Sample records for distal sigmoid colon

  1. Sigmoid volvulus after laparoscopic surgery for sigmoid colon cancer.

    PubMed

    Sadatomo, Ai; Miyakura, Yasuyuki; Zuiki, Toru; Koinuma, Koji; Horie, Hisanaga; Lefor, Alan T; Yasuda, Yoshikazu

    2013-08-01

    We report the first case of sigmoid volvulus after laparoscopic surgery for sigmoid colon cancer. The patient is a 75-year-old man who presented with the sudden onset of severe abdominal pain. He had undergone laparoscopic sigmoidectomy for cancer 2 years before presentation. CT scan showed a distended sigmoid colon with a mesenteric twist, or "whirl sign." Colonoscopy showed a mucosal spiral and luminal stenosis with dilated sigmoid colon distally and ischemic mucosa. The diagnosis of ischemic colonic necrosis due to sigmoid volvulus was established. Resection of the necrotic sigmoid colon was performed and a descending colon stoma was created. A long remnant sigmoid colon and chronic constipation may contribute to the development of sigmoid volvulus after laparoscopic sigmoidectomy. Prompt diagnosis is essential for adequate treatment, and colonoscopy aids in the diagnosis of ischemic changes in patients without definitive findings of a gangrenous colon. PMID:23879414

  2. Indolent carcinoid tumor of the sigmoid colon.

    PubMed

    Berger, J J; Berman, S S; Morgan, R E; Britt, L D

    1994-04-01

    Carcinoid tumors of the colon are a rare cause of colonic malignant disease. A case of carcinoid tumor of the sigmoid colon is presented that illustrates the indolent course of this type of tumor. The case presented highlights the clinicopathologic features of carcinoid tumors of hindgut origin, including advanced local and widely metastatic disease at the time of diagnosis in the absence of symptoms of the carcinoid syndrome. The diagnosis and management of gastrointestinal carcinoid tumors are reviewed. PMID:8129244

  3. Adenosquamous carcinoma of the sigmoid colon: a case report and review of literature

    PubMed Central

    Shafaghi, Afshin; Askari, Kourosh; Ashoobi, Mohammad Taghi; Mansour-Ghanaei, Fariborz

    2013-01-01

    Adenosquamous carcinoma of the colon consisting of both glandular and squamous histopathologic features is a rare colorectal neoplasm. Metastasis commonly occurs in right and transverse colon. A 71-year-old Caucasian man presented with a four-month history of intermittent rectal bleeding. Pathologic analysis of biopsy specimen revealed an adenosquamous carcinoma of sigmoid colon. Sigmoid resection with a proximal and distal resection was performed. Early detection and radical operation with other available therapeutic modalities may improve clinical outcome. PMID:23724159

  4. Sigmoid colon migration of an intrauterine device.

    PubMed

    Akpinar, Funda; Ozgur, Esra Nur; Yilmaz, Saynur; Ustaoglu, Oguzhan

    2014-01-01

    Background. Intrauterine devices (IUD) are commonly used birth control methods. Colonic perforation is an infrequent but serious complication of IUD. Case. A 34-year-old woman with 2-years history of IUD, inserted at early puerperal period, presented to gynecologist with chronic pelvic pain and dyspareunia. Radiological assessment revealed that there were two copper-T devices: one in uterine cavity and another in the colonic lumen. Attempts of retrieval with colonoscopy and laparoscopy were unsuccessful. Intrauterine device embedded in sigmoid colon wall was removed with resection of the involved segment and primary anastomosis was performed. Conclusion. Although there are cases in literature that are successfully managed with colonoscopy, in chronic cases, formation of granulation tissue complicates retrieval of an IUD by this intervention. PMID:25136463

  5. Sigmoid Colon Migration of an Intrauterine Device

    PubMed Central

    Akpinar, Funda; Ozgur, Esra Nur; Yilmaz, Saynur; Ustaoglu, Oguzhan

    2014-01-01

    Background. Intrauterine devices (IUD) are commonly used birth control methods. Colonic perforation is an infrequent but serious complication of IUD. Case. A 34-year-old woman with 2-years history of IUD, inserted at early puerperal period, presented to gynecologist with chronic pelvic pain and dyspareunia. Radiological assessment revealed that there were two copper-T devices: one in uterine cavity and another in the colonic lumen. Attempts of retrieval with colonoscopy and laparoscopy were unsuccessful. Intrauterine device embedded in sigmoid colon wall was removed with resection of the involved segment and primary anastomosis was performed. Conclusion. Although there are cases in literature that are successfully managed with colonoscopy, in chronic cases, formation of granulation tissue complicates retrieval of an IUD by this intervention. PMID:25136463

  6. Small intestinal complications of diverticulitis of the sigmoid colon

    SciTech Connect

    Frager, D.; Wolf, E.L.; Frager, J.D.; Beneventano, T.C.

    1986-12-19

    The clinical and radiological manifestations of diverticulitis of the sigmoid colon are well recognized. Mild cases respond to medical therapy, while more severe and complicated cases require surgical intervention in approximately 25% to 33% of instances. The barium enema examination usually demonstrates the following: (1) paracolic abscess or fistula, (2) spasm of the sigmoid colon, (3) stricturing of the sigmoid, often with complete obstruction, and (4) fistulals to other viscera, particularly the urinary bladder. This study describes the less recognized clinical and radiological findings of small intestinal involvement as a complication of diverticulitis of the sigmoid colon.

  7. Migrated biliary plastic stent causing double sigmoid colon perforation

    PubMed Central

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

    2014-01-01

    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

  8. Right sided descending and sigmoid colon: its embryological basis and clinical implications

    PubMed Central

    Tuli, Anita; Kaur, Sohinder; Raheja, Shashi

    2013-01-01

    Anatomical variations of the colon are described by various authors, but the occurrence of right sided descending and sigmoid colon is rare and has not been reported. We found that the anomalous right-sided descending and sigmoid colon had four parts. The proximal segment of the first part consisted of the descending colon extending across the midline from the splenic flexure to the portion supplied by the left colic artery. The distal segment was supplied by the superior sigmoid artery. The second and third parts formed a loop in the right lumbar region anterior to the lumbar cecum. The fourth part was in the lesser pelvis, extending from right sacroiliac joint to the third sacral body. Parts two, three, and four were supplied by the inferior sigmoid artery, which arose from the right side of the inferior mesenteric artery. The ascending and transverse colon was normally placed. This is a rare anomaly that has not been reported so far in adults and is of immense importance to interventional radiologists and colorectal surgeons. The embryological basis of such an anomaly is defective fixation occurring as early as the 12th-17th week of intrauterine life. PMID:24386604

  9. Laparoscopic removal of an intrauterine device from the sigmoid colon

    PubMed Central

    ?anl?kan, Fatih; Arslan, O?uz; Avc?, Muhittin Eftal; Göçmen, Ahmet

    2015-01-01

    Uterine wall perforation which is commonly seen through the posterior wall of the uterus is the most serious complication of an intrauterine device (IUD). We present a case of laparoscopic removal of an IUD from the sigmoid colon in a 31-years-old female who was admitted to hospital with a history of pelvic pain and abnormal vaginal bleeding for one month. The dislocated IUD was removed from the sigmoid colon of laparoscopic intervention without any complications. In conclusion, the treatment modality for the removal of a dislocated IUD is possible by laparoscopic surgery in selected patients where the dislocated IUD is accessible.

  10. [A case of sigmoid colon cancer with abdominal wall abscess].

    PubMed

    Yamamoto, Yuji; Shimizu, Shinichiro; Maruyama, Takashi; Tanaka, Hajime; Matsuzaki, Hiroshi; Natsume, Toshiyuki; Miyazaki, Akinari; Satoh, Yayoi; Satsuka, Tetsutaro; Yoshioka, Takafumi; Kanada, Yoko; Otsuka, Ryota; Yanagihara, Akitoshi; Yokoyama, Masaya; Kobayashi, Takushi

    2014-11-01

    A 63-year-old man was admitted for an abdominal mass. Computed tomography revealed an abscess (21 × 20 cm) in the abdominal wall and a tumor in the sigmoid colon. Thus, cancer of the sigmoid colon complicated by an abscess of the abdominal wall was diagnosed. The abscess was drained and transverse colostomy was performed with curative intent. After the intervention, chemotherapy (XELOX×3) was administered. Three months later, sigmoidectomy was performed and the stoma was closed. Macroscopic and microscopic examination of the resected specimen detected no remnants of cancer. In patients with advanced colon cancer and abdominal wall involvement, a two-stage operation and preoperative chemotherapy may be considered essential when curative resection is performed. PMID:25731327

  11. Clostridium septicum aortitis with associated sigmoid colon adenocarcinoma.

    PubMed

    Ge, Phillip S; de Virgilio, Christian

    2012-02-01

    We report an unusual case of Clostridium septicum aortitis with associated adenocarcinoma of the sigmoid colon. An 87-year-old man with multiple medical comorbidities presented with a 1-week history of severe abdominal pain in the left lower quadrant of his abdomen. Abdominal computed tomography showed, in addition to a mass in the sigmoid colon, a gas density within the wall of the abdominal aorta with extensive periaortic fat stranding and some additional gas densities in the proximal left common iliac artery. The patient refused surgery, and was treated with intravenous antibiotics. He died 5 weeks later. The development of Clostridiumsepticum aortitis, an extremely rare but life-threatening infection, is highly associated with an underlying colonic malignancy and demands immediate surgical intervention. PMID:22304871

  12. Stercoral Perforation of the Sigmoid Colon in a Schizophrenic Patient

    PubMed Central

    Singh, Amit; Singh, Rohit Pratap

    2015-01-01

    Stercoral perforation of the colon is a life threatening condition, due to pressure necrosis by hard fecaloma which, are commonly found in chronic constipated patients. We report the case of a 45-year-old schizophrenic woman, under psychiatric treatment for two years, presenting with a 10-day history of absolute obstipation and distension. On physical examination the patient had signs of generalized peritonitis. Preoperative diagnostic workup gave no clear-cut clues about diagnosis. Emergency laparotomy revealed a single perforation over the antimesentric border of the sigmoid colon with hard fecal matter protruding through perforation margin. A segmental resection of the sigmoid colon with colonic lavage and end to end anastomosis was performed. The patient made an uneventful recovery. We have discussed the diagnostic work-up, and the management of this rare entity. Patient was on antipsychotic, anticholenergic and NSAID’S drugs for long time with longstanding immobilisation and poor oral intake. Association of these etiological factors with chronic constipation which ultimately leads to stercoral perforation have been corroborated. PMID:25738027

  13. Perforated diverticulitis of the sigmoid colon causing a subcutaneous emphysema

    PubMed Central

    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

    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

  14. Position of a sigmoid colon in right iliac fossa in children: A retrospective study

    PubMed Central

    Saxena, Akshay Kumar; Sodhi, Kushaljit Singh; Tirumani, Sreeharsha; Mumtaz, Hina Arif; Narasimha Rao, Katragadda Lakshmi; Khandelwal, Niranjan

    2011-01-01

    Aim: The aim was to identify the position of sigmoid colon in children and discuss its clinical significance. Materials and Methods: Ninety-one contrast enema studies were retrospectively evaluated and the position of sigmoid colon categorized as below: Left lower quadrant, right lower quadrant, midline, and indeterminate. Results: The position of sigmoid colon in the right lower quadrant, left lower quadrant, midline, and indeterminate was 32 (35.16%), 33 (36.26%), 12 (13.19%), and 14 (15.38%), respectively. There was no statistically significant difference in mean age (P = 0.87) or gender prevalence (P = 0.49) for different positions of the sigmoid colon. Conclusion: The sigmoid colon occupies the right lower quadrant in a large number of children. Awareness of this finding is of crucial importance in correct interpretation of abdominal radiographs in the emergency room. PMID:21897567

  15. [A case of adenosquamous carcinoma of the sigmoid colon with inferior mesenteric vein thrombosis].

    PubMed

    Otsuka, Ryota; Maruyama, Takashi; Tanaka, Hajime; Matsuzaki, Hiroshi; Natsume, Toshiyuki; Miyazaki, Akinari; Sato, Yayoi; Sazuka, Tetsutaro; Yamamoto, Yuji; Yoshioka, Takafumi; Kanada, Yoko; Yanagihara, Akitoshi; Yokoyama, Masaya; Kobayashi, Hiroshi; Shimizu, Shinichiro

    2014-11-01

    A 63-year-old man who had been admitted to another institute with sepsis and renal failure was referred to our hospital after computed tomography(CT)findings showed thickening of the walls in the sigmoid colon and a defect in contrast enhancement in the portal and inferior mesenteric veins. Emergency sigmoid colon resection with D2 lymphadenectomy was performed after detection of perforation due to sigmoid colon cancer. The histopathological diagnosis was adenosquamous carcinoma, pSS, int, INF b, ly1, v0, pN2, pStage IIIband inferior mesenteric vein thrombosis. He was discharged on day 12, and we administered anticoagulant warfarin therapy. PMID:25731288

  16. Impacted foreign body in the sigmoid colon presenting as recurrent diverticulitis

    Microsoft Academic Search

    Jaime RamosDorothy; Dorothy E. Dean; Elias Tarakji; Jeremy Rich

    2011-01-01

    We report on a patient with left-sided abdominal pain thought to be caused by recurring diverticulitis. Computed tomography\\u000a of the sigmoid colon revealed diverticulosis without the presence of a foreign body. During colonoscopy, a phytobezoar in\\u000a the form of a vegetable stem was discovered transversely impacted within two diverticular openings in the lumen of the sigmoid\\u000a colon. A localized inflammatory

  17. Giant Submucosal Lipomatous Polyp Causing Perforation of Sigmoid Colon: A Case Report and Review of Literature

    PubMed Central

    Laksman, Triza Kumar

    2015-01-01

    Colonic lipomas are rare benign tumours that are usually asymptomatic. Large colonic lipomas can present with symptoms such as constipation, abdominal pain, bleeding per rectum, and intussusception. We report the case of an 82-year-old man presenting with sudden onset lower abdomen pain and features of peritonitis. An exploratory laparotomy revealed a perforation of sigmoid colon with a fleshy mass protruding through the perforation. No case of spontaneous perforated sigmoid colon by submucous giant lipoma is reported yet in the literature. We discuss the details of first such case, our management, the outcome and also briefly review the literature. PMID:25738034

  18. Mesenteric panniculitis of the sigmoid colon: a case report and review of the literature

    PubMed Central

    Popkharitov, Angel I; Chomov, Georgi N

    2007-01-01

    Introduction Mesenteric panniculitis of the sigmoid colon is a rare occurrence in surgical practice. The aim of this article is to present a case of mesenteric panniculitis of the sigmoid colon and a short review of the literature. Case presentation We reviewed the hospital record of a 63-year-old man who presented with a palpable mass in the left abdomen and clinical signs of a partial bowel obstruction. The pre-operative impression was a possible cancer of the sigmoid colon. A laparotomy was performed through a midline incision. The mesentery was found to be markedly thickened, constricted and puckered. The normal architecture of the adipose tissue had been lost and replaced with an irregular nodular mass. The microscopic pathologic sections demonstrated a chronic reactive inflammatory process with an exuberant proliferation of fibroblasts and fibrocytes. The adipose tissue contained scattered areas of steatonecrosis with foci of lipid-laden macrophages, lymphocytes and plasma cells. The sigmoid colon and its mesocolon were resected. The postoperative course was uneventful and the patient was discharged in good condition, and followed up for the next two years. Conclusion Mesenteric panniculitis of sigmoid is an extremely rare entity of unknown origin in which the normal architecture of the mesentery is replaced by fibrosis, necrosis and calcification. On gross examination the alterations may be mistaken for a neoplastic process. A frozen section may be necessary for confirmation of the diagnosis. When the advanced inflammatory changes became irreversible and bowel obstruction occurs, resection may be indicated. PMID:17910751

  19. Migrated biliary stent causing perforation of sigmoid colon and pelvic abscess.

    PubMed

    Mady, Raafat Fadly; Niaz, Osamah Saad; Assal, Mohamed Moustafa

    2015-01-01

    Endoscopically placed biliary stents are a well-established procedure for the treatment of benign and malignant causes of obstructive jaundice. A plastic stent is usually inserted in patients with obstructive jaundice due to pancreatic cancer as a short-term procedure. Stent migration has been reported as a complication, although in most cases the stent will pass through or remain in the bowel lumen for a period of time. In rare cases, the stent may cause sigmoid perforation and pelvic abscess formation, especially in patients with sigmoid diverticulae or abdominal adhesions due to previous surgery. We present a patient with sigmoid perforation and pelvic abscess due to distal migration of a biliary stent placed to decompress a pancreatic head carcinoma. PMID:25870211

  20. Low-grade fibromyxoid sarcoma of the sigmoid colon.

    PubMed

    Mendoza, Alejandro S; O'Leary, Michael P; Peng, Shi-Kaung; Petrie, Beverley A; Li, Andrew I; French, Samuel W

    2015-04-01

    Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft tissue tumor with a slight male predominance. The tumor has a tendency to arise from deep soft tissue of the trunk and lower extremities. Rare cases are reported to arise from the mediastinal and retroperitoneal areas. Its deceptively bland histologic appearance makes this tumor difficult to diagnose. Also, there are several histologic mimics that may hinder in its diagnosis. We report a case of low-grade fibromyxoid sarcoma from a 48-year-old woman, first documented herein to arise from the sigmoid. We also report the value of CD99, BCL2 and MUC4 stains in the diagnosis of this tumor. PMID:25708661

  1. [Laparoscopic treatment of sigmoid colon intussusception secondary to giant submucosal lipoma].

    PubMed

    Ruiz-Tovar, Jaime; López-Delgado, Alberto; Santos, Jair E; Arroyo, Antonio; Calpena, Rafael

    2013-03-01

    Colonic lipomas have very low frequency, are usually asymptomatic and diagnosis is made incidentally. Seventy-five per cent of lipomas larger than 4 cm are symptomatic, causing abdominal pain, rectal bleeding, obstruction and exceptionally invagination. The resection of invaginated segment is mandatory in cases with invagination and can be performed by laparoscopy when colonic dilation is moderate. We present a 73-year-old man who entered the emergency department complaining of intermitent abdominal pain, rectal bleeding, absence of bowel movements and flatulence, during four days. A CT scan showed a generalized colonic dilation until left lower quadrant. A colo-colonic invagination secondary to an endoluminal lipoma was observed in sigmoid colon. A laparoscopic sigmoidectomy was performed with extracorporeal termino-terminal anastomosis. The postoperative period was uneventful and the patient was discharged from the hospital five days later. A sumbmucous colonic lipoma was diagnosed in the pathological study. PMID:23650832

  2. [A case of liver metastasis from sigmoid colon cancer treated effectively by second-line chemotherapy].

    PubMed

    Gokita, Kentaro; Ami, Katsunori; Matsunaga, Yutaro; Fujiya, Keiichi; Ohshima, Nana; Amagasa, Hidetoshi; Ganno, Hideaki; Imai, Kenichiro; Fukuda, Akira; Nagahama, Takeshi; Ando, Masayuki; Akita, Hidetaka; Tei, Shikofumi; Okada, Youichi; Arai, Kuniyoshi

    2014-11-01

    A case of successful chemotherapy for a metachronous liver metastasis following resection for sigmoid colon cancer is presented. A 51-year-old man underwent sigmoidectomy, ileocecal resection, and descending colon colostomy for sigmoid colon cancer with ileum invasion. Six courses of FOLFOX4 were performed as adjuvant chemotherapy. One year after sigmoidectomy, a liver metastasis was detected on computed tomography (CT) examination. Chemotherapy with FOLFOX+bevacizumab was restarted. Three courses were administered, but hepatic dysfunction occurred after the second and third courses, and FOLFOX was discontinued. Subsequent chemotherapy was reinitiated with FOLFIRI+bevacizumab. After 9 courses, the carcinoembryonic antigen level was normalized and appeared to be decreased by imaging studies. Upon the patient's request, only oral S-1 was administered. After 2 courses, CT revealed that the diameter of the tumor had increased by 2 cm. Therefore, right lobectomy of the liver, colostomy closure, and anastomosis were performed. During these procedures, a nodule was found in the omentum and was removed. Rapid intra-operative diagnosis revealed peritoneal dissemination. The pathological diagnosis was liver metastasis of sigmoid colon cancer, with necrosis and fibrosis seen in approximately one-half of specimens. The surgical margins were negative. Neither metastatic cancer nor dissemination were found in the resected greater omentum. PMID:25731321

  3. Inflammatory Pseudotumor of the Sigmoid Colon by Enterobius vermicularis: A Case Report

    Microsoft Academic Search

    O. Topcu; E. Canbay; M. Turan; S. Arici; Z. Sumer; M. Sen

    2004-01-01

    SummaryFor the first time, we report a case of an inflammatory pseudotumor of the sigmoid colon originating from an infection withEnterobius vermicularis. A 42-year-old man presented with left lower abdominal pain, weight loss, fever, nausea, and vomiting. Physical examination revealed tenderness and a palpable mass in the left lower quadrant. Laboratory results demonstrated elevated leukocyte count. Colonoscopy showed 25 cm

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

    PubMed Central

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

    2013-01-01

    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

  5. Strangulation and necrosis of an epiploic appendage of the sigmoid colon in a right inguinal hernia.

    PubMed

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

    2013-01-01

    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

  6. Perforated diverticulitis of the sigmoid colon revealed by a perianal fistula

    PubMed Central

    Amor, Imed Ben; Kassir, Radwan; Bachir, Elias; Katharina, Hufschmidt; Debs, Tarek; Gugenheim, Jean

    2015-01-01

    Introduction Diverticular disease of the colon is a frequent pathology; however, perforated diverticulitis with a spontaneous sigmoidocutaneous fistula revealed by a perianal abscess is an uncommon presentation. We present this extremely rare case of a perforated sigmoid diverticulum in the perianal area, which is the first case that we have encountered in our practice and in the literature, along with the accompanying diagnostic and therapeutic issues and a review of the literature. Presentation of case We report the case of a 47-year-old man who was admitted to the emergency room due to a perianal abscess. The patient was taken to the operating room on an emergency basis. In the lithotomy position, the abscess was located at the 4 o’clock position. Incision and drainage was performed. Intraoperatively, the abscess was found to be deep, and considered an ischiorectal abscess. No fistulous tract was identified. An MRI of the pelvis was performed one month postoperatively which revealed a perforated diverticulitis of the sigmoid colon causing a perianal fistula. After the abscess was successfully treated, a sigmoidectomy was performed. Fifteen centimeters of the colon were resected. No postoperative complications occurred. Discussion Perianal fistula is an obvious physical sign but its etiology is complex to determine. The pathophysiological mechanism involved is the emergence of a pressure gradient between the peritoneum and surrounding structures, causing rupture of the perianal tissue, allowing gas from a perforation to diffuse along tissue planes. Conclusion General surgeons should bear in mind this rare presentation of a sigmoid diverticulitis. PMID:25635602

  7. A Case of Malignant Granular Cell Tumor in the Sigmoid Colon

    PubMed Central

    Choi, Sang Myung; Kang, Shin Myung; Chae, Byung Gi; Kim, Sung Jin; Park, Pyung Kang; Park, Hyun Sung

    2014-01-01

    Granular cell tumor (GCT) is an uncommon, usually benign neoplasm; however, a malignant potential has been described. Malignant GCT is an extremely rare neoplasm showing rapid growth and invasion into adjacent muscles, lymph nodes, or vessels, or even distant metastasis. We recently experienced a case of a histologically benign or atypical but clinically malignant GCT, with invasion of the lymph nodes and vessels in the sigmoid colon, diagnosed by segmental colon resection with lymph node dissection. We also performed a review of relevant medical literature. PMID:24765605

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

    PubMed Central

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

    2014-01-01

    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

  9. MRI identified prognostic features of tumors in distal sigmoid, rectosigmoid, and upper rectum: Treatment with radiotherapy and chemotherapy

    SciTech Connect

    Burton, Sarah [Division of Colorectal Surgery, Mayday University Hospital, Croydon (United Kingdom); Brown, Gina [Academic Department of Radiology, Royal Marsden Hospital, Sutton, Surrey (United Kingdom)]. E-mail: gina.brown@rmh.nhs.uk; Daniels, Ian [Division of Colorectal Surgery, Epsom and St. Helier NHS Trust, Epsom (United Kingdom); Norman, Andy [Department of Medical Statistics and Computing, Royal Marsden Hospital, Sutton, Surrey (United Kingdom); Swift, Ian [Division of Colorectal Surgery, Mayday University Hospital, Croydon (United Kingdom); Abulafi, Muti [Division of Colorectal Surgery, Mayday University Hospital, Croydon (United Kingdom); Wotherspoon, Andy [Department of Histopathology, Royal Marsden Hospital, Sutton, Surrey (United Kingdom); Tait, Diana [Department of Clinical Oncology, Royal Marsden Hospital, Sutton, Surrey (United Kingdom)

    2006-06-01

    Purpose: Neoadjuvant therapy is traditionally reserved for locally advanced mid and low rectal cancers. In tumors above this level, the need for adjuvant treatment is based on poor histopathologic features, but this approach has potential disadvantages. The aim of this study was to determine whether magnetic resonance imaging (MRI) could accurately stage tumors of the distal sigmoid, rectosigmoid, and upper rectum and help direct preoperative treatment. Materials and Methods: A total of 75 patients with distal sigmoid, rectosigmoid, and upper rectal tumors were assessed preoperatively by MRI. If tumor extended beyond the planned surgical resection plane, chemoradiotherapy was offered. Results: Of the 75 patients, 57 (76%) underwent primary surgery. Agreement between the MRI prognosis and histopathologic findings was 84% (95% confidence interval [CI], 72.6-92.7%). The other 18 patients underwent neoadjuvant chemoradiotherapy for poor prognostic features with predicted surgical resection margin involvement. The histopathologic examination confirmed tumor downstaging in 9 of the 18 patients who underwent chemoradiotherapy. The 3-year survival rate in the good prognosis group (91%; 95% CI, 77.1-97.3%) was not significantly different from that of the chemoradiotherapy group (81.4%; 95% CI, 52.4-93.6%). The poor prognosis group undergoing primary surgery had significantly worse survival (62.2%; 95% CI, 30.3-82.8%, p < 0.03). Conclusion: Our findings indicate that tumors of the distal sigmoid, rectosigmoid, and upper rectum can be staged accurately using high spatial resolution MRI and that those with poor prognostic disease may benefit from preoperative therapy.

  10. Diphallus with Imperforate Anus and Complete Duplication of Recto-Sigmoid Colon and Lower Urinary Tract

    PubMed Central

    Mirshemirani, Alireza; Roshanzamir, Fatollah; Shayeghi, Shahnaz; Mohajerzadeh, Leily; Hasas-yeganeh, Shaghayegh

    2010-01-01

    Background Diphallus is a rare anomaly and accompanying anomalies vary from bifid scrotum, bladder exstrophy, imperforate anus and colo-rectal anomaly such as duplication, and other associated anomalies. Case Presentation A 2-day old infant is reported with imperforate anus and complete duplication of recto-sigmoid colon, rectal pouch, doubling of the genitalia with completely formed penis (diphallus), double bladder, urethra and hypospadias. No family history of abnormalities was noted. The patient underwent several operations: laparatory and colostomy at 3rd day of life, and after clinical and paraclinical investigations, cystoplasty, ureteral reimplantation and resection of left phallus were carried out when 4 months old. At the age of 1 year, after colostogram and total colon evaluation, laparatomy, resection of duplicated recto-sigmoid colon, and pull-through was carried out; 3 months later colostomy closure was performed and the patient discharged without complications. Conclusion The patients with diphallus have to be examined carefully because of the high incidence of other systemic anomalies. Treatment of diphallus usually includes excision of the duplicated penile structure, its urethra, and repair of associated anomalies. PMID:23056710

  11. Laparoscopic Pelvic Autonomic Nerve-Preserving Surgery for Sigmoid Colon Cancer

    Microsoft Academic Search

    Jin-Tung Liang; Hong-Shiee Lai; Po-Huang Lee; King-Jen Chang

    2008-01-01

    Background  To test the feasibility of laparoscopic approach in performing the simultaneous pelvic autonomic nerve preservation during\\u000a standard anterior resection of sigmoid colon cancer.\\u000a \\u000a \\u000a \\u000a Methods  Patients meeting appropriate eligibility criteria were recruited for the present study. The surgical procedures are shown\\u000a in the video. The genitourinary function was evaluated on the basis of validated questionnaires including International Prostate\\u000a Symptom Score (IPSS), International

  12. [A case of multiple peripheral pulmonary carcinoids showing a diffuse lung disease synchronously associated with sigmoid colon cancer].

    PubMed

    Watanabe, M; Imamura, M; Abe, I; Itagaki, M; Takahashi, H

    1990-12-01

    Reported is a rare case of a multiple peripheral pulmonary carcinoids showing a diffuse lung disease synchronously associated with a sigmoid colon cancer. An abnormal chest shadow was detected in a 75-year-old male by X ray during a periodic health examination. After admission to hospital for a more thorough examination he was found to have a sigmoid colon cancer. A CT scan of his chest suggested sarcoidosis, but the results of a bronchofiberscopic examination appeared normal. Subsequently, a TBLB specimen revealed typical carcinoid tumors. Thus, the diagnosis of diffuse multiple peripheral carcinoids was made. A surgical resection of the sigmoid colon cancer was performed successfully, but five months later, the patient died of acute pneumonia. An autopsy was not permitted. Also discussed are multiple pulmonary carcinoids and a double cancer. PMID:2266591

  13. [Poor outcome of a patient with early double cancers of the stomach and sigmoid colon in which liver metastases were detected postoperatively].

    PubMed

    Ojima, Toshihiko; Nezuka, Hideaki; Earashi, Mitsuharu; Saitou, Tomohiro; Saitou, Mitsukazu; Fujii, Hisatake

    2014-11-01

    A 63-year-old man underwent laparoscopic-assisted distal gastrectomy (LADG) and laparoscopic assisted colectomy (LAC) simultaneously for double cancers of the gastric antrum and sigmoid colon in August 2012. Both cancers, considered to be at an early-Stage, were pathologically diagnosed as tub1, sm, and n0. The patient was observed but no adjuvant chemotherapy was administered. A follow-up computed tomography (CT) in December 2012 detected a 15 mm tumor mass in the lateral segment of the liver and another 5mm mass in the S4. Liver metastasis of the sigmoid colon cancer was suspected, and 6 courses of BEV+mFOLFOX6 were administered. The metastatic tumor in the lateral segment showed stable disease (SD) and the S4 tumor showed a complete response (CR). Thereafter, the lateral hepatic segment was partially resected in March 2013. Pathological examinations led to a diagnosis of stomach cancer liver metastasis, and the patient was given oral TS-1. During the first course of treatment, a CT showed new tumor masses in the lateral segment of the liver and S4. Treatment was changed to TS-1+CDDP in mid-May. However, after completion of the first course of treatment, the patient experienced exacerbation of the liver metastases, pulmonary metastasis, and inflammation of the intrahepatic bile ducts. The patient was hospitalized in mid-June to receive inpatient care, but died in early July. PMID:25731545

  14. Unusual foreign body in the sigmoid colon, chronic alcohol abuse, and Fournier gangrene: a case report

    PubMed Central

    Schulz, Dietmar; Mohor, Georgiana Simona; Solovan, Caius

    2015-01-01

    Fournier gangrene (FG) is an infectious condition with fulminant evolution and is sometimes life-threatening. Here, we present the case of an immunocompromised 59-year-old male with surgical history of a pancreatic pseudocyst stented endoscopically. After unrecognized stent migration in the sigmoid without colonic perforation, he developed severe necrosis of the scrotum and perineum, which spontaneously perforated, presenting a smell suggesting moist gangrene. FG that has spread to the male genital organs presents therapeutic challenges. The purpose of our study is to present this case, typical for FG, with an educational aim both for the internal and surgical specialties, and the goal of further multidisciplinary collaboration for the optimal management of the patient with personalized treatment.

  15. Effects of excitatory and inhibitory neurotransmission on motor patterns of human sigmoid colon in vitro

    PubMed Central

    Aulí, M; Martínez, E; Gallego, D; Opazo, A; Espín, F; Martí-Gallostra, M; Jiménez, M; Clavé, P

    2008-01-01

    Background and purpose: To characterize the in vitro motor patterns and the neurotransmitters released by enteric motor neurons (EMNs) in the human sigmoid colon. Experimental approach: Sigmoid circular strips were studied in organ baths. EMNs were stimulated by electrical field stimulation (EFS) and through nicotinic ACh receptors. Key results: Strips developed weak spontaneous rhythmic contractions (3.67±0.49?g, 2.54±0.15?min) unaffected by the neurotoxin tetrodotoxin (TTX; 1??M). EFS induced strong contractions during (on, 56%) or after electrical stimulus (off, 44%), both abolished by TTX. Nicotine (1–100??M) inhibited spontaneous contractions. Latency of off-contractions and nicotine responses were reduced by NG-nitro-L-arginine (1?mM) and blocked after further addition of apamin (1??M) or the P2Y1 receptor antagonist MRS 2179 (10??M) and were unaffected by the P2X antagonist NF279 (10??M) or ?-chymotrypsin (10?U?mL?1). Amplitude of on- and off-contractions was reduced by atropine (1??M) and the selective NK2 receptor antagonist Bz-Ala-Ala-D-Trp-Phe-D-Pro-Pro-Nle-NH2 (1??M). MRS 2179 reduced the amplitude of EFS on- and off-contractions without altering direct muscular contractions induced by ACh (1?nM–1?mM) or substance P (1?nM–10??M). Conclusions and implications: Latency of EFS-induced off-contractions and inhibition of spontaneous motility by nicotine are caused by stimulation of inhibitory EMNs coreleasing NO and a purine acting at muscular P2Y1 receptors through apamin-sensitive K+ channels. EFS-induced on- and off-contractions are caused by stimulation of excitatory EMNs coreleasing ACh and tachykinins acting on muscular muscarinic and NK2 receptors. Prejunctional P2Y1 receptors might modulate the activity of excitatory EMNs. P2Y1 and NK2 receptors might be therapeutic targets for colonic motor disorders. PMID:18846038

  16. [A case report of the use of laparoscopic surgery to remove an adrenal tumor following resection of sigmoid colon cancer].

    PubMed

    Okano, Miho; Yasui, Masayoshi; Nishino, Masaya; Hosoda, Yohei; Nagai, Kenichi; Kim, Yongkook; Tsujinaka, Toshimasa

    2014-11-01

    A 58-year-old woman underwent sigmoidectomy and partial cystectomy for sigmoid colon cancer following colostomy. The final staging of the tumor was T3, N1, tub2, M0, fStage IIIa. She received 6 courses of CapeOX (oxaliplatin 130mg/m², capecitabine 200mg/m²) as adjuvant chemotherapy, which was discontinued because of severe general fatigue. At the same time, an increase in the levels of serum carcinoembryonic antigen (CEA) was detected and abdominal computed tomography (CT) revealed an expanded adrenal mass. Since whole-body ¹?F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) showed no evidence of multiple organ metastases except for the right adrenal tumor, a solitary adrenal metastasis from sigmoid colon cancer was strongly suspected. Hence, colostomy closure and laparoscopic adrenalectomy were concurrently performed. Histological examination revealed non-functional adrenal adenoma. Therefore, laparoscopic surgery was a reasonable choice even in this complex case. PMID:25731277

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

    PubMed

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

    2014-09-01

    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

  18. NANC inhibitory neuromuscular transmission in the hamster distal colon.

    PubMed

    El-Mahmoudy, A; Khalifa, M; Draid, M; Shiina, T; Shimizu, Y; El-Sayed, M; Takewaki, T

    2006-12-01

    The neurotransmitter(s) that generate the inhibitory junctional potential (IJP) in the circular muscle of hamster distal colon and their mechanisms have not been elucidated. The aim of the present study, therefore, was to determine the contributing roles of the non-adrenergic, non-cholinergic (NANC) inhibitory transmitter(s) including nitric oxide (NO), adenosine 5'-triphosphate (ATP) and vasoactive intestinal polypeptide (VIP) in the generation of IJP in the hamster distal colon. For this purpose, the effects of the corresponding blockers of these putative NANC inhibitory mediators have been investigated using microelectrode technique. Intracellular membrane potential recordings were made from smooth muscle cells at 35 degrees C in Tyrode's solution that contained atropine (0.5microM), guanethidine (3microM) and nifedipine (0.5microM). Single electrical stimuli (0.5ms, 50V) as well as trains of two and five pulses (20Hz at the same duration and voltage) elicited NANC IJP consisted of initial fast (IJP-F) followed by a slow hyperpolarization (IJP-S). The response had been abolished by tetrodotoxin (TTX, 0.3microM). The nitric oxide synthase (NOS) inhibitor, N(G)-nitro-L-arginine methyl ester (L-NAME; 200microM) blocked IJP-S but enhanced IJP-F. The later had been blocked with suramin, a universal P2 receptor antagonist, or with CBF3GA, a P2Y receptor antagonist at dose-dependent fashions. The IJP-F had been markedly inhibited by desensitization of P2Y receptor with its putative agonist 2-methylthio-ATP (2-meSATP, 50microM for 30min). IJP-F was sensitive to the P2Y1 receptor specific antagonist A3P5PS (10microM) and to the G-protein inhibitor, pertussis toxin (PTX, 400ng/ml for 2h) as well as to the small and intermediate Ca(2+) sensitive K(+) channels blocker, apamin (0.3microM). IJP-S was blocked by the guanylate cyclase (GC) inhibitor, 1H-[1,2,4]oxadiazolo-[4,3-a]quinoxalin-1-one (ODQ, 10microM) and was partially sensitive to apamin. Exogenously applied ATP (100microM-1mM) produced typical hyperpolarization that was blocked by suramin, CBF3GA and 2-meSATP desensitization; while exogenously applied NO (3-10microM) produced slowly developing hyperpolarization that was not blocked by L-NAME but ODQ. In the presence of both purinergic and nitrergic inhibitors, stimulation using a train of eight pulses at 25Hz evoked a small slow hyperpolarization that was sensitive to the VIP antagonist (VIP 6-28, 1microM). Exogenous application of VIP (1-10microM) produced similar response that was not evident in the presence of VIP 6-28. These data indicate that NANC IJP that is generated in the circular muscle cells of hamster distal colon is mediated by ATP and NO via P2Y1/P2Y2 receptor and GC-dependent pathways, respectively. A masked role for VIP is also indicated. PMID:17035041

  19. Molecular and immunohistochemical profile of a basaloid (cloacogenic) carcinoma of the sigmoid colon: possible predictive value for clinical outcomes.

    PubMed

    Gurzu, Simona; Szentirmay, Zoltan; Bara, Tivadar; Bara, Tivadar; Iurcsuk, Olga; Jung, Ioan

    2014-05-01

    A 61-year-old woman was hospitalized with a 5-week history of abdominal discomfort, change in bowel habits, and weight loss. Colonoscopy showed a protruded tumor of the sigmoid colon first diagnosed as undifferentiated carcinoma. Surgical resection of the sigmoid colon was performed. Histological examination of the surgical specimen showed a proliferation of basaloid cells arranged in tumor clusters with central comedonecrosis and peripheral palisading of the nuclei. The tumor invaded the subserosa and presented liver metastasis without lymph node metastases. The tumor cells were marked by keratin AE1/AE3, keratin 5/6, epithelial membrane antigen, bcl-2, vascular endothelial growth factor, CD105, neuron-specific enolase, MLH-1, MSH-2, and p53, and were negative for keratin 7/20, chromogranin, synaptophysin, carcinoembryonic antigen, p63, c-KIT, and maspin. A high p53 nuclear index was also detected. On the basis of these characteristics and molecular examinations, the final diagnosis was microsatellite stable/human papilloma virus-negative/K-ras mutated/BRAF wild-type basaloid carcinoma (BC). Only seven BCs of the colon were reported in the literature, this being the eighth one and the first case that reports new molecular findings about microsatellite instability, K-ras/BRAF mutations, angiogenesis, and maspin expression in BC, with direct involvement in targeted therapy. PMID:24584270

  20. Synchronous Distal Pancreatic Metastatic Lesion Arising from Colonic Adenocarcinoma: Case Report and Literature Review

    PubMed Central

    Su, Lowell; Wernberg, Jessica

    2014-01-01

    Solitary metastatic pancreatic lesions comprise 0.5% to 3% of all pancreas neoplasms, most commonly arising from primary tumors of the kidney, lung, or colon. Synchronous metastatic pancreatic lesions are exceptionally rare. Only 25 cases of isolated colorectal pancreatic metastasis amenable to resection have been reported, 11 of those in the distal pancreas. To our knowledge we report the first case of a primary colonic malignancy with a synchronous distal pancreatic metastatic lesion treated with resection. PMID:24667222

  1. Neurogenic and myogenic motor patterns of rabbit proximal, mid, and distal colon.

    PubMed

    Dinning, P G; Costa, M; Brookes, S J; Spencer, N J

    2012-07-01

    The rabbit colon consists of four distinct regions. The motility of each region is controlled by myogenic and neurogenic mechanisms. Associating these mechanisms with specific motor patterns throughout all regions of the colon has not previously been achieved. Three sections of the colon (the proximal, mid, and distal colon) were removed from euthanized rabbits. The proximal colon consists of a triply teniated region and a single tenia region. Spatio-temporal maps were constructed from video recordings of colonic wall diameter, with associated intraluminal pressure recorded from the aboral end. Hexamethonium (100 ?M) and tetrodotoxin (TTX; 0.6 ?M) were used to inhibit neural activity. Four distinct patterns of motility were detected: 1 myogenic and 3 neurogenic. The myogenic activity consisted of circular muscle (CM) contractions (ripples) that occurred throughout the colon and propagated in both antegrade (anal) and retrograde (oral) directions. The neural activity of the proximal colon consisted of slowly (0.1 mm/s) propagating colonic migrating motor complexes, which were abolished by hexamethonium. These complexes were observed in the region of the proximal colon with a single band of tenia. In the distal colon, tetrodotoxin-sensitive, thus neurally mediated, but hexamethonium-resistant, peristaltic (anal) and antiperistaltic (oral) contractions were identified. The distinct patterns of neurogenic and myogenic motor activity recorded from isolated rabbit colon are specific to each anatomically distinct region. The regional specificity motor pattern is likely to facilitate orderly transit of colonic content from semi-liquid to solid composition of feces. PMID:22556138

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

    SciTech Connect

    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

    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.

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

    PubMed Central

    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

    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

  4. Expression of membrane drug efflux transporters in the sigmoid colon of HIV-infected and uninfected men.

    PubMed

    De Rosa, María Fabiana; Robillard, Kevin R; Kim, Connie J; Hoque, Md Tozammel; Kandel, Gabor; Kovacs, Colin; Kaul, Rupert; Bendayan, Reina

    2013-09-01

    The use of antiretroviral therapy (ART) as pre-exposure prophylaxis (PrEP) has gained global attention as a promising HIV prevention strategy in men who have sex with men. Permeability of these agents in the rectal mucosa may be partially regulated by interactions with drug efflux transporters, P-glycoprotein (P-gp), multidrug resistance-associated proteins (MRPs) and/or breast cancer resistance protein (BCRP). The objective of this work was to investigate the expression of drug efflux transporters in recto-sigmoid colon tissues of HIV-infected and uninfected men, and evaluate the association of ART and/or HIV infection with drug transporter expression. MDR1/P-gp, MRPs (1-4) and BCRP mRNA and protein expression were detected in sigmoid colon biopsies of HIV-uninfected individuals. Biopsies from HIV-infected, ART-naïve participants revealed a significant downregulation of P-gp and MRP2 protein levels compared to HIV-uninfected individuals. Biopsies from HIV-infected ART-treated patients showed 1.9-fold higher P-gp protein expression and 1.5-fold higher MRP2 protein expression compared to the ones obtained from the HIV-infected ART-naïve patients. This is a first report demonstrating that HIV infection or ART could alter expression of drug efflux transporters in gut mucosa which in turn could affect the permeability of PrEP antiretroviral agents across this barrier, a highly vulnerable site of HIV transmission. PMID:23856938

  5. [Conservative operations in malignant tumors of the rectum and the sigmoid colon].

    PubMed

    Fedorov, V D; Brusilovski?, M I; Safina, F M; Sadovnichi?, V A

    1975-01-01

    The results of treatment in 230 patients with malignant transformation of polyps and villous tumors, carcinoid and cancer of the rectum and sigmoid are reported. The aforementioned tumors were removed by transanal excision, electrocoagulation adn posterior proctotomy. In 33 patients economic operations for rectal cancer were associated with radiotherapy. Late results indicated that after economic resections for rectal cancer in most cases a persistant cure is gained. In malignified polyps, villous tumors and rectal carcinoids electroexcision or electrocoagulation seems to be an adequate procedure. Patients subjected to economic resections need to be examined every month during the first postoperative year, and later once in six months. PMID:1189362

  6. Distal colonic Na + absorption inhibited by luminal P2Y 2 receptors

    Microsoft Academic Search

    J. E. Matos; M. V. Sorensen; C. S. Geyti; B. Robaye; J. M. Boeynaems; J. Leipziger

    2007-01-01

    Luminal P2 receptors are ubiquitously expressed in transporting epithelia. In steroid-sensitive epithelia (e.g., lung, distal\\u000a nephron) epithelial Na+ channel (ENaC)-mediated Na+ absorption is inhibited via luminal P2 receptors. In distal mouse colon, we have identified that both, a luminal P2Y2 and a luminal P2Y4 receptor, stimulate K+ secretion. In this study, we investigate the effect of luminal adenosine triphosphate\\/uridine triphosphate

  7. Short latency cerebral response evoked by painful electrical stimulation applied to the human sigmoid colon and to the convergent referred somatic pain area

    Microsoft Academic Search

    Petra Rössel; Lars Arendt-Nielsen; David Niddam; Andrew C. N. Chen; Asbjørn M. Drewes

    2003-01-01

    Background. The brain-gut interaction is important for the understanding of pain mechanisms related to gastroenterological diseases.\\u000a Unfortunately little is known about the early cerebral events related to the processing of gut-evoked pain. The aims of this\\u000a human study were (1) to investigate the early-evoked brain potentials (EPs) to painful sigmoid colon stimulation and (2) to\\u000a evaluate the EPs evoked from

  8. Characterization of rectal, proximal and distal colon cancers based on clinicopathological, molecular and protein profiles.

    PubMed

    Minoo, P; Zlobec, I; Peterson, M; Terracciano, L; Lugli, A

    2010-09-01

    Accumulating evidence suggests that colorectal cancer (CRC) should be viewed as a heterogeneous disease, with proximal and distal CRCs showing multiple biological and clinical differences. The aim of this study was to develop a clinicopathological, molecular and protein profile for CRCs based on their region and thus providing insight into their heterogeneity. CRC patients (n=399) were evaluated for clinicopathologic and molecular features including K-RAS, BRAF and MSI status. Tumors were also screened for expression of 50 immunohistochemical markers linked to major signaling pathways involved in tumor-progression or immune response. Proximally located tumors show significantly larger tumor size, higher T-stage, higher tumor grade and more frequent mucinous histologic subtype compared to the distal colon and rectum. The frequency of BRAF mutation and MSI-high phenotype were significantly higher in proximal colon cancers. There is a significant difference in regional expression of 10 tumor-associated markers (CDX2, CD44v6, CD44s, TOPK, nuclear beta-catenin, pERK, APAF-1, E-cadherin, p21 and bcl2) and 4 immune response markers (CD68, CD163, FoxP3 and TIA-1). In multivariate analysis CD44s, CD44v6, nuclear beta-catenin and CD68 expression was found to best discriminate left- versus right-sided colon cancers. Tumor diameter, pT stage and MSI status best distinguish right-sided colon cancers from rectal cancers and pT stage and E-cadherin best discriminate left-sided colon cancers and rectal cancers. These data along with existing evidence for the presence of distinct regional embryological origin and gene expression profile are highly supportive of the concept that proximal and distal CRCs are distinct clinicopathologic entities. PMID:20664940

  9. Delayed development of amiloride-sensitive sodium transport in lamb distal colon.

    PubMed Central

    Hills, F; James, P S; Paterson, J Y; Smith, M W

    1980-01-01

    1. Na transport has been measured in vitro across distal colons taken from fetal and early post-natal lambs. 2. The mucosal to serosal Na flux fell by half during the first three weeks of post-natal life. Similar falls were recorded for measured short-circuit current and open-circuit voltage. The net transport of Na, measured isotopically at all stages of development, corresponded approximately to that calculated from measurements of short-circuit current. 3. The serosal to mucosal flux of Na was approximately half the mucosal to serosal flux at all stages in development. 4. Amiloride affected neither the short-circuit current nor the mucosal to serosal flux of Na measured during the first five days of post-natal life. The short-circuit current of an increasing proportion of distal colons (30-70%) began to show some sensitivity to amiloride during the second to third week of post-natal life. Sensitivity of the short-circuit to inhibition by amiloride appeared to be fully developed in the 8-week-old lamb colon. 5. The serum concentration of aldosterone was high at birth. It then fell rapidly to levels approaching those found in fetuses in the last week of pregnancy. The serum concentration of cortisol was two orders of magnitude higher than for aldosterone. Changes in cortisol concentration during development paralleled those for aldosterone. 6. There appears to be no aldosterone-induced change in Na transport across lamb distal colon during the first week of post-natal development. Comparisons are made between this situation and that found in the neonatal pig, where aldosterone acts to increase Na reabsorption immediately after birth. Possible reasons for this species difference are discussed. PMID:7431239

  10. Differential roles of stretch-sensitive pelvic nerve afferents innervating mouse distal colon and rectum

    PubMed Central

    Brumovsky, Pablo R.; Gebhart, Gerald F.

    2010-01-01

    Information about colorectal distension (i.e., colorectal dilation by increased intraluminal pressure) is primarily encoded by stretch-sensitive colorectal afferents in the pelvic nerve (PN). Despite anatomic differences between rectum and distal colon, little is known about the functional roles of colonic vs. rectal afferents in the PN pathway or the quantitative nature of mechanosensory encoding. We utilized an in vitro mouse colorectum-PN preparation to investigate pressure-encoding characteristics of colorectal afferents. The colorectum with PN attached was dissected, opened longitudinally, and pinned flat in a Sylgard-lined chamber. Action potentials of afferent fibers evoked by circumferential stretch (servo-controlled force actuator) were recorded from the PN. Stretch-sensitive fibers were categorized into the following four groups: colonic muscular, colonic muscular/mucosal, rectal muscular, and rectal muscular/mucosal. Seventy-nine stretch-sensitive PN afferents evenly distributed into the above four groups were studied. Rectal muscular afferents had significantly greater stretch-responses than the other three groups. Virtually all rectal afferents (98%) had low thresholds for response and encoded stimulus intensity into the noxious range without obvious saturation. Most colonic afferents (72%) also had low thresholds (<14 mmHg), but a significant proportion (28%) had high thresholds (>18 mmHg) for response. These high-threshold colonic afferents were sensitized to stretch by inflammatory soup; response threshold was significantly reduced (from 23 to 12 mmHg), and response magnitude significantly increased. These results suggest that the encoding of mechanosensory information differs between colonic and rectal stretch-sensitive PN afferents. Rectal afferents have a wide response range to stretch, whereas high-threshold colonic afferents likely contribute to visceral nociception. PMID:20075141

  11. Niti CAR 27 Versus a Conventional End-to-End Anastomosis Stapler in a Laparoscopic Anterior Resection for Sigmoid Colon Cancer

    PubMed Central

    Kwag, Seung-Jin; Kim, Jun-Gi; Kang, Won-Kyung; Lee, Jin-Kwon

    2014-01-01

    Purpose The Niti CAR 27 (ColonRing) uses compression to create an anastomosis. This study aimed to investigate the safety and the effectiveness of the anastomosis created with the Niti CAR 27 in a laparoscopic anterior resection for sigmoid colon cancer. Methods In a single-center study, 157 consecutive patients who received an operation between March 2010 and December 2011 were retrospectively assessed. The Niti CAR 27 (CAR group, 63 patients) colorectal anastomoses were compared with the conventional double-stapled (CDS group, 94 patients) colorectal anastomoses. Intraoperative, immediate postoperative and 6-month follow-up data were recorded. Results There were no statistically significant differences between the two groups in terms of age, gender, tumor location and other clinical characteristics. One patient (1.6%) in the CAR group and 2 patients (2.1%) in the CDS group experienced complications of anastomotic leakage (P = 0.647). These three patients underwent a diverting loop ileostomy. There were 2 cases (2.1%) of bleeding at the anastomosis site in the CDS group. All patients underwent a follow-up colonoscopy (median, 6 months). One patient in the CAR group experienced anastomotic stricture (1.6% vs. 0%; P = 0.401). This complication was solved by using balloon dilatation. Conclusion Anastomosis using the Niti CAR 27 device in a laparoscopic anterior resection for sigmoid colon cancer is safe and feasible. Its use is equivalent to that of the conventional double-stapler. PMID:24851217

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

    PubMed Central

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

    2015-01-01

    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

  13. Localization and vasopressin regulation of the Na+-K+-2Cl- cotransporter in the distal colonic epithelium

    PubMed Central

    Xue, Hong; Zhang, Zi-Juan; Li, Xiao-Shuang; Sun, Hai-Mei; Kang, Qian; Wu, Bo; Wang, Ya-Xi; Zou, Wan-Jing; Zhou, De-Shan

    2014-01-01

    AIM: To investigate whether Na+-K+-2Cl- cotransporter (NKCC2) is expressed in the mouse distal colonic epithelia and whether it is regulated by vasopressin in the colon. METHODS: The mRNA expression of NKCC2 in the mouse colonic mucosa was examined by reverse transcription-polymerase chain reaction. NKCC trafficking in the colon stimulated by 1-D-amino(8-D-arginine)-vasopressin (dDAVP) infusion (10 ng/mouse, intraperitoneal injection ) within 15 min, 30 min and 1h was investigated by laser confocal scanning microscopy. Total and membrane NKCC2 expression in the colonic mucosa from control and dDAVP-treated mice was detected by Western blotting. Short circuit current method was performed to determine regulation of NKCC2 by vasopressin in the colon. RESULTS: NKCC2 was predominantly located in the apical region of the surface of the distal colonic epithelia; by comparison, a large amount of NKCC1 was distributed in the basolateral membrane of the lower crypt epithelia of the mouse distal colon. Short-term treatment with dDAVP, a V2-type receptor-specific vasopressin analog, induced NKCC2 re-distribution, i.e., NKCC2 traffics to the apical membrane after dDAVP stimulation. In contrast, no obvious NKCC1 membrane translocation was observed. Western blotting results confirmed that membrane NKCC2 had significantly higher abundance in the dDAVP-treated mouse colonic mucosa relative to that in the untreated control, which is consistent with our immunostaining data. Moreover, the short-circuit current method combined with a NKCC2 inhibitor demonstrated that NKCC2 was also activated by serosal vasopressin in isolated distal colonic mucosa. CONCLUSION: Our results provide direct evidence that vasopressin also plays an important role in the colonic epithelia by stimulating NKCC2 trafficking to the apical membrane and inducing NKCC2-mediated ion transport. PMID:24782621

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

    PubMed

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

    2015-04-01

    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

  15. [A case of pathologically complete response in a patient with locally advanced sigmoid colon cancer after chemotherapy including bevacizumab/FOLFOX4].

    PubMed

    Mikami, Youshi; Tamura, Naoshi; Akiyama, Masayuki; Muraoka, Takeshi; Sakurai, Urara; Sawabe, Motoshi

    2014-06-01

    A 65-year-old man complaining of abdominal pain was admitted to our hospital. A diagnosis of colon ileus due to sigmoidal colon cancer was made. A stoma was created at the transverse colon, and elective surgery was scheduled. During the operation, the tumor was found to have invaded the bladder and the pelvic wall, making curative resection impossible. Chemotherapy consisting of bevacizumab/oxaliplatin, Leucovorin, and 5-fluorouracil(FOLFOX4, intravenous drip infusion every 2 weeks)was started. After 12 courses of treatment, remarkable shrinkage of the tumor was noted, which led us to perform a sigmoidectomy and partial resection of the bladder wall. A histopathological study of the surgically resected specimen showed no cancer cells. Recovery was uneventful and the patient was discharged on the 17th postoperative day. In cases of advanced colon cancer, complete response of the primary tumor with preoperative chemotherapy is very unusual. We conclude that chemotherapy with bevacizumab/FOLFOX4 plays a role in the management of advanced/unresectable colon cancer. PMID:25129094

  16. Methylation status of normal background mucosa is correlated with occurrence and development of neoplasia in the distal colon.

    PubMed

    Hiraoka, Sakiko; Kato, Jun; Horii, Joichiro; Saito, Shunsuke; Harada, Keita; Fujita, Hideyuki; Kuriyama, Motoaki; Takemoto, Koji; Uraoka, Toshio; Yamamoto, Kazuhide

    2010-01-01

    The aim of this study is to evaluate the methylation status of normal colonic mucosa in relation to the stage of neoplasia arising from the mucosa. The methylation status of 2 age-related loci (ESR1 and MYOD1) and global methylation (the mean of Alu and Sat2) in the normal colonic mucosa of 156 patients with and without colorectal neoplasia were examined. The distal colon and proximal colon were analyzed separately because neoplasia is biologically and clinically different between these sites. The methylation status was determined by MethyLight using percentage of methylated reference (PMR). In the distal colon, methylation of the age-related loci decreased as the stage of neoplasia increased (patients with no neoplasia or with adenoma < or =9 mm versus patients with advanced adenoma or with invasive cancer: ESR1-PMR median, 21.0 versus 15.7; P = .015; MYOD1-PMR median, 5.35 versus 3.80; P = .0037, respectively). Interestingly, global methylation was inversely correlated with the stage of neoplasia (59.7 versus 61.5; P = .054). In contrast, the proximal colon showed no significant correlations. The methylation of MYOD1 in the normal mucosa was significantly correlated with K-ras mutation in neoplastic tissue arising from the mucosa. Specific epigenetic changes in normal colonic mucosa may be correlated with the occurrence and development of neoplasia in the distal colon. PMID:19733896

  17. [Capacitative Ca²? entry is involved in ACh-induced distal colon smooth muscle contraction in rats].

    PubMed

    Kong, De-Hu; Zhou, Hua; Song, Jie; Ke, Dao-Ping; Hu, Jin-Lan; Li, Zhong-Wen; Ma, Rong

    2006-04-25

    Contraction of smooth muscle cells is triggered by an increase in cytosolic Ca(2+) upon agonist stimulation. Ca(2+) influx across the plasma membrane constitutes a major component of the agonist-induced response in smooth muscle cells. Traditionally, voltage-operated Ca(2+) channel (VOCC) is considered as the channel mediating the Ca(2+) entry. However, this view has been challenged by recent discoveries, which demonstrated that other types of ion channels, such as store-operated and/or receptor-operated Ca(2+) channels (SOCC and/or ROCC), also participate in Ca(2+) response induced by agonists in smooth muscle cells. SOCC is defined as the channel activated in response to the depletion of the internal Ca(2+) stores, an event secondary to G protein coupled receptor or receptor tyrosine kinase stimulation. The Ca(2+) flow mediated by SOCC is termed as capacitative Ca(2+) entry (CCE). Previous study from other group has demonstrated that VOCC played a predominant role in ACh-induced contraction of distal colon smooth muscle in guinea pig. However, whether SOCC participates in the agonist-induced contractile response in this particular tissue is unknown. The present study was performed to investigate the role of CCE in ACh-induced mechanical activity of distal colon smooth muscle in rats. The contractile function of the smooth muscle was assessed by measuring isometric force of isolated rat distal colon rings. We showed that both high extracellular K(+) (40 mmol/L) and ACh (5 mumol/L) evoked striking contraction of the smooth muscle. The contractile responses were almost abolished by removal of extracellular Ca(2+) with ethylene glycol-bis(2-aminoethylether)-N,N,N',N' tetraacetic acid (EGTA), suggesting a critical contribution of extracellular source of Ca(2+) to the contraction. Verapamil (5 mumol/L), an L-type VOCC blocker, significantly attenuated, but didn't completely eliminate the high K(+)- and ACh-induced contraction (74% and 41% for high K(+) and ACh, respectively), indicating that additional channels might be involved in the contractile mechanism. Furthermore, ACh only induced transient contractions in the absence of extracellular Ca(2+). Readmission of Ca(2+) into the extracellular compartment resulted in a significant and sustained increase in the tension of the smooth muscle. This response was not affected by verapamil (5 mumol/L) and Cd(2+) (5 mumol/L), both of which efficiently block VOCC at the doses. However, La(3+), a known inhibitor of SOCC, significantly suppressed the Ca(2+) readdition-induced contraction in a dose-dependent manner. On the basis of these results, we conclude that contraction of smooth muscle in the distal colon is regulated by multiple Ca(2+) channels. In addition to VOCC-mediated Ca(2+) influx, SOCC-mediated CCE participates in agonist-induced contractile response of distal colon smooth muscle in rats. PMID:16628362

  18. 17?-Oestradiol acutely regulates Cl? secretion in rat distal colonic epithelium

    PubMed Central

    Condliffe, Steven B; Doolan, Christina M; Harvey, Brian J

    2001-01-01

    In this study we used the short circuit current (ISC) technique to measure the non-genomic effects of the female sex steroid 17?-oestradiol (E2) on electrogenic transepithelial ion transport in rat distal colonic epithelium. Basal ISC was largely composed of a transepithelial Cl? secretory component with minimal electrogenic Na+ movement. E2 (1-100 nm) caused a significant decrease in basal ISC after 15 min. In addition, pre-treating colonic epithelial tissues with E2 (0.1-100 nm) for 10 min significantly reduced forskolin (20 ?m)-induced Cl? secretion. E2 also down-regulated Cl? secretion which was pre-stimulated by forskolin. Cl? secretory responses to the Ca2+-dependent secretagogue carbachol (10 ?m) were also significantly reduced in the presence of E2 (10- 100 nm). However, E2 had no effect on amiloride-sensitive Na+ absorption. The rapid anti-secretory effect of E2 was abolished in the presence of the intracellular Ca2+ chelator BAPTA (50 ?m) or the protein kinase C (PKC) inhibitor chelerythrine chloride (1 ?m). However, in the presence of the nuclear oestrogen receptor antagonist tamoxifen (10 ?m), E2 still produced an inhibition of Cl? secretion. Testosterone, progesterone and 17?-oestradiol had no significant effect on colonic Cl? secretion. Also, E2 (100 nm) did not alter Cl? secretion in colonic epithelia isolated from male rats. We conclude that E2 inhibits colonic Cl? secretion via a non-genomic pathway that involves intracellular Ca2+ and PKC. It is possible that this gender-specific mechanism contributes to the salt and water retention associated with high E2 states. PMID:11136857

  19. The secretory K Ca 1.1 channel localises to crypts of distal mouse colon: functional and molecular evidence

    Microsoft Academic Search

    Mads V. Sørensen; Anne B. Strandsby; Casper K. Larsen; Helle A. Praetorius; Jens Leipziger

    The colonic epithelium absorbs and secretes electrolytes and water. Ion and water absorption occurs primarily in surface cells,\\u000a whereas crypt cells perform secretion. Ion transport in distal colon is regulated by aldosterone, which stimulates both Na+ absorption and K+ secretion. The electrogenic Na+ absorption is mediated by epithelial Na+ channel (ENaC) in surface cells. Previously, we identified the large conductance

  20. [The case of a patient who experienced perforation related to sigmoid colon cancer, was bearing a hepatic metastasis, and who underwent radical resection for advanced colon cancer after a salvage operation for pan-peritonitis and chemotherapy].

    PubMed

    Murayama, Minoru; Nakashima, Osamu; Yamazaki, Katsuo; Koizumi, Kazuo; Miyauchi, Tatsuomi; Miyaki, Akira; Usuda, Atsuko; Yamaguchi, Kentarou; Yokomizo, Hajime; Shiozawa, Shunichi; Yoshimatsu, Kazuhiko; Shimakawa, Takeshi; Katsube, Takao; Naritaka, Yoshihiko

    2014-11-01

    Colorectal cancer associated perforation initially develops as pan-peritonitis but easily progresses to septic shock, which can be fatal. As such, it can be hard for patients to recover from this pathological condition. A 79-year-old man who was suffering from pan-peritonitis due to sigmoid colon cancer-associated perforation and also had a metastatic hepatic lesion was admitted to our hospital. He underwent an emergency operation in October 2012. Due to hemodynamic instability, peritoneal lavage and drainage, and stomal formation were performed during the operation. Polymyxin-B direct hemoperfusion (PMXDHP) and continuous hemodiafiltration (CHDF) were performed for septic shock and acute renal failure, respectively. The patient was administered 5 courses of chemotherapy consisting of capecitabine, oxaliplatin, and bevacizumab (Cape+L-OHP +Beva) with no severe adverse reactions; the primary colonic and metastatic hepatic lesions showed a good response to the chemotherapy. A radical resection for the sigmoid colon cancer, including a partial hepatic resection for the metastatic lesion, was performed in May 2013. Surveillance examinations have indicated that the patient is recurrence-free 13 months after radical resection. PMID:25731328

  1. An autopsy case of penetration of a sigmoid colon diverticulum with septic shock during the treatment of lung cancer-related pain.

    PubMed

    Haga, Tomoaki; Shibahara, Hiroaki; Narita, Michihiko; Okubo, Kenji; Nishimura, Daisaku; Katada, Naoyuki

    2015-01-01

    A 70-year-old man presented with septic shock and abdominal pain during treatment of pain caused by stage IV lung adenocarcinoma. CT revealed air collection from the retroperitoneum to the muscle around the thigh. Septic shock due to retroperitoneal penetration from the digestive tract was suspected. Despite treatment attempts, the patient died. The autopsy diagnosis was penetration of a sigmoid colon diverticulum under the serosa. When a diverticulum is located near the mesenterium and the size of penetration is small, the air collection rather than fecal matter is likely to extend retroperitoneally. Abdominal pain is little manifest in the penetration in contrast to perforation into abdominal cavity, and the attention is needed. PMID:25748156

  2. Distal colonic Na(+) absorption inhibited by luminal P2Y(2) receptors.

    PubMed

    Matos, J E; Sorensen, M V; Geyti, C S; Robaye, B; Boeynaems, J M; Leipziger, J

    2007-09-01

    Luminal P2 receptors are ubiquitously expressed in transporting epithelia. In steroid-sensitive epithelia (e.g., lung, distal nephron) epithelial Na(+) channel (ENaC)-mediated Na(+) absorption is inhibited via luminal P2 receptors. In distal mouse colon, we have identified that both, a luminal P2Y(2) and a luminal P2Y(4) receptor, stimulate K(+) secretion. In this study, we investigate the effect of luminal adenosine triphosphate/uridine triphosphate (ATP/UTP) on electrogenic Na(+) absorption in distal colonic mucosa of mice treated on a low Na(+) diet for more than 2 weeks. Transepithelial electrical parameters were recorded in an Ussing chamber. Baseline parameters: transepithelial voltage (V (te)): -13.7 +/- 1.9 mV (lumen negative), transepithelial resistance (R (te)): 24.1 +/- 1.8 Omega cm(2), equivalent short circuit current (I (sc)): -563.9 +/- 63.8 microA/cm(2) (n = 21). Amiloride completely inhibited I (sc) to -0.5 +/- 8.5 microA/cm(2). Luminal ATP induced a slowly on-setting and persistent inhibition of the amiloride-sensitive I (sc) by 160.7 +/- 29.7 microA/cm(2) (n = 12, NMRI mice). Luminal ATP and UTP were almost equipotent with IC(50) values of 10 microM and 3 microM respectively. In P2Y(2) knock-out (KO) mice, the effect of luminal UTP on amiloride-sensitve Na(+) absorption was absent. In contrast, in P2Y(4) KO mice the inhibitory effect of luminal UTP on Na(+) absorption remained present. Semiquantitative polymerase chain reaction did not indicate regulation of the P2Y receptors under low Na(+) diet, but it revealed a pronounced axial expression of both receptors with highest abundance in surface epithelia. Thus, luminal P2Y(2) and P2Y(4) receptors and ENaC channels co-localize in surface epithelium. Intriguingly, only the stimulation of the P2Y(2) receptor mediates inhibition of electrogenic Na(+) absorption. PMID:17356885

  3. On the transmission of sacral parasympathetic nervous influence on distal colonic and rectal motility in the cat.

    PubMed

    Hedlund, H; Fändriks, L; Delbro, D; Fasth, S

    1985-10-01

    Experiments were performed on cats anaesthetized with chloralose and treated with adrenoceptor blocking agents. Distal colonic and rectal motility were selectively recorded by a volumetric method. The effects of muscarinic and ganglionic nicotine receptor blockade on motor responses induced by graded efferent electrical pelvic nerve stimulation (PNS) were studied. Stimulation at low current strength evoked contractions in both the colon and the rectum, which were sensitive to atropine and to hexamethonium. High intensity stimulation elicited distal colonic contractions resistant to both atropine and hexamethonium. Similar excitatory responses to high strength PNS were also observed in the rectum, though not in all experiments. Stimulation at intermediate intensities evoked distal colonic and rectal relaxations which were resistant to atropine but blocked by hexamethonium. The results indicate that PNS influences colonic and rectal motility by activation of at least three discrete non-adrenergic nervous pathways: (1) low-threshold excitatory fibres involving nicotinic and muscarinic transmission, (2) high-threshold excitatory fibres with a non-muscarinic, non-nicotinic transmission mechanism, (3) inhibitory fibres with an intermediate stimulus intensity threshold, exerting their effect by a non-muscarinic mechanism involving a nicotinic step. PMID:2866661

  4. The secretory KCa1.1 channel localises to crypts of distal mouse colon: functional and molecular evidence.

    PubMed

    Sørensen, Mads V; Strandsby, Anne B; Larsen, Casper K; Praetorius, Helle A; Leipziger, Jens

    2011-11-01

    The colonic epithelium absorbs and secretes electrolytes and water. Ion and water absorption occurs primarily in surface cells, whereas crypt cells perform secretion. Ion transport in distal colon is regulated by aldosterone, which stimulates both Na(+) absorption and K(+) secretion. The electrogenic Na(+) absorption is mediated by epithelial Na(+) channel (ENaC) in surface cells. Previously, we identified the large conductance Ca(2+)-activated K(+) channel, K(Ca)1.1 or big potassium (BK) channel, as the only relevant K(+) secretory pathway in mouse distal colon. The exact localisation of K(Ca)1.1 channels along the crypt axis is, however, still controversial. The aim of this project was to further define the localisation of the K(Ca)1.1 channel in mouse distal colonic epithelium. Through quantification of mRNA extracted from micro-dissected surface and crypt cells, we confirmed that Na(+)/K(+)/2Cl(-) (NKCC1) is expressed primarily in the crypts and ?-ENaC primarily in the surface cells. The K(Ca)1.1 ?-subunit mRNA was like NKCC1, mainly expressed in the crypts. The crypt to surface expression pattern of the channels and transporters was not altered when plasma aldosterone was elevated. The mRNA levels for NKCC1, ?-ENaC and K(Ca)1.1 ?-subunit were, however, under these circumstances substantially augmented (K(Ca)1.1 ?-subunit, twofold; NKCC1, twofold and ENaC, tenfold). Functionally, we show that ENaC-mediated Na(+) absorption and BK channel-mediated K(+) secretion are two independent processes. These findings show that K(Ca)1.1-mediated K(+) secretion mainly occurs in the crypts of the murine distal colon. This is in agreement with the general model of ion secretion being preferentially located to the crypt and not surface enterocytes. PMID:21822598

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

    PubMed Central

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

    2014-01-01

    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

  6. Regulation of transepithelial ion transport in the rat late distal colon by the sympathetic nervous system.

    PubMed

    Zhang, X; Li, Y; Zhang, X; Duan, Z; Zhu, J

    2015-03-01

    The colorectum (late distal colon) is innervated by the sympathetic nervous system, and many colorectal diseases are related to disorders of the sympathetic nervous system. The sympathetic regulation of colorectal ion transport is rarely reported. The present study aims to investigate the effect of norepinephrine (NE) in the normal and catecholamine-depleted condition to clarify the regulation of the sympathetic adrenergic system in ion transport in the rat colorectum. NE-induced ion transport in the rats colorectum was measured by short-circuit current (I(sc)) recording; the expression of beta-adrenoceptors and NE transporter (NET) were quantified by real-time PCR, and western blotting. When the endogenous catecholamine was depleted by reserpine, the baseline I(sc) in the colorectum was increased significantly comparing to controls. NE evoked downward deltaI(sc) in colorectum of treated rats was 1.8-fold of controls. The expression of beta(2)-adrenoceptor protein in the colorectal mucosa was greater than the control, though the mRNA level was reduced. However, NET expression was significantly lower in catecholamine-depleted rats compared to the controls. In conclusion, the sympathetic nervous system plays an important role in regulating basal ion transport in the colorectum. Disorders of sympathetic neurotransmitters result in abnormal ion transport, beta-adrenoceptor and NET are involved in the process. PMID:25194126

  7. Active K transport across rabbit distal colon: relation to Na absorption and Cl secretion

    SciTech Connect

    Halm, D.R.; Frizzell, R.A.

    1986-08-01

    The authors measured isotopic unidirectional fluxes of K to elucidate the mechanisms of active K transport across the distal colon of the rabbit. Separate pathways for active K absorption and active K secretion were detected using various transport inhibitors and stimulators. The rate and direction of net USK transport depend on the activities of these two pathways. K absorption was reduced by orthovanadate (both solutions) or serosal Ba, consistent with ATPase-dependent uptake of K across the apical membrane and exit via a Ba-sensitive basolateral K conductance. K secretion was inhibited by serosal ouabain or mucosal Ba, indicating that K secretion involves basolateral uptake via the Na-K pump and apical exit via a Ba-sensitive K conductance. Active K secretion appears to be electrogenic, since inhibition by ouabain produced equivalent changes in the net K flux and short-circuit current. Addition of bumetanide to the serosal solution or the removal of either Na or Cl from the serosal solution inhibited K secretion; mucosal solutions amiloride was without effect. These results indicate that this K secretory process is independent of electrogenic Na absorption but is mechanistically similar to TWCl secretory processes. Both epinephrine and prostaglandin E2 (PGE2) stimulate K secretion, but only PGE2 also stimulates Cl secretion. The response to these secretogogues suggest that the mechanisms underlying K and Cl secretion are closely linked but can be regulated independently.

  8. Mechanisms of oxalate absorption and secretion across the rabbit distal colon.

    PubMed

    Hatch, M; Freel, R W; Vaziri, N D

    1994-01-01

    To further evaluate the mechanisms of oxalate (Ox2-) transport in the intestine the following studies were performed using isolated, short-circuited segments of the rabbit distal colon (DC). In control buffer, the DC absorbed Ox2- (net Ox2- flux, JNetOx = 5.4 +/- 0.7 pmol.cm-1.h-1). Replacement of Na+ with N-methyl-D-glucamine (NMDG+) abolished Ox2- absorption by decreasing mucosal to serosal Ox2- flux (JmsOx), without affecting Cl- transport, while gluconate substitution for Cl- did not affect JNetOx or net Na+ flux (JNetNa). Addition of Na+ to the serosal side of tissues bathed by NMDG+ buffer increased JmsOx 40% without altering mucosal to serosal Cl- flux (JmsCl). Serosal amiloride or dimethyl amiloride (10(-3) M) abolished JNetOx by decreasing JmsOx, it increased serosal to muscosal Cl- flux (JsmCl) and it gradually inhibited short-circuit current (Isc). Mucosal amiloride (10(-4) M) abolished Ise but had no effect on Ox2- or Cl- fluxes. Serosal 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid (DIDS, 10(-6) M) reduced JmsOx by 20% and JNetOx by 43% without affecting JmsCl or JNetCl. Dibutyryl cyclic adenosine monophosphate (dB-cAMP, 5 x 10(-4) M, both sides) stimulated Ox2- secretion (JNetOx = -12.6 +/- 3.3 pmol.cm-2.h-1). The dB-cAMP-induced secretion of Ox2- and Cl- were fully abolished by serosal furosemide (10(-4) M) and partially inhibited (35%) by 5 x 10(-4) M mucosal NPPB [5-nitro-2-(3-phenylpropylamino)-benzoic acid], a putative Cl- channel blocker.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8146012

  9. Cyclic AMP-dependent regulation of K+ transport in the rat distal colon.

    PubMed Central

    Diener, M.; Hug, F.; Strabel, D.; Scharrer, E.

    1996-01-01

    1. The effect of agonists of the cyclic AMP pathway and of 293B, a chromanole-derived K+ channel blocker, on K+ transport in the rat distal colon was studied by measuring unidirectional fluxes, uptake, and efflux of Rb+ in mucosa-submucosa preparations and by patch-clamp of crypt epithelia from isolated crypts. 2. 293B concentration-dependently inhibited basal and forskolin-stimulated short-circuit current. In isolated crypts 293B blocked a basal K+ conductance but had no effect on cyclic AMP-evoked depolarization induced by the opening of apical Cl- channels. When the effect of cyclic AMP on Cl- conductance was prevented by substituting Cl- with gluconate, an inhibition of total cellular K+ conductance by forskolin and a membrane-permeable cyclic AMP analogue was unmasked. 3. Unidirectional ion flux measurements revealed that 293B suppressed the increase in JRbsm induced by forskolin. This, together with the inhibition of cyclic AMP-induced anion secretion indicates that the drug blocks K+ channels, presumably both in the apical and the basolateral membrane. Forskolin caused not only inhibition of K+ absorption, but also stimulation of K+ secretion. The inhibition was diminished, but not blocked, in the presence of inhibitors of the apical H(+)-K(+)-ATPase, vanadate and ouabain. Forskolin stimulated serosal, bumetanide-sensitive Rb+ uptake, whereas mucosal, ouabain/vanadate-sensitive uptake remained unaffected. 4. Efflux experiments revealed that forskolin caused a redistribution of cellular K+ efflux reducing the ratio of basolateral versus apical Rb+ efflux. 5. These results suggest that intracellular cyclic AMP exerts its effects on K+ transport by several mechanisms: an increase in the driving force for K+ efflux due to the depolarization induced by opening of Cl- channels, a stimulation of the basolateral uptake of K+ via the Na(+)-K(+)-Cl(-)-cotransporter, and a decrease of the ratio of basolateral versus apical K+ conductance leading to an enhanced efflux of K+ into the lumen and a reduced K+ efflux to the serosal compartment. PMID:8832075

  10. Colonic phytobezoar as a rare cause of large bowel obstruction.

    PubMed

    Law, Gin Way; Lin, Diwei; Thomas, Rebecca

    2015-01-01

    Bezoars are masses formed by the concretion of stomach contents or debris within the gastrointestinal tract. Bezoars are rare and account for only 0.4-4% of all cases of gastrointestinal obstruction and mainly occur in the stomach or small intestine. Intestinal obstruction caused by colonic bezoars is extremely rare. We report a case of a distal sigmoid obstruction caused by a phytobezoar in a 60-year-old man with no obvious precipitating causes. He presented to the emergency department acutely unwell and a subsequent abdominal CT scan showed a mass within the proximal sigmoid colon suspicious for a bezoar. He proceeded to have an urgent laparotomy and the obstructive intraluminal mass in the sigmoid colon was identified and manually broken down. Subsequent histopathological assessment reported amorphous material and plant cellular matter consistent with the diagnosis of a phytobezoar. PMID:25858930

  11. Osteotomy for sigmoid notch obliquity and ulnar positive variance.

    PubMed

    Dickson, Lisa M; Tham, Stephen K Y

    2014-02-01

    Background?Several causes of ulnar wrist pain have been described. One uncommon cause is ulnar carpal abutment associated with a notable distally facing sigmoid notch (reverse obliquity). Such an abnormality cannot be treated with ulnar shortening alone because it will result in incongruity of the distal radioulnar joint (DRUJ). Case Description?A 23-year-old woman presented with ulnar wrist pain aggravated by forearm rotation. Ten years earlier she had sustained a distal radius fracture that was conservatively treated. Examination revealed mild tenderness at the DRUJ and decreased wrist flexion and grip strength on the affected side. Radiographic examination demonstrated 1 cm ulnar positive variance, ulnar styloid nonunion, and a 37° reverse obliquity of the sigmoid notch. The patient was treated with ulnar shortening and rotation sigmoid notch osteotomy to realign the sigmoid notch with the ulnar head. Literature Review?Sigmoid notch incongruity is one of several causes of wrist pain after distal radius fracture. Traditional salvage options for DRUJ arthritis may result in loss of grip strength, painful ulnar shaft instability, or reossification and are not acceptable options in the young patient. Sigmoid notch osteotomy or osteoplasty have been described to correct the shape of the sigmoid notch in the axial plane. Clinical Relevance?We report a coronal plane osteotomy of the sigmoid notch to treat reverse obliquity of the sigmoid notch associated with ulnar carpal abutment. The rotation osteotomy described is particularly useful for patients in whom a salvage procedure is not warranted. PMID:24533247

  12. Osteotomy for Sigmoid Notch Obliquity and Ulnar Positive Variance

    PubMed Central

    Dickson, Lisa M.; Tham, Stephen K. Y.

    2014-01-01

    Background?Several causes of ulnar wrist pain have been described. One uncommon cause is ulnar carpal abutment associated with a notable distally facing sigmoid notch (reverse obliquity). Such an abnormality cannot be treated with ulnar shortening alone because it will result in incongruity of the distal radioulnar joint (DRUJ). Case Description?A 23-year-old woman presented with ulnar wrist pain aggravated by forearm rotation. Ten years earlier she had sustained a distal radius fracture that was conservatively treated. Examination revealed mild tenderness at the DRUJ and decreased wrist flexion and grip strength on the affected side. Radiographic examination demonstrated 1 cm ulnar positive variance, ulnar styloid nonunion, and a 37° reverse obliquity of the sigmoid notch. The patient was treated with ulnar shortening and rotation sigmoid notch osteotomy to realign the sigmoid notch with the ulnar head. Literature Review?Sigmoid notch incongruity is one of several causes of wrist pain after distal radius fracture. Traditional salvage options for DRUJ arthritis may result in loss of grip strength, painful ulnar shaft instability, or reossification and are not acceptable options in the young patient. Sigmoid notch osteotomy or osteoplasty have been described to correct the shape of the sigmoid notch in the axial plane. Clinical Relevance?We report a coronal plane osteotomy of the sigmoid notch to treat reverse obliquity of the sigmoid notch associated with ulnar carpal abutment. The rotation osteotomy described is particularly useful for patients in whom a salvage procedure is not warranted. PMID:24533247

  13. Meat consumption and the risk of incident distal colon and rectal adenoma

    PubMed Central

    Ferrucci, L M; Sinha, R; Huang, W-Y; Berndt, S I; Katki, H A; Schoen, R E; Hayes, R B; Cross, A J

    2012-01-01

    Background: Most studies of meat and colorectal adenoma have investigated prevalent events from a single screening, thus limiting our understanding of the role of meat and meat-related exposures in early colorectal carcinogenesis. Methods: Among participants in the screening arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial who underwent baseline and follow-up sigmoidoscopy (n=17?072), we identified 1008 individuals with incident distal colorectal adenoma. We calculated odds ratios (ORs) and 95% confidence intervals (95% CIs) for associations between meat and meat-related components and incident distal colorectal adenoma using multivariate logistic regression. Results: We observed suggestive positive associations for red meat, processed meat, haeme iron, and nitrate/nitrite with distal colorectal adenoma. Grilled meat (OR=1.56, 95% CI=1.04–2.36), well or very well-done meat (OR=1.59, 95% CI=1.05–2.43), 2-amino-1-methyl-6-phenyl-imidazo[4,5-b]pyridine (PhIP) (OR=1.75, 95% CI=1.17–2.64), benzo[a]pyrene (OR=1.53, 95% CI=1.06–2.20), and total mutagenic activity (OR=1.57, 95% CI=1.03–2.40) were positively associated with rectal adenoma. Total iron (diet and supplements) (OR=0.69, 95% CI=0.56–0.86) and iron from supplements (OR=0.65, 95% CI=0.44–0.97) were inversely associated with any distal colorectal adenoma. Conclusion: Our findings indicate that several meat-related components may be most relevant to early neoplasia in the rectum. In contrast, total iron and iron from supplements were inversely associated with any distal colorectal adenoma. PMID:22166801

  14. Chronic obstipation in a leopard (Panthera pardus) caused by intrapelvic uterine leiomyoma compression of the distal colon.

    PubMed

    Siegal-Willott, Jessica L; Henrikson, Todd; Carpenter, James W; Andrews, Gordon A

    2005-09-01

    A 6-yr-old female leopard (Panthera pardus) was evaluated for a history of chronic obstipation of 4-mo duration. Radiographic, ultrasonographic, and computed tomographic evaluation revealed an intrapelvic mass that was compressing the distal colon. Because of the difficulties of postsurgical management of this animal, the owner requested euthanasia. On postmortem examination, a mass measuring 3 times 5 times 10 cm was found arising from the body of the uterus. Histopathologic evaluation of the mass revealed a leiomyoma of the uterus. This case report documents the presence of a uterine tumor in a large felid that resulted in constipation and obstipation. Additionally, the value and limitations of the imaging modalities used to provide diagnostic, prognostic, and treatment options are discussed. PMID:17312780

  15. Chromoendoscopy with Indigo Carmine in Flexible Sigmoidoscopy Screening: Does it Improve the Detection of Adenomas in the Distal Colon and Rectum?

    Microsoft Academic Search

    Nadia Ratiu; Cornelia Gelbmann; Heiko C. Rath; Hans Herfarth; Frank Kullmann; Jürgen Schölmerich

    Background and aims. The aim of our study was to determine whether chromoendoscopy with indigo carmine significantly improves the detection of adenomas in the distal colon and rectum and therefore could become routine in flexible sigmoidoscopy screening. Methods. Between 2001- 2003, two sigmoidoscopies, the first conventional, the second with chromoendoscopy, were performed in a \\

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

    SciTech Connect

    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

    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.

  17. Laparoscopic single-port colectomy for sigmoid cancer

    Microsoft Academic Search

    F. H. RemziH; H. T. Kirat; D. P. Geisler

    2010-01-01

    Background  Single-port laparoscopic surgery can be performed via one incision hidden in the umbilicus. Herein, we report a patient with\\u000a a sigmoid colon cancer undergoing single-port laparoscopic sigmoid colectomy.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Laparoscopic single-port sigmoid colectomy through a 3-cm umbilical incision was performed on a patient with a diagnosis of\\u000a sigmoid cancer. Patient was 54-year-old female with a body mass index of 25.8 kg\\/m2. Preoperatively,

  18. Cecal pneumatosis intestinalis in obstructing sigmoid cancer: emergency metallic stenting.

    PubMed

    Fong, Kai-Yu; Siao, Fu-Yuan; Yen, Hsu-Heng

    2014-04-01

    An 85-year-old man presented with acute abdomen. Abdominal computed tomography revealed obstructing sigmoid colon cancer with pneumatosis intestinalis of the ascending colon. A surgeon was consulted for colonic obstruction with impending sepsis, who declined surgery considering the patient's advanced age. After discussion, the patient consented for emergent endoscopic metallic colonic stent placement. Complete obstruction of the lumen was observed at the sigmoid colon, followed by successful metallic colonic stent placement through the obstructed area. Normal stool passage was achieved after this, and the patient survived the 9-month follow-up period. Acute colonic obstruction from obstructive colon cancer requires emergency management, wherein the presence of pneumatosis intestinalis poses a high risk of cecal perforation. Emergency endoscopic colonic metallic stent placement provides an alternative therapy, particularly when surgery is not feasible, as described here. PMID:24275044

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

    PubMed

    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

    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

  20. Elective laparoscopically assisted sigmoidectomy for the sigmoid volvulus

    Microsoft Academic Search

    J.-T. Liang; H.-S. Lai; P.-H. Lee

    2006-01-01

    Background  The laparoscopic approach for the treatment of sigmoid volvulus has been a rare surgical indication. This phase 2 study investigated\\u000a the feasibility and surgical outcomes of elective laparoscopic surgery for sigmoid volvulus.\\u000a \\u000a \\u000a \\u000a Methods  Patients with sigmoid volvulus were first offered colonoscopic decompression for their acute colonic obstruction. If the colonic\\u000a decompression was successful, complete bowel preparation was performed, followed by elective

  1. Sigmoid volvulus: is it a possible complication after stapled transanal rectal resection (STARR)?

    PubMed Central

    RESTA, G.; SCAGLIARINI, L.; BANDI, M.; VEDANA, L.; MARZETTI, A.; FERROCCI, G.; SANTINI, M.; ANANIA, G.; CAVALLESCO, G.; BACCARINI, M.

    2013-01-01

    Summary We report a case of sigmoid volvulus post-stapled transanal rectal resection (STARR) for obstructed defecation. The patient, a 68-year-old woman with chronic constipation and dolichosigma, two days post-STARR presented severe abdominal pain. CT revealed sigmoid ischemia. The patient underwent resection of the sigmoid colon with end colostomy (Hartmann’s procedure). Can STARR procedure produce a serious complication as sigmoid volvulus in patient with dolichosigma and obstructed defecation syndrome? PMID:24091179

  2. Complete colonic duplication in children

    PubMed Central

    Khaleghnejad Tabari, Ahmad; Mirshemirani, Alireza; Khaleghnejad Tabari, Nasibeh

    2012-01-01

    Background: Complete colonic duplication is a very rare congenital anomaly that may have different presentations according to its location and size. Complete colonic duplication can occur in 15% of gastrointestinal duplication. We report two cases of complete colonic duplications, and their characteristics. Case Presentation: We present two patients with complete colonic duplication with different types and presentations. Case 1: A 2- year old boy presented to the clinic with abdominal protrusion, difficulty to defecate, chronic constipation and mucosal prolaps covered bulging (rectocele) since he was 6 months old. The patient had palpable pelvic mass with doughy consistency. Rectal exam confirmed perirectal mass with soft consistency. The patient underwent a surgical operation that had total tubular colorectal duplication with one blind end and was treated with simple fenestration of distal end, and was discharged without complication. After two years follow up, he had normal defecation and good weight gain. Case 2: A 2 –day old infant was referred with imperforate anus and complete duplication of recto-sigmoid colon, diphallus, double bladder, and hypospadiasis. After clinical and paraclinical investigations, he underwent operations in several stages in different periods, and was discharged without complications. After four years follow up, he led a normal life. Conclusion: The patients with complete duplication have to be examined carefully because of the high incidence of other systemic anomalies. Treatment includes simple resection of distal common wall, fenestration, and repair other associated anomalies. PMID:24358440

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

    PubMed Central

    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

    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

  4. Effects of Hange-shashin-to (TJ-14) and Keishi-ka-shakuyaku-to (TJ-60) on contractile activity of circular smooth muscle of the rat distal colon.

    PubMed

    Kito, Yoshihiko; Teramoto, Noriyoshi

    2012-11-01

    The Japanese Kampo medicines Hange-shashin-to (TJ-14) and Keishi-ka-shakuyaku-to (TJ-60) have been used to treat symptoms of human diarrhea on an empirical basis as Japanese traditional medicines. However, it remains unclear how these drugs affect smooth muscle tissues in the distal colon. The aim of the present study was to investigate the effects of TJ-14 and TJ-60 on the contractile activity of circular smooth muscle from the rat distal colon. TJ-14 and TJ-60 (both 1 mg/ml) inhibited spontaneous contractions of circumferentially cut preparations with the mucosa intact. Blockade of nitric oxide (NO) synthase or soluble guanylate cyclase activity abolished the inhibitory effects of TJ-60 but only attenuated the inhibitory effects of TJ-14. Apamin (1 ?M), a blocker of small-conductance Ca(2+)-activated K(+) channels (SK channels), attenuated the inhibitory effects of 5 mg/ml TJ-60 but not those of 5 mg/ml TJ-14. TJ-14 suppressed contractile responses (phasic contractions and off-contractions) evoked by transmural nerve stimulation and increased basal tone, whereas TJ-60 had little effect on these parameters. These results suggest that 1 mg/ml TJ-14 or TJ-60 likely inhibits spontaneous contractions of the rat distal colon through the production of NO. Activation of SK channels seems to be involved in the inhibitory effects of 5 mg/ml TJ-60. Since TJ-14 has potent inhibitory effects on myogenic and neurogenic contractile activity, TJ-14 may be useful in suppressing gastrointestinal motility. PMID:22917628

  5. The guinea-pig distal colon--a sensitive preparation for the investigation of 5-HT4 receptor-mediated contractions.

    PubMed Central

    Wardle, K. A.; Sanger, G. J.

    1993-01-01

    1. Experiments were designed to characterize pharmacologically the contractile responses to 5-hydroxytryptamine (5-HT) in the guinea-pig isolated distal colon longitudinal muscle-myenteric plexus preparation (LMMP). 2. In the presence of methiothepin (100 nM) and granisetron (1 microM), 5-HT (10 pM-10 nM) produced concentration-dependent contractile responses of the guinea-pig distal colon LMMP, with a pEC50 of 9.2 +/- 0.08. 3. Responses to 5-HT were mimicked by a series of tryptamine analogues, with the following rank order of potency; 5-HT > 5-MeOT >> 5-CT > tryptamine > 2-Me-5-HT. All were found to be full agonists. 4. Responses to 5-HT were also mimicked by a series of substituted benzamide analogues. Their rank order of potency was 5-HT > renzapride > cisapride > (S)-zacopride > (R)-zacopride > metoclopramide. All were full agonists relative to 5-HT. 5. The benzimidazolone derivatives, BIMU 1 and BIMU 8 were approximately equipotent partial agonists (intrinsic activities of 0.8 +/- 0.07 and 0.5 +/- 0.08 respectively) in the guinea-pig distal colon. 6. Tropisetron produced a rightward displacement of the 5-HT concentration-effect curve, yielding an apparent pA2 of 6.4 +/- 0.1. The slope of the Schild plot (1.3 +/- 0.1) was significantly greater than unity. 7. SDZ 205,557 produced a concentration-dependent shift to the right of the 5-HT concentration-response curve, yielding an estimated pA2 of 7.8 +/- 0.1 and a slope which did not significantly deviate from unity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8306106

  6. Re-establish pneumoperitoneum in laparoscopic-assisted sigmoid resection?

    Microsoft Academic Search

    Roberto Bergamaschi; Jean Jacques Tuech; Charles Cervi; Jean-Pierre Arnaud

    2000-01-01

    PURPOSE: Operating room time and anastomosis-related morbidity of laparoscopic-assisted sigmoid resection with anastomosis performed in an open fashion through a horizontal suprapubic incision or laparoscopically after re-establishing pneumoperitoneum were compared. METHODS: A randomized trial was performed on patients with recurrent uncomplicated diverticulitis of the sigmoid colon during a 14-month period. Inclusion criteria were persistence of symptoms despite medical treatment and

  7. Laparoscopic Approach for Metachronous Cecal and Sigmoid Volvulus

    PubMed Central

    Greenstein, Alexander J.; Zisman, Sharon R.

    2010-01-01

    Background: Metachronous colonic volvulus is a rare event that has never been approached laparoscopically. Methods: Here we discuss the case of a 63-year-old female with a metachronous sigmoid and cecal volvulus. Results: The patient underwent 2 separate successful laparoscopic resections. Discussion and Conclusion: The following is a discussion of the case and the laparoscopic technique, accompanied by a brief review of colonic volvulus. In experienced hands, laparoscopy is a safe approach for acute colonic volvulus. PMID:21605523

  8. Progressive Proximal-to-Distal Reduction in Expression of the Tight Junction Complex in Colonic Epithelium of Virally-Suppressed HIV+ Individuals

    PubMed Central

    Chung, Charlotte Y.; Alden, Stephanie L.; Funderburg, Nicholas T.; Fu, Pingfu; Levine, Alan D.

    2014-01-01

    Effective antiretroviral therapy (ART) dramatically reduces AIDS-related complications, yet the life expectancy of long-term ART-treated HIV-infected patients remains shortened compared to that of uninfected controls, due to increased risk of non-AIDS related morbidities. Many propose that these complications result from translocated microbial products from the gut that stimulate systemic inflammation – a consequence of increased intestinal paracellular permeability that persists in this population. Concurrent intestinal immunodeficiency and structural barrier deterioration are postulated to drive microbial translocation, and direct evidence of intestinal epithelial breakdown has been reported in untreated pathogenic SIV infection of rhesus macaques. To assess and characterize the extent of epithelial cell damage in virally-suppressed HIV-infected patients, we analyzed intestinal biopsy tissues for changes in the epithelium at the cellular and molecular level. The intestinal epithelium in the HIV gut is grossly intact, exhibiting no decreases in the relative abundance and packing of intestinal epithelial cells. We found no evidence for structural and subcellular localization changes in intestinal epithelial tight junctions (TJ), but observed significant decreases in the colonic, but not terminal ileal, transcript levels of TJ components in the HIV+ cohort. This result is confirmed by a reduction in TJ proteins in the descending colon of HIV+ patients. In the HIV+ cohort, colonic TJ transcript levels progressively decreased along the proximal-to-distal axis. In contrast, expression levels of the same TJ transcripts stayed unchanged, or progressively increased, from the proximal-to-distal gut in the healthy controls. Non-TJ intestinal epithelial cell-specific mRNAs reveal differing patterns of HIV-associated transcriptional alteration, arguing for an overall change in intestinal epithelial transcriptional regulation in the HIV colon. These findings suggest that persistent intestinal epithelial dysregulation involving a reduction in TJ expression is a mechanism driving increases in colonic permeability and microbial translocation in the ART-treated HIV-infected patient, and a possible immunopathogenic factor for non-AIDS related complications. PMID:24968145

  9. Volvulus of the transverse colon in children--Report of a case and review of the literature.

    PubMed

    Black, R E; Cox, J A

    1984-02-01

    Sigmoid, cecal and transverse colon volvulus have been responsible for approximately 3% of all large bowel obstruction in the United States. Transverse colon volvulus is much less frequent, occurring in less than 4% of all reported cases of colonic torsion. In the pediatric age group a review of the literature revealed seven cases only, to which we are able to add an eighth. Predisposing abnormalities implicated in the etiology of volvulus of the transverse colon include a redundant transverse colon, an elongated mesentery and close attachment or lack of fixation of the proximal and distal transverse colon. Chronic constipation and mental retardation are associated with this condition. The treatment is surgical intervention to untwist the volvulus and resect the redundant and often nonviable colon with primary colocolostomy or end-colostomy and mucous fistula as indicated. PMID:6730709

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

    PubMed Central

    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

    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

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

    PubMed

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

    2015-02-01

    The colon differs regionally in local luminal environment, excretory function, and gene expression. Polycistronic microRNA (miR)-143 and miR-145 are downregulated early in colon cancer. We asked if these microRNAs (miRNAs) might be differentially expressed in the proximal vs. 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 blotting, 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 miRNAs were assessed following transfection with miR-143 or miR-145. Mean expression of mature miR-143 and miR-145 was 2.0-fold (P < 0.001) and 1.8-fold (P = 0.03) higher, respectively, in proximal than distal colon. DNA methylation or primary transcript expression of these miRNAs did not differ by location. In agreement with increased expression of miR-143 and miR-145 in proximal colon, predicted targets of these miRNAs, apoptosis inhibitor 5 (API5), ERK5, K-RAS, and insulin receptor substrate 1 (IRS-1), which are cell cycle and survival regulators, were expressed at a lower level in proximal than distal colon. Transfection of HCA-7 colon cancer cells with miR-145 downregulated IRS-1, and transfection of HT-29 colon cancer cells with miR-143 decreased K-RAS and ERK5 expression. In conclusion, miR-143 and miR-145 and the predicted target proteins API5, ERK5, K-RAS, 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

  12. Sigmoidal volvulus in childhood: Report of two cases

    Microsoft Academic Search

    Sumedha B. Taneja; Arun Kakar; Col R. D. Ayyar

    1977-01-01

    Summary  Volvulus of the sigmoid colon is a very uncommon cause of acute obstruction in children. Although common in adults in India,\\u000a it was found to account for only 0.8 per cent of all acute obstructions in infants and children in this institution. It causes\\u000a a proximal torsional obstruction of the colon with an acute onset of symptoms. the onset of

  13. Association of anorectal malformation with duplicated colon, sacral meningomyelocele and scrotal anomalies

    PubMed Central

    Singh, Sunita; Ahmed, Intezar; Rawat, Jiledar; Panday, Anand

    2011-01-01

    A 3-day-old male baby presented with anorectal agenesis, sacral meningomyelocele (MMC), bifurcated scrotal raphae, abdominal distension and septicaemia. X-ray in the prone position cross table view showed high anorectal malformation. On exploration for colostomy, an 8 cm terminal (sigmoid and descending colon) colonic tubular duplication was found. Both the colonic segments were communicating proximally to each other and distally with urinary bladder, along with complete anorectal agenesis. The excision and repair of the colovesical fistula were done. The colonic segment communicating proximally to the normal colon was exteriorised by window colostomy. The high-resolution ultrasonography of the scrotum revealed two well-developed testis. The bifurcated scrotal raphae and sacral MMC were left to be treated in the future. Unfortunately, the baby died in the immediate postoperative period due to ongoing sepsis. PMID:22689733

  14. Laparoscopic-assisted sigmoid colectomy for sigmoid volvulus.

    PubMed

    Sundin, J A; Wasson, D; McMillen, M M; Ballantyne, G H

    1992-12-01

    A 75-year-old black man came to the emergency room because of nausea, vomiting, abdominal pain, and distension and obstipation. An abdominal radiograph revealed a sigmoid volvulus. This was nonoperatively reduced in the emergency room. Following a mechanical and antibiotic bowel preparation, the patient underwent elective exploration. We report, for the first time, operative treatment of sigmoid volvulus with a laparoscopic-assisted sigmoid colectomy and primary anastomosis. Because of dense fibrous scarring of the sigmoid mesentery produced by chronic mesosigmoiditis, the redundant sigmoid was exteriorized and resected extracorporeally. A stapled, side-to-side, functional end-to-end anastomosis was constructed. The patient experienced little postoperative pain and virtually no postoperative ileus. We believe that laparoscopic-assisted sigmoid resection may offer distinct advantages for the treatment of the typically elderly, debilitated patient in whom sigmoid volvulus develops. Furthermore, because of the characteristic mesosigmoiditis associated with sigmoid volvulus, we suspect that exteriorization and extracorporeal resection may prove the easiest and most rapid laparoscopic approach to this disease. PMID:1341564

  15. Percutaneous Endoscopic Colostomy: A New Technique for the Treatment of Recurrent Sigmoid Volvulus

    PubMed Central

    Al-Alawi, Ibrahim K.

    2010-01-01

    Sigmoid volvulus is a common cause of large bowel obstruction in western countries and Africa. It accounts for 25% of the patients admitted to the hospital for large bowel obstruction. The acute management of sigmoid volvulus is sigmoidoscopic decompression. However, the recurrence rate can be as high as 60% in some series. Recurrent sigmoid volvulus in elderly patients who are not fit for definitive surgery is difficult to manage. The percutaneous endoscopic placement of two percutaneous endoscopic colostomy tube placement is a simple and relatively safe procedure. The two tubes should be left open to act as vents for the colon from over-distending. In our opinion, this aspect is key to its success as it keeps the sigmoid colon deflated until adhesions form between the colon and the abdominal wall. PMID:20339184

  16. [Follow-up and dietary advice after sigmoid diverticulitis].

    PubMed

    Barret, Maximilien; Abbes, Leila; Zinzindohoué, Franck

    2013-06-01

    Currently published data do not demonstrate the benefit of any medical treatment in the prevention of the onset or the recurrence of colonic diverticular disease. No specific diet can be recommended to patients with colonic diverticula for the prevention of diverticular disease. Non steroidal anti-inflammatory drugs as well as corticosteroids should be used cautiously in patients with diverticular disease since they induce a higher rate of complications, especially diverticular haemorrhage and severe sigmoid diverticulitis. In patients over 50 years old, or if a sigmoidectomy is needed, physicians should perform a colonoscopy in order to rule out colonic polyps or neoplasm. PMID:23923764

  17. Is serotonin in enteric nerves required for distension-evoked peristalsis and propulsion of content in guinea-pig distal colon?

    PubMed

    Sia, T C; Flack, N; Robinson, L; Kyloh, M; Nicholas, S J; Brookes, S J; Wattchow, D A; Dinning, P; Oliver, J; Spencer, N J

    2013-06-14

    Recent studies have shown genetic deletion of the gene that synthesizes 5-HT in enteric neurons (tryptophan hydroxylase-2, Tph-2) leads to a reduction in intestinal transit. However, deletion of the Tph-2 gene also leads to major developmental changes in enteric ganglia, which could also explain changes in intestinal transit. We sought to investigate this further by acutely depleting serotonin from enteric neurons over a 24-h period, without the confounding influences induced by genetic manipulation. Guinea-pigs were injected with reserpine 24h prior to euthanasia. Video-imaging and spatio-temporal mapping was used to record peristalsis evoked by natural fecal pellets, or slow infusion of intraluminal fluid. Immunohistochemical staining for 5-HT was used to detect the presence of serotonin in the myenteric plexus. It was found that endogenous 5-HT was always detected in myenteric ganglia of control animals, but never in guinea-pigs treated with reserpine. Interestingly, peristalsis was still reliably evoked by either intraluminal fluid, or fecal pellets in reserpine-treated animals that also had their entire mucosa and submucosal plexus removed. In these 5-HT depleted animals, there was no change in the frequency of peristalsis or force generated during peristalsis. In control animals, or reserpine treated animals, high concentrations (up to 10 ?M) of ondansetron and SDZ-205-557, or granisetron and SDZ-205-557 had no effect on peristalsis. In summary, acute depletion of serotonin from enteric nerves does not prevent distension-evoked peristalsis, nor propulsion of luminal content. Also, we found no evidence that 5-HT3 and 5-HT4 receptor activation is required for peristalsis, or propulsion of contents to occur. Taken together, we suggest that the intrinsic mechanisms that generate peristalsis and entrain propagation along the isolated guinea-pig distal colon are independent of 5-HT in enteric neurons or the mucosa, and do not require the activation of 5-HT3 or 5-HT4 receptors. PMID:23500097

  18. Sigmoid diverticulitis: US findings.

    PubMed

    Mazzei, Maria Antonietta; Cioffi Squitieri, Nevada; Guerrini, Susanna; Stabile Ianora, Amato Antonio; Cagini, Lucio; Macarini, Luca; Giganti, Melchiore; Volterrani, Luca

    2013-07-15

    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

  19. Membrane Protein Profiling of Human Colon Reveals Distinct Regional Differences *

    PubMed Central

    van der Post, Sjoerd; Hansson, Gunnar C.

    2014-01-01

    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

  20. Sigmoid volvulus in 16-year-old boy with an associated anomalous congenital band.

    PubMed

    Albert, Ann A; Nolan, Tracy L; Weidner, Bryan C

    2013-11-01

    Sigmoid volvulus, a condition generally seen in debilitated elderly patients, is extremely rare in the pediatric age group. Frequent predisposing conditions that accompany pediatric sigmoid volvulus include intestinal malrotation, omphalomesenteric abnormalities, Hirschsprung's disease, imperforate anus and chronic constipation. A 16-year-old previously healthy African American male presented with a 12 hour history of sudden onset abdominal pain and intractable vomiting. CT was consistent with sigmoid volvulus. A contrast enema did not reduce the volvulus, but it was colonoscopically reduced. Patient condition initially improved after colonoscopy, but he again became distended with abdominal pain, so he was taken to the operating room. On exploratory laparotomy, a band was discovered where the mesenteries of the sigmoid and small bowel adhered and created a narrow fixation point around which the sigmoid twisted. A sigmoidectomy with primary anastomosis was performed. The diagnosis of sigmoid volvulus may be more difficult in children, with barium enema being the most consistently helpful. Seventy percent of cases do not involve an associated congenital problem, suggesting that some pediatric patients may have congenital redundancy of the sigmoid colon and elongation of its mesentery. The congenital band found in our patient was another potential anatomic factor that led to sigmoid volvulus. Pediatric surgeons, accustomed to unusual problems in children, may thus encounter a condition generally found in the debilitated elderly patient. PMID:24165246

  1. Management of Colonic Volvulus

    PubMed Central

    Gingold, Daniel; Murrell, Zuri

    2012-01-01

    Colonic volvulus is a common cause of large bowel obstruction worldwide. It can affect all parts of the colon, but most commonly occurs in the sigmoid and cecal areas. This disease has been described for centuries, and was studied by Hippocrates himself. Currently, colonic volvulus is the third most common cause of large bowel obstruction worldwide, and is responsible for ?15% of large bowel obstructions in the United States. This article will discuss the history of colonic volvulus, and the predisposing factors that lead to this disease. Moreover, the epidemiology and diagnosis of each type of colonic volvulus, along with the various treatment options will be reviewed. PMID:24294126

  2. Single-port laparoscopic surgery for sigmoid volvulus

    PubMed Central

    Choi, Byung Jo; Jeong, Won Jun; Kim, Say-June; Lee, Sang Chul

    2015-01-01

    AIM: To report our experience with single-port laparoscopic surgery (SPLS) for sigmoid volvulus (SV). METHODS: Between October 2009 and April 2013, 10 patients underwent SPLS for SV. SPLS was performed transumbilically or through a predetermined stoma site. Conventional straight and rigid-type laparoscopic instruments were used. After intracorporeal, segmental resection of the affected sigmoid colon, the specimen was extracted through the single-incision site. Patient demographics and perioperative data were analyzed. RESULTS: SPLS for SV was successful in all 10 patients (4, resection and primary anastomosis; 6, Hartmann’s procedure). The median operative time and postoperative hospitalization period were 168 (range, 85-315) min and 6.5 (range, 4-29) d, respectively. No intraoperative complications were noted; there were 2 postoperative complications, including 1 anastomotic leak. CONCLUSION: SPLS was a safe and feasible therapeutic approach for SV, when performed by a surgeon experienced in conventional laparoscopic surgery. PMID:25741145

  3. A Rare Case Presentation of a Perforated Giant Sigmoid Diverticulum

    PubMed Central

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

    2013-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

  5. Rectal and colonic carcinoids. A clinicopathologic study of 84 cases.

    PubMed

    Federspiel, B H; Burke, A P; Sobin, L H; Shekitka, K M

    1990-01-01

    Eighty-four carcinoids of the colon and rectum were studied with emphasis on prognostic features, immunohistochemical characteristics, and pitfalls in diagnosis. Follow-up data were available on 35 patients. Tumors with adenocarcinomatous components, or those resembling small cell carcinomas of the lung, were excluded. Eighty-one tumors were in the rectum and three tumors were in the distal sigmoid colon. Neuron-specific enolase, chromogranin, and Leu-7 were positive in 87%, 58%, and 53% of the tumors, respectively. Hormones were positive in the following percentages: serotonin, 45%; pancreatic polypeptide, 46%; glucagon, 10%; gastrin, 3%; somatostatin, 3%; adrenocorticotrophic hormone, 1%; cholecystokinin, 0%; calcitonin, 0%; and insulin, 0%. Many tumors elaborated more than one hormone. Fifty-five percent of the tumors were argyrophil and 28% were argentaffin. Carcinoembryonic antigen was present in 24% of the tumors; 82% of the tumors contained prostatic acid phosphatase. Three patients had liver metastases; their tumors ulcerated, invaded muscularis propria, and had more than 2 mitoses per 10 high-power fields (HPF). One patient with a 2.5-cm tumor without mitoses had regional lymph node metastases. All non-metastasizing tumors had less than one mitosis in 10 HPF. We conclude that large bowel carcinoid tumors are essentially limited to the rectum and sigmoid, that they are indolent if mitotically inactive and smaller than 2 cm, and that most show production of a selected group of endocrine markers. PMID:2293859

  6. Giant colonic volvulus due to colonic pseudo-obstruction.

    PubMed

    Karaman, Kerem; Tanoglu, Alpaslan; Beyazit, Yavuz; Han, Ismet

    2015-01-01

    Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome, is a clinical syndrome characterised by gross dilation of the caecum and right hemicolon, which sometimes extends to the sigmoid colon and rectum in the absence of an anatomic lesion in the intestinal lumen. It is characterised by impaired propulsion of contents of the gastrointestinal tract, which results in a clinical picture of intestinal obstruction. A careful examination of the markedly distended colon can exclude several colonic pathologies, including mechanical obstruction and other causes of toxic megacolon. ACPO can sometimes predispose or mimic colonic volvulus, especially in geriatric patients. PMID:25716038

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

    PubMed Central

    2014-01-01

    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

  8. Sigmoid Volvulus Complicating Pregnancy: A Case Report

    PubMed Central

    Atamanalp, Sabri Selcuk; Kisaoglu, Abdullah; Ozogul, Bunyami; Kantarci, Mecit; Disci, Esra; Bulut, O. Hakan; Aksungur, Nurhak; Atamanalp, Refik Selim

    2015-01-01

    Sigmoid volvulus during pregnancy is a rare complication, and as of 2012, fewer than 100 cases had been reported. In this report, we present a 30 year-old pregnant woman with sigmoid volvulus, and we discuss this rare entity. PMID:25745351

  9. Colonic carcinoma presenting as strangulated inguinal hernia: report of two cases and review of the literature.

    PubMed

    Slater, R; Amatya, U; Shorthouse, A J

    2008-09-01

    Inguinal hernia and colonic carcinoma are common surgical conditions, yet carcinoma of the colon occurring within an inguinal hernia sac is rare. Of 25 reported cases, only one was a perforated sigmoid colon carcinoma in an inguinal hernia. We report two cases of sigmoid colon carcinoma, one of which had locally perforated. Each presented within a strangulated inguinal hernia. Oncologically correct surgery in these patients presents a technical challenge. PMID:18798013

  10. The Whirl CT Sign in Patient with Sigmoid Volvulus due Chagas' Disease.

    PubMed

    da Fonseca, Leonardo Maciel; Caldeira, Daniel Adonai Machado

    2013-04-01

    It is believed that sigmoid volvulus (SV) in Brazil is a frequent complication of megacolon caused by Chagas' disease (CD), differing in some characteristics from volvulus found in other countries. Bowel obstruction in patients with CD, principally when the cause is SV, may be sometimes difficult to diagnosis exclusively with plain abdominal radiograph. Fecaloma impacted in retossigmoidal area is one of the differential diagnoses. In addition, the huge amount of gas and feces, and distension of the colon normally increase the difficulty to make the correct diagnostic. The use of computer tomography (CT) scan can easy elucidate the picture of SV, and can be a great tool in cases of patients with CD and suspicion of this entity. A 62-year-old man showed bowel distention and stop disposal of gas for 5 days. He had previous diagnosis of CD. He also had been suffering from chronic constipation for several years, including impacted fecaloma, with the necessity of manual extraction. Plain abdominal radiographs showed an important colon dilatation and gross amount of feces in the sigmoid colon. Abdominal computer tomography sacan revealed dilated colon filled with feces, as well, the "whirl sign" composed of mesentery and twisted colon. When abdominal radiograph films reveal gross colonic dilatation of unknown etiology in patients with CD, a whirl sign on CT scans raises the possibility of colonic volvulus. PMID:24426419

  11. Multiple mineralocorticoid response elements localized in different introns regulate intermediate conductance K+ (Kcnn4) channel expression in the rat distal colon.

    PubMed

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

    2014-01-01

    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

  12. Mean Field Theory for Sigmoid Belief Networks

    E-print Network

    Saul, Lawrence K.

    1996-08-01

    We develop a mean field theory for sigmoid belief networks based on ideas from statistical mechanics. Our mean field theory provides a tractable approximation to the true probability distribution in these networks; it ...

  13. Angiolipomatous mesenchymal hamartoma (angiolipomatosis) of the sigmoid mesocolon

    PubMed Central

    Demir, Resit; Schmid, Axel; Hohenberger, Werner; Agaimy, Abbas

    2011-01-01

    Background: Primary mesenteric tumors are exceedingly rare and may thus pose a diagnostic challenge. They encompass both benign and malignant neoplasms as well as reactive and idiopathic tumefactive fibroinflammatory lesions. Method and results: A 70-year-old man who was diagnosed with sigmoid colon cancer was found to have a large non-homogeneous predominantly fatty retroperitoneal soft tissue mass on computerized tomography (CT) scan. The mass was attached to the aorta and have encased the inferior mesenteric artery and extended into the sigmoid mesocolon. Histological examination of the mass showed ill-defined lipoma-like mature fatty tissue traversed by paucicellular fibrous septa entrapping small nerves and containing remarkably increased venous blood vessels reminiscent of soft tissue angiomatosis without evidence of malignancy. The histological features were consistent with an angiolipomatous hamartomatous mesenchymal proliferation. Conclusions: Angiolipomatous hamartoma might be histogenetically related to soft tissue angiomatosis. To our knowledge, this case represents the first well documented lesion of this type at this location and must be distinguished from other fat-containing masses, particularly angiomyolipoma, sclerosing mesenteritis and mesenteric liposarcoma. PMID:21326818

  14. Perinephric Urinoma Due to Locally Advanced Recto-Sigmoid Tumor: Incidental Finding on Bone Scan

    PubMed Central

    Al Tamimi, Ammad Shanoon Marzooq; Magsombol, Butch; Ng, Arthur; Ng, David

    2014-01-01

    We are presenting a 59 years old man with locally advanced recto-sigmoid colon cancer; complaining of left flank pain and bone scan was done to rule out bone metastases. Findings in bone scan were suggesting left renal obstruction, but further SPECT/CT imaging to localize the uptake revealed a perinephric collection likely due to leak from the left ureter close to tumor site. PMID:25191129

  15. Perinephric urinoma due to locally advanced recto-sigmoid tumor: incidental finding on bone scan.

    PubMed

    Al Tamimi, Ammad Shanoon Marzooq; Magsombol, Butch; Ng, Arthur; Ng, David

    2014-05-01

    We are presenting a 59 years old man with locally advanced recto-sigmoid colon cancer; complaining of left flank pain and bone scan was done to rule out bone metastases. Findings in bone scan were suggesting left renal obstruction, but further SPECT/CT imaging to localize the uptake revealed a perinephric collection likely due to leak from the left ureter close to tumor site. PMID:25191129

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

    PubMed Central

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

    2014-01-01

    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

  17. Use of trephine stoma in sigmoid volvulus

    Microsoft Academic Search

    Daniel M. Caruso; Andrew A. Kassir; Ramon A. Robles; Michael W. Gregory; Ryan B. Tsujimura; Peter Cheung; Peter J. Ferrara

    1996-01-01

    Introduction: Sigmoid volvulus is a disease of the elderly who often have severe comorbid conditions that increase their operative risk and limit treatment options. Conservative treatment with decompressionviasigmoidoscopy with rectal tube placement has high success and recurrence rates. Surgical resection with primary anastomosis is the treatment of choice when decompression fails or if the volvulus recurs. Unfortunately, perioperative complications are

  18. An embedded sigmoidal neural network for modeling of nonlinear systems

    Microsoft Academic Search

    Jinglu Hu; Kotaro Hirasawa

    2001-01-01

    This paper discusses the problem of applying sigmoidal neural network to prediction and control of nonlinear dynamical systems. Instead of directly using neural networks as nonlinear models, we first develop a shield based on application specific knowledge, and then embed a sigmoidal neural network model in the shield. An embedded sigmoidal neural network model obtained in this way not only

  19. Influence of spices on the bacterial (enzyme) activity in experimental colon cancer

    Microsoft Academic Search

    N Nalini; K Sabitha; P Viswanathan; V. P Menon

    1998-01-01

    In the presence of a known colon carcinogen, 1,2-dimethyl hydrazine (DMH), the activity of ?-glucuronidase was found to be significantly increased in the distal colon, distal intestine, liver and colon contents and the activity of mucinase was increased in both the colon and fecal contents when compared to control rats. Chilli (Capsicum annum L., Solanaceae) administration also showed an increase

  20. Effects of Local Ischemia and Bacterial Flora on Healing of Experimental Colonic Anastomoses

    Microsoft Academic Search

    D. K. Wilker; J. R. Izbicki; J. Sklarek; B. Passlick; R. Huber; R. W. Kenn; H. Waldner

    1992-01-01

    In the present study the effects of local bowel perfusion on anastomotic healing of experimental colonic anastomoses were evaluated in 54 female chinchilla rabbits. Local ischemia was induced by devascularization of the sigmoid colon. Animals were randomly allocated to 4 operative groups. In the animals of group 1 a colo-colonic anastomosis was performed in an area graded as ischemia grade

  1. Distal Convoluted Tubule

    PubMed Central

    Ellison, David H.

    2014-01-01

    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

  2. "Cat Scratch Colon" in a Patient with Ischemic Colitis

    PubMed Central

    Park, Eui Ju; Lee, Tae Hee; Choi, Dae Han; Kim, Eui Bae; Jeon, Seong Ran; Hong, Su Jin; Kim, Jin-Oh

    2015-01-01

    "Cat scratch colon" is a gross finding characterized by hemorrhagic mucosal scratches on colonoscopy. It is usually associated with a normal colon and is rarely associated with collagenous colitis. In a previous report, cat scratch colon was noted in the cecum and ascending colon, but has also been observed in the distal transverse colon. The patient in this study was also diagnosed with ischemic colitis that may have played a role in the development of cat scratch colon.

  3. Gastrointestinal transit and prolonged ambulatory colonic motility in health and faecal incontinence

    PubMed Central

    Herbst, F; Kamm, M; Morris, G; Britton, K; Woloszko, J; Nicholls, R

    1997-01-01

    Background—Colonic motor function has not been studied in the ambulatory setting over a prolonged period in the unprepared state. Furthermore, the disturbance of this function in patients with faecal incontinence is unknown. ?Aim—To study colonic function over two to three days in the ambulatory, unprepared state in health and in patients with idiopathic faecal incontinence. ?Methods—Six healthy women and six women with faecal incontinence and a structurally intact anal sphincter ingested a dual radioisotope meal, and had a six sensor, solid state manometric probe colonoscopically inserted into the left colon. Scanning was performed until radioisotope left the gut and pressure was recorded for a median of 44hours. ?Results—Three of six patients showed abnormal gastric emptying. Patients showed no disturbance of colonic radioisotope transit. Controls had a median of 12, whereas patients had a median of 16, high amplitude propagated waves per 24 hours. In three patients urge incontinence was associated with high amplitude (up to 500 cm water) propagated waves which often reached the rectum. These high pressure waves were identical to those occuring in healthy subjects, the only difference being the lack of adequate sphincter response. Passive incontinence was not associated with colonic motor activity. Defaecation in all subjects was associated with identical propagated waves, and distal movement of 13% (median) of right colonic content and excretion of 32% from the left colon and rectum. The urge to defaecate was associated with either propagated waves (45%) or non-propagated contractions (55%). Rectal motor complexes were recorded in both groups of subjects, but similar rhythmic activity was also recorded in the sigmoid and descending colon. ?Conclusions—Normal colonic function consists of frequent high pressure propagated waves. Rhythmic activity occurs both proximal to and in the rectum. Defaecation is characterised by high pressure propagated waves associated with coordinated anal sphincter relaxation. Patients with faecal incontinence may have a widespread disturbance of gut function. Urge incontinence, an urge to defaecate, and defaecation can all be associated with identical high amplitude propagated pressure waves. ?? Keywords: colonic motility; gastric emptying; faecal incontinence PMID:9378396

  4. Position paper: management of perforated sigmoid diverticulitis

    PubMed Central

    2013-01-01

    Over the last three decades, emergency surgery for perforated sigmoid diverticulitis has evolved dramatically but remains controversial. Diverticulitis is categorized as uncomplicated (amenable to outpatient treatment) versus complicated (requiring hospitalization). Patients with complicated diverticulitis undergo computerized tomography (CT) scanning and the CT findings are used categorize the severity of disease. Treatment of stage I (phlegmon with or without small abscess) and stage II (phlegmon with large abscess) diverticulitis (which includes bowel rest, intravenous antibiotics and percutaneous drainage (PCD) of the larger abscesses) has not changed much over last two decades. On the other hand, treatment of stage III (purulent peritonitis) and stage IV (feculent peritonitis) diverticulitis has evolved dramatically and remains morbid. In the 1980s a two stage procedure (1st - segmental sigmoid resection with end colostomy and 2nd - colostomy closure after three to six months) was standard of care for most general surgeons. However, it was recognized that half of these patients never had their colostomy reversed and that colostomy closure was a morbid procedure. As a result starting in the 1990s colorectal surgical specialists increasing performed a one stage primary resection anastomosis (PRA) and demonstrated similar outcomes to the two stage procedure. In the mid 2000s, the colorectal surgeons promoted this as standard of care. But unfortunately despite advances in perioperative care and their excellent surgical skills, PRA for stage III/IV diverticulitis continued to have a high mortality (10-15%). The survivors require prolonged hospital stays and often do not fully recover. Recent case series indicate that a substantial portion of the patients who previously were subjected to emergency sigmoid colectomy can be successfully treated with less invasive nonoperative management with salvage PCD and/or laparoscopic lavage and drainage. These patients experience a surprisingly lower mortality and more rapid recovery. They are also spared the need for a colostomy and do not appear to benefit from a delayed elective sigmoid colectomy. While we await the final results ongoing prospective randomized clinical trials testing these less invasive alternatives, we have proposed (based primarily on case series and our expert opinions) what we believe safe and rationale management strategy. PMID:24369826

  5. Determinants of Recurrence After Sigmoid Resection for Uncomplicated Diverticulitis

    Microsoft Academic Search

    Klaus Thaler; Mirza K. Baig; Mariana Berho; Eric G. Weiss; Juan J. Nogueras; J. P. Arnaud; Steven D. Wexner; Roberto Bergamaschi

    2003-01-01

    PURPOSE: This study aimed to evaluate the impact of surgery-associated variables on recurrence rates after sigmoid resection for diverticulitis. METHODS: Patients who underwent elective sigmoid resection for uncomplicated diverticulitis between 1992 and 2000 at two tertiary referral centers were followed up for recurrent disease as the primary end point. Recurrence after surgery was defined as left lower quadrant pain, fever,

  6. Semiconstrained Distal Radioulnar Joint Prosthesis

    PubMed Central

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

    2013-01-01

    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

  7. Incidental Phaeochromocytoma on Staging PET-CT in a Patient with a Sigmoid Tumour and Situs Inversalis Totalis

    PubMed Central

    Boland, M. R.; Lowery, A. J.; Walsh, S.; Beddy, D.; Prichard, R. S.; O'Shea, D.; Skehan, S. J.; McDermott, E. W.

    2014-01-01

    An adrenal “incidentaloma” is defined as an unexpected finding on radiological imaging performed for unrelated indications. Improvements in radiological technology have seen a dramatic increase in this phenomenon. We report the unique case of a 60-year-old female presenting with a 6-month history of abdominal pain, altered bowel habit, and rectal bleeding. Her past medical history included situs inversus totalis and a patent ductus arteriosus. Colonoscopy revealed an ulcerated tumour in her sigmoid colon. Staging PET-CT confirmed a sigmoid tumour and also identified a large heterogenous enhancing FDG-avid right adrenal mass. Biochemical testing/MIBG imaging confirmed a right adrenal phaeochromocytoma. Hypertension was controlled and excision was performed via a transperitoneal laparoscopic adrenalectomy, in the left lateral decubitus position. Uniquely, liver retraction was not required due to its position in the left hypochondrium. Histology confirmed a benign 46?mm phaeochromocytoma. Subsequent uncomplicated sigmoid colectomy/right salpingo-oophorectomy for a locally advanced colonic tumour was performed with adjuvant chemotherapy. This case highlights the importance of accurately identifying functioning adrenal tumours before elective surgery as undiagnosed phaeochromocytomas carry significant intraoperative morbidity/mortality. Right adrenalectomy was made easier in this patient by the liver's unique position. Uncomplicated colorectal resection was made possible by combined preoperative functional/anatomical imaging. PMID:25110602

  8. Robotic Distal Pancreatectomy

    PubMed Central

    Rutledge, John; Yiengpruksawan, Anusak

    2013-01-01

    Background: A robotic-assisted minimal invasive approach has the potential to overcome the limitations of conventional laparoscopic pancreatectomies. We analyzed the outcomes of robotic-assisted distal pancreatectomies (RDPs) to demonstrate the safety and feasibility of robotic distal pancreas resection, including spleen preservation. Methods: We performed a descriptive retrospective analysis of 40 RDPs. Statistical comparisons were performed between two groups of patients undergoing robotic-assisted spleen-preserving distal pancreatectomy (SPDP) and distal pancreatectomy with splenectomy (SDP). Survival analysis was performed using the Kaplan-Meier method. Results: Of 49 attempted RDPs, 40 were completed with robotic assistance, with a conversion rate of 18.4%. Compared with the published reports of laparoscopic distal pancreatotomy (DP) and robotic DP, the spleen preservation rate (30%), operating time (203 minutes), major complications rate (5%), fistula rate (20%), and length of hospital stay (5 days) were similar in our RDP patients. Also, the perioperative outcomes of the SPDP and SDP groups did not differ significantly. The median survival was 12.5 months for the patients undergoing RDP for pancreatic ductal adenocarcinoma. Conclusions: Robotic-assisted distal pancreatectomy, with or without splenic preservation, can be safely performed for lesions of the distal pancreas, with appropriate indications. PMID:24398207

  9. 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 ...

  10. Sigmoid Perforation Following Radiation Therapy in Patients with Cervical Cancer

    Microsoft Academic Search

    Pedro T. Ramirez; Charles Levenback; Thomas W. Burke; Patricia Eifel; Judith K. Wolf; David M. Gershenson

    2001-01-01

    Objective. We describe the clinical presentation, evaluation, management, and outcome of patients experiencing sigmoid perforation following radiation therapy for cervical cancer.Methods. A database consisting of over 5000 patients with stage IB–IIIB cervix cancer treated between 1963 and 1992 revealed 35 patients with sigmoid perforation. Twenty-seven were diagnosed and managed at one institution, and they form the study group.Results. The median

  11. Sigmoid Carcinoma in an Inguinal Hernia: A Blessing in Disguise?

    PubMed Central

    Salemans, P. B.; Vles, G. F.; Fransen, S. A. F.; Smeenk, R. M.

    2013-01-01

    Colorectal cancer is a rising problem, as the incidence increases with age. In most cases the goal of treatment is oncological resection followed by adjuvant chemotherapy in order to optimize the survival. In this case report we present a 93-year-old patient with a sigmoid carcinoma inside an irreducible inguinal hernia, which was diagnosed prior to surgery. We chose to perform a sigmoid resection through an oblique inguinal incision as a safer alternative to laparotomy. PMID:24381780

  12. Biotin absorption by distal rat intestine

    SciTech Connect

    Bowman, B.B.; Rosenberg, I.H.

    1987-12-01

    We used the in vivo intestinal loop approach, with short (10-min) and long (3-h) incubations, to examine biotin absorption in proximal jejunum, distal ileum, cecum and proximal colon. In short-term studies, luminal biotin disappearance from rat ileum was about half that observed in the jejunum, whereas absorption by proximal colon was about 12% of that in the jejunum. In 3-h closed-loop studies, the absorption of 1.0 microM biotin varied regionally. Biotin absorption was nearly complete in the small intestine after 3 h; however, only about 15% of the dose had been absorbed in the cecum and 27% in the proximal colon after 3 h. Independent of site of administration, the major fraction of absorbed biotin was recovered in the liver; measurable amounts of radioactive biotin were also present in kidney and plasma. The results support the potential nutritional significance for the rat of biotin synthesized by bacteria in the distal intestine, by demonstrating directly an absorptive capability of mammalian large bowel for this vitamin.

  13. Revisiting colostomy irrigation: a viable option for persons with permanent descending and sigmoid colostomies.

    PubMed

    Kent, Dea J; Arnold Long, Mary; Bauer, Carole

    2015-01-01

    Colostomy irrigation (CI) is the regular irrigation of the bowel for persons with a permanent colostomy of the descending or sigmoid colon. Although this technique was first described in the 1920s, a recent study of 985 WOC nurses found that almost half (47%) do not routinely teach CI to persons with colostomies. In a systematic review (Evidence-Based Report Card) published in this issue of the Journal, we summarized current best evidence concerning the effect of CI on bowel function and found that irrigation reduces the frequency of bowel elimination episodes and allows some patients to reduce or eliminate ongoing use of a pouching system. This article describes techniques for teaching CI and discussed additional findings associated with CI. PMID:25734459

  14. Appropriate treatment of acute sigmoid volvulus in the emergency setting

    PubMed Central

    Lou, Zheng; Yu, En-Da; Zhang, Wei; Meng, Rong-Gui; Hao, Li-Qiang; Fu, Chuan-Gang

    2013-01-01

    AIM: To investigate an appropriate strategy for the treatment of patients with acute sigmoid volvulus in the emergency setting. METHODS: A retrospective review of 28 patients with acute sigmoid volvulus treated in the Department of Colorectal Surgery, Changhai Hospital, Shanghai from January 2001 to July 2012 was performed. Following the diagnosis of acute sigmoid volvulus, an initial colonoscopic approach was adopted if there was no evidence of diffuse peritonitis. RESULTS: Of the 28 patients with acute sigmoid volvulus, 19 (67.9%) were male and 9 (32.1%) were female. Their mean age was 63.1 ± 22.9 years (range, 21-93 years). Six (21.4%) patients had a history of abdominal surgery, and 17 (60.7%) patients had a history of constipation. Abdominal radiography or computed tomography was performed in all patients. Colonoscopic detorsion was performed in all 28 patients with a success rate of 92.8% (26/28). Emergency surgery was required in the other two patients. Of the 26 successfully treated patients, seven (26.9%) had recurrent volvulus. CONCLUSION: Colonoscopy is the primary emergency treatment of choice in uncomplicated acute sigmoid volvulus. Emergency surgery is only for patients in whom nonoperative treatment is unsuccessful, or in those with peritonitis. PMID:23946604

  15. The role of immunohistochemistry in diagnosing a synchronous colon tumor.

    PubMed

    Ciobanu, Daniela; Me?in?, Cristian; Streba, Liliana; Gruia, Corina Lavinia; Di?escu, Damian; ?arl?, C?lin Gabriel; Enescu, Aurelia; Petrescu, Florin

    2014-01-01

    Simultaneous presence of an epithelial and lymphoid tumor of the digestive tract is quite rarely met in literature. In this paper, we describe a case which presented such an association. Diagnosis was established by histological study, followed by immunohistochemistry. It is a synchronous colon tumor, associating a non-Hodgkin's lymphoma to a colon adenocarcinoma. The 57-year-old male patient has been clinically diagnosed with a tumor of the left abdominal quadrant and paraclinically (imaging and endoscopic) with colon neoplasm. Exploratory laparotomy revealed two tumors: one tumor of five centimeters in the sigmoid, with firm consistency, mobile on lower plans and the second tumor in the ceco-ascending colon, measuring about 7 cm, irregular, with firm consistency, mobile on lower plans, with lymph nodes extending to retroperitoneal space. The urinary bladder, kidneys, liver and stomach were of normal aspect. Subtotal colectomy was performed with latero-lateral ileo-sigmoid anastomosis. Microscopic examination revealed sigmoid tumor as G1 adenocarcinoma and cecal tumor as B-cell type lymphoma. Immunohistochemistry established the final diagnosis of cecal localization being a diffuse immunoblastic large B-cell non-Hodgkin's malignant lymphoma. The final diagnosis of this patient was actually a synchronous manifestation of a colon adenocarcinoma and non-Hodgkin's lymphoma. This association puts into question synchronous tumors etiopathogeny matter. PMID:25607408

  16. More patients should undergo surgery after sigmoid volvulus

    PubMed Central

    Ifversen, Anne Kathrine Wewer; Kjaer, Daniel Willy

    2014-01-01

    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. PMID:25561806

  17. Synchronous ileal carcinoid and primary colonic neoplasms: a case report.

    PubMed

    Aslam, Muhammad Imran; Salha, Imen Ben; Muller, Salli; Jameson, John Stuart

    2009-01-01

    Primary colonic tumours with synchronous ileal carcinoid tumours are rare in occurrence and are mainly found incidentally on autopsies or pathological examination of resected surgical specimens. This article describes a case of adenomatous colonic polyps, adenocarcinoma of sigmoid colon and concurrent malignant carcinoid tumour of ileocaecal junction, detected on colonoscopic examination. The radiological staging investigations revealed no distant spread of disease. The patient was effectively treated with subtotal colectomy, resection of terminal ileum, excision of locoregional lymph nodes and the bowel continuity was restored with stapled ileo-rectal anastomosis. This article is as an example of concomitant presence of two types of malignant tumours, effectively managed surgically. PMID:19918418

  18. Distal nephron neoplasms.

    PubMed

    Fleming, Stewart

    2015-03-01

    Tumours of the distal nephron are uncommon but can create diagnostic difficulties. They may be divided into three groups-tumours of intercalated cell phenotype, those of principal cell phenotype and others with an unconfirmed distal nephron origin. Oncocytomas, chromophobe carcinoma and hybrid oncocytoma chromophobe carcinoma, all show features of intercalated cells and the distinction amongst these is one of the most common areas of diagnostic dilemma. Collecting duct carcinoma and renal medullary carcinoma are the most aggressive forms of renal cancer but recent evidence suggests they may respond to targeted therapy so their recognition becomes crucial to the management of these patients. There remains debate over the precise phenotype of both tubulocystic carcinoma and mucinous tubular and spindle cell carcinoma. PMID:25804446

  19. Distal radioulnar joint injuries

    PubMed Central

    Thomas, Binu P; Sreekanth, Raveendran

    2012-01-01

    Distal radioulnar joint is a trochoid joint relatively new in evolution. Along with proximal radioulnar joint, forearm bones and interosseous membrane, it allows pronosupination and load transmission across the wrist. Injuries around distal radioulnar joint are not uncommon, and are usually associated with distal radius fractures,fractures of the ulnar styloid and with the eponymous Galeazzi or Essex_Lopresti fractures. The injury can be purely involving the soft tissue especially the triangular fibrocartilage or the radioulnar ligaments. The patients usually present with ulnar sided wrist pain, features of instability, or restriction of rotation. Difficulty in carrying loads in the hand is a major constraint for these patients. Thorough clinical examination to localize point of tenderness and appropriate provocative tests help in diagnosis. Radiology and MRI are extremely useful, while arthroscopy is the gold standard for evaluation. The treatment protocols are continuously evolving and range from conservative, arthroscopic to open surgical methods. Isolated dislocation are uncommon. Basal fractures of the ulnar styloid tend to make the joint unstable and may require operative intervention. Chronic instability requires reconstruction of the stabilizing ligaments to avoid onset of arthritis. Prosthetic replacement in arthritis is gaining acceptance in the management of arthritis. PMID:23162140

  20. A sigmoidal transcriptional response: cooperativity, synergy and dosage effects.

    PubMed

    Veitia, Reiner A

    2003-02-01

    A sigmoidal transcriptional response (STR) is thought to act as a molecular switch to control gene expression. This nonlinear behaviour arises as a result of the cooperative recognition of a promoter/enhancer by transcription factors (TFs) and/or their synergy to attract the basal transcriptional machinery (BTM). Although this cooperation between TFs is additive in terms of energy, it leads to an exponential increase in affinity between the BTM and the pre-initiation complexes. This exponential increase in the strength of interactions is the principle that governs synergistic systems. Here, I propose a minimalist quasi-equilibrium model to explore qualitatively the STR taking into account cooperative recognition of the promoter/enhancer and synergy. Although the focus is on the effect of activators, a similar treatment can be applied to inhibitors. One of the main insights obtained from the model is that generation of a sigmoidal threshold is possible even in the absence of cooperative DNA binding provided the TFs synergistically interact with the BTM. On the contrary, when there is cooperative binding, the impact of synergy diminishes. It will also be shown that a sigmoidal response to a morphogenetic gradient can be used to generate a nested gradient of another morphogen. Previously, I had proposed that halving the amounts of TFs involved in sigmoidal transcriptional switches could account for the abnormal dominant phenotypes associated with some of these genes. This phenomenon, called haploinsufficiency (HI), has been recognised as the basis of many human diseases. Although a formal proof linking HI and a sigmoidal response is lacking, it is tempting to explore the model from the perspective of dosage effects. PMID:12620064

  1. MAGNETOHYDRODYNAMIC SIMULATION OF A SIGMOID ERUPTION OF ACTIVE REGION 11283

    SciTech Connect

    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

    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.

  2. Uniform persistence for sigmoidal diet selection with keystone prey species

    Microsoft Academic Search

    Asim Sikder

    2000-01-01

    .   In this paper we discuss uniform persistence (UP) criteria of two prey- one predator systems, where we consider that the\\u000a predator's diet selection is a sigmoidal function of the most profitable prey type in place of a step function of conventional\\u000a diet choice theory. We also derive UP results of the system with direct interspecific competition between the prey.

  3. Sigmoidal Curve Shift in Idiopathic Hypoparathyroidism and Pseudohypoparathyroidism

    Microsoft Academic Search

    K. Mizunashi; Y. Furukawa; M. M. Goto; K. Abe

    1998-01-01

    .   The sigmoidal curves plotting serum parathyroid hormone (PTH) against serum Ca in primary hyperparathyroidism and secondary\\u000a hyperparathyroidism due to renal failure deviate to the right. We previously found the leftward curve shift in PTH-deficient\\u000a hypoparathyroidism. In the present study, we investigated the curve shift in pseudohypoparathyroidism (PHP) with secondary\\u000a hyperparathyroidism due to target organ resistance to PTH. In renal

  4. Training a Sigmoidal Network is Difficult Barbara Hammer,

    E-print Network

    Hammer, Barbara

    deals with the sigmoidals sgd(x) or tanh(x). Hoeff­ gen has proved the NP­completeness for sgd to functions which can be approximated by a scaled or shifted sgd. 2. The loading problem The 3­node) = sgd(a 0 + P n i=1 a i x i ) and N 2 : R n ! R; N 2 (x) = sgd(b 0 + P n i=1 b i x i ) #12; on the input

  5. Intrapulmonary Solitary Fibrous Tumor Masquerade Sigmoid Adenocarcinoma Metastasis

    PubMed Central

    Koukis, Ioannis; Marouflidou, Theodora; Panagiotou, Ioannis; Piyis, Anastasios; Tsolakis, Konstantinos

    2013-01-01

    Solitary fibrous tumor is a rare spindle cell mesenchymal tumor entity, with either benign or malignant behavior that cannot be accurately predicted by histological findings. An intrapulmonary site of origin is even rarer. We report a case of a 51-year-old woman in whom an abnormal nodule in the lower right lung was detected during staging for sigmoid adenocarcinoma. The nodule was excised and pathological examination revealed an intrapulmonary solitary fibrous tumor. PMID:24003413

  6. A colonic mineralocorticoid receptor cell model expressing epithelial Na + channels

    Microsoft Academic Search

    Theresa Bergann; Svenja Plöger; Anja Fromm; Sebastian Zeissig; Steffen A. Borden; Michael Fromm; Jörg D. Schulzke

    2009-01-01

    In the distal colon, the epithelial sodium channel (ENaC) is rate limiting for sodium absorption. Progress in the molecular characterization of ENaC expression and trafficking in response to the mineralocorticoid aldosterone has been hampered, since no epithelial colonic cell line existed expressing functional ENaC stimulated by nanomolar aldosterone via mineralocorticoid receptor (MR). Here, we present a human colonic epithelial cell

  7. Disturbances of colonic ion secretion in inflammation: role of the enteric nervous system and cAMP

    Microsoft Academic Search

    F. Sánchez de Medina; R. Pérez; O. Martínez-Augustin; R. González; M. Lorente; J. Gálvez; A. Zarzuelo

    2002-01-01

    We used the trinitrobenzenesulphonic acid (TNBS) rat model of experimental colitis to study the alterations in electrogenic ion transport in the inflamed distal colon. The distal colon exhibited decreased basal transport and reduced short-circuit current responses to carbachol and isobutylmethylxanthine (IBMX). The concentration\\/response curve for IBMX was also shifted to the right. Ion substitution experiments indicated that electrogenic transport was

  8. Avitene granulomas of colonic serosa.

    PubMed

    McGregor, D H; MacArthur, R I; Carter, T

    1986-01-01

    Avitene, microfibrillar collagen hemostat, is an absorbable topical hemostatic agent prepared from purified bovine corium collagen. A case is reported of a 58-year-old man who, one month after sigmoid colectomy for volvulus in which Avitene as used to control bleeding from a splenic capsular tear, developed symptoms of intestinal obstruction. On exploratory laparotomy, the transverse and descending colon had numerous 0.1 to 2.0 cm nodules, adherent to the serosa of the bowel and mesentery, with kinking and partial obstruction of the splenic flexure. Light microscopically, the nodules were found to be composed of chronic inflammatory and granulomatous reaction with numerous deposits of eosinophilic fibrillar material consistent with Avitene. Electron microscopic examination of the lesions and of Avitene confirmed the nature of this material. The practical and pathobiological implications of utilization of Avitene as a hemostatic agent are discussed. PMID:3740798

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

    PubMed Central

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

    2014-01-01

    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

  10. Sigmoid colocolic fistula caused by intrauterine device migration: a case report

    PubMed Central

    2014-01-01

    Introduction The intrauterine device is a form of contraception with a long duration of action and few systemic side effects. Migration into the abdominal cavity may occur early or years after insertion giving rise to bowel obstruction, perforation, ischemia, mesenteric injury, strictures or fistulae. Colocolic fistula formation is a rare but serious complication of intrauterine device migration, which may lead to difficulties in diagnosis and device retrieval. Case presentation We report the case of a 29-year-old Sri Lankan woman who became pregnant 5 years after intrauterine device insertion. The device could not be located during pregnancy. She was asymptomatic and defaulted follow up during the antenatal period. She had an uncomplicated vaginal delivery. A subsequent laparotomy for device retrieval failed due to technical difficulties. A repeat laparotomy identified a sigmoid colocolic fistula with adhesions to the fallopian tube. The device was removed and colonic defects primarily closed following which the patient made an uneventful recovery. Conclusions All translocated intrauterine devices should be removed regardless of type and location. This case illustrates that they may cause complex bowel lesions leading to serious technical difficulties during retrieval. With the increasing use of minimally invasive approaches for intrauterine device retrieval, a low threshold for open surgery in complicated cases is advocated. PMID:24594141

  11. Comparison of Laparoscopic vs Open Sigmoid Colectomy for Benign and Malignant Disease at Academic Medical Centers

    Microsoft Academic Search

    Marcelo W. Hinojosa; Zuri A. Murrell; Viken R. Konyalian; Steven Mills; Ninh T. Nguyen; Michael J. Stamos

    2007-01-01

    Few studies have examined outcomes of laparoscopic and open sigmoid colectomy performed at US academic centers. Using ICD-9\\u000a diagnosis and procedural codes, data was obtained from the University HealthSystem Consortium (UHC) Clinical Database of 10,603\\u000a patients who underwent laparoscopic or open sigmoid colectomy for benign and malignant disease between 2003–2006. A total\\u000a of 1,092 patients (10.3%) underwent laparoscopic sigmoid colectomy.

  12. Colon Adenocarcinoma

    MedlinePLUS

    ... that examine the colon. These tests include colonoscopy, flexible sigmoidoscopy, or double-contrast barium enema. How does ... found, each polyp is removed through colonoscopy or flexible sigmoidoscopy. In some cases, when the tumor is ...

  13. 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

    Shetty, Prakashchandra

    2014-01-01

    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. PMID:25548728

  14. Enzymatic Logic Gates with Noise-Reducing Sigmoid Response

    E-print Network

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

    2010-10-09

    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.

  15. Pylephlebitis of a variant mesenteric vein complicating sigmoid diverticulitis.

    PubMed

    Falkowski, Anna L; Cathomas, Gieri; Zerz, Andreas; Rasch, Helmut; Tarr, Philip E

    2014-02-01

    Pylephlebitis--suppurative thrombophlebitis of the portal and/or mesenteric veins--is a rare complication of abdominal infections, especially diverticulitis. It can lead to severe complications such as hepatic abscess, sepsis, peritonitis, bowel ischemia, etc., which increase the mortality rate. Here we present a case of suppurative thrombophlebitis of the inferior mesenteric vein, as a complication of sigmoid diverticulitis. The epidemiology, clinical and radiological features as well as treatment strategies are discussed. We also review the anatomy of the mesenteric vein given its anatomic variation in the present case and how this anatomic knowledge might influence the operative approach should surgery be necessary. PMID:24967018

  16. Atomic bomb survivors and the sigmoidal response model

    SciTech Connect

    Kondo, S. [Kinki Univ. (Japan)

    1994-12-31

    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.

  17. Recurrent Sigmoid Volvulus Associated With Eventration of Diaphragm in a Twenty-Six-Year-Old Man

    PubMed Central

    Prabhu, Shailesh Mukund; Venkatesan, Bhuvaneswari; Shetty, Gurucharan; Narula, Mahender Kaur; Chauhan, Udit; Udiya, Alok Kumar

    2015-01-01

    Recurrent sigmoid volvulus is a clinical entity characterized by recurrent episodes of partial or complete sigmoid volvulus. Although it is commonly seen in the elderly, it can be occasionally seen in younger patients. Patients with recurrent partial sigmoid volvulus are relatively asymptomatic or present with mild abdominal pain. Early diagnosis and treatment is essential to prevent conversion to acute gangrenous volvulus. We present a case of recurrent partial sigmoid volvulus in association with eventration of diaphragm in a 26-year-old man. PMID:25901269

  18. Simultaneous Colonic Obstruction and Hydroureteronephrosis due to Mesenteric Fibromatosis

    PubMed Central

    Jung, Sung Hoon; Jung, Ji Han; Lee, Kang-Moon; Chung, Woo Chul; Yang, Jin-Mo

    2009-01-01

    Mesenteric fibromatosis (MF) is a rare benign mesenchymal lesion that can occur throughout the gastrointestinal tract, especially small bowel. Its biological behavior is intermediate between benign fibrous tissue proliferation and malignant fibrosarcoma. In previously reported cases of MF, we could find colonic obstruction or ureter obstruction, but simultaneous involvement of colon and ureter was not able to be seen. We described a patient that presented with colonic obstruction and hydroureteronephrosis due to MF at sigmoid colon which mimicked submucosal tumor such as gastrointestinal tumor. This case resulted in a positive positron emission tomography scan suggesting malignant neoplasm, but ?-catenin positivity on immunohistochemical staining separated MF from gastrointestinal stromal tumor and sclerosing mesenteritis. The clinical course of the patient was improved after surgical resection. PMID:20431749

  19. Simultaneous Colonic Obstruction and Hydroureteronephrosis due to Mesenteric Fibromatosis.

    PubMed

    Jung, Sung Hoon; Paik, Chang Nyol; Jung, Ji Han; Lee, Kang-Moon; Chung, Woo Chul; Yang, Jin-Mo

    2009-09-01

    Mesenteric fibromatosis (MF) is a rare benign mesenchymal lesion that can occur throughout the gastrointestinal tract, especially small bowel. Its biological behavior is intermediate between benign fibrous tissue proliferation and malignant fibrosarcoma. In previously reported cases of MF, we could find colonic obstruction or ureter obstruction, but simultaneous involvement of colon and ureter was not able to be seen. We described a patient that presented with colonic obstruction and hydroureteronephrosis due to MF at sigmoid colon which mimicked submucosal tumor such as gastrointestinal tumor. This case resulted in a positive positron emission tomography scan suggesting malignant neoplasm, but beta-catenin positivity on immunohistochemical staining separated MF from gastrointestinal stromal tumor and sclerosing mesenteritis. The clinical course of the patient was improved after surgical resection. PMID:20431749

  20. Perivascular epithelioid cell neoplasm of the colon.

    PubMed

    Freeman, Hugh James; Webber, Doug L

    2010-04-15

    A 17-year-old female presented with rectal bleeding from an ulcerated sigmoid mass in 1994. Initial pathological evaluation revealed a rare clear cell neoplasm of the colon, possibly originating from kidneys, adrenals, lung or a gynecologic source as a metastatic lesion. Extensive imaging studies were negative, and over the next 15 years, she remained well with no recurrence. The original resected neoplasm was reviewed and re-classified as a perivascular epithelioid cell neoplasm (PEComa). Although the long-term natural history of PEComas requires definition, increased clinical and pathological awareness should lead to increased recognition of an apparently rare type of colonic neoplasm that likely occurs more often than is currently appreciated. PMID:21160599

  1. Racial/ethnic variation in the anatomic subsite location of in situ and invasive cancers of the colon.

    PubMed Central

    Shavers, Vickie L.

    2007-01-01

    INTRODUCTION: Approximately 145,000 Americans were diagnosed with colorectal cancer and 56,000 died from colorectal cancer in 2006. Although colorectal screening can reduce mortality and incidence, U.S. screening rates are particularly low for racial/ethnic minorities. Racial differences in the subsite location of colon cancers could have implications for colorectal screening. This study examines the anatomic subsite distribution of tumors among African-American, Hispanic, Asian-American/Pacific-Islander and non-Hispanic white (NHW) patients with colon cancer. METHODS: Surveillance and End Results program data for 254,469 primary in situ and invasive colon cancers for patients from 1973-2002 are included in this analysis. Descriptive analyses and logistic regression are used to describe and examine variations in the proportion of colon cancers diagnosed at sites proximal to the sigmoid colon or proximal to the splenic flexure over three successive time periods. RESULTS: The proportion of colon cancers diagnosed at the sigmoid colon was 15.6-21.3% lower, while diagnoses at the descending colon were 40.5.0-45.3.0% higher for African Americans than NHWs over the three time periods. In logistic regression analyses adjusted for gender, age group and year of diagnosis, the odds of a diagnosis of cancer proximal to the sigmoid colon or proximal to the splenic flexure was significantly higher for African Americans but lower for Hispanics and Asian Americans/Pacific Islanders compared to NHWs. DISCUSSION: The higher proportion of cancers among African Americans diagnosed at sites that are generally attempted but not always reached with a sigmoidscope suggest that African Americans may benefit from screening colonoscopy. They also highlight the need for systems that collect data that would allow a direct examination of the role that the differential use of specific colon screening tests and polypectomy play in racial/ethnic variation in colon cancer incidence and in the anatomic subsite distribution of colon cancers. PMID:17668639

  2. Intraspecies Competition for Niches in the Distal Gut Dictate Transmission during Persistent Salmonella Infection

    PubMed Central

    Lam, Lilian H.; Monack, Denise M.

    2014-01-01

    In order to be transmitted, a pathogen must first successfully colonize and multiply within a host. Ecological principles can be applied to study host-pathogen interactions to predict transmission dynamics. Little is known about the population biology of Salmonella during persistent infection. To define Salmonella enterica serovar Typhimurium population structure in this context, 129SvJ mice were oral gavaged with a mixture of eight wild-type isogenic tagged Salmonella (WITS) strains. Distinct subpopulations arose within intestinal and systemic tissues after 35 days, and clonal expansion of the cecal and colonic subpopulation was responsible for increases in Salmonella fecal shedding. A co-infection system utilizing differentially marked isogenic strains was developed in which each mouse received one strain orally and the other systemically by intraperitoneal (IP) injection. Co-infections demonstrated that the intestinal subpopulation exerted intraspecies priority effects by excluding systemic S. Typhimurium from colonizing an extracellular niche within the cecum and colon. Importantly, the systemic strain was excluded from these distal gut sites and was not transmitted to naïve hosts. In addition, S. Typhimurium required hydrogenase, an enzyme that mediates acquisition of hydrogen from the gut microbiota, during the first week of infection to exert priority effects in the gut. Thus, early inhibitory priority effects are facilitated by the acquisition of nutrients, which allow S. Typhimurium to successfully compete for a nutritional niche in the distal gut. We also show that intraspecies colonization resistance is maintained by Salmonella Pathogenicity Islands SPI1 and SPI2 during persistent distal gut infection. Thus, important virulence effectors not only modulate interactions with host cells, but are crucial for Salmonella colonization of an extracellular intestinal niche and thereby also shape intraspecies dynamics. We conclude that priority effects and intraspecies competition for colonization niches in the distal gut control Salmonella population assembly and transmission. PMID:25474319

  3. Perforated Sigmoid Diverticulitis in the Presence of Toxic Epidermal Necrolysis

    PubMed Central

    Heye, P.; Descloux, A.; Singer, G.; Rosenberg, R.; Kocher, T.

    2014-01-01

    Even though the incidence of toxic epidermal necrolysis (TEN) is low, it is also associated with a high mortality rate. The condition predominantly affects the skin, but may also affect the gastrointestinal tract, dramatically increasing mortality. We present a case of perforated sigmoid diverticulitis in the presence of TEN. The patient was taking medication, known to be a risk factor, and presented an affected total body surface area and temporal development similar to previously reported cases of TEN. Characteristic abdominal symptoms, however, were missing. Gastrointestinal involvement in TEN appears to be a poor prognostic factor; medical staff must therefore be alert to patients with TEN who complain of abdominal discomfort. The exact pathogenesis, however, remains unclear. PMID:24707250

  4. Function estimation by feedforward sigmoidal networks with bounded weights

    SciTech Connect

    Rao, N.S.V.; Protopoescu, V. [Oak Ridge National Lab., TN (United States). Center for Engineering Systems Advanced Research; Qiao, H. [Fort Valley State Coll., GA (United States). Dept. of Mathematics and Physics

    1996-05-01

    The authors address the problem of PAC (probably and approximately correct) learning functions f : [0, 1]{sup d} {r_arrow} [{minus}K, K] based on iid (independently and identically distributed) sample generated according to an unknown distribution, by using feedforward sigmoidal networks. They use two basic properties of the neural networks with bounded weights, namely: (a) they form a Euclidean class, and (b) for hidden units of the form tanh ({gamma}z) they are Lipschitz functions. Either property yields sample sizes for PAC function learning under any Lipschitz cost function. The sample size based on the first property is tighter compared to the known bounds based on VC-dimension. The second estimate yields a sample size that can be conveniently adjusted by a single parameter, {gamma}, related to the hidden nodes.

  5. Unusual presentation of pheochromocytoma with ischemic sigmoid colitis and stenosis.

    PubMed

    Tan, Florence; Thai, Ah Chuan; Cheah, Wei Keat; Mukherjee, J J

    2009-10-01

    A 45-year-old woman with poorly controlled hypertension and diabetes mellitus presented with left iliac fossa pain, constipation alternating with diarrhea, and weight loss. She had been diagnosed with idiopathic cardiomyopathy five years previously. Echocardiogram had shown a left ventricular ejection fraction (LVEF) of 35%; coronary angiogram was normal. Colonoscopy revealed sigmoid colitis with stenosis. Abdominal computed tomography revealed a 5 cm right adrenal tumor. Twenty-four hour urinary free catecholamines and fractionated metanephrine excretion values were elevated, confirming pheochromocytoma. Her colitis resolved after one month of adrenergic blockade. Repeat echocardiogram showed improvement of LVEF to 65%. After laparoscopic right adrenalectomy, the patient's hypertension resolved, and diabetic control improved. Timely management avoided further morbidity and potential mortality in our patient. PMID:19738530

  6. Space colonization.

    PubMed

    2002-12-01

    NASA interest in colonization encompasses space tourism; space exploration; space bases in orbit, at L1, on the Moon, or on Mars; in-situ resource utilization; and planetary terraforming. Activities progressed during 2002 in areas such as Mars colonies, hoppers, and biomass; space elevators and construction; and in-situ consumables. PMID:12506926

  7. Traumatic Distal Ulnar Artery Thrombosis

    PubMed Central

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

    2014-01-01

    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

  8. Equations for describing sigmoid yield responses and their application to some phosphate responses by lupins and by subterranean clover

    Microsoft Academic Search

    N. J. Barrow; R. E. Mendoza

    1990-01-01

    Responses to nutrients are sometimes sigmoid. A series of equations is proposed to describe such curves and to test whether the sigmoid component is significant. These equations are then applied to responses to freshly applied, and to incubated, phosphate by three species of lupin and by subterranean clover. The responses byLupinus angustifolius, and especially by subterranean clover, were sigmoid on

  9. Epigenomic enhancer profiling defines a signature of colon cancer

    PubMed Central

    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.

    2013-01-01

    Cancer is characterized by gene expression aberrations. Studies have largely focused on coding sequences and promoters, despite the fact that distal regulatory elements play a central role in controlling transcription patterns. Here we utilize 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 unique transcriptional program to promote colon carcinogenesis. PMID:22499810

  10. Urodynamic comparison of ileum vs. sigmoid in augmentation cystoplasty for neurogenic bladder dysfunction.

    PubMed

    Radomski, S B; Herschorn, S; Stone, A R

    1995-01-01

    We performed multichannel urodynamics before and after augmentation cystoplasty in 26 patients (11 females, 15 males) to determine which bowel segment is best to achieve a large volume and low pressure reservoir. All 26 patients had a neurogenic cause for their bladder dysfunction. Ileum was used in 14 patients and sigmoid was used in 12 patients. Detubularization was performed in all patients. Capacity improved significantly in both the ileum and the sigmoid group after surgery. When detubularized ileum was used, the maximum amplitude of uninhibited reservoir contractions was significantly improved or eliminated postoperatively. When sigmoid was used, uninhibited reservoir contractions did not significantly improve postoperatively and were, in fact, more common than preoperatively. Despite the detubularization, pressure waves were identified in 15 of the 26 patients postoperatively. There was significant improvement in end filling pressures at capacity (compliance) with both ileum and sigmoid postoperatively. However, end filling pressures were significantly higher in the sigmoid group. In conclusion, good capacity was achieved with both ileum and sigmoid postoperatively. However, ileum provided lower reservoir pressures and better compliance. We feel that urodynamically detubularized ileum is better suited than sigmoid for augmentation cystoplasty in patients with neurogenic bladder dysfunction. PMID:7647805

  11. Perforated appendicitis and obstructing colonic carcinoma in the elderly.

    PubMed

    Sumpio, B E; Ballantyne, G H; Zdon, M J; Modlin, I M

    1986-10-01

    Two patients admitted with perforated appendicitis and obstructing colonic cancers are presented. The first patient, a 75-year-old man, developed a persistent fecal fistula following appendectomy. Barium enema demonstrated an obstructing hepatic flexure carcinoma. The second patient, a 62-year-old man, recovered uneventfully following appendectomy. Persistent occult blood was found in his stools during follow-up examinations. Three months after surgery, diagnostic colonoscopy revealed a nearly obstructing sigmoid carcinoma. Obstruction of the appendiceal lumen by such lesions as fecaliths, carcinoid tumors, lymphoid hyperplasia, or cecal carcinoma accounts for appendicitis in the majority of patients. These two patients illustrate a less common cause. As many as 3 percent of patients over 40 years of age presenting with appendicitis also have obstructing colonic carcinomas. Elderly patients with appendicitis should be evaluated for colonic neoplasms at a clinically suitable time. PMID:3757711

  12. Coincidental Colonization

    NSDL National Science Digital Library

    California Academy of Sciences

    2008-01-01

    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.

  13. Stenting for Obstructing Colon Cancer: Fewer Complications and Colostomies

    PubMed Central

    Miller, Peter; Goldstein, Rachel; Coury, Joseph; Hackford, Alan; Dao, Haisar

    2015-01-01

    Background and Objectives: Colonic stenting has been used in the setting of malignant obstruction to avoid an emergent colectomy. We sought to determine whether preoperative placement of a colonic stent decreases morbidity and the rate of colostomy formation. Methods: Cases of obstructing sigmoid, rectosigmoid, and rectal cancer from January 1, 2010, to December 31, 2011, were identified in the Nationwide Inpatient Sample (NIS) database. All patients were treated at hospitals in the United States, and the database generated national estimates. Postoperative complications, mortality, and the rate of colostomy formation were analyzed. Results: Of the estimated 7891 patients who presented with obstructing sigmoid, rectosigmoid, or rectal cancer necessitating intervention, 12.1% (n = 956) underwent placement of a colonic stent, and the remainder underwent surgery without stent placement. Of the patients who underwent stenting, 19.9% went on to have colon resection or stoma creation during the same admission. Patients who underwent preoperative colonic stent placement had a lower rate of total postoperative complications (10.5% vs 21.7%; P < .01). There was no significant difference in mortality (4.7% vs 4.2%; P = .69). The rate of colostomy formation was more than 2-fold higher in patients who did not undergo preoperative stenting (42.5% vs 19.5%; P < .01). Preoperative stenting was associated with increased use of laparoscopy (32.6% vs 9.7%; P < .01). Conclusions: Our study characterizes the national incidence of preoperative placement of a colonic stent in the setting of malignant obstruction. Preoperative stent placement is associated with lower postoperative complications and a lower rate of colostomy formation. The results support the hypothesis that stenting as a bridge to surgery may benefit patients by converting an emergent surgery into an elective one.

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

    Microsoft Academic Search

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

    1994-01-01

    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

  15. Distal Oblique Bundle Reconstruction and Distal Radioulnar Joint Instability

    PubMed Central

    Riggenbach, Michael D.; Conrad, Bryan P.; Wright, Thomas W.; Dell, Paul C.

    2013-01-01

    Background?This study created an anatomic reconstruction of the distal oblique bundle (DOB) of the interosseous membrane to determine its effect on distal radioulnar joint (DRUJ) instability and compare this technique with distal radioulnar ligament (DRUL) reconstruction. Questions/Purposes?We hypothesized that this reconstruction would provide equivalent stability to DRUL reconstruction and that combining the two techniques would enhance stability. Methods?Six cadaveric upper limbs were affixed to a custom frame. The volar/dorsal translation of the radius relative to the ulna was measured in 60° pronation, neutral, and 60° supination. Translation was sequentially measured with the DRUJ intact, with sectioned DRULs and triangular fibrocartilaginous complex (TFCC), and with sectioned DOBs. Reconstructions were performed on the DRULs, on the DOB tensioned in both neutral and supination, and employing both techniques. Results?The DOB reconstruction, tensioned both in the neutral position and in 60° supination, was more stable than the partial and complete instability in 6/6 specimens in pronation and the neutral position and in 5/6 specimens in supination. The DOB reconstruction and the DOB reconstruction tensioned in supination were more stable than the DRUL reconstruction in 4/6 patients. Combining the two techniques did not further reduce translation. Conclusions?The DOB reconstruction is capable of improving stability in the unstable DRUJ. PMID:24436838

  16. Laparoscopic segmental colectomy for colonic lymphangiomas: A definitive, minimally invasive surgical option

    PubMed Central

    Zhuo, Chang-Hua; Shi, De-Bing; Ying, Min-Gang; Cheng, Yu-Fan; Wang, Yu-Wei; Zhang, Wen-Ming; Cai, San-Jun; Li, Xin-Xiang

    2014-01-01

    Colonic lymphangioma is an unusual benign malformation. We herein describe two cases. A 36-year-old woman was admitted with one year of intermittent abdominal pain; colonoscopy, abdominopelvic computed tomography and endoscopic ultrasonography (EUS) revealed enlarged cystic masses at the ascending colon. In another 40-year-old man, colonoscopy and EUS revealed an asymptomatic lobulated cystic mass with four small sessile polyps at the sigmoid colon. Both patients underwent laparoscopic segmental colectomy. Both masses were histologically confirmed as cystic lymphangiomas, and the patients were discharged without complications. The management of colonic lymphangioma depends on the individual situation; close surveillance or endoscopic therapy may be appropriate for asymptomatic lesions smaller than 2.5 cm in diameter. Surgical intervention can be considered for larger lesions or in patients who develop complication risks. Laparoscopic segmental colon resection may be recommended to excise relatively large submucosal lesions because it is a definitive, minimally invasive intervention with a fast postoperative recovery. PMID:25024636

  17. Regression of metastatic colon tumour from primary adenocarcinoma of the lung due to fistulisation to the bowel lumen.

    PubMed

    Iwamuro, Masaya; Miyabe, Yoshio; Hanae, Kai; Yoshinari, Kawai; Katsuyoshi, Takata; Murakami, Toshi; Hirofumi, Mifune; Yamamoto, Kazuhide

    2014-01-01

    An 80-year-old Japanese male was diagnosed with pulmonary adenocarcinoma. The patient exhibited extensive extra pulmonary involvement in the bone, adrenal gland, abdominal lymph nodes, and sigmoid colon. A single course of chemotherapy with carboplatin and pemetrexed was administered as the first-line treatment. Subsequently, the patient received pemetrexed monotherapy. Two months after the diagnosis, rapid regression of the metastatic tumour in the sigmoid colon was observed. Based on the findings of CT scanning and colonoscopic examination, tumour-bowel fistulisation was considered to be a cause of the rapid regression. This case report illustrates a tumour-bowel fistula of a colonic metastatic tumour in a patient with lung cancer. Radiographic and endoscopic features of the rare manifestation are presented. PMID:24834113

  18. Distal Tibial Fractures: Intramedullary Nailing

    Microsoft Academic Search

    Andreas H. Ruecker; Michael Hoffmann; Martin E. Rupprecht; Johannes M. Rueger

    2009-01-01

    \\u000a Abstract\\u000a   The tibia is an exposed bone with vulnerable soft tissue coverage and is therefore predisposed to local soft tissue problems\\u000a and delayed bone healing. The objective in distal tibial fracture treatment is to achieve stable fixation patterns with a\\u000a minimum of soft-tissue affection. Thus, the risk of soft tissue breakdown and bone healing complications is more likely related\\u000a to

  19. Colonic perforation by a large gallstone: A rare case report

    PubMed Central

    Halleran, Devin R.; Halleran, David R.

    2014-01-01

    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

  20. Autonomic Nerve Regulation of Colonic Peristalsis in Guinea Pigs

    PubMed Central

    Gribovskaja-Rupp, Irena; Babygirija, Reji; Takahashi, Toku; Ludwig, Kirk

    2014-01-01

    Background/Aims Colonic peristalsis is mainly regulated via intrinsic neurons in guinea pigs. However, autonomic regulation of colonic motility is poorly understood. We explored a guinea pig model for the study of extrinsic nerve effects on the distal colon. Methods Guinea pigs were sacrificed, their distal colons isolated, preserving pelvic nerves (PN) and inferior mesenteric ganglia (IMG), and placed in a tissue bath. Fecal pellet propagation was conducted during PN and IMG stimulation at 10 Hz, 0.5 ms and 5 V. Distal colon was connected to a closed circuit system, and colonic motor responses were measured during PN and IMG stimulation. Results PN stimulation increased pellet velocity to 24.6 ± 0.7 mm/sec (n = 20), while IMG stimulation decreased it to 2.0 ± 0.2 mm/sec (n = 12), compared to controls (13.0 ± 0.7 mm/sec, P < 0.01). In closed circuit experiments, PN stimulation increased the intraluminal pressure, which was abolished by atropine (10?6 M) and hexamethonium (10?4 M). PN stimulation reduced the incidence of non-coordinated contractions induced by NG-nitro-L-arginine methyl ester (L-NAME; 10?4 M). IMG stimulation attenuated intraluminal pressure increase, which was partially reversed by alpha-2 adrenoceptor antagonist (yohimbine; 10?6 M). Conclusions PN and IMG input determine speed of pellet progression and peristaltic reflex of the guinea pig distal colon. The stimulatory effects of PN involve nicotinic, muscarinic and nitrergic pathways. The inhibitory effects of IMG stimulation involve alpha-2 adrenoceptors. PMID:24847719

  1. Colon Cancer

    NSDL National Science Digital Library

    Patient Education Institute

    This patient education program explains what colon cancer is, the symptoms, diagnosis, and available treatment options. This is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: The tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

  2. Dark-lumen magnetic resonance colonography in patients with suspected sigmoid diverticulitis: a feasibility study

    Microsoft Academic Search

    Waleed Ajaj; Stefan G. Ruehm; Thomas Lauenstein; Susanne Goehde; Christiane Kuehle; Christoph U. Herborn; Jost Langhorst; Thomas Zoepf; Guido Gerken; Mathias Goyen

    2005-01-01

    To assess dark-lumen magnetic resonance colonography (MRC) for the evaluation of patients with suspected sigmoid diverticulitis. Forty patients with suspected sigmoid diverticulitis underwent MRC within 72 h prior to conventional colonoscopy (CC). A three-dimensional T1-weighted volumetric interpolated breath-hold examination sequence was acquired after an aqueous enema and intravenous administration of gadolinium-based contrast agents. All MRC data were evaluated by two radiologists.

  3. Colon cancer - resources

    MedlinePLUS

    Resources - colon cancer ... The following organizations are good resources for information on colon cancer : American Cancer Society - www.cancer.org/cancer/colonandrectumcancer/index Colon Cancer Alliance - www.ccalliance.org National ...

  4. Stages of Colon Cancer

    MedlinePLUS

    ... I Stage II Stage III Stage IV After colon cancer has been diagnosed, tests are done to find ... lung cancer . The following stages are used for colon cancer: Stage 0 (Carcinoma in Situ) Stage 0 (colon ...

  5. Colonic gallstone ileus: the rolling stones.

    PubMed

    Heaney, Roisin Mary

    2014-01-01

    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

  6. Direct Arthroscopic Distal Clavicle Resection

    PubMed Central

    Lervick, Gregory N

    2005-01-01

    Degenerative change involving the acromioclavicular (AC) is frequently seen as part of a normal aging process. Occasionally, this results in a painful clinical condition. Although AC joint symptoms commonly occur in conjunction with other shoulder pathology, they may occur in isolation. Treatment of isolated AC joint osteoarthritis is initially non-surgical. When such treatment fails to provide lasting relief, surgical treatment is warranted. Direct (superior) arthroscopic resection of the distal (lateral) end of the clavicle is a successful method of treating the condition, as well as other isolated conditions of the AC joint. The following article reviews appropriate patient evaluation, surgical indications and technique. PMID:16089089

  7. Colonic metastases from small cell carcinoma of the lung presenting with an acute abdomen: A case report

    PubMed Central

    Costa Almeida, Carlos Eduardo; dos Reis, Luís Simões; Costa Almeida, Carlos Manuel

    2015-01-01

    Introduction Colonic metastases are rare, and usually secondary from malignant tumours of the stomach, breast, ovarian, cervix, kidney, lung, prostate, or skin. Around one third are asymptomatic or found only at autopsy. Case Report A middle-aged male smoker, who had a small cell carcinoma of the lung diagnosed two years previously and treated with radiotherapy and chemotherapy, was admitted to the emergency room with intense abdominal pain and constipation. With the suspicion of an acute appendicitis he was submitted to surgery. At laparotomy he was found to have a normal appendix but two hard colonic lesions: a mobile one in the right colon and the other fixing the sigmoid colon to the sacrum. A right hemicolectomy and a sigmoid loop colostomy were performed. Pathology showed those lesions to be colonic metastases from small cell carcinoma of the lung. Discussion Colonic secondaries are most frequently diagnosed in patients who have had a known primary tumour, and may present with bowel obstruction, lower gastrointestinal haemorrhage, gastrointestinal fistula, or intestinal perforation. Presentation with acute abdomen is rare, and survival is usually limited. Conclusion Colonic metastatic disease should be considered in any patient presenting with an acute abdomen and past history of lung malignancy. PMID:25732616

  8. Suture-Free Anastomosis of the Colon Experimental Comparison of Two Cyanoacrylate Adhesives

    Microsoft Academic Search

    Jiri Paral; Zdenek Subrt; Petr Lochman; Leo Klein; Dimitar Hadzi-Nikolov; Zdenek Turek; Martin Vejbera

    2011-01-01

    Background  We explored the potential of two cyanoacrylate tissue adhesives for constructing colonic anastomoses.\\u000a \\u000a \\u000a \\u000a Method  The study involved 12 female domestic pigs. The animals were divided into two equal groups. In both groups, the sigmoid colon\\u000a was transected. An intestinal anastomosis was constructed with a modified circular stapler (all staples were withdrawn) and\\u000a cyanoacrylate tissue adhesives. Glubran 2® was used in group

  9. Rectal irrigation with short-chain fatty acids for distal ulcerative colitis

    Microsoft Academic Search

    Richard I. Breuer; Stephen K. Buto; Miriam L. Christ; Judy Bean; Piero Vernia; P. Paoluzi; M. C. Di Paolo; Renzo Caprilli

    1991-01-01

    Colon cells from patients with ulcerative colitis utilize short-chain fatty acids inefficiently and may be exposed to decreased concentrations of these compounds. To test whether irrigation of the inflamed mucosa with short-chain fatty acids is useful, we conducted a six-week preliminary trial in 12 patients with distal colitis. Each patient used twice daily rectal irrigations with 100 ml of a

  10. Spinal cord influences on the colonic myoelectrical activity of fed and fasted rats.

    PubMed

    Du, C; Ferré, J P; Ruckebusch, Y

    1987-02-01

    1. The myoelectrical activity of the large intestine of fed and fasted rats was recorded with chronically implanted nichrome wire electrodes after destruction of the spinal cord, after spinal cord transection, and after spinal anaesthesia. 2. After spinal cord ablation, the cyclical organization of the colonic electrical spiking activity, as well as the gastrocolic reflex and accompanying postprandial enhancement of the cyclical pattern of activity, persisted on the proximal and distal colon. On the transverse colon, however, the spiking activity was considerably increased. This latter effect obliterated the gastrocolic response due to feeding but not the subsequent postprandial enhancement of the cyclical pattern of activity. 3. After spinal cord transection, the level of spiking activity also increased on both the transverse and distal colon, but no major changes in cyclical activity or in postprandial responses were recorded. 4. Spinal anaesthesia produced by intrathecal lidocaine increased the motility of the transverse colon to a level which masked the gastrocolic reflex. 5. These results suggest a prevertebral ganglia and/or a local control mechanism for the cyclical organization of the spiking activity of the colon. The central control mechanisms involve mostly spinal inhibitory influences on the transverse colon and supraspinal inhibitory influences on the distal colon. PMID:3656127

  11. Colon distention induces persistent visceral hypersensitivity by mechanotranscription of pain mediators in colonic smooth muscle cells.

    PubMed

    Lin, You-Min; Fu, Yu; Wu, Chester C; Xu, Guang-Yin; Huang, Li-Yen; Shi, Xuan-Zheng

    2015-03-01

    Abdominal pain and distention are major complaints in irritable bowel syndrome. Abdominal distention is mainly attributed to intraluminal retention of gas or solid contents, which may cause mechanical stress to the gut wall. Visceral hypersensitivity (VHS) may account for abdominal pain. We sought to determine whether tonic colon distention causes persistent VHS and if so whether mechanical stress-induced expression (mechanotranscription) of pain mediators in colonic smooth muscle cells (SMCs) plays a role in VHS. Human colonic SMCs were isolated and stretched in vitro to investigate whether mechanical stress upregulates expression of the pain mediator cyclooxygenase-2 (COX-2). Rat colon was distended with a 5-cm-long balloon, and gene expression of COX-2, visceromotor response (VMR), and sensory neuron excitability were determined. Static stretch of colonic SMCs induced marked expression of COX-2 mRNA and protein in a force- and time-dependent manner. Subnoxious tonic distention of the distal colon at ?30-40 mmHg for 20 or 40 min induced COX-2 expression and PGE2 production in colonic smooth muscle, but not in the mucosa layer. Lumen distention also increased VMR in a force- and time-dependent manner. The increase of VMR persisted for at least 3 days. Patch-clamp experiments showed that the excitability of colon projecting sensory neurons in the dorsal root ganglia was markedly augmented, 24 h after lumen distention. Administration of COX-2 inhibitor NS-398 partially but significantly attenuated distention-induced VHS. In conclusion, tonic lumen distention upregulates expression of COX-2 in colonic SMC, and COX-2 contributes to persistent VHS. PMID:25540231

  12. Colonic angiosarcoma: A case report and review of literature

    PubMed Central

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

    2012-01-01

    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

  13. [An autopsy case of colonic carcinoid with marked leukocytosis].

    PubMed

    Kobayashi, T; Akahonai, Y; Kawasaki, K; Suga, M; Yachi, A; Suzuki, T; Yamada, S; Narasaki, M; Oyamada, Y

    1986-07-01

    A 45-year-old man with right hypochondralgia and marked leukocytosis was found to have Borrmann type II carcinoma of the sigmoid colon and its metastasis to the liver. The peripheral leukocyte count gradually increased up to 150 X 10(3)/mm3 according to the tumor enlargement. The patient died of hepatic insufficiency, and autopsy revealed carcinoid of the colon and its metastasis to the liver. Leukemoid reaction has been reported in various kinds of malignancies. However, the present case seems to be of particular interest because of the rare association with carcinoid and marked leukocytosis of more than 100 X 10(3)/mm3 without any evidence of infection. PMID:3489111

  14. [Rectoscopy and Hemoccult II in irritable colon. A prospective study].

    PubMed

    Hovendal, C P; Kronborg, O; Hem, J; Grinsted, P; Fenger, C

    1990-09-17

    It was investigated whether Hemoccult-II test (H-II) could reduce the number of colonic examinations in patients with the irritable bowel syndrome, with normal rigid proctoscopic findings. A negative H-II was obtained in 299 patients from general practice and a positive test in nine. Colonoscopy was done in 157 and double contrast barium enema in 142 after random allocation. The nine patients with positive H-II all had colonoscopy. Among the 299 with negative H-II, colonic adenomas were detected in ten and an early cancer in an adenoma in the sigmoid colon; overlooked rectal adenomas were found in three, rectal cancer in one, rectal carcinoid in another and a coecal cancer, which could be palpated, in a third patient. Two patients with colonic cancer and one with adenoma were detected among those with positive H-II. All patients were followed by clinical examination after one year. In conclusion, colonic examination should carry a low priority in patients with symptoms of irritable bowel, negative Hemoccult-II and normal rigid proctoscopic findings performed by an experienced examiner. The investigation confirmed the recommendation of total colonoscopy in patients with a positive H-II and added support for increasing number of endoscopy services in contrast to those of diagnostic radiology, which should be reduced. PMID:2219505

  15. Spatial Modeling of Colonic Lesions With Geographic Information Systems

    PubMed Central

    Imanieh, Mohammad Hadi; Goli, Ali; Imanieh, Mohammad Hossein; Geramizadeh, Bita

    2014-01-01

    Background: Geographic information system (GIS) software has been used in health care systems to display and analyze spatial pattern of diseases and health services. Objectives: This study was performed to assess spatial patterns of colon’s pathologic lesions based on the pathologic reports and assess whether it is possible to use GIS software in health services. Patients and Methods: Archives of pathology of Namazi and Faghihi hospitals, two main referral centers of south-west of Iran, were obtained and reviewed between January 2009 and September 2011 for biopsy reports of patients who underwent colonoscopy. Abnormal biopsies were categorized into five different subgroups according to the type of pathologic specimens. By GIS, spatial patterns of colon biopsies were plotted in different maps and spatial auto-correlation of colon biopsies was calculated using the Moran’s Index. Results: A total of 4815 biopsies from 2663 different patients were reviewed, 53.8% of which were men. Abnormal biopsies were 2781 of all specimens (57.8%). Neoplastic lesions, inflammatory bowel diseases and polyps were 9.3%, 19.3% and 29.2% of total biopsies, respectively. Pathologic biopsies were more common in the distal colon. Maps of all biopsies and maps of specific pathologies were manifested in GIS. Conclusions: Our study showed that left-sided lesions are still more common in the Iranian population. On the other hand, surveying the right side of colon is as important as the distal part, which necessitates total colonoscopy.

  16. Corticotropin releasing factor in the rat colon: expression, localization and upregulation by endotoxin

    PubMed Central

    Yuan, P.-Q.; Wu, S. V.; Wang, L.; Taché, Y.

    2009-01-01

    Little is known about CRF expression and regulation in the rat colon compared to the brain. We investigated CRF gene expression, cellular location, and regulation by endotoxin and corticosterone in the male rat colon at 6 h after intraperitoneal (ip) injection. CRF mRNA level, detected by reverse transcription polymerase chain reaction (RT-PCR) was 2.3-fold higher in the distal than proximal colon and 4.4-fold higher in the proximal colonic submucosa plus muscle layers than in mucosa. CRF immunoreactivity was located in the epithelia, lamina propria and crypts, and co-localized with tryptophan hydroxylase, a marker for enterochromaffin (EC) cells, and in enteric neurons. Lipopolysaccharide (LPS, 100 ?g/kg, ip) increased defecation by 2.9-fold and upregulated CRF mRNA by 3.5-fold in the proximal and 2.1-fold in the distal colon while there was no change induced by corticosterone as monitored by quantitative PCR. LPS-induced increased CRF mRNA expression occurred in the submucosa plus muscle layers (2.5-fold) and the mucosa of proximal colon (1.9-fold). LPS increased significantly CRF immunoreactivity in the submucosal and myenteric plexuses of proximal and distal colon compared to saline groups. These results indicate that in rats, CRF is expressed in both proximal and distal colon and more prominently in enteric neurons of the submucosa plus muscle layers and subject to upregulation at the gene and protein levels by LPS through corticosteroid independent pathways. These data suggests that colonic CRF may be part of the local effector limb of the CRF1 receptor mediated colonic alterations induced by acute stress. PMID:19944726

  17. Vanilloid receptor-1 regulates neurogenic inflammation in colon and protects mice from colon cancer.

    PubMed

    Vinuesa, Amaya G; Sancho, Rocío; García-Limones, Carmen; Behrens, Axel; ten Dijke, Peter; Calzado, Marco A; Muñoz, Eduardo

    2012-04-01

    Neuroinflammation driven by the vanilloid-type ion channel receptor transient receptor potential vanilloid type 1 (TRPV-1) is suspected to play a role in the pathophysiology of inflammatory bowel disease. Because inflammatory bowel disease is known to elevate the risk of colon cancer, we examined postulated roles for TRPV-1-driven neuroinflammation in promoting colitis-associated and spontaneous colon cancer development. Using a well-established model of colitis-associated cancer (CAC), we found that mice genetically deficient in TRPV-1 showed a higher incidence and number of tumors in the distal colon. In like manner, genetic deficiency of TRPV-1 in the APC(Min/+) model of spontaneous colon cancer accentuated the number of colonic adenomas formed. Mechanistic analyses in the CAC model revealed an increased infiltration of inflammatory cells into the tumors along with elevated expression of interleukin (IL)-6 and IL-11 and activation of the STAT3 and NF-?B signaling pathways. Notably, TPRV-1-deficient mice exhibited a defect in expression of the anti-inflammatory neuropeptides, vasoactive intestinal peptide (VIP), and pituitary adenylate cyclase-activating peptide (PACAP) which contributed to the generation of a local proinflammatory environment. Together, our findings argue that by limiting neuroinflammatory processes, TRPV-1 exerts a protective role that restricts the initiation and progression of colon cancer. PMID:22396497

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

    E-print Network

    Oleksandr Zavalov; Vera Bocharova; Vladimir Privman; Evgeny Katz

    2013-05-07

    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.

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

    E-print Network

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

    2013-01-01

    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.

  20. Acquired distal renal tubular acidosis in man

    Microsoft Academic Search

    O. S. Better

    1982-01-01

    Summary Distal renal tubular acidosis (dRTA) may complicate renal transplantation, liver cirrhosis, and obstructive uropathy. Indeed, its occurrence may be an early clue to an episode of rejection of the graft or to obstructive uropathy. The mechanism in most patients with dRTA is impaired distal secretion of protons. In some patients, however, back leak of protons from tubular lumen to

  1. Distal symphalangism: a report of two families.

    PubMed

    Poush, J R

    1991-01-01

    This study describes distal symphalangism in 36 individuals in two families, one of which is the largest pedigree of this rare defect yet documented. Distal symphalangism is ankylosis or rigidity of the distal interphalangeal joints of the hands and/or feet. The findings of this report substantiate the mutation as an autosomal dominant phenotype. Several manifestations of distal symphalangism were observed, including the lack of cutaneous creases over affected joints, brachydactyly, fourth-finger hypophalangism, absent nails, and rudimentary nails. Variability ranged from just toes affected, to a single finger affected, to all fingers and all lesser toes affected. The most common expression of the mutant gene was rigid index fingers. Craniosynostosis, premature closure of the sutures of the skull, was encountered twice in the larger of the two families. It is a possible pleiotropic effect of distal symphalangism. PMID:2061594

  2. Patterns of DNA methylation in the normal colon vary by anatomical location, gender, and age

    PubMed Central

    Kaz, Andrew M; Wong, Chao-Jen; Dzieciatkowski, Slavomir; Luo, Yanxin; Schoen, Robert E; Grady, William M

    2014-01-01

    Alterations in DNA methylation have been proposed to create a field cancerization state in the colon, where molecular alterations that predispose cells to transformation occur in histologically normal tissue. However, our understanding of the role of DNA methylation in field cancerization is limited by an incomplete characterization of the methylation state of the normal colon. In order to determine the colon’s normal methylation state, we extracted DNA from normal colon biopsies from the rectum, sigmoid, transverse, and ascending colon and assessed the methylation status of the DNA by pyrosequencing candidate loci as well as with HumanMethylation450 arrays. We found that methylation levels of repetitive elements LINE-1 and SAT-? showed minimal variability throughout the colon in contrast to other loci. Promoter methylation of EVL was highest in the rectum and progressively lower in the proximal segments, whereas ESR1 methylation was higher in older individuals. Genome-wide methylation analysis of normal DNA revealed 8388, 82, and 93 differentially methylated loci that distinguished right from left colon, males from females, and older vs. younger individuals, respectively. Although variability in methylation between biopsies and among different colon segments was minimal for repetitive elements, analyses of specific cancer-related genes as well as a genome-wide methylation analysis demonstrated differential methylation based on colon location, individual age, and gender. These studies advance our knowledge regarding the variation of DNA methylation in the normal colon, a prerequisite for future studies aimed at understanding methylation differences indicative of a colon field effect. PMID:24413027

  3. Colon cleansing: Health or hype?

    MedlinePLUS

    ... cancer treatment, research, education and prevention. Subscribe Colon cleansing: Health or hype? Focused on Health - March 2015 ... bother with a colon cleanse? What’s behind colon cleansing You may see colon cleansing as a solution ...

  4. Evaluation of "instant" preparation of the colon with povidone-iodine.

    PubMed Central

    Jones, F E; DeCosse, J J; Condon, R E

    1976-01-01

    The antimicrobial effect of 20 minutes exposure to 10% povidone-iodine solution and to 5% neomycin-erythromycin solution was evaluated in vitro in 6 suspensions of dog feces. Povidone-iodine eliminated aerobic growth (P less than 0.001) and reduced anaerobes 4.01 +/- 1.06 (P less than 0.02); C. perfringens was the only anaerobic organism grown. Forty unprepared dogs underwent resection of the sigmoid colon and primary anastomosis. Twenty received normal saline and 20 povidone-iodine injected intraluminally immediately before resection. The colon contents of povidone-iodine treated dogs grew only 0.07 +/- 0.07 aerobes and 3.74 +/- 0.49 anaerobes (all Clostridia) (log10/ml colon contents) (P less than 0.001). All povidone-iodine dogs survived 3 weeks with no anastomotic leaks; three controls died from anastomotic leak within the first week (P = 0.12). Reexploration of survivors revealed less perianastomotic reaction in the povidone-iodine group. Twenty minutes exposure to povidone-iodine produced a significant decrease in bacterial counts in vitro and in unprepared sigmoid colon. No adverse effects were demonstrated. Images Fig. 4. PMID:180916

  5. Focal parietal necrosis of the sigmoid due to atypical neuroleptics: a case report.

    PubMed

    Devresse, Arnaud; Maldague, Philippe; Coulier, Bruno; Pierard, Frédéric; Gielen, Isabelle

    2012-06-01

    We present the case of a 26-year-old man with schizoid personality disorder who suffered from a very focal and transparietal necrosis of the sigmoid after an overdose of atypical neuroleptics. This is a singular, rather unknown and potentially lethal side effect of these drugs. The physiopathology of this complication is multifactorial. PMID:22870793

  6. information and computation 128, 48 56 (1996) The Dynamic Universality of Sigmoidal Neural Networks

    E-print Network

    Siegelmann , Hava T

    networks. In the simplest form, an N-state recurrent neural network is an N-dimensional dynamical systeminformation and computation 128, 48 56 (1996) The Dynamic Universality of Sigmoidal Neural Networks-mail: iehavaÃ?ie.technion.ac.il We investigate the computational power of recurrent neural networks that apply

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

    Microsoft Academic Search

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

    1990-01-01

    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

  8. Resection and primary anastomosis with or without modified blow-hole colostomy for sigmoid volvulus

    PubMed Central

    Coban, Sacid; Yilmaz, Mehmet; Terzi, Alpaslan; Yildiz, Fahrettin; Ozgor, Dincer; Ara, Cengiz; Yologlu, Saim; Kirimlioglu, Vedat

    2008-01-01

    AIM: To evaluate the efficacy of resection and primary anastomosis (RPA) and RPA with modified blow-hole colostomy for sigmoid volvulus. METHODS: From March 2000 to September 2007, 77 patients with acute sigmoid volvulus were treated. A total of 47 patients underwent RPA or RPA with modified blow-hole colostomy. Twenty-five patients received RPA (Group A), and the remaining 22 patients had RPA with modified blow-hole colostomy (Group B). The clinical course and postoperative complications of the two groups were compared. RESULTS: The mean hospital stay, wound infection and mortality did not differ significantly between the groups. Superficial wound infection rate was higher in group A (32% vs 9.1%). Anastomotic leakage was observed only in group A, with a rate of 6.3%. The difference was numerically impressive but was statistically not significant. CONCLUSION: RPA with modified blow-hole colostomy provides satisfactory results. It is easy to perform and may become a method of choice in patients with sigmoid volvulus. Further studies are required to further establish its role in the treatment of sigmoid volvulus. PMID:18810779

  9. Recognizing names in biomedical texts using mutual information independence model and SVM plus sigmoid

    Microsoft Academic Search

    G. D. Zhou

    2006-01-01

    Summary In this paper, we present a biomedical name recognition system, called PowerBioNE. In order to deal with the special phenomena in the biomedical domain, various evidential features are proposed and integrated through a mutual infor- mation independence model (MIIM). In addition, a support vector machine (SVM) plus sigmoid is proposed to resolve the data sparseness problem in the MIIM.

  10. A New Sigmoid Catalog from Hinode and the Solar Dynamics Observatory: Statistical Properties and Evolutionary Histories

    NASA Astrophysics Data System (ADS)

    Savcheva, A. S.; McKillop, S. C.; McCauley, P. I.; Hanson, E. M.; DeLuca, E. E.

    2014-09-01

    We present a new sigmoid catalog covering the duration of the Hinode mission and the Solar Dynamics Observatory (SDO) until the end of 2012. The catalog consists of 72 mostly long-lasting sigmoids. We collect and make available all X-ray and EUV data from Hinode, SDO, and the Solar TErrestrial RElations Observatory (STEREO), and we determine the sigmoid lifetimes, sizes, and aspect ratios. We also collect the line-of-sight magnetograms from the Helioseismic and Magnetic Imager (HMI) for SDO or the Michelson Doppler Imager (MDI) on the Solar and Heliospheric Observatory (SOHO) to measure flux versus time for the lifetime of each region. We determine that the development of a sigmoidal shape and eruptive activity is more strongly correlated with flux cancelation than with emergence. We find that the eruptive properties of the regions correlate well with the maximum flux, largest change, and net change in flux in the regions. These results have implications for constraining future flux-rope models of ARs and gaining insight into their evolutionary properties.

  11. 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; ...

  12. Unilateral Molar Distalization: A Nonextraction Therapy

    PubMed Central

    Prasad, M. Bhanu; Sreevalli, S.

    2012-01-01

    In the recent years, nonextraction treatment approaches and noncompliance therapies have become more popular in the correction of space discrepancies. One of the conventional approaches for space gaining in the arches without patient compliance is done by using certain extra oral appliances or intraoral appliance. The greatest advantage of certain appliances like fixed functional and molar distalization appliances is that they minimize the dependence on patient cooperation. Molar distalization appliances like pendulum appliance which distalizes the molar rapidly without the need of head gear can be used in patients as a unilateral space gaining procedure due to buccal segment crowding. PMID:23320203

  13. Cecal adenocarcinoma presenting as colonic intussusception in adulthood

    PubMed Central

    Garcia, Fernando

    2015-01-01

    Intussusception occurs when a proximal segment of intestine invaginates into a distal segment. It is a common cause of intestinal obstruction in children but is infrequent in adults. A 77-year-old woman presented with a 1-month history of intermittent abdominal pain associated with nausea and distended abdomen. Imaging showed a complex elongated sausage-shaped mass in the transverse colon with no obstructive pattern or free air. Surgery confirmed colonic intussusception in addition to a palpable cecal mass requiring a right hemicolectomy. Histologic study demonstrated adenocarcinoma in situ within a tubulovillous adenoma. Surgical excision of the affected intestine is the recommended treatment of choice. PMID:25829646

  14. Perioperative management of distal pancreatectomy

    PubMed Central

    Fujino, Yasuhiro

    2015-01-01

    Recent advances in surgical techniques and perioperative management have markedly reduced operative morbidity after distal pancreatectomy (DP). However, some questions remain regarding the protocol for the perioperative management of DP, in particular, with regard to the development of pancreatic fistula (PF). A review of DP was therefore conducted in order to standardize the management of patients for a favorable outcome. Overall, operative technique and perioperative management emerged as two critical factors contributing to favorable outcome in DP patients. As for the operative method, surgical and closure techniques exhibited differences in outcome. Laparoscopic DP generally yields more favorable perioperative outcomes compared to open DP, and is applicable for benign tumors and some ductal carcinomas of the pancreas. Robotic DP is also available for safe pancreatic surgery. En bloc celiac axis resection offers a high R0 resection rate and potentially allows for some local control in the case of advanced pancreatic cancer. Following resection, staple closure was not found to reduce the rate of PF when compared to hand-sewn closure. In addition, ultrasonic dissection devices, fibrin glue sealing, and staple closure with mesh reinforcement were shown to significantly reduce PF, although there was some bias in these studies. In perioperative management, both preoperative and postoperative treatment affected outcome. First, preoperative endoscopic pancreatic stenting may be an effective prophylactic measure against fistula development following DP in selected patients. Second, in postoperative management, a multifactorial approach including prophylactic antibiotics improved high surgical site infection rates following complex hepato-pancreato-biliary surgery. Furthermore, although conflicting results have been reported, somatostatin analogues should be administered selectively to patients considered to have a high risk for PF. Finally, careful drain management also facilitates a favorable outcome in patients with PF after DP. The results of the review indicate that laparoscopic DP coupled with perioperative management influences outcome in DP patients. PMID:25805921

  15. Perioperative management of distal pancreatectomy.

    PubMed

    Fujino, Yasuhiro

    2015-03-21

    Recent advances in surgical techniques and perioperative management have markedly reduced operative morbidity after distal pancreatectomy (DP). However, some questions remain regarding the protocol for the perioperative management of DP, in particular, with regard to the development of pancreatic fistula (PF). A review of DP was therefore conducted in order to standardize the management of patients for a favorable outcome. Overall, operative technique and perioperative management emerged as two critical factors contributing to favorable outcome in DP patients. As for the operative method, surgical and closure techniques exhibited differences in outcome. Laparoscopic DP generally yields more favorable perioperative outcomes compared to open DP, and is applicable for benign tumors and some ductal carcinomas of the pancreas. Robotic DP is also available for safe pancreatic surgery. En bloc celiac axis resection offers a high R0 resection rate and potentially allows for some local control in the case of advanced pancreatic cancer. Following resection, staple closure was not found to reduce the rate of PF when compared to hand-sewn closure. In addition, ultrasonic dissection devices, fibrin glue sealing, and staple closure with mesh reinforcement were shown to significantly reduce PF, although there was some bias in these studies. In perioperative management, both preoperative and postoperative treatment affected outcome. First, preoperative endoscopic pancreatic stenting may be an effective prophylactic measure against fistula development following DP in selected patients. Second, in postoperative management, a multifactorial approach including prophylactic antibiotics improved high surgical site infection rates following complex hepato-pancreato-biliary surgery. Furthermore, although conflicting results have been reported, somatostatin analogues should be administered selectively to patients considered to have a high risk for PF. Finally, careful drain management also facilitates a favorable outcome in patients with PF after DP. The results of the review indicate that laparoscopic DP coupled with perioperative management influences outcome in DP patients. PMID:25805921

  16. Genetics Home Reference: Distal arthrogryposis type 1

    MedlinePLUS

    ... angled outward toward the fifth finger (ulnar deviation). Clubfoot, which is an inward- and upward-turning foot, ... providers. American Academy of Orthopedic Surgeons: Treatment for Clubfoot Genetic Testing Registry: Arthrogryposis multiplex congenita distal type ...

  17. Neurogenic and Myogenic Properties of Pan-Colonic Motor Patterns and Their Spatiotemporal Organization in Rats

    PubMed Central

    Chen, Ji-Hong; Zhang, Qian; Yu, Yuanjie; Li, Kongling; Liao, Hong; Jiang, Longying; Hong, Lu; Du, Xiaohui; Hu, Xinghai; Chen, Sifeng; Yin, Sheng; Gao, Qingmin; Yin, Xiangdong; Luo, Hesheng; Huizinga, Jan D.

    2013-01-01

    Background and Aims Better understanding of intrinsic control mechanisms of colonic motility will lead to better treatment options for colonic dysmotility. The aim was to investigate neurogenic and myogenic control mechanisms underlying pan-colonic motor patterns. Methods Analysis of in vitro video recordings of whole rat colon motility was used to explore motor patterns and their spatiotemporal organizations and to identify mechanisms of neurogenic and myogenic control using pharmacological tools. Results Study of the pan-colonic spatiotemporal organization of motor patterns revealed: fluid-induced or spontaneous rhythmic propulsive long distance contractions (LDCs, 0.4–1.5/min, involving the whole colon), rhythmic propulsive motor complexes (RPMCs) (0.8–2.5/min, dominant in distal colon), ripples (10–14/min, dominant in proximal colon), segmentation and retrograde contractions (0.1–0.8/min, prominent in distal and mid colon). Spontaneous rhythmic LDCs were the dominant pattern, blocked by tetrodotoxin, lidocaine or blockers of cholinergic, nitrergic or serotonergic pathways. Change from propulsion to segmentation and distal retrograde contractions was most prominent after blocking 5-HT3 receptors. In the presence of all neural blockers, bethanechol consistently evoked rhythmic LDC-like propulsive contractions in the same frequency range as the LDCs, indicating the existence of myogenic mechanisms of initiation and propulsion. Conclusions Neurogenic and myogenic control systems orchestrate distinct and variable motor patterns at different regions of the pan-colon. Cholinergic, nitrergic and serotonergic pathways are essential for rhythmic LDCs to develop. Rhythmic motor patterns in presence of neural blockade indicate the involvement of myogenic control systems and suggest a role for the networks of interstitial cells of Cajal as pacemakers. PMID:23577116

  18. Intraepithelial and lamina propria leucocyte subsets in inflammatory bowel disease: an immunohistochemical study of colon and rectal biopsy specimens.

    PubMed Central

    Caballero, T; Nogueras, F; Medina, M T; Caracuel, M D; de Sola, C; Martínez-Salmerón, F J; Rodrigo, M; García del Moral, R

    1995-01-01

    AIMS--To gain new insights into the pathogenesis and differential diagnosis of ulcerative colitis and colonic Crohn's disease. METHODS--Immunohistochemistry for different leucocyte subsets was performed in biopsy specimens of the sigmoid colon and rectum from 55 patients with inflammatory bowel disease and 11 healthy controls. RESULTS--Colonic biopsy specimens from patients with active ulcerative colitis had significantly higher numbers of CD45+ and CD3+ leucocytes compared with those from patients with inactive disease, and higher numbers of total leucocytes and macrophages than those from patients with Crohn's disease. Rectal biopsy specimens from patients with Crohn's disease had greater numbers of intraepithelial leucocytes (CD45, CD3 and CD8 cells) than specimens from patients with active or inactive ulcerative colitis, or from healthy controls. CONCLUSIONS--Because of the phenotypic differences in the inflammatory infiltrate in the mucosa from the sigmoid colon and the rectum, the segment of the intestine to be biopsied should be specified. Assessment of the leucocytic component of the intraepithelial infiltrate in rectal biopsy specimens was more useful than examination of colonic biopsy specimens in the differential diagnosis of ulcerative colitis and Crohn's disease. Images PMID:7560202

  19. [A bridge to surgery for colon cancer obstruction in a very elderly patient - a case report].

    PubMed

    Kagawa, Yoshinori; Kato, Takeshi; Sakisaka, Hideki; Sato, Yasufumi; Morimoto, Yoshihiro; Kusama, Hiroki; Hashimoto, Tadayoshi; Kawashima, Hiroshi; Kimura, Kei; Mukai, Yosuke; Katsura, Yoshiteru; Takeno, Jun; Nakahira, Shin; Taniguchi, Hirokazu; Takeda, Yutaka; Tamura, Shigeyuki

    2014-11-01

    A 94-year-old woman with a distended abdomen was transferred to our hospital.Based on the enhanced abdominal computed tomographic (CT) finding, she was diagnosed with colonic obstruction due to sigmoid cancer. Colonoscopy was performed to make definitive and qualitative diagnoses, and to release the stenosis using a self-expanding metallic stent (SEMS). The SEMS was inserted without complication.On the fifth day after the decompression, the patient underwent laparoscope-assisted sigmoidectomy with lymph node resection.Despite the colon obstruction, a primary anastomosis was performed.The operation time was 163 min, and 3 mL of blood was lost.The patient was discharged without complications. We describe the case of a bridge to surgery in a very elderly patient. A bridge to surgery can be an effective option for the treatment of colon obstruction in non-elderly and very elderly patients. PMID:25731263

  20. Characterization of Expression Quantitative Trait Loci in the Human Colon

    PubMed Central

    Singh, Tarjinder; Levine, Adam P.; Smith, Philip J.; Smith, Andrew M.; Segal, Anthony W.

    2015-01-01

    Background: Many genetic risk loci have been identified for inflammatory bowel disease and colorectal cancer; however, identifying the causal genes for each association signal remains a challenge. Expression quantitative trait loci (eQTL) studies have identified common variants that induce differential gene expression and eQTLs can be cross-referenced with disease association signals for gene prioritization. However, the genetics of gene expression are highly tissue-specific, and further eQTL datasets from primary tissues are needed. Methods: We have conducted an eQTL discovery study using tissue extracted endoscopically from the terminal ileum and 4 colonic locations of non-inflamed bowel from 65 controls and patients with quiescent inflammatory bowel disease. A genome-wide cis-eQTL analysis was performed on >3,600,000 variants and 13,558 expressed probes. Results: We identified 1312 independent eQTLs associated with the differential expression of 1222 genes in rectal mucosa. One hundred seventy-one, 211, 168, and 102 independent eQTLs were identified in the sigmoid, descending colon, ascending colon, and terminal ileum, respectively. Twenty-six percent of genes with rectal eQTLs were novel and unique compared with 7 published eQTL datasets. Rectal eQTLs were significantly enriched for genes expressed in the colon. Examining 163 inflammatory bowel disease risk loci identified 11 tag single-nucleotide polymorphisms that were rectal eQTLs. A colorectal cancer locus at 11q23 contained a rectal eQTL for COLCA2, a protein implicated in colon cancer pathogenesis. Conclusions: This study defines a catalog of ileal and colonic eQTLs. Our data reaffirm the tissue specificity of eQTLs and support the notion that identification of functional variants in relevant tissue can be effective in fine-mapping genetic risk loci. PMID:25569741

  1. Archaic and modern human distal humeral morphology.

    PubMed

    Yokley, Todd R; Churchill, Steven E

    2006-12-01

    The morphology of the proximal ulna has been shown to effectively differentiate archaic or premodern humans (such as Homo heidelbergensis and H. neanderthalensis) from modern humans (H. sapiens). Accordingly, the morphology of adjacent, articulating elements should be able to distinguish these two broad groups as well. Here we test the taxonomic utility of another portion of the elbow, the distal humerus, as a discriminator of archaic and modern humans. Principal components analysis was employed on a suite of log-raw and log-shape distal humeral measures to examine differences between Neandertal and modern human distal humeri. In addition, the morphological affinities of Broken Hill (Kabwe) E.898, an archaic human distal humeral fragment from the middle Pleistocene of Zambia, and five Pliocene and early Pleistocene australopith humeri were assessed. The morphometric analyses effectively differentiated the Neandertals from the other groups, while the Broken Hill humerus appears morphologically similar to modern human distal humeri. Thus, an archaic/modern human dichotomy-as previously reported for proximal ulnar morphology-is not supported with respect to distal humeral morphology. Relative to australopiths and modern humans, Neandertal humeri are characterized by large olecranon fossae and small distodorsal medial and lateral pillars. The seeming disparity in morphological affinities of proximal ulnae (in which all archaic human groups appear distinct from modern humans) and distal humeri (in which Neandertals appear distinct from modern humans, but other archaic humans do not) is probably indicative of a highly variable, possibly transitional population of which our knowledge is hampered by sample-size limitations imposed by the scarcity of middle-to-late Pleistocene premodern human fossils outside of Europe. PMID:16959299

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

    E-print Network

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

    2010-09-13

    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.

  3. Efficient Digital Implementation of The Sigmoidal Function For Artificial Neural Network

    NASA Astrophysics Data System (ADS)

    Pratap, Rana; Subadra, M.

    2011-10-01

    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.

  4. Ectopic third molar in the mandibular sigmoid notch: Report of a case and literature review

    PubMed Central

    Baykul, Timuçin

    2015-01-01

    Purpose: To evaluate the etiopathogenesis, clinical features and surgical approaches for removal of ectopic third molars in the mandible. Methods: We report a case of an impacted mandibular third molar dislocated on mandibular sigmoid notch. 20 cases of ectopic mandibular third molars reported in the English-language literature, identified from Pubmed and Medline databases are also reviewed. Results: Among the 20 article reported in the presented study, ectopic third molars were generally located in the condylar region. The common symptoms of the clinical examination were pain, trismus, swelling, temporomandibular joint syndroms or no symptoms. Conclusions: Ectopic third molar may be asymptomatic initially with clinical manifestations, later on as adjacent structures are affected. The surgical approach must be carefully planned for the aim of choosing the more conservative technique that produces the minimum trauma to patients. Key words:Ectopic third molar, sigmoid notch, cyst.

  5. Modularity of Biochemical Filtering for Inducing Sigmoid Response in Both Inputs in an Enzymatic AND Gate

    E-print Network

    Bakshi, Saira; Halamek, Jan; Privman, Vladimir; Katz, Evgeny

    2013-01-01

    We report the first systematic study of designed two-input biochemical systems as information processing gates with favorable noise-transmission properties accomplished by modifying the gate's response from convex shape to sigmoid in both inputs. This is realized by an added chemical "filter" process which recycles some of the output back into one of the inputs. We study a system involving the biocatalytic function of the enzyme horseradish peroxidase, functioning as an AND gate. We consider modularity properties, such as the use of three different input chromogens that, when oxidized yield signal-detection outputs for various ranges of the primary input, hydrogen peroxide. We also examine possible uses of different filter-effect chemicals (reducing agents) to induce the sigmoid-response. A modeling approach is developed and applied to our data, allowing us to describe the enzymatic kinetics in the framework of a formulation suitable for evaluating the noise-handling properties of the studied systems as logic...

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

    E-print Network

    Privman, Vladimir; Arugula, Mary A; Melnikov, Dmitriy; Bocharova, Vera; Katz, Evgeny

    2010-01-01

    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...

  7. Distal penile prosthesis extrusion: treatment with distal corporoplasty or Gortex windsock reinforcement

    Microsoft Academic Search

    C C Carson; C H Noh

    2002-01-01

    Subcutaneous extrusion of penile prosthesis cylinders beneath the glans penis is an unusual but difficult complication of penile prosthesis. Without surgical repair, extrusion, infection, and corporeal fibrosis may ensue. Twenty-eight patients with distal corporeal extrusion were reviewed to identify the optimum treatment outcome for these penile prosthesis complications. Records of 28 men with subcutaneous distal penile prosthesis cylinder extrusion were

  8. Segmental colonic transit time

    Microsoft Academic Search

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

    1981-01-01

    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.

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

    SciTech Connect

    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

    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.

  10. COLON TARGETED DRUG DELIVERY SYSTEMS

    Microsoft Academic Search

    Ceyda Tuba

    Colon targeted drug delivery systems have the potential to deliver drugs for the treatment of a variety of colonic diseases and to deliver proteins and peptides to the colon for their systemic absorption. In recent years, various pharmaceutical approaches have been developed for targeting the drugs to the colon include, formation of prodrugs, coating of pH-sensitive polymers, use of colon

  11. After-hyperpolarization currents and acetylcholine control sigmoid transfer functions in a spiking cortical model

    Microsoft Academic Search

    Jesse Palma; Massimiliano Versace; Stephen Grossberg

    Recurrent networks are ubiquitous in the brain, where they enable a diverse set of transformations during perception, cognition,\\u000a emotion, and action. It has been known since the 1970’s how, in rate-based recurrent on-center off-surround networks, the\\u000a choice of feedback signal function can control the transformation of input patterns into activity patterns that are stored\\u000a in short term memory. A sigmoid

  12. Orthotopic bladder substitution following radical cystectomy in women: comparative study between sigmoid and ileal neobladders.

    PubMed

    Miyake, Hideaki; Furukawa, Junya; Muramaki, Mototsugu; Takenaka, Atsushi; Fujisawa, Masato

    2012-01-01

    The objective of this study was to retrospectively compare the clinical outcomes of sigmoid and ileal neobladders (NBs) created in women. This study included 18 and 14 women who underwent orthotopic NB reconstruction using sigmoid and ileal segment, respectively, after radical cystectomy, and postoperative clinical outcomes between the sigmoid and ileal NB groups (SNBG and INBG) were compared. Eighteen early and 7 late complications occurred in 12 and 6 women, respectively; however, there was no significant difference in the incidence of complications between SNBG and INBG. The proportion of patients who could void spontaneously in SNBG (94.4%) was significantly greater than that in INBG (64.3%), while there was no significant difference in continent status between these 2 groups. Despite the lack of significant differences in maximal flow rate and voided volume, post-void residual in SNBG (15.7 ml) was significantly smaller than that in INBG (62.0 ml). SF-36 survey for postoperative quality of life (QOL) did not show any significant differences in 7 of the 8 scores between the 32 women with NB and an age-matched control population; however, 3 of the 8 scores in SNBG were significantly superior to those in INBG. During the observation period of this study, urethral recurrence did not occur in any woman, and there was no significant difference in cancer-specific survival between the 2 groups. These findings suggest that it might be preferable to create sigmoid rather than ileal NB in women following radical cystectomy considering the favorable voiding function and QOL in SNBG. PMID:20056456

  13. Recto-sigmoid endoscopic-ultrasonography in the staging of deep infiltrating endometriosis

    PubMed Central

    Roseau, Gilles

    2014-01-01

    Recto-sigmoid endoscopic ultrasonography (RS-EUS) has first been used in the staging of pelvic deep infiltrating endometriosis in the early 1990's. Since then, although publications have been sparse, RS-EUS is routinely used for this indication in few centers. In this paper, we focus on technical aspects and operating method of rectal and sigmoid endo-sonography, and describe the most characteristic echographic presentations of endometriosis of the lower digestive tract. Through a literature review, results obtained with different types of endo-rectal probes, either flexible endoscopic, or blind rigid, are presented and compared with those of other close imaging techniques: magnetic resonance imaging and the more recent trans-vaginal sonography. As well as these two latter techniques, RS-EUS appears as an interesting method in the staging of pelvic deep infiltrating endometriosis particularly to evaluate rectal and sigmoid infiltrations. However, more prospective studies are required, to correctly define respective indications for each exam, in the light of recent advancements in treating this frequent disease. PMID:25400866

  14. Modeling of X-ray CT image by using revised GMDH-type neural networks with sigmoid functions

    Microsoft Academic Search

    Tadashi Kondo; Abhijit S. Pandya

    2003-01-01

    In this paper, X-ray CT image is identified by using a revised GMDH-type neural network with sigmoid functions. The revised GMDH-type neural network algorithm with sigmoid functions proposed in this paper is developed based on the conventional GMDH-type neural network algorithm with a feedback loop. The revised GMDH-type neural networks can identify nonlinear complex systems very accurately because the complexity

  15. Silicone rubber distal ulnar replacement arthroplasty.

    PubMed

    Sagerman, S D; Seiler, J G; Fleming, L L; Lockerman, E

    1992-12-01

    We retrospectively reviewed 42 patients who underwent resection of the distal ulna with implantation of a silicone rubber ulnar head prosthesis (45 wrists). Two prostheses were used: the original Swanson prosthesis, and a prosthesis of our own design. Follow-up X-rays showed migration or breakage of 63% of the prostheses. No statistically significant correlation existed between the quality of functional outcome and the integrity of the prostheses. There was no significant difference between pre-operative and post-operative range of motion for the entire group or between patients with broken or intact prostheses. Histological confirmation of silicone synovitis was documented in one patient who required implant removal. We suggest that destabilization and breakage of prostheses result from fatigue failure secondary to the torque generated at the distal radio-ulnar joint during repeated pronation and supination. Use of a silicone rubber ulnar head prosthesis following distal ulna resection is not recommended. PMID:1484256

  16. Disorders of the distal radioulnar joint.

    PubMed

    Houdek, Matthew T; Wagner, Eric R; Moran, Steven L; Berger, Richard A

    2015-01-01

    The distal radioulnar joint is responsible for stable forearm rotation. Injury to this joint can occur following a variety of mechanisms, including wrist fractures, ligamentous damage, or degenerative wear. Accurate diagnosis requires a clear understanding of the anatomy and mechanics of the ulnar aspect of the wrist. Injuries can be divided into three major categories for diagnostic purposes, and these include pain without joint instability, pain with joint instability, and joint arthritis. New advancements in imaging and surgical technique can allow for earlier detection of injuries, potentially preserving joint function. In this article, the authors review the pertinent anatomy, biomechanics, and major abnormality involving the distal radioulnar joint. PMID:25285686

  17. Advanced small-cell colon carcinoma: a case report

    PubMed Central

    2013-01-01

    Introduction Small-cell colon carcinoma is a very rare disease among colon neoplasms; it is difficult to achieve long-term survival due to its aggressive tumor behavior. Here we report the long-term survival of a patient with advanced small-cell colon carcinoma achieved by a combination of surgery and continuous chemotherapy. Case presentation A 67-year-old Japanese man underwent abdominal computed tomography in our institution for follow up after gastrectomy, and abnormal thickness of the sigmoid colon wall was revealed. An endoscopy demonstrated a 20mm Bormann 2 lesion with central ulceration located 20cm from the anal verge. A sigmoidectomy was performed. Histologically, the tumor deeply invaded the tissue and extended beyond the serosa, and was diagnosed as small-cell carcinoma. Cisplatin plus irinotecan was administered for adjuvant chemotherapy. Nine months after surgery, a follow-up computed tomography showed an enlarged lymph node behind the inferior vena cava and a 15×8mm nodule located at the ventral side of the cecum. Under consideration of progressive disease, cisplatin plus irinotecan therapy was performed again using the same regimen. After nine cycles of cisplatin plus irinotecan therapy, a follow-up gastric endoscopy demonstrated external tumor invasion to the duodenum wall. Carboplatin plus etoposide therapy was selected as a third-line regimen. After six cycles of carboplatin plus etoposide therapy, the recurrence sites were maintained in a stable condition, and the survival time reached approximately 30 months after the initial surgery. Conclusions We report the long-term survival of a patient with advanced small-cell colon carcinoma. In the future, the accumulation and analysis of rare cases that obtain a better survival time will contribute to clarifying neuroendocrine carcinoma biology, and help to improve the prognosis. PMID:23506215

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

    PubMed Central

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

    2014-01-01

    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

  19. Internal Iliac Artery Aneurysmo–Colonic Fistula after Endovascular Stent-Graft Repair: A Case Report

    PubMed Central

    Fukada, Johji; Tamiya, Yukihiko

    2015-01-01

    We describe rare ilio-enteric fistula that developed after endovascular repair of a left internal iliac artery aneurysm (IIAA). An 83-year-old man with a history of previous surgeries via laparotomies suddenly developed a high fever 3 years after undergoing endovascular abdominal aortic repair (EVAR) with a stent-graft to treat a left isolated IIAA. Computed tomography imaging revealed a fistula between the IIAA and the sigmoid colon. A colostomy was created because severe intraperitoneal adhesions prevented resection of the IIAA. The postoperative course was uneventful and the patient remained free of infection without antibiotics. Residual aneurysms can cause complications after EVAR. PMID:25848433

  20. Identification of bladder and colon afferents in the nodose ganglia of male rats.

    PubMed

    Herrity, April N; Rau, Kristofer K; Petruska, Jeffrey C; Stirling, David P; Hubscher, Charles H

    2014-11-01

    The sensory neurons innervating the urinary bladder and distal colon project to similar regions of the central nervous system and often are affected simultaneously by various diseases and disorders, including spinal cord injury. Anatomical and physiological commonalities between the two organs involve the participation of shared spinally derived pathways, allowing mechanisms of communication between the bladder and colon. Prior electrophysiological data from our laboratory suggest that the bladder also may receive sensory innervation from a nonspinal source through the vagus nerve, which innervates the distal colon as well. The present study therefore aimed to determine whether anatomical evidence exists for vagal innervation of the male rat urinary bladder and to assess whether those vagal afferents also innervate the colon. Additionally, the relative contribution to bladder and colon sensory innervation of spinal and vagal sources was determined. By using lipophilic tracers, neurons that innervated the bladder and colon in both the nodose ganglia (NG) and L6/S1 and L1/L2 dorsal root ganglia (DRG) were quantified. Some single vagal and spinal neurons provided dual innervation to both organs. The proportions of NG afferents labeled from the bladder did not differ from spinal afferents labeled from the bladder when considering the collective population of total neurons from either group. Our results demonstrate evidence for vagal innervation of the bladder and colon and suggest that dichotomizing vagal afferents may provide a neural mechanism for cross-talk between the organs. PMID:24845615

  1. Pathways To Colonization

    Microsoft Academic Search

    David V. Smitherman

    2003-01-01

    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.

  2. Insulin and colon cancer

    Microsoft Academic Search

    Edward Giovannucci

    1995-01-01

    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

  3. Early stage colon cancer

    PubMed Central

    Freeman, Hugh James

    2013-01-01

    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

  4. Incidence and mortality of carcinoids of the colon. Data from the Connecticut Tumor Registry.

    PubMed

    Ballantyne, G H; Savoca, P E; Flannery, J T; Ahlman, M H; Modlin, I M

    1992-05-15

    The aims of this study were to calculate the true incidence of colonic carcinoids in Connecticut from 1976 to 1986 and to determine the outcome of patients with these lesions. Fifty-four patients with carcinoids of the colon were identified (23 male and 31 female patients). Their average age was 64.1 +/- 2.1 years, with a range of 12 to 83 years. The age-adjusted incidence was 0.31 cases/100,000 population/year. Forty-eight percent of the carcinoids were located in the cecum; 16%, ascending colon; 6%, transverse colon; 11%, descending colon; 13%, sigmoid colon; and 6%, not assigned. Follow-up information was available in all cases. The crude 2-year survival rate was 63%, whereas the 5-year survival rate was 37%. Only one of six (16.6%) lesions that were 2 cm or smaller metastasized, whereas 23 of 31 lesions larger than 2 cm metastasized (74%). Six patients have survived an average of 43.5 months after local excision of their carcinoids. Fourteen patients died of their carcinoids. Metachronous gastrointestinal malignant neoplasms developed in six patients. These results suggest that, when found at an early stage, carcinoids of the colon (2 cm or smaller) can be treated by local excision. The vast majority of colonic carcinoids, however, are discovered at an advanced stage and should be treated aggressively with standard colonic resection. In addition, surveillance of the entire gastrointestinal tract should be initiated in these patients because of a high rate of other gastrointestinal malignant neoplasms. PMID:1568162

  5. In vivo studies of biotin absorption in distal rat intestine

    SciTech Connect

    Bowman, B.B.; Rosenberg, I.H.

    1986-03-01

    The authors have extended their previous studies of biotin absorption in rat proximal jejunum (PJ) to examine biotin absorptive capacity of rat ileum (I) and proximal colon (PC) using in vivo intestinal loop technique. Intestinal loops (2.5 cm) were filled with 0.3 ml of solution containing (/sup 3/H)-biotin and (/sup 14/C)-inulin in phosphate buffer, pH 6.5. Biotin absorption was determined on the basis of luminal biotin disappearance after correction for inulin recovery and averaged (pmol/loop-10 min; X +/- SEM). In related experiments, 5-cm loops of PJ, distal I (DI), or PC were filled with 0.5 ml of solution of similar composition (1.0 ..mu..M biotin). The abdominal cavity was closed and the rats were allowed to recover from anesthesia, then sacrificed 3 hr after injection. Biotin absorption averaged 96.2% (PJ), 93.2% (DI), and 25.8% (PC) of the dose administered. These differences were reflected in the radioactive biotin content of plasma and intestinal loop, kidney, and liver. These data demonstrate significant biotin absorption in rat DI and PC, as required if the intestinal microflora are to be considered as a source of biotin for the host.

  6. Torsional properties of distal femoral cortical defects.

    PubMed

    Amanatullah, Derek F; Williams, Joel C; Fyhrie, David P; Tamurian, Robert M

    2014-03-01

    The optimal management of pathologic long bone lesions remains a challenge in orthopedic surgery. The goal of the current study was to investigate the effect of defect depth on the torsional properties of the distal femur. A laterally placed distal metaphyseal cylindrical defect was milled in the cortex of the distal femur in 20 composite models. The proximal extent of the defects was constant. By decreasing the radius of the cylinder that intersected this predefined cord, 4 different radii defining 4 different depths of resection of the distal femur were created for testing: 17%, 33%, 50%, and 67% cortical defects, when normalized to the width of the femur at the level of resection. Each femur was mounted into a hydraulic axial/torsion materials testing machine and each specimen underwent torsional stiffness testing and torsional failure in external rotation. The specimens with less than a 33% cortical loss consistently demonstrated a superiorly oriented spiral fracture pattern, while the specimens with greater than a 50% cortical loss consistently demonstrated an inferiorly oriented transverse fracture pattern. The cortical defects were all statistically (P<.05) less stiff in torsion as the defect grew larger. There was a strong linear correlation between the mean torsional stiffness and cortical defect size (r(2)=0.977). This observation is supported by finite element analysis. The amount of femur remaining is crucial to stability. This biomechanical analysis predicts a critical loss of torsional integrity when a cortical defect approaches 50% of the width of the femur. PMID:24762144

  7. Tailor-made composite functions as tools in model choice: the case of sigmoidal vs bi-linear growth profiles

    PubMed Central

    Peters, Winfried S; Baskin, Tobias I

    2006-01-01

    Background Roots are the classical model system to study the organization and dynamics of organ growth zones. Profiles of the velocity of root elements relative to the apex have generally been considered to be sigmoidal. However, recent high-resolution measurements have yielded bi-linear profiles, suggesting that sigmoidal profiles may be artifacts caused by insufficient spatio-temporal resolution. The decision whether an empirical velocity profile follows a sigmoidal or bi-linear distribution has consequences for the interpretation of the underlying biological processes. However, distinguishing between sigmoidal and bi-linear curves is notoriously problematic. A mathematical function that can describe both types of curve equally well would allow them to be distinguished by automated curve-fitting. Results On the basis of the mathematical requirements defined, we created a composite function and tested it by fitting it to sigmoidal and bi-linear models with different noise levels (Monte-Carlo datasets) and to three experimental datasets from roots of Gypsophila elegans, Aurinia saxatilis, and Arabidopsis thaliana. Fits of the function proved robust with respect to noise and yielded statistically sound results if care was taken to identify reasonable initial coefficient values to start the automated fitting procedure. Descriptions of experimental datasets were significantly better than those provided by the Richards function, the most flexible of the classical growth equations, even in cases in which the data followed a smooth sigmoidal distribution. Conclusion Fits of the composite function introduced here provide an independent criterion for distinguishing sigmoidal and bi-linear growth profiles, but without forcing a dichotomous decision, as intermediate solutions are possible. Our function thus facilitates an unbiased, multiple-working hypothesis approach. While our discussion focusses on kinematic growth analysis, this and similar tailor-made functions will be useful tools wherever models of steadily or abruptly changing dependencies between empirical parameters are to be compared. PMID:16749928

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

    PubMed Central

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

    2007-01-01

    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

  9. Proximal Tumors Are Associated with Greater Mortality in Colon Cancer

    PubMed Central

    2010-01-01

    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

  10. An Incidental Finding of Mucinous Colon Cancer by 18F-Choline PET/CT Determining a Change in Clinical Management of a Patient with Recurrent Prostate Adenocarcinoma

    PubMed Central

    Tuscano, Carmelo; Al Sayyad, Said

    2014-01-01

    A 66-year-old-man underwent a PET/CT scan after a biochemical relapse for a prostate cancer previously treated with a laparoscopic surgical procedure which revealed a focal uptake in the posterior wall of sigmoid colon. The biopsy demonstrated a colon cancer with mucinous differentiation producing a shift in clinical priority. To the best of our knowledge this is the first report in the English literature describing the detection by 18F-choline PET/CT of a colorectal cancer with mucinous differentiation. PMID:25197590

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

    NASA Astrophysics Data System (ADS)

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

    2010-01-01

    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.

  12. Actinomycotic intracavitary lung colonization.

    PubMed

    Severo, L C; Kaemmerer, A; Camargo, J J; Porto, N S

    1989-10-01

    We describe four cases of actinomycotic intracavitary lung colonization and review the literature on the subject. Aspergillus fumigatus, A. niger, A. flavus, Pseudallescheria boydii are responsible for the majority of fungi intracavitary lung colonization (fungus ball). The similarities in clinical symptom (haemoptysis) and radiologic feature (pulmonary air meniscus) of fungus ball and actinomycotic intracavitary colonization prompted the investigation into a range of microorganisms, including Nocardia spp. and Actinomyces spp. We report four cases of such actinomycotic syndrome, three of them in diabetic patients, and review briefly the literature. PMID:2615797

  13. Cell edge detection in JPEG2000 wavelet domain - analysis on sigmoid function edge model.

    PubMed

    Punys, Vytenis; Maknickas, Ramunas

    2011-01-01

    Big virtual microscopy images (80K x 60K pixels and larger) are usually stored using the JPEG2000 image compression scheme. Diagnostic quantification, based on image analysis, might be faster if performed on compressed data (approx. 20 times less the original amount), representing the coefficients of the wavelet transform. The analysis of possible edge detection without reverse wavelet transform is presented in the paper. Two edge detection methods, suitable for JPEG2000 bi-orthogonal wavelets, are proposed. The methods are adjusted according calculated parameters of sigmoid edge model. The results of model analysis indicate more suitable method for given bi-orthogonal wavelet. PMID:21893794

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

    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.

  15. Clinical, endoscopic, and histopathological aspects of sigmoid actinomycosis; a case report and literature review.

    PubMed

    Zamani, Farhad; Sohrabi, Masoudreza

    2015-01-01

    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. PMID:25628853

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

    PubMed Central

    Zamani, Farhad; Sohrabi, Masoudreza

    2015-01-01

    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. PMID:25628853

  17. Minimally Invasive Colon Surgery

    MedlinePLUS Videos and Cool Tools

    ... pathway that I’m talking about involves an assessment of the patient before the hospitalization; it involves ... question submitted about what factors might raise your risk of developing colon cancer. The question specifically relates ...

  18. Colonic pseudo-obstruction.

    PubMed

    Durai, R

    2009-03-01

    Colonic pseudo-obstruction is often confused with mechanical intestinal obstruction. It occurs when there is an autonomic imbalance resulting in sympathetic over-activity affecting some part of the colon. The patient is often elderly with numerous comorbidities. Once mechanical obstruction is excluded by contrast enema, the patient should be treated conservatively with nasogastric and flatus tubes for at least 48 hours, and precipitating factors should be treated. When pseudo-obstruction does not settle with waitful watching, prokinetic agents and/or colonoscopic decompression can be tried. When there is a risk of impending perforation of the caecum from massive colonic dilatation and colonic ischaemia, it should be dealt with by caecostomy or hemicolectomy. In spite of available medical and surgical interventions, the outcome remains poor. PMID:19352564

  19. Causes, Inheritance: Colon cancer

    NSDL National Science Digital Library

    2009-12-26

    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.

  20. Distal tibial fractures and pilon fractures.

    PubMed

    Huebner, E J; Iblher, N; Kubosch, D-C; Suedkamp, N P; Strohm, P C

    2014-01-01

    Fractures of the distal tibia are often very severe injuries that generally occur in the context of high-energy trauma and present with significant concomitant soft tissue involvement. Open fractures and extensive destruction of the articular surfaces are important challenges to the treating surgeon. In consequence the outcome for distal meta- and epiphyseal tibial fractures depends largely on the severity of the soft tissue injury and its management. Conventionally, tibial pilon fractures require surgical intervention. Conservative treatment would only be considered in some exceptional cases, for example, inoperability of the patient. Controversial discussion of optimal surgical technique and optimal timing of surgery is ongoing. There is broad consensus that soft tissue consolidation must have first priority as this is the basis for both fracture healing and good long-term outcomes. Surgical intervention can be managed as a one-stage or multi-stage procedure to achieve internal or external fracture fixation. PMID:24945386

  1. Distal tubular dysfunction in lupus nephritis of childhood and adolescence.

    PubMed

    Hataya, H; Ikeda, M; Ide, Y; Kobayashi, Y; Kuramochi, S; Awazu, M

    1999-11-01

    We describe a girl with lupus nephritis who presented with distal renal tubular acidosis and hyporeninemic hypoaldosteronism. While distal tubular dysfunction is well recognized in adult systemic lupus erythematosus (SLE), only a few pediatric patients have been reported. Evaluation of five pediatric patients with SLE revealed that distal tubular dysfunction in childhood and adolescence is rare. PMID:10603134

  2. Embolic capture angioplasty of lower extremity lesion following distal embolization

    Microsoft Academic Search

    Ahmad Zankar; Emmanouil S. Brilakis; Subhash Banerjee

    2011-01-01

    Peripheral embolization is a known complication of peripheral artery interventions. It can lead to occlusion of distal vessels leading to significant lower extremity ischemia and complications. Peripheral artery interventions involving chronic total occlusions have been shown to have higher rates of complications including distal embolization. Although distal embolic protection strategies are available, they are seldom utilized during lower extremity interventions,

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

    PubMed

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

    2014-04-01

    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

  4. [Surgical management of metastatic colon cancer causing obstruction of the right ventricular outflow tract].

    PubMed

    Sudo, Yoshio; Enomoto, Yoshinori

    2013-09-01

    Metastatic cardiac tumors are commonly detected during autopsy. However, they are seldom diagnosed during life, and surgical resection is rarely indicated. Among the malignant tumors, colon cancer rarely metastasizes to the heart. We report a case of a 70-year-old woman with sigmoid colon cancer, which metastasized to her heart and caused obstruction of the right ventricular outflow tract. The tumor had already metastasized to the liver, lungs, periaortic lymph nodes, and peritoneum. Cardiopulmonary bypass surgery was performed to excise the right ventricular metastatic tumor and to reconstruct the tricuspid valve. Histological analysis of the specimen confirmed a metastatic adenocarcinoma. Although this surgery was performed as palliative cancer therapy, the patient's symptoms were satisfactorily improved. Follow-up echocardiography 2 months after her cardiac surgery showed no space-occupying mass in the right ventricle. PMID:24008642

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

    SciTech Connect

    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

    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.

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

    PubMed

    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

    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

  7. Spatiotemporal evaluation of human colon motility using three-axis fluxgates and magnetic markers.

    PubMed

    Córdova-Fraga, T; Carneiro, A A O; de Araujo, D B; Oliveira, R B; Sosa, M; Baffa, O

    2005-11-01

    An alternative method to study the mechanical activity of the human colon in fasting and postprandial states is presented. The method is based on measurements of the magnetic fields produced by a magnetic marker, a small cylindrical NdBFe magnet, when it was ingested by the subjects. A portable magnetic probe, consisting of two digital three-axis fluxgate magnetometers, arranged in a first-order electronic gradiometer, was implemented for this research. Measurements were taken in 16 healthy male subjects. Contractile activity frequency measurements were taken along the colon length, including the ascending, transverse and descending sections, as well as the rectal sigmoidal section. Values for the contractile activity frequency of 2-5 cycles min(-1) were measured. The set-up is simple, low-cost and suitable for use in an unshielded environment. PMID:16594296

  8. Malunion of distal radius fractures in children.

    PubMed

    Jeroense, Kimberly T V; America, Tim; Witbreuk, Melinda M E H; Sluijs, Johannes A van der

    2015-04-01

    Background and purpose - Distal forearm fractures in children have excellent remodeling potential. The current literature states that 15° is the maximum acceptable angulation limit, though studies focusing on remodeling capacity above this value are lacking. We present data on the remodeling process in children with distal radius malunions with an angulation of ? 15°. Patients and methods - Retrospectively, we radiographically evaluated the remodeling in 33 children (aged 3-14 years) with 40 distal radius fractures healed in ? 15° angulation in the dorsovolar (DV) plane (n = 32) and/or the radioulnar (RU) plane (n = 8). Malunion angulation at the start and at last follow-up was measured on AP and lateral-view radiographs. Mean follow-up time was 9 (3-29) months. Results - All fractures showed remodeling. Mean DV malunion angulation was 23° (15-49) and mean RU malunion angulation was 21° (15-33). At follow-up, this had remodeled to mean 8° (-2 to 21) DV and 10° (3-17) RU. Mean remodeling speed (RS) was 2.5° (0.4-7.6) per month. There was a negative correlation between RS and remodeling time (RT) and a positive correlation between RS and malunion angulation. The relationship between RS and RT was exponential. RS was not found to be related to age or sex. Interpretation - Remodeling speed decreases exponentially over time. Its starting value depends on the amount of angulation of distal radius fractures. This compensates for the increased need for remodeling in severely angulated fractures. PMID:25355309

  9. Fracture of distal end clavicle: A review

    PubMed Central

    Sambandam, Balaji; Gupta, Rajat; Kumar, Santosh; Maini, Lalit

    2014-01-01

    Management of fracture distal end clavicle has always puzzled the orthopaedic surgeons. Now-a-days with a relatively active lifestyle, patients want better results both cosmetically and functionally. Despite so much literature available for the management of this common fracture, there is no consensus regarding the gold standard treatment for this fracture. In this article, we reviewed the literature on various techniques of management for this fracture, both conservative as well as surgical, and their merits and demerits.

  10. Colon Cryptogenesis: Asymmetric Budding

    PubMed Central

    Tan, Chin Wee; Hirokawa, Yumiko; Gardiner, Bruce S.; Smith, David W.; Burgess, Antony W.

    2013-01-01

    The process of crypt formation and the roles of Wnt and cell-cell adhesion signaling in cryptogenesis are not well described; but are important to the understanding of both normal and cancer colon crypt biology. A quantitative 3D-microscopy and image analysis technique is used to study the frequency, morphology and molecular topography associated with crypt formation. Measurements along the colon reveal the details of crypt formation and some key underlying biochemical signals regulating normal colon biology. Our measurements revealed an asymmetrical crypt budding process, contrary to the previously reported symmetrical fission of crypts. 3D immunofluorescence analyses reveals heterogeneity in the subcellular distribution of E-cadherin and ?-catenin in distinct crypt populations. This heterogeneity was also found in asymmetrical budding crypts. Singular crypt formation (i.e. no multiple new crypts forming from one parent crypt) were observed in crypts isolated from the normal colon mucosa, suggestive of a singular constraint mechanism to prevent aberrant crypt production. The technique presented improves our understanding of cryptogenesis and suggests that excess colon crypt formation occurs when Wnt signaling is perturbed (e.g. by truncation of adenomatous polyposis coli, APC protein) in most colon cancers. PMID:24205248

  11. Colon cryptogenesis: asymmetric budding.

    PubMed

    Tan, Chin Wee; Hirokawa, Yumiko; Gardiner, Bruce S; Smith, David W; Burgess, Antony W

    2013-01-01

    The process of crypt formation and the roles of Wnt and cell-cell adhesion signaling in cryptogenesis are not well described; but are important to the understanding of both normal and cancer colon crypt biology. A quantitative 3D-microscopy and image analysis technique is used to study the frequency, morphology and molecular topography associated with crypt formation. Measurements along the colon reveal the details of crypt formation and some key underlying biochemical signals regulating normal colon biology. Our measurements revealed an asymmetrical crypt budding process, contrary to the previously reported symmetrical fission of crypts. 3D immunofluorescence analyses reveals heterogeneity in the subcellular distribution of E-cadherin and ?-catenin in distinct crypt populations. This heterogeneity was also found in asymmetrical budding crypts. Singular crypt formation (i.e. no multiple new crypts forming from one parent crypt) were observed in crypts isolated from the normal colon mucosa, suggestive of a singular constraint mechanism to prevent aberrant crypt production. The technique presented improves our understanding of cryptogenesis and suggests that excess colon crypt formation occurs when Wnt signaling is perturbed (e.g. by truncation of adenomatous polyposis coli, APC protein) in most colon cancers. PMID:24205248

  12. Aldosterone increases KCa1.1 (BK) channel-mediated colonic K+ secretion

    PubMed Central

    Sørensen, Mads V; Matos, Joana E; Sausbier, Matthias; Sausbier, Ulrike; Ruth, Peter; Praetorius, Helle A; Leipziger, Jens

    2008-01-01

    Mammalian K+ homeostasis results from highly regulated renal and intestinal absorption and secretion, which balances the unregulated K+ intake. Aldosterone is known to enhance both renal and colonic K+ secretion. In mouse distal colon K+ secretion occurs exclusively via luminal KCa1.1 (BK) channels. Here we investigate if aldosterone stimulates colonic K+ secretion via BK channels. Luminal Ba2+ and iberiotoxin (IBTX)-sensitive electrogenic K+ secretion was measured in Ussing chambers. In vivo aldosterone was augmented via a high K+ diet. High K+ diet led to a 2-fold increase of luminal Ba2+ and IBTX-sensitive short-circuit current in distal mouse colonic mucosa. This effect was absent in BK ?-subunit-deficient (BK?/?) mice. The resting and diet-induced K+ secretion was stimulated by luminal ionomycin. In BK?/? mice luminal ionomycin did not stimulate K+ secretion. In vitro addition of aldosterone likewise triggered a 2-fold increase in K+ secretion, which was inhibited by the mineralocorticoid receptor antagonist spironolactone and the BK channel blocker IBTX. Semi-quantification of mRNA from colonic crypts showed up-regulation of BK ?- and ?2-subunits in high K+ diet mice. The BK channel could be detected luminally in colonic crypt cells by immunohistochemistry. The expression level of the channel in the luminal membrane was strongly up-regulated in K+-loaded animals. Taken together, these data strongly suggest that aldosterone-induced K+ secretion occurs via increased expression of luminal BK channels. PMID:18617563

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

    E-print Network

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

    2013-01-01

    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.

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

    E-print Network

    Jan Halamek; Oleksandr Zavalov; Lenka Halamkova; Sevim Korkmaz; Vladimir Privman; Evgeny Katz

    2013-04-14

    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.

  15. Two-Input Enzymatic Logic Gates Made Sigmoid by Modifications of the Biocatalytic Reaction Cascades

    SciTech Connect

    Zavalov, Oleksandr [Clarkson University, Potsdam, NY; Bocharova, Vera [ORNL; Halamek, Jan [Clarkson University, Potsdam, NY; Halamkova, Lenka [Clarkson University, Potsdam, NY; Korkmaz, Sevim [Clarkson University, Potsdam, NY; Arugula, Mary [University of Utah; Chinnapareddy, Soujanya [Clarkson University, Potsdam, NY; Katz, Evgeny [Clarkson University, Potsdam, NY; Privman, Vladimir [Clarkson University, Potsdam, NY

    2012-01-01

    Computing based on biochemical processes is a newest rapidly developing field of unconventional information and signal processing. In this paper we present results of our research in the field of biochemical computing and summarize the obtained numerical and experimental data for implementations of the standard two-input OR and AND gates with double-sigmoid shape of the output signal. This form of response was obtained as a function of the two inputs in each of the realized biochemical systems. The enzymatic gate processes in the first system were activated with two chemical inputs and resulted in optically detected chromogen oxidation, which happens when either one or both of the inputs are present. In this case, the biochemical system is functioning as the OR gate. We demonstrate that the addition of a filtering biocatalytic process leads to a considerable reduction of the noise transmission factor and the resulting gate response has sigmoid shape in both inputs. The second system was developed for functioning as an AND gate, where the output signal was activated only by a simultaneous action of two enzymatic biomarkers. This response can be used as an indicator of liver damage, but only if both of these of the inputs are present at their elevated, pathophysiological values of concentrations. A kinetic numerical model was developed and used to estimate the range of parameters for which the experimentally realized logic gate is close to optimal. We also analyzed the system to evaluate its noise-handling properties.

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

    NASA Astrophysics Data System (ADS)

    Verma, Harish Kumar; Pal, Sandeep

    2015-01-01

    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.

  17. Two-Input Enzymatic Logic Gates Made Sigmoid by Modifications of the Biocatalytic Reaction Cascades

    E-print Network

    Zavalov, Oleksandr; Halamek, Jan; Halamkova, Lenka; Korkmaz, Sevim; Arugula, Mary A; Chinnapareddy, Soujanya; Katz, Evgeny; Privman, Vladimir

    2013-01-01

    Computing based on biochemical processes is a newest rapidly developing field of unconventional information and signal processing. In this paper we present results of our research in the field of biochemical computing and summarize the obtained numerical and experimental data for implementations of the standard two-input OR and AND gates with double-sigmoid shape of the output signal. This form of response was obtained as a function of the two inputs in each of the realized biochemical systems. The enzymatic gate processes in the first system were activated with two chemical inputs and resulted in optically detected chromogen oxidation, which happens when either one or both of the inputs are present. In this case, the biochemical system is functioning as the OR gate. We demonstrate that the addition of a "filtering" biocatalytic process leads to a considerable reduction of the noise transmission factor and the resulting gate response has sigmoid shape in both inputs. The second system was developed for functi...

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

    Microsoft Academic Search

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

    1996-01-01

    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

  19. Detubularized Sigmoid Neobladder Versus Detubularized W-Shaped Ileal Neobladder as a Bladder Substitute after Radical Cystectomy for Carcinoma of the Urinary Bladder: A Study of 60 Patients

    Microsoft Academic Search

    MAHMOUD BASSIOUNY; ASHRAF S. ZAGHLOUL; MAGDY EL SHERBINY; NAGI SABER; HASSAN ABDALLA; AHMAD SHOKRY

    2004-01-01

    Objectives: To compare the urodynamic parameters, continence rates, and complications between two different continent urinary reservoirs-the sigmoid neobladder (SN) and W-shaped ileal neobladder (IN). Material and Methods: Sixty patients with bladder cancer underwent radical cystectomy and were divided into two groups. The first group comprised 33 patients who underwent detubularized sigmoid neobladder surgery. The second group included 27 patients who

  20. Surgical and pathological outcomes of laparoscopic surgery for transverse colon cancer

    PubMed Central

    Lee, I. K.; Kang, W. K.; Cho, H. M.; Park, J. K.; Oh, S. T.; Kim, J. G.; Kim, Y. H.

    2008-01-01

    Purpose Several multi-institutional prospective randomized trials have demonstrated short-term benefits using laparoscopy. Now the laparoscopic approach is accepted as an alternative to open surgery for colon cancer. However, in prior trials, the transverse colon was excluded. Therefore, it has not been determined whether laparoscopy can be used in the setting of transverse colon cancer. This study evaluated the peri-operative clinical outcomes and oncological quality by pathologic outcomes of laparoscopic surgery for transverse colon cancer. Materials and methods Analysis of the medical records of patients who underwent laparoscopic colorectal resection from August 2004 to November 2007 was made. Computed tomography, barium enema, and colonoscopy were performed to localize the tumor preoperatively. Extended right hemicolectomy, transverse colectomy, and extended left hemicolectomy were performed for transverse colon cancer. Surgical outcomes and pathologic outcomes were compared between transverse colon cancer (TCC) and other site colon cancer (OSCC). Results Of the 312 colorectal cancer patients, 94 patients underwent laparoscopic surgery for OSCC, and 34 patients underwent laparoscopic surgery for TCC. Patients with TCC were similar to patients with OSCC in age, gender, body mass index, operating time, blood loss, time to pass flatus, start of diet, hospital stay, tumor size, distal resection margin, proximal resection margin, number of lymph nodes, and radial margin. One case in TCC and three cases in OSCC were converted to open surgery. Conclusions Laparoscopic surgery for transverse colon cancer and OSCC had similar peri-operative clinical and acceptable pathological outcomes. PMID:18379794

  1. 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...

  2. VSHOT Measurements of Distal II Dish Concentrators

    SciTech Connect

    Jones, S.A.

    1998-12-14

    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.

  3. Distal amputations for the diabetic foot

    PubMed Central

    Nather, Aziz; Wong, Keng Lin

    2013-01-01

    Minor amputations in diabetic patients with foot complications have been well studied in the literature but controversy still remains as to what constitutes successful or non-successful limb salvage. In addition, there is a lack of consensus on the definition of a minor or distal amputation and a major or proximal amputation for the diabetic population. In this article, the authors review the existing literature to evaluate the efficacy of minor amputations in this selected group of patients in terms of diabetic limb salvage and also propose several definitions regarding diabetic foot amputations. PMID:23869251

  4. Distal Renal Tubular Acidosis and Calcium Nephrolithiasis

    NASA Astrophysics Data System (ADS)

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

    2008-09-01

    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.

  5. Laparoscopically assisted colon surgery

    PubMed Central

    2000-01-01

    Laparoscopy has been used in surgical procedures more frequently in the past decade because it reduces postoperative pain, decreases the length of hospitalization, decreases the duration of disability, and provides a better cosmetic result. We retrospectively reviewed our experience with laparoscopic colon surgery at Baylor University Medical Center. Since 1995, we have done 17 procedures, including 10 colon resections and 7 colostomies. The results in these patients have been quite good: only 1 patient was converted to an open procedure, and the remaining 16 patients experienced no mortality, major morbidity, or wound infection. PMID:16389383

  6. Treatment Option Overview (Colon Cancer)

    MedlinePLUS

    ... are different types of treatment for patients with colon cancer. Different types of treatment are available for patients with colon cancer . Some treatments are standard (the currently used treatment), ...

  7. Young Adults and Colon Cancer

    MedlinePLUS

    ... hand corner of the player. Young Adults and Colon Cancer HealthDay January 28, 2015 Related MedlinePlus Pages Colorectal Cancer Health Screening Transcript Colon cancer may be on the decline in older Americans, ...

  8. Stable encoding of large finite-state automata in recurrent neural networks with sigmoid discriminants.

    PubMed

    Omlin, C W; Giles, C L

    1996-05-15

    We propose an algorithm for encoding deterministic finite-state automata (DFAs) in second-order recurrent neural networks with sigmoidal discriminant function and we prove that the languages accepted by the constructed network and the DFA are identical. The desired finite-state network dynamics is achieved by programming a small subset of all weights. A worst case analysis reveals a relationship between the weight strength and the maximum allowed network size, which guarantees finite-state behavior of the constructed network. We illustrate the method by encoding random DFAs with 10, 100, and 1000 states. While the theory predicts that the weight strength scales with the DFA size, we find empirically the weight strength to be almost constant for all the random DFAs. These results can be explained by noting that the generated DFAs represent average cases. We empirically demonstrate the existence of extreme DFAs for which the weight strength scales with DFA size. PMID:8624958

  9. A new SIR-based sigmoid power control game in cognitive radio networks.

    PubMed

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

    2014-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

  11. A Study on Sigmoid Kernels for SVM and the Training of non-PSD Kernels by SMO-type Methods

    Microsoft Academic Search

    Hsuan-Tien Lin; Chih-Jen Lin

    2003-01-01

    The sigmoid kernel was quite popular for support vector machines due to its origin from neural networks. However, as the kernel matrix may not be positive semi- definite (PSD), it is not widely used and the behavior is unknown. In this paper, we analyze such non-PSD kernels through the point of view of separability. Based on the investigation of parameters

  12. Distal metatarsal coalition: A rare case report

    PubMed Central

    Vun, Shen Hwa; Drampalos, Efstathios; Shareef, Sajan; Sinha, Satyajit; Bramley, Diane

    2015-01-01

    Introduction Metatarsal coalition is an extremely rare condition. We report the second documented case of 4th and 5th distal metatarsal coalition in the literature. Presentation of case An eight-year-old girl was referred to an orthopaedic clinic with a four-month history of forefoot pain and swelling on the plantar aspect of the right little toe. Radiograph and clinical examination confirmed distal metatarsal coalition between the 4th and 5th metatarsals. Following a period of conservative treatment, excision was eventually performed due to worsening symptoms. Patient re-attended two years later with a recurrence of the coalition confirmed by computed tomography (CT) scan. The case was discussed at a tertiary paediatric orthopaedic insititution. Decision was made to manage patient conservatively with insole and physiotherapy until skeletal maturity. A year later, patient’s symptoms did not worsen, and her foot displayed no evidence of change in the arch and shape. Discussion The timing of ossification of coalition varies from one anatomical site to another. Surgery when performed before ossification is complete runs the risk of recurrence. Conclusion Our case report illustrates the importance of restoring normal weight bearing dynamics and pain relief when managing metatarsal coalition, or synostosis in skeletally immature patients. We recommend persevering with conservative treatment, with operative treatment reserved only as a later option, and ideally, until skeletal maturity is achieved. PMID:25670408

  13. Ruptures of the distal biceps tendon.

    PubMed

    Ward, James P; Shreve, Mark C; Youm, Thomas; Strauss, Eric J

    2014-01-01

    Distal biceps ruptures occur most commonly in middle-aged males and result from eccentric contraction of the biceps tendon. The injury typically presents with pain and a tearing sensation in the antecubital fossa with resultant weakness in flexion and supination strength. Physical exam maneuvers and diagnostic imaging aid in determining the diagnosis. Nonoperative management is reserved for elderly, low demand patients, while operative intervention is generally pursued for younger patients and can consist of nonanatomic repair to the brachialis or anatomic repair to the radial tuberosity. Anatomic repair through a one-incision or two-incision approach is commonplace, while the nonanatomic repairs are rarely performed. No clear advantage exists in operative management with a one-incision versus two-incision techniques. Chronic ruptures present a more difficult situation, and allograft augmentation is often necessary. Common complications after repair include transient nerve palsy, which often resolves, and heterotopic ossification. Despite these possible complications, most studies suggest that better patient outcomes are obtained with operative, anatomic reattachment of the distal biceps tendon. PMID:25150334

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

    NASA Astrophysics Data System (ADS)

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

    2014-07-01

    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.

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

    PubMed Central

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

    2014-01-01

    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. PMID:25568786

  16. Genomic homeostasis is dysregulated in favour of apoptosis in the colonic epithelium of the azoxymethane treated rat

    PubMed Central

    2013-01-01

    Background The acute response to genotoxic carcinogens in rats is an important model for researching cancer initiation events. In this report we define the normal rat colonic epithelium by describing transcriptional events along the anterior-posterior axis and then investigate the acute effects of azoxymethane (AOM) on gene expression, with a particular emphasis on pathways associated with the maintenance of genomic integrity in the proximal and distal compartments using whole genome expression microarrays. Results There are large transcriptional changes that occur in epithelial gene expression along the anterior-posterior axis of the normal healthy rat colon. AOM administration superimposes substantial changes on these basal gene expression patterns in both the distal and proximal rat colonic epithelium. In particular, the pathways associated with cell cycle and DNA damage and repair processes appear to be disrupted in favour of apoptosis. Conclusions The healthy rats’ colon exhibits extensive gene expression changes between its proximal and distal ends. The most common changes are associated with metabolism, but more subtle expression changes in genes involved in genomic homeostasis are also evident. These latter changes presumably protect and maintain a healthy colonic epithelium against incidental dietary and environmental insults. AOM induces substantial changes in gene expression, resulting in an early switch in the cell cycle process, involving p53 signalling, towards cell cycle arrest leading to the more effective process of apoptosis to counteract this genotoxic insult. PMID:23343511

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

    PubMed Central

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

    2014-01-01

    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

  18. 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

  19. Campylobacter colonization in broilers

    Microsoft Academic Search

    2009-01-01

    Poultry is generally considered the most important source of foodborne campylobacteriosis. Field studies have provided knowledge on risk factors for colonization of commercial broilers, but the exact routes of transmission remain largely unknown. To identify these routes and develop specific interventions, information on the moment of introduction would be useful. Therefore, in this thesis transmission of Campylobacter among broilers was

  20. Prosthetic reconstruction for tumours of the distal tibia and fibula

    Microsoft Academic Search

    S. H. Lee; H.-S. Kim; Y.-B. Park; T.-Y. Rhie; H. K. Lee

    1999-01-01

    e 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

  1. Distal tubular dysfunction in lupus nephritis of childhood and adolescence

    Microsoft Academic Search

    Hiroshi Hataya; Masahiro Ikeda; Yoshiaki Ide; Yasuaki Kobayashi; Shigeru Kuramochi; Midori Awazu

    1999-01-01

    We describe a girl with lupus nephritis who presented with distal renal tubular acidosis and hyporeninemic hypoaldosteronism.\\u000a While distal tubular dysfunction is well recognized in adult systemic lupus erythematosus (SLE), only a few pediatric patients\\u000a have been reported. Evaluation of five pediatric patients with SLE revealed that distal tubular dysfunction in childhood and\\u000a adolescence is rare.

  2. The injured colon.

    PubMed Central

    Burch, J M; Brock, J C; Gevirtzman, L; Feliciano, D V; Mattox, K L; Jordan, G L; DeBakey, M E

    1986-01-01

    Controversy continues regarding the initial management of civilian colon injuries. The main issues are the safety of colostomy versus the desirability of primary repair and the role of exteriorized repair. From 1979 through 1984, 727 patients with injuries to the colon were treated at a large urban trauma center. Ninety-seven per cent of injuries were caused by penetrating wounds. Ten patients died in the operating room prior to repair of the colon wound. For patients who survived long enough to have their injury treated, 52.4% were treated by primary repair, 32.9% were treated with colostomies, and 14.6% were treated with exteriorized repair. Of the factors that have been stated to influence decision making, the extent of the colon injury was the most important. Location, number, and type of associated injuries, fecal contamination, and shock were less important. However, none of these latter factors mandated performance of a colostomy. The overall mortality rate for the series was 9.9%. Forty-one out of 70 deaths occurred within the first 48 hours and were due to shock and hemorrhage. The mortality rate for primary repair was significantly lower than that for colostomies (p less than 0.01). The presence of shock and age greater than 40 were significant factors influencing mortality (p less than 0.01). Mortality also was directly related to the number and type of associated abdominal injuries. Abdominal abscess also occurred significantly less often in patients treated with primary repair than in those with colostomies (p less than 0.01). The use of exteriorized repair was successful in avoiding colostomy in 59% of patients. Primary repair can be performed with minimal morbidity and mortality and should be the mainstay of treatment for civilian colon injuries. PMID:3718032

  3. Streptococcus Adherence and Colonization

    PubMed Central

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

    2009-01-01

    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

  4. Distal radioulnar joint instability: a review of literature.

    PubMed

    Zyluk, Andrzej; Piotuch, Bernard

    2013-01-01

    Distal radioulnar joint instability most commonly accompanies fractures of the distal radius and is directly caused by lesion of the triangular fibrocartilage complex, which is the major structure responsible for congruity of the distal radioulnar joint. Acute instability accompanying fractures of the distal radius usually does not require separate management, if the fracture itself is firmly fixated. Chronic instabilities causing persistent pain and wrist dysfunction are treated by arthroscopic reinsertion of the torn attachments of the triangular fibrocartilage. If not possible, radioulnar functional tenodesis is performed using palmaris longus tendon graft, thus restoring joint stability. PMID:23493197

  5. Automatic segmentation of the colon

    NASA Astrophysics Data System (ADS)

    Wyatt, Christopher L.; Ge, Yaorong; Vining, David J.

    1999-05-01

    Virtual colonoscopy is a minimally invasive technique that enables detection of colorectal polyps and cancer. Normally, a patient's bowel is prepared with colonic lavage and gas insufflation prior to computed tomography (CT) scanning. An important step for 3D analysis of the image volume is segmentation of the colon. The high-contrast gas/tissue interface that exists in the colon lumen makes segmentation of the majority of the colon relatively easy; however, two factors inhibit automatic segmentation of the entire colon. First, the colon is not the only gas-filled organ in the data volume: lungs, small bowel, and stomach also meet this criteria. User-defined seed points placed in the colon lumen have previously been required to spatially isolate only the colon. Second, portions of the colon lumen may be obstructed by peristalsis, large masses, and/or residual feces. These complicating factors require increased user interaction during the segmentation process to isolate additional colon segments. To automate the segmentation of the colon, we have developed a method to locate seed points and segment the gas-filled lumen with no user supervision. We have also developed an automated approach to improve lumen segmentation by digitally removing residual contrast-enhanced fluid resulting from a new bowel preparation that liquefies and opacifies any residual feces.

  6. Laparoscopic Nephroureterectomy: The Distal Ureteral Dilemma

    PubMed Central

    Srirangam, Shalom J.; van Cleynenbreugel, Ben; van Poppel, Hein

    2009-01-01

    Transitional cell carcinoma affecting the upper urinary tract, though uncommon, constitutes a serious urologic disease. Radical nephroureterectomy remains the treatment of choice but has undergone numerous modifications over the years. Although the standard technique has not been defined, the laparoscopic approach has gained in popularity in the last two decades. The most appropriate oncological management of the distal ureteral and bladder cuff has been a subject of much debate. The aim of the nephroureterectomy procedure is to remove the entire ipsilateral upper tract in continuity while avoiding extravesical transfer of tumor-containing urine during bladder surgery. A myriad of technical modifications have been described. In this article, we review the literature and present an overview of the options for dealing with the lower ureter during radical nephroureterectomy. PMID:19020654

  7. Laparoscopic nephroureterectomy: the distal ureteral dilemma.

    PubMed

    Srirangam, Shalom J; van Cleynenbreugel, Ben; van Poppel, Hein

    2009-01-01

    Transitional cell carcinoma affecting the upper urinary tract, though uncommon, constitutes a serious urologic disease. Radical nephroureterectomy remains the treatment of choice but has undergone numerous modifications over the years. Although the standard technique has not been defined, the laparoscopic approach has gained in popularity in the last two decades. The most appropriate oncological management of the distal ureteral and bladder cuff has been a subject of much debate. The aim of the nephroureterectomy procedure is to remove the entire ipsilateral upper tract in continuity while avoiding extravesical transfer of tumor-containing urine during bladder surgery. A myriad of technical modifications have been described. In this article, we review the literature and present an overview of the options for dealing with the lower ureter during radical nephroureterectomy. PMID:19020654

  8. [Renal arteries stenting using distal antiembolic devices].

    PubMed

    Khokhlov, A V; Furkalo, S N; Khasianova, I V

    2011-10-01

    Endovascular treatment of vasorenal hypertension (VRH) constitutes the operation of choice in selected groups of patients. In the Centre there was conducted a renal arteries (RA) stenting, using antiembolic devices in 6 patients (4 men and 2 women). There were applied distal filters Accunet (Abbot Vascular, USA) 12 mm in length with diameter of a cell 150 mcm. The devices application, having a net structure, is possible in optimal anatomy of artery (rectangular branching), significant stenosis of RA, primarily bad renal function, a presence of anatomically loose plaque in RA, atherosclerotic ulceration of the abdominal aorta wall. There are limitations of their application: an ischemia while performing of the procedure, complexity of the stenotic region visualization, as well as a control of a precise delivering and implantation of a stent-system and a possibility of the embolism occurrence after extraction of occluding balloon. PMID:22295544

  9. Glucocorticoid receptor is indispensable for physiological responses to aldosterone in epithelial Na + channel induction via the mineralocorticoid receptor in a human colonic cell line

    Microsoft Academic Search

    Theresa Bergann; Anja Fromm; Steffen A. Borden; Michael Fromm; Jörg D. Schulzke

    2011-01-01

    The epithelial Na+ channel (ENaC) plays a crucial role in electrogenic Na+ absorption in the distal colon. ENaC induction via the mineralocorticoid receptor (MR) and the glucocorticoid receptor (GR) is differentially regulated by modulatory components. As most existing epithelial cell lines including colonic epithelial cell lines miss the co-expression of functional GR and MR, signaling on ENaC is only poorly

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

    PubMed Central

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

    2012-01-01

    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

  11. Insights into Vibrio cholerae Intestinal Colonization from Monitoring Fluorescently Labeled Bacteria

    PubMed Central

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

    2014-01-01

    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

  12. Differential stimulation of S-adenosylmethionine decarboxylase by difluoromethylornithine in the rat colon and small intestine.

    PubMed Central

    Halline, A G; Dudeja, P K; Brasitus, T A

    1989-01-01

    The effects of chronic inhibition of ornithine decarboxylase (ODC) by the specific inhibitor difluoromethylornithine (DFMO) in the rat colon and small intestine on mucosal contents of polyamines, decarboxylated S-adenosylmethionine (decarboxylated AdoMet) and S-adenosylmethionine decarboxylase (AdoMet decarboxylase) activity were studied. Administration of 1% DFMO in the drinking water for 10 or 15 weeks resulted in inhibition of ODC and decreases in intracellular putrescine and spermidine contents in both proximal and distal segments of small intestine and colon. At both time points DFMO administration resulted in a dramatic stimulation of AdoMet decarboxylase activity and a rise in decarboxylated AdoMet content in the proximal and distal small-intestinal segments compared with controls, which was not seen in either colonic segment of DFMO-treated animals. This differential stimulation of AdoMet decarboxylase by DFMO in the small intestine and colon could not be entirely explained on the basis of differences in polyamine contents, which are known to regulate this enzyme activity. Kinetic and inhibition studies of AdoMet decarboxylase in control small and large intestine revealed that: (1) there was no difference in Vmax. values between the tissues; (2) the Km for AdoMet was higher in the small intestine than in the colon; and (3) the Ki for product inhibition by decarboxylated AdoMet was higher in the small intestine than in the colon. These results suggest that the differential stimulation of AdoMet decarboxylase by DFMO in the small intestine and colon may be due to different isoenzymes and could play a significant role in the regulation of polyamine contents throughout the gut. PMID:2497738

  13. A rare case of medullary carcinoma of the colon presenting as intussusception in an adult with rectal bleeding.

    PubMed

    Jain, Shilpa; Jain, Ankur; Onizuka, Neil; Boukhar, Sarag A

    2014-11-01

    Medullary carcinoma is a recently recognized rare subtype of colorectal cancer resembling both poorly differentiated adenocarcinoma and neuroendocrine tumors. Medullary carcinoma most commonly presents in the proximal colon and can be differentiated from other right-sided malignant lesions by histology and immunochemical markers. We present here a rare case of an adult patient with rectal bleeding who was found to have an intussusception due to underlying medullary carcinoma of the splenic flexure. A 72-year-old woman presented to our GI clinic with rectal bleeding. Colonoscopy revealed a necrotic mass of the sigmoid colon, later determined by CT to be a colo-colonic intussusception at the level of the splenic flexure. Patient underwent diagnostic laparoscopy with findings of a large splenic flexure mass, which was resected and found to be medullary carcinoma of the colon. The tumor was poorly differentiated and exhibited microsatellite instability but was discovered at an early stage and thus did not require any adjuvant chemotherapy. Unlike most previously reported cases of medullary carcinoma, our patient presented with a left sided tumor. To our knowledge, this is the first report of a medullary colon cancer presenting with intussusception. PMID:25414804

  14. Difficult colon polypectomy

    PubMed Central

    Vormbrock, Klaus; Mönkemüller, Klaus

    2012-01-01

    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

  15. Laparoscopic-assisted resection of giant sigmoid lipoma under colonoscopic guidance

    Microsoft Academic Search

    R. Ladurner; T. Mussack; F. Hohenbleicher; C. Folwaczny; M. Siebeck; K. Hallfeld

    Colonic lipomata are rare and mostly asymptomatic lesions; but as they become larger they may produce abdominal pain, constipation, diarrhea, hemorrhage, and intussusception. We report the case of a 75-year-old man who suffered from nonspecific recurrent abdominal pain in the left upper and lower quadrants and had variable episodes of diarrhea and constipation of 4 weeks' duration. During colonoscopy, a

  16. Non familial juvenile distal spinal muscular atrophy of upper extremity

    Microsoft Academic Search

    J B Peiris; K N Seneviratne; H R Wickremasinghe; S B Gunatilake; R Gamage

    1989-01-01

    An uncommon variety of non familial, juvenile onset, spinal muscular atrophy with asymmetric distal upper extremity affection is described. One hundred and two patients with a one to 14 year follow up are analysed. Spinal muscular atrophies with a distal distribution are rare. However, in the past three decades, previously unrecognised varieties of neurogenic muscular atrophy have been described in

  17. Distal Prosodic Context Affects Word Segmentation and Lexical Processing

    ERIC Educational Resources Information Center

    Dilley, Laura C.; McAuley, J. Devin

    2008-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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. PMID:25674123

  19. The use of distal rhynchokinesis by birds feeding in water.

    PubMed

    Estrella, Sora M; Masero, José A

    2007-11-01

    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

  20. Distal Deposits from a Cometary Impact Event

    NASA Astrophysics Data System (ADS)

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

    2011-12-01

    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.

  1. Laparoscopic permanent sigmoid stoma creation through the extraperitoneal route versus transperitoneal route

    PubMed Central

    Wang, Feng-Bing; Pu, Yu-Wei; Zhong, Feng-Yun; Lv, Xiao-Dong; Yang, Zhi-Xue; Xing, Chun-Gen

    2015-01-01

    Objectives: To compare laparoscopic extraperitoneal colostomy with transperitoneal colostomy for construction of a permanent stoma by measuring the incidence of parastomal hernia, and other postoperative complications related to colostomy. Methods: The meta-analysis was carried out in the General Surgery Department of the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China in 2014. A literature search of Medline, EMBASE, Cochrane database, and the Chinese Biomedical Literature Database (CBM) from the years 1990 to 2014 was performed. The literature searches were carried out using medical subject headings and free-text words: extraperitoneal colostomy, transperitoneal colostomy, laparoscopic extraperitoneal colostomy, rectal cancer, laparoscopic abdominoperineal resection, parastomal hernia, permanent stoma, and colostomy-related complications. Two different reviewers carried out the search and evaluated studies independently. Results: One randomized controlled trial and 6 retrospective studies were included. A total of 378 patients (209 extraperitoneal colostomy and 169 transperitoneal colostomy) were identified. Our analysis showed that there was a significantly lower rate of parastomal hernia (odds ratio 0.10; 95% confidence interval 0.03-0.29, p<0.0001) in the extraperitoneal colostomy group. However, the other stoma-related complications were not significantly different between the 2 groups. Conclusion: Colostomy construction via the extraperitoneal route using a laparoscopic approach can largely reduce the incidence of parastomal hernia. Laparoscopic permanent sigmoid stoma creation through the extraperitoneal route should be the first choice after laparoscopic abdominoperineal resection. PMID:25719578

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

    PubMed

    Voukelatos, Dimitrios; Pain, Matthew Tg

    2015-02-26

    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

  3. Prospective randomized controlled trial (phase III) to comparing laparoscopic distal gastrectomy with open distal gastrectomy for gastric adenocarcinoma (KLASS 01)

    PubMed Central

    Han, Sang-Uk; Kim, Min-Chan; Hyung, Woo Jin; Kim, Wook; Lee, Hyuk-Joon; Ryu, Seung Wan; Cho, Gyu Seok; Kim, Chan Young; Yang, Han-Kwang; Park, Do Joong; Song, Kyo Young; Lee, Sang IL; Ryu, Seong Yeob; Lee, Joo Ho

    2013-01-01

    A randomized controlled trial to evaluate the long-term outcomes of laparoscopic distal gastrectomy for gastric cancer is currently ongoing in Korea. Patients with cT1N0M0-cT2aN0M0 (American Joint Committee on Cancer, 6th edition) distal gastric cancer were randomized to receive either laparoscopic or open distal gastrectomy. For surgical quality control, the surgeons participating in this trial had to have performed at least 50 cases each of laparoscopy-assisted distal gastrectomy and open distal gastrectomy and their institutions should have performed more than 80 cases each of both procedures each year. Fifteen surgeons from 12 institutions recruited 1,415 patients. The primary endpoint is overall survival. The secondary endpoints are disease-free survival, morbidity, mortality, quality of life, inflammatory and immune responses, and cost-effectiveness (ClinicalTrials.gov ID: NCT00452751). PMID:23396494

  4. Ipsilateral olecranon and distal radius fracture: A case report

    PubMed Central

    Cengiz, Ömer; Polat, Gökhan; Karademir, Gökhan; Kara, Deniz; Erdil, Mehmet

    2014-01-01

    Introduction Concomitant ipsilateral olecranon and distal radius fracture are rare injuries. Their clinical presentation is unusual and investigation and management is poorly described. Presentation of case We present a 55-year-old woman patient who fell off sustaining a concomitant distal radius and olecranon fracture in the same extremity. On examination, there was gross swelling of the proximal and distal forearm and no neurovascular deficit. Radiographs confirmed distal radius and olecranon fracture. Patient was treated with open reduction and anatomic locking plate for olecranon and a closed reduction percuteneous K wire fixation with penning fixator for distal radius fracture. After physical therapy program, functional results were good and DASH score was 60. Discussion Several different combinations of fracture with dislocation have been described, but, to our knowledge, concurrent ipsilateral olecranon and distal radius fracture has not been reported before. In the literature review there are two similar cases in the English literature. Conclusion Ipsilateral olecranon and distal radius fracture is a very rare injury due to different trauma mechanisms. However we should keep in mind that there may be adjacent joints and structures for concomitant injuries. PMID:25544490

  5. Is distal locking with IMHN necessary in every pertrochanteric fracture?

    PubMed Central

    Skála-Rosenbaum, Ji?í; Bartoška, Radek

    2009-01-01

    Two groups of patients were treated for pertrochanteric fractures (AO/ASIF 31A1+A2) with an intramedullary hip nail. In the first group of 44 patients distal dynamic locking was used, and in the second group of 74 patients the nail was not distally locked. Comparison of the two groups of patients did not show any difference in terms of the period of fracture healing, radiological and functional results or frequency of complications. In the group with a distally locked nail the surgery took 40.4 minutes, while in the group without distal locking only 34.4 minutes. In total, we recorded only seven complications, none of which were caused by absence of distal locking of the nail. This study has shown that distal locking of IMHN is unnecessary in most pertrochanteric fractures (AO/ASIF 31A1+2). The only exceptions are comminution of the lateral wall of the greater trochanter, secondary diaphyseal fracture line, large posteromedial fragment extended distally below the level of the lesser trochanter and broad intramedullary canal. PMID:19882156

  6. Colon cancer stem cells.

    PubMed

    Ricci-Vitiani, Lucia; Fabrizi, Eros; Palio, Elisabetta; De Maria, Ruggero

    2009-11-01

    Colorectal cancer (CRC) is the third most common form of cancer and the second cause of cancer-related death in the Western world, leading to 655,000 deaths worldwide per year (Jemal et al. in CA Cancer J Clin 56:106-130, 2006). Despite the emergence of new targeted agents and the use of various therapeutic combinations, none of the treatment options available is curative in patients with advanced cancer. A growing body of evidence is increasingly supporting the idea that human cancers can be considered as a stem cell disease. According to the cancer stem cell model, malignancies originate from a small fraction of cancer cells that show self-renewal and pluripotency and are capable of initiating and sustaining tumor growth (Boman and Wicha in J Clin Oncol 26:2795-2799, 2008). The cancer-initiating cells or "cancer stem cells" were first identified in hematologic malignancies and most recently in several solid tumors, including CRC. The hypothesis of stem cell-driven tumorigenesis in colon cancer raises questions as to whether current treatments are able to efficiently target the tumorigenic cell population that is responsible for tumor growth and maintenance. This review will focus on the different aspects of stem cell biology in the context of CRC, which might help to understand the mechanisms that give rise to tumor development and resistance to therapy. First, we will briefly revise the knowledge available on normal intestinal stem cells and recent advances in understanding crypt biology, which have led to new theory on the origins of colon adenomas and cancers. Then, we will summarize the evidence and current status on colon cancer stem cells, focusing on their relevance and promises for the treatment of colorectal carcinoma. PMID:19727638

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

    PubMed

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

    2013-05-01

    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 (1)H 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

  8. A colonic mineralocorticoid receptor cell model expressing epithelial Na+ channels.

    PubMed

    Bergann, Theresa; Plöger, Svenja; Fromm, Anja; Zeissig, Sebastian; Borden, Steffen A; Fromm, Michael; Schulzke, Jörg D

    2009-05-01

    In the distal colon, the epithelial sodium channel (ENaC) is rate limiting for sodium absorption. Progress in the molecular characterization of ENaC expression and trafficking in response to the mineralocorticoid aldosterone has been hampered, since no epithelial colonic cell line existed expressing functional ENaC stimulated by nanomolar aldosterone via mineralocorticoid receptor (MR). Here, we present a human colonic epithelial cell line inducibly expressing the MR (HT-29/B6-Tet-On-MR) which exhibits aldosterone-dependent ENaC-mediated sodium transport in the presence of the short-chain fatty acid butyrate. Butyrate was necessary for high-level expression of MR which allowed for aldosterone-dependent upregulation of beta- and gamma-ENaC expression. As butyrate alone was not capable of promoting ENaC-mediated sodium transport, aldosterone-induced GILZ (glucocorticoid-induced leucine zipper protein) was identified as a candidate factor increasing apical ENaC levels. PMID:19275887

  9. In vivo motility of rat colon chronically pretreated with sennosides.

    PubMed

    Fioramonti, J; Dupuy, C; Buéno, L

    1993-10-01

    Ceco-colonic myoelectrical activity was investigated in rats pretreated for 23 weeks by sennosides (10 or 40 mg/kg/day), Na-picosulfate (2.5 or 10 mg/kg/day) or laxative vehicle (control). On the last week of treatment the animals were equipped with Nichrome electrodes on the cecum, the proximal and distal colon. In comparison with controls, sennoside or Na-picosulfate treatment did not induce any significant (p > 0.05) change in the duration of long spike bursts (LSB) which are associated with phasic contractions. On the last 2 days of treatment the frequency of LSB for 2 h before and 2 h after laxative administration, as well as for 30 min after a 3-gram meal was not significantly (p > 0.05) different in control and treated animals. Similarly, on the first 2 days, as well as on days 13 and 14, after the end of treatment, no significant (p > 0.05) difference in the LSB frequency appeared between control and treated animals, in the fasted state or after a 3-gram meal. It is concluded that long-term treatment with sennosides or Na-picosulfate does not induce chronic changes in colonic motility in rats. PMID:8234424

  10. 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

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

    1990-01-01

    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%),

  11. c-Myb is required for progenitor cell homeostasis in colonic crypts

    PubMed Central

    Malaterre, Jordane; Carpinelli, Marina; Ernst, Matthias; Alexander, Warren; Cooke, Michael; Sutton, Susan; Dworkin, Sebastian; Heath, Joan K.; Frampton, Jon; McArthur, Grant; Clevers, Hans; Hilton, Douglas; Mantamadiotis, Theo; Ramsay, Robert G.

    2007-01-01

    The colonic crypt is the functional unit of the colon mucosa with a central role in ion and water reabsorption. Under steady-state conditions, the distal colonic crypt harbors a single stem cell at its base that gives rise to highly proliferative progenitor cells that differentiate into columnar, goblet, and endocrine cells. The role of c-Myb in crypt homeostasis has not been elucidated. Here we have studied three genetically distinct hypomorphic c-myb mutant mouse strains, all of which show reduced colonic crypt size. The mutations target the key domains of the transcription factor: the DNA binding, transactivation, and negative regulatory domains. In vivo proliferation and cell cycle marker studies suggest that these mice have a progenitor cell proliferation defect mediated in part by reduced Cyclin E1 expression. To independently assess the extent to which c-myb is required for colonic crypt homeostasis we also generated a novel tissue-specific mouse model to allow the deletion of c-myb in adult colon, and using these mice we show that c-Myb is required for crypt integrity, normal differentiation, and steady-state proliferation. PMID:17360438

  12. An Asian Perspective on the Management of Distal Radius Fractures

    PubMed Central

    Sebastin, Sandeep J.; Chung, Kevin C.

    2012-01-01

    Synopsis There is little data with regards to the epidemiology, pathology, or management of distal radius fractures from centers in Asia. Asia includes five advanced economies, namely Hong Kong SAR, Japan, Korea, Singapore, and Taiwan and a number of emerging economies prominent among which are China, India, Malaysia, Philippines, and Thailand. This article examines the available epidemiological data from Asia, and compares the management of distal radius fractures in the advanced and emerging Asian economies and how they match up to the current management in the west. It concludes by offering solutions for improving outcomes of distal radius fractures in both the advanced and emerging economies of Asia. PMID:22554658

  13. Recurrence of colonic cancer twice at the site of stapled colorectal anastomosis.

    PubMed

    Futami, Ryouhei; Shimanuki, Kimiyoshi; Sugiura, Atsushi; Tsuchiya, Yoshikazu; Kaneko, Masahiro; Okawa, Keiichi; Mineta, Sho; Sugiyama, Yoshihiko; Akimaru, Koho; Tajiri, Takashi

    2007-06-01

    Recurrence at the site of a stapled anastomosis is generally believed to result from the luminal implantation of viable cancer cells during stapling. We report a case in which colon cancer recurred twice at the site of a stapled anastomosis, despite povidone iodine (PVP-I) lavage consisting of an enema with 5% PVP-I solution before the operation and intraoperative lavage of the rectal remnant and the descending colon with a 10% PVP-I solution. Three months after sigmoidectomy to resect a carcinoma of the sigmoid colon, a circular anastomotic recurrence was found at the suture line after anastomosis with a stapler. However, 11 months after the subsequent resection and reanastomosis to remove the first anastomotic recurrence, another anastomotic recurrence was found. We performed abdominoperineal resection for the second recurrence at the site of the stapled anastomosis. Suture-line recurrence could not be prevented in the present case despite lavage with a PVP-I solution for prophylaxis. PMID:17625376

  14. Distal acidification defect induced by phosphate deprivation.

    PubMed

    Arruda, J A; Julka, N K; Rubinstein, H; Sabatini, S; Kurtzman, N A

    1980-09-01

    The effect of phosphate deprivation on urinary acidification was investigated in rats fed a phosphate-deficient diet and in control rats fed the same diet supplemented with phosphate. Phosphate-deprived animals developed hypophosphatemia, hypercalcemia, and hypophosphaturia, but failed to develop hyperchloremic metabolic acidosis following 30 or 60 days of phosphate deprivation. Baseline urine pH was significantly higher in phosphate-deprived rats than in controls, but baseline urine HCO3 excretion was not significantly different between the two groups. The pattern of HCO3 reabsorption in phosphate-deprived rats was identical to that of controls at both low and high plasma HCO3 levels. During chronic NH4Cl administration, both 30- and 60-day phosphate-deprived rats had a sigificantly higher minimal urine pH and lower titratable acid and net acid excretion than seen in controls. NH4 excretion was significantly lower than controls in the 60-day phosphate-deprived rats only. During Na2SO4 administration the minimal urine pH was significantly lower in controls than in phosphate-deprived rats, but there was overlap of urine pH values. At comparable levels of urine pH, NH4 excretion was significantly lower in phosphate-deprived rats than in controls. Phosphate-deprived rats were able to raise urine-blood CO2 pressure to the same levels as controls during both HCO3 loading and Tris buffer administration. Phosphate-deprived rats had greater extrarenal buffering capacity than controls as evidenced by a lower decline in blood pH and HCO3 during HCl infusion in phosphate-deprived rats. These data demonstrate that phosphate deprivation is associated with distal acidification defect, impaired NH3 excretion, and increased extrarenal buffering capacity. The increased availability of buffer in phosphate deprivation may play an important role in acid-base homeostasis in this condition. PMID:7412557

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

    PubMed Central

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

    2011-01-01

    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

  16. [Volvulus of the transverse colon].

    PubMed

    Genoni, E; Bonzi, F; Bernieri, A; Boccazzi, G; Ciprandi, G

    1987-08-01

    A case of transverse colon volvulus is described. The authors illustrate the procedures adopted for diagnosing the condition, which are mainly radiological consisting in plain film of the abdomen and barium enema, where necessary. The treatment is invariably surgical: detorsion of the volvulus and colopexy, and resection of the transverse colon in the presence of ischaemic lesions or right hemicolectomy. PMID:3690776

  17. Colonic Drug Delivery: Prodrug Approach

    Microsoft Academic Search

    V. R. Sinha; Rachna Kumria

    2001-01-01

    The colon is largely being investigated as a site for administration of protein and peptides, which are degraded by digestive enzymes in the upper GIT. Also for local diseases of the colon, drug administration to the site of action can not only reduce the dose to be administered, but also decrease the side effects. One of the approaches used for

  18. 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 ...

  19. About Colon Cancer Family Registries

    Cancer.gov

    The Colon CFR includes lifestyle, medical history, and family history data collected from more than 41,000 men and women from 14,500 families with and without colorectal cancer. The Colon CFR began recruiting families in 1997, and all participants are followed up every 5 years to update personal and family histories and expand recruitment if new cases have occurred since baseline.

  20. Intraarterial and Intravenous Treatment of Transverse/Sigmoid Sinus Dural Arteriovenous Fistulas

    PubMed Central

    Lv, X.; Jiang, C.; Li, Y.; Yang, X.; Wu, Z.

    2009-01-01

    Summary Transverse/sigmoid sinus (TS) is the most common location for cerebral dural arteriovenous fistulas (DAVFs). Most of them are cured by venous embolization or a combination of arterial embolization and surgery/radiosurgery. Our goal was to reconsider the endovascular treatment strategy of TSDAVFs according to the new possibilities of arterial embolization using Onyx-18. Nineteen patients with TSDAVFs were included in a prospective study between 2004 and 2007. Three of them had type I, four had type IIa, six had type IIa+b, three had type III, and three had type IV fistulas. Three presented with subarachnoid hemorrhage. The approach routes, angiographic results, complications, and clinical outcome were assessed. The mean clinical follow-up period was 32.5 months. In one patient, the DAVF had been obliterated spontaneously at ten month follow-up. Complete angiographic cure was obtained in nine cases with one case of progressive thrombosis. Of these ten cures were achieved after a single procedure in seven out of ten patients who had not been embolized previously. Three patients were cured with sinus packing with prior arterial embolization. Among these 19 patients, 15 underwent follow-up angiography which confirmed the complete cure. Partial occlusion was obtained in nine patients, one was cured after additional surgery, and one underwent radiosurgery. Hallucination occurred in one completely cured patient on day one. Based on this experience, we believe that intraarterial Onyx may be the primary treatment of choice for patients with TSDAVFs. The applicability of this new embolic agent indicates the need for reconsideration of the treatment strategy for such fistulas. PMID:20465912

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

    SciTech Connect

    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

    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.

  2. Combined open proximal and stent-graft distal repair for distal arch aneurysms: an alternative to total debranching.

    PubMed

    Zierer, Andreas; Sanchez, Luis A; Moon, Marc R

    2009-07-01

    We present herein a novel, combined, simultaneous open proximal and stent-graft distal repair for complex distal aortic arch aneurysms involving the descending aorta. In the first surgical step, the transverse arch is opened during selective antegrade cerebral perfusion, and a Dacron graft (DuPont, Wilmington, DE) is positioned down the descending aorta in an elephant trunk-like fashion with its proximal free margin sutured circumferentially to the aorta just distal to the left subclavian or left common carotid artery. With the graft serving as the new proximal landing zone, subsequent endovascular repair is performed antegrade during rewarming through the ascending aorta. PMID:19559261

  3. Standardized palmar plating of dorsally displaced distal radius fractures.

    PubMed

    Löw, Steffen; Herold, Dirk; Eingartner, Christoph

    2013-06-01

    With the inauguration of fixed-angle plates, palmar plating has become a widely accepted way to treat dorsally displaced distal radius fractures. The technique by which the plate is applied to the radius varies. Such plates are primarily fixed either distally or at the proximal limbs. In this article, the standardized technique by which osteosynthesis is conducted in our institution is described step by step. The plate is first fixed to the shaft. Reduction is temporarily maintained by K-wires that run through the plate's distal margin. These K-wires are usually reliable in maintaining adequate reduction and are gradually replaced by locking screws in the distal row. Of 96 consecutive procedures, the duration of operation, the amount of fluoroscopy needed, and the intraoperative radiographic results are reported. Using this method, constantly good results can be achieved, even if the operation is done by less experienced surgeons. PMID:23689859

  4. Genetics Home Reference: CAV3-related distal myopathy

    MedlinePLUS

    ... to 30 seconds and may be painful. Overgrowth (hypertrophy) of the calf muscles can also occur in ... cardiomyopathy ; cell ; cell membrane ; contraction ; distal ; gene ; hypertrophic ; hypertrophy ; inherited ; muscle cell ; muscle cells ; muscular dystrophy ; mutation ; ...

  5. Distal Renal Tubular Acidosis in Infancy: A Bicarbonate Wasting State

    ERIC Educational Resources Information Center

    Rodriguez-Soriano, J.; And Others

    1975-01-01

    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)

  6. Distal clavicle osteolysis following fixation with a synthetic ligament

    PubMed Central

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

    2011-01-01

    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

  7. Distal facial nerve exposure: A key to partial parotidectomy

    Microsoft Academic Search

    Robert C. Wang; Annabel E. Barber; Marcia Ditmyer; Paul Vantine

    2009-01-01

    Objectives1) Compare outcomes of distal facial nerve identification with antegrade exposure in partial parotidectomy; 2) Be able to incorporate other modifications of parotidectomy including preservation of the great auricular nerve, superficial musculo-aponeurotic system (SMAS), and parotid duct.

  8. Popliteal-to-Distal Bypass for Limb Salvage

    Microsoft Academic Search

    Franco Grego; Michele Antonello; Rudi Stramana’; Giovanni P. Deriu; Sandro Lepidi

    2004-01-01

    A retrospective study was carried out to examine the patency and limb salvage rates of popliteal-to-distal bypass and compare the results of diabetic to those of nondiabetic patients and elective versus emergency procedures. From January 1990 to December 2001, 71 popliteal-to-distal bypasses were performed. Indications for surgery were rest pain, tissue loss, and acute ischemia, including extensive post-traumatic tibial lesions.

  9. Biomechanical Analysis of Distal Biceps Tendon Repair Methods

    Microsoft Academic Search

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

    2007-01-01

    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.

  10. Incidence of Distal Forearm Fracture in British Men and Women

    Microsoft Academic Search

    T. W. O’Neill; C. Cooper; J. D. Finn; M. Lunt; D. Purdie; D. M. Reid; R. Rowe; A. D. Woolf; W. A. Wallace

    2001-01-01

    :   Fracture of the distal forearm is one of the most frequent osteoporotic fractures. However, there are few data concerning\\u000a its incidence in Britain. The aim of this study was to determine the incidence of distal forearm fracture in adult British\\u000a men and women. Six centers took part in the study: Aberdeen, Hull, Nottingham, Portsmouth, Southampton and Truro. At each

  11. Distal tibia fractures: management and complications of 101 cases

    Microsoft Academic Search

    Pierre Joveniaux; Xavier Ohl; Alain Harisboure; Aboubekr Berrichi; Ludovic Labatut; Patrick Simon; Didier Mainard; Nicolas Vix; Emile Dehoux

    2010-01-01

    Distal tibia fractures are complex injuries with a high complication rate. In this retrospective and multicentre study we\\u000a attempted to detail complications and outcomes of this type of injury in order to determine predictive factors of poor results.\\u000a Between 2002 and 2004, 104 patients were admitted for 105 distal tibia fractures. One hundred patients (101 fractures) were\\u000a reviewed with an

  12. Endovascular Treatment for Ruptured Distal Anterior Inferior Cerebellar Artery Aneurysm

    PubMed Central

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

    2014-01-01

    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

  13. Prognostic factors following surgical resection of distal bile duct cancer

    PubMed Central

    Chung, Young Jae; Choi, Seong Ho; Heo, Jin Seok; Kim, Dong Hun

    2013-01-01

    Purpose Prognostic factors for distal bile duct cancer are contentious. This study was conducted to analyze the prognostic factors of distal bile duct cancer after surgery with the aim of identifying those associated with diminished survival. Methods Two hundred forty-one patients who underwent pylorus-preserving pancreaticoduodenectomy (PPPD) or Whipple procedure in our tertiary hospital from February 1995 to June 2011 were retrospectively analyzed. All patients were pathologically proven to have distal bile duct adenocarcinoma. Postoperative complications, survival, and well-known prognostic factors after resection for distal bile duct cancer were investigated. Results Preoperative elevated carbohydrate antigen 19-9 (CA 19-9) level (P = 0.006), positive resection margin (P < 0.001), advanced T stage (P = 0.043), and lymph node metastasis (P = 0.002) were significantly independent worse prognostic indicators by multivariate analysis of resectable distal bile duct cancer. Conclusion R0 resection is the most important so that frozen sections should be utilized aggressively during each operation. For the distal bile duct cancer with elevated preoperative CA 19-9 level or advanced stage, further study on postoperative adjuvant treatment may be warranted. PMID:24266011

  14. Distal biceps brachii tendon rupture resulting in acute compartment syndrome.

    PubMed

    Grandizio, Louis C; Suk, Michael; Feltham, Glen T

    2013-11-01

    Distal biceps brachii tendon rupture is an uncommon injury. Compartment syndrome of the upper arm is rarely described in the literature. The diagnosis of upper arm compartment syndrome requires a high index of suspicion, and emergent surgical treatment with fasciotomy in the acute setting is necessary to avoid devastating neurovascular complications. This article reports a case of acute compartment syndrome of the anterior compartment of the upper arm after a complete rupture of the distal biceps brachii tendon. A healthy 45-year-old man presented with increasing arm pain; paresthesia in the lateral antebrachial cutaneous nerve distribution; and a tense, swollen anterior compartment of his upper arm. Side port catheter absolute pressure measurement was 83 mm Hg with a diastolic blood pressure of 92 mm Hg. The patient underwent an emergent fasciotomy and was found to have a complete rupture of his distal biceps brachii tendon. He subsequently underwent distal biceps tendon repair and delayed primary closure of his incision. Postoperatively, his paresthesia improved and he has no neurological deficit. There is a paucity of case reports describing compartment syndrome after rupture of either the proximal or distal end of the biceps brachii tendon, and none of the reports describe compartment syndrome of the upper arm after rupture of the distal biceps tendon. This article highlights an unusual complication of an uncommon injury and reviews diagnostic and treatment principles for the management of acute compartment syndrome of the upper arm. PMID:24200459

  15. Primary ciliogenesis requires the distal appendage component Cep123

    PubMed Central

    Sillibourne, James E.; Hurbain, Ilse; Grand-Perret, Thierry; Goud, Bruno; Tran, Phong; Bornens, Michel

    2013-01-01

    Summary Primary cilium formation is initiated at the distal end of the mother centriole in a highly co-ordinated manner. This requires the capping of the distal end of the mother centriole with a ciliary vesicle and the anchoring of the basal body (mother centriole) to the cell cortex, both of which are mediated by the distal appendages. Here, we show that the distal appendage protein Cep123 (Cep89/CCDC123) is required for the assembly, but not the maintenance, of a primary cilium. In the absence of Cep123 ciliary vesicle formation fails, suggesting that it functions in the early stages of primary ciliogenesis. Consistent with such a role, Cep123 interacts with the centriolar satellite proteins PCM-1, Cep290 and OFD1, all of which play a role in primary ciliogenesis. These interactions are mediated by a domain in the C-terminus of Cep123 (400–783) that overlaps the distal appendage-targeting domain (500–600). Together, the data implicate Cep123 as a new player in the primary ciliogenesis pathway and expand upon the role of the distal appendages in this process. PMID:23789104

  16. Development of multiple-unit colon-targeted drug delivery system by using alginate: in vitro and in vivo evaluation.

    PubMed

    Lai, Huiming; Zhu, Feng; Yuan, Wenmin; He, Na; Zhang, Zhirong; Zhang, Xiaoning; He, Qin

    2011-11-01

    Drug delivery systems to the colon are being actively investigated. However, it is difficult to ensure that an oral preparation disintegrates specifically in the human colon. In this study, a pH- and enzyme-controlled, colon-targeted tablets (PECCTT) was established by using outer pH-coated layer and inner alginate-coated compression layer. The influence of the amount of alginate and enteric coat thickness on drug release had been investigated and the formulation that contained 30% alginate in compression layer and 13% weight gain in pH-coated layer was proved to protect the drug release from stomach and small intestine, the lag time was 7.04 ± 0.17 h, and 84.45 ± 1.3% of prednisone was released at 12 h. The results of drug release behaviors and SEM study indicated that drug release mechanism of PECCTT was corrosion. Hybrid scanner combining SPECT and CT was employed to monitor (99m)Tc-contained tablets in the human gastrointestinal tract (GIT) and to obtain the images of the disintegration process. The results showed that the tablet remained intact during its transit through the upper GIT, the anatomical site of disintegration was found to be the sigmoidal colon, and the disintegration of the tablet started at 8 h post-dose in the volunteer. PMID:21524152

  17. Colonize, evade, flourish

    PubMed Central

    Rubin, Erica J; Trent, M Stephen

    2013-01-01

    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

  18. Colon Cancer: Virtual Detection

    NSDL National Science Digital Library

    Colon cancer is both the second most pervasive cancer to attack humans and one of the most preventable. One of the sad reasons for its prevalence has little to do with genes, diet, or overall health. Instead, it is the social stigma of the colon and rectum and the associated test --the colonoscopy -- which drives this cancer to the top of the list of killers. As with many cancer types, colon and rectal cancer is best treated in the early stages. And, when done so, the success of treatment is exponentially greater than dealing with it later on. While the typical test, the colonoscopy, is reliable, safe, and relatively easy, it still requires temporary sedation of the patient and the insertion of a camera through the large intestines. While the patient is sleepy and relaxed due to the sedation, and the procedure is reliably painless, the very thought of the proceture has kept many away. Now, with the advent of amazing virtual imaging technology, a virtual colonoscopy can be performed in seconds without sedation, and without the insertion of a camera. While there are pros and cons to each -- namely that by using the old method, any growths can be removed by the colonoscope immediately -- this may be the answer for crossing the formally highest hurdle: simply getting people in the door for testing. The several sites below offer a look at this new technology. Teachers will hopefully value not only the descriptive sites, but also the link to a related lesson plan.The first link leads to a segment from PBS' Newshour and offers a very good introduction to the topic. The link leads to your choice of the transcript, audio, or video of the interview conducted by Margaret Warner with Dr. Perry Pickhardt, radiologist at the University of Wisconsin -- Madison and co-director of a recent virtual colonoscopy study found in the New England Journal of Medicine and the object of a lot of buzz in the medical world. The second site leads to the University of Wisconsin's press release on the study's findings and the technology itself. The third site, while a bit technical for many readers, takes you to the New England Journal of Medicine website and the actual report produced by Dr. Pickhardt and his colleagues on their findings related to virtual colonoscopy. The fourth link leads the foremost cancer information center sponsored by the U.S. government, the National Cancer Institute and its web home for Colon and Rectal cancer. This is a great site to obtain both general and specific information related to the disease and the various treatments. The next link leads an exceptionally well produced series of reports by a Madison (Wisconsin) area television station, WISC. Its web home, channel3000.com, offers this site which gives a good report of virtual colonoscopy as well as many links to additional information. Finally, teachers, the last link leads back to PBS.org and a great lesson that asks students (grades 6-8) to think about this topic from its scientific point of view.

  19. Neurotensin expression and release in human colon cancers.

    PubMed Central

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

    1992-01-01

    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

  20. Severe Symptomatic Hypermagnesemia Associated with Over-the-Counter Laxatives in a Patient with Renal Failure and Sigmoid Volvulus

    PubMed Central

    Khairi, Talal; Amer, Syed; Spitalewitz, Samuel; Alasadi, Lutfi

    2014-01-01

    Hypermagnesemia is an uncommon but a potentially serious clinical condition. Over-the-counter magnesium containing products are widely used as antacids or laxatives. Although generally well tolerated in patients with normal renal function, their unsupervised use in the elderly can result in severe symptomatic hypermagnesemia, especially in those patients with concomitant renal failure and bowel disorders. We report a case of severe symptomatic hypermagnesemia associated with over-the-counter laxatives in a 70-year-old male patient with renal failure and sigmoid volvulus, who was successfully treated with hemodialysis. PMID:24563801

  1. Blocking screws for the treatment of distal femur fractures.

    PubMed

    Seyhan, Mustafa; Cakmak, Selami; Donmez, Ferdi; Gereli, Arel

    2013-07-01

    Intramedullary nailing is one of the most convenient biological options for treating distal femoral fractures. Because the distal medulla of the femur is wider than the middle diaphysis and intramedullary nails cannot completely fill the intramedullary canal, intramedullary nailing of distal femoral fractures can be difficult when trying to obtain adequate reduction. Some different methods exist for achieving reduction. The purpose of this study was determine whether the use of blocking screws resolves varus or valgus and translation and recurvatum deformities, which can be encountered in antegrade and retrograde intramedullary nailing. Thirty-four patients with distal femoral fractures underwent intramedullary nailing between January 2005 and June 2011. Fifteen patients treated by intramedullary nailing and blocking screws were included in the study. Six patients had distal diaphyseal fractures and 9 had distal diaphyseo-metaphyseal fractures. Antegrade nailing was performed in 7 patients and retrograde nailing was performed in 8. Reduction during surgery and union during follow-up were achieved in all patients with no significant complications. Mean follow-up was 26.6 months. Mean time to union was 12.6 weeks. The main purpose of using blocking screws is to achieve reduction, but they are also useful for maintaining permanent reduction. When inserting blocking screws, the screws must be placed 1 to 3 cm away from the fracture line to avoid from propagation of the fracture. When applied properly and in an adequate way, blocking screws provide an efficient solution for deformities encountered during intramedullary nailing of distal femur fractures. PMID:23823053

  2. Improved Perioperative Outcomes With Minimally Invasive Distal Pancreatectomy

    PubMed Central

    Cao, Hop S. Tran; Lopez, Nicole; Chang, David C.; Lowy, Andrew M.; Bouvet, Michael; Baumgartner, Joel M.; Talamini, Mark A.; Sicklick, Jason K.

    2015-01-01

    IMPORTANCE Interest in minimally invasive distal pancreatectomy (MIDP) has grown in recent years, but currently available data are limited. Greater insight into application patterns and outcomes may begained from a national database inquiry OBJECTIVES To study trends in the use of MIDP and compare the short-term outcomes of MlDPwith those of open distal pancreatectomy. DESIGN, SETTING, AND PARTICIPANTS Population-based retrospective cohort study evaluating perioperative outcomes and hospital charge measures for distal pancreatectomy, comparing the surgical approaches and adjusting for patient- and hospital-level factors, among patients undergoing elective distal pancreatectomy from 1998 to 2009 in the Nationwide Inpatient Sample in a 20% stratified sample of all US hospitals MAIN OUTCOMES AND MEASURES In-hospital mortality, rates of perioperative complications and splenectomy, total charges, and length of stay. RESULTS A total of 8957 distal pancreatectomies were included in this analysis, of which 382 (4 3%) were MIDPs. On a national level, this projected to 42 320 open distal pancreatectomies and 1908 MlDPs. The proportion of distal pancreatectomies performed via minimally invasive approaches tripled between 1998 and 2009, from 2 4% to 7.3%. The groups were comparable for sex and comorbidity profiles, while patients who underwent MlDPwere 15 years older. On multivariate analysis. MIDP was associated with lower rates of overall predischarge complications, including lower incidences of postoperative infections and bleeding complications, as well as a shorter length of stay by 1.22 days There were no differences in rates of in-hospital mortality, concomitant splenectomy, or total charges CONCLUSIONS AND RELEVANCE This population-based study of MlDP reveals that the application of this approach has tripled in practice and provides strong evidence that MIDP has evolved into a safe option in the treatment of benign and malignant pancreatic diseases. PMID:24402232

  3. CIP ... Colonic Manometry Pediatric and Adolescent

    E-print Network

    child is scheduled for a specialozed test called Colonic Manometry that will check the motility of the colon. This guide will help to prepare you and your child so that the experience is as successful is colonic manometry? · The colon is also called the large bowel or large intestine. Its job is to store

  4. Fall/Winter CONCERNED ABOUT COLON CANCER?

    E-print Network

    Holsinger, Kent

    TRADITIONS Fall/Winter 2005 #12;CONCERNED ABOUT COLON CANCER? PREVENTION IS POSSIBLE. Introducing the Colon C ancer Prevention Program at UConn Health C enter IT'S TRUE: C OLON CANCER MAY BE PREVENTED colon cancer prevention pl an sta rts w ith a phone call to the new Colon C an cer Prevention P r ogr am

  5. cAMP sensitivity conferred to the epithelial Na + channel by a-subunit cloned from guinea-pig colon

    Microsoft Academic Search

    M. Schnizler; L. Mastroberardino; F. Reifarth; W.-M. Weber; F. Verrey; W. Clauss

    2000-01-01

    The rate of Na+ (re)absorption across tight epithelia such as in distal kidney nephron and colon is to a large extent controlled at the level of the epithelial Na+ channel (ENaC). In kidney, antidiuretic hormone (ADH, vasopressin) stimulates the expression\\/activity of this channel by a cAMP\\/protein-kinase-A- (PKA-) mediated pathway. However, a clear upregulation of ENaC function by cAMP could not

  6. An Improved Electronic Colon Cleansing Method for Detection of Colonic Polyps by Virtual Colonoscopy

    Microsoft Academic Search

    Zigang Wang; Zhengrong Liang; Xiang Li; Lihong Li; Bin Li; Daria Eremina; Hongbing Lu

    2006-01-01

    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

  7. Management of penetrating colon injuries.

    PubMed Central

    Bostick, P. J.; Heard, J. S.; Islas, J. T.; Johnson, D. A.; Sims, E. H.; Fleming, A. W.; Sterling-Scott, R. P.

    1994-01-01

    The management of colon injuries remains an area of major controversy. Selecting the patients who can undergo primary repair safely remains undefined. To address this issue, 231 consecutive patients with penetrating colon injuries were reviewed to determine those factors that affected outcome. Overall, there were 54 (25.2%) septic complications, with 36 (16.8%) wound infections and 18 (8.4%) intra-abdominal abscesses. There were seven (3.3%) deaths in the entire series. The surgical management method of the colon injury was not significant in wound infections (P > .39), intra-abdominal abscesses (P > .24), or mortality (P > .39). A more aggressive approach of primary repair should be performed for civilian colon injuries. PMID:8046767

  8. Diet and Colon Cancer Risk

    MedlinePLUS Videos and Cool Tools

    ... hand corner of the player. Diet and Colon Cancer Risk HealthDay March 13, 2015 Related MedlinePlus Pages Colorectal Cancer Diets Vegetarian Diet Transcript Vegetarian, vegan, pesco-vegetarian, ...

  9. Microprocessor controlled movement of solid colonic content using sequential neural electrical stimulation

    PubMed Central

    Amaris, M A; Rashev, P Z; Mintchev, M P; Bowes, K L

    2002-01-01

    Background and aims: Invoked peristaltic contractions and movement of solid content have not been attempted in normal canine colon. The purpose of this study was to determine if movement of solid content through the colon could be produced by microprocessor controlled sequential stimulation. Methods: The study was performed on six anaesthetised dogs. At laparotomy, a 15 cm segment of descending colon was selected, the proximal end closed with a purse string suture, and the distal end opened into a collecting container. Four sets of subserosal stimulating electrodes were implanted at 3 cm intervals. The segment of bowel was filled with a mixture of dog food and 50 plastic pellets before each of 2–5 random sessions of non-stimulated or stimulated emptying. Propagated contractions were generated using microprocessor controlled bipolar trains of 50 Hz rectangular voltage having 20 V (peak to peak) amplitude, 18 second stimulus duration, and a nine second phase lag between stimulation trains in sequential electrode sets. Results: Electrical stimulation using the above mentioned parameters resulted in powerful phasic contractions that closed the lumen. By phase locking the stimulation voltage between adjacent sets of electrodes, propagated contractions could be produced in an aboral or orad direction. The number of evacuated pellets during the stimulation sessions was significantly higher than during the non-stimulated sessions (p<0.01). Conclusions: Microprocessor controlled electrical stimulation accelerated movement of colonic content suggesting the possibility of future implantable colonic stimulators. PMID:11889065

  10. Selective influence of host microbiota on cAMP-mediated ion transport in mouse colon.

    PubMed

    Lomasney, K W; Houston, A; Shanahan, F; Dinan, T G; Cryan, J F; Hyland, N P

    2014-06-01

    More microbes are resident in the distal colon than any other part of the body, and this microbiota has the capacity to influence enteric nerve development, excitability, and gastrointestinal function. Germ-free (GF) mice are a valuable tool in interrogating the communication between microbiota and host. Despite the intimate relationship which exists between the microbiota and the colonic mucosa-submucosa, there is a paucity of studies examining the influence of the microbiota on secretogogue-evoked responses. To this end, we investigated both epithelial and neural-evoked ion transport, and the response elicited by two commensal organisms, in colonic mucosa-submucosa preparations from GF mice in Ussing chambers. Baseline electrical parameters, short-circuit current and transepithelial resistance, were comparable between tissues from GF and conventional animals. Noteworthy, however, was a hyper-responsiveness of GF colon to forskolin stimulation. In contrast, the absence of the microbiota did not influence the tissue response to bethanechol. Moreover, responses to the sodium-channel activator, veratridine, and the TRPV1 receptor agonist, capsaicin were preserved in GF mice relative to conventional tissues. Similarly, the short-circuit current response to two well-characterized commensal organisms occurred independent of an interaction with the host microbiota. This is the first comprehensive characterization of secretomotor responses in GF colon. PMID:24612168

  11. [A case of metastatic gastric cancer originating from transverse colon cancer].

    PubMed

    Nushijima, Youichirou; Nakano, Katsutoshi; Sugimoto, Keishi; Nakaguchi, Kazunori; Kan, Kazuomi; Maruyama, Hirohide; Doi, Sadayuki; Okamura, Shu; Murata, Kohei

    2014-11-01

    Metastatic gastric cancer is uncommon, and metastasis of colorectal cancer to the stomach is extremely rare. We report a case of metastatic gastric cancer that originated from transverse colon cancer. A 52-year-old woman underwent a left hemicolectomy and D3 lymph node dissection based on a diagnosis of transverse colon cancer. The pathology results were as follows: mucinous adenocarcinoma, type 2, 6 × 11 cm, ss, ly1 v1, pm (-), dm (-), n1 (+), P0, H0, M0, Stage IIIa. The patient received XELOX as postoperative adjuvant therapy for 6 months. One year and 3 months after the left hemicolectomy, gastroscopy revealed a submucosal tumor in the lower body of the stomach and an incipient cancer in the cardia of the stomach, and a colonoscopy revealed an incipient cancer in the transverse colon. An endoscopic ultrasonography fine needle aspiration biopsy of the submucosal tumor in the lower body of the stomach was performed. Histology showed that this tumor was a mucinous adenocarcinoma similar to the primary transverse colon cancer, which led to a diagnosis of metastatic gastric cancer originating from transverse colon cancer. Distant metastasis was not detected. Endoscopic submucosal dissection of the incipient gastric cancer was performed, as were distal gastrectomy and partial colectomy. Peritoneal dissemination and para-aortic lymph node recurrence were detected 7 months after the second surgery. PMID:25731335

  12. Colonization and bioherbicidal activity on green foxtail by Pseudomonas fluorescens BRG100 in a pesta formulation.

    PubMed

    Caldwell, Caressa J; Hynes, Russell K; Boyetchko, Susan M; Korber, Darren R

    2012-01-01

    Pseudomonas fluorescens BRG100 produces secondary metabolites with herbicidal activity on green foxtail ( Setaria viridis ), an important weed pest in Canadian agriculture. Five gfp transformants of P. fluorescens BRG100 were compared with the wild-type isolate for green foxtail root herbicide activity, i.e., root growth suppression, doubling time, carbon utilization, and colonization of green foxtail root (proximal and distal regions). The most revealing comparison between the wild type and its gfp transformants was herbicidal activity on green foxtail. Herbicidal activity of transformant gfp-7 was not significantly different from the uninoculated control, suggesting that insertion of the gfp gene may have interfered with a gene, or genes, vital to the bioherbicide process. Doubling time, carbon utilization, and colonization of green foxtail did not differ to a great extent between the wild type and the gfp transformants, indicating their suitability as conservatively tagged organisms for subsequent colonization-herbicidal activity studies. Accordingly, a pesta granule formulation delivered transformant gfp-2 to the seed coat and roots of green foxtail. Epifluorescent and confocal laser scanning microscopy revealed the transformant gfp-2 colonized the ventral portion of the seed coat, root hairs, and all areas of the root except the root cap region, where gfp-2 presumably exerted herbicidal effects. These results suggest that P. fluorescens BRG100 has considerable potential as a bioherbicide because of its successful colonization and suppressive activity on green foxtail root growth. PMID:22188391

  13. Selenium, Folate, and Colon Cancer

    PubMed Central

    Connelly-Frost, Alexandra; Poole, Charles; Satia, Jessie A.; Kupper, Lawrence L.; Millikan, Robert C.; Sandler, Robert S.

    2009-01-01

    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

  14. [Extramedullary plasmacytoma of the colon].

    PubMed

    Amo Trillo, Víctor; Vera García, Pilar; Pinto, Isabel; Olmedo Martín, Raúl; Romero Blasco, Bartolomé

    2007-05-01

    We report the case of a 68 year-old man in whom a tumour of the colon was identified by colonoscopy, during diagnostic studies for lower gastrointestinal bleeding as an outpatient. Histological examination showed clonal proliferation of plasma cells IgG-K. No other location was affected (including bone marrow). Diagnosis of plasmacytoma of the colon was made. We have carried out a review of the literature in relation to this unusual disorder. PMID:17493438

  15. Fiber type, meal frequency and colonic cytokinetics

    E-print Network

    Zhang, Jianhu

    1993-01-01

    in male Sprague-Dawley rats. Results from those laboratory animal studies demonstrate the effects of fiber types on the development of colon tumors. Not all dietary fibers seem to have a protective effect in experimental colon cancer studies. Dietary... colon carcinogenesis, or fail to protect against tumor development. Cell proliferation as a blomarker of colonic carclnogenesis. The action of dietary fiber in preventing or promoting the development of colon cancer is thought to be the modulation...

  16. Surgical management of colonic diverticular disease: Discrepancy between right- and left-sided diseases

    PubMed Central

    Oh, Heung-Kwon; Han, Eon Chul; Ha, Heon-Kyun; Choe, Eun Kyung; Moon, Sang Hui; Ryoo, Seung-Bum; Jeong, Seung-Yong; Park, Kyu Joo

    2014-01-01

    AIM: To compare the outcome of the surgical management of left-sided and right-sided diverticular disease. METHODS: The medical records of 77 patients who were surgically treated for diverticular disease between 1999 and 2010 in a tertiary referral hospital were retrospectively reviewed. The study population was limited to cases wherein the surgical specimen was confirmed as diverticulosis by pathology. Right-sided diverticula were classified as those arising from the cecum, ascending colon, and transverse colon, and those from the descending colon, sigmoid colon, and rectum were classified as left-sided diverticulosis. To assess the changing trend of occurrence of diverticulosis, data were compared with two previous studies of 51 patients. RESULTS: The proportion of left-sided disease cases was significantly increased compared to the results of our previous studies in 1994 and 2001, (27.5% vs 48.1%, P < 0.05). Moreover, no differences in gender, body mass index, multiplicity of the diverticula, fever, or leukocytosis were noted between patients with right-sided and left-sided disease. However, patients with right-sided disease were significantly younger (50.9 year vs 64.0 year, P < 0.01). Furthermore, left-sided disease was significantly associated with a higher incidence of complicated diverticulitis (89.2% vs 57.5%, P < 0.01), combined resection due to extensive inflammation (21.6% vs 5.0%, P < 0.05), operative complications (51.4% vs 27.5%, P < 0.05), and in-hospital mortality (10.8% vs 0%, P < 0.05), along with longer post-operative hospitalization duration (21.3 ± 10.2 d vs 10.6 ± 8.1 d, P < 0.05). CONCLUSION: Compared with right-sided diverticular disease, the incidence of left-sided disease in Korea has increased since 2001 and is associated with worse surgical outcomes. PMID:25110438

  17. Ejecta emplacement: from distal to proximal

    NASA Astrophysics Data System (ADS)

    Artemieva, N.

    2008-09-01

    Introduction Most part of impact ejecta is deposited ballistically at some distance from a crater, defined by ejection velocity V and ejection angle ?: d=v2sin?/g. In case of giant impacts, planetary curvature should be taken into account [1]. Combined with ejecta scaling [2], these relations allow to define ejecta thickness as a function of distance. Ejecta from large craters are deposited at velocity high enough to mobilize substrate material and to thicken ejecta deposits [3]. Ballistic approximation is valid for airless bodies (if impact vaporization is not vast) or for proximal ejecta of large impact craters, where ejecta mass per unit area is substantially greater than the mass of involved vapor/atmosphere (M-ratio). Deposition of distal ejecta, in which ejecta mass is negligible compared to the atmosphere, may be also treated in a simplified manner, i.e. as 1) passive motion of ejected particles within an impact plume and 2) later, as sedimentation of particles in undisturbed atmosphere (equilibrium between gravity and drag). In all intermediate M-ratio values, impact ejecta move like a surge, i.e. dilute suspension current in which particles are carried in turbulent flows under the influence of gravity. Surges are well-known for near-surface explosive tests, described in detail for volcanic explosions (Plinian column collapse, phreato-magmatic eruption, lateral blast), and found in ejecta from the Chicxulub [4] and the Ries [5]. Important aspects of surge transport include its ability to deposit ejecta over a larger area than that typical of continuous ballistic ejecta and to create multiple ejecta layers. Numerical model Two-phase hydrodynamics. Surges should be modeled in the frame of two-phase hydrodynamics, i.e. interaction between solid/molten particles and atmospheric gas/impact vapor should be taken into account. There are two techniques of solving equations for dust particle motion in a gas flow. The first one describes solid/molten particles as a liquid with specific properties, i.e. finite-difference equations are the same as in standard hydrodynamics [6-8]. Another approach is based on solving equations of motion for representative particles [9]. Each of these markers describes the motion of a large number of real particles with similar sizes, velocities, and trajectories. Equation of motion (gravity, viscosity, and drag) is solved for every marker and then exchange of momentum, heat and energy with surrounding vaporair mixture is taken into account. This approach is used in the SOVA code [10] and allows to vary particle sizes within a broad range (from a few m to a few microns). Implicit procedure of velocity update allows a larger time step. The substantial advantage of the model is its three-dimensional geometry, allowing modeling of asymmetric deposits of oblique impact ejecta. Turbulent diffusion is taken into account in a simplified manner [6]. Fragments size-frequency distribution (SFD) may be of crucial importance: while large fragments move ballistically, the smallest ones are passively involved in gas motion. Ejected material is usually transformed into particles under tension. The initial particle velocity is given by the hydrodynamic velocity, but the object's initial position within the cell is randomly defined. The SFD of solid fragments in high velocity impacts has been studied experimentally [2,11], numerically [12,13], and has been derived from the lunar and terrestrial crater observations [14,15]. Various approaches may be used to implement fragment size in a dynamic model: in Grady-Kipp model the average fragment size is defined by strain rate [12]; alternatively, average ejection velocity [16] or maximum shock compression [17] may be used. All methods may be verified through comparison with known data. Volcanic direct blast. Numerical modeling of pyroclastic flows, checked against recent observations and young deposits, may be then a useful instrument for reconstruction of terrestrial craters' ejecta, which are mostly eroded or buried; and for impact ejecta study on other planets

  18. THE CONTRACTION OF OVERLYING CORONAL LOOP AND THE ROTATING MOTION OF A SIGMOID FILAMENT DURING ITS ERUPTION

    SciTech Connect

    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

    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.

  19. The Contraction of Overlying Coronal Loop and the Rotating Motion of a Sigmoid Filament during Its Eruption

    NASA Astrophysics Data System (ADS)

    Yan, X. L.; Pan, G. M.; Liu, J. H.; Qu, Z. Q.; Xue, Z. K.; Deng, L. H.; Ma, L.; Kong, D. F.

    2013-06-01

    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.

  20. The Plasma Structure of a Long-lasting Sigmoid as Revealed by Hinode and Magnetic Field Modeling

    NASA Astrophysics Data System (ADS)

    Stefanova Savcheva, Antonia

    2015-04-01

    We present multi-thermal observations from Hinode/XRT and EIS plasma diagnostics over a large part of the lifetime of a long-lasting sigmoid observed between Dec 05 and Dec 07, 2007. This region is the best observationally covered sigmoidal region by XRT and EIS simultaneously. We analyze EIS/XRT thermal maps as well EIS Doppler velocity, density and non-thermal width (NTW) maps in conjunction with non-linear force-free field (NLFFF) models constrained by the XRT data. We show that material accumulates in the dips oftwisted flux rope field lines, the temperature is enhanced at the locations of strong current concentrations in the model, and NTWs are enhanced at the outskirts of the region coinciding with large-scale QSLs that envelope the region. We follow the evolution of these plasma parameters and the filed lines from the best-fit NLFFF models in time and space leading to the flare on Dec 07, 2007.

  1. Distal Biceps Brachii Tendon: The Spectrum of Strain

    PubMed Central

    Miller, Ray F.; Cullen, Myron J.; Krein, Ann M.; Miller, Ray F.; Cullen, Myron J.; Krein, Mary M.

    1991-01-01

    An injured tendinous attachment of the distal biceps brachii to the radial tuberosity was diagnosed in fifteen male patients. One additional patient sustained a first-degree strain of the distal biceps musculotendinous junction. Conservative treatment was effective for the two patients representing first-degree strains. Five patients with second-degree, partial tears were treated conservatively and experienced an average recovery time of over one year. Two patients with partial tears required a surgical reattachment of the biceps to the radial tuberosity for relief of symptoms. The Boyd-Anderson technique was used on six patients with complete ruptures. One complete separation was repaired three years post-injury by reattaching the distal biceps tendon to the brachialis. Post-operative Cybex evaluation demonstrated return to near-normal levels of strength, endurance, and total work in both flexion and supination following early reattachment to the radial tuberosity. ImagesFigure 1AFigure 1BFigure 2

  2. Isolation and Characterization of Distal Lung Progenitor Cells

    PubMed Central

    Driscoll, Barbara; Kikuchi, Alex; Lau, Allison N.; Lee, Jooeun; Reddy, Raghava; Jesudason, Edwin; Kim, Carla F.; Warburton, David

    2013-01-01

    The majority of epithelial cells in the distal lung of rodents and humans are quiescent in vivo, yet certain cell populations retain an intrinsic capacity to proliferate and differentiate in response to lung injury or in appropriate culture settings, thus giving them properties of stem/progenitor cells. Here, we describe the isolation of two such populations from adult mouse lung: alveolar epithelial type 2 cells (AEC2), which can generate alveolar epithelial type 1 cells, and bronchioalveolar stem cells (BASCs), which in culture can reproduce themselves, as well as generate a small number of other distal lung epithelial cell types. These primary epithelial cells are typically isolated using enzyme digestion, mechanical disruption, and serial filtration. AEC2 and BASCs are distinguished from other distal lung cells by expression of specific markers as detected by fluorescence-activated cell sorting, immunohistochemistry, or a combination of both of these techniques. PMID:22610556

  3. Comparison of distal and proximal centralising devices in hip arthroplasty

    PubMed Central

    Bezer, M.; Akgulle, A. H.; Saygi, B.; Kocao?lu, B.; Guven, O.

    2008-01-01

    Centralising devices were introduced to ensure that the prosthesis is implanted in a neutral position and that a cement mantle of optimal thickness is achieved proximally and distally. A distal centralising device (DCD) is compared with a proximal midshaft centralising device (PCD) to test which one provides a more neutral prosthetic alignment. Thirty consecutive patients undergoing hemiarthroplasties for femoral neck fractures were studied prospectively. Patients were blindly randomised to receive either a femoral component with proximal midshaft centraliser or distal centraliser. Both components were implanted following the manufacturer’s protocol. Postoperative true anteroposterior and lateral radiographs were made to assess the stem position. There was no statistically significant difference between the two groups in zones 1, 2, 3, 4, 5, 6 and 7 in both anteroposterior and lateral radiographic measurements. DCP and PCD both have similar centralisation and cement mantle. Future studies should be done to evaluate their long-term effect. PMID:18712387

  4. Management of radionecrosis of the vulva and distal vagina

    SciTech Connect

    Roberts, W.S.; Hoffman, M.S.; LaPolla, J.P.; Ruas, E.; Fiorica, J.V.; Cavanagh, D. (Univ. of South Florida, Tampa (USA))

    1991-05-01

    Twelve patients were seen between January 1983 and June 1989 with the clinical diagnosis of radionecrosis of the vulva or distal vagina. Seven patients received radiation for vulvar cancer, three for distal vaginal cancer, and two for recurrent endometrial cancer. No patient healed spontaneously and the mean delay in surgical therapy was 8.5 months. The radionecrotic site was treated with local therapy, radical local excision (with or without colostomy), or exenteration. The operative defect was closed primarily in three patients and covered with local flaps or myocutaneous flaps in seven patients. The two patients with local care still have radionecrotic ulcers. One of three patients who were closed primarily continues to have an ulcer. All other patients have healed satisfactorily except one who died after two attempts to correct the problem. Radionecrosis of the vulva and distal vagina should generally be treated surgically.

  5. Molar distalization with the assistance of Temporary Anchorage Devices.

    PubMed

    Palencar, Adrian J

    2015-01-01

    This article describes efficient techniques for distalization of maxillary and mandibular molars with the assistance of Temporary Anchorage Devices (TADs). There are numerous occasions where the distalization of molars is required in lieu of the odontectomy of bicuspids. In the past, extra-oral force has been used, (i.e. Cervical or Combination Head Gear, or intra-oral force, i.e. Posterior Sagittal Appliance, Modified Greenfield Appliance, Williams DMJ 20001, CD Distalizer, Magill Sagittal, Pendulum Appliance, etc.). All the intra-oral appliances have a common denominator the orthodontic clinician has to deal with, the undesirable expression of the Third Law of Newton. The utilization of TADs allows us to circumvent this shortcoming, establishing an absolute anchorage, and thus completely negate the expression of the Third Law of Newton. PMID:25881377

  6. The influence of distal locking on the need for fibular plating in intramedullary nailing of distal metaphyseal tibiofibular fractures.

    PubMed

    Attal, R; Maestri, V; Doshi, H K; Onder, U; Smekal, V; Blauth, M; Schmoelz, W

    2014-03-01

    Using human cadaver specimens, we investigated the role of supplementary fibular plating in the treatment of distal tibial fractures using an intramedullary nail. Fibular plating is thought to improve stability in these situations, but has been reported to have increased soft-tissue complications and to impair union of the fracture. We proposed that multidirectional locking screws provide adequate stability, making additional fibular plating unnecessary. A distal tibiofibular osteotomy model performed on matched fresh-frozen lower limb specimens was stabilised with reamed nails using conventional biplanar distal locking (CDL) or multidirectional distal locking (MDL) options with and without fibular plating. Rotational stiffness was assessed under a constant axial force of 150 N and a superimposed torque of ± 5 Nm. Total movement, and neutral zone and fracture gap movement were analysed. In the CDL group, fibular plating improved stiffness at the tibial fracture site, albeit to a small degree (p = 0.013). In the MDL group additional fibular plating did not increase the stiffness. The MDL nail without fibular plating was significantly more stable than the CDL nail with an additional fibular plate (p = 0.008). These findings suggest that additional fibular plating does not improve stability if a multidirectional distal locking intramedullary nail is used, and is therefore unnecessary if not needed to aid reduction. PMID:24589796

  7. The retroperitoneal, inguinal approach to distal part of the ureter

    PubMed Central

    Urbanowicz, Wies?aw; Sulis?awski, Janusz; Dobrowolska–glazar, Barbara

    2014-01-01

    Introduction The inguinal approach to the distal part of the ureter allows the surgeon to perform various types of procedures and is considered to be one of the minimally invasive techniques in pediatric surgery. We aim to describe our initial experience with the surgery of the distal ureter performed through an inguinal mini–incision. Material and methods Between March 2012 and June 2013, 8 patients were treated using a minimally invasive inguinal technique. The indications for surgical correction were single system primary obstructive megaureter, obstructive megaureter of the upper pole in a duplex kidney and distal ureteral stones. In all patients with single system obstructive megaureter and significant hydronephrosis, ureterocutaneostomy was performed. In one patient with duplex system primary obstructive megaureter and significant hydronephrosis of the upper pole, ureteroureterostomy of the dilated ureter to the normal caliber ureter in the distal part was performed. In the second patient with duplex system primary obstructive megaureter and reduced marker excretion of the upper pole in renal scintigraphy, ureterocutaneostomy was performed. In both cases of distal ureteral stones, deposits were removed by a simple incision. Results We did not observe any perioperative or postoperative complications. The imaging studies have shown that ureteral dilatation decreased in all but one child in whom the upper pole and the ureter were resected due to lack of function. Conclusions The inguinal approach allows for the adequate visualization of the distal ureter, creating the conditions for implementation of the various procedures, reduces the risk of retrovesical plexus injury and minimizes visible scars. PMID:24982797

  8. Reverse telescoping in distal skarns at Campiglia Marittima (Italy)

    NASA Astrophysics Data System (ADS)

    Vezzoni, Simone; Dini, Andrea; Rocchi, Sergio

    2014-05-01

    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.

  9. Pharmacological profiles of the murine gastric and colonic H,K-ATPases

    PubMed Central

    Shao, Jiahong; Gumz, Michelle L.; Cain, Brian D.; Xia, Shen-Ling; Shull, Gary E.; van Driel, Ian R.; Wingo, Charles S.

    2010-01-01

    Background The H,K-ATPase, consisting of ? and ? subunits, belongs to the P-type ATPase family. There are two isoforms of the ? subunit, HK?1 and HK?2 encoded by different genes. The ouabain-resistant gastric HK?1-H,K-ATPase is Sch28080-sensitive. However, the colonic HK?2-H,K-ATPase from different species shows poor primary structure conservation of the HK?2 subunit between species and diverse pharmacological sensitivity to ouabain and Sch28080. This study sought to determine the contribution of each gene to functional activity and its pharmacological profile using mouse models with targeted disruption of HK?1, HK?2, or HK? genes. Methods Membrane vesicles from gastric mucosa and distal colon in wild type (WT), HK?1, HK?2 or HK? knockout (KO) mice were extracted. K-ATPase activity and pharmacological profiles were examined. Results The colonic H,K-ATPase demonstrated slightly greater affinity for K+ than the gastric H,K-ATPase. This K-ATPase activity was not detected in the colon of HK?2 KO, but was observed in HK? KO with properties indistinguishable from WT. Neither ouabain nor Sch28080 had a significant effect on the WT colonic K-ATPase activity, but orthovanadate abolished this activity. Amiloride and its analogues benzamil and 5-N-ethyl-N-isopropylamiloride inhibited K-ATPase activity of HK?1-containing H,K-ATPase; the dose dependence of inhibition was similar for all three inhibitors. In contrast, the colonic HK?2-H,K-ATPase was not inhibited by these compounds. Conclusions These data demonstrated that the mouse colonic H,K-ATPase exhibits a ouabain- and Sch28080-insensitive, orthovanadate-sensitive K-ATPase activity. Interestingly, pharmacological studies suggested that the mouse gastric H,K-ATPase is sensitive to amiloride. PMID:20594946

  10. Distal renal tubular acidosis and amelogenesis imperfecta: A rare association.

    PubMed

    Ravi, P; Ekambaranath, T S; Arasi, S Ellil; Fernando, E

    2013-11-01

    Renal tubular acidosis (RTA) is characterized by a normal anion gap with hyperchloremic metabolic acidosis. Primary distal RTA (type I) is the most common RTA in children. Childhood presentation of distal RTA includes vomiting, failure to thrive, metabolic acidosis, and hypokalemia. Amelogenesis imperfecta (AI) represents a condition where the dental enamel and oral tissues are affected in an equal manner resulting in the hypoplastic or hypopigmented teeth. We report a 10-year-old girl, previously asymptomatic presented with the hypokalemic paralysis and on work-up found out to have type I RTA. The discoloration of teeth and enamel was diagnosed as AI. PMID:24339526

  11. Extreme distal bypass to improve wound healing in Buerger's disease.

    PubMed

    De Caridi, Giovanni; Massara, Mafalda; Villari, Simona; Martelli, Eugenio; Spinelli, Francesco; Grande, Raffaele; Butrico, Lucia; de Franciscis, Stefano; Serra, Raffaele

    2014-02-25

    Thromboangiitis obliterans or Buerger's disease is a rare non-atherosclerotic segmental inflammatory vasculitis that most commonly involves small and medium-sized arteries, veins and nerves of the extremities, and generally affects young tobacco smokers. A 53-year-old man was found to have critical ischaemia of his left lower limb with foot gangrene. He underwent extremely distal surgical revascularisation using a great saphenous vein bypass graft. The choice of a very distal artery as run-off vessel promoted a faster wound healing and pain relief, with improvement in quality of life. PMID:24612761

  12. Tubularized incised plate urethroplasty for distal hypospadias: A literature review

    PubMed Central

    Braga, Luis Henrique P.; Lorenzo, Armando J.; Salle, Joao L. Pippi

    2008-01-01

    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

  13. Bilateral osteochondrosis of the distal tibial epiphysis: a case report.

    PubMed

    Turati, Marco; Afonso, David; Salazard, Bruno; Maillet Declerck, Marie; Bigoni, Marco; Glard, Yann

    2015-03-01

    Osteochondrosis is a developmental disease characterized by an alteration of endochondral ossification. Genetic causes, repetitive mechanical stresses, vascular abnormalities, hormonal imbalances, and interruption of the blood supply to the epiphyseal cartilage are all described causes of osteochondrosis and the etiology is probably multifactorial. Osteochondrosis can occur in different apophysis and epiphysis in all immature skeletons. Distal tibial epiphysis is rarely involved and most of the time unilaterally. We report on an 11-year-old female with bilateral osteochondrosis on distal tibial epiphysis. Only one other similar case has been described in the literature to date. PMID:25504104

  14. Distal tibial metaphyseal fractures: the role of fibular fixation

    Microsoft Academic Search

    R. Varsalona; G. T. Liu

    2006-01-01

    Distal tibial extra-articular fractures are often a\\u000a result of complex high-energy trauma, which commonly\\u000a involves associated fibular fractures and soft tissue injury.\\u000a The goal of tibial fixation is to maximise fracture stability\\u000a without increasing soft tissue morbidity from surgical\\u000a intervention. The role of adjunctive fibular fixation in distal\\u000a tibial metaphyseal fractures has been controversial;\\u000a although fibular fixation has been shown

  15. Sigmoidal diagnostics with SOHO/CDS G. Del Zanna 1 , S. E. Gibson 1;2 , H. E. Mason 1 , C.D. Pike 3 , and C. H. Mandrini 4

    E-print Network

    Del Zanna, Giulio

    Sigmoidal diagnostics with SOHO/CDS G. Del Zanna 1 , S. E. Gibson 1;2 , H. E. Mason 1 , C.D. Pike 3 (SOHO), and with other instruments, both satellite and ground­based. On August 21st, a small flare, associated with a brightening of the sigmoidal structure, occurred. SOHO Coronal Diagnostic Spectrometer (CDS

  16. A Newer Technique of Distal Ulna Reconstruction Using Proximal Fibula and TFCC Reconstruction Using Palmaris Longus Tendon following Wide Resection of Giant Cell Tumour of Distal Ulna.

    PubMed

    Mariappan, Elango; Mohanen, Pragash; Moses, Justin

    2013-01-01

    Giant cell tumour of the bone (GCT) is a rare locally aggressive primary bone tumour with an incidence of 3% to 5% of all primary bone tumours. The most common location for this tumour is the long bone metaepiphysis especially of the distal femur, proximal tibia, distal radius, and the proximal humerus. Involvement of distal ulna is rare accounting for 0.45% to 3.2%. Considering local aggressive nature and high recurrence, wide resection is the treatment recommended. Instability of ulnar stump and ulnar translation of the carpals are known complications following resection of distal ulna. To overcome these problems, we attempted a newer technique of distal ulna reconstruction using proximal fibula and TFCC reconstruction using palmaris longus tendon following wide resection of giant cell tumour of distal ulna in a 44-year-old male. This technique of distal radioulnar joint reconstruction has excellent functional results with no evidence of recurrence after one-year followup. PMID:24455371

  17. A Newer Technique of Distal Ulna Reconstruction Using Proximal Fibula and TFCC Reconstruction Using Palmaris Longus Tendon following Wide Resection of Giant Cell Tumour of Distal Ulna

    PubMed Central

    Mariappan, Elango; Mohanen, Pragash; Moses, Justin

    2013-01-01

    Giant cell tumour of the bone (GCT) is a rare locally aggressive primary bone tumour with an incidence of 3% to 5% of all primary bone tumours. The most common location for this tumour is the long bone metaepiphysis especially of the distal femur, proximal tibia, distal radius, and the proximal humerus. Involvement of distal ulna is rare accounting for 0.45% to 3.2%. Considering local aggressive nature and high recurrence, wide resection is the treatment recommended. Instability of ulnar stump and ulnar translation of the carpals are known complications following resection of distal ulna. To overcome these problems, we attempted a newer technique of distal ulna reconstruction using proximal fibula and TFCC reconstruction using palmaris longus tendon following wide resection of giant cell tumour of distal ulna in a 44-year-old male. This technique of distal radioulnar joint reconstruction has excellent functional results with no evidence of recurrence after one-year followup. PMID:24455371

  18. Effects of alverine on the spontaneous electrical activity and nervous control of the proximal colon of the rabbit.

    PubMed

    Bouvier, M; Grimaud, J C; Abysique, A; Chiarelli, P

    1992-01-01

    To analyse the mechanisms of the antispasmodic action of alverine, the effects of this drug on the spontaneous motility and nervous control of the proximal colon of the rabbit were studied in vivo. The electrical activity of the colonic smooth muscle was recorded using extracellular electrodes. The parasympathetic efferents were activated by electrical stimulation of distal ends of the vagus nerves. Alverine given intravenously inhibits spike potentials without modifying the slow waves. Excitatory and inhibitory responses induced by parasympathetic efferent stimulations, as well as the hyperpolarization due to intraluminal distension, were also blocked after drug injection. Our results show that alverine is able to block the spontaneous contractions and the nervous control of rabbit proximal colon, indicating that this drug has powerful antispasmodic effects. PMID:1397853

  19. Functional outcome of arthroscopic assisted fixation of distal radius fractures

    PubMed Central

    Khanchandani, Prakash; Badia, Alejandro

    2013-01-01

    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

  20. Radiation injury to the axillary artery presenting as distal thromboembolism

    SciTech Connect

    Bressler, E.L.; Vogelzang, R.L.; Atlas, S.W.; Neiman, H.L.

    1984-11-01

    Clinically significant radiation injury to large arteries is unusual and axillary artery involvement is rare with only a handful of cases reported. Recently the authors studied a patient with radiation therapy injury to the axillary artery who had distal embolic vascular occlusion, a highly unusual occurrence.

  1. [Distal revascularization in diabetic patients with chronic limb ischemia].

    PubMed

    Courtois, M-C; Sapoval, M; Del Giudice, C; Ducloux, R; Mirault, T; Messas, E

    2015-02-01

    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

  2. Ultrasound-Guided Reduction of Distal Radius Fractures

    Microsoft Academic Search

    Brian Chinnock; Alexander Khaletskiy; Kane Kuo; Gregory W. Hendey

    2011-01-01

    Background: Ultrasound (US) may provide the emergency physician with the ability to do real-time assessment of fracture reduction adequacy. Objectives: To assess whether US guidance aids in determining the adequacy of distal radius fracture reduction in the emergency department (ED), and to compare the rates of successful reduction with and without US. Methods: We conducted a prospective study of patients

  3. Genetics Home Reference: Distal hereditary motor neuropathy, type V

    MedlinePLUS

    ... and transport. This accumulation likely damages and kills motor neurons (specialized nerve cells in the brain and spinal cord that control muscle movement), leading to muscle weakness in the hands and ... to distal hereditary motor neuropathy, type V. The mutations probably reduce the ...

  4. Proximal Versus Distal Gastric Carcinoma—What Are the Differences?

    Microsoft Academic Search

    Pompiliu Piso; Uwe Werner; Hauke Lang; Petrit Mirena; Jürgen Klempnauer

    2000-01-01

    Background: The incidence of proximal gastric third carcinoma (PGC) has been rising in recent years. Classification and surgical therapy remain controversial. Methods: Between May 1986 and October 1997, 532 patients were operated for primary gastric carcinoma. All patient data were analyzed retrospectively comparing findings in patients with PGC and those with distal gastric carcinoma (DGC). Results: Two hundred fifty patients

  5. Ovarian apoptosis after shock wave lithotripsy for distal ureteral stones.

    PubMed

    Bayrak, Omer; Cimentepe, Ersin; Karatas, Omer Faruk; Aker, Aylin; Bayrak, Reyhan; Yildirim, Mehmet Erol; Unsal, Ali; Unal, Dogan

    2009-04-01

    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

  6. Interlocking medullary nails — Radiation doses in distal targeting

    Microsoft Academic Search

    S. Skjeldal; S. Backe

    1987-01-01

    Distal interlocking of intramedullary nails involves the use of a fluoroscope and a targeting device. A specially designed awl makes the interlocking procedure simple and efficient. The 30-cm-long side arm of this awl protects the surgeon's hand from direct radiation, and measurements of X-ray exposure show that the protection against radiation is sufficient.

  7. Osteotomy of the Distal Fibula for Correction of Posttraumatic Malunion

    Microsoft Academic Search

    Daniel Weber; Daniel Fritschy; Niklaus F. Friederich; Werner Müller

    2001-01-01

    Objective Restoration of anatomic alignment of the lateral malleolus to delay or prevent development of posttraumatic osteoarthritis of the ankle joint. Indications Posttraumatic malunion of the distal fibula with shortening, often combined with external rotation and abduction of the lateral malleolus. Osteoarthritic changes may be absent, mild or moderate. Contraindications Severe, preexisting osteoarthritis of the ankle. Presence of a remote

  8. Feedforward postural stabilization in a distal bimanual unloading task

    Microsoft Academic Search

    P. Kaluzny; M. Wiesendanger

    1992-01-01

    The aim of the present study was to investigate postural adjustments and positional stability in a bimanual unloading task, involving essentially the index finger, in order to test whether proactive adjustments are also observed in distal body segments. A second goal of the study was to evaluate the concept of a central command that would be responsible for coupling movement

  9. Chemotherapy Is More Active against Proximal than Distal Gastric Carcinoma

    Microsoft Academic Search

    Katsuhiko Higuchi; Wasaburo Koizumi; Satoshi Tanabe; Katsunori Saigenji; Jaffer A. Ajani

    2004-01-01

    Objective: Patients with localized proximal gastric carcinoma (PGC) have a poorer outcome than those with distal gastric carcinoma (DGC) following curative resection. However, it remains uncertain whether the location of the primary tumor influences the effect of chemotherapy in advanced gastric carcinoma. Methods: We assessed 270 eligible patients with unresectable, advanced gastric carcinoma who had received first-line chemotherapy between 1989

  10. Haptic Distal Spatial Perception Mediated by Strings: Haptic "Looming"

    ERIC Educational Resources Information Center

    Cabe, Patrick A.

    2011-01-01

    Five experiments tested a haptic analog of optical looming, demonstrating string-mediated haptic distal spatial perception. Horizontally collinear hooks supported a weighted string held taut by a blindfolded participant's finger midway between the hooks. At the finger, the angle between string segments increased as the finger approached…

  11. Distal biceps reconstruction 13 years post-injury

    PubMed Central

    Burrus, M. Tyrrell

    2015-01-01

    Distal biceps tendon ruptures are relatively rare injuries most commonly caused by an eccentric contraction of the biceps brachii. The majority of complete ruptures receive early surgical intervention, however, some patients do present in a delayed fashion. There are many surgical options at this time for acute and chronic injuries, and this case report describes an Achilles allograft reconstruction in a male who sustained a complete tear 13 years prior to presentation. At 12-month follow up, he had regained full function of his dominant extremity as evidence by returning to work with no limitations and by a Disabilities of the Arm, Shoulder, and Hand (DASH) score of zero. We are unaware of a successfully surgically reconstructed distal biceps tendon of this chronicity. As the literature on this subject is sparse, this case report gives credence to the idea that certain patients with a chronic distal biceps rupture should be considered for operative reconstruction and not relegated to continued failed conservative treatment. Discussed are the surgical treatment options and controversies for chronic distal biceps ruptures, and we review various outcome studies using different surgical techniques. PMID:25829956

  12. Hepatoid adenocarcinoma of the colon.

    PubMed

    Armaghani, Avan; Gonzalo, David Hernandez; Daily, Karen

    2015-01-01

    Hepatoid adenocarcinoma (HAC) is a rare extrahepatic adenocarcinoma that morphologically and immunophenotypically mimics hepatocellular carcinoma (HCC). We report the case of a 42-year-old woman with an extensive cancer history who presented with right-sided abdominal pain and lower gastrointestinal (GI) bleeding, and was ultimately diagnosed with colon adenocarcinoma. She underwent sigmoidectomy and adjuvant chemotherapy. Approximately 1?month after completion of chemotherapy, positron emission tomography showed presence of a 1.8?cm×1.4?cm mesenteric lymph node. She underwent treatment with chemotherapy and radiation followed by lymph node resection. Pathological findings from the lymph node were consistent with poorly differentiated carcinoma with hepatocellular differentiation. When compared with pathology from the colonic resection, both specimens showed histomorphological features and immunohistochemical profiles consistent with hepatocellular differentiation. Given these findings, a diagnosis of HAC of the colon with metastasis to a mesenteric lymph node was made. PMID:25883249

  13. Colonic motility in ulcerative colitis

    PubMed Central

    Antonelli, Elisabetta; Villanacci, Vincenzo; Baldoni, Monia; Dore, Maria Pina

    2014-01-01

    Background Inflammatory conditions affecting the gut may cause motility disturbances, and ulcerative colitis – one of the main disorders among the inflammatory bowel diseases – may display abnormal colonic motility. Aim To review the abnormalities of the large bowel in ulcerative colitis, by considering the motility, laboratory (in vitro) and pathological studies dealing with this topic. Methods A comprehensive online search of Medline and the Science Citation Index was carried out. Results Patients with ulcerative colitis frequently display colonic motor abnormalities, including lack of contractility, an increase of propulsive contractile waves, an excessive production of nitric oxide, vasoactive intestinal polypeptide nerves, interleukin 1 beta, neurotensin, tachykinins levels and the weaker action of substance P, likely related to a neuromuscular dysfunction due to the inflammatory process. Conclusions A better understanding of the pathophysiological grounds of altered colonic motility in ulcerative colitis may lead to a more in-depth knowledge of the accompanying symptoms and to better and more targeted therapeutic approaches. PMID:25452840

  14. Bacterial oncogenesis in the colon

    PubMed Central

    Dejea, Christine; Wick, Elizabeth; Sears, Cynthia L

    2013-01-01

    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

  15. Distal Pancreatectomy and Splenectomy: A Robotic or LESS Approach

    PubMed Central

    Ryan, Carrie E.; Ross, Sharona B.; Sukharamwala, Prashant B.; Sadowitz, Benjamin D.; Wood, Thomas W.

    2015-01-01

    Introduction: The role and application of robotic surgery are debated, particularly given the expansion of laparoscopy, especially laparoendoscopic single-site (LESS) surgery. This cohort study was undertaken to delineate differences in outcomes between LESS and robotic distal pancreatectomy and splenectomy. Methods: With Institutional Review Board approval, patients undergoing LESS or robotic distal pancreatectomy and splenectomy from September 1, 2012, through December 31, 2014, were prospectively observed, and data were collected. The results are expressed as the median, with the mean ± SD. Results: Thirty-four patients underwent a minimally invasive distal pancreatectomy and splenectomy: 18 with robotic and 16 with LESS surgery. The patients were similar in sex, age, and body mass index. Conversions to open surgery and estimated blood loss were similar. There were two intraoperative complications in the group that underwent the robotic approach. Time spent in the operating room was significantly longer with the robot (297 vs 254 minutes, P = .03), although operative duration (i.e., incision to closure) was not longer (225 vs 190 minutes; P = .15). Of the operations studied, 79% were undertaken for neoplastic processes. Tumor size was 3.5 cm for both approaches; R0 resections were achieved in all patients. Length of stay was similar in the two study groups (5 vs 4 days). There was one 30-day readmission after robotic surgery. Conclusions: Patient outcomes are similar with LESS or robotic distal pancreatectomy and splenectomy. Robotic operations require more time in the operating room. Both are safe and efficacious minimally invasive operations that follow similar oncologic principles for similar tumors, and both should be in the surgeon's armamentarium for distal pancreatectomy and splenectomy.

  16. Metacognition of agency: proximal action and distal outcome.

    PubMed

    Metcalfe, Janet; Eich, Teal S; Miele, David B

    2013-09-01

    The cues contributing to people's metacognitions of agency were investigated in two experiments in which people played a computer game that involved trying to "touch", via a mouse moving a cursor, downward scrolling X's (Experiment 1), or trying to "explode" the downward scrolling X's (Experiment 2). Both experiments varied (a) proximal action-related information by either introducing or not introducing Turbulence into the mouse controls and (b) distal outcome-related information such that touched X's "exploded" either 100 or 75 % of the time. Both variables affected people's judgments of agency (JOAs), but the effect was different. First, the decrement in feelings of agency was greater with the proximal variable than with distal variable. Second, while the proximal variable always had a large direct effect on JOAs, even taking judgments of performance (JOPs) into account, JOPs completely accounted for the effect of the distal variable in Experiment 1, where the instructions were just to touch the X's. And even in Experiment 2, in which the instructions were to explode the X's, the direct effect of the distal variable on JOAs was small. These data indicate that these two cues exhibit different psychological profiles. The proximal action-related information is a diagnostic cue to agency indicating the match between one's own intentions and actions. Internal monitoring of intentions is necessary and so the self is implicated. However, distal outcome can be largely monitored using information external to the agent, and so-while it is used by people to make agency judgments-it is a non-diagnostic cue. PMID:23358706

  17. Surgical indications for distal tibial epiphyseal fractures in children.

    PubMed

    Cai, Haoqi; Wang, Zhigang; Cai, Haiqing

    2015-03-01

    The goal of this study was to investigate the treatment methods and surgical indications of distal tibial epiphyseal fractures in children. Two hundred eighty-six children with distal tibial epiphyseal fractures were included in the study. Among these patients, 202 were male and 84 were female. Mean age was 11.7 years. A retrospective study on the postoperative long-term complications and related risk factors was performed. Treatment methods were determined according to the distance of fracture displacement. A long-leg cast was applied after closed reduction for patients with primary fracture displacement less than 2 mm. For cases with more than 2 mm of fracture displacement, K-wire or screw fixation was performed. For patients with less than 2 mm of fracture displacement, closed reduction and internal fixation was performed. Open reduction was performed in patients with more than 2 mm of fracture displacement, even after closed reduction. Mean follow-up was 6.4 years. Premature physeal closure occurred in 42 patients, and, among them, varus and valgus ankle deformities occurred in 16 patients. Associated fibular fractures and cast immobilization after closed reduction for Salter-Harris type III and IV fractures were risk factors for premature physeal closure. It is not effective to determine the surgical procedure according to the distance of preoperative fracture displacement for improving the prognosis of distal tibial epiphyseal fractures in children. Conservative treatment should be performed for patients with Salter-Harris type I and II distal tibial epiphyseal fractures, and surgery should be performed in patients with Salter-Harris type III and IV distal tibial epiphyseal fractures to reduce the incidence of premature physeal closure. [Orthopedics. 2015; 38(3):e189-e195.]. PMID:25760505

  18. Far cortical locking screws in distal femur fractures.

    PubMed

    Adams, John D; Tanner, Stephanie L; Jeray, Kyle J

    2015-03-01

    Distal femur fractures routinely heal by secondary bone healing, which relies on interfragmentary motion. Periarticular locking plates are commonly used for fixation in distal femur fractures but are associated with a high nonunion rate, likely due to the stiffness of the constructs. Far cortical locking (FCL) screws are designed to allow micromotion at the near cortex while maintaining purchase in only the far cortex. Although clinical data are limited, these screws have been shown in biomechanical studies to provide excellent interfragmentary motion, and animal models have shown increased callus formation compared with traditional locking screws. The purpose of this study was to examine the clinical effects that FCL screws have on healing in distal femur fractures treated with locked constructs. In this retrospective case series, 15 patients with a distal femur fracture treated with MotionLoc screws (Zimmer, Warsaw, Indiana) were analyzed. Serial radiographs were evaluated for callus presence and time to union. All fractures were either 33-A3 or 33-C2 according to the AO classification system, and 5 (33%) were open. Bone loss was recorded in 2 patients. There were no nonunions, and average time to union was 24 weeks. There were no implant failures, and all 5 open fractures, including the 2 with bone loss, healed without intervention. There was 1 reoperation due to painful hardware. Although this is a small case series, these results are promising. Far cortical locking screws may provide the answer to the high nonunion rate associated with distal femur fractures treated with traditional locked constructs. [Orthopedics. 2015; 38(3):e153-e156.]. PMID:25760500

  19. Indolent infection in nonunion of the distal femur.

    PubMed

    Kim, Ji Wan; Byun, Seong-Eun; Oh, Hyoung Keun; Kim, Jung Jae

    2015-04-01

    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

  20. Comparative analysis of inflamed and non-inflamed colon biopsies reveals strong proteomic inflammation profile in patients with ulcerative colitis

    PubMed Central

    2012-01-01

    Background Accurate diagnostic and monitoring tools for ulcerative colitis (UC) are missing. Our aim was to describe the proteomic profile of UC and search for markers associated with disease exacerbation. Therefore, we aimed to characterize specific proteins associated with inflamed colon mucosa from patients with acute UC using mass spectrometry-based proteomic analysis. Methods Biopsies were sampled from rectum, sigmoid colon and left colonic flexure from twenty patients with active proctosigmoiditis and from four healthy controls for proteomics and histology. Proteomic profiles of whole colonic biopsies were characterized using 2D-gel electrophoresis, and peptide mass fingerprinting using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was applied for identification of differently expressed protein spots. Results A total of 597 spots were annotated by image analysis and 222 of these had a statistically different protein level between inflamed and non-inflamed tissue in the patient group. Principal component analysis clearly grouped non-inflamed samples separately from the inflamed samples indicating that the proteomic signature of colon mucosa with acute UC is strong. Totally, 43 individual protein spots were identified, including proteins involved in energy metabolism (triosephosphate isomerase, glycerol-3-phosphate-dehydrogenase, alpha enolase and L-lactate dehydrogenase B-chain) and in oxidative stress (superoxide dismutase, thioredoxins and selenium binding protein). Conclusions A distinct proteomic profile of inflamed tissue in UC patients was found. Specific proteins involved in energy metabolism and oxidative stress were identified as potential candidate markers for UC. PMID:22726388

  1. Bone metastasis from colon carcinoma in an 11-year-old boy: radiological features and brief review of the literature.

    PubMed

    Colangeli, Marco; Calamelli, Carlotta; Manfrini, Marco; Frisoni, Tommaso; Donati, Davide Maria

    2015-05-01

    We report the case of an 11-year-old boy who came to our observation with localized pain in the left arm for nearly 5 months. No previous history of trauma was referred in an otherwise healthy patient. Radiographs, isotope bone-scan, computed tomography, and magnetic resonance imaging of the lesion involving the left humerus are discussed. Histological diagnosis from biopsy of the humerus was metastasis from mucinous adenocarcinoma. The primary tumor site was identified in the sigmoid-descending colon, and at presentation, in addition to the left humerus, the disease had already developed in multiple skeletal sites. This report also considers literature concerning such a rare disease in children. This is, to our knowledge, the first report of childhood colorectal cancer diagnosed because of a bone metastasis. PMID:25351420

  2. Interaction of human chagasic IgG with human colon muscarinic acetylcholine receptor: molecular and functional evidence

    PubMed Central

    Sterin-Borda, L; Goin, J; Bilder, C; Iantorno, G; Hernando, A; Borda, E

    2001-01-01

    BACKGROUND AND AIMS—Gastrointestinal disorders is one of the clinical manifestations of chronic Chagas' disease. The pathogenesis seems to be associated with autonomic dysfunction. Here, we consider the muscarinic cholinoceptor mediated alteration in distal colon function in chagasic megacolon.?PATIENTS—Patients were divided into four groups: group I, chronic chagasic patients with megacolon; group II, chronic chagasic patients without megacolon; group III, non-chagasic patients with megacolon; and group IV, normal healthy volunteers (control).?METHODS—Binding assay and immunoblot of cholinoceptors from human and rat colon and enzyme immunoassay (ELISA) using a synthetic 24mer peptide corresponding to the second extracellular loop of human M2 muscarinic acetylcholine receptors (mAChR) were used to detect the presence of serum antibodies. The effect of antibodies on basal tone and 3',5'-cyclic monophosphate (cAMP) production of human and rat distal colon strips were also tested.?RESULTS—Group I but not the other groups had circulating antibodies capable of interacting with human colon activating M2 mAChR, as they competed with binding of specific radioligand to mAChR and interacted with the second extracellular loop of human M2 mAChR. Moreover, affinity purified anti-M2 peptide IgG from group I, in common with monoclonal antihuman M2 mAChR, recognised bands with a molecular weight corresponding to colon mAChR. This antibody also displayed an agonist-like activity, increasing basal tone and decreasing cAMP accumulation. Both effects were blunted by AF-DX 116 and neutralised by the synthetic peptide.?CONCLUSIONS—In chagasic patients with megacolon there are antibodies that can recognise and activate M2 mAChR. The implications of these autoantibodies in the pathogenesis of chagasic megacolon is discussed.???Keywords: chagasic megacolon; acetylcholine receptor; antibodies; colon contractility PMID:11600475

  3. An in vitro rat model of colonic motility to determine the effect of ?-casomorphin-5 on propagating contractions.

    PubMed

    Dalziel, J E; Spencer, N J; Dunstan, K E; Lynch, A T; Haggarty, N W; Gopal, P K; Roy, N C

    2014-11-01

    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

  4. Vitamin D and Colon Cancer

    Microsoft Academic Search

    Heide S. Cross; Meinrad Peterlik

    \\u000a Protection from colon cancer by vitamin D can be traced to the role of 1,25-dihydroxyvitamin D3 [1,25-(OH)2D] in controlling proliferation, differentiation, and apoptosis of colonic epithelial cells. Human colonocytes express the\\u000a CYP27B1-encoded 25(OH)D-1?-hydroxylase and therefore are able to convert 25-hydroxyvitamin D[25(OH)D] to 1,25(OH)2D. In vitamin D insufficiency, availability of 25(OH)D is low, so that CYP27B1 activity in colonocytes may be

  5. Microenvironment influence on human colon adenocarcinoma phenotypes and matrix metalloproteinase-2, p53 and ?-catenin tumor expressions from identical monoclonal cell tumor in the orthotopic model in athymic nude rats.

    PubMed

    Priolli, Denise Gonçalves; Abrantes, Ana Margarida; Neves, Silvia; Gonçalves, Ana Cristina; Lopes, Camila Oliveira; Martinez, Natalia Peres; Cardinalli, Izilda Aparecida; Ribeiro, Ana Bela Sarmento; Botelho, Maria Filomena

    2014-03-01

    The present study aims to identify differences between left and right colon adenocarcinoma arising from identical clonal cell and to find out if microenvironment has any influence on matrix metalloproteinase-2 (MMP2), p53 and ?-catenin tumor expressions. MATERIAL AND METHODS. Rats (RNU) were submitted to cecostomy to obtain the orthotopic model of right colon tumor (n = 10), while for the left colon model (n = 10), a colon diversion and distal mucous fistula in the descending colon was used. Cultivated human colon adenocarcinoma cells (WiDr) were inoculated in stomas submucosa. Histopathological analysis, real-time reverse transcription-PCR for ?-catenin, p53 and MMP2, as well as immunohistochemical analysis for p53 and ?-catenin expression were conducted. Central tendency, variance analysis and the Livak delta-delta-CT method were used for statistical analysis, adopting a 5% significance level. RESULTS. All tumors from the left colon exhibited infiltrative ulceration, while in the right colon tumor growth was predominantly exophytic (67%). In the left colon, tumor growth was undifferentiated (100%), while it was moderately differentiated in the right colon (83%). In right colon tumors, MMP2, p53, and ?-catenin gene expressions were higher than compared to left colon (p = 4.59354E-05, p = 0.0035179, p = 0.00093798, respectively, for MMP2, p53 and ?-catenin). ?-catenin and p53 results obtained by real-time polymerase chain reaction were confirmed by immunohistochemistry assay (p = 0.01 and p = 0.001, respectively, for ?-catenin and p53). CONCLUSION. Left and right human colon adenocarcinomas developed in animal models have distinct phenotypes even when they have the same clonal origin. Microenvironment has influenced p53, ?-catenin, and MMP2 expression in animal models of colon cancer. PMID:24325610

  6. Comparison between cerebral state index and bispectral index as measures of electroencephalographic effects of sevoflurane using combined sigmoidal Emax model

    PubMed Central

    Han, Dong Woo; Linares-Perdomo, Olinto-Jose; Lee, Jong Seok; Kim, Jun Ho; Kern, Steven E

    2011-01-01

    Aim: The cerebral state index (CSI) was recently introduced as an electroencephalographic monitor for measuring the depth of anesthesia. We compared the performance of CSI to the bispectral index (BIS) as electroencephalographic measures of sevoflurane effect using two combined sigmoidal Emax models. Methods: Twenty adult patients scheduled for laparotomy were studied. After induction of general anesthesia, sevoflurane concentrations were progressively increased and then decreased over 70 min. An analysis of the BIS and CSI with the sevoflurane effect-site concentration was conducted using two combined sigmoidal Emax models. Results: The BIS and CSI decreased over the initial concentration range of sevoflurane and then reached a plateau in most patients. A further increase in sevoflurane concentration produced a secondary plateau in the pharmacodynamic response. The CSI was more strongly correlated with effect-site sevoflurane concentration (R2=0.95±0.04) than the BIS was (R2=0.87±0.07) (P<0.05). The individual Emax and Ceff50 (effect-site concentration associated with 50% decrease from baseline to plateau) values for the upper and lower plateaus were significantly greater for BIS (12.7±7.3, 1.6±0.4, and 4.2±0.5, respectively) than for CSI (3.4±2.2, 1.2±0.4, and 3.8±0.5, respectively) (P<0.05). The remaining pharmacodynamic parameters for the BIS and CSI were similar. Conclusion: The overall performance of the BIS and CSI during sevoflurane anesthesia was similar despite major differences in their algorithms. However, the CSI was more consistent and more sensitive to changes in sevoflurane concentration, whereas the measured BIS seemed to respond faster. The newly developed combined Emax model adequately described the clinical data, including the pharmacodynamic plateau. PMID:21892201

  7. Estrogen's Impact on Colon Tumor Formation

    E-print Network

    Tinsley, Kirby

    2010-07-14

    One hundred thirty six men and women die every day from colon cancer in the United States (2008 statistics). Estrogen has been shown to reduce colonic tumor inflammation; however, it is unclear in the tumor development and growth process what...

  8. Teaching about the Colonization of Space.

    ERIC Educational Resources Information Center

    Huebner, Jay S.

    1979-01-01

    Describes an undergraduate course, The Colonization of Space, which introduces nonscience majors at the University of North Florida to current topics in the exploration, industrialization, and colonization of space. References to the audiovisual resources and literature are also included. (HM)

  9. STUDIES OF DBP-INDUCED COLON CANCER

    EPA Science Inventory

    Induction of colon carcinomas by trihalomethanes in rats may be relevant to epidemiological findings of increased incidences of colon-rectal cancer associated with exposure to chlorination byproducts. These studies have demonstrated that the brominated THMs in drinking water ind...

  10. Colon cancer secreted protein-2 (CCSP-2), a novel candidate serological marker of colon neoplasia

    Microsoft Academic Search

    Baozhong Xin; Petra Platzer; Stephen P Fink; Lisa Reese; Arman Nosrati; James K V Willson; Keith Wilson; Sanford Markowitz

    2005-01-01

    Cancers of the colon and rectum are the second leading cause of cancer death among adult Americans. When detected at early stages, colon cancer is highly curable. Colonoscopy, an effective but invasive screening test, has been limited in its public acceptance. The goal of this study was to identify novel serum markers of colon cancers and precancerous colon adenomas as

  11. Colon Answers - MP/H Rules

    Cancer.gov

    Answers and Rationale Colon Case # Primary Data Item Name Preferred Answer Rationale Colon 1 Is this a multiple primary? Yes/No No Single tumor – right colon Primary 1 Histologic Type 8140/3 Adenocarcinoma Code 8140 when the pathology report describes

  12. Breast and Colon Cancer Family Registries

    Cancer.gov

    The Breast Cancer Family Registry (Breast CFR) and the Colon Cancer Family Registry (Colon CFR) were established by the National Cancer Institute (NCI) as a unique resource for investigators to use in conducting studies on the genetics and molecular epidemiology of breast and colon cancer.

  13. Space Colonization—Benefits for the World

    Microsoft Academic Search

    W. H. Siegfried

    We have begun to colonize space, even to the extent of early space tourism. Our early Vostok, Mercury, Gemini, Apollo, Skylab, Spacehab, Mir and now ISS are humankind's first ventures toward colonization. Efforts are underway to provide short space tours, and endeavors such as the X-Prize are encouraging entrepreneurs to provide new systems. Many believe that extended space travel (colonization)

  14. A comparative analysis of space colonization enterprises

    NASA Astrophysics Data System (ADS)

    Drake, F. D.

    It is shown that the energy requirements for interstellar colonization exceed that for interplanetary colonization by a factor of ten million or perhaps much more. This is offered as an argument against extensive interstellar colonization as a means of dealing with population expansion, and as a possible explanation of the Fermi paradox.

  15. Space Colonization-Benefits for the World

    Microsoft Academic Search

    W. H. Siegfried

    2003-01-01

    We have begun to colonize space, even to the extent of early space tourism. Our early Vostok, Mercury, Gemini, Apollo, Skylab, Spacehab, Mir and now ISS are humankind's first ventures toward colonization. Efforts are underway to provide short space tours, and endeavors such as the X-Prize are encouraging entrepreneurs to provide new systems. Many believe that extended space travel (colonization)

  16. Space Colonization—Benefits for the World

    Microsoft Academic Search

    W. H. Siegfried

    2003-01-01

    We have begun to colonize space, even to the extent of early space tourism. Our early Vostok, Mercury, Gemini, Apollo, Skylab, Spacehab, Mir and now ISS are humankind’s first ventures toward colonization. Efforts are underway to provide short space tours, and endeavors such as the X-Prize are encouraging entrepreneurs to provide new systems. Many believe that extended space travel (colonization)

  17. Energy Balance and Colon Cancer â€\\

    Microsoft Academic Search

    Martha L. Slattery; John Potter; Bette Caan; Sandra Edwards; Ashley Coates; Khe-Ni Ma; T. Dennis

    Lowlevelsofphysicalactivityand highlevelsofenergyintakeand body mass have all been directly associated with colon cancer. The purpose of this study was to determine how physical inactivity interacts with other components of energy balance (energy intake and body mass) in deter mining colon cancer risk. Data were obtained from 2073 first primary cases of colon cancer and 2466 age- and sex-matched controls identified from

  18. [A case of metastatic carcinoma of the colon after curative resection for gastric cancer].

    PubMed

    Watanabe, Megumi; Narusaka, Toru; Hayashi, Dofu; Matsumura, Toshihisa; Nonaka, Yasuyuki; Kurose, Michihiro; Tokuda, Naohiko; Miyake, Takayoshi

    2013-11-01

    We report a rare case of metastatic colon cancer that occurred after gastric cancer surgery. The patient was a 63-year- old man who had received distal gastrectomy for type 2 advanced gastric cancer, which was a moderately differentiated adenocarcinoma, pT4a (SE),pN0, P0, CY0, M0, and Stage IIB. He was treated with S-1 for 1 year after the operation. However, levels of CA19-9 gradually increased postoperatively. Subsequently, 2 years and 10 months after the operation, computed tomography indicated a mass in the transverse colon. Colonoscopy showed half-circumferential stenosis in the transverse colon. The histopathological diagnosis was metastasis of gastric cancer. We performed right-hemicolectomy. Histopathology showed a moderately or poorly differentiated adenocarcinoma, which was colonic metastasis of the gastric cancer. After the operation, he was treated with paclitaxel weekly. Our findings suggest that after surgery for gastric cancer, it is worthwhile to monitor for metastatic colorectal cancer. PMID:24394053

  19. Late Colonization of Easter Island

    Microsoft Academic Search

    Terry L. Hunt; Carl P. Lipo

    2006-01-01

    Easter Island (Rapa Nui) provides a model of human-induced environmental degradation. A reliable chronology is central to understanding the cultural, ecological, and demographic processes involved. Radiocarbon dates for the earliest stratigraphic layers at Anakena, Easter Island, and analysis of previous radiocarbon dates imply that the island was colonized late, about 1200 A.D. Substantial ecological impacts and major cultural investments in

  20. Colon Histology Coding Rules Flowchart

    Cancer.gov

    Ne xt Page NO Rule Action Notes and Examples Colon Histology Coding Rules - Flowchart Flowchart Key Flow Direction Notes and Examples Rule Action (Exc ludes lym phom a and leukem ia M9590-9989 and Kapos i sarcoma M9140) (C180-C189) M ULT IPLE TUM ORS ABSTRACTED AS A SINGLE PRIM ARY H20 Are there multiple invasive tumors?

  1. Vitamin D and colon cancer

    PubMed Central

    Klampfer, Lidija

    2014-01-01

    Calcitriol, 1?, 25-dihydroxyvitamin D3 (1,25 (OH)2D3), the most active form of vitamin D, is a pleotropic hormone with a wide range of biological activities. Due to its ability to regulate calcium and phosphate metabolism, 1,25D3 plays a major role in bone health. In addition, 1,25D3 binds to the vitamin D receptor and thereby regulates the expression of a number of genes which control growth, differentiation and survival of cancer cells. In agreement, the levels of vitamin D3 appear to be an essential determinant for the development and progression of colon cancer and supplementation with vitamin D3 is effective in suppressing intestinal tumorigenesis in animal models. Vitamin D3 has been estimated to lower the incidence of colorectal cancer by 50%, which is consistent with the inverse correlation between dietary vitamin D3 intake or sunlight exposure and human colorectal cancer. Several studies confirmed that increasing vitamin D3 lowers colon cancer incidence, reduces polyp recurrence, and that sufficient levels of vitamin D3 are associated with better overall survival of colon cancer patients. Vitamin D regulates the homeostasis of intestinal epithelium by modulating the oncogenic Wnt signaling pathway and by inhibiting tumor-promoting inflammation. Both activities contribute to the ability of 1,25D3 to prevent the development and progression of colon cancer. PMID:25400874

  2. Self-expanding metal stents in malignant colonic obstruction: experiences from Sweden

    PubMed Central

    2011-01-01

    Background Acute surgery in the management of malignant colonic obstruction is associated with high morbidity and mortality. The use of self-expanding metal stents (SEMS) is an alternative method of decompressing colonic obstruction. SEMS may allow time to optimize the patient and to perform preoperative staging, converting acute surgery into elective. SEMS is also proposed as palliative treatment in patients with contraindications to open surgery. Aim: To review our experience of SEMS focusing on clinical outcome and complications. The method used was a review of 75 consecutive trials at SEMS on 71 patients based on stent-protocols and patient charts. Findings SEMS was used for palliation in 64 (85%) cases and as a bridge to surgery in 11 (15%) cases. The majority of obstructions, 53 (71%) cases, were located in the recto-sigmoid. Technical success was achieved in 65 (87%) cases and clinical decompression was achieved in 60 (80%) cases. Reasons for technical failure were inability to cannulate the stricture in 5 (7%) cases and suboptimal SEMS placement in 3 (4%) cases. Complications included 4 (5%) procedure-related bowel perforations of which 2 (3%) patients died in junction to post operative complications. Three cases of bleeding after SEMS occurred, none of which needed invasive treatment. Five of the SEMS occluded. Two cases of stent erosion were diagnosed at the time of surgery. Average survival after palliative SEMS treatment was 6 months. Conclusion Our results correspond well to previously published data and we conclude that SEMS is a relatively safe and effective method of treating malignant colonic obstruction although the risk of SEMS-related perforations has to be taken into account. PMID:21801447

  3. [Combination of self-expandable metallic stent insertion and laparoscopic surgery as a less invasive treatment of obstructive left-sided colon cancer].

    PubMed

    Koizumi, Noriaki; Nakase, Yuen; Takagi, Tsuyoshi; Fukumoto, Kanehisa

    2014-11-01

    The purpose of this study was to evaluate the outcome of treating obstructive left-sided colon cancer with a combination of self-expandable metallic stent (SEMS) insertion and laparoscopic surgery. Ten patients were included in this study. Two patients had obstructive transverse colon cancer, and eight had obstructive sigmoid colon cancer. The patients had a SEMS inserted preoperatively as a bridge to surgery. Efficient decompression was achieved in all the patients, without any complications. Normal oral intake was possible until the laparoscopic, or laparoscope-assisted, one-stage radical operation. The SEMS insertion did not affect the surgical maneuver or laparoscopic operation at all. None of the patients developed any postoperative complications. After surgery, five patients were diagnosed with Stage II disease and three patients were diagnosed with Stage IIIA disease. The remaining two patients had distant metastasis (para-aortic lymph node and liver) and were diagnosed with Stage IV disease. Chemotherapy was administered to the two patients with Stage IV disease after a comparatively early recovery from a less invasive surgical procedure. SEMS insertion appears to be an effective, less invasive decompression method. When used in combination with laparoscopic surgery, SEMS insertion appears to be a safe and less invasive method of treating obstructive left-sided colon cancer. PMID:25731260

  4. Role of distal reabsorption and peritubular environment in glomerulotubular balance.

    NASA Technical Reports Server (NTRS)

    Schrier, R. W.; Humphreys, M. H.

    1972-01-01

    Total kidney glomerulotubular balance was examined during aortic constriction and release in saline-loaded dogs and in dogs undergoing water diuresis. Aortic constriction lowered the glomerular filtration rate by 45% in both groups, and glomerulotubular balance, as judged by changes in absolute sodium reabsorption, was also comparable. During water diuresis, a linear relationship was observed between free water clearance and urine flow during all maneuvers, suggesting that distal sodium reabsorption is related primarily to distal delivery. The results suggest that if alterations in the peritubular environment are responsible for the changes in tubular sodium reabsorption during aortic constriction in the saline- or water-loaded dog, then a change in renal plasma flow, and presumably delivery rate of oncotic force, may be the most likely mediator.

  5. A New Distal Arthrogryposis Syndrome Characterized by Plantar Flexion Contractures

    PubMed Central

    Stevenson, D.A.; Swoboda, K.J.; Sanders, R.K.; Bamshad, M.

    2011-01-01

    The distal arthrogryposis (DA) syndromes are a distinct group of disorders characterized by contractures of two or more different body areas. More than a decade ago, we revised the classification of DAs and distinguished several new syndromes. This revision has facilitated the identification of five genes (i.e., TNNI2, TNNT3, MYH3, MYH8, and TPM2) that encode components of the contractile apparatus of fast-twitch myofibers and cause DA syndromes. We now report the phenotypic features of a novel DA disorder characterized primarily by plantar flexion contractures in a large five-generation Utah family. Contractures of hips, elbows, wrists, and fingers were much milder though they varied in severity among affected individuals. All affected individuals had normal neurological examinations; electromyography and creatinine kinase levels were normal on selected individuals. We have tentatively labeled this condition distal arthrogryposis type 10 (DA10). PMID:17103435

  6. Experience with the technique of pancreas-sparing distal duodenectomy.

    PubMed

    Sali, Priyanka A; Shah, Rajiv; Jagannath, Palepu

    2014-01-01

    Pancreas-sparing distal duodenectomy (PSDD) is a novel surgical technique for tumors of distal duodenum below the ampulla to achieve oncologically free margins and avoid multiple anastomoses. We report PSDD performed in five cases, three duodenal adenocarcinoma, and two neuroendocrine tumors (NETs). Three patients had adenocarcinoma of D3 and D4 with free ampulla. PSDD was performed with total excision of regional nodes. In the two patients with NETs, one had a mass lesion close to the pancreatic head. The mass was excised followed by PSDD. There were four small primary NETs in the duodenum, and the mass was metastatic lymph node. The second patient had primary duodenal NET with liver metastases. After transarterial chemoembolization, PSDD with liver metastatectomy was performed. Specimens in all five cases showed clear margins. The patients had a smooth recovery and were well at a median follow up of 10 months. PMID:24243079

  7. Unravelling intention: distal intentions increase the subjective sense of agency.

    PubMed

    Vinding, Mikkel C; Pedersen, Michael N; Overgaard, Morten

    2013-09-01

    Experimental studies investigating the contribution of conscious intention to the generation of a sense of agency for one's own actions tend to rely upon a narrow definition of intention. Often it is operationalized as the conscious sensation of wanting to move right before movement. Existing results and discussion are therefore missing crucial aspects of intentions, namely intention as the conscious sensation of wanting to move in advance of the movement. In the present experiment we used an intentional binding paradigm, in which we distinguished between immediate (proximal) intention, as usually investigated, and longer standing (distal) intention. The results showed that the binding effect was significantly enhanced for distal intentions compared to proximal intentions, indicating that the former leads to stronger sense of agency. Our finding provides empirical support for a crucial distinction between at least two types of intention when addressing the efficacy of conscious intentions. PMID:23732190

  8. Osteomyelitis Caused by Candida glabrata in the Distal Phalanx

    PubMed Central

    Hibino, Naohito; Sairyo, Koichi; Yoshioka, Shinji; Yamano, Masahiro; Henmi, Tatsuhiko

    2014-01-01

    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

  9. Simultaneous Dislocation of Radiocapitellar and Distal Radioulnar Joint

    PubMed Central

    Nishi, Tomio; Suzuki, Noriyuki; Tani, Takayuki

    2013-01-01

    A 45-year-old male presented to the emergency room of our institution complaining of severe pain around the left elbow. While playing volleyball, he slipped down with his left arm hit between the floor and his body. He complaind of strong pain from left elbow to hand, and active motion of elbow and wrist joint was impossible. His forearm was held in supinated position. On X-ray examination, radius head was deviated to anterior lateral side, and distal end of radius was dislocated to dorsal side. Tenderness was prominent at the site of radial head and distal radioulnar joint. Surgical treatment was performed using triceps tendon strip. Good functional recovery was gained. PMID:24194995

  10. [The pendulis appliance: a palatal miniscrew supported molar distalization device].

    PubMed

    Nappée-Miévilly, Magali; Nappée, François-Joseph; Kerbrat, Jean-Baptiste; Goudot, Patrick

    2014-09-01

    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

  11. Scintisplenoportography in assessing patency of distal splenorenal shunts

    SciTech Connect

    Teres, J.; Herranz, R.; Visa, J.; Lomena, F.; Pera, C.; Rodes, J.

    1983-06-01

    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.

  12. Distal Fibular Stabilization With A Modified Knowles Pin

    PubMed Central

    Brown, George A.; Copus, Amanda

    1992-01-01

    Intramedullary fixation of the distal fibula has been used routinely by the first author (G.A.B.) for fifteen years. Twenty patients with ankle fractures fixed with a modified Knowles pin (Howmedica®) in the intramedullary canal of the distal fibula were evaluated as a follow-up study to one conducted in 1984 on thirty-three patients. The 1984 study showed successful stabilization of the injured ankles by use of the modified Knowles, Deyerle, and Steinman pins. No patient had a measurable change in fibular fracture alignment or position of the intramedullary device. There was a 100% union rate and no infections. The modified Knowles pin appears to be a successful device for internal fixation of the lateral malleolus and allows early return to full function. ImagesFigure 1 (A, B)Figure 2 (A,B, C)

  13. LUSSAZIONE PALMARE ISOLATA DELL'ARTICOLAZIONE RADIO ULNARE DISTALE: PRESENTAZIONE DI UN CASO CLINICO

    Microsoft Academic Search

    M. CALCAGNI; T. GIESEN; R. LUCHETTI; U. MARTORANA; G. PAJARDI

    Isolated volar distal radio-ulnar joint dislocation: case report SUMMARY Palmar distal radio-ulnar joint (DRUJ) dislocation is a rare injury that may occur isolated from other injuries but, most frequently occurs in association with a distal radius fracture. In the literature, no more than 20 cases of pa- tients with isolated DRUJ dislocation were found. The diagnosis of this injury is

  14. Functional Consequence of Distal Brachioradialis Tendon Release: A Biomechanical Study

    PubMed Central

    Tirrell, Timothy F.; Franko, Orrin I.; Bhola, Siddharth; Hentzen, Eric R.; Abrams, Reid A.; Lieber, Richard L.

    2013-01-01

    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

  15. Distal biceps tendon injuries--current treatment options.

    PubMed

    Quach, Tony; Jazayeri, Reza; Sherman, Orrin H; Rosen, Jeffrey E

    2010-01-01

    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

  16. Aldosterone Paradox: Differential Regulation of Ion Transport in Distal Nephron

    NSDL National Science Digital Library

    Juan Pablo Arroyo (Universidad Nacional Autónoma de México, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Molecular Physiology Unit, Instituto de Investigaciones Biomédicas,)

    2011-04-01

    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.

  17. Distal axonopathy in peripheral nerves of PMP22-mutant mice

    Microsoft Academic Search

    Sara Sancho; Josef P. Magyar; Adriano Aguzzi; Ueli Suter

    1999-01-01

    Summary A partial duplication of chromosome 17 is associated with Charcot-Marie-Tooth disease type 1A (CMT1A), a demyelinating peripheral neuropathy that causes progressive distal muscle atrophy and sensory impairment. Trisomic expression of peripheral myelin protein 22 (PMP22) whose gene is contained within the duplicated region is considered to be responsible for the disease. By using recombinant gene technology in rodents, we

  18. Sphincter-Sparing Treatment for Distal Rectal Adenocarcinoma

    Microsoft Academic Search

    Glenn D. Steele; James E. Herndon; Ron Bleday; Anthony Russell; Al Benson III; Maha Hussain; Anne Burgess; Joel E. Tepper; Robert J. Mayer

    1999-01-01

    Background: Studies suggest that the anal sphincter can be preserved in some patients with distal rectal adenocarcinoma (DRA), but this has not been validated in any prospective multi-institutional trial.Methods: To test the hypothesis that the anal sphincter can be preserved in some patients with DRA, the Cancer and Leukemia Group B and collaborators reviewed 177 patients who had T1\\/T2 adenocarcinomas

  19. A Simple Grafting Method to Repair Irreparable Distal Biceps Tendon

    Microsoft Academic Search

    Martti Vastamäki; Heidi Vastamäki

    2008-01-01

    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

  20. Predictors of Proximal Neoplasia in Patients Without Distal Adenomatous Pathology

    Microsoft Academic Search

    Joseph C. Anderson; Zvi Alpern; Catherine R. Messina; Patricia Hubbard; Roger Grimson; Peter F. Ells; Douglas L. Brand

    2004-01-01

    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

  1. Distal tibia fractures: locked or non-locked plating?

    PubMed Central

    Khalsa, Amrit S; Toossi, Nader; Tabb, Loni P; Amin, Nirav H; Donohue, Kenneth W; Cerynik, Douglas L

    2014-01-01

    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

  2. Treatment of distal femur fractures in a regional Australian hospital

    PubMed Central

    Batchelor, Ewan; Heal, Clare; Haladyn, J Kimberly; Drobetz, Herwig

    2014-01-01

    AIM: To review our outcomes and compare the results of the Less Invasive Stabilization System (LISS) to other implants for distal femur fracture management at a regional Australian hospital. METHODS: The LISS is a novel implant for the management of distal femur fractures. It is, however, technically demanding and treatment results have not yet been assessed outside tertiary centres. Twenty-seven patients with 28 distal femur fractures who had been managed surgically at the Mackay Base Hospital from January 2004 to December 2010 were retrospectively enrolled and assessed clinically and radiologically. Outcomes were union, pain, Lysholm score, knee range of motion, and complication rates. RESULTS: Twenty fractures were managed with the LISS and eight fractures were managed with alternative implants. Analysis of the surgical techniques revealed that 11 fractures managed with the LISS were performed according to the recommended principles (LISS-R) and 9 were not (LISS-N). Union occurred in 67.9% of fractures overall: 9/11 (82%) in the LISS-R group vs 5/9 (56%) in the LISS-N group and 5/8 (62.5%) in the alternative implant group. There was no statistically significant difference between pain, Lysholm score, and complication rates between the groups. However, there was a trend towards the LISS-R group having superior outcomes which were clinically significant. There was a statistically significant greater range of median knee flexion in the LISS-R group with compared to the LISS-N group (P = 0.0143) and compared with the alternative implant group (P = 0.0454). CONCLUSION: The trends towards the benefits of the LISS procedure when correctly applied would suggest that not only should the LISS procedure be performed for distal femur fractures, but the correct principle of insertion is important in improving the patient’s outcome. PMID:25035843

  3. Endovascular Treatment of the Distal Internal Carotid Artery Large Aneurysm

    PubMed Central

    Bae, Hong-Ju; Huh, Pil-Woo; Lee, Tae-Gyu; Cho, Kyoung-Suok; Lee, Sang-Bok

    2014-01-01

    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

  4. Dorsal Capsuloplasty for Dorsal Instability of the Distal Ulna

    PubMed Central

    Kouwenhoven, S.T.P.; de Jong, T.; Koch, A.R.

    2013-01-01

    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

  5. Transverse Colon Diverticulitis with Calcified Fecalith

    PubMed Central

    Solak, Aynur; Solak, Ilhami; Genç, Berhan; Sahin, Neslin; Yalaz, Seyhan

    2013-01-01

    Left colonic diverticula are common in Western populations, whereas right colonic diverticulosis primarily occurs in Oriental populations. Diverticulitis of the transverse colon is very rare, with very few cases reported in the literature. Herein, we report a case of transverse colon diverticulitis caused by a calcified stone in a 69-year-old female. This was a solitary diverticulum. The signs and symptoms of the disease are similar to acute pancreatitis. To the best of our knowledge, this is the first report describing the MRI findings of a patient with trans-verse colon diverticulitis caused by a calcified stone. PMID:25610254

  6. Molecular nature of colon tumors in hereditary nonpolyposis colon cancer, familial polyposis, and sporadic colon cancer

    Microsoft Academic Search

    M Konishi; R Kikuchi-Yanoshita; K Tanaka; M Muraoka; A Onda; Y Okumura; N Kishi; T Iwama; T Mori; M Koike; K Ushio; M Chiba; S Nomizu; F Konishi; J Utsunomiya; M Miyaki

    1996-01-01

    BACKGROUND & AIMS: Microsatellite instability (replication error [RER]) is a characteristic of tumors in hereditary nonpolyposis colon cancer (HNPCC), but the mechanism of HNPCC carcinogenesis is not yet understood. To clarify the nature of HNPCC tumors, RER and genetic changes were compared between HNPCC and non-HNPCC tumors. METHODS: RER and genetic changes were analyzed in 21 HNPCC, 389 familial adenomatous

  7. Distal Femoral Complications Following Antegrade Intramedullary Nail Placement

    PubMed Central

    Fantry, Amanda J.; Elia, Gregory; Vopat, Bryan G.; Daniels, Alan H.

    2015-01-01

    While antegrade nailing for proximal and diaphyseal femur fractures is a commonly utilized fixation method with benefits including early mobilization and high rates of fracture union, both intraoperative and postoperative complications may occur. Intraoperative errors include leg length discrepancy, anterior cortical perforation, malreduction of the fracture, and neurovascular injury, and postoperative complications include nonunion, malunion, infection, and hardware failure. This case series reviews complications affecting the distal femur after intramedullary nailing including fracture surrounding a distal femoral interlocking screw (Case #1), nonunion after dynamization with nail penetration into the knee joint (Case #2), and anterior cortical perforation (Case #3). Prevention of intraoperative and postoperative complications surrounding intramedullary nailing requires careful study of the femoral anatomy and nail design specifications (radius of curvature), consideration of the necessity of distal interlocking screws, the need for close radiographic follow-up after nail placement with X-rays of the entire length of the nail, and awareness of possible nail penetration into the knee joint after dynamization. PMID:25874066

  8. Early Distal Axonopathy of the Visual Pathway in Experimental Diabetes

    PubMed Central

    Fernandez, Diego C.; Pasquini, Laura A.; Dorfman, Damián; Aldana Marcos, Hernán J.; Rosenstein, Ruth E.

    2012-01-01

    Diabetic retinopathy is a leading cause of acquired blindness. Visual function disorders have been observed in diabetic patients with very early retinopathy or even before the onset of retinopathy. The aim of the present work was to analyze the visual pathway in an early stage of experimental diabetes. Diabetes was induced in Wistar rats by an i.p. injection of streptozotocin. A deficit in anterograde transport from the retina to the superior colliculus was observed 6 weeks after streptozotocin injection. At this time point, morphologic studies did not reveal retinal ganglion cell loss or substantial alterations in the superior colliculus. The optic nerve was morphometrically evaluated at intraorbital (unmyelinated and myelinated) and intracranial sections. In animals that had been diabetic for 6 weeks, a large increase in astrocyte reactivity occurred in the distal (but not the intraorbital) portion, which coincided with significant axon loss. Moreover, profound myelin alterations and altered morphologic features of oligodendrocyte lineage were observed at the distal (but not the proximal) optic nerve portion. The present results suggest that axoglial alterations at the distal portion of the optic nerve could be the first structural change in the diabetic visual pathway. PMID:22079928

  9. Distal histidine conformational flexibility in dehaloperoxidase from Amphitrite ornata

    SciTech Connect

    Chen, Zuxu; de Serrano, Vesna; Betts, Laurie; Franzen, Stefan; (NCSU); (UNC)

    2009-01-28

    The enzyme dehaloperoxidase (DHP) from the terebellid polychaete Amphitrite ornata is a heme protein which has a globin fold but can function as both a hemoglobin and a peroxidase. As a peroxidase, DHP is capable of converting 2,4,6-trihalophenols to the corresponding 2,6-dihaloquinones in the presence of hydrogen peroxide. As a hemoglobin, DHP cycles between the oxy and deoxy states as it reversibly binds oxygen for storage. Here, it is reported that the distal histidine, His55, exhibits conformational flexibility in the deoxy form and is consequently observed in two solvent-exposed conformations more than 9.5 {angstrom} away from the heme. These conformations are analogous to the open conformation of sperm whale myoglobin. The heme iron in deoxy ferrous DHP is five-coordinate and has an out-of-plane displacement of 0.25 {angstrom} from the heme plane. The observation of five-coordinate heme iron with His55 in a remote solvent-exposed conformation is consistent with the hypothesis that His55 interacts with heme iron ligands through hydrogen bonding in the closed conformation. Since His55 is also displaced by the binding of 4-iodophenol in an internal pocket, these results provide new insight into the correlation between heme iron ligation, molecular binding in the distal pocket and the conformation of the distal histidine in DHP.

  10. Ionotropic GABA Receptors and Distal Retinal ON and OFF Responses.

    PubMed

    Popova, E

    2014-01-01

    In the vertebrate retina, visual signals are segregated into parallel ON and OFF pathways, which provide information for light increments and decrements. The segregation is first evident at the level of the ON and OFF bipolar cells in distal retina. The activity of large populations of ON and OFF bipolar cells is reflected in the b- and d-waves of the diffuse electroretinogram (ERG). The role of gamma-aminobutyric acid (GABA), acting through ionotropic GABA receptors in shaping the ON and OFF responses in distal retina, is a matter of debate. This review summarized current knowledge about the types of the GABAergic neurons and ionotropic GABA receptors in the retina as well as the effects of GABA and specific GABAA and GABAC receptor antagonists on the activity of the ON and OFF bipolar cells in both nonmammalian and mammalian retina. Special emphasis is put on the effects on b- and d-waves of the ERG as a useful tool for assessment of the overall function of distal retinal ON and OFF channels. The role of GABAergic system in establishing the ON-OFF asymmetry concerning the time course and absolute and relative sensitivity of the ERG responses under different conditions of light adaptation in amphibian retina is also discussed. PMID:25143858

  11. Results of intravenous regional anaesthesia with distal forearm application.

    PubMed

    Karalezli, Nazim; Karalezli, Kubilay; Iltar, Serkan; Cimen, O?uzhan; Aydo?an, Nevres

    2004-10-01

    The aim of this study was to evaluate the clinical effectiveness of distal forearm intravenous regional anaesthesia (IVRA) with the tourniquet applied 3 cm above the wrist. One hundred and twenty patients undergoing out-patient hand surgery were operated for 13 different hand problems under distal forearm IVRA, using 10 ml of a solution containing 1.5 mg/kg prilocaine. Sensory block onset time was 4.5 minutes (3.5-6.5 min.). Mean tourniquet time was 17.6 minutes (range, 7-27.5 min). Mean tourniquet pressure was 240 mmHg (range, 220-270 mm Hg). The mean VAS score for tourniquet pain was 3.8 (range, 2-10). No local or systemic side effects related to the IVRA were observed. The study showed that distal forearm IVRA using 10 ml of a solution containing 1.5 mg/kg prilocaine provides safe, rapid and effective anaesthesia for patients undergoing outpatient hand surgery. PMID:15587026

  12. A Novel, New Robotic Platform for Natural Orifice Distal Pancreatectomy.

    PubMed

    Thakkar, Shyam; Awad, Michael; Gurram, Krishna C; Tully, Steven; Wright, Cornell; Sanan, Siddharth; Choset, Howie

    2014-10-15

    Laparoendoscopic technology has revolutionized the practice of surgery; however, surgeons have not widely accepted laparoscopic techniques for pancreatic surgeries due to the complexity of the operation. Natural orifice transluminal endoscopic surgery (NOTES) offers a great new potential for pancreatic procedures, with early data showing benefits of reduced visible scarring and the potential for decreased wound infections, hernias, pain, and postoperative complications. However, there are significant limitations to the currently used flexible endoscopy tools, including a diminished visual field, spatial orientation and tissue manipulation issues, and 2-dimensional visual feedback. We have adopted a novel snake-like robot, the minimally invasive cardiac surgery (MICS) robot, which addresses these issues. In the current pilot study, the MICS robot was evaluated for transrectal distal pancreas exploration and resection in 2 nonsurvival porcine models. Abdominal navigation and accessing the pancreas was investigated in the first pig, and based on its success, pancreas resection was studied in pig 2. The MICS robot was successful in accessing and visualizing the right upper, left upper, and left lower quadrants of the abdomen in pig 1 and was able to perform a successful complex NOTES procedure with distal pancreas resection in pig 2, with only minimal laparoscopic retraction assistance. In conclusion, preliminary results showing the MICS robot in natural orifice distal pancreatectomy are positive. Enhancements to optics and instrumentation will help further increase the usability in pancreatic interventions. Future indications may include transgastric NOTES approaches, endoluminal procedures, and single-port applications. PMID:25320108

  13. Distal femoral complications following antegrade intramedullary nail placement.

    PubMed

    Fantry, Amanda J; Elia, Gregory; Vopat, Bryan G; Daniels, Alan H

    2015-03-01

    While antegrade nailing for proximal and diaphyseal femur fractures is a commonly utilized fixation method with benefits including early mobilization and high rates of fracture union, both intraoperative and postoperative complications may occur. Intraoperative errors include leg length discrepancy, anterior cortical perforation, malreduction of the fracture, and neurovascular injury, and postoperative complications include nonunion, malunion, infection, and hardware failure. This case series reviews complications affecting the distal femur after intramedullary nailing including fracture surrounding a distal femoral interlocking screw (Case #1), nonunion after dynamization with nail penetration into the knee joint (Case #2), and anterior cortical perforation (Case #3). Prevention of intraoperative and postoperative complications surrounding intramedullary nailing requires careful study of the femoral anatomy and nail design specifications (radius of curvature), consideration of the necessity of distal interlocking screws, the need for close radiographic follow-up after nail placement with X-rays of the entire length of the nail, and awareness of possible nail penetration into the knee joint after dynamization. PMID:25874066

  14. Ionotropic GABA Receptors and Distal Retinal ON and OFF Responses

    PubMed Central

    Popova, E.

    2014-01-01

    In the vertebrate retina, visual signals are segregated into parallel ON and OFF pathways, which provide information for light increments and decrements. The segregation is first evident at the level of the ON and OFF bipolar cells in distal retina. The activity of large populations of ON and OFF bipolar cells is reflected in the b- and d-waves of the diffuse electroretinogram (ERG). The role of gamma-aminobutyric acid (GABA), acting through ionotropic GABA receptors in shaping the ON and OFF responses in distal retina, is a matter of debate. This review summarized current knowledge about the types of the GABAergic neurons and ionotropic GABA receptors in the retina as well as the effects of GABA and specific GABAA and GABAC receptor antagonists on the activity of the ON and OFF bipolar cells in both nonmammalian and mammalian retina. Special emphasis is put on the effects on b- and d-waves of the ERG as a useful tool for assessment of the overall function of distal retinal ON and OFF channels. The role of GABAergic system in establishing the ON-OFF asymmetry concerning the time course and absolute and relative sensitivity of the ERG responses under different conditions of light adaptation in amphibian retina is also discussed. PMID:25143858

  15. Laparoendoscopic single-site distal pancreatectomy in pigs

    PubMed Central

    Wang, Dong; Ji, Zhen-Ling; Jiang, Xiao-Hua; Wang, Jing-Min; Tan, Yu-Yan; Wang, Yan; Wen, Ya-Zhou

    2014-01-01

    AIM: To explore the technique for laparoendoscopic single-site distal pancreatectomy. METHODS: Laparoendoscopic single-site spleen-preserving distal pancreatectomy was performed in pigs using a novel flexible multichannel port, a curved laparoscopic multifunctional operative device and a fish hook retractor, which provided a favorable operative field. RESULTS: Six pigs were involved in this study, and five survived the procedure. The first animal died following injury to the superior mesenteric vein and uncontrolled intraoperative bleeding. Except for this failure, the mean operative time was 155 min (range: 102-236 min). A steep learning curve was observed in the study, with a mean operative time of 177 min in the first two operations vs 134 min in the last three operations. The mean blood loss was 50 mL, and the postoperative course was uneventful. The animals were sacrificed three weeks after the procedures, and no pancreatic leakage or abdominal infection was found macroscopically. CONCLUSION: Laparoendoscopic single-site distal pancreatectomy is a safe and feasible procedure and can be implemented in humans in selected cases at qualified surgical centers. PMID:24944478

  16. Retrospective Evaluation of Colon Injury Cases

    PubMed Central

    Sa??ro?lu, Tamer; Tunca, Fatih; Eren, Eryi?it; Meydan, Burhan; Gezer, Cem; Tunca, Erhan

    2008-01-01

    Objective: When considering abdominal region injuries, the colon is one of the most frequently wounded organs. Due to the septic contents of the colon, failure to treat or improper treatment of colon injuries increases the risk of major complications and may result in death. The aim of our study is a retrospective evaluation of colon injury cases over a 5-year period. Materials and Methods: Forty-nine patients with a diagnosis of colon injury were included in the study. The cause of colon injury, injured area, Flint colon injury score, additional organs injured, type of surgical procedure performed, postoperative complications and mortality were evaluated. Results: The most frequent cause of colon injury was cutters (57.2%), followed by firearms (36.7%). The left colon was the most common site of injury (40.8%), followed by the transverse (28.6%) and right colon (20.4%). Primary treatment or resection and primary anastomosis were performed on 38 patients (77.6%), while primary treatment and proximal decompression colostomy were performed on 11 patients (22.4%). Eighteen of the patients (36.7%) experienced major postoperative complications, and 6 patients (12.2%) died. Conclusion: The morbidity and mortality of colonic injuries can be reduced by rapid patient transportation, good operational experience, use of wide spectrum antibiotics and postoperative care in an intensive care unit. PMID:25610019

  17. Volumetric Colon Wall Unfolding Using Harmonic Differentials

    PubMed Central

    Zeng, Wei; Marino, Joseph; Kaufman, Arie; Gu, Xianfeng David

    2011-01-01

    Volumetric colon wall unfolding is a novel method for virtual colon analysis and visualization with valuable applications in virtual colonoscopy (VC) and computer-aided detection (CAD) systems. A volumetrically unfolded colon enables doctors to visualize the entire colon structure without occlusions due to haustral folds, and is critical for performing efficient and accurate texture analysis on the volumetric colon wall. Though conventional colon surface flattening has been employed for these uses, volumetric colon unfolding offers the advantages of providing the needed quantities of information with needed accuracy. This work presents an efficient and effective volumetric colon unfolding method based on harmonic differentials. The colon volumes are reconstructed from CT images and are represented as tetrahedral meshes. Three harmonic 1-forms, which are linearly independent everywhere, are computed on the tetrahedral mesh. Through integration of the harmonic 1-forms, the colon volume is mapped periodically to a canonical cuboid. The method presented is automatic, simple, and practical. Experimental results are reported to show the performance of the algorithm on real medical datasets. Though applied here specifically to the colon, the method is general and can be generalized for other volumes. PMID:21765563

  18. Giant colonic diverticulum: Clinical presentation, diagnosis and treatment: Systematic review of 166 cases

    PubMed Central

    Nigri, Giuseppe; Petrucciani, Niccolò; Giannini, Giulia; Aurello, Paolo; Magistri, Paolo; Gasparrini, Marcello; Ramacciato, Giovanni

    2015-01-01

    AIM: To investigate the clinical presentation, diagnosis, and treatment of giant colonic diverticulum (GCD, by means of a complete and updated literature review). GCD is a rare manifestation of diverticular disease of the colon. Less than 200 studies on GCD were published in the literature, predominantly case reports or small patient series. METHODS: A systematic review of the literature was performed using the Embase and PubMed databases to identify all the GCD studies. The following MESH search headings were used: “giant colonic diverticulum”; “giant sigmoid diverticulum”. The “related articles” function was used to broaden the search, and all of the abstracts, studies, and citations were reviewed by two authors. The following outcomes were of interest: the disease and patient characteristics, study design, indications for surgery, type of operation, and post-operative outcomes. Additionally, a subgroup analysis of cases treated in the last 5 years was performed to show the current trends in the treatment of GCD. A GCD case in an elderly patient treated in our department by a sigmoidectomy with primary anastomosis and a diverting ileostomy is presented as a typical example of the disease. RESULTS: In total, 166 GCD cases in 138 studies were identified in the literature. The most common clinical presentation was abdominal pain, which occurred in 69% of the cases. Among the physical signs, an abdominal mass was detected in 48% of the cases, whereas 20% of the patients presented with fever and 14% with abdominal tenderness. Diagnosis is based predominantly on abdominal computed tomography. The most frequent treatment was colic resection with en-bloc resection of the diverticulum, performed in 57.2% of cases, whereas Hartmann’s procedure was followed in 11.4% of the cases and a diverticulectomy in 10.2%. An analysis of sixteen cases reported in the last 5 years showed that the majority of patients were treated with sigmoidectomy and en-bloc resection of the diverticulum; the postoperative mortality was null, morbidity was very low (1 patient was hospitalized in the intensive care unit for postoperative hypotension), and the patients were discharged 4-14 d after surgery. CONCLUSION: Giant colonic diverticulum is a rare manifestation of diverticular diseases. Surgical treatment, consisting predominantly of colonic resection with en bloc resection of the diverticulum, is the preferred option for GCD and guarantees excellent results. PMID:25574112

  19. [Haemophilus influenzae: colonization and infection].

    PubMed

    Borderon, J C

    1995-03-01

    Haemophilus influenzae can be demonstrated as a saprophyte in more than two-thirds of children, and almost as frequently in adults. Noncapsulated strains are more frequent than capsulated type b strains which are found in 5% of the samples. Other capsulated strains are rare. Transmission is made easier with close contact (daycare nurseries, home). Colonization is the result of adherence to nasopharyngeal epithelial cells, although characterized adhesion factors cannot be demonstrated for all strains (pili, adhesins, secretory IgA1 protease). Systemic infection is the result of the invasion of pharyngeal epithelium, made easier by upper respiratory tract infection. There is a risk of meningitis for high level bacteremia (> or = 10(5) CFU/ml). Risk factors are: age (child < 5 years), alteration of reticuloendothelial system, agammaglobulinemia. Anti-Haemophilus type b vaccine prevents nearly all infections, and suppresses or sharply reduces colonization. PMID:7742911

  20. A continent colonic urinary reservoir: the Florida pouch.

    PubMed

    Lockhart, J L; Pow-Sang, J M; Persky, L; Kahn, P; Helal, M; Sanford, E

    1990-10-01

    A total of 92 patients underwent continent urinary diversion with an extended, detubularized right colonic segment as the urinary reservoir and the distal ileum as a continent catheterizable efferent system. In this series 65 patients were followed for 6 to 46 months (average 17 months). Our reservoir allows the accommodation of a large volume of urine; urodynamic studies in 28 patients demonstrated a maximum reservoir capacity varying between 550 and 1,200 cc (average 747 cc). Maximal reservoir pressures ranged from 10 to 58 cm. water (average 35 cm. water). Of the 127 ureterocolonic reimplantations 4 ureters were initially reimplanted with a modified Le Duc procedure, 26 ureters were managed subsequently with the Goodwin transcolonic approach and 91 reimplantations were done with a direct (nontunneled) mucosa-to-mucosa anastomosis. The overall success rates with each of the 3 techniques (absence of reflux and obstruction) were 75, 88.6 and 90.1%, respectively. Six megaureters underwent imbrication and direct reimplantation, and 3 of these (50%) became obstructed. Two converted ileal conduits were opened at the antimesenteric edge and were patched to the reservoir while the ureteroileal anastomosis was left undisturbed. One patient (1.5%) died of pulmonary embolism. Medical and surgical complications occurred only in the group who underwent simultaneous cystectomy and the over-all rate of complication was comparable to previous series with ileal conduits. The double row plication of the distal ileum and ileocecal valve allows for easy catheterization every 4 to 6 hours and 63 patients (97%) remain continent between catheterization. Four patients (6%) required reoperation for correction of incontinence or other complications. Our satisfactory experience with these patients makes this technique an excellent approach to achieving continent urinary diversion. PMID:2398560

  1. Colonization of Mucin by Human Intestinal Bacteria and Establishment of Biofilm Communities in a Two-Stage Continuous Culture System

    PubMed Central

    Macfarlane, Sandra; Woodmansey, Emma J.; Macfarlane, George T.

    2005-01-01

    The human large intestine is covered with a protective mucus coating, which is heavily colonized by complex bacterial populations that are distinct from those in the gut lumen. Little is known of the composition and metabolic activities of these biofilms, although they are likely to play an important role in mucus breakdown. The aims of this study were to determine how intestinal bacteria colonize mucus and to study physiologic and enzymatic factors involved in the destruction of this glycoprotein. Colonization of mucin gels by fecal bacteria was studied in vitro, using a two-stage continuous culture system, simulating conditions of nutrient availability and limitation characteristic of the proximal (vessel 1) and distal (vessel 2) colon. The establishment of bacterial communities in mucin gels was investigated by selective culture methods, scanning electron microscopy, and confocal laser scanning microscopy, in association with fluorescently labeled 16S rRNA oligonucleotide probes. Gel samples were also taken for analysis of mucin-degrading enzymes and measurements of residual mucin sugars. Mucin gels were rapidly colonized by heterogeneous bacterial populations, especially members of the Bacteroides fragilis group, enterobacteria, and clostridia. Intestinal bacterial populations growing on mucin surfaces were shown to be phylogenetically and metabolically distinct from their planktonic counterparts. PMID:16269790

  2. Surgical Management of Colon Cancer

    Microsoft Academic Search

    David E. Beck; Patricia L. Roberts; John L. Rombeau; Michael J. Stamos; Steven D. Wexner

    \\u000a Planning an operation for a patient with colon cancer requires the surgeon to have as much understanding as possible of the\\u000a tumor’s location in the bowel, the stage of the cancer, and the patient’s physiologic status. Localization of the tumor and\\u000a the histopathology are important data elements that allow preoperative selection of an operative plan and selection of the\\u000a optimal

  3. Late colonization of Easter Island.

    PubMed

    Hunt, Terry L; Lipo, Carl P

    2006-03-17

    Easter Island (Rapa Nui) provides a model of human-induced environmental degradation. A reliable chronology is central to understanding the cultural, ecological, and demographic processes involved. Radiocarbon dates for the earliest stratigraphic layers at Anakena, Easter Island, and analysis of previous radiocarbon dates imply that the island was colonized late, about 1200 A.D. Substantial ecological impacts and major cultural investments in monumental architecture and statuary thus began soon after initial settlement. PMID:16527931

  4. Colon Multiple Primary Rules Matrix

    Cancer.gov

    Colon Multiple Primary Rules – Matrix C180-C189 (Excludes lymphoma and leukemia M9590 – 9989 and Kaposi sarcoma M9140) * P r e p ar e o n e abs tr a c t. U s e t h e hi s t o lo g y c o di ng r u le s t o as s i gn th e ap pr o p

  5. Laparoscopic-assisted colon resection

    Microsoft Academic Search

    K. A. Zucker; D. E. Pitcher; D. T. Martin; R. S. Ford

    1994-01-01

    The popularity and success of laparoscopic biliary tract surgery have persuaded surgeons to explore other applications for\\u000a rigid endoscopic surgery. From July 1990 to February 1993 a total of 65 patients (mean age 57 years; range 41–82) underwent\\u000a attempted laparoscopic colon resection. Indications for surgical intervention included cancer (39), adenomatous polyps (14),\\u000a diverticulosis (10), stricture (1), and foreign-body perforation (1).

  6. Laparoscopic excision of mesenteric duplication enteric cyst embedded in sigmoid mesocolon mimicking retroperitoneal neurogenic tumor in adults.

    PubMed

    Wang, Jui-Ho; Lin, Jen-Tai; Hsu, Chao-Wen

    2012-10-01

    Mesenteric cysts are rare abdominal tumors with an incidence of 1/105,000 to 250,000 hospitalized adult surgical patients. These cysts may occur in every part of the mesentery, from duodenum to rectum. Most frequently, cysts are localized in small bowel mesentery. They usually present during the first decade of life, mostly occurring in pediatric patients. These lesions characteristically arise from the mesenteric border of the bowel. The majority are asymptomatic and, if found, are discovered incidentally during abdominal exploration or radiologic examination. Traditionally, the treatment of mesenteric cyst is surgical excision by laparotomy. However, in 1993, Mackenzie described the first laparoscopic excision of a mesenteric cyst. Since then, several cases have been reported but mainly in small intestine. Here, we reported an adult patient of a mesenteric duplication enteric cyst embedded in sigmoid mesocolon mimicking retroperitoneal neurogenic tumor, which was completely excised using the laparoscopic approach (Supplemental Digital Content 1, http://links.lww.com/SLE/A73). PMID:23047411

  7. Abdominal Wall Abscess due to Acute Perforated Sigmoid Diverticulitis: A Case Report with MDCT and US Findings

    PubMed Central

    Vasileios, Rafailidis; Anna, Gavriilidou; Christos, Liouliakis; Asimina, Tsimitri; Sofia, Paschaloudi; Vasiliki, Karadimou

    2013-01-01

    Perforation of the inflamed diverticula is a common diverticulitis complication. It usually leads to the formation of a local abscess. In some rare cases, the inflammatory process may spread towards extra-abdominal sites like the anterior or posterior abdominal wall or the thigh and form an abscess in these sites. We present the case of a 73-year-old man with a history of pain at the lower left quadrant of the abdomen for 20 days and a visible mass in this site. Ultrasonography and computed tomography revealed this mass to be an abscess of the abdominal wall which had been formed by the spread of ruptured sigmoid diverticulitis by continuity of tissue through the lower left abdominal wall. Local drainage of the abscess was performed and the patient was discharged after alleviation of symptoms and an uneventful course. We also discuss causes of abdominal wall abscesses along with the possible pathways by which an intra-abdominal abscess could spread outside the abdominal cavity. PMID:24386584

  8. Swelling controlled zero order and sigmoidal drug release from thermo-responsive poly(N-isopropylacrylamide-co-butyl methacrylate) hydrogel.

    PubMed

    Okuyama, Y; Yoshida, R; Sakai, K; Okano, T; Sakurai, Y

    1993-01-01

    Thermo-responsive hydrogels of poly(N-isopropylacrylamide-co-butyl methacrylate) (poly-(IPAAm-co-BMA)) are capable of swelling-deswelling changes in response to external temperature. As poly(IPAAm-co-BMA) gels swell larger at a lower temperature, the degree and rate of the swelling could be controlled by temperature without altering the chemical structure. Therefore, drug release profiles were remarkably changed by alternation of temperature. The release profiles of indomethacin from poly(IPAAm-co-BMA) were observed to be zero-order at 20 degrees C. This release profile was explained in terms of a Case-II diffusion mechanism; which indicates relaxation of polymer chains with swelling was rate-determining. In the case of 10 degrees C, release demonstrated a sigmoidal profile. The acceleration of drug release was due to a rapid increase in swelling with disappearance of the glassy core which had constrained swelling. The regulation of the water-uptake process by changing external temperature remarkably affected drug release and resulted in several different release profiles. PMID:8241069

  9. Relationship between methylation and colonic inflammation in inflammatory bowel disease

    PubMed Central

    Lobatón, Triana; Azuara, Daniel; Rodríguez-Moranta, Francisco; Loayza, Carolina; Sanjuan, Xavier; de Oca, Javier; Fernández-Robles, Ana; Guardiola, Jordi; Capellá, Gabriel

    2014-01-01

    AIM: To investigate the relationship between the methylation status in the SLIT2 and TGFB2 promoters and colonic inflammation in inflammatory bowel disease patients. METHODS: We evaluated the methylation status of 2 genes (SLIT2 and TGFB2) in 226 biopsies taken from 62 colonoscopies of 38 patients (29 ulcerative colitis and 9 Crohn’s colitis) using methylation-specific melting curve analysis. The relationships between methylation status and clinical, biological, endoscopic and histological activities were evaluated. Twenty-three of the 38 patients had a second colonoscopy and were included in a longitudinal analysis. Numerical results were given as the means ± SD of the sample and range, except when specified. Student t analysis, U Mann Whitney and ANOVA factor were used to compare the means. Qualitative results were based on the ?2 test. RESULTS: SLIT2 methylation was more frequent in samples with endoscopic activity than with endoscopic remission (55% vs 18%, P < 0.001). SLIT2 methylation was also higher in samples with acute inflammation (56.5%) than in samples with chronic (24%) or absent inflammation (15%) (P < 0.001). For TGFB2 methylation, the correlation was only significant with endoscopic activity. Methylation was higher in the distal colon for both genes (P < 0.001 for SLIT2 and P = 0.022 for TGFB2). In the multivariate analysis, only inflammation status (and not disease duration or extension) was independently associated with SLIT2 methylation [OR = 6.6 (95%CI: 1.65-27.36), P = 0.009]. In the longitudinal analysis, the maintenance of endoscopic remission was protective for methylation. CONCLUSION: Endoscopic and histological inflammation are predictive for SLIT2 methylation. PMID:25132780

  10. Outcome Assessment after Aptis Distal Radioulnar Joint (DRUJ) Implant Arthroplasty

    PubMed Central

    Kachooei, Amir Reza; Chase, Samantha M; Jupiter, Jesse B

    2014-01-01

    Background: Conventional treatments after complicated injuries of the distal radioulnar joint (DRUJ) such as Darrach and Kapandji-Sauvé procedures have many drawbacks, which may eventually lead to a painful unstable distal ulna. The development of DRUJ prosthesis has significantly evolved over the past years. In this study, we assessed the outcome results of patients after DRUJ implant arthroplasty using the Aptis (Scheker) prosthesis. Methods: We identified 13 patients with 14 prosthesis during the past 10 years. Patients underwent DRUJ arthroplasty due to persistent symptoms of instability, chronic pain, and stiffness. Records and follow-up visits were reviewed to find the final post-operative symptoms, pain, range of motion, and grip strength with a mean follow-up of 12 months (range: 2-25 months). Also, patients were contacted prospectively by phone in order to administer the disabilities of the arm shoulder and hand (DASH), patient rated wrist evaluation (PRWE), and visual analogue scale (VAS), and to interview regarding satisfaction and progress in daily activities. Eleven patients out of 13 could be reached with a median follow-up time of 60 months (range: 2 to 102 months). Results: No patient required removal of the prosthesis. Only two patients underwent secondary surgeries in which both required debridement of the screw tip over the radius. The median DASH score, PRWE score, VAS, and satisfaction were 1.3, 2.5, 0, and 10, respectively. The mean range of flexion, extension, supination, and pronation was 62, 54, 51, and 64, respectively. Conclusions: Distal radioulnar joint injuries are disabling and patients usually undergo one or more salvage surgeries prior to receiving an arthroplasty. The Scheker prosthesis has shown satisfactory results with 100% survival rate in all reports. The constrained design of this prosthesis gives enough stability to prevent painful subluxation. PMID:25386579

  11. Temporary bridging external fixation in distal tibial fracture.

    PubMed

    Lavini, F; Dall'Oca, C; Mezzari, S; Maluta, T; Luminari, E; Perusi, F; Vecchini, E; Magnan, B

    2014-12-01

    Fractures that involve the distal area of the tibia are associated with a high percentage of complications. Soft tissue oedema, swelling, blisters, skin abrasions and open wounds could compromise the outcome of these lesions. The waiting time before surgery with ORIF is mostly due to soft tissue conditions. Early application of a simple joint-spanning external fixator would achieve the initial goal of stability and the respect of soft tissue, thereby decreasing the time necessary for definitive treatment. A total of 40 consecutive patients (22 male and 18 female) with a mean age of 52 years (range 17-82 years) with distal tibial fracture treated between January 2010 and January 2013 were evaluated. Early temporary external fixation was the first treatment step. Twenty patients had pilon fractures, characterised by the intra-articular involvement of the distal tibia with metaphyseal extension, and 20 patients had malleolar fracture-dislocation. Patients were divided into two groups, A and B. Group A comprised 10 patients with ankle fracture-dislocation and bone fragmentation, who were treated with a temporary bridging external fixation that was maintained after ORIF to exploit ligamentotaxis during the first phases of bone healing. In Group B (30 patients), the external fixation was removed after ORIF. The results of the study are in line with the recent literature: temporary external fixation in high-energy trauma and fracture-dislocation of the ankle enables soft tissue to be restored, which facilitates postoperative assessment of bone fragments by CT scan. The complication rate in this study was 5% in patients with malleolar fractures and 20% in patients with pilon fractures. The maintenance of temporary external fixation after ORIF synthesis during the entire first stage of bone healing seems to be a good method of treatment that has a low rate of soft tissue complications. PMID:25457321

  12. S100A8/A9 activate key genes and pathways in colon tumor progression

    PubMed Central

    Ichikawa, Mie; Williams, Roy; Wang, Ling; Vogl, Thomas; Srikrishna, Geetha

    2011-01-01

    The tumor microenvironment plays an important role in modulating tumor progression. We earlier showed that S100A8/A9 proteins secreted by myeloid-derived suppressor cells (MDSC) present within tumors and metastatic sites promote an autocrine pathway for accumulation of MDSC. In a mouse model of colitis-associated colon cancer, we also showed that S100A8/A9 positive cells accumulate in all regions of dysplasia and adenoma. Here we present evidence that S100A8/A9 interact with RAGE and carboxylated glycans on colon tumor cells and promote activation of MAPK and NF-?B signaling pathways. Comparison of gene expression profiles of S100A8/A9-activated colon tumor cells versus unactivated cells led us to identify a small cohort of genes upregulated in activated cells, including Cxcl1, Ccl5 and Ccl7, Slc39a10, Lcn2, Zc3h12a, Enpp2 and other genes, whose products promote leukocyte recruitment, angiogenesis, tumor migration, wound healing, and formation of premetastatic niches in distal metastatic organs. Consistent with this observation, in murine colon tumor models we found that chemokines were up-regulated in tumors, and elevated in sera of tumor-bearing wild-type mice. Mice lacking S100A9 showed significantly reduced tumor incidence, growth and metastasis, reduced chemokine levels, and reduced infiltration of CD11b+Gr1+ cells within tumors and premetastatic organs. Studies using bone marrow chimeric mice revealed that S100A8/A9 expression on myeloid cells is essential for development of colon tumors. Our results thus reveal a novel role for myeloid-derived S100A8/A9 in activating specific downstream genes associated with tumorigenesis and in promoting tumor growth and metastasis. PMID:21228116

  13. Claudin-3 and occludin tissue content in the glands of colonic mucosa with and without a fecal stream.

    PubMed

    Martinez, Carlos Augusto Real; de Campos, Fabio Guilherme Caserta Maryssael; de Carvalho, Viviel Rodrigo José; de Castro Ferreira, Caroline; Rodrigues, Murilo Rocha; Sato, Daniela Tiemi; Pereira, José Aires

    2015-04-01

    The synthesis of the proteins of the apical tight junctions (TJs) depends on a continuous supply of short-chain fatty acids (SCFAs) in colonic epithelium. No studies have evaluated the tissue contents of the TJs proteins in colon segments devoid of a fecal stream. To evaluate the contents of claudin-3 and occludin in the glands of colonic mucosa devoid of a fecal stream. Forty-five rats underwent a diversion of the fecal stream via a left side colostomy and distal mucous fistula. Three groups of 15 animals each were sacrificed at 6, 12 or 18 weeks after surgery. The presence and severity of colitis were defined by histology and inflammation grading scales, respectively. The expression of claudin-3 and occludin were evaluated by immunohistochemistry, and their contents were evaluated by computer-assisted image analysis. Mann-Whitney and Kruskal-Wallis tests were used to evaluate the results at a significance level of 5 % (p < 0.05). The colonic epithelium without a fecal stream had a higher degree of inflammation. Colonic glands without a fecal stream showed a reduction in claudin-3 content independent of the time and reduction in occludin content after 12 weeks of intestinal exclusion. The content of claudin-3 and occludin were mainly reduced at the apical surfaces of the colon glands, whereas segments retaining the fecal stream were maintained. The content of claudin-3 was not reduced with time, although the levels of occludin were reduced after 6 weeks and did not vary thereafter. Deficiencies in SCFAs decreased the content of claudin-3 and occludin in colonic glands with the areas of worst inflammation, confirming the importance of an adequate supply of SCFAs in maintaining the integrity of TJ proteins. PMID:25649016

  14. Historical and Current Trends in Colon Trauma

    PubMed Central

    Causey, Marlin Wayne; Rivadeneira, David E.; Steele, Scott R.

    2012-01-01

    The authors discuss the evolution of the evaluation and management of colonic trauma, as well as the debate regarding primary repair versus fecal diversion. Their evidence-based review covers diagnosis, management, surgical approaches, and perioperative care of patients with colon-related trauma. The management of traumatic colon injuries has evolved significantly over the past 50 years; here the authors describe a practical approach to the treatment and management of traumatic injuries to the colon based on the most current research. However, management of traumatic colon injuries remains a challenge and continues to be associated with significant morbidity. Familiarity with the different methods to the approach and management of colonic injuries will allow surgeons to minimize unnecessary complications and mortality. PMID:24294119

  15. Complications of distal radial and scaphoid fracture treatment.

    PubMed

    Meyer, Carissa; Chang, James; Stern, Peter J; Osterman, A Lee; Abzug, Joshua M

    2014-01-01

    Fractures of the distal radius and the scaphoid are common injuries in adults. In recent years, surgical fixation of these types of fractures has increased in response to improved patient outcomes and evolving fixation techniques. Potential soft-tissue, neurovascular, or osseous complications, including tendon injuries, carpal tunnel syndrome, loss of fracture reduction, and osteonecrosis, can increase the time the patient requires immobilization and can lead to poor patient outcomes. Prompt recognition and diagnosis of these complications may improve patient outcomes and satisfaction. PMID:24720299

  16. [Tendon rupture as a complication after osteosynthesis of distal radius].

    PubMed

    Lugger, L J; Pechlaner, S

    1984-10-01

    Close contact between extensor and flexor tendons to the bone structure of the wrist and distal radius shaft implies the possibility of alteration concerning the tendons' slide way and tensile direction in case of osteosynthesis in this region. Even a slightly damaged screw is mechanically capable of irritation and can be made responsible for a scrub-necrosis of an above tendon. The metal implant has to be selected in consideration of both the demands of the fracture and a free and natural tendons pathway. This is discussed by means of two implant-induced scrub necroses of the long pollex extensor and flexor tendon. PMID:6516033

  17. Distal renal tubular acidosis associated with Sjogren syndrome.

    PubMed

    Lim, A K H; Choi, M J

    2013-12-01

    Renal tubular acidosis is a common cause of normal anion gap metabolic acidosis but these disorders can be easily missed or misdiagnosed. We highlight the approach to assessing renal tubular acidosis by discussing a case study with a temporal data set collected over more than 5 weeks. We highlight the principles and the necessary information required for a diagnosis of classic distal renal tubular acidosis. We also briefly review several aspects of type 1 renal tubular acidosis related to autoimmune disease, drugs and thyroid disorders. PMID:24330363

  18. Mutational study of the bacterial hemoglobin distal heme pocket

    Microsoft Academic Search

    Sandhya Verma; Sangeeta Patel; Ramandeep Kaur; Yeon-Tae Chung; Brian T. Duk; Kanak L. Dikshit; Benjamin C. Stark; Dale A. Webster

    2005-01-01

    Ligand binding experiments on three mutants in the distal heme pocket of Vitreoscilla hemoglobin (GlnE7His, ProE8Ala, and GlnE7His,ProE8Ala) were used to probe the role of GlnE7 and ProE8 in the pocket’s unusual structure. The oxygen dissociation constants for the wild type, E8Ala mutant, and E7His mutant proteins were 4.5, 4.7, and 1.7?M, respectively; the Kd for the double mutant was

  19. Propylene oxide causes central-peripheral distal axonopathy in rats

    SciTech Connect

    Ohnishi, A.; Yamamoto, T.; Murai, Y.; Hayashida, Y.; Hori, H.; Tanaka, I.

    1988-09-01

    In Wistar rats subjected daily to a 6-hr exposure of propylene oxide (PO) at a concentration of 1,500 ppm (5 times a wk for 7 wk), ataxia developed in the hindlegs. Myelinated fibers in hindleg nerves and in the fasciculus gracilis showed axonal degeneration, sparing the nerve cell body of the first sacral dorsal root ganglion and myelinated fibers of the first sacral dorsal and ventral roots. These pathologic findings are compatible with central-peripheral distal axonopathy. This is apparently the first animal model of PO neuropathy to be verified histologically.

  20. Medial Column Arthrodesis Using an Anatomic Distal Fibular Locking Plate.

    PubMed

    Nasser, Ellianne M; LaPorta, Guido A; Trott, Kasandra

    2014-07-01

    The medial column fusion is performed for a multitude of etiologies, including peritalar subluxation deformity, Charcot arthropathy, trauma, post-traumatic degenerative joint disease, and rheumatoid arthritis. Various surgical techniques have been described for medial column arthrodesis. We describe a new fixation method using an anatomic distal fibular locking plate for medial column arthrodesis. This technique provides a rigid construct in compromised or at risk bone. After a review of the surgical technique, we outline 2 case examples of patients with peritalar subluxation and Charcot arthropathy. PMID:24998041