thrombosed. Gammagraphic patterns and spleen-heart times helped determine which patients did not have a surgical shunt, which had a patent shunt, and which patients had a thrombosed shunt. A patent shunt pattern and a thrombosed shunt pattern have been defined. It is concluded that scintisplenoportography is a useful, reproducible, and safe method to assess the patency of distal splenorenal shunts.

Teres, J.; Herranz, R.; Visa, J.; Lomena, F.; Pera, C.; Rodes, J.

1983-06-01

388

Distal basilar artery aneurysms: conditions for safe and secure clipping.  

PubMed

In general, vertebro-basilar aneurysms are good indications for endovascular treatment. However, basilar artery (BA) bifurcation aneurysms, BA-superior cerebellar artery (SCA) aneurysms, and sometimes mid-basilar aneurysms are also good indications for clipping. In this paper, conditions for safe and secure clipping for distal basilar aneurysms are discussed.There are several tips for the clipping of distal BA aneurysms. Among them, the following are very important: patency of the perforators, posterior cerebral artery (P1), and SCA must always be maintained. Several modalities including micro-Doppler ultrasonography and indocyanine green video-angiography (ICGVA) should be used to confirm the patency of these vessels. Each confirmation of patency of the vessels after clipping must be compared to those from before the clipping. Intra-operative digital subtraction angiography (DSA) is needed for large or giant aneurysms. PMID:24728630

Nakagomi, Tadayoshi

2014-01-01

389

Human colonic motility: physiological aspects.  

PubMed

From the point of view of its motor activity, the human colon is probably the least understood of the abdominal hollow viscera. This is due to several facts: a) its proximal portions are relatively inaccessible due to anatomical reasons; b) there is no reliable animal model due to the considerable anatomic-physiological differences among mammals. For instance, most deductions about human colonic motor activity have been drawn from experiences in cats and dogs, in which the colon displays a cecum which is almost atrophic, and the viscus is featureless and C-shaped, without the haustrations and the sharp angulations seen in man, c) the wide fluctuations of motility in the daily time course of the same individual makes the interpretation of many studies difficult, especially considering the fact that, until recently, most of the studies on human colonic motility have been conducted for relatively short (30-180 min) recording periods. Recently, however, techniques that allow recording from the proximal portions of the human colon have been developed, and prolonged (24 h or more) observations of myoelectrical and contractile events have been achieved, thus improving our knowledge of the normal physiologic properties of the viscus. These informations have furthermore been integrated and confirmed by scintigraphic techniques (less invasive), that allow the measurement of intracolonic flow activity. The purpose of the present paper is to review the physiological aspects of colonic motility in man, quoting animal studies where human ones are lacking. We will briefly introduce some basic concepts, then a more detailed description of the main topic will follow. PMID:7561438

Bassotti, G; Germani, U; Morelli, A

1995-01-01

390

Anatomic Reconstruction of the Distal Radioulnar Ligaments: Long-Term Results  

Microsoft Academic Search

Chronic post-traumatic dynamic distal radioulnar joint instability following rupture of the distal radioulnar ligaments may cause disabling and progressive ulnar-sided wrist symptoms. We use a free tendon graft to anatomically reconstruct both dorsal and palmar distal radioulnar ligaments simultaneously. Nine patients who underwent this procedure between 1990 and 1997 were assessed using a modified Mayo Wrist Score. Following surgery, average

L. C. TEOH; A. K. T. YAM

2005-01-01

391

Chilling response of ‘Granny Smith’ apple lateral buds inhibited by distal shoot tissues  

Microsoft Academic Search

Apple (Malus×domestica Borkh.) shoots were decapitated before or after chilling and then forced to budburst to determine the influence of distal inhibition (paradormancy) on the chilling response of lateral buds. Shoots were chilled and forced with the presence or absence of an inhibitory distal disbudded shoot piece. Endogenous cytokinins were determined from distal and proximal segments of shoots segmented before

Nigel C Cook; Dirk U Bellstedt

2001-01-01

392

Distal femur fractures of the elderly—Different treatment options in a biomechanical comparison  

Microsoft Academic Search

BackgroundFractures of the distal femur, especially in the elderly patient, are an unsolved problem in orthopaedic and trauma surgery. Poor bone stock quality caused by osteoporosis often results in bad implant anchorage in the distal part with a high risk of secondary failures such as cutout. This study investigates the biomechanical characteristics of four implants with different distal locking options

Dirk Wähnert; Konrad Hoffmeier; Rosemarie Fröber; Gunther O. Hofmann; Thomas Mückley

2011-01-01

393

Surgical treatment of distal tarsal joint luxations in three horses.  

PubMed

The clinical signs, radiographic findings, surgical treatment, and outcome of three horses with luxation of the distal tarsal joints are reported. Two patients showed luxations of the tarsometatarsal joint whereas luxation of the proximal intertarsal joint was found in one case. Open reduction, followed by internal fixation was performed in two horses and closed reduction with a transfixation pin cast was performed in the third. The treatment in all three cases resulted in a satisfactory clinical outcome. PMID:23857573

Abuja, G A; Bubeck, K A; Quinteros, D D; García-López, J M

2013-01-01

394

Dorsal Capsuloplasty for Dorsal Instability of the Distal Ulna  

PubMed Central

Background?Dorsal instability of the distal ulna can lead to chronic wrist pain and loss of function. Structural changes to the dorsal radioulnar ligaments (DRUL) of the triangular fibrocartilage complex (TFCC) and the dorsal capsule around the ulnar head with or without foveal detachment can lead to volar subluxation of the distal radius e.g., dorsal instability of the distal ulna. Purpose?Is to evaluate the post-operative results of reinstituting distal radioulnar joint (DRUJ) stability through reefing of the dorsal capsule and dorsal radioulnar ligaments, with and without a foveal reattachment of the TFCC. Methods?A total of 37 patients were included in this retrospective study. Diagnosis and treatment was based strictly on dry wrist arthroscopy. In 17 patients isolated reefing of the DRUL and their collateral tissue extension was performed. In 20 patients an additional foveal reinsertion was performed. Postoperative results were evaluated with the DASH questionnaire, VAS scores, grip strength and range of motion. These findings were extrapolated in the Mayo wrist score. The two subgroups were compared. Results?Mayo wrist scores of the whole population had a mean of 73. There was no difference between the group that was treated with reefing of the DRUL only and the group that was treated with a combined foveal reinsertion. Conclusion?This relatively simple 'dorsal reefing' procedure, with foveal reinsertion when indicated, is a reliable method to restore volar-dorsal DRUJ stability with a significant decrease in pain sensation, good DASH scores and restoration of functional grip strength and ROM. Type of Study/Level of Evidence?Therapeutic, Level IV. PMID:24436811

Kouwenhoven, S.T.P.; de Jong, T.; Koch, A.R.

2013-01-01

395

A Simple Grafting Method to Repair Irreparable Distal Biceps Tendon  

Microsoft Academic Search

Irreparable distal biceps tendon tears typically are treated using a free tendon graft. We asked whether our new method to\\u000a fix the graft—using two suture anchors—yields similar results to our previous bone canal method. We compared the two methods\\u000a for strength, endurance, and clinical findings. There were two groups, the suture anchor group (Group A, seven patients) and\\u000a the bone

Martti Vastamäki; Heidi Vastamäki

2008-01-01

396

Distal biceps tendon injuries--current treatment options.  

PubMed

Three percent of all biceps tendon ruptures occur at the distal aspect, where the tendon inserts into the radial tuberosity. Distal bicep tendon ruptures typically occur in middle-aged males after an eccentric extension load is applied to the elbow. Patients usually complain of a sudden, sharp, and painful tearing sensation in the antecubital region, with a palpable defect. The biceps squeeze and hook tests are specific maneuvers by which to diagnose distal biceps ruptures on physical examination. Magnetic resonance imaging (MRI) or ultrasound maybe be helpful to distinguish between partial and complete tears. Anatomic studies suggest there are two distinct insertions for the short and long heads of the distal biceps. The short head may be a more powerful flexor, and the long head may be a more powerful supinator. Nonoperative treatment typically results in loss of flexion and supination strength and endurance. Early anatomic re-attachment is the goal. Surgical approaches include one- or two-incision techniques, and tendon fixation methods include the use of suture anchors, bone tunnels, an endobutton, or biotenodesis screws. Biomechanical studies have shown that endobuttons have higher load-to-failure strengths, compared to the other fixation methods. However, clinical studies have demonstrated that patients do well regardless of surgical approach or fixation method. Possible complications include nerve injuries, heterotopic ossification, postoperative fracture, tendon rerupture, complex regional pain syndrome, and wound infection. Partial ruptures are significantly less common and initially can be treated conservatively. Chronic tears are more difficult to treat because of possible tendon retraction and poor tissue quality. Tendon grafts using semitendinosus, fascia lata, hamstring, Achilles (calcaneal), or flexor carpi radialis have been successfully used for length restoration in these cases. PMID:20632985

Quach, Tony; Jazayeri, Reza; Sherman, Orrin H; Rosen, Jeffrey E

2010-01-01

397

Distal tibia fractures: locked or non-locked plating?  

PubMed Central

Background and purpose Although plating is considered to be the treatment of choice in distal tibia fractures, controversies abound regarding the type of plating for optimal fixation. We conducted a systematic review to evaluate and compare the outcomes of locked plating and non-locked plating in treatment of distal tibia fractures. Patients and methods A systematic review was conducted using PubMed to identify articles on the outcomes of plating in distal tibia fractures that were published up to June 2012. We included English language articles involving a minimum of 10 adult cases with acute fractures treated using single-plate, minimally invasive techniques. Study-level binomial regression on the pooled data was conducted to determine the effect of locking status on different outcomes, adjusted for age, sex, and other independent variables. Results 27 studies met the inclusion criteria and were included in the final analysis of 764 cases (499 locking, 265 non-locking). Based on descriptive analysis only, delayed union was reported in 6% of cases with locked plating and in 4% of cases with non-locked plating. Non-union was reported in 2% of cases with locked plating and 3% of cases with non-locked plating. Comparing locked and non-locked plating, the odds ratio (OR) for reoperation was 0.13 (95% CI: 0.03–0.57) and for malalignment it was 0.10 (95% CI: 0.02–0.42). Both values were statistically significant. Interpretation This study showed that locked plating reduces the odds of reoperation and malalignment after treatment for acute distal tibia fracture. Future studies should accurately assess causality and the clinical and economic impact of these findings. PMID:24758325

Khalsa, Amrit S; Toossi, Nader; Tabb, Loni P; Amin, Nirav H; Donohue, Kenneth W; Cerynik, Douglas L

2014-01-01

398

Functional Consequence of Distal Brachioradialis Tendon Release: A Biomechanical Study  

PubMed Central

Purpose Open reduction and internal fixation of distal radius fractures often necessitates release of the brachioradialis from the radial styloid. However, this common procedure has the potential to decrease elbow flexion strength. To determine the potential morbidity associated with brachioradialis release, we measured the change in elbow torque as a function of incremental release of the brachioradialis insertion footprint. Methods In 5 upper extremity cadaveric specimens, the brachioradialis tendon was systematically released from the radius, and the resultant effect on brachioradialis elbow flexion torque was measured. Release distance was defined as the distance between the release point and the tip of the radial styloid. Results Brachioradialis elbow flexion torque dropped to 95%, 90% and 86% of its original value at release distances of 27mm, 46mm, and 52mm, respectively. Importantly, brachioradialis torque remained above 80% of its original value at release distances up to 7 centimeters. Conclusions Our data demonstrate that release of the brachioradialis tendon from its insertion has minor effects on its ability to transmit force to the distal radius. Clinical Relevance These data may imply that release of the distal brachioradialis tendon during distal radius open reduction internal fixation can be performed without meaningful functional consequences to elbow flexion torque. Even at large release distances, overall elbow flexion torque loss after brachioradialis release would be expected to be less than 5% due to the much larger contributions of the biceps and brachialis. Use of the brachioradialis as a tendon transfer donor should not be limited by concerns of elbow flexion loss, and the tendon could be considered as an autograft donor. PMID:23528425

Tirrell, Timothy F.; Franko, Orrin I.; Bhola, Siddharth; Hentzen, Eric R.; Abrams, Reid A.; Lieber, Richard L.

2013-01-01

399

Aldosterone Paradox: Differential Regulation of Ion Transport in Distal Nephron  

NSDL National Science Digital Library

The mechanisms through which aldosterone promotes apparently opposite effects like salt reabsorption and K+ secretion remain poorly understood. The identification, localization, and physiological analysis of ion transport systems in distal nephron have revealed an intricate network of interactions between several players, revealing the complex mechanism behind the aldosterone paradox. We review the mechanisms involved in differential regulation of ion transport that allow the fine tuning of salt and K+ balance.

Juan Pablo Arroyo (Universidad Nacional Autónoma de México, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Molecular Physiology Unit, Instituto de Investigaciones Biomédicas,); Caroline Ronzaud (University of Lausanne Department of Pharmacology and Toxicology); Dagmara Lagnaz (University of Lausanne Department of Pharmacology and Toxicology); Dr. Olivier Staub (University of Lausanne Department of Pharmacology and Toxicology); Dr. Gerardo Gamba (Universidad Nacional Autónoma de México Molecular Physiology Unit, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán)

2011-04-01

400

Opening lines of communication in the distal nephron  

PubMed Central

The distal nephron is composed of two main cell types: principal cells and intercalated cells. These cells have distinct morphologic features that allow them to be readily distinguished by light microscopy, as well as distinct suites of proteins that facilitate cell-specific transport properties. In this issue of the JCI, Gueutin and colleagues describe a new mechanism by which ?-intercalated cells, via release of ATP and prostaglandin E2 (PGE2), influence the activity of transporters in principal cells. PMID:24051382

Kleyman, Thomas R.; Satlin, Lisa M.; Hallows, Kenneth R.

2013-01-01

401

Endovascular Treatment of the Distal Internal Carotid Artery Large Aneurysm  

PubMed Central

Objective According to the development of endovascular technique and devices, larger aneurysms on the distal internal carotid artery (ICA) can be treated using a less invasive method. The authors report on clinical and angiographic outcomes of these aneurysms treated using an endovascular technique. Materials and Methods Data on 21 patients with large aneurysms at distal ICA treated by endovascular method between January 2005 and December 2012 were included in this retrospective analysis. Results Clinical outcome of patients showed strong correlation with the initial neurologic status (p < 0.05). Aneurysm morphology showed saccular, fusiform, and wide-neck in 12, six and three patients. Six patients underwent stent assisted coiling and the other 15 patients underwent simple coiling. Aneurysm occlusion was performed immediately after embolization with near-complete (Raymond class 1-2) in 20 patients (95.2%) and incomplete (Raymond class 3) in one patient (4.8%). Delayed thrombotic occlusion occurred in two patients and their clinical result was fatal. Another five patients died in the hospital, from massive brain edema and/or increased intracranial pressure due to initial subarachnoid hemorrhage. Overall mortality was 30% (seven out of 21). Fatal complication related to the endovascular procedure occurred in two patients with thrombosis at middle cerebral artery (one with stent, the other without it). Conclusion Recent developed endovascular device and technique is safe enough and a less invasive method for distal large or giant aneurysms. Based on our analysis of the study, we suspect that coil embolization of large distal ICA aneurysms (with or without stenting) is effective and safe. PMID:25340021

Bae, Hong-Ju; Huh, Pil-Woo; Lee, Tae-Gyu; Cho, Kyoung-Suok; Lee, Sang-Bok

2014-01-01

402

A tapered distal fiber tip for thulium fiber laser lithotripsy  

Microsoft Academic Search

The Thulium fiber laser has recently been tested as a potential alternative to the Holmium:YAG laser for lithotripsy. This study explores use of a short taper for expanding the Thulium fiber laser beam at the distal tip of a small-core fiber. Thulium fiber laser radiation with a wavelength of 1908 nm, 10 Hz pulse rate, 70 mJ pulse energy, and

Richard L. Blackmon; Pierce B. Irby; Nathaniel M. Fried

2010-01-01

403

Predictors of Proximal Neoplasia in Patients Without Distal Adenomatous Pathology  

Microsoft Academic Search

BACKGROUND:Previous colorectal cancer screening studies have observed that some patients may have advanced proximal neoplasia without distal findings. Since these studies have included only gender, age, and family history as risk factors, they are limited in their ability to identify predictors of isolated proximal neoplasia.METHODS:Data were collected from the charts of 1,988 patients who presented for colonoscopy. Information gathered included

Joseph C. Anderson; Zvi Alpern; Catherine R. Messina; Patricia Hubbard; Roger Grimson; Peter F. Ells; Douglas L. Brand

2004-01-01

404

Alteration of colonic stem cell gene signatures during the regenerative response to injury  

PubMed Central

Since aberrant wound healing and chronic inflammation can promote malignant transformation, we determined whether dietary bioactive fish oil (FO)-derived n-3 polyunsaturated fatty acids (n-3 PUFA) modulate stem cell kinetics in a colitis-wounding model. Lgr5-LacZ and Lgr5-EGFP-IRES-creERT2 mice were fed diets enriched with n-3 PUFA vs n-6 PUFA (control) and exposed to dextran sodium sulfate (DSS) for 5 days in order to induce crypt damage and colitis throughout the colon. Stem cell number, cell proliferation, apoptosis, expression of stem cell (Lgr5, Sox9, Bmi1, Hopx, mTert, Ascl2, and DCAMKL-1) and inflammation (STAT3) markers were quantified. DSS treatment resulted in the ablation of Lgr5+ stem cells in the distal colon, concurrent with the loss of distal crypt structure and proliferating cells. Lgr5, Ascl2 and Hopx mRNA expression levels were decreased in damaged colonic mucosa. Lgr5+ stem cells reappeared at day 5 of DSS recovery, with normal levels attained by day 6 of recovery. There was no effect of diet on the recovery of stem cells. FO fed animals exhibited higher levels of phospho-STAT3 at all time points, consistent with a higher wounding by DSS in FO feeding. n-3 PUFA-fed mice exhibited a reduction in stem cell associated factors, Ascl2, Axin2 and EphB3. These results indicate that rapidly cycling Lgr5+ stem cells residing at position 1 in the colon epithelium are highly susceptible to DSS-induced damage and that dietary cues can impact stem cell regulatory networks. PMID:22750333

Davidson, Laurie A.; Goldsby, Jennifer S.; Callaway, Evelyn S.; Shah, Manasvi S.; Barker, Nick; Chapkin, Robert S.

2012-01-01

405

Alteration of colonic stem cell gene signatures during the regenerative response to injury.  

PubMed

Since aberrant wound healing and chronic inflammation can promote malignant transformation, we determined whether dietary bioactive fish oil (FO)-derived n-3 polyunsaturated fatty acids (n-3 PUFA) modulate stem cell kinetics in a colitis-wounding model. Lgr5-LacZ and Lgr5-EGFP-IRES-creER(T2) mice were fed diets enriched with n-3 PUFA vs n-6 PUFA (control) and exposed to dextran sodium sulfate (DSS) for 5days in order to induce crypt damage and colitis throughout the colon. Stem cell number, cell proliferation, apoptosis, expression of stem cell (Lgr5, Sox9, Bmi1, Hopx, mTert, Ascl2, and DCAMKL-1) and inflammation (STAT3) markers were quantified. DSS treatment resulted in the ablation of Lgr5(+) stem cells in the distal colon, concurrent with the loss of distal crypt structure and proliferating cells. Lgr5, Ascl2 and Hopx mRNA expression levels were decreased in damaged colonic mucosa. Lgr5(+) stem cells reappeared at day 5 of DSS recovery, with normal levels attained by day 6 of recovery. There was no effect of diet on the recovery of stem cells. FO fed animals exhibited higher levels of phospho-STAT3 at all time points, consistent with a higher wounding by DSS in FO feeding. n-3 PUFA-fed mice exhibited a reduction in stem cell associated factors, Ascl2, Axin2 and EphB3. These results indicate that rapidly cycling Lgr5(+) stem cells residing at position 1 in the colon epithelium are highly susceptible to DSS-induced damage and that dietary cues can impact stem cell regulatory networks. PMID:22750333