Sample records for distal sigmoid colon

  1. Sigmoid colon endometriotic mass

    PubMed Central

    Al-Qahtani, Hamad H.; Alfalah, Haitham; Al-Salamah, Reem A.; Elshair, Adel A.

    2015-01-01

    Large bowel obstruction is a rare complication of gastrointestinal endometriosis. A 32-year-old female patient presented to the emergency department with complaints of diffuse abdominal pain and constipation for 10 days with progressive abdominal distention and vomiting. Plain abdominal x-ray showed grossly dilated large bowel up to the sigmoid colon with no gas in the rectum. Abdominal computed tomography revealed hugely dilated large bowel up to the sigmoid colon, with sigmoid soft tissue mass. Flexible sigmoidoscopy showed a non-ulcerating sigmoid mass, with complete obstruction of the sigmoid colon, which impeded the further advancement of the scope. She underwent exploratory laparotomy with provisional diagnosis of complete large bowel obstruction due to sigmoid tumor. Sigmiodectomy with end colostomy was performed. Histopathology revealed endometrial glands with stroma in muscularis properia of the sigmoid colon mass. Endometriosis should be considered in women of reproductive age presenting with symptoms of large bowel obstruction. PMID:25935187

  2. Acute volvulus of the sigmoid colon

    Microsoft Academic Search

    G. H. Welch; J. R. Anderson

    1987-01-01

    Fifty patients presenting with acute volvulus of the sigmoid colon have been analyzed. The diagnosis was made in 39 patients from the presenting features and abdominal radiographs. Deflation by sigmoidoscopy and flatus tube was performed in 19 patients with initial success in 15. Recurrent volvulus occurred in 6 of these patients. Laparotomy was carried out in 36 patients and colonie

  3. Migrated biliary plastic stent causing double sigmoid colon perforation.

    PubMed

    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

  4. 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

  5. A noninterventional management approach to endovascular coil migration into the sigmoid colon.

    PubMed

    Sexton, Jonathan J; Whittaker, David R

    2015-02-01

    A 75-year-old man underwent endovascular treatment of a right internal iliac artery (IIA) aneurysm by placing coils in the distal IIA and occluding the inflow with a common iliac artery-to-external iliac artery stent graft. Surveillance computed tomography angiography discovered migration of an endovascular coil from the thrombosed right IIA into the sigmoid colon. Subsequent serial imaging demonstrated uncomplicated extracorporeal passage of the coil. We review the relevant literature and treatment rationale. PMID:24239522

  6. Basaloid Squamous Cell Carcinoma of the Sigmoid Colon

    PubMed Central

    Sherid, Muhammed; Liu, Kevin; Kia, Leila; Elliott, Glynn J.

    2015-01-01

    Basaloid squamous cell carcinoma (BSCC) of the colon is rarely found proximal to the anal canal. We report a case of an 81-year-old woman who was diagnosed with squamous cell carcinoma (SCC) of the lung without metastasis and BSCC of the sigmoid with differing histologic findings suggesting that these tumors were separate primary neoplasms. SCC of the colon has a dismal prognosis. Surgery is the primary method of treatment when feasible, in addition to chemotherapeutic agents.

  7. Myoelectrical activity and intraluminal flow in human sigmoid colon

    Microsoft Academic Search

    J. C. Schang; M. Hémond; M. Hébert; M. Pilote

    1986-01-01

    Myoelectric spike bursts were recorded in the sigmoid colon by means of an intraluminal silastic tube equipped with 3 Ag-AgCl ring electrodes fixed 15 cm apart on the tube that was introduced by flexible sigmoidoscopy. In six subjects, the tube was also equipped with three catheters whose tip opened 1 cm aborad from each electrode, for pressure recordings. In six

  8. 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

  9. Increased segmental activity and intraluminal pressures in the sigmoid colon of patients with the irritable bowel syndrome.

    PubMed Central

    Rogers, J; Henry, M M; Misiewicz, J J

    1989-01-01

    Intraluminal pressure activity has been recorded in the unprepared true sigmoid colon of seven normal controls (mean age 37 years, range 22-55, three men) and seven patients with irritable bowel syndrome (IBS) (45 years, 24-75, four men) for 30 minutes before and 100 minutes after a standard 1000 kcal meal. Results differ from previously published data by showing much higher indices of pressure activity with amplitudes up to 490 mmHg in IBS, and 450 mmHg in controls. Study segment activity index and mean pressure wave amplitudes were significantly (p less than 0.015 and p less than 0.01) higher in IBS than controls, but per cent duration of activity was similar for the whole period of study. During the basal period in controls mean amplitudes recorded from the proximal sigmoid (40 cm from anus) were significantly (p less than 0.01) higher than those in the descending colon (50 cm), distal sigmoid (30 cm) and rectum (15 cm). This study shows that the increased colonic activity in IBS is characterised by increased amplitude, but not duration of pressure waves. In the basal state there is a high pressure zone in the proximal sigmoid colon of controls. Pressures in the unprepared colon of controls and IBS were higher than those measured under other experimental conditions. PMID:2731756

  10. Sigmoid colon endometriotic mass. A rare cause of complete large bowel obstruction.

    PubMed

    Al-Qahtani, Hamad H; Alfalah, Haitham; Al-Salamah, Reem A; Elshair, Adel A

    2015-05-01

    Large bowel obstruction is a rare complication of gastrointestinal endometriosis. A 32-year-old female patient presented to the emergency department with complaints of diffuse abdominal pain and constipation for 10 days with progressive abdominal distention and vomiting. Plain abdominal x-ray showed grossly dilated large bowel up to the sigmoid colon with no gas in the rectum. Abdominal computed tomography revealed hugely dilated large bowel up to the sigmoid colon, with sigmoid soft tissue mass. Flexible sigmoidoscopy showed a non-ulcerating sigmoid mass, with complete obstruction of the sigmoid colon, which impeded the further advancement of the scope. She underwent exploratory laparotomy with provisional diagnosis of complete large bowel obstruction due to sigmoid tumor. Sigmiodectomy with end colostomy was performed. Histopathology revealed endometrial glands with stroma in muscularis properia of the sigmoid colon mass. Endometriosis should be considered in women of reproductive age presenting with symptoms of large bowel obstruction. PMID:25935187

  11. 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

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

    PubMed Central

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

    2014-01-01

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

  13. Differences in colonic tone and phasic response to a meal in the transverse and sigmoid human colon.

    PubMed Central

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

    1995-01-01

    It is not yet clear whether the regional differences in the physical properties of the colon influence its motor responses. Tonic and phasic colonic motility and compliance of the transverse and sigmoid colon were therefore assessed using a combined barostat-manometry assembly in 22 healthy subjects. Measured colonic compliance was corrected by subtraction of the compliance of the closed barostat system. The mean (SEM) preprandial colonic volumes in the transverse and sigmoid colon were similar (150 (12) and 128 (13) ml, p = NS), corresponding to calculated mean (SEM) colonic diameters of 4.3 cm and 4.0 cm respectively. The mean increase in colonic tone postprandially was significantly greater in the transverse (24.1% (3.5)) than in the sigmoid colon (13.1% (3.0), p < 0.01). The mean increase in phasic contractility was significantly greater, however, in the sigmoid than in the transverse colon (1270 (210) and 425 (60) mm Hg/90 min respectively, p < 0.01). Compliance was greater in the transverse than sigmoid colon (7.6 (0.44) and 4.1 (0.15) ml/mm Hg, p < 0.001). The fasting volume of the colon was significantly correlated with the magnitude of the tonic response to the meal in the transverse and sigmoid colon (p < 0.001 for both). In conclusion, there are quantitatively different but qualitatively similar phasic and tonic responses to the meal in the two colonic regions. Differences in the viscoelastic and luminal dimensions may partly account for these differences in tonic responses. PMID:7557579

  14. Elective laparoscopic surgery for sigmoid colon carcinoma incarcerated within an inguinal hernia: report of a case.

    PubMed

    Kanemura, Takashi; Takeno, Atsushi; Tamura, Shigeyuki; Okishiro, Masatsugu; Nakahira, Shin; Suzuki, Rei; Nakata, Ken; Egawa, Chiyomi; Miki, Hirohumi; Takeda, Yutaka; Kato, Takeshi

    2014-07-01

    Primary colon carcinoma within an inguinal hernia sac is very rare and most reported cases were found at emergency open surgery for an incarcerated hernia. We report a case of incarcerated sigmoid colon carcinoma diagnosed preoperatively and treated with elective laparoscopic surgery. A 67-year-old man with a 2-year history of swelling of the scrotum and a breast lump was referred to us for surgical treatment of an irreducible left inguinal hernia and a right breast tumor. Blood examination results showed severe anemia. Computed tomography scan and endoscopic biopsy confirmed sigmoid colon carcinoma incarcerated in the left inguinal hernia. Thus, we performed definitive laparoscopic sigmoidectomy and conventional hernia repair for preoperatively diagnosed sigmoid colon carcinoma within an inguinal hernia. PMID:23846798

  15. Delayed sigmoid colon perforation and enterocutaneous fistula due to tension free transvaginal tape operation for stress urinary incontinence

    PubMed Central

    Lee, In Kyu; Sohn, Dong Wan

    2015-01-01

    A 56-year-old female patient presented with sustained sigmoid colon perforation at the time of a tension-free vaginal tape (TVT) procedure and subsequently developed enterocutaneous fistula and subcutaneous abscess. She came to our emergency department complaining of left lower abdominal tenderness and swelling for 2 weeks previously. Her right thigh also was tender and swollen. A foreign body in sigmoid colon and subcutaneous abscess were found on computed tomography scan. We diagnosed the perforation of sigmoid colon and enterocutaneous fistula by TVT mesh. We performed laparoscopic excision of the mesh in sigmoid colon. We performed transobturator tape surgery for recurrence of stress urinary incontinence after 6 months. PMID:26085881

  16. Potassium transport across guinea pig distal colon

    SciTech Connect

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

    1986-03-05

    Active absorption and secretion of K was studied by measuring bidirectional /sup 42/K fluxes across short-circuited guinea pig distal colon. Tissues were pretreated with mucosal (m) and serosal (s) indomethacin (1 ..mu..M) and amiloride (0.1 mM, m) to suppress spontaneous, electrogenic Cl secretion and Na absorption. Under these conditions, the short-circuit current (I/sub sc/) was 0.4 ..mu..eq/cm/sup 2/h while electroneutral K absorption was 2.8 ..mu..eq/cm/sup 2/h. Epinephrine (5 ..mu..M, s) stimulated electrogenic K secretion, reducing net K absorption to 1.3 ..mu..eq/cm/sup 2/h. Bumetanide (0.1 mM, s) abolished this K secretion and restored K absorption to control values, suggesting mechanistic similarities between K and Cl secretion. K absorption was inhibited 40% by the gastric H/K ATPase inhibitor, omeprazole (0.1 mM, m), and was abolished by ouabain (0.1 mM, m). Neutral K absorption does not appear to be mediated by an apical membrane Na/K pump since: the effect of mucosal ouabain on K absorption does not require the presence of mucosal or serosal Na, unidirectional Na fluxes are not influenced by mucosal ouabain, and K absorption is not affected when Na absorption is abolished by amiloride. Net K transport is determined by the balance between electroneutral K absorption and electrogenic K secretion. The ouabain sensitivity of K absorption suggests that colonic H/K ATPase differs from its gastric counterpart.

  17. Delayed Recognition of Type 1 Sigmoid-Colon Atresia: The Perforated Web Variety

    PubMed Central

    Mirza, Bilal; Bashir, Zahid; Sheikh, Afzal

    2010-01-01

    Colonic atresias are the rare malformations of the colon and constitute about 1.7 to 15% of all gastrointestinal (GI) atresias. A 6-month old infant presented with recurrent episodes of sub-acute intestinal obstruction since birth. During the index admission, patient had clinical signs of complete intestinal obstruction. The patient was operated and type I sigmoid-colon atresia found which on further exploration tuned out to be of perforated mucosal web variety. The resection of the involved part of colon and a primary end to oblique colo-colic anastomosis was performed. PMID:22953248

  18. Angiosarcoma of sigmoid colon with intraperitoneal bleeding: case report and literature review.

    PubMed

    Lo, Tse-Hua; Tsai, Mu-Shiun; Chen, Tzu-An

    2011-09-01

    Primary angiosarcomas arising from the alimentary tract are rare and only a few cases have been reported in the literature. We report a case of an angiosarcoma of the sigmoid colon with intraperitoneal bleeding but not rectal bleeding. A 21-year-old female patient received a laparotomy and a mass lesion over the sigmoid colon was found with active bleeding. A sigmoid colectomy was performed as a curative resection. Grossly, the sigmoid colon contained a kidney shaped, hemorrhagic tumour from the submucosal layer extension to the antimesenteric side. Intraluminally, the mucosa of the colon was intact. Microscopic examination revealed a high grade angiosarcoma composed of fascicles of spindle cells and solid sheets of epithelioid cells. Immunohistochemical stains revealed a positive result for CD31 and the endothelial nature of the malignancy was confirmed. Smooth muscle antigens, desmins, cytokeratins AE1/AE3 and CD117 were all negative. The patient is still alive without evidence of recurrence or metastasis at a three-year follow-up appointment. Owing to the availability of immunohistochemical studies, some atypical sarcomas would now be correctly classified as angiosarcomas. Since no optimal adjuvant treatment is effective, curative surgical excision is still the best choice of treatment. PMID:21929896

  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. Sigmoid Resection with Primary Anastomosis for Uncomplicated Giant Colonic Diverticulum : a Report of two Cases.

    PubMed

    Mahieu, J; Mansvelt, B; Veys, E

    2014-01-01

    Giant colonic diverticulum (GCD) is a rare complication of colonic diverticulosis. A small number of cases has been reported in the literature. Patients with GCD have often few non-specific symptoms. Unfortunately, severe complications exist and may lead to surgical acute abdomen. Therefore, this complication of the diverticular disease must be known and properly treated. There is no gold standard diagnostic test, but an air-fluid or air-filled, rounded, pseudocystic image in relation with the colonic wall in a patient with colonic diverticula should suggest this diagnosis to the clinician. We report two cases of a 70-year-old male patient and a 44-year-old female patient having a giant sigmoid diverticulum. The treatment of choice of an uncomplicated GCD is an elective colonic resection, including the giant -diverticulum, with primary anastomosis ; while in case of complicated GCD (peritonitis, abscess or complex fistula), a two-stage resection should be considered. PMID:26021425

  1. Pyogenic Granuloma of the Sigmoid Colon causing Intussusception in an Infant

    PubMed Central

    Garofalo, Salvatore; Mostert, Michael; Morra, Isabella; Cortese, Maria Grazia; Mussa, Alessandro; Canesi, Mario; Carbonaro, Giulia; Cerrina, Alessia; Ferrero, Luisa; Cussa, Davide; Schleef, Jurgen

    2015-01-01

    Pyogenic granuloma is a benign vascular tumor that may affect the gastrointestinal tract. This report describes a rare case of sigmoid-colon pyogenic granuloma in a 4-month-old boy causing intussusception. Resection and anastomosis were curative. The mother had history of high dose of progesterone exposure during initial weeks of conception for vaginal bleeding. This may point towards etiology of the lesion.

  2. 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

  3. Stereo x-ray photogrammetry applied for prevention of sigmoid-colon damage caused by radiation from intrauterine sources

    SciTech Connect

    Kuipers, T.

    1982-06-01

    Radiation therapy of cervix carcinoma is applied in this Institute by means of modified Stockholm method in combination with external beam irradiation. In 1968, parametrial portals were replaced by large planeparallel opposed fields extending cranially to LIII/LIV with central shielding in order to avoid overdosage in the area of intracavitary treatment. This resulted in a marked increased incidence of serere sigmoid-colon radiation lesions from 0.25% to 4%; predominantly in Stage I and II patients. Therefore two measures have been introduced: beginning in 1972 measures were taken to prevent the cranial displacement of the uterus during intracavitary treatment in order to avoid shortening the distance between the radioactive sources and the sigmoid-colon; from 1973 stereo X ray photogrammetry (SRM) was applied for dose determinations at points of the sigmoid-colon, which were seen to be located close to the applicator. When SRM data indicated that a high dose at the sigmoid-colon might occur, treatment modifications enabled prevention of radiation damage. Change of position of the applicator was the first to be considered. In the last seven years no surgical intervention had to be performed because of a sigmoid-colon lesion resulting from an unexpected high radiation dose delivered by intrauterine sources. The local recurrence rate was not increased following treatment modifications for prevention of sigmoid-colon radiation damage.

  4. 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

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

    PubMed Central

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

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2010-09-01

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

  7. Case of plasmablastic lymphoma of the sigmoid colon and literature review

    PubMed Central

    Haramura, Tomoko; Haraguchi, Masashi; Irie, Junji; Ito, Shinichiro; Tokai, Hirotaka; Noda, Kazumasa; Kitajima, Masachika; Minami, Shigeki; Inoue, Keiji; Sasaki, Yuya; Oshima, Koichi; Eguchi, Susumu

    2015-01-01

    Plasmablastic lymphoma (PBL) is a rare form of non-Hodgkin’s lymphoma that is associated with human immunodeficiency virus (HIV) infection. Although PBL is most commonly observed in the oral cavity of HIV-positive patients, it can also be observed at extra-oral sites in HIV-negative patients. This report represents an unusual case of HIV-negative PBL that occurred in the sigmoid colon. This patient had a history of systemic lupus erythematosus and an underlying immunosuppressive state from long term steroid therapy. The lymphoma cells were positive for CD138, kappa light chain restriction and Epstein-Barr virus and negative for CD20/L26, CD3, CD79a, UCHL1 (CD45RO) and cytokeratin (AE1/AE3). The patient died approximately 2 mo after the operation. In the present paper, we review cases of PBL of the colon in HIV-negative patients.

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

    PubMed

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

    2014-02-01

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

  9. Histamine augments colonic secretion in guinea pig distal colon.

    PubMed

    Wang, Y Z; Cooke, H J; Su, H C; Fertel, R

    1990-03-01

    We tested the hypothesis that the role of histamine in the control of intestinal secretion is mediated by prostaglandins (PGs). The effects of histamine on ion transport were examined in muscle-stripped sheets of mucosa/submucosa set up in flux chambers. Histamine evoked a transient concentration-dependent increase in short-circuit current (Isc) that was reduced by the Cl- transport inhibitor bumetanide. Histamine also caused the release of PGE2. The Isc response to histamine was reduced by indomethacin and piroxicam, which block PG formation, but not by nordihydroguaiaretic acid, which prevents production of lipoxygenase products. 2-Methylhistamine, but not dimaprit, evoked a concentration-dependent increase in Isc. The Isc response to histamine was reduced by the H1-blocker pyrilamine, but not by the H2-antagonist cimetidine. In addition to its direct effect, histamine augmented the responses of endogenously released neurotransmitters with and without indomethacin and hexamethonium. Tetrodotoxin (TTX) reduced the Isc response to 10(-3) M histamine. In the presence of TTX, exogenous histamine amplified the responses to PGs, vasoactive intestinal polypeptide, 2-chloroadenosine, bethanechol, and carbachol. These results suggest that histamine acts at H1-receptors on cells within the gut to mediate intestinal Cl- secretion in part by releasing PGs and by augmenting the actions of endogenously released neurotransmitters. Our results indicate that histamine has a role in the regulation of colonic transport function. PMID:1969234

  10. The Incidence of Inclusion of the Sigmoid Colon and Small Bowel in the Planning Target Volume in Radiotherapy for Prostate Cancer

    Microsoft Academic Search

    Gert O. De Meerleer; Geert M. Villeirs; Luc Vakaet; Louke J. Delrue; Wilfried J. De Neve

    2004-01-01

    Background and Purpose: In radiotherapy for prostate cancer, the rectum is considered the dose-limiting organ. The incidence of overlap between the sigmoid colon and\\/or small bowel and the planning target volume (PTV) as well as the dose to sigmoid colon and small bowel were investigated. Patients and Methods: The CT data of 75 prostate cancer patients were analyzed. The clinical

  11. Differential gene expression in colon cancer of the caecum versus the sigmoid and rectosigmoid

    PubMed Central

    Birkenkamp-Demtroder, K; Olesen, S H; Sørensen, F B; Laurberg, S; Laiho, P; Aaltonen, L A; Ørntoft, T F

    2005-01-01

    Background and aims: There are epidemiological, morphological, and molecular differences between normal mucosa as well as between adenocarcinomas of the right and left side of the large bowel. The aim of this study was to investigate differences in gene expression. Methods: Oligonucleotide microarrays (GeneChip) were used to compare gene expression in 45 single samples from normal mucosa and sporadic colorectal carcinomas (Dukes’ B and C) of the caecum compared with the sigmoid and rectosigmoid. Findings were validated by real time polymerase chain reaction. Results: Fifty eight genes were found to be differentially expressed between the normal mucosa of the caecum and the sigmoid and rectosigmoid (p<0.01), including pS2, S100P, and a sialyltransferase, all being expressed at higher levels in the caecum. A total of 118 and 186 genes were differentially expressed between normal and right or left sided tumours of the colon, showing more pronounced differences in Dukes’ C than B tumours. Thirty genes differentially expressed in tumour tissue were common to adenocarcinomas of both sides, including known tumour markers such as the matrix metalloproteinases. Keratins 8, 19, and 20 as well as carbonic anhydrases (II, IV, VII) showed side specific expression and were downregulated in left sided tumours whereas teratocarcinoma growth factor and cyclooxygenase 2 (COX-2) were upregulated in left sided adenocarcinomas. Immunohistochemical analysis confirmed differences in side specific expression for cytokeratin 20 and COX-2. Conclusions: Differences in gene expression between normal mucosa as well as between adenocarcinomas of the caecum and sigmoid or rectosigmoid exist and should be taken into account when examining new targeted therapeutic regimens. PMID:15710986

  12. Giant sigmoid diverticulum: A case report.

    PubMed

    Durgakeri, Pramod; Strauss, Paul

    2015-01-01

    Sigmoid colon diverticulosis is commonly seen in both the surgical outpatient and emergency departments. Rarely, these sigmoid diverticulum, which usually range from 2-3mm to 2cm in size, can enlarge to more than 10 times. This is due to a ball-valve type mechanism that traps colonic gas inside the sigmoid diverticulum causing it to gradually enlarge. Patients with a giant sigmoid diverticulum (GSD) must be investigated thoroughly as two per cent of patients will present with a colonic carcinoma either within or distal to the GSD. Clinical symptoms of a GSD can range from chronic abdominal pain, altered bowel habits, abdominal distention, weight loss, bleeding, perforation, fistula formation, or bowel obstruction. CT and plain abdominal x-ray is the investigation of choice for its diagnosis. Barium enema is useful to determine the presence of a carcinoma within the GSD. Sigmoidoscopy is useful to rule out a distal colonic carcinoma. This is the first published case where nocturnal diarrhoea is the primary differentiating symptom in the patient. The treatment of choice for a GSD is complete resection of the diverticulum and/or the adjacent sigmoid colon. This can be performed with a primary anastomosis or a double-stage procedure. PMID:25870658

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

    PubMed

    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. PMID:25878494

  14. Mechanism(s) of Chloride Transport in Human Distal Colonic Apical Membrane Vesicles

    Microsoft Academic Search

    W. A. Alrefai; K. Ramaswamy; P. K. Dudeja

    2001-01-01

    Previous studies from our laboratory have demonstrated the presence of an electroneutral Cl-\\/HCO3- exchange process across the human proximal colonic apical membrane vesicles (AMV). However, very little is known about the mechanism(s) of chloride transport in the apical membrane of the human distal colon. Utilizing AMV purified from organ donor distal colonic mucosa and a rapid Millipore filtration technique, the

  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. Bowel cancer screening-generated diagnostic conundrum of the century: pseudoinvasion in sigmoid colonic polyps.

    PubMed

    Shepherd, Neil A; Griggs, Rebecca K L

    2015-01-01

    The introduction of bowel cancer screening, in the United Kingdom, United States of America, and many other Western countries, has provided considerable interest and no little diagnostic consternation for pathologists. In the United Kingdom, the universal introduction of bowel cancer screening, initially by fecal occult blood testing and more recently by the introduction of flexible sigmoidoscopy, has provided four main areas of pathological diagnostic difficulty. This is the biopsy diagnosis of adenocarcinoma, serrated pathology, the diagnosis and management of polyp cancer, and, finally, the phenomenon of pseudoinvasion/epithelial misplacement (PEM), particularly in sigmoid colonic adenomatous polyps. The diagnostic difficulties associated with the latter phenomenon have provided particular problems that have led to the institution of a UK national 'Expert Board', comprising three pathologists, who adjudicate on difficult cases. The pathological features favoring PEM are well recognized but there is no doubt that there can be profound mimicry of adenocarcinoma, and, as yet, no adjunctive diagnostic tools have been developed to allow the differentiation in difficult cases. Research in this area is proceeding and some methodologies do show promise in this difficult diagnostic area. PMID:25560603

  17. Potassium secretion in the guinea pig distal colon.

    PubMed

    Ishida, H; Suzuki, Y

    1987-01-01

    Active K+ secretion in guinea pig distal colon was studied in vitro in Ussing chambers. Changes in short-circuit current (Isc), transepithelial conductance (Gt), and the unidirectional flux of 42K from serosa to mucosa (JKsm) were determined under a variety of physiological and pharmacological conditions. Mucosal tetraethylammonium (TEA) (10 or 30 mM) increased Isc, while it decreased Gt and JKsm. Seroal bumetanide (10(-4) M) also caused an increase in Isc and decreases in Gt and JKsm. The effects produced by TEA were abolished in the presence of bumetanide. The increase in Isc caused by bumetanide was greatly reduced by mucosal high-K+ conditions. Isoproterenol (10(-6) M), a beta-adrenergic agonist, elicited a decrease in Isc and an increase in Gt. Responses to isoproterenol (10(-6) M) were reduced or abolished by mucosal TEA, serosal bumetanide, serosal ouabain (10(-4) M), and serosal Na+- or Cl(-)-free conditions. Mucosal high K+ also reduced the isoproterenol-induced decrease in Isc. These results suggest that K+ secretion is electrogenic and dependent on the bumetanide-sensitive cotransport in the basolateral membrane. K+ exit across the apical membrane might be conductive and sensitive to TEA. In addition, beta-adrenergic agonists might stimulate K+ secretion. PMID:3039216

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

    Microsoft Academic Search

    Takashi Ueda; Takahiro Yamada; Shinya Ugawa; Yusuke Ishida; Shoichi Shimada

    2009-01-01

    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

  19. 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

  20. 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

  1. Learning curves for laparoscopic sigmoidectomy used to manage curable sigmoid colon cancer: single-institute, three-surgeon experience

    Microsoft Academic Search

    Dong Hyun Choi; Woon Kyung Jeong; Sang-Woo Lim; Tae Sung Chung; Jung-In Park; Seok-Byung Lim; Hyo Seong Choi; Byung-Ho Nam; Hee Jin Chang; Seung-Yong Jeong

    2009-01-01

    Background  Laparoscopic surgery demands mastery of a steep learning curve. Defining a learning curve in laparoscopic surgery is useful\\u000a for planning training programs or clinical trials. This study aimed to define the learning curves for laparoscopic sigmoidectomy\\u000a used to manage curable sigmoid colon cancer by evaluating early surgical outcome data from three colorectal surgeons.\\u000a \\u000a \\u000a \\u000a Methods  This study analyzed data from 138 consecutive

  2. Immunohistochemical changes in sigmoid colon after allogeneic and autologous bone marrow transplantation.

    PubMed Central

    Forbes, G M; Erber, W N; Herrmann, R P; Davies, J M; Collins, B J

    1995-01-01

    AIM--To determine whether there are characteristic immunohistological changes in the colonic mucosa in acute graft versus host disease (GvHD). METHODS--Consecutive allogeneic (n = 11) and autologous (n = 11) bone marrow transplant recipients underwent endoscopic biopsy of sigmoid mucosa before transplant and on day 30 post-transplant. Immunohistochemical staining and quantitation of intraepithelial and lamina propria mononuclear cells were undertaken using a panel of monoclonal antibodies and a Streptavidin-biotin alkaline phosphatase staining technique. RESULTS--In the allogeneic group (nine of whom had clinical acute GvHD) there was a fivefold increase in lamina propria CD16+ mononuclear cells (3.1 +/- 4.3 to 17.0 +/- 12.2 per 100 lamina propria nucleated cells), compared with autologous transplant recipients in whom this rise was twofold (5.5 +/- 4.6 to 10.6 +/- 7.1 per 100 lamina propria nucleated cells). The CD16+ mononuclear cells had morphological appearances of tissue macrophages, but in neither the allogeneic nor autologous groups was there an increase in total macrophage numbers (CD14+). In patients with acute GvHD the lamina propria CD4+:CD8+ lymphocyte ratio fell (1.97 +/- 1.12 to 1.07 +/- 1.01), primarily because of a fall in the number of lamina propria CD4+ lymphocytes. In both allogeneic and autologous groups there was a fall in intraepithelial lymphocyte numbers, but there was no change in CD19+ (B cell), CD25+ (interleukin-2 receptor positive) or CD56+ (natural killer) cell numbers. CONCLUSION--Following bone marrow transplantation, there appears to be upregulation of lamina propria tissue macrophage CD16 (an Fc receptor for IgG), a change which is more noticeable after allogeneic transplantation and which may be related to the development of acute GvHD. In patients with acute GvHD there was a fall in the lamina propria CD4+:CD8+ lymphocyte ratio. If these changes are functionally important, they may have significant implications for understanding the pathogenesis of GvHD. Images PMID:7615847

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

    PubMed

    Ueda, Takashi; Yamada, Takahiro; Ugawa, Shinya; Ishida, Yusuke; Shimada, Shoichi

    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(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. PMID:19336223

  4. [Continent urostomy: sigmoid reservoir and sigmoid hydraulic valve].

    PubMed

    Benchekroun, A; Lachkar, A; Bouslikhane, N; Nouini, Y; Benslimane, L; Farih, M H; Belahnech, Z; Marzouk, M; Faik, M

    1997-01-01

    We report our experience of continent sigmoidostomy. The technique consisted in urinary diversion with sigmoid pouch and hydraulic valve. Eleven patients underwent this procedure (10 men and 1 women, mean age 48 years, range 20 to 77 years). Indications were bladder tumor in 7 cases, bladder exstrophy in 2 patients, neurogenic bladder in 1 case and 1 bladder with a small capacity secondary to a stricture of traumatic urethra. The pouch was made according to the detubularized model. The sigmoid was opened on its antimesenteric edge, leaving the distal portion of the sigmoid intended to do the sigmoid valve. The posterior edges of the colonic segment opened were alined then secured by a Dexon 3/0 whipping then the anterior adges were secured, as the former after reimplantation of the ureters according to Camey Leduc or Politano Leadbetter's procedure. The post operative follow-up was marked by a fistula of the pouch in one case treated by securing it. All the patients were continent day and night. The purpose of this study was the description of the technique and the results of the continent sigmoïdostomy. PMID:9765769

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

    Microsoft Academic Search

    D. R. Halm; R. A. Frizzell

    1986-01-01

    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

  6. Onyx Distal Embolization in Transarterial Embolization of Dural Arteriovenous Fistula with Subtotally Isolated Transverse-Sigmoid Sinus

    PubMed Central

    Jiang, Y.; Li, Y.; Wu, Z.

    2009-01-01

    Summary We describe a 39-year-old woman with dural arteriovenous fistula in the region of transverse-sigmoid sinus. A combination approach was designed to treat the fistula but the balloon failed to pass the severely stenosed proximal end of a subtotally isolated sinus. Although successfully occlusion of most feeding arteries from a single arterial injection was achieved, Onyx was found to shift to the outflow tract of the right heart ventricle and then to the lung latterly on six month follow-up. PMID:20465904

  7. Oxygen Consumption and Chloride Secretion in Rat Distal Colon Isolated Mucosa

    Microsoft Academic Search

    Fernando D. Saraví; Teobaldo A. Saldeña; Cristian A. Carrera; Jorge E. Ibañez; Liliana M. Cincunegui; Graciela E. Carra

    2003-01-01

    The aerobic metabolic cost of chloride secretion was studied in rat distal colon isolated mucosa under several conditions by simultaneous measurement of short-circuit current and oxygen consumption under conditions that preserve vectorial ion transport. A low-chloride solution and the presence of bumetanide plus diphenylamine-2-carboxylate reduced short-circuit current by 75% and oxygen consumption by 25%. Ouabain decreased short-circuit current by 93%

  8. 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

  9. Characterization of apical potassium channels induced in rat distal colon during potassium adaptation.

    PubMed Central

    Butterfield, I; Warhurst, G; Jones, M N; Sandle, G I

    1997-01-01

    1. Chronic dietary K+ loading stimulates an active K+ secretory process in rat distal colon, which involves an increase in the macroscopic apical K+ conductance of surface epithelial cells. In the present study, the abundance and characteristics of K+ channels constituting this enhanced apical K+ conductance were evaluated using patch clamp recording techniques. 2. In isolated non-polarized surface cells, K+ channels were seen in 9 of 90 (10%) cell-attached patches in cells from control animals, and in 247 of 437 (57%) cell-attached patches in cells from K(+)-loaded animals, with a significant (P < 0.001) shift in distribution density. Similarly, recordings from cell-attached patches of the apical membrane of surface cells surrounding the openings of distal colonic crypts revealed identical K+ channels in 1 of 11 (9%) patches in control animals, and in 9 of 13 (69%) patches in K(+)-loaded animals. 3. In isolated surface cells and surface cells in situ, K+ channels had mean slope conductances of 209 +/- 6 and 233 +/- 14 pS, respectively, when inside-out patches were bathed symmetrically in K2SO4 solution. The channels were sensitive to 'cytosolic' Ca2+ concentration, were voltage sensitive at 'cytosolic' Ca2+ concentrations encountered in colonic epithelial cells, and were inhibited by 1 mM quinidine, 20 mM TEA or 5 mM Ba2+ ions. 4. The data show that dietary K+ loading increases the abundance of Ca(2+)- and voltage-sensitive large-conductance K+ channels in the apical membrane of surface cells in rat distal colon. These channels constitute the enhanced macroscopic apical K+ conductance previously identified in these cells, and are likely to play a critical role in the active K+ secretory process that typifies this model of colonic K+ adaptation. PMID:9218214

  10. [A case report of undifferentiated carcinoma of the sigmoid colon with rhabdoid features].

    PubMed

    Baba, Youichirou; Uchiyama, Tomoko; Hamada, Kenji; Ishihara, Yoshiko; Tanaka, Hiroki; Isono, Yoshiaki; Saito, Tomonori; Mukai, Katsumi; Murata, Tetsuya; Ajioka, Yoichi

    2014-07-01

    A 45-year-old woman with persistent abdominal pain was admitted to our hospital. Detailed examination revealed a type 4 lesion with circumferential narrowing, which was diagnosed as a poorly differentiated carcinoma following forceps biopsy and ascitic fluid cytology. Although the lesion was surgically resected, the ascites increased rapidly, and her general condition deteriorated in the postoperative period. She died 6 weeks after the appearance of her symptoms. Autopsy and histological examination confirmed a very rare undifferentiated colon carcinoma with rhabdoid features, which is a high-grade malignant lesion associated with a poor prognosis. PMID:24998729

  11. Electrolyte transport in distal colon of sodium-depleted rats: Effect of sodium repletion

    SciTech Connect

    Turnamian, S.G.; Binder, H.J. (Yale Univ. School of Medicine, New Haven, CT (USA))

    1988-09-01

    Dietary sodium depletion increases plasma aldosterone level and, as a result, induces amiloride-sensitive electrogenic sodium absorption and electrogenic potassium secretion and stimulates Na{sup +}-K{sup +}-ATPase activity in rat distal colon, while inhibiting electroneutral sodium chloride absorption. To assess the events that occur as the aldosterone-stimulated colon reverts to normal, unidirectional {sup 22}Na and {sup 36}Cl fluxes were measured under voltage-clamp conditions across isolated distal colonic mucosa of rats that were initially dietary sodium depleted for 7 days and then sodium repleted for varying periods of time before the study. Within 8 h of dietary sodium repletion, plasma aldosterone level and Na{sup +}-K{sup +}-ATPase activity declined to normal, amiloride-sensitive electrogenic sodium absorption decreased by >90%, and active electrogenic potassium secretion also decreased markedly. In contrast, electroneutral sodium chloride absorption did not completely return to levels seen in normal animals until {approximately}64-68 h. These results demonstrate that maintenance of electrogenic sodium absorption and potassium secretion are directly dependent on elevated plasma aldosterone levels. The inhibition of electroneutral sodium absorption, although initiated by excess aldosterone, persists after normalization of the plasma aldosterone level, thereby implying that the inhibition is dependent on additional factor(s).

  12. Factors predicting clinical outcomes of endoscopic submucosal dissection in the rectum and sigmoid colon during the learning curve

    PubMed Central

    Agapov, Mikhail; Dvoinikova, Ekaterina

    2014-01-01

    Background and study aims: Colorectal endoscopic submucosal dissection (ESD) is associated with significant technical difficulty, long procedure time, and increased risk of complications, especially perforation. This study aimed to determine the factors associated with clinical results of ESD during the learning curve. Patients and methods: In total, 44 patients with sessile and flat rectal and sigmoid colon lesions underwent ESD from November 2009 to September 2013.?The procedure time, resection method, tumor size, location, gross morphology, presence of fibrosis, histologic findings, rates of en bloc and piecemeal resections and perforation were analyzed. The ESD procedure was classified as technically difficult in the case of procedure time >?120 minutes and/or piecemeal resection. The whole study time was divided into two periods: first period: resections 1?–?22, second period: resections 23?–?44. Results: En bloc and R0 resection have been achieved in 84.1?% of lesions. The mean procedure time was 119.95?±?11.22 minutes (range 25?–?360 minutes). Perforation was seen in five cases (11.4?%). A larger tumor size was a risk factor for difficult ESD (P?=?0.0001). A finding of fibrosis was a risk factor for piecemeal ESD (P?=?0.0074), and perforation (P?=?0.0012). There was a high direct positive correlation between tumor size and operation time (r?=?0.83, P?

  13. 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

  14. 5-Hydroxytryptamine-induced Cl ? transport is mediated by 5HT 3 and 5HT 4 receptors in the rat distal colon

    Microsoft Academic Search

    Misra R. Budhoo; R. Paul Harris; John M. Kellum

    1996-01-01

    In the rat distal colon, 5-hydroxytryptamine (5-HT)-induced Cl? secretion is seen as a rise in short circuit current (Isc). We investigated the 5-HT receptor mediating 5-HT-induced Cl? secretion in the rat distal colon. Rat distal colon was prepared either by stripping away the muscularis propria with the neural ganglia, or by leaving it intact. The tissue was mounted in Ussing

  15. 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. PMID:25380190

  16. Local and distal effects of arbuscular mycorrhizal colonization on direct pathway Pi uptake and root growth in Medicago truncatula.

    PubMed

    Watts-Williams, Stephanie J; Jakobsen, Iver; Cavagnaro, Timothy R; Grønlund, Mette

    2015-07-01

    Two pathways exist for plant Pi uptake from soil: via root epidermal cells (direct pathway) or via associations with arbuscular mycorrhizal (AM) fungi, and the two pathways interact in a complex manner. This study investigated distal and local effects of AM colonization on direct root Pi uptake and root growth, at different soil P levels. Medicago truncatula was grown at three soil P levels in split-pots with or without AM fungal inoculation and where one root half grew into soil labelled with (33)P. Plant genotypes included the A17 wild type and the mtpt4 mutant. The mtpt4 mutant, colonized by AM fungi, but with no functional mycorrhizal pathway for Pi uptake, was included to better understand effects of AM colonization per se. Colonization by AM fungi decreased expression of direct Pi transporter genes locally, but not distally in the wild type. In mtpt4 mutant plants, direct Pi transporter genes and the Pi starvation-induced gene Mt4 were more highly expressed than in wild-type roots. In wild-type plants, less Pi was taken up via the direct pathway by non-colonized roots when the other root half was colonized by AM fungi, compared with non-mycorrhizal plants. Colonization by AM fungi strongly influenced root growth locally and distally, and direct root Pi uptake activity locally, but had only a weak influence on distal direct pathway activity. The responses to AM colonization in the mtpt4 mutant suggested that in the wild type, the increased P concentration of colonized roots was a major factor driving the effects of AM colonization on direct root Pi uptake. PMID:25944927

  17. Local and distal effects of arbuscular mycorrhizal colonization on direct pathway Pi uptake and root growth in Medicago truncatula

    PubMed Central

    Watts-Williams, Stephanie J.; Jakobsen, Iver; Cavagnaro, Timothy R.; Grønlund, Mette

    2015-01-01

    Two pathways exist for plant Pi uptake from soil: via root epidermal cells (direct pathway) or via associations with arbuscular mycorrhizal (AM) fungi, and the two pathways interact in a complex manner. This study investigated distal and local effects of AM colonization on direct root Pi uptake and root growth, at different soil P levels. Medicago truncatula was grown at three soil P levels in split-pots with or without AM fungal inoculation and where one root half grew into soil labelled with 33P. Plant genotypes included the A17 wild type and the mtpt4 mutant. The mtpt4 mutant, colonized by AM fungi, but with no functional mycorrhizal pathway for Pi uptake, was included to better understand effects of AM colonization per se. Colonization by AM fungi decreased expression of direct Pi transporter genes locally, but not distally in the wild type. In mtpt4 mutant plants, direct Pi transporter genes and the Pi starvation-induced gene Mt4 were more highly expressed than in wild-type roots. In wild-type plants, less Pi was taken up via the direct pathway by non-colonized roots when the other root half was colonized by AM fungi, compared with non-mycorrhizal plants. Colonization by AM fungi strongly influenced root growth locally and distally, and direct root Pi uptake activity locally, but had only a weak influence on distal direct pathway activity. The responses to AM colonization in the mtpt4 mutant suggested that in the wild type, the increased P concentration of colonized roots was a major factor driving the effects of AM colonization on direct root Pi uptake. PMID:25944927

  18. 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

  19. Effects of higenamine on regulation of ion transport in guinea pig distal colon.

    PubMed

    Liu, W; Sato, Y; Hosoda, Y; Hirasawa, K; Hanai, H

    2000-11-01

    Effects of higenamine on Na+, K+ and Cl- transport were studied on stripped guinea pig distal colonic mucosa in vitro using Ussing chambers. Addition of 10(-5) M higenamine induced a biphasic change in short circuit current (Isc): a transient increase followed by a long-lasting decrease that was accompanied by an increase in transepithelial conductance (Gt). The initial phase with an increase in Isc was partially inhibited by serosal bumetanide and abolished by mucosal diphenylamine-2-carboxylate, a chloride channel blocker, indicating transient induction of Cl- secretion. The second phase with a decrease in Isc was composed of two effects: the inhibition of the amiloride-sensitive electrogenic Na+ absorption and the stimulation of the bumetanide-sensitive K+ secretion. However, the initial transient increase was not observed at the lower concentration of higenamine (10(-8)-10(-6) M). All the changes in Isc and Gt induced by higenamine were suppressed by the non-selective beta-adrenergic receptor antagonist propranolol and by the beta2-adrenergic receptor antagonist ICI-118,551, but not by the beta1-adrenergic-receptor-selective antagonist atenolol or by the alpha-antagonists phentolamine, prazosin and yohimbine. These results suggest that higenamine inhibits electrogenic Na+ absorption and stimulates electrogenic K+ and Cl- secretion through beta2-adrenergic receptors in guinea pig distal colon. PMID:11138724

  20. H2 receptors mediate cyclical chloride secretion in guinea pig distal colon.

    PubMed

    Wang, Y Z; Cooke, H J

    1990-06-01

    We tested the hypothesis that histamine mediates ion secretion in the guinea pig distal colon by stimulating H2 receptors on submucosal neurons. Serosal addition of histamine evoked a transient increase in short-circuit current (Isc) followed by recurrent cyclical increases in Isc. The transient phase of the response was examined previously and was not investigated in these studies. Histamine (1.5-2.5 x 10(-5) M) evoked a peak increase in Isc of 177 +/- 25 microA/cm2 at intervals of 5 min for 1-2 h. The duration of each recurrent cycle averaged 2.1 +/- 0.3 min. The H2 agonist dimaprit evoked recurrent cycles that had larger amplitudes than those caused by histamine. In the presence of histamine or dimaprit, the amplitude of the first cycle of the response was always less than subsequent cycles, regardless of the initial concentration. The cyclical responses to histamine, 2-methylhistamine, or dimaprit were unaltered by the H1 blocker pyrilamine, were reduced by the H2 antagonist cimetidine, and were abolished by the neuronal blocker tetrodotoxin. Blockade of prostaglandin formation with piroxicam did not prevent the recurrent cycles. The recurrent cycles were inhibited by the chloride transport blocker bumetanide and by removal of chloride ions. Our results demonstrate that histamine mediates prolonged cyclical chloride secretion in the guinea pig distal colon by activating H2 receptors on submucosal neurons involved in regulation of epithelial chloride transport. PMID:2141762

  1. The effects of biofeedback on rectal sensation and distal colonic motility in patients with disorders of rectal evacuation

    Microsoft Academic Search

    Roland M. H. G. Mollen; Beatrice Salvioli; Michael Camilleri; Duane Burton; Louis J. Kost; Sidney F. Phillips; John H. Pemberton

    1999-01-01

    OBJECTIVE:Abnormalities of descending colon motility reported in a subset of patients with rectal evacuation disorders are consistent with a rectocolonic inhibitory reflex. Our aims were to evaluate distal colon motor function and rectal sensation in such patients and assess effects of biofeedback (BF) training on these functions.METHODS:Seven patients (five women, two men; mean age 36 yr) with rectal evacuation disorders

  2. Mode of action of ANG II on ion transport in guinea pig distal colon.

    PubMed

    Hosoda, Y; Winarto, A; Iwanaga, T; Kuwahara, A

    2000-04-01

    The effect of ANG II on mucosal ion transport and localization of ANG type 1 receptor (AT(1)R) in the guinea pig distal colon was investigated. Submucosal/mucosal segments were mounted in Ussing flux chambers, and short-circuit current (I(sc)) was measured as an index of ion transport. Serosal addition of ANG II produced a concentration-dependent (10(-9)-10(-5) M) increase in I(sc). The maximal response was observed at 10(-6) M; the increase in I(sc) was 164.4 +/- 11.8 microA/cm(2). The ANG II (10(-6) M)-evoked response was mainly due to Cl(-) secretion. Tetrodotoxin, atropine, the neurokinin type 1 receptor antagonist FK-888, and piroxicam significantly reduced the ANG II (10(-6) M)-evoked response to 28, 45, 58, and 16% of control, respectively. Pretreatment with prostaglandin E(2) (10(-5) M) resulted in a threefold increase in the ANG II-evoked response. The AT(1)R antagonist FR-130739 completely blocked ANG II (10(-6) M)-evoked responses, whereas the ANG type 2 receptor antagonist PD-123319 had no effect. Localization of AT(1)R was determined by immunohistochemistry. In the immunohistochemical study, AT(1)R-immunopositive cells were distributed clearly in enteric nerves and moderately in surface epithelial cells. These results suggest that ANG II-evoked electrogenic Cl(-) secretion may involve submucosal cholinergic and tachykinergic neurons and prostanoid synthesis pathways through AT(1)R on the submucosal plexus and surface epithelial cells in guinea pig distal colon. PMID:10762617

  3. Submucosal reflexes: distension-evoked ion transport in the guinea pig distal colon.

    PubMed

    Frieling, T; Wood, J D; Cooke, H J

    1992-07-01

    Muscle-stripped segments of distal colon from guinea pigs were mounted in modified flux chambers to determine the effect of distension on mucosal secretion. Ion secretion was monitored as changes in short-circuit current (Isc). Distending forces were pressure gradients established by controlled reduction in liquid volume of the submucosal compartment of the chamber. Volume removal for 10 s or 5 min evoked a monophasic or biphasic increase in Isc, which returned to baseline within 5-20 min. The amplitude of the response correlated with the volume removed and was reduced by bumetanide and Cl-free solutions but not by tetraethylammonium or amiloride. Tetrodotoxin and atropine also suppressed the response. Neither the nicotinic receptor antagonist mecamylamine, the 5-hydroxytryptamine3 (5-HT3) receptor antagonist ICS 205-930, or the prostaglandin synthesis inhibitor piroxicam altered the response. Addition of prostaglandin D2 to the submucosal bath significantly enhanced the response. The results suggest that distension of the colon evokes anion secretion by activation of reflex circuits with cholinergic neurons and muscarinic synapses. Prostaglandins and 5-hydroxytryptamine acting at 5-HT3 receptors appear not to be signal substances in the reflex pathway, which evokes the secretory response to distension. PMID:1636721

  4. Neurally mediated actions of leukotrienes on ion transport in guinea pig distal colon.

    PubMed

    Hammerbeck, D M; Brown, D R

    1993-01-01

    The effects of the sulfidopeptide leukotrienes (LT), LTC4, LTD4 and LTE4 on short-circuit current (Isc), a measure of active ion transport, were determined in muscle-stripped mucosa sheets from the guinea pig distal colon. LTC4 and D4, but not E4, evoked concentration-dependent increases in Isc. Auto- and cross-tachyphylaxis could be demonstrated in LT actions. LTD4 was more sensitive than LTC4 to inhibition by the LTD4 antagonist, 1-<2-hydroxy-3-propyl-4-<4-(1H-tetrazol-5-yl)butoxy>phenyl>etha none, and the intracellular Ca++ inhibitor, 3,4,5-trimethoxybenzoic acid 8-(diethylamino)octyl ester. Mucosal LT effects were reduced in tissues pretreated with bumetanide or bathed in HCO3(-)-free media. Measurements of transepithelial Na+ and Cl- fluxes revealed that LTC4 increased unidirectional and net secretory fluxes of Cl- but had no effect on Na+ transport. Tetrodotoxin, atropine and indomethacin inhibited mucosal responses to LTC4 and D4; in addition prazosin inhibited LTD4 effects. The results suggest that LTC4 and D4 evoke anion secretion by acting through distinct LT receptor populations. These effects are mediated in part by cholinergic and adrenergic submucosal neurons as well as by colonic prostanoids. PMID:8093730

  5. Actions of hydrogen sulphide on ion transport across rat distal colon

    PubMed Central

    Hennig, B; Diener, M

    2009-01-01

    Background and purpose: The aim of this study was to identify the actions of H2S on ion transport across rat distal colon. Experimental approach: Changes in short-circuit current (Isc) induced by the H2S-donor, NaHS, were measured in Ussing chambers. Cytosolic Ca2+ concentration was evaluated using fura-2. Key results: NaHS concentration-dependently induced a change in Isc, that was only partially inhibited by the neurotoxin, tetrodotoxin. Lower concentrations (?10?3 mol·L?1) of NaHS induced a monophasic increase in Isc, whereas higher concentrations induced an additional, secondary fall of Isc, before a third phase when Isc rose again. Blockers of H2S-producing enzymes (expression demonstrated immunohistochemically) decreased basal Isc, suggesting that endogenous production of H2S contributes to spontaneous anion secretion. The positive Isc phases induced by NaHS were due to Cl? secretion as shown by anion substitution and transport inhibitor experiments, whereas the transient negative Isc induced by higher concentrations of the H2S-donor was inhibited by mucosal tetrapentylammonium suggesting a transient K+ secretion. When applied from the serosal side, glibenclamide, an inhibitor of ATP-sensitive K+ channels, and tetrapentylammonium, a blocker of Ca2+-dependent K+ channels, suppressed NaHS-induced Cl? secretion suggesting different types of K+ channels are stimulated by the H2S-donor. NaHS-induced increase in cytosolic Ca2+ concentration was confirmed in isolated, fura-2-loaded colonic crypts. This response was not dependent on extracellular Ca2+, but was inhibited by blockers of intracellular Ca2+ channels present on Ca2+ storage organelles. Conclusions and implications: H2S induces colonic ion secretion by stimulation of apical as well as basolateral epithelial K+ channels. PMID:19785650

  6. 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

  7. Contribution of NK3 tachykinin receptors to propulsion in the rabbit isolated distal colon.

    PubMed

    Onori, L; Aggio, A; Taddei, G; Ciccocioppo, R; Severi, C; Carnicelli, V; Tonini, M

    2001-06-01

    The role of NK3 receptors in rabbit colonic propulsion has been investigated in vitro with the selective agonist, senktide, and two selective antagonists, SR142801 and SB222200. Peristalsis was elicited by distending a rubber balloon with 0.3 and 1.0 mL of water leading to a velocity of 2.2 and 2.8 mm s-1, respectively. At concentrations of 1 nM, senktide inhibited propulsion evoked by both distensions (range 25-40%), whereas at 6 and 60 nmol L-1 facilitated 'submaximal' propulsion by 30%. In the presence of Nomega-nitro-L-arginine (L-NNA, 200 micromol L-1), which per se caused a slight prokinetic effect, 1 nmol L-1 senktide markedly accelerated propulsion (range 35-50%). Hexamethonium (200 micromol L-1) had minor effects on propulsion. In its presence, 60 nmol L-1 senktide significantly inhibited propulsion induced by both stimuli (range 20-50%). SR142801 (0.3, 3 nmol L-1) and SB222200 (30, 300 nmol L-1) facilitated 'submaximal' propulsion (range 20-40%). Conversely, higher antagonist concentrations (SR142801: 30, 300 nM; SB222200: 1, 10 micromol L-1) inhibited propulsion to both distensions by 20%. A combination of SR142801 (300 nmol L-1) plus hexamethonium (200 micromol L-1) induced an approximately four-fold greater inhibition of propulsion than that induced by SR142801 alone. In conclusion, in the rabbit-isolated distal colon, a subset of NK3 receptors located on descending pathways mediates an inhibitory effect on propulsion by activating a NO-dependent mechanism. Another subset of NK3 receptors, located on ascending pathways mediates a facilitative effect involving a synergistic interaction with cholinergic nicotinic receptors. PMID:11437983

  8. Regulation of intracellular pH in crypt cells from rabbit distal colon.

    PubMed

    Abrahamse, S L; Vis, A; Bindels, R J; van Os, C H

    1994-09-01

    H+ secretory mechanisms and intrinsic intracellular buffering capacity were studied in crypt cells from rabbit distal colon. To this end crypts of Lieberkühn were isolated by microdissection, and intracellular pH (pHi) was measured using digital imaging fluorescence microscopy and the pH-sensitive fluorescent dye 2',7'-bis(2-carboxyethyl)- 5(6)-carboxyfluorescein. In the absence of HCO(3-)-CO2 and presence of Na+, resting pHi was 7.51 +/- 0.04 (n = 237/23, cells/crypts). However, 6 min after superfusion with a solution containing zero Na+, 1 x 10(5) M Sch-28080 and 5 x 10(-8) M bafilomycin A1, pHi in cells at the bottom of the crypts was significantly reduced, whereas pHi in cells at the top of the crypts remained unchanged. The intrinsic buffering capacity of cells from the middle to the top portion of crypts was significantly higher in the pHi range 7.2-7.6 than of cells at the bottom of the crypt. H+ secretion after an NH(4+)-NH3 pulse amounted to 245 +/- 53 microM/s (n = 73/7) at pHi 7.1 and was largely Na+ dependent and ethylisopropylamiloride sensitive. The Na(+)-independent recovery of pHi after an acid load was insensitive to Sch-28080 and bafilomycin A1. In conclusion, pHi in colonic crypt cells is regulated through Na+/H+ exchange activity in the absence of HCO3-. In addition, intracellular buffering capacity varied with the position along the crypt axis, whereas Na+/H+ exchange activity and pHi did not. PMID:7943238

  9. Role of luminal ATP in regulating electrogenic Na(+) absorption in guinea pig distal colon.

    PubMed

    Yamamoto, Takeshi; Suzuki, Yuichi

    2002-08-01

    Extracellular ATP regulates a variety of functions in epithelial tissues by activating the membrane P2-receptor. The purpose of this study was to investigate the autocrine/paracrine regulation by luminal ATP of electrogenic amiloride-sensitive Na(+) absorption in the distal colon from guinea pigs treated with aldosterone by measuring the amiloride-sensitive short-circuit current (I(sc)) and (22)Na(+) flux in vitro with the Ussing chamber technique. ATP added to the luminal side inhibited the amiloride-sensitive I(sc) and (22)Na(+) absorption to a similar degree. The concentration dependence of the inhibitory effect of ATP on amiloride-sensitive I(sc) had an IC(50) value of 20-30 microM, with the maximum inhibition being approximately 50%. The effects of different nucleotides and of a nucleoside were also studied, the order of potency being ATP = UTP > ADP > adenosine. The effects of ATP were slightly, but significantly, reduced in the presence of suramin in the luminal solution. The inhibitory effect of luminal ATP was more potent in the absence of both Mg2+ and Ca2+ from the luminal solution. Pretreatment of the tissue with ionomycin or thapsigargin in the absence of serosal Ca2+ did not affect the percent inhibition of amiloride-sensitive I(sc) induced by ATP. Mechanical perturbation with a hypotonic luminal solution caused a reduction in amiloride-sensitive I(sc), this effect being prevented by the presence of hexokinase, an ATP-scavenging enzyme. These results suggest that ATP released into the luminal side by hypotonic stimulation could exert an inhibitory effect on the electrogenic Na(+) absorption. This effect was probably mediated by a P2Y(2) receptor on the apical membrane of colonic epithelial cells, and a change in the intracellular Ca2+ concentration may not be necessary for this process. PMID:12121876

  10. Potassium secretion in rat distal colon during dietary potassium loading: role of pH regulated apical potassium channels

    PubMed Central

    Sandle, G; Butterfield, I

    1999-01-01

    Background—Chronic dietary K+ loading increases the abundance of large conductance (210 pS) apical K+ channels in surface cells of rat distal colon, resulting in enhanced K+ secretion in this epithelium. However, the factors involved in the regulation of these K+ channels are at present unclear. ?Aims—To evaluate the effect of dietary K+ loading on intracellular pH and its relation to large conductance apical K+ channel activity in surface cells of rat distal colon. ?Methods/Results—As assessed by fluorescent imaging, intracellular pH was higher in K+ loaded animals (7.48 (0.09)) than in controls (7.07 (0.04); p<0.01) when surface cells were bathed in NaCl solution, and a similar difference in intracellular pH was observed when cells were bathed in Na2SO4 solution (7.67 (0.09) and 6.92 (0.05) respectively; p<0.001). Ethylisopropylamiloride (EIPA; an inhibitor of Na+-H+ exchange; 1 µM) decreased intracellular pH when surface cells from K+ loaded animals were bathed in either solution, although the decrease was greater when the solution contained NaCl (?pH 0.50 (0.03)) rather than Na2SO4 (?pH 0.18 (0.02); p<0.05). In contrast, EIPA had no effect in cells from control animals. As assessed by patch clamp recording techniques, the activity of large conductance K+ channels in excised inside-out membrane patches from distal colonic surface cells of K+ loaded animals increased twofold when the bath pH was raised from 7.40 to 7.60. As assessed by cell attached patches in distal colonic surface cells from K+ loaded animals, the addition of 1 µM EIPA decreased K+ channel activity by 50%, consistent with reversal of Na+-H+ exchange mediated intracellular alkalinisation. ?Conclusion—Intracellular alkalinisation stimulates pH sensitive large conductance apical K+ channels in rat distal colonic surface cells as part of the K+ secretory response to chronic dietary K+ loading. Intracellular alkalinisation seems to reflect an increase in EIPA sensitive Na+-H+ exchange, which may be a manifestation of the secondary hyperaldosteronism associated with this model of colonic K+ adaptation. ?? Keywords: colon; dietary potassium; pH; potassium channels PMID:9862824

  11. 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.

  12. Aldosterone stimulates K secretion prior to onset of Na absorption in guinea pig distal colon.

    PubMed

    Halm, D R; Halm, S T

    1994-02-01

    Distal colon from guinea pig was stimulated in vitro by aldosterone in Ussing chambers that allowed measurement of short-circuit current (Isc) and tissue conductance (Gt). The response to aldosterone was delayed by approximately 20 min and resulted in a negative Isc, consistent with K secretion. Approximately 1 h later the Isc began to increase and eventually became positive, consistent with subsequent stimulation of Na absorption. The Na-absorptive response could be inhibited by mucosal amiloride without altering the rate of K secretion. Similarly, K secretion could be inhibited by serosal bumetanide without altering Na absorption. In the presence of spironolactone, actinomycin D, or cycloheximide, aldosterone failed to stimulate both K secretion and Na absorption. A dose response to aldosterone provided an apparent Kd of 2.6 +/- 0.5 nM, consistent with a high-affinity receptor coupled to this secretory response. Stimulation by the K secretagogue epinephrine did not produce an additive increase in K secretion, suggesting that the same cell type responds to both aldosterone and epinephrine and that the protein induced by aldosterone was not one of the membrane proteins responsible for K secretion. PMID:8141270

  13. Eserine-induced hypertone of guinea pig distal colon in vivo: a new pharmacological procedure for testing smooth muscle relaxants.

    PubMed

    Maggi, C A; Meli, A

    1984-09-01

    A new in vivo procedure suitable for testing the smooth muscle relaxant properties of a test substance is described. Topical eserine produced a long-lasting steady increase in tone of guinea pig distal colon and enhanced the atropine-sensitive phasic activity. Intravenously administered atropine, pirenzepine, and dicyclomine (which possess competitive antimuscarinic properties) produced a dose-related inhibition of eserine-induced muscle tone and suppressed phasic contractions. On the other hand, verapamil and octylonium bromide (which produce smooth muscle relaxation by interfering with Ca++ availability for contraction) did not suppress phasic contraction although they were fully effective in inhibiting eserine-induced tone. The eserine-induced contraction of guinea pig distal colon appears to be a suitable, quick, and inexpensive test for evaluating the effects of potential smooth muscle relaxants against background hypermotility produced by amplifying the neurogenic drive to the target organ. PMID:6549541

  14. Rabit distal colon epithelium: II. Characterization of (Na + , K + , Cl ? )-cotransport and [ 3 H]bumetanide binding

    Microsoft Academic Search

    Hubert Wiener; Carel H. van Os

    1989-01-01

    Summary Loop diuretic-sensitive (Na+,K+,Cl-)-cotransport activity was found to be present in basolateral membrane vesicles of surface and crypt cells of rabbit distal colon epithelium. The presence of grandients of all three ions was essential for optimal transport activity (Na+,K+) gradien-driven36Cl fluxes weree half-maximally inhibited by 0.14 µm bumetanide and 44 µm furosimide. While86Rb uptake rates showed hyperbolic dependencies on Na+

  15. Rabbit distal colon epithelium: I. Isolation and characterization of basolateral plasma membrane vesicles from surface and crypt cells

    Microsoft Academic Search

    Hubert Wiener; Klaus Turnheim; Carel H. van Os

    1989-01-01

    Summary A method has been developed for the simultaneous isolation of basolateral plasma membrane vesicles from surface and crypt cells of rabbit distal colon epithelium by sequential use of differential sedimentation, isopycnic centrifugation and Ficoll 400 barrier centrifugation. The protein yield was high (total 0.81 mg\\/g mucosa) and surface and crypt cell-derived basolateral membrane fractions have been purified 34- and

  16. Role of cyclooxygenases 1 and 2 in the modulation of neuromuscular functions in the distal colon of humans and mice

    Microsoft Academic Search

    M Fornai; C Blandizzi; R Colucci; L Antonioli; N Bernardini; C Segnani; B Baragatti; S Barogi; P Berti; R Spisni; M Del Tacca

    2005-01-01

    Background: Cyclooxygenase isoforms (COX-1, COX-2) may exert differential regulatory actions on enteric motor functions under normal or pathological conditions.Aims: To examine the occurrence and functions of COX-1 and COX-2 in the neuromuscular compartment of normal distal colon using human and murine tissue.Methods: Gene expression (human, mouse), protein expression (human), gene deletion (mouse), and the effects of dual and isoform specific

  17. [Unusual presentation of sigmoid diverticulitis. Sigmoid-vesical fistula in sigmoid diverticulitis].

    PubMed

    Jöres, A P W; Probst, P

    2011-09-01

    A 68-year-old male patient presented with mild tenderness in the suprasymphyseal region, hematuria and dysuria. In this case typical symptoms of a sigmoid-vesical fistula were initially absent. Because of hematuria and the findings provided by urethrocystoscopy, the radiological diagnosis was a bladder tumor. Contrast-enhanced computed tomography with rectal contrast administration provided the decisive information. In addition to sigmoid diverticulitis (fat stranding/centipede sign) in the urographic phase, contrast media was well traceable intraluminally from the bladder through the bladder wall abscess and subsequently in the sigmoid colon. PMID:21748488

  18. Interleukin-6 (IL-6) mediated the increased contraction of distal colon in streptozotocin-induced diabetes in rats via IL-6 receptor pathway

    PubMed Central

    Chang, Xin-Wen; Qin, Ying; Jin, Zhi; Xi, Tao-Fang; Yang, Xiao; Lu, Ze-Hao; Tang, Yu-Ping; Cai, Wen-Ting; Chen, Shao-Jun; Xie, Dong-Ping

    2015-01-01

    Colonic dysmotility occurs in diabetes and blood plasma interleukin (IL)-6 levels are significantly elevated in type 1 diabetes mellitus. The aim of this study was to investigate whether IL-6 and the IL-6 receptor pathway mediates colonic dysfunction in type 1 diabetes mellitus. Male SD rats were treated with a single intraperitoneally injected dose of streptozotocin (STZ), and those displaying sustained high blood glucose were selected as diabetes mellitus models. Longitudinal muscle strips of colon were prepared to monitor colonic contraction in vitro. Contractile responses of strips of colon were recorded following treatment with IL-6 in control animals, and following anti IL-6 antibody treatment in STZ-induced diabetes in rats. Concentration of IL-6 in plasma and colon were determined by ELISA. Expressions of IL-6 ?-receptor and IL-6 ?-receptor in colon tissues were determined by immunohistochemistry or Western blot analysis. The non-diabetes rats treated with IL-6 and the untreated diabetes rats showed increased contraction of distal colon, whereas the diabetes rats treated with anti-IL-6 antibody showed decreased contraction of distal colon compared with the untreated diabetes rats. The IL-6 levels of plasma but not colon increased in diabetes rats. The expression of IL-6 ?-receptor increased in diabetes rats. These results indicate that diabetes rats show an increase in the contractions of distal colon partly via the IL-6-IL-6 receptor pathway.

  19. Neural components of distension-evoked secretory responses in the guinea-pig distal colon

    PubMed Central

    Weber, Eckhard; Neunlist, Michel; Schemann, Michael; Frieling, Thomas

    2001-01-01

    Using a Ussing chamber and neuronal retrograde tracing with 1,1?-didodecyl-3,3,3?,3?-tetramethylindocarbocyanine perchlorate (DiI) we characterized the afferent and efferent neuronal pathways which mediated distension-evoked secretion in the guinea-pig distal colon. Acute capsaicin application (10 ?m) to the serosal site of the Ussing chamber evoked a secretory response which was blocked by tetrodotoxin (1 ?m), the combined application of the NK1 and NK3 receptor antagonists CP-99,994–1 and SR 142801 (1 ?m), and by combined application of atropine (10 ?m) and the VIP receptor antagonist VIP(6–28) (10 ?m). Functional desensitization of extrinsic primary afferents by long-term application of capsaicin significantly diminished distension-evoked secretion by 46 %. After functional desensitization by capsaicin, serosal application of gadolinium (100 ?m) inhibited the distension-evoked chloride secretion by 54 %; the L-type Ca2+ channel blocker nifedipine (1 ?m) and the 5-HT1P receptor antagonist renzapride (1 ?m) had no effect. The combination of atropine and VIP(6–28) or the combination of NK1 and NK3 receptor antagonists almost abolished distension-evoked secretion. The secretory response evoked by electrical field stimulation, carbachol (1 ?m) or VIP (1 ?m) was not attenuated by gadolinium. Field stimulation-evoked chloride secretion was not affected by blockade of NK1 and NK3 receptors. Twelve per cent of DiI-labelled submucosal neurones with projections to the mucosa were immunoreactive for choline acetyltransferase, substance P and calbindin and very probably represented intrinsic primary afferent neurones. Distension-evoked chloride secretion was mediated by capsaicin-sensitive extrinsic primary afferents and by stretch-sensitive intrinsic primary afferent neurones. Both the extrinsic and intrinsic afferents converge on common efferent pathways. These pathways consist of VIPergic and cholinergic secretomotor neurones that are activated via NK1 and NK3 receptors. PMID:11691869

  20. Prostanoids stimulate K secretion and Cl secretion in guinea pig distal colon via distinct pathways.

    PubMed

    Halm, D R; Halm, S T

    2001-10-01

    Short-circuit current (I(sc)) and transepithelial conductance (Gt) were measured in guinea pig distal colonic mucosa isolated from submucosa and underlying muscle layers. Indomethacin (2 microM) and NS-398 (2 microM) were added to suppress endogenous production of prostanoids. Serosal addition of PGE2 (10 nM) stimulated negative I(sc) consistent with K secretion, and concentrations >30 nM stimulated positive I(sc) consistent with Cl secretion. PGE2 also stimulated Gt at low and high concentrations. Dose responses to prostanoids specific for EP prostanoid receptors were consistent with stimulating K secretion through EP2 receptors, based on a rank order potency (from EC50 values) of PGE2 (1.9 nM) > 11-deoxy-PGE1 (8.3 nM) > 19(R)-hydroxy-PGE2 (13.9 nM) > butaprost (67 nM) > 17-phenyl-trinor-PGE2 (307 nM) > sulprostone (>10 microM). An isoprostane, 8-iso-PGE2, stimulated K secretion with an EC50 of 33 nM. Cl secretory response was stimulated by PGD2 and BW-245C, a DP prostanoid receptor-specific agonist: BW-245C (15 nM) > PGD2 (30 nM) > PGE2 (203 nM). Agonists specific for FP, IP, and TP prostanoid receptors were ineffective in stimulating I(sc) and Gt at concentrations <1 microM. These results indicate that PGE2 stimulated electrogenic K secretion through activation of EP2 receptors and electrogenic KCl secretion through activation of DP receptors. Thus stimulation of Cl secretion in vivo would occur either via physiological concentrations of PGD2 (<100 nM) or pathophysiological concentrations of PGE2 (>100 nM) that could occur during inflammatory conditions. PMID:11557519

  1. Prospective evaluation of laparoscopy-assisted colectomy versus laparotomy with resection for management of complex polyps of the sigmoid colon.

    PubMed

    Liang, Jin-Tung; Shieh, Ming-Jium; Chen, Chiung-Nien; Cheng, Yung-Ming; Chang, King-Jen; Wang, Shih-Ming

    2002-03-01

    Laparoscopy-assisted colectomy is technically feasible, but objective evidence of its benefits remains scarce. This study was done to evaluate the outcomes and operative stress of laparoscopy-assisted colectomy versus the traditional open method in the management of sigmoid complex polyps that cannot be safely or adequately removed by colonofibroscopy. Between January 1997 and December 1999, a total of 42 patients were equally randomized to the laparoscopy group and the laparotomy group by the blocked randomization method. Three patients randomized to the laparoscopy group did not complete the trial; therefore 18 patients treated by laparoscopy-assisted sigmoidectomy and the other 21 treated by the open method were prospectively evaluated. These two groups of patients were well matched in age, gender, symptoms, tumor location, localization method, tumor size, morphology, histopathology, and the accuracy of the clinical diagnosis. Two standardized surgical strategies, the lateral-to-medial and medial-to-lateral dissection sequences, were performed in 14 and 4 patients of the laparoscopy group, respectively, according to whether their tumors were located above or below 20 cm above the anal verge. After evaluating the surgical outcomes, we found that the laparoscopy group was significantly better than the laparotomy group in regard to parameters that included severity of postoperative pain, wound size, postoperative complication rate, and the duration of postoperative ileus, hospitalization, and disability. There was no significant difference in the operating times for these two groups. However, the costs of the laparoscopy group were significantly higher. To evaluate the surgical stress, we measured the serum C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), total lymphocyte count, and CD4+/CD8+ ratio 24 hours before and after surgery. We found that the postoperative serum CRP level and the ESR were significantly less elevated and the total lymphocyte counts and CD4+/CD8+ ratio were significantly less depressed in the laparoscopy group than in the laparotomy group. We thus concluded that laparoscopy-assisted sigmoidectomy can be safely performed with shorter convalescence and less operative stress but at a higher cost. We strongly recommended the use of this technique in the management of sigmoid complex polyps if the patient's economic status permits. PMID:11865378

  2. Neural components of distension-evoked secretory responses in the guinea-pig distal colon.

    PubMed

    Weber, E; Neunlist, M; Schemann, M; Frieling, T

    2001-11-01

    1. Using a Ussing chamber and neuronal retrograde tracing with 1,1'-didodecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate (DiI) we characterized the afferent and efferent neuronal pathways which mediated distension-evoked secretion in the guinea-pig distal colon. 2. Acute capsaicin application (10 microM) to the serosal site of the Ussing chamber evoked a secretory response which was blocked by tetrodotoxin (1 microM), the combined application of the NK1 and NK3 receptor antagonists CP-99,994-1 and SR 142801 (1 microM), and by combined application of atropine (10 microM) and the VIP receptor antagonist VIP(6-28) (10 microM). Functional desensitization of extrinsic primary afferents by long-term application of capsaicin significantly diminished distension-evoked secretion by 46 %. 3. After functional desensitization by capsaicin, serosal application of gadolinium (100 microM) inhibited the distension-evoked chloride secretion by 54 %; the L-type Ca(2+) channel blocker nifedipine (1 microM) and the 5-HT(1P) receptor antagonist renzapride (1 microM) had no effect. The combination of atropine and VIP(6-28) or the combination of NK1 and NK3 receptor antagonists almost abolished distension-evoked secretion. 4. The secretory response evoked by electrical field stimulation, carbachol (1 microM) or VIP (1 microM) was not attenuated by gadolinium. Field stimulation-evoked chloride secretion was not affected by blockade of NK1 and NK3 receptors. 5. Twelve per cent of DiI-labelled submucosal neurones with projections to the mucosa were immunoreactive for choline acetyltransferase, substance P and calbindin and very probably represented intrinsic primary afferent neurones. 6. Distension-evoked chloride secretion was mediated by capsaicin-sensitive extrinsic primary afferents and by stretch-sensitive intrinsic primary afferent neurones. Both the extrinsic and intrinsic afferents converge on common efferent pathways. These pathways consist of VIPergic and cholinergic secretomotor neurones that are activated via NK1 and NK3 receptors. PMID:11691869

  3. Active potassium transport across guinea-pig distal colon: action of secretagogues.

    PubMed

    Rechkemmer, G; Frizzell, R A; Halm, D R

    1996-06-01

    1. Adrenaline (5 microM) stimulated a K+ secretory current by 2.2 mu equiv h-1 cm-2 in isolated guinea-pig distal colonic epithelium. This secretory activity was inhibited entirely by addition of the loop diuretic bumetanide to the serosal solution. On-going K+ uptake via the absorptive pathway was unaltered by these changes. 2. Prostaglandin E2 (PGE2, 2 microM) stimulated electrogenic K+ secretion and Cl- secretion by 3.0 and 3.6 mu equiv h-1 cm-2, respectively. Serosal addition of bumetanide completely inhibited this K+ secretion but blocked only approximately 70% of Cl- secretion. The bumetanide-insensitive Cl- secretory current was dependent on the presence of Cl- and HCO3- in the bathing solutions. 3. Stimulation of electrogenic K+ secretion by PGE2 occurred with a half-maximal concentration of 4 nM, an affinity approximately 300 times higher than that for stimulation of Cl- secretion by PGE2. 4. Forskolin (10 microM) stimulated Cl- secretion by 4.9 mu equiv h-1 cm-2. The apparent K+ secretory rate was increased by only 1.5 mu equiv h-1 cm-2. A bumetanide-insensitive short-circuit current (ISC) was apparent and of the same size as that stimulated by PGE2. 5. Addition of the Ca2+ ionophore A23187 (10 microM), in the presence of indomethacin (1 microM) to reduce prostaglandin production, inhibited the K+ absorptive pathway by 40% and concurrently stimulated a small rate of electrogenic K+ secretion. 6. Active K+ absorption was inhibited by the addition of ouabain, omeprazole or SCH28080 to the mucosal solution. Both omeprazole and SCH28080 also stimulated a small negative ISC, consistent with electrogenic K+ secretion. 7. Association of K+ absorption, K+ secretion and Cl- secretion is indicated by similarities in transport mechanism and by secretagogue regulation. In particular, maximal rates of K+ secretory current require uptake via apical membrane K+ pumps. Such interrelations support a common cellular locus for these ion transport pathways. PMID:8782111

  4. Prostaglandin- and theophylline-induced C1 secretion in rat distal colon is inhibited by microtubule inhibitors.

    PubMed

    Grotmol, T; Van Dyke, R W

    1992-11-01

    The aim of the present study was to examine the possible role of microtubules in chloride secretion by distal rat colon stimulated by prostaglandin (PGE2) and theophylline. Distal colonic tissue from male rats was mounted in Ussing chambers, and short-circuit current (Isc) was measured to assess chloride secretion. Three microtubule inhibitors, colchicine, nocodazole, and taxol, all inhibited the stimulated Isc and reduced the 60-min integrated secretory response to PGE2 and theophylline (integral of Iscdt) by 39-52%, whereas the inactive colchicine analog lumicolchicine did not. Atropine and tetrodotoxin had no effect on stimulated chloride secretion. To confirm the source of Isc, unidirectional 22Na+ and 36Cl- fluxes were measured in tissues exposed to lumicolchicine (control) or colchicine. Control tissues absorbed both chloride [5.0 (1.1-8.6) (median and 95% confidence interval) mueq/cm2/hr] and sodium [2.8 (0.9-7.2) mueq/cm2/hr], and this net absorption was reduced by 96% and 79%, respectively, by treatment with PGE2 and theophylline due to an increase in serosal-to-mucosal chloride and sodium movement. Colchicine-treated tissues exhibited similar net basal chloride and sodium absorption that was reduced by 71% and 75%, respectively, by treatment with PGE2 and theophylline. Thus the PGE2- and theophylline-induced increase in chloride secretion was significantly reduced by colchicine (P < 0.05 by Wilcoxon rank-sum test), whereas colchicine had no effect on PGE2- and theophylline-induced changes in sodium fluxes. Furthermore, the colchicine-related changes in stimulated chloride secretion were numerically similar to colchicine-related changes in stimulated Isc.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1425071

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

    PubMed Central

    Zhang, Jin; Halm, Susan T.

    2012-01-01

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

  6. Emodin induces chloride secretion in rat distal colon through activation of mast cells and enteric neurons

    PubMed Central

    Xu, J-D; Liu, S; Wang, W; Li, L-S; Li, X-F; Li, Y; Guo, H; Ji, T; Feng, X-Y; Hou, X-L; Zhang, Y; Zhu, J-X

    2012-01-01

    BACKGROUND AND PURPOSE Emodin (1,3,8-trihydroxy-6-methylanthraquinone) is an active component of many herb-based laxatives. However, its mechanism of action is unclear. The aim of the present study was to investigate the role of mast cells and enteric neurons in emodin-induced ion secretion in the rat colon. EXPERIMENTAL APPROACH Short-circuit current (ISC) recording was used to measure epithelial ion transport. A scanning ion-selective electrode technique was used to directly measure Cl- flux (JCl?) across the epithelium. RIA was used to measure emodin-induced histamine release. KEY RESULTS Basolateral addition of emodin induced a concentration-dependent increase in ISC in colonic mucosa/submucosa preparations, EC50 75 µM. The effect of emodin was blocked by apically applied glibenclamide, a Cl- channel blocker, and by basolateral application of bumetanide, an inhibitor of the Na+-K+-2Cl- cotransporter. Emodin-evoked JCl? in mucosa/submucosa preparations was measured by scanning ion-selective electrode technique, which correlated to the increase in ISC and was significantly suppressed by glibenclamide and bumetanide. Pretreatment with tetrodotoxin and the muscarinic receptor antagonist atropine had no effect on emodin-induced ?ISC in mucosa-only preparations, but significantly reduced emodin-induced ?ISC and JCl? in mucosa/submucosa preparations. The COX inhibitor indomethacin, the mast cell stabilizer ketotifen and H1 receptor antagonist pyrilamine significantly reduced emodin-induced ?ISC in mucosa and mucosa/submucosa preparations. The H2 receptor antagonist cimetidine inhibited emodin-induced ?ISC and JCl? only in the mucosa/submucosa preparations. Furthermore, emodin increased histamine release from the colonic mucosa/submucosa tissues. CONCLUSIONS AND IMPLICATIONS The results suggest that emodin-induced colonic Cl- secretion involves mast cell degranulation and activation of cholinergic and non-cholinergic submucosal neurons. PMID:21718311

  7. Neural 5-hydroxytryptamine receptors regulate chloride secretion in guinea pig distal colon.

    PubMed

    Cooke, H J; Wang, Y Z; Frieling, T; Wood, J D

    1991-11-01

    The effects of 5-hydroxytryptamine (5-HT) on epithelial short-circuit current (Isc) were determined and related to the 5-HT effects on electrical and synaptic behavior of neurons in the submucosal plexus of the guinea pig colon. 5-HT evoked a biphasic increase in Isc that was reduced by bumetanide, Cl(-)-free solutions, atropine, and mecamylamine and abolished by tetrodotoxin. The 5-HT response was mimicked by 2-methyl-5-HT, but not by 5-hydroxyindalpine, 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane, and 5-methoxytryptamine (5-MeOT). ICS 205-930 suppressed the 5-HT response. Electrical field stimulation of submucosal neurons evoked an increase in Isc indicative of Cl- secretion that was reduced by 5-MeOT and enhanced by 2-methyl-5-HT. Application of 5-HT to submucosal neurons by micropressure ejection resulted in membrane depolarization, augmented excitability, and repetitive spike discharge. The depolarization was biphasic, consisting of rapidly and slowly activating components. The rapidly activating component was suppressed by ICS 205-930. Fast excitatory postsynaptic potentials evoked by electrical stimulation of interganglionic connectives were suppressed by 5-HT and 5-MeOT. These results suggest that 5-HT activates 5-HT3 receptors, which mediate fast excitatory responses in submucosal neurons, leading to release of acetylcholine at nicotinic and muscarinic synapses and stimulation of Cl- secretion. Presynaptic inhibition suppresses acetylcholine release and results in attenuation of neurally evoked Cl- secretion. PMID:1951703

  8. Role of nitric oxide in the impairment of circular muscle contractility of distended, uninflamed mid-colon in TNBS-induced acute distal colitis in rats

    PubMed Central

    Onori, Luciano; Aggio, Annalisa; D’Alo’, Simona; Muzi, Paola; Cifone, Maria Grazia; Mellillo, Gabriella; Ciccocioppo, Rachele; Taddei, Gennaro; Frieri, Giuseppe; Latella, Giovanni

    2005-01-01

    AIM: To evaluate the role of nitric oxide (NO) in the motor disorders of the dilated uninflamed mid-colon (DUMC) from trinitrobenzene sulfonic acid (TNBS)-induced acute distal colitis in rats. METHODS: Colitis was induced in male Sprague-Dawley rats by a single intracolonic administration of TNBS. Control rats received an enema of 0.9% saline. The rats were killed 48 h after TNBS or saline administration. Macroscopic and histologic lesions of the colon were evaluated. Myeloperoxidase (MPO) and nitric oxide synthase (NOS) activity were measured on the colonic tissue. In TNBS rats, we evaluated spontaneous and evoked contractile activity in circular muscle strips derived from DUMC in comparison to the same colonic segment of control rats, both in the presence and in the absence of a non-selective NOS isoforms inhibitor N-nitro-L-arginine (L-NNA). Pharmacological characterization of electric field stimulation (EFS)-evoked contractile responses was also performed. RESULTS: In TNBS rats, the distal colon showed severe histological lesions and a high MPO activity, while the DUMC exhibited normal histology and MPO activity. Constitutive NOS activity was similar in TNBS and control rats, whereas inducible NOS activity was significantly increased only in the injured distal colon of TNBS rats. Isometrically recorded mechanical activity of circular muscle strips from DUMC of TNBS rats showed a marked reduction of the force and frequency of spontaneous contractions compared to controls, as well as of the contractile responses to a contracting stimulus. In the presence of L-NNA, the contractile activity and responses displayed a significantly greater enhancement compared to controls. The pharmacological characterization of EFS contractile responses showed that a cooperative-like interaction between cholinergic muscarinic and tachykinergic neurokinin 1 and 2 receptors mediated transmission in DUMC of TNBS rats vs a simple additive interaction in controls. CONCLUSION: The results of this study show that, during TNBS-induced acute distal colitis, circular muscle intrinsic contractile mechanisms and possible enteric neural excitatory activity are inhibited in the distended uninflamed mid-colon. Suppression of NO synthesis markedly improves spontaneous and evokes muscle contractions, in spite of any evident change in local NO activity. PMID:16237764

  9. Sigmoid Afferent Mechanisms in Patients with Irritable Bowel Syndrome

    Microsoft Academic Search

    T. Lembo; J. Munakata; B. Naliboff; S. Fullerton; E. A. Mayer

    1997-01-01

    Up to 60% of patients with IBS have loweredperception thresholds in the rectum to balloondistension. The current study sought to test thehypothesis that IBS patients with normal perceptionthresholds in the rectum show hypersensitivity of afferentpathways in the sigmoid colon. Eleven healthy normalsubjects and eight IBS patients with normal rectalperception thresholds underwent a balloon distension protocol in the sigmoid and rectum.

  10. A novel surgical approach for treatment of sigmoid gallstone ileus.

    PubMed

    Cargill, Abbey; Farkas, Nicholas; Black, John; West, Nicholas

    2015-01-01

    We report a rare case of large bowel obstruction secondary to a gallstone impacted within the sigmoid colon, in the presence of sigmoid diverticular disease. An 89-year-old woman presented with an 8-day history of increasing abdominal distension, pain and associated nausea. Abdominal X-ray demonstrated large bowel dilation. CT scan revealed a fistula between an inflamed gallbladder and the hepatic flexure of the colon, with a large gallstone in the sigmoid colon. Proximal dilated large bowel was evident to the caecum. Flexible sigmoidoscopy was performed as the least invasive potential treatment method with a view to basket retrieval or fragmentation of the stone. Owing to poor views and risk of diverticular perforation, the procedure was abandoned, hence laparotomy was performed. Antegrade manipulation and per-rectal evacuation were attempted but failed due to a thickened, angulated sigmoid colon. Retrograde milking of the stone to the caecum and retrieval via modified appendicectomy was successful. PMID:26150623

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

    PubMed

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

    2014-05-01

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

  12. 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

  13. Utility of an upper echoendoscope for endoscopic ultrasonography of malignant and benign conditions of the sigmoid\\/left colon and the rectum

    Microsoft Academic Search

    M. S. Bhutani; P. Nadella

    2001-01-01

    OBJECTIVE:The majority of data on colonic endoscopic ultrasound (EUS) are limited to malignant lesions in the rectum and diseases of the anal sphincter. The forward-oblique-viewing upper echoendoscope has been mostly applied for staging rectal cancer. A front-viewing echocolonoscope is available but has not been widely used because of limited indications and the expense of buying another instrument. The purpose of

  14. 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

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

    PubMed Central

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

    2014-01-01

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

  16. Successful laparoscopic repair of a large traumatic sigmoid perforation.

    PubMed

    de Bakker, Jk; Bruin, Sc

    2012-01-01

    Bowel perforation can be potentially fatal. We describe the case of a 42-year-old male who presented with severe abdominal pain following anal fisting. Clinical examination revealed tenderness of the complete abdomen with signs of peritonism. A CT-scan with rectal contrast showed a perforation of the sigmoid 40 cm above the anus. At laparoscopy, a perforation in the sigmoid colon was found and successfully repaired. Patient recovered uneventful and was discharged in 5 days. We present a unique case of a sigmoid perforation after anal fisting which was laparoscopically repaired without formation of a protective colostomy. PMID:24960779

  17. Successful laparoscopic repair of a large traumatic sigmoid perforation

    PubMed Central

    de Bakker, JK; Bruin, SC

    2012-01-01

    Bowel perforation can be potentially fatal. We describe the case of a 42-year-old male who presented with severe abdominal pain following anal fisting. Clinical examination revealed tenderness of the complete abdomen with signs of peritonism. A CT-scan with rectal contrast showed a perforation of the sigmoid 40 cm above the anus. At laparoscopy, a perforation in the sigmoid colon was found and successfully repaired. Patient recovered uneventful and was discharged in 5 days. We present a unique case of a sigmoid perforation after anal fisting which was laparoscopically repaired without formation of a protective colostomy. PMID:24960779

  18. HCO3- potentiates the cAMP-dependent secretory response of the human distal colon through a DIDS-sensitive pathway.

    PubMed

    Taylor, J; Hamilton, K L; Butt, A G

    2001-05-01

    We used the Ussing short-circuit technique to investigate the role of HCO3- in the adenosine 3',5'-cyclic monophosphate (cAMP)-dependent secretory response of the human distal colon. In HCO3(-)-free 4-(2-hydroxyethyl)-1-piperazineethanesulphonic acid (HEPES)-Ringer's, forskolin (10 mumol l-1 mucosal and serosal) evoked a sustained increase in short-circuit current (Isc) (delta Isc = 24 +/- 3 microA cm-2, n = 57). However, this was only 25% of the forskolin-stimulated Isc response in HCO3(-)-Ringer's (delta Isc = 84 +/- 8 microA cm-2, n = 57). The reduced response to forskolin in HCO3(-)-free HEPES-Ringer's was not due to inhibition of the secretory mechanism by HEPES, as replacing HCO3- with a different buffer, N-tris[hydroxymethyl)methyl-2-aminoethanesulphonic acid (TES), had a similar effect and inclusion of HEPES in the HCO3(-)-Ringer's did not reduce the secretory response. Similarly, it was not due to an indirect modulation of electrogenic Cl- secretion, as the forskolin-stimulated bumetanide-sensitive Isc was comparable in the two Ringer's. Rather it was due to the activation of a HCO3(-)-dependent Isc which was inhibited by serosal 4,4'-diisothiocyano-stilbene-2,2'-disulphonate (DIDS). This DIDS-sensitive Isc was not inhibited by acetazolamide, but it was inhibited by the replacement of bathing solution Cl- with gluconate, suggesting a role for a Na(+)-dependent Cl-/HCO3- exchanger in the cAMP-dependent secretory response of the human distal colon. PMID:11417223

  19. The effects of SB 204070, a highly potent and selective 5-HT4 receptor antagonist, on guinea-pig distal colon.

    PubMed Central

    Wardle, K. A.; Ellis, E. S.; Baxter, G. S.; Kennett, G. A.; Gaster, L. M.; Sanger, G. J.

    1994-01-01

    1. The pharmacology of a novel 5-HT4 receptor antagonist, SB 204070 has been evaluated in the guinea-pig isolated distal colon longitudinal muscle-myenteric plexus (LMMP). 2. SB 204070 is a highly potent antagonist of 5-HT-evoked cholinergically-mediated contractions in the guinea-pig distal colon. Low concentrations (10-100 pM) produced a shift to the right of the curve (apparent pA2 10.8 +/- 0.1) with no significant effect on the maximum response. With higher concentrations of SB 204070 (300 pM and above), the maximum response to 5-HT was reduced. 3. When tested against the partial 5-HT4 receptor agonist, BIMU 1, SB 204070 was active at similar low concentrations (10 pM and above) but produced a reduction in maximum, with no prior shift to the right of the curve, at all concentrations tested (10-300 pM). 4. The antagonism seen with SB 204070 is unlikely to be due to a non-selective effect since high concentrations (10 nM and 1 microM) of the compound had no effect on cholinergically-mediated contractions evoked by the nicotinic receptor agonist, DMPP, in the same preparation. SB 204070 is unlikely to be an irreversible antagonist since the effects of the compound could be reversed upon washing of the tissue. 5. Radioligand binding studies show that SB 204070 has a greater that 5000 fold selectivity for the 5-HT4 receptor over 5-HT1A, 5-HT1D, 5-HT1E, 5-HT2A, 5-HT2C, 5-HT3, GABAA, BDZ, TBPS, A1 adenosine receptors, alpha 1, alpha 2, beta 1, beta 2 adrenoceptors and D1, D2 and D3 dopamine receptors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7921604

  20. Characterization of Changes in Global Genes Expression in the Distal Colon of Loperamide-Induced Constipation SD Rats in Response to the Laxative Effects of Liriope platyphylla

    PubMed Central

    Kim, Ji Eun; Park, So Hae; Kwak, Moon Hwa; Go, Jun; Koh, Eun Kyoung; Song, Sung Hwa; Sung, Ji Eun; Lee, Hee Seob; Hong, Jin Tae; Hwang, Dae Youn

    2015-01-01

    To characterize the changes in global gene expression in the distal colon of constipated SD rats in response to the laxative effects of aqueous extracts of Liriope platyphylla (AEtLP), including isoflavone, saponin, oligosaccharide, succinic acid and hydroxyproline, the total RNA extracted from the distal colon of AEtLP-treated constipation rats was hybridized to oligonucleotide microarrays. The AEtLP treated rats showed an increase in the number of stools, mucosa thickness, flat luminal surface thickness, mucin secretion, and crypt number. Overall, compared to the controls, 581 genes were up-regulated and 216 genes were down-regulated by the constipation induced by loperamide in the constipated rats. After the AEtLP treatment, 67 genes were up-regulated and 421 genes were down-regulated. Among the transcripts up-regulated by constipation, 89 were significantly down-regulated and 22 were recovered to the normal levels by the AEtLP treatment. The major genes in the down-regulated categories included Slc9a5, klk10, Fgf15, and Alpi, whereas the major genes in the recovered categories were Cyp2b2, Ace, G6pc, and Setbp1. On the other hand, after the AEtLP treatment, ten of these genes down-regulated by constipation were up-regulated significantly and five were recovered to the normal levels. The major genes in the up-regulated categories included Serpina3n, Lcn2 and Slc5a8, whereas the major genes in the recovered categories were Tmem45a, Rerg and Rgc32. These results indicate that several gene functional groups and individual genes as constipation biomarkers respond to an AEtLP treatment in constipated model rats. PMID:26151867

  1. Mutations induced by 2-amino-1-methyl-6-phenylimidazo [4,5-b]pyridine (PhIP) in cecum and proximal and distal colon of lacI transgenic rats.

    PubMed

    Stuart, G R; de Boer, J G; Haesevoets, R; Holcroft, J; Kangas, J; Sojonky, K; Thorleifson, E; Thornton, A; Walsh, D F; Yang, H; Glickman, B W

    2001-09-01

    2-Amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) is a food-borne mutagen and carcinogen that induces tumors of the colon and the prostate gland in male rats and of the mammary gland in female rats. In this study we describe the frequency and specificity of PhIP-induced mutations in the cecum, proximal colon and distal colon of male and female lacI transgenic rats. This is the first report of mutational data from discrete regions of the colon. After 61 days of treatment with 200 p.p.m. PhIP mixed into the diet, PhIP-induced mutant frequencies were elevated 7-fold in the cecum and 14- to 21-fold in the colon of male and female rats compared with untreated controls. PhIP-induced mutant frequencies increased significantly (overall trend, P < 10(-4)) along the length of the colon of both males and females, with cecum < proximal colon < distal colon. A total of 754 PhIP mutants (363 male, 391 female) were sequenced to provide the mutational spectra for each of the three tissue sections from males and females. These mutational spectra consisted predominantly of G:C-->T:A and G:C-->C:G transversions and deletions of G:C base pairs. There were no significant differences between the mutational spectra with respect to sex or position in the colon. Therefore, we surmise that following induction of mutations by PhIP in male and female colons, non-mutagenic factors, possibly hormonal, preferentially influence the formation of tumors in the colon of male rats. PMID:11507243

  2. Giant Sigmoid Diverticulum: A Rare Presentation of a Common Pathology.

    PubMed

    Guarnieri, A; Cesaretti, M; Tirone, A; Francioli, N; Piccolomini, A; Vuolo, G; Verre, L; Savelli, V; Di Cosmo, L; Carli, A F

    2009-01-01

    Although colonic diverticulum is a common disease, affecting about 35% of patients above the age of 60, giant sigmoid diverticulum is an uncommon variant of which only relatively few cases have been described in the literature. We report on our experience with a patient affected by giant sigmoid diverticulum who was treated with diverticulectomy. Resection of the diverticulum is a safe surgical procedure, provided that the colon section close to the lesion presents no sign of flogosis or diverticula; in addition, recurrences are not reported after 6-year follow-up. PMID:20651957

  3. Giant Sigmoid Diverticulum: A Rare Presentation of a Common Pathology

    PubMed Central

    Guarnieri, A.; Cesaretti, M.; Tirone, A.; Francioli, N.; Piccolomini, A.; Vuolo, G.; Verre, L.; Savelli, V.; Di Cosmo, L.; Carli, A.F.

    2009-01-01

    Although colonic diverticulum is a common disease, affecting about 35% of patients above the age of 60, giant sigmoid diverticulum is an uncommon variant of which only relatively few cases have been described in the literature. We report on our experience with a patient affected by giant sigmoid diverticulum who was treated with diverticulectomy. Resection of the diverticulum is a safe surgical procedure, provided that the colon section close to the lesion presents no sign of flogosis or diverticula; in addition, recurrences are not reported after 6-year follow-up. PMID:20651957

  4. Peristalsis and fecal pellet propulsion do not require nicotinic, purinergic, 5-HT3, or NK3 receptors in isolated guinea pig distal colon.

    PubMed

    Nicholas, Sarah; Spencer, Nick J

    2010-06-01

    The neuronal mechanism by which distension of the colon triggers peristalsis and the propulsion of colonic contents is incompletely understood. In this study, we used video imaging and spatiotemporal mapping techniques to investigate the neuroneuronal mechanisms underlying peristalsis in isolated guinea pig distal colon. In direct contrast to previous studies, we found that hexamethonium (100 muM-1 mM) or mecamylamine (20 muM) never abolished peristalsis or fecal pellet propulsion, although a temporary blockade of peristalsis was common, giving the impression perhaps that peristalsis was blocked permanently. During the initiation of peristalsis, the intraluminal propulsive force applied to an inserted fecal pellet was significantly reduced by hexamethonium 100 muM, even though, once initiated, the propagation velocity of fecal pellets was never reduced by nicotinic antagonists. In the presence of hexamethonium or mecamylamine, further addition of PPADS (10 muM), ondansetron (1 muM), and SR 142801 (300 nM) had no inhibitory effect on the propagation velocity of fecal pellets. In these preparations, antagonists for nicotinic, purinergic (P2), serotonergic (5-HT3), or tachykinergic (NK3) receptors always abolished responses to the agonists for these receptors, confirming that when peristalsis occurred, nicotinic, P2, 5-HT3, and NK3 receptors were blocked. Tetrodotoxin abolished nonnicotinic peristalsis. In summary, nicotinic transmission contributes to excitatory neuroneuronal transmission underlying peristalsis and fecal pellet propulsion but is not required for peristalsis, nor fecal pellet propulsion, as once thought. These observations could be explained by an excitatory nonnicotinic neuroneuronal pathway that can generate peristalsis and induce normal fecal pellet propagation velocities but does not require nicotinic, P2, 5-HT3, or NK3 receptors. PMID:20360134

  5. Measuring Sigmoidality Paul L. Rosin

    E-print Network

    Martin, Ralph R.

    Sigmoidality 411 rates. Moreover, such intuitive, symbolic descriptors are closer to those currently used on the sigmoid shape we use y = ax3 + bx + c and miss out the x2 term to ensure a symmetric curve is fitted

  6. Palmatine, a protoberberine alkaloid, inhibits both Ca2+- and cAMP-activated Cl? secretion in isolated rat distal colon

    PubMed Central

    Wu, D Z; Yuan, J Y; Shi, H L; Hu, Z B

    2008-01-01

    Background and purpose: The protoberberine alkaloid berberine has been reported to inhibit colonic Cl? secretion. However, it is not known if other protoberberine alkaloids share these effects. We have therefore selected another protoberberine alkaloid, palmatine, to assess its effects on active ion transport across rat colonic epithelium. Experimental approach: Rat colonic mucosa was mounted in Ussing chambers and short circuit current (I SC), apical Cl? current and basolateral K+ current were recorded. Intracellular cAMP content was determined by an enzyme immunoassay. Intracellular Ca2+ concentration was measured with Fura-2 AM. Key results: Palmatine inhibited carbachol-induced Ca2+-activated Cl? secretion and the carbachol-induced increase of intracellular Ca2+ concentration. Palmatine also inhibited cAMP-activated Cl? secretion induced by prostaglandin E2 (PGE2) or forskolin. Palmatine prevented the elevation of intracellular cAMP by forskolin. Determination of apical Cl? currents showed that palmatine suppressed the forskolin-stimulated, apical cAMP-activated Cl? current but not the carbachol-stimulated apical Ca2+-activated Cl? current. Following permeabilization of apical membranes with nystatin, we found that palmatine inhibited a carbachol-stimulated basolateral K+ current that was sensitive to charybdotoxin and resistant to chromanol 293B. However, the forskolin-stimulated basolateral K+ current inhibited by palmatine was specifically blocked by chromanol 293B and not by charybdotoxin. Conclusions and implications: Palmatine attenuated Ca2+-activated Cl? secretion through inhibiting basolateral charybdotoxin-sensitive, SK4 K+ channels, whereas it inhibited cAMP-activated Cl? secretion by inhibiting apical CFTR Cl? channels and basolateral chromanol 293B-sensitive, KvLQT1 K+ channels. PMID:18204477

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

    PubMed Central

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

    2008-01-01

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

  8. Role of the vasopressin V(1) receptor in regulating the epithelial functions of the guinea pig distal colon.

    PubMed

    Sato, Y; Hanai, H; Nogaki, A; Hirasawa, K; Kaneko, E; Hayashi, H; Suzuki, Y

    1999-10-01

    Vasopressin has a wide spectrum of biological action. In this study, the role of vasopressin in regulating electrolyte transport in the colon was elucidated by measuring the short-circuit current (I(sc)) as well as the Na(+), K(+), and Cl(-) flux in a chamber-mounted mucosal sheet. The cytosolic Ca(2+) concentration ([Ca(2+)](i)) was also measured in fura 2-loaded cells by fluorescence imaging. Serosal vasopressin decreased I(sc) at 10(-9) M and increased I(sc) at 10(-7)-10(-6) M. The decrease in I(sc) was accompanied by two effects: one was a decrease in the amiloride-sensitive Na(+) absorption, whereas the other was an increase in the bumetanide-sensitive K(+) secretion. The increase in I(sc) was accompanied by an increase in the Cl(-) secretion that can be inhibited by serosal bumetanide or mucosal diphenylamine-2-carboxylate. Vasopressin caused an increase in [Ca(2+)](i) in crypt cells. These responses of I(sc) and the [Ca(2+)](i) increase in crypt cells were all more potently inhibited by the vasopressin V(1) receptor antagonist than by the V(2) receptor antagonist. These results suggest that vasopressin inhibits electrogenic Na(+) absorption and stimulates electrogenic K(+) and Cl(-) secretion. In all of these responses, the V(1) receptor is involved, and the [Ca(2+)](i) increase may play an important role. PMID:10516148

  9. Propionate-induced epithelial K(+) and Cl(-)/HCO3(-) secretion and free fatty acid receptor 2 (FFA2, GPR43) expression in the guinea pig distal colon.

    PubMed

    Karaki, Shin-ichiro; Kuwahara, Atsukazu

    2011-01-01

    Propionate, a fermented product in the lumen of the large intestine, is a short-chain fatty acid (SCFA) known to have a variety of localized physiological and pathophysiological functions (e.g., luminal fluid secretion and anti-inflammatory response). In the present study, we investigated propionate-induced transepithelial ion transport and the expression of SCFA receptor, free fatty acid receptor 2 (FFA2, otherwise known as GPR43) in the guinea pig distal colon utilizing the Ussing chamber technique and immunohistochemistry. The addition of propionate to the luminal bathing solution concentration-dependently induced transient K(+) and Cl(-) and/or bicarbonate secretion within approximately 30 s and long-lasting Cl(-) secretion for approximately 60 min was first identified in the present study. The transient anion secretion was tetrodotoxin (TTX)-sensitive and mediated through the cholinergic (both nicotinic and muscarinic) neural pathway, but the transient K(+) and long-lasting Cl(-) secretion were due to TTX-insensitive mechanism. Immunohistochemistry studies showed that some chromogranin A-immunoreactive enteroendocrine cells were also immunoreactive for FFA2 but not colocalized with 5-hydroxytryptamine. In conclusion, the propionate-induced secretion consisted of the neural and non-neural three-phase secretory manner possibly mediated by the stimulation of FFA2 expressed by enteroendocrine cells. PMID:20945073

  10. 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

  11. Laparoscopic excision of mesenteric cyst of sigmoid mesocolon

    PubMed Central

    Bhandarwar, Ajay H; Tayade, Mukund B; Borisa, Ashok D; Kasat, Gaurav V

    2013-01-01

    Mesenteric cysts are rare abdominal tumours. They are found in the mesentery of small bowel (66%) and mesentery of large intestine (33%), usually in the right colon. Very few cases have been reported of tumours found in mesentery of descending colon, sigmoid or rectum. Mesenteric cysts do not show classical clinical findings and are detected incidentally during imaging due to absent or non-specific clinical presentation or during management of one of their complications. Ultrasonography (USG)/computed tomography (CT)/ magnetic resonance imaging (MRI) are used in diagnosing mesenteric cyst but they cannot determine the origin of cyst. Laparoscopy not only helps in diagnosing the site and origin of the mesenteric cyst but also has a therapeutic role. Laparoscopic treatment of mesenteric cyst is a safe, preferred method of treatment and is a less-invasive surgical technique. Here, we present an unusual case of mesenteric cyst arising from the sigmoid mesocolon treated by laparoscopic excision. PMID:23626420

  12. 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

  13. 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

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

    PubMed Central

    O’Hara, Bryan; de la Rosa, Diego Alvarez; 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

  15. 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

  16. 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 ...

  17. Sigmoid diverticulitis with perforation and generalized peritonitis

    Microsoft Academic Search

    David M. Nagorney; Martin A. Adson; John H. Pemberton

    1985-01-01

    Sigmoid diverticulitis with perforation and generalized peritonitis is a grave complication of diverticular disease. To compare\\u000a accurately the results of two operative approaches—proximal colostomy with drainage and proximal colostomy with resection\\u000a or exteriorization—the authors assessed the clinical and pathologic features of 121 consecutive patients with perforating\\u000a sigmoid diverticulitis. There were no differences between treatment groups in age, sex, mean duration

  18. Sigmoids as precursors of solar eruptions

    Microsoft Academic Search

    Richard C. Canfield; Hugh S. Hudson; Alexei A. Pevtsov

    2000-01-01

    Coronal mass ejections (CMEs) appear to originate preferentially in regions of the Sun's corona that are sigmoidal, i.e., have sinuous S or reverse-S shapes. Yohkoh solar X-ray images have been studied before and after a modest number of Earth-directed (halo) CMEs. These images tend to show sigmoidal shapes before the eruptions and arcades, cusps, and transient coronal holes after. Using

  19. 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

  20. Motor effects of locally administered pinaverium bromide in the sigmoid tract of patients with irritable bowel syndrome.

    PubMed

    Passaretti, S; Sorghi, M; Colombo, E; Mazzotti, G; Tittobello, A; Guslandi, M

    1989-01-01

    The effects of pinaverium bromide, a non-absorbable antispasmodic agent, administered locally, on sigmoid-rectal motility was investigated in 20 patients with irritable bowel syndrome. The influence of either pinaverium (10 subjects) or placebo (10 subjects) on a neostigmine-induced increase of sigmoid pressure was assessed and compared by means of computerized electromanometry. The drug was found to counteract significantly the motor effects of neostigmine, thus appearing to be an effective compound for the treatment of functional disorders of the colon. PMID:2744907

  1. Fibrin Sealant Injection: An Aid to Reduce Venous Bleeding during Jugular Bulb and Sigmoid Sinus Dissection in Glomus Jugulare (Jugulotympanic Paraganglioma) Surgery

    PubMed Central

    List, Richard James; Thomas, Sebastien Philippe Henry; Shenouda, Emad; Lang, Dorothy; Davis, Anne; Mathad, Nijaguna

    2011-01-01

    Glomus jugulare (jugulotympanic paraganglioma) surgery requires tumor dissection in the region of the jugular bulb, upper internal jugular vein, and sigmoid sinus. Despite ligation or external compression of the sigmoid sinus proximally and ligation of the internal jugular vein distally, troublesome venous bleeding can arise from the inferior petrosal sinus or condylar veins at the medial wall of the jugular bulb. Excessive packing in this area can place the integrity of the lower cranial nerves at risk. We report a technique in which Tisseel® fibrin sealant is injected into the ligated sigmoid sinus and internal jugular vein. This forms an internal cast around the tumor in the sigmoid-jugular complex and helps seal the inferior petrosal sinus and condylar veins. This allows for safer dissection with reduced venous bleeding. Our experience in five cases has shown this technique to be effective. PMID:22451831

  2. Fibrin Sealant Injection: An Aid to Reduce Venous Bleeding during Jugular Bulb and Sigmoid Sinus Dissection in Glomus Jugulare (Jugulotympanic Paraganglioma) Surgery.

    PubMed

    List, Richard James; Thomas, Sebastien Philippe Henry; Shenouda, Emad; Lang, Dorothy; Davis, Anne; Mathad, Nijaguna

    2011-09-01

    Glomus jugulare (jugulotympanic paraganglioma) surgery requires tumor dissection in the region of the jugular bulb, upper internal jugular vein, and sigmoid sinus. Despite ligation or external compression of the sigmoid sinus proximally and ligation of the internal jugular vein distally, troublesome venous bleeding can arise from the inferior petrosal sinus or condylar veins at the medial wall of the jugular bulb. Excessive packing in this area can place the integrity of the lower cranial nerves at risk. We report a technique in which Tisseel(®) fibrin sealant is injected into the ligated sigmoid sinus and internal jugular vein. This forms an internal cast around the tumor in the sigmoid-jugular complex and helps seal the inferior petrosal sinus and condylar veins. This allows for safer dissection with reduced venous bleeding. Our experience in five cases has shown this technique to be effective. PMID:22451831

  3. Irritable bowel syndrome: A test of the colonic hyperalgesia hypothesis

    Microsoft Academic Search

    Paul Latimer; Dugal Campbell; Margaret Latimer; Sushil Sarna; Ed Daniel; William Waterfall

    1979-01-01

    This study tested the hypothesis that, in patients with irritable bowel syndrome (IBS), there is a primary hyperalgesia of the colon. Previous work, which examined these patients and normals, has not included subjects who provide a control for relevant psychological characteristics. We compared ratings of pain, following varying degrees of distension of the sigmoid colon, in normals, patients with IBS,

  4. The Evolution of Sigmoidal Active Regions

    NASA Astrophysics Data System (ADS)

    Savcheva, Antonia

    2013-07-01

    The formation, evolution and eruption of solar active regions are among the main themes of research in solar physics. Special kinds of S-shaped active regions (sigmoids) facilitate this line of research, since they provide conditions that are easier to disentangle and have been shown to possess high probability for erupting as flares and/or coronal mass ejections (CME). Several theories have been proposed for the formation, evolution, and eruption of solar active regions. Testing these against detailed models of sigmoidal regions can provide insight into the dominant mechanisms and conditions required for eruption. We explore the behavior of solar sigmoids via both observational and magnetic modeling studies. Data from the most modern space-based solar observatories are utilized in addition to state-of-the-art, three-dimensional, data-driven magnetic field modeling to gain insight into the physical processes controlling the evolution and eruption of solar sigmoids. We use X-ray observations and the magnetic models to introduce the underlying magnetic and plasma structure defining these regions. By means of a large, comprehensive observational study, we look at the formation and evolution mechanism. Specifically, we apply additional analysis to show that flux cancellation is a major mechanism for building the underlying magnetic structure associated with sigmoids, namely magnetic flux ropes. We make use of topological analysis to describe the complicated magnetic field structure of the sigmoids. We show that when data-driven models are used in sync with MHD simulations and observations, we can arrive at a consistent picture of the scenario for CME onset, namely the positive feedback between reconnection at a generalized X-line and the torus instability.

  5. An Unusual Complication of a Colonic Wallstent

    SciTech Connect

    Low, Deborah E.; Panto, Philip N. [Kings Mill Hospital, Department of Radiology (United Kingdom); Hastings, Andrew G. [Kings Mill Hospital, Department of Pathology (United Kingdom); Nigam, Keshav [Kings Mill Hospital, Department of Surgery (United Kingdom)

    2004-08-15

    We report a case of delayed perforation of normal colonic wall by the wire tips of an enteral Wallstent, which had successfully been used to treat a malignant obstruction of the sigmoid colon. Perforation occurred 5 days following insertion and despite surgery, resulted in fatality. Though perforation at the tumor site is a recognized complication during or following colonic stent placement, it is rare for the ends of the stent to perforate through nondiseased bowel wall. The site of the obstructing lesion and thus the position of the stent on a bend in the colon may be a contributory factor.

  6. Virtual Colonoscopy: An Alternative Approach to Examination of the Entire Colon

    E-print Network

    and women in the United States, following lung cancer, with 56,000 deaths reported in 1998 and an estimated-15% sigmoid colon carcinomas [5, 10, 15, 37]). While optical colonoscopy is accurate and can biopsy detected

  7. Distal splenorenal shunt

    MedlinePLUS

    ... splenic venous shunt; Warren shunt; Cirrhosis - distal splenorenal; Liver failure - distal splenorenal ... the intestine, spleen, pancreas, and gallbladder to the liver. When blood flow is blocked, the pressure in ...

  8. 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

  9. Colonic Polyps

    MedlinePLUS

    ... Colonic polyps grow in the large intestine, or colon. Most polyps are not dangerous. However, some polyps ... member with polyps Have a family history of colon cancer Most colon polyps do not cause symptoms. ...

  10. Distal median nerve dysfunction

    MedlinePLUS

    ... type of distal median nerve dysfunction is carpal tunnel syndrome . ... repetitive movements increase the chance of developing carpal tunnel entrapment. Conditions that affect connective tissue or cause ...

  11. Distal Radius Attachments of the Radiocarpal Ligaments: An Anatomical Study

    PubMed Central

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

    2013-01-01

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

  12. Les amyotrophies spinales distales

    Microsoft Academic Search

    P. Devic; P. Petiot

    2011-01-01

    IntroductionDistal hereditary motor neuropathy (dHMN), also known as spinal muscular atrophy, represents a group of clinically and genetically heterogeneous diseases caused by degenerations of spinal motor neurons and leading to distal muscle weakness and wasting. Nerve conduction studies reveal a pure motor axonopathy and needle examination shows chronic denervation.

  13. 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

  14. [Megacolon and sigmoid volvulus: incidence and physiopathology].

    PubMed

    Saravia Burgos, Jaime; Acosta Canedo, Abel

    2015-01-01

    The etiology of Megacolon is multiple. One of these causes and the most frequent is Chagas disease. Its complication: sigmoid volvulus was de main diagnosis in the admitted patients at the Bolivian and Japanese Gastroenterological Institute of Cochabamba Bolivia. It usually affects people of a low economic income. In this Gastroenterological Hospital a transversal and prospective study has been done, in order to know the real incidence and the physiopathology of this disease. In a six year period, from 2000 to 2006, 8.954 patients were admitted to the Hospital: of these, 814 (9.09%), where diagnosticated as lower intestinal obstruction. In 608 (74.7%) the final diagnosis was sigmoid torsion. Radiological diagnosis was made in 84% of the patients and endoscopic decompression was successful in 88.7%. As reported in the medical literature, the main cause of megacolon in this part of the world is Chagas disease. In our investigation 22% (98 patients), were serology positive to Chagas disease, and another 21.44% (95 patients) were serology negative. They were coca leaf chewers. One of coca leaf compounds is cocaine which blocks the adrenaline and noradrenaline degradation by mean of monoamine oxidase inactivation. These two hormones stay a long term of time in the target organ: the large bowel. By this mean chronic and persistent vessel constriction develops intestinal wall atrophy and lower resistance to the intraintestinal pressure. PMID:25875517

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

    Microsoft Academic Search

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

    2010-01-01

    Studies have suggested that red and processed meat consumption elevate the risk of colon cancer; however, the relationship between red meat, as well as fat and protein, and distal colorectal cancer (CRC) specifically is not clear. We determined the risk of distal CRC associated with red and processed meat, fat, and protein intakes in Whites and African Americans. There were

  16. Leaf surface roughness influences colonization success of aquatic hyphomycete conidia

    Microsoft Academic Search

    Sheamus G. Kearns; Felix Bärlocher

    2008-01-01

    Aquatic hyphomycetes are primary colonizers and decomposers of deciduous leaves decaying in streams. Conidial attachment to new substrata is a crucial first step in their life cycle, and the dominant spore morphologies – multiradiate or sigmoid – are assumed to have been shaped by convergent evolution to increase the probability of attachment to a substratum. Another factor influencing attachment success

  17. Synchronous primary adenocarcinoma and ancient schwannoma in the colon: an unusual case report.

    PubMed

    Vasilakaki, T; Skafida, E; Arkoumani, E; Grammatoglou, X; Tsavari, K Koulia A; Myoteri, D; Mavromati, E; Manoloudaki, K; Zisis, D

    2012-01-01

    Gastrointestinal schwannomas are uncommon stromal tumors of the intestinal tract and colon schwannomas are extremely rare. We report a rare case of ascending colon schwannoma with associated synchronous adenocarcinoma of the sigmoid colon. A 68-year-old man presented with a 20-day history of bleeding per rectum. Colonoscopy revealed a mass of 4.2 cm in diameter with endoluminal protrusion in the sigmoid colon and a second submucosal tumor in the ascending colon. Surgical intervention was suggested and ileo-hemicolectomy was done. Microscopically, the submucosal tumor of 4 cm in diameter showed features of schwannoma with degenerative change (ancient schwannoma). Lesional cells were positive for S100p and negative for actin, desmin, CD34, CD117, and pankeratin. The mass showed features of an invasive moderately differentiated adenocarcinoma. Colon schwannoma is a rare submucosal tumor, and the incidental occurrence with adenocarcinoma has not been well described in the literature. PMID:22666207

  18. Delayed Presentation of Sigmoid Volvulus in a Young Woman

    PubMed Central

    Weingrow, Daniel; McCague, Andrew; Shah, Ravi; Lalezarzadeh, Fariborz

    2012-01-01

    Volvulus is an unusual condition in Western countries, generally isolated to elderly patients with multiple comorbidities. This report describes an unusual case of a very large gangrenous sigmoid volvulus in a young, otherwise healthy 25-year-old female. A review of the diagnosis and management is subsequently described. Without a consideration of the atypical demographics for sigmoid volvulus, the case illustrates the potential morbidity due to a delayed diagnosis. Early identification and management are crucial in treating sigmoid volvulus before the appearance of gangrene and necrosis, thereby avoiding further complications and associated mortality. PMID:22461935

  19. Properties of magnetic clouds and geomagnetic storms associated with eruption of coronal sigmoids

    Microsoft Academic Search

    Robert J. Leamon; Richard C. Canfield; Alexei A. Pevtsov

    2002-01-01

    (1) We study 46 solar coronal eruptions associated with sigmoids seen in images from the Yohkoh Soft X-ray Telescope (SXT). We relate the properties of the sigmoids to in situ measurements at 1 AU and geomagnetic storms. Our primary result is that erupting sigmoids tend to produce geoeffective magnetic clouds (MCs): 85% of the erupting sigmoidal structures studied spawned at

  20. Does magnetic stimulation of sacral nerve roots modify colonic motility? Results of a randomized double-blind sham-controlled study.

    PubMed

    Gallas, S; Gourcerol, G; Ducrotté, P; Mosni, G; Menard, J-F; Michot, F; Leroi, A-M

    2009-04-01

    Although sacral nerve root stimulation (SNS) can result in a symptomatic improvement of faecal incontinence, the mechanism of action remains unknown. The aim of this study was to assess whether short-term magnetic SNS can inhibit pharmacologically induced propulsive colonic contractions. Twelve healthy volunteers (median age: 43.5 years old) were studied on two separate occasions and randomized into either active (15 Hz, 100% output intensity for 5 s min(-1) for 30 min) or sham rapid rate lumbosacral magnetic stimulation (rLSMS). Colorectal motility was recorded with a manometric catheter located at the most proximal transducer in the left colon and the most distal, in the rectum. Colonic contractions were provoked by instilling Bisacodyl. The effects of rLSMS on colonic, sigmoid and rectal contractions were monitored and recorded after Bisacodyl instillation. The appearance of high-amplitude contractions propagated or not (HAC/HAPC) provoked by Bisacodyl instillation was significantly delayed during active compared to sham stimulation (P = 0.03). There was no difference in the characteristics of HAC/HAPC (i.e. frequency, amplitude, duration, velocity of propagation) or the motility index with active or sham stimulation. The perception of urgency tended to be decreased with rLSMS following Bisacodyl instillation. The catheter was expulsed within a median of 16.5 min (range 8-39) after Bisacodyl administration during active stimulation compared to 14 min (range 5-40) during sham stimulation (P = 0.03). This study suggests that rLSMS could delay the appearance of the first Bisacodyl-induced colonic contractions. PMID:19126187

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

    Microsoft Academic Search

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

    2011-01-01

    We applied constrained ordination numerical ecology methods to data produced with a human intestinal tract-specific phylogenetic microarray (the Aus-HIT Chip) to examine the microbial diversity associated with matched biopsy tissue samples taken from the caecum, transverse colon, sigmoid colon and rectum of 10 healthy patients. Consistent with previous studies, the profiles revealed a marked intersubject variability; however, the numerical ecology

  2. [Vesico-sigmoidal fistulas of diverticular origin].

    PubMed

    Benchimol, D; Lagautrière, F; Richelme, H

    1995-01-01

    From 1984 to 1993, 11 patients (7 men and 4 women, mean aged 70 years) underwent surgical procedure for sigmoido-vesical fistula due to diverticulitis. Fecaluria and/or pneumaturia was present in 10 patients. The diagnosis of sigmoido-vesical fistula due to diverticulitis was confirmed by urologic and colonic investigations. All patients underwent surgical treatment. One patient underwent creation of a diverting colostomy alone because of a poor general status. Definitive surgical correction of the fistula with resection of the diverticular colon was attempted in the remaining 10 patients, including colo-rectal anastomosis. A temporary diverting colostomy was performed in 5 cases. There was no post operative death. One small wound infection occurred. All the diverting colostomies have been closed, meanly 2 months after the operation. Concerning long-term results, 3 patients died from an independant reason. All the other patients are alive and asymptomatic from the urologic as well as the digestive point of view. Based on these results, we advocate single stage repair, including correction of the fistula and resection of the diverticular colon with colo rectal anastomosis, in cases of good local and general conditions. PMID:7771753

  3. 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

  4. Absolute constipation caused by sigmoid volvulus in a young man

    PubMed Central

    Nuevo, Sergio Pozo; Macías Robles, María Dolores; Sevillano, Ramón Delgado; Pérez-Gallarza, Susana Serrano

    2013-01-01

    We describe a challenging case of sigmoid volvulus where a previously unrecognised anatomical condition, rather than the patient's age, was the main predisposing factor. A man in his thirties presented to the emergency department with a 3-day history of constipation and acute abdominal pain. Initial assessment and studies were inconclusive, but a CT scan revealed torsion of the large bowelSigmoid volvulus is a frequent cause of bowel obstruction that can be missed if appropriate imaging is not available. Clinical presentation and blood analysis can be similar to the findings in acute abdomen caused by other more common causes. PMID:23744852

  5. Metatarsalgia: distal metatarsal osteotomies.

    PubMed

    Schuh, Reinhard; Trnka, Hans Joerg

    2011-12-01

    Metatarsalgia is a common pathologic entity. It refers to pain at the MTP joints. Pain in the foot unrelated to the MTP joints (such as Morton’s neuroma) must be distinguished from those disorders, which lead to abnormal pressure distribution, reactive calluses, and pain. Initial treatment options for metatarsalgia include modifications of shoe wear, metatarsal pads, and custom-made orthoses. If conservative treatment fails, operative reconstructive procedures in terms of metatarsal osteotomies should be considered. Lesser metatarsal osteotomy is an effective and well-accepted method for the management of metatarsalgia. The main purpose of these osteotomies is to decrease prominence of the symptomatic metatarsal head. The distal metatarsal oblique osteotomy (Weil osteotomy) with its modification represents the best evaluated distal metatarsal osteotomy in terms of outcome studies and biomechanical analysis. The role of the Weil osteotomy in metatarsalgia owing to a subluxed or dislocated MTP joint is to bring the metatarsal head proximal to the callus and to provide axial decompression of the toe to correct the deformity contributing to metatarsalgia. PMID:22118231

  6. Objective assessment of the antispasmodic effect of Shakuyaku-kanzo-to (TJ-68), a Chinese herbal medicine, on the colonic wall by direct spraying during colonoscopy

    Microsoft Academic Search

    Masato Ai; Taketo Yamaguchi; Takeo Odaka; Kanae Mitsuhashi; Tadayuki Shishido; Jun Yan; Ayaka Seza; Hiromitsu Saisho

    AIM: To objectively evaluate the effect of TJ-68 on colonic spasms during colonoscopy. METHODS: One hundred and one patients subjected to screening colonoscopy were randomly assigned to two groups: TJ-68 in 51 subjects and saline as the control in 50. The endoscope was inserted into the sigmoid colon, then a spastic region was identifi ed and the tip of the

  7. The use of endoscopic biopsy in evaluation of polypoid lesions of the colon.

    PubMed Central

    Barwick, K. W.

    1986-01-01

    Use of flexible endoscopes affords biopsy sampling of polypoid lesions of the colon, especially within the rectum and sigmoid colon by flexible fiberoptic sigmoidoscopes. Histologic examination of colonic biopsies usually allows division of polyps into neoplastic and non-neoplastic categories. There are significant limitations to such biopsies, however, due to sampling error and inability to reach deep submucosal cores of polyps where malignant invasion may occur. When properly aware of its limitations, the endoscopist will find the endoscopic biopsy a valuable aid in planning the therapeutic approach to a polypoid lesion of the colon. Images FIG. 1 FIG. 2 FIG. 3 FIG. 4 FIG. 5 FIG. 6 FIG. 7 PMID:3962341

  8. Cathartic colon

    Microsoft Academic Search

    Richard H. Marshak; Arnold Gerson

    1960-01-01

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

  9. Learning from Multiple Graphs using a Sigmoid Thomas Ricatte

    E-print Network

    Paris-Sud XI, Université de

    Learning from Multiple Graphs using a Sigmoid Kernel Thomas Ricatte SAP Research Gemma Garriga Lille Abstract--This paper studies the problem of learning from a set of input graphs, each of them be used for different graph learning tasks. We consider two combination methods: the (classical) linear

  10. Local inhibition of myoelectrical activity of human colon by loperamide

    Microsoft Academic Search

    Ivan Altaparmakov; Martin Wienbeck

    1984-01-01

    In order to study whether the antidiarrheal effects of loperamide are largely brought about by a local inhibition of the drug, we applied doses of 0.2 mg directly on the mucosa of the descending and sigmoid colon of 33 healthy volunteers. Loperamide decreased BER frequencies and reduced spike activity to 6.6±0.3% of time vs 11.3±0.7% in the control recorded from

  11. Case report: Colonic bezoar due to Box Myrtle seeds: A very rare occurrence

    PubMed Central

    Chauhan, Narvir Singh; Sood, Dinesh

    2011-01-01

    Large bowel seed bezoars are rare and are mostly due to seeds of sunflower, prickly pear cactus, sesame and cucumber. We present a rare case of sigmoid colon seed bezoar due to Box Myrtle seeds because of an underlying benign stricture. PMID:21431028

  12. Giant extraluminal leiomyoma of the colon: rare cause of symptomatic pelvic mass.

    PubMed

    Sagnotta, Andrea; Sparagna, Alessandra; Uccini, Stefania; Mercantini, Paolo

    2015-05-01

    Leiomyomas (LMs) may appear throughout the entire gastrointestinal tract but are rarely seen in the colon-rectum and only 5 of those measured greater than 15 cm in diameter. Pain and palpable abdominal mass are the most common symptoms. Surgical resection is the treatment of choice for most LMs. We here describe a case of a 46-year-old woman who presented with a 3-month history of abdominal pain associated with worsening constipation and abdominal distension. A pelvic solid, polylobulate, left-sided mass was noted on examination. Preoperative findings revealed a dishomogeneous sigmoid mass with calcified spots compressing small intestine and bladder. At laparotomy, a large polylobulate and well-circumscribed mass arising from the descending colon mesentery and displacing small intestine, uterus, and ovaries. A segmental colon resection was performed. An extraluminal 18- × 12- × 5-cm paucicellular sigmoid colon leiomyoma was histologically diagnosed. Our case is one of the few giant (>15 cm) sigmoid colon LMs reported in the literature. Although rare and benign in nature, LMs of the colon can cause life-threatening complications that could require emergency treatment and they should be included in the differential diagnosis of large abdominopelvic masses. Follow-up after surgery is necessary for tumors with any atypia or mitotic activity. PMID:26011198

  13. Distal plate placement for distal radius fractures limits wrist motion

    Microsoft Academic Search

    Shingo Komura; Hiroyuki Tanahashi; Yoshihisa Yamada; Tatsuo Yokoi; Hidehiko Nonomura; Yasushi Suzuki

    Purpose  To investigate the influence of distal plate placement for distal radius fractures on risk of flexor tendon complications\\u000a and wrist motion by performing hardware removal.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  Fourteen patients treated with a Synthes 2.4 mm juxta-articular LCP Distal Radius Plate underwent hardware removal at ?6 months\\u000a postoperatively when improvement of range of motion and grip strength were obtained. Location of plate placement,

  14. Cathartic colon

    Microsoft Academic Search

    William L. Campbell

    1983-01-01

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

  15. Genetics and Pathogenesis of Distal Muscular Dystrophies

    Microsoft Academic Search

    Bjarne Udd

    \\u000a Distal myopathies are distal muscular dystrophies because they are genetic disorders with progressive loss of muscle tissue.\\u000a The true distal dystrophies not only show a distal onset; they also remain more distal than proximal throughout the course\\u000a of the disease. Currently almost 20 different entities of distal muscular dystrophies have been genetically determined, compared\\u000a to just five entities delineated on

  16. 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

  17. 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

  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. Distal convoluted tubule.

    PubMed

    McCormick, James A; Ellison, David H

    2015-01-01

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

  20. On the Circuit Complexity of Sigmoid Feedforward Neural Networks.

    PubMed

    Taylor, John G.; Beiu, Valeriu

    1996-10-01

    This paper aims to examine the circuit complexity of sigmoid activation feedforward artificial neural networks by placing them amongst several classic Boolean and threshold gate circuit complexity classes. The starting point is the class NN(k) defined by [Shawe-Taylor et al. (1992)] Classes of feedforward neural nets and their circuit complexity. Neural Networks 5(6), 971-977. For a better characterisation, we introduce two additional classes NN(k)(Delta) and NN(k)(Delta,epsilon) having less restrictive conditions than NN(k) concerning fan-in and accuracy, and proceed to prove relations amongst these three classes and well established circuit complexity classes. For doing that, a particular class of Boolean functions F(Delta) is first introduced and we show how a threshold gate circuit can be recursively built for any f(Delta) belonging to F(Delta). As the G-functions (computing the carries) are f(Delta) functions, a class of solutions is obtained for threshold gate adders. We then constructively prove the inclusions amongst circuit complexity classes. This is done by converting the sigmoid feedforward artificial neural network into an equivalent threshold gate circuit [Shawe-Taylor et al. (1992)]. Each threshold gate is then replaced by a multiple input adder having a binary tree structure, relaxing the logarithmic fan-in condition from ([Shawe-Taylor et al. 1992]) to (almost) polynomial. This means that larger classes of sigmoid activation feedforward neural networks can be implemented in polynomial size Boolean circuits with a small constant fan-in at the expense of a logarithmic factor increase in the number of layers. Similar results are obtained for threshold circuits, and are liked with the previous ones. The main conclusion is that there are interesting fan-in dependent depth-size tradeoffs when trying to digitally implement sigmoid activation feedforward neural networks. Copyright 1996 Elsevier Science Ltd PMID:12662590

  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

    Lam, Lilian H; Monack, Denise M

    2014-12-01

    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. A hemangioma of the sigmoid colon mesentery presenting as a retroperitonealtumor: a case report and review

    PubMed Central

    2014-01-01

    Hemangiomas of the gastrointestinal tract and mesentery are uncommon benign vascular lesions. While spontaneous bleeding is the hallmark of the gastrointestinal tumor variant, clinical signs of mesenteric hemangiomas are mostly unspecific. Despite the increasing imaging quality of computerized tomography (CT), in most cases the final diagnosis is established through surgery and histopathologic analysis of a macrobiopsy. We present a case report of a 20-year-old female patient who was admitted with progressive abdominal distension and suffered from persistent abdominal pain for 3 months. A large retroperitoneal tumor mass was detected on the CT scan. Due to radiographic signs of an intraabdominal liposarcoma, an explorative laparotomy was performed revealing a large hemangioma originating from the mesosigmoid. Although rare, gastrointestinal hemangiomas should be kept in mind by oncological visceral surgeons as one differential diagnosis of large intraabdominal tumorous masses, especially in young adults. PMID:24684941

  4. Differential gene expression in colon cancer of the caecum versus the sigmoid and rectosigmoid

    Microsoft Academic Search

    K Birkenkamp-Demtroder; S H Olesen; F B Sørensen; S Laurberg; P Laiho; L A Aaltonen; T F Ørntoft

    2005-01-01

    Background and aims: There are epidemiological, morphological, and molecular differences between normal mucosa as well as between adenocarcinomas of the right and left side of the large bowel. The aim of this study was to investigate differences in gene expression.Methods: Oligonucleotide microarrays (GeneChip) were used to compare gene expression in 45 single samples from normal mucosa and sporadic colorectal carcinomas

  5. Colonic Tuberculosis

    Microsoft Academic Search

    EduardoVillanueva Sáenz; PaulinoMartínezHernández Magro; JoséFernandoÁlvarez-Tostado Fernández; MiguelValdés Ovalle

    2002-01-01

    Tubercle bacillus was discovered in 1882 by Robert Koch. With the introduction of chemotherapy for tuberculosis in the 1940s the incidence of this entity decreased. The incidence of the tuberculosis of the colon began to increase at the 1980s with the rise in numbers of patients considered as high risk for this entity, such as HIV-infected individuals, patients with chronic

  6. 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

  7. CONTRACTING AND ERUPTING COMPONENTS OF SIGMOIDAL ACTIVE REGIONS

    SciTech Connect

    Liu Rui; Wang Yuming [CAS Key Lab of Geospace Environment, Department of Geophysics and Planetary Sciences, University of Science and Technology of China, Hefei 230026 (China); Liu Chang; Wang Haimin [Space Weather Research Laboratory, Center for Solar-Terrestrial Research, NJIT, Newark, NJ 07102 (United States); Toeroek, Tibor, E-mail: rliu@ustc.edu.cn [Predictive Science Inc., 9990 Mesa Rim Road, Suite 170, San Diego, CA 92121 (United States)

    2012-10-01

    It has recently been noted that solar eruptions can be associated with the contraction of coronal loops that are not involved in magnetic reconnection processes. In this paper, we investigate five coronal eruptions originating from four sigmoidal active regions, using high-cadence, high-resolution narrowband EUV images obtained by the Solar Dynamic Observatory (SDO). The magnitudes of the flares associated with the eruptions range from GOES class B to class X. Owing to the high-sensitivity and broad temperature coverage of the Atmospheric Imaging Assembly (AIA) on board SDO, we are able to identify both the contracting and erupting components of the eruptions: the former is observed in cold AIA channels as the contracting coronal loops overlying the elbows of the sigmoid, and the latter is preferentially observed in warm/hot AIA channels as an expanding bubble originating from the center of the sigmoid. The initiation of eruption always precedes the contraction, and in the energetically mild events (B- and C-flares), it also precedes the increase in GOES soft X-ray fluxes. In the more energetic events, the eruption is simultaneous with the impulsive phase of the nonthermal hard X-ray emission. These observations confirm that loop contraction is an integrated process in eruptions with partially opened arcades. The consequence of contraction is a new equilibrium with reduced magnetic energy, as the contracting loops never regain their original positions. The contracting process is a direct consequence of flare energy release, as evidenced by the strong correlation of the maximal contracting speed, and strong anti-correlation of the time delay of contraction relative to expansion, with the peak soft X-ray flux. This is also implied by the relationship between contraction and expansion, i.e., their timing and speed.

  8. Contracting and Erupting Components of Sigmoidal Active Regions

    NASA Astrophysics Data System (ADS)

    Liu, Rui; Liu, Chang; Török, Tibor; Wang, Yuming; Wang, Haimin

    2012-10-01

    It has recently been noted that solar eruptions can be associated with the contraction of coronal loops that are not involved in magnetic reconnection processes. In this paper, we investigate five coronal eruptions originating from four sigmoidal active regions, using high-cadence, high-resolution narrowband EUV images obtained by the Solar Dynamic Observatory (SDO). The magnitudes of the flares associated with the eruptions range from GOES class B to class X. Owing to the high-sensitivity and broad temperature coverage of the Atmospheric Imaging Assembly (AIA) on board SDO, we are able to identify both the contracting and erupting components of the eruptions: the former is observed in cold AIA channels as the contracting coronal loops overlying the elbows of the sigmoid, and the latter is preferentially observed in warm/hot AIA channels as an expanding bubble originating from the center of the sigmoid. The initiation of eruption always precedes the contraction, and in the energetically mild events (B- and C-flares), it also precedes the increase in GOES soft X-ray fluxes. In the more energetic events, the eruption is simultaneous with the impulsive phase of the nonthermal hard X-ray emission. These observations confirm that loop contraction is an integrated process in eruptions with partially opened arcades. The consequence of contraction is a new equilibrium with reduced magnetic energy, as the contracting loops never regain their original positions. The contracting process is a direct consequence of flare energy release, as evidenced by the strong correlation of the maximal contracting speed, and strong anti-correlation of the time delay of contraction relative to expansion, with the peak soft X-ray flux. This is also implied by the relationship between contraction and expansion, i.e., their timing and speed.

  9. 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.

  10. Rendering of virtual fixtures for MIS using generalized sigmoid functions.

    PubMed

    Ren, Jing; Patel, Rajni V; McIsaac, Kenneth A

    2006-01-01

    To avoid undesired collisions and improve the level of safety and precision, artificial potential field (APF) can be employed to generate virtual forces around protected tissue and to provide surgeons with real-time force refection through haptic feedback. In this paper, we propose a potential field-based force model using the generalized sigmoid function, and show that it can represent a large class of shapes. The proposed approach has several advantages such as computational efficiency, easily adjustable level of force reflection, and force continuity. PMID:16404096

  11. 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.

  12. Colonic Mucosa-Associated Lymphoid Tissue Lymphoma

    PubMed Central

    Akasaka, Risaburo; Chiba, Toshimi; Dutta, Amit K.; Toya, Yosuke; Mizutani, Tomomi; Shozushima, Tatsuyori; Abe, Keinosuke; Kamei, Masato; Kasugai, Satoshi; Shibata, Sho; Abiko, Yukito; Yokoyama, Naoki; Oana, Shuhei; Hirota, Shigeru; Endo, Masaki; Uesugi, Noriyuki; Sugai, Tamotsu; Suzuki, Kazuyuki

    2012-01-01

    Colonic mucosa-associated lymphoid tissue (MALT) lymphomas are rare and a definitive treatment has not been established. Solitary or multiple, elevated or polypoid lesions are the usual appearances of MALT lymphoma in the colon and sometimes the surface may reveal abnormal vascularity. In this paper we report our experience with four cases of colonic MALT lymphoma and review the relevant literature. The first patient had a smooth elevated lesion in the rectum and histopathologic examination of the biopsy from the lesion showed centrocyte-like cells infiltrating the lamina propria. Endoscopic ultrasonography (EUS) revealed thickening of the submucosa and muscularis propria. The patient underwent radiation therapy, and 9 months later a repeat colonoscopy showed complete resolution of the lesion. In case 2, colonoscopy showed a polyp in the cecum; the biopsy was diagnostic of MALT lymphoma. EUS detected a hypoechoic lesion confined to the mucosal layer of the colonic wall. The patient underwent endoscopic mucosal resection of the lesion and after 6 years of follow-up there was no evidence of recurrence. The third patient had a sessile elevated lesion in the sigmoid colon for which she underwent sigmoidectomy. Pathological examination of the surgical specimen was suggestive of MALT lymphoma. The last patient had a smooth elevated lesion in the rectum and magnification endoscopy showed irregular vascular pattern. The patient underwent endoscopic submucosal dissection, and biopsy examination showed the tumor to be MALT lymphoma. Although rare, awareness of MALT lymphoma of the colon is important to evaluate the patient appropriately and to plan further management. PMID:23012617

  13. [Fractures of the distal radius].

    PubMed

    Rueger, J M; Hartel, M J; Ruecker, A H; Hoffmann, M

    2014-11-01

    The most prevalent fractures managed by trauma surgeons are those involving the distal radius. The injury occurs in two peaks of prevalence: the first peak around the age of 10 years and the second peak around the age of 60 years. Distal radius fracture management requires sensitive diagnostics and classification. The objectives of treatment are the reconstruction of a pain-free unlimited durable functioning of the wrist and avoidance of typical fracture complications. Non-operative conservative management is generally employed for stable non-displaced fractures of the distal radius with the expectation of a good functional outcome. Unstable comminuted fractures with intra-articular and extra-articular fragment zones are initially set in a closed operation and finally by osteosynthesis. An armament of surgical implants is available for instable fractures requiring fixation. Palmar locked plate osteosynthesis has been established in recent years as the gold standard for operative management of distal radius fractures. Complex Working Group on Osteosynthesis (AO) classification type 3 fractures require extensive preoperative diagnostics to identify and treat typical associated injuries around the wrist. PMID:25398510

  14. Plasma composition in a sigmoidal anemone active region

    SciTech Connect

    Baker, D.; Van Driel-Gesztelyi, L.; Green, L. M.; Carlyle, J. [University College London, Mullard Space Science Laboratory, Holmbury St Mary, Dorking, Surrey, RH5 6NT (United Kingdom); Brooks, D. H. [College of Science, George Mason University, 4400 University Drive, Fairfax, VA 22030 (United States); Démoulin, P. [Observatoire de Paris, LESIA, CNRS, F-92195 Meudon (France); Steed, K. [Centre for Mathematical Plasma Astrophysics, KU Leuven, Celestijnenlaan 200B, B-3001 Leuven (Belgium)

    2013-11-20

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

  15. 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

  16. In Vivo Alterations of Fluid and Electrolyte Fluxes in Rat Colon by Gamma Irradiation

    Microsoft Academic Search

    Isabelle Dublineau; Brigitte Ksas; Jocelyne Aigueperse; Patrick Gourmelon; Nina M. Griffiths

    1998-01-01

    Colonic function in rats was investigated up to14 days following exposure to whole-body gammairradiation (8 Gy) using a combination of in vivo and invitro approaches. Water and electrolyte fluxes were measured in vivo under anesthesia by insertionof an agarose cylinder into the descending colon.Short-circuit current responses (Isc; basal,agonist-stimulated) of distal colon were measured invitro as were mannitol and sodium fluxes.

  17. 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

  18. Colonic mucosal necrosis following administration of calcium polystryrene sulfonate (Kalimate) in a uremic patient.

    PubMed

    Joo, Mee; Bae, Won Ki; Kim, Nam Hoon; Han, Seong Rok

    2009-12-01

    Colonic necrosis is known as a rare complication following the administration of Kayexalate (sodium polystryrene sulfonate) in sorbitol. We report a rare case of colonic mucosal necrosis following Kalimate (calcium polystryrene sulfonate), an analogue of Kayexalate without sorbitol in a 34-yr-old man. He had a history of hypertension and uremia. During the management of intracranial hemorrhage, hyperkalemia developed. Kalimate was administered orally and as an enema suspended in 20% dextrose water to treat hyperkalemia. Two days after administration of Kalimate enema, he had profuse hematochezia, and a sigmoidoscopy showed diffuse colonic mucosal necrosis in the rectum and sigmoid colon. Microscopic examination of random colonic biopsies by two consecutive sigmoidoscopies revealed angulated crystals with a characteristic crystalline mosaic pattern on the ulcerated mucosa, which were consistent with Kayexalate crystals. Hematochezia subsided with conservative treatment after a discontinuance of Kalimate administration. PMID:19949685

  19. 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 ...

  20. Angiodysplasia of the colon

    MedlinePLUS

    Vascular ectasia of the colon; Colonic arteriovenous malformation ... Angiodysplasia of the colon is mostly related to the aging and degeneration of the blood vessels. It is more common in older adults. ...

  1. 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.

  2. 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

  3. Severe cellulitis and abdominal wall emphysema following laparoscopic colonic surgery: A case report.

    PubMed

    Tanaka, Ryo; Kameyama, Hitoshi; Chida, Tadasu; Kanda, Tatsuo; Kano, Yosuke; Ichikawa, Hiroshi; Hanyu, Takaaki; Ishikawa, Takashi; Kosugi, Shin-Ichi; Wakai, Toshifumi

    2015-05-01

    Abdominal wall emphysema is a common complication of laparoscopic surgery. This condition is usually harmless; however, if an infection occurs, it can develop into a serious condition such as necrotizing fasciitis. We report a case of a 51-year-old woman suffering from severe cellulitis that spread from an area of abdominal wall emphysema after laparoscopic surgery for sigmoid colon cancer. Recognizing this complication, early diagnosis, and prompt treatment are cornerstones for successful management of this potentially fatal disease. PMID:25913586

  4. The physical origin of sigmoidal respiratory pressure-volume curves: Alveolar recruitment and nonlinear elasticity

    NASA Astrophysics Data System (ADS)

    do Amaral, R. A.; Tavares, D. M.; Lucena, L. S.; Brandão-Neto, J.

    2011-05-01

    An important unsolved problem in medical science concerns the physical origin of the sigmoidal shape of pressure-volume curves of healthy (and some unhealthy) lungs. Conventional wisdom holds that linear response, i.e., Hooke’s law, together with alveolar overdistention play a dominant role in respiration, but such assumptions cannot explain the crucial empirical sigmoidal shape of the curves. Here, we propose a theory of alveolar recruitment together with nonlinear elasticity of the alveoli. The proposed model surprisingly and correctly predicts the observed sigmoidal pressure-volume curves. We discuss the importance of this result and its implications for medical practice.

  5. Adult sigmoidorectal intussusception related to colonic lipoma: A rare case report with an atypical presentation

    PubMed Central

    Mohamed, Mohamed; Elghawy, Karim; Scholten, Donald; Wilson, Kenneth; McCann, Michael

    2015-01-01

    Introduction Adult intussusception is rare. Lipoma is the second most common benign tumor of the colon and most common to cause colonic intussusception in adults, but rare. Presentation of case A 35-years-old male presented with a history of intermittent abdominal pain and bright red rectal bleeding, with symptoms waxing and waning for one month. On physical examination, the abdomen was distended with tenderness over the periumbilical, suprapubic, and left lower quadrant regions with guarding. CT demonstrated colo-colonic intussusception of the sigmoid colon with a 2.3 cm × 2.6 cm intra-mural lipoma of the rectosigmoid region. The patient underwent an exploratory laparotomy with partial reduction of the intussusception, sigmoid colon resection and end colostomy. Histopathology confirmed a 2.5 cm sub-mucosal lipoma without evidence of malignancy. Discussion Sixty–sixty five percent of cases with intussusception of the large bowel in adults are related to a malignant etiology and most cases of sigmoidorectal intussusception reported in the literature are secondary to underlying malignancy. Colo-colic intussusception is the most common type of intussusception in adults. The incidence of lipomas of the large intestine is reported to range from 0.035% to 4.4%. Ninety percent of colonic lipomas are submuscosal and are mostly located in the right hemicolon. Only 25% of patients with colonic lipoma develop symptoms. Colonic lipomas of the rectosigmoid region represent a very rare occurrence and subsequent etiology for sigmoidorectal intussusceptions in adults. Conclusion Colonic lipoma should be considered in the differential diagnosis of adults with intussusception, with reduction and resection leading to excellent results. PMID:25839433

  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. 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

  8. 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

  9. Hypokalemia Associated with Colonic Pseudo-Obstruction (Ogilvie's Syndrome).

    PubMed

    Sunnoqrot, Naseem; Reilly, Robert F

    2015-01-01

    We report a case of hypokalemia resulting from colonic pseudo-obstruction or Ogilvie's syndrome. Colonic pseudo-obstruction is characterized by profuse watery diarrhea that has a low sodium and high potassium concentration. It is seen in a variety of medical and surgical conditions, but its exact cause remains unknown. It is thought to result from an imbalance of sympathetic and parasympathetic input in the distal colon. The diarrhea is secretory and driven by potassium secretion rather than the inhibition of sodium reabsorption or chloride secretion, which are the most common pathophysiologic mechanisms of secretory diarrhea. Affected patients often lose >100 mmol of potassium daily. Colonic pseudo-obstruction is associated with a dramatic upregulation of the maxiK or BK potassium channel. This channel plays a prominent role in flow-mediated potassium secretion in the connecting tubule and collecting duct and is also upregulated in the distal colon in patients with advanced chronic kidney disease and end-stage renal disease. In vitro studies show that the channel is regulated by catecholamine binding to the ? receptor and cyclic AMP upregulation, somatostatin and aldosterone, insights that can be used to help guide pharmacologic therapy. Nephrologists should be aware of colonic pseudo-obstruction as a cause of extrarenal potassium loss. PMID:26120577

  10. Hypokalemia Associated with Colonic Pseudo-Obstruction (Ogilvie's Syndrome)

    PubMed Central

    Sunnoqrot, Naseem; Reilly, Robert F.

    2015-01-01

    We report a case of hypokalemia resulting from colonic pseudo-obstruction or Ogilvie's syndrome. Colonic pseudo-obstruction is characterized by profuse watery diarrhea that has a low sodium and high potassium concentration. It is seen in a variety of medical and surgical conditions, but its exact cause remains unknown. It is thought to result from an imbalance of sympathetic and parasympathetic input in the distal colon. The diarrhea is secretory and driven by potassium secretion rather than the inhibition of sodium reabsorption or chloride secretion, which are the most common pathophysiologic mechanisms of secretory diarrhea. Affected patients often lose >100 mmol of potassium daily. Colonic pseudo-obstruction is associated with a dramatic upregulation of the maxiK or BK potassium channel. This channel plays a prominent role in flow-mediated potassium secretion in the connecting tubule and collecting duct and is also upregulated in the distal colon in patients with advanced chronic kidney disease and end-stage renal disease. In vitro studies show that the channel is regulated by catecholamine binding to the ? receptor and cyclic AMP upregulation, somatostatin and aldosterone, insights that can be used to help guide pharmacologic therapy. Nephrologists should be aware of colonic pseudo-obstruction as a cause of extrarenal potassium loss.

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

    PubMed

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

    2014-11-01

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

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

    PubMed

    Sikder, A

    2000-07-01

    In this paper we discuss uniform persistence (UP) criteria of two prey- one predator systems, where we consider that the predator's diet selection is a sigmoidal function of the most profitable prey type in place of a step function of conventional diet choice theory. We also derive UP results of the system with direct interspecific competition between the prey. The role of the most profitable prey item as a keystone species, the magnitude of its carrying capacity, the ability to withstand predation of both prey species, and the ratios of their profitability values (to predators) are important to whether or not adaptive foraging may promote UP. In general, foraging decision rules play no role in UP if the alternative prey item is the keystone species. The result is also not affected by the effect of direct competitive coexistence or dominance relationship of the prey. In some cases, dominance of one of the prey species provides the most advantageous situation for ensuring UP. PMID:10958414

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

    PubMed Central

    2014-01-01

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

  14. Metachronous colonic metastasis from pancreatic cancer presenting as mechanical obstruction: a case report.

    PubMed

    Kim, Woogyeong; Lee, Yedaun

    2015-01-01

    Colonic metastasis from pancreatic cancer is extremely rare. We present the case of a 64-year-old man who developed colonic metastasis of pancreatic cancer 2years after distal pancreatectomy. The level of carbohydrate antigen 19-9 (CA19-9) was elevated to 5133.0 U/ml. Pathologic diagnosis was a metastasis from the primary pancreatic cancer. Based on the present case, colonic metastasis should be included in the differential diagnosis of colonic mass with elevated CA 19-9 and history of curative resection of primary pancreatic cancer. PMID:25735449

  15. Surgical treatment of pulsatile tinnitus caused by the sigmoid sinus diverticulum: a preliminary study.

    PubMed

    Wang, Guo-Peng; Zeng, Rong; Ma, Xiao-Bo; Liu, Zhao-Hui; Wang, Zhen-Chang; Gong, Shu-Sheng

    2015-05-01

    The sigmoid sinus diverticulum (SSD) is an increasingly recognized cause of pulsatile tinnitus (PT). Surgical reconstruction of the sigmoid sinus wall has been found to be highly effective for SSD; however, surgical techniques still need to be refined to reduce the incidence of serious postoperative complications. Moreover, scrutinizing more cases of SSD is desirable for establishing the diagnostic criteria and standardizing the surgical technique. This study was retrospectively undertaken in 28 patients who were diagnosed with SSD upon computed tomography angiography (CTA) and digital subtraction angiography findings at Beijing Tongren Hospital in China. A majority of patients (20/28) presented with SSD and accompanying sigmoid sinus wall dehiscence (SSWD). Twenty-five patients opted to undergo sigmoid sinus wall reconstruction, and 3 patients refused surgery. Following surgery, 17 patients experienced complete resolution of PT, 3 patients experienced partial resolution, and 5 patients experienced no change in PT. No serious complications were found postoperatively. A comparative analysis of the preoperative and postoperative CTA findings suggested that completely resolving SSD and the accompanying SSWD resulted in the elimination of PT. In conclusion, SSD is generally accompanied by SSWD. Sigmoid sinus wall reconstruction is a safe and effective approach for the treatment of SSD. During surgery, completely resolving both SSD and SSWD is advisable, and maintaining the normal diameter of the sigmoid sinus is imperative. PMID:26020395

  16. Predicting the presigmoid retrolabyrinthine space using a sigmoid sinus tomography classification: A cadaveric study

    PubMed Central

    de Melo, José Orlando; Klescoski, João; Nunes, Cristian Ferrareze; Cabral, Gustavo Augusto Porto Sereno; Lapenta, Mário Alberto; Landeiro, José Alberto

    2014-01-01

    Background: The presigmoid retrolabyrinthine space is characterized by a widely variable size. The main structure involved in this large variability is the sigmoid sinus. Few studies have attempted to establish a reliable classification of sigmoid sinus to predict the presigmoid retrolabyrinthine space. We used tomographic mapping of human cadaver temporal bones to classify the position of sigmoid sinus and performed a cadaveric study to assess the validity of a novel classification in predicting the presigmoid retrolabyrinthine space. Methods: Ten human cadaver temporal bones were randomly selected and subjected to fine-cut computed tomography scanning to classify the position of sigmoid sinus using a reference line. The specimens were classified into medial and lateral groups and each specimen was then subjected to mastoidectomy. The groups were compared using quantitative and qualitative analysis. Results: The medial group showed a larger distance between the sigmoid sinus and the external auditory canal and a shallower lateral semicircular canal. In the lateral group, the mastoidectomy was more demanding, and the Trautmann's triangle was typically narrower and often “hidden” medially to the sigmoid sinus. Conclusions: The tomographic classification proposed in this study predicts, in a cadaveric model, the presigmoid retrolabyrinthine space. It may help the surgeon select the best approach to reach the petroclival region and lead to safer neurological and otological surgeries. PMID:25250185

  17. Extracellular pH Regulation in Microdomains of Colonic Crypts: Effects of Short-Chain Fatty Acids

    Microsoft Academic Search

    Shaoyou Chu; Marshall H. Montrose

    1995-01-01

    It has been suggested that transepithelial gradients of short-chain fatty acids (SCFAs; the major anions in the colonic lumen) generate pH gradients across the colonic epithelium. Quantitative confocal microscopy was used to study extracellular pH in mouse distal colon with intact epithelial architecture, by superfusing tissue with carboxy SNARF-1 (a pH-sensitive fluorescent dye). Results demonstrate extracellular pH regulation in two

  18. Degree of Sigmoid Sinus Compression and the Symptom Relief Using Magnetic Resonance Angiography in Venous Pulsating Tinnitus

    PubMed Central

    Guo, Ping

    2015-01-01

    Objectives To show that mechanical compression of sigmoid sinus is effective for treatment of pulsatile tinnitus caused by sigmoid sinus enlargement, and to evaluate the relationship between the compression degree of sigmoid sinus and the tinnitus symptom relief using magnetic resonance angiography. Methods Medical records of twenty-four patients who were diagnosed with venous tinnitus caused by sigmoid sinus enlargement and underwent mechanical compression of sigmoid sinus were reviewed between April 2009 and May 2013. All these patients received computed tomography and magnetic resonance venography study before undergoing surgery and were followed for at least 4 months. Results Twenty-three patients felt relief from tinnitus three months after the surgery, and the cross-sectional area of the sigmoid sinus on the tinnitus side was compressed approximately by half (46%-69%) after the surgery. There were 4 patients whose tinnitus suddenly disappeared while lying on the operating table before operation, which may be a result of the patient's emotional tension or postural changes from standing. One of the four patients felt no relief from tinnitus after the surgery, with the cross-sectional area of the sigmoid sinus only compressed by 30%. And two patients of them had a recurrence of tinnitus about 6 months after the surgery. Seven patients had sigmoid sinus diverticula, and tinnitus would not disappear merely by eliminating the diverticulum until by compressing the sigmoid sinus to certain degree. There were 3 minor complications, including aural fullness, head fullness and hyperacusis. The preoperative low frequency conductive and sensorineural hearing loss of 7 subjects subsided. Conclusion Mechanical compression of sigmoid sinus is an effective treatment for pulsatile tinnitus caused by sigmoid sinus enlargement, even if it might be accompanied by sigmoid sinus diverticulum. A compression degree of sigmoid sinus about 54% is adequate for the relief of tinnitus symptom. Cases in which patients' tinnitus suddenly disappeared before the surgery might be excluded to improve the efficacy of surgery.

  19. Synchronous breast and colon cancer: factors determining treatment strategy

    PubMed Central

    Higgins, L; Robertson, I; Khan, W; Barry, K

    2013-01-01

    A 67-year-old woman presented with synchronous breast and colonic tumours, in the absence of family history. Following multidisciplinary discussion, the patient was started on endocrine therapy for breast cancer. Initial surgical management consisted of right hemicolectomy together with segmental resection of a serosal deposit adherent to the distal ileum, for a moderately differentiated pT4NO caecal carcinoma. Three months later, right mastectomy and axillary clearance confirmed node positive invasive ductal carcinoma. The original treatment plan was to prioritise adjuvant chemotherapy for breast cancer postmastectomy. However, the subsequent CT finding of an enlarged, suspicious mesenteric lymph node mass on repeat staging raised concern regarding its origin. Image-guided biopsy revealed metastatic colonic adenocarcinoma and the patient was switched to a colon cancer chemotherapy regime. Following adjuvant chemotherapy for colonic carcinoma, an en-bloc surgical resection of the enlarging metastatic nodal mass was performed with clear resection margins. The patient is currently asymptomatic. PMID:23845673

  20. Treatment of osteoporotic distal radius fractures

    Microsoft Academic Search

    David Ring; Jesse B. Jupiter

    2005-01-01

    Fracture of distal radius is most commonly an injury of the fit osteoporotic patient. As the population and health of older individuals continue to expand, osteoporotic distal radius fractures will become increasingly common. While many older patients have limited functional demands and can accept some deformity and wrist dysfunction, others remain very active into older age and desire optimal wrist

  1. Sigmoidal equilibria and eruptive instabilities in laboratory magnetic flux ropes

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

  2. Endoscopic findings and clinicopathologic characteristics of colonic schistosomiasis: A report of 46 cases

    PubMed Central

    Cao, Jun; Liu, Wen-Jia; Xu, Xin-Yun; Zou, Xiao-Ping

    2010-01-01

    AIM: To make a retrospective analysis of endoscopy findings and clinicopathologic characteristics of colonic schistosomiasis in order to further improve our understanding of the disease and decrease its misdiagnosis. METHODS: Endoscopy findings and clinicopathologic characteristics of 46 intestinal schistosomiasis patients were retrospectively analyzed. All the patients underwent colonoscopy and all biopsy specimens stained with hematoxylin and eosin were observed under a light microscope. RESULTS: Of the 46 colonic schistosomiasis patients, 1 was diagnosed as acute schistosomal colitis, 16 as chronic schistosomal colitis and 29 as chronic active schistosomal colitis according to their endoscopic findings and pathology. Not all patients were suspected of or diagnosed as colonic schistosomiasis. Of the 12 misdiagnosed patients, 4 were misdiagnosed as ulcerative colitis, 1 as Crohn’s disease, and 7 as ischemic colitis. The segments of rectum and sigmoid colon were involved in 29 patients (63.0%). Intact Schistosoma ova were deposited in colonic mucosa accompanying infiltration of eosinocytes, lymphocytes, and plasma cells in acute schistosomal colitis patients. Submucosal fibrosis was found in chronic schistosomal colitis patients. Among the 17 patients with a signal polyp, hyperplastic polyp, canalicular adenoma with a low-grade intraepithelial neoplastic change, tubulovillous adenoma with a high-grade intraepithelial neoplastic change were observed in 10, 5, and 2 patients, respectively. Eight out of the 46 patients were diagnosed as colonic carcinoma. CONCLUSION: Endoscopy contributes to the diagnosis of colonic schistosomiasis although it is nonspecific. A correct diagnosis of colonic schistosomiasis can be established by endoscopy in combination with its clinicopathologic characteristics. PMID:20135720

  3. Genetics Home Reference: Distal hereditary motor neuropathy, type V

    MedlinePLUS

    ... OMIM Genetic disorder catalog Conditions > Distal hereditary motor neuropathy, type V On this page: Description Genetic changes ... Reviewed August 2009 What is distal hereditary motor neuropathy, type V? Distal hereditary motor neuropathy, type V ...

  4. Genetics Home Reference: Distal hereditary motor neuropathy, type II

    MedlinePLUS

    ... OMIM Genetic disorder catalog Conditions > Distal hereditary motor neuropathy, type II On this page: Description Genetic changes ... Reviewed August 2009 What is distal hereditary motor neuropathy, type II? Distal hereditary motor neuropathy, type II ...

  5. Colonic Varices Due to Chronic Pancreatitis: A Rare Cause of Lower Gastrointestinal Bleeding

    PubMed Central

    Sato, Takahiro; Hirayama, Atsushi

    2015-01-01

    A 75-year-old man with chronic pancreatitis presented with painless bloody stool. Computed tomography revealed a splenic vein occlusion with several collaterals towards the descending colon. Colonoscopy showed tortuous varices in the descending colon, which suggested recent bleeding. Sinistral portal hypertension (SPH) due to chronic pancreatitis was diagnosed, so splenectomy and distal pancreatectomy were performed. Our case illustrates a rare complication of SPH.

  6. Atresia of the Colon Associated with Hirschsprung's Disease.

    PubMed

    Diaz, Diana N; Eftekhari, Kambiz

    2015-05-01

    Atresia of the colon is a rare anomaly with an incidence of between 1:20,000 and 1:66,000 live births being reported. Hirschsprung's disease association with Colonic atresia is usually diagnosed after several failures of intestinal anastomoses. We herein report one of the first patients in the literature diagnosed before a therapeutic challenge. A 2-day-old female was admitted with severe abdominal distention, bilious vomiting and failure to pass meconium. A distended abdomen accompanied by hypoactive bowel sounds was also observed. Abdominal X-ray revealed increased intestinal gas, mainly in the colon. Type IIIa atresia of the colon at the level of the splenic flexure was found at laparotomy. A temporary double-barrel colostomy was completed, and she was discharged from hospital on the tenth day after operation without any complications. At the age of 3 months, due to the aspect of the distal colon, a rectal biopsy was performed and aganglionosis was confirmed. The combination of intestinal aganglionosis and colonic atresia is extremely rare.  The concomitance of colonic atresia and aganglionosis is calculated to be in 1 in 10 million live births. Wilson, et al. claims that 80 percent of infants with colonic atresia have associated gastrointestinal anomalies. These defects include rotation and fixation anomalies. However, aganglionosis and intestinal neuronal dysplasia should be taken into account as well. When both diseases are combined, the etiology is still uncertain and several etiologies have been suggested. The association should be suspected in all cases of colonic atresia and rectal biopsies are advocated at the primary operation in patients with atresia of the colon. PMID:25959916

  7. The distal hereditary motor neuropathies.

    PubMed

    Rossor, Alexander M; Kalmar, Bernadett; Greensmith, Linda; Reilly, Mary M

    2012-01-01

    The distal hereditary motor neuropathies (dHMN) comprise a heterogeneous group of diseases that share the common feature of a length-dependent predominantly motor neuropathy. Many forms of dHMN have minor sensory abnormalities and/or a significant upper-motor-neuron component, and there is often an overlap with the axonal forms of Charcot-Marie-Tooth disease (CMT2) and with juvenile forms of amyotrophic lateral sclerosis and hereditary spastic paraplegia. Eleven causative genes and four loci have been identified with autosomal dominant, recessive and X-linked patterns of inheritance. Despite advances in the identification of novel gene mutations, 80% of patients with dHMN have a mutation in an as-yet undiscovered gene. The causative genes have implicated proteins with diverse functions such as protein misfolding (HSPB1, HSPB8, BSCL2), RNA metabolism (IGHMBP2, SETX, GARS), axonal transport (HSPB1, DYNC1H1, DCTN1) and cation-channel dysfunction (ATP7A and TRPV4) in motor-nerve disease. This review will summarise the clinical features of the different subtypes of dHMN to help focus genetic testing for the practising clinician. It will also review the neuroscience that underpins our current understanding of how these mutations lead to a motor-specific neuropathy and highlight potential therapeutic strategies. An understanding of the functional consequences of gene mutations will become increasingly important with the advent of next-generation sequencing and the need to determine the pathogenicity of large amounts of individual genetic data. PMID:22028385

  8. 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

  9. 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.

  10. 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.

  11. Villous adenoma of the distal appendix.

    PubMed

    Taylor, J V; Thomas, M G; Kelly, S; Sutton, R

    1997-04-01

    Villous adenoma confined to the distal appendix has not been previously reported in conjunction with acute apendicitis. The presence of an adenoma indicates a need for further investigation due to an association with neoplasia elsewhere. PMID:9158197

  12. Chicxulub Distal Ejecta: Modeling Versus Observations

    NASA Astrophysics Data System (ADS)

    Morgan, J. V.; Artemieva, N.

    We investigate the formation of the K-P layer through numerical modeling. A subset of our models replicate the observational data reasonably well, and suggest that non-ballistic ejection is required for shocked minerals to reach distal sites.

  13. Genetics Home Reference: Laing distal myopathy

    MedlinePLUS

    ... of type I fibers. In cardiac and skeletal muscle cells, the protein produced from the MYH7 gene forms ... autosomal dominant ; cardiac ; cell ; contraction ; distal ; gene ; inherited ; muscle cells ; muscular dystrophy ; mutation ; myosin ; prevalence ; protein ; sign ; skeletal ...

  14. NONLINEAR FORCE-FREE MODELING OF A THREE-DIMENSIONAL SIGMOID OBSERVED ON THE SUN

    SciTech Connect

    Inoue, S.; Watari, S. [National Institute of Information and Communications Technology (NICT), 4-2-1 Nukui-Kitamachi, Koganei, Tokyo 184-8795 (Japan); Magara, T.; Choe, G. S., E-mail: inosato@khu.ac.kr [School of Space Research, Kyung Hee University, Yongin, Gyeonggi-do 446-701 (Korea, Republic of)

    2012-03-01

    In this work, we analyze the characteristics of the three-dimensional magnetic structure of a sigmoid observed over an active region (AR 10930) and followed by X-class flares. This is accomplished by combining a nonlinear force-free field (NLFFF) model of a coronal magnetic field and the high-resolution vector-field measurement of a photospheric magnetic field by Hinode. The key findings of our analysis reveal that the value of the X-ray intensity associated with the sigmoid is more sensitive to the strength of the electric current rather than the twist of the field lines. The strong electric current flows along the magnetic field lines and composes the central part of the sigmoid, even though the twist of the field lines is weak in that region. On the other hand, the outer region (i.e., the elbow part) of the sigmoid is basically occupied by field lines of strong twist and weak current density. Consequently, weak X-ray emission is observed. As the initial Ca II illumination basically occurs from the central part of the sigmoid, this region plays an important role in determining the onset mechanism of the flare despite its weak twisted field-line configuration. We also compare our results with the magnetohydrodynamic simulation for the formation of a sigmoid. Although the estimated values of the twist from the simulation are found to be a little higher than the values obtained from the NLFFF, we find that the field-line configurations generated by the simulation and NLFFF are remarkably analogous as long as we deal with the lower coronal region.

  15. Nonlinear Force-free Modeling of a Three-dimensional Sigmoid Observed on the Sun

    NASA Astrophysics Data System (ADS)

    Inoue, S.; Magara, T.; Watari, S.; Choe, G. S.

    2012-03-01

    In this work, we analyze the characteristics of the three-dimensional magnetic structure of a sigmoid observed over an active region (AR 10930) and followed by X-class flares. This is accomplished by combining a nonlinear force-free field (NLFFF) model of a coronal magnetic field and the high-resolution vector-field measurement of a photospheric magnetic field by Hinode. The key findings of our analysis reveal that the value of the X-ray intensity associated with the sigmoid is more sensitive to the strength of the electric current rather than the twist of the field lines. The strong electric current flows along the magnetic field lines and composes the central part of the sigmoid, even though the twist of the field lines is weak in that region. On the other hand, the outer region (i.e., the elbow part) of the sigmoid is basically occupied by field lines of strong twist and weak current density. Consequently, weak X-ray emission is observed. As the initial Ca II illumination basically occurs from the central part of the sigmoid, this region plays an important role in determining the onset mechanism of the flare despite its weak twisted field-line configuration. We also compare our results with the magnetohydrodynamic simulation for the formation of a sigmoid. Although the estimated values of the twist from the simulation are found to be a little higher than the values obtained from the NLFFF, we find that the field-line configurations generated by the simulation and NLFFF are remarkably analogous as long as we deal with the lower coronal region.

  16. Colon Perforation and Budd-Chiari Syndrome in Behçet’s Disease

    PubMed Central

    Ba?, Y?lmaz; Güney, Güven; Uzbay, P?nar; Zobac?, Ethem; Ardal?, Selin; Özkan, Ay?egül Taylan

    2015-01-01

    Patient: Female, 38 Final Diagnosis: Behçet’s disease Symptoms: Severe abdominal pain • fever Medication: — Clinical Procedure: Parsiyel colectomy Specialty: Surgery Objective: Unusual clinical course Background: Behçet’s disease is a chronic inflammatory disease involving multiple systems, with vasculitis being the most important pathological feature. Multiple colon perforations are thought to be secondary to vasculitis and they occur in patients with ulcers. These may be encountered within the entire colon but most commonly in the ileocecal region. Intestinal perforation and Budd-Chiari syndrome are infrequent in Behçet’s disease, and are associated with high mortality and morbidity. Budd-Chiari syndrome results from occlusion of either hepatic veins or adjacent inferior vena cava, or both. Case Report: We report a patient with Behçet’s disease having multiple perforations in the transverse colon, descending colon, and sigmoid colon. The patient also had Budd-Chiari syndrome due to inferior vena cava thrombosis extending into the right and middle hepatic vein. Our observations are presented with a review of the literature. Conclusions: In Behçet’s disease, treatment of colon perforation necessitates urgent surgery, whereas management of Budd-Chiari syndrome is directed towards the underlying cause. Behçet’s disease, as a chronic multisystemic disease with various forms of vasculitis, is resistant to medical and surgical treatment. Prognosis is worse in Behçet’s disease with colon perforation than that in Budd-Chiari syndrome alone. PMID:25934795

  17. Clinical effect of double coaxial self-expandable metallic stent in management of malignant colon obstruction

    PubMed Central

    Won, Yoodong; Lee, Su Lim; Ku, Young Mi; Kim, Ki Tae; Won, Hye Sung; An, Chang Hyeok

    2015-01-01

    PURPOSE We aimed to evaluate the clinical effectiveness and safety of double coaxial self-expandable metallic stent (DCSEMS) in management of malignant colonic obstruction as a bridge to surgery or palliation for inoperable patients. METHODS Between April 2006 and December 2012, 49 patients (27 males and 22 females; median age, 68 years; age range, 38–91 years) were selected to receive decompressive therapy for malignant colonic obstruction by implanting a DCSEMS. Application of DCSEMS was attempted in 49 patients under fluoroscopic guidance. The obstruction was located in the transverse colon (n=2), descending colon (n=7), sigmoid colon (n=24), rectosigmoid junction (n=6), and the rectum (n=10). The intended use of DCSEMS was as a bridge to elective surgery in 23 patients and palliation in 26 patients. RESULTS Clinical success, defined as >50% dilatation of the stent with subsequent symptomatic improvement, was achieved in 48 of 49 patients (98%). The stent was properly inserted in all patients. No immediate major procedure-related complications occurred. One patient in the bridge-to-surgery group had colon perforation three days after DCSEMS application. Four patients had late migrations of the double stent. CONCLUSION Application of DCSEMS is safe and effective in management of malignant colonic obstruction; it prevents stent migration and tumor ingrowth and lowers perforation rate during the stent application. PMID:25698096

  18. Distal forearm tourniquet for hand surgery

    Microsoft Academic Search

    Alberto D. Delgado-Martinez; J. M. Marchal; F. Blanco; M. Molina; A. Palma

    2004-01-01

    To evaluate the usefulness of the tourniquet placed at the distal forearm, 30 patients were operated with the tourniquet set at the distal forearm using nerve-block anaesthesia. Pain during surgery, flexion of the fingers, bloodless field, and general complications during surgery and 18 months thereafter were recorded. The mean time of ischemia was 19.6±7.5 (10–50) min. A bloodless field was achieved in

  19. [The arrest of bleeding from the sigmoid sinus and the upper segments of internal jugular vein].

    PubMed

    Antoniv, T V; Antoniv, V F; Ushakova, S V

    2012-01-01

    The objective of the present work was to develop an efficacious non-injurious technique for the arrest of hemorrhage from the sigmoid sinus and the upper segments of the internal jugular vein. The authors proposed a relatively simple and highly effective method to be used to the blockade of the sigmoid sinus. It was employed to treat 8 patients none of whom suffered complications in the late postoperative period (the follow-up study lasting from 6 months to 2 years after the intervention). PMID:23250537

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

    PubMed

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

    2015-07-01

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

  1. [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

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

    PubMed Central

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

    2014-01-01

    Submucosal neurons are vital regulators of water and electrolyte secretion and local blood flow in the gut. Due to the availability of transgenic models for enteric neuropathies, the mouse has emerged as the research model of choice, but much is still unknown about the murine submucosal plexus. The progeny of choline acetyltransferase (ChAT)-Cre × ROSA26YFP reporter mice, ChAT-Cre;R26R-yellow fluorescent protein (YFP) mice, express YFP in every neuron that has ever expressed ChAT. With the aid of the robust YFP staining in these mice, we correlated the neurochemistry, morphology and electrophysiology of submucosal neurons in distal colon. We also examined whether there are differences in neurochemistry along the colon and in neurally mediated vectorial ion transport between the proximal and distal colon. All YFP+ submucosal neurons also contained ChAT. Two main neurochemical but not electrophysiological groups of neurons were identified: cholinergic (containing ChAT) or non-cholinergic. The vast majority of neurons in the middle and distal colon were non-cholinergic but contained vasoactive intestinal peptide. In the distal colon, non-cholinergic neurons had one or two axons, whereas the cholinergic neurons examined had only one axon. All submucosal neurons exhibited S-type electrophysiology, shown by the lack of long after-hyperpolarizing potentials following their action potentials and fast excitatory postsynaptic potentials (EPSPs). Fast EPSPs were predominantly nicotinic, and somatic action potentials were mediated by tetrodotoxin-resistant voltage-gated channels. The size of submucosal ganglia decreased but the proportion of cholinergic neurons increased distally along the colon. The distal colon had a significantly larger nicotinic ion transport response than the proximal colon. This work shows that the properties of murine submucosal neurons and their control of epithelial ion transport differ between colonic regions. There are several key differences between the murine submucous plexus and that of other animals, including a lack of conventional intrinsic sensory neurons, which suggests there is an incomplete neuronal circuitry within the murine submucous plexus. PMID:24344165

  3. Management of distal humeral coronal shear fractures.

    PubMed

    Yari, Shahram S; Bowers, Nathan L; Craig, Miguel A; Reichel, Lee M

    2015-05-16

    Coronal shear fractures of the distal humerus are rare, complex fractures that can be technically challenging to manage. They usually result from a low-energy fall and direct compression of the distal humerus by the radial head in a hyper-extended or semi-flexed elbow or from spontaneous reduction of a posterolateral subluxation or dislocation. Due to the small number of soft tissue attachments at this site, almost all of these fractures are displaced. The incidence of distal humeral coronal shear fractures is higher among women because of the higher rate of osteoporosis in women and the difference in carrying angle between men and women. Distal humeral coronal shear fractures may occur in isolation, may be part of a complex elbow injury, or may be associated with injuries proximal or distal to the elbow. An associated lateral collateral ligament injury is seen in up to 40% and an associated radial head fracture is seen in up to 30% of these fractures. Given the complex nature of distal humeral coronal shear fractures, there is preference for operative management. Operative fixation leads to stable anatomic reduction, restores articular congruity, and allows initiation of early range-of-motion movements in the majority of cases. Several surgical exposure and fixation techniques are available to reconstruct the articular surface following distal humeral coronal shear fractures. The lateral extensile approach and fixation with countersunk headless compression screws placed in an anterior-to-posterior fashion are commonly used. We have found a two-incision approach (direct anterior and lateral) that results in less soft tissue dissection and better outcomes than the lateral extensile approach in our experience. Stiffness, pain, articular incongruity, arthritis, and ulnohumeral instability may result if reduction is non-anatomic or if fixation fails. PMID:25984515

  4. Gossypiboma diagnosed by a forward-view endoscopic ultrasound fine-needle aspiration out of the sigmoid colon.

    PubMed

    Kato, Masayuki; Kawahara, Yosuke; Matsuda, Koji; Tajiri, Hisao

    2015-01-01

    Gossypiboma is a term used to describe a foreign mass within the body that is composed of a cotton matrix. Gossypiboma can cause infection or abscess formation from an early stage, or it can remain clinically silent for many years. Gossypiboma can be diagnosed using several methods including abdominal X-ray films, US of the abdomen, contrast-enhanced computed tomography of the abdomen, and during surgery. However, the variable appearance of gossypiboma can lead to diagnostic misinterpretations. Here, we report a successful diagnosis of gossypiboma using a novel method, that is, endoscopic ultrasound-fine-needle aspiration. PMID:26020051

  5. An Organic Acid-Induced Sigmoidal Release System for Oral Controlled-Release Preparations

    Microsoft Academic Search

    Shinji Narisawa; Minako Nagata; Chieko Danyoshi; Hiroyuki Yoshino; Kazuo Murata; Yoshiyuki Hirakawa; Kazuo Noda

    1994-01-01

    To achieve time-controlled or site-specific drug delivery in the gastrointestinal tract, a sigmoidal release system (SRS) was developed, which achieved a prolonged lag time, followed by rapid release. The theophylline beads with a thick Eudragit RS film coating showed very low drug release in water, whereas the release rate increased considerably in organic acid solutions. A hydration study of Eudragit

  6. Repetitive sigmoid stimulation induces rectal hyperalgesia in patients with irritable bowel syndrome

    Microsoft Academic Search

    J Munakata; B Naliboff; F Harraf; A Kodner; T Lembo; L Chang; DH Silverman; EA Mayer

    1997-01-01

    BACKGROUND & AIMS: Only a fraction of patients with irritable bowel syndrome (IBS) show hypersensitivity to rectal distention. The current study sought to determine if repetitive high-pressure stimulation of sigmoid mechanoreceptors modulates perception of rectal pain and discomfort. METHODS: In 14 patients with IBS and 11 healthy controls, perception thresholds for discomfort and pain during rectal sensory tracking and verbal

  7. Motion Control of Mini Underwater Robots Based on Sigmoid Fuzzy Neural Network

    Microsoft Academic Search

    Liang Xiao; Guo Bingjie; Wan Lei

    2007-01-01

    Aiming at high maneuverability and ability to avoid obstacles in motion control of mini underwater robots, a novel method of control based on sigmoid fuzzy neural network was presented. The structure of fuzzy neural network was constructed according to the moving characters, and the learning algorithm which calculated dynamic learning ratio based on least disturbance was deduced in detail. Finally,

  8. Image Lightness Rescaling Using Sigmoidal Contrast Enhancement Gustav J. Braun and Mark D. Fairchild

    E-print Network

    Fairchild, Mark D.

    Image Lightness Rescaling Using Sigmoidal Contrast Enhancement Functions Gustav J. Braun and Mark D. Fairchild Munsell Color Science Laboratory Center for Imaging Science Rochester Institute of Technology Rochester, New York ABSTRACT In color gamut mapping of pictorial images, the lightness rendition

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

    Microsoft Academic Search

    S Obrador; M Soto; J Silvela

    1975-01-01

    Arteriovenous malformations or fistulae shunting arterial blood from branches of the external and internal carotid and vertebral arteries into the transverse-sigmoid sinus may produce different clinical syndromes. The literature is reviewed with 96 patients including six personal cases. Usually these malformations have a congenital origin and only in 4% of the series was there a previous history of a severe

  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. Anatomical relationship between position of the sigmoid sinus and regional mastoid pneumatization

    Microsoft Academic Search

    A. Aslan; T. Kobayashi; D. Diop; F. R. Balyan; A. Russo; A. Taibah

    1996-01-01

    In order to examine the relationship between the location of the sigmoid sinus (SS) and mastoid pneumatization, 25 adult temporal bones were dissected. Pneumatization was evaluated according to findings during dissections of three separate regions of the mastoid: i.e., the sinodural angle (SDA) area, inter-sinofacial area and mastoid apex. In addition, the SDA and distances between the SS and vertical

  12. A New Robust Design Strategy for Sigmoidal Models Based on Model Nesting

    E-print Network

    O'Brien, Timothy E.

    growth models (e.g., those given in Chapter 4 of [11] and Chapter 7 of [13]). 2 Sigmoidal Growth _Models-Logistic, and the Richards. Special cases of these models include the Logistic, Gompertz, Michaelis-Menton, Mischerlich;98 to adequately describe a given set of data. For example. the two-parameter Weibull function (W2), (1

  13. The effect of electrical stimulation on colonic transit following spinal cord injury in cats.

    PubMed

    Bruninga, K; Riedy, L; Keshavarzian, A; Walter, J

    1998-12-01

    The effect of direct electrical stimulation on colinic transit and manometric recordings following spinal cord injury were assessed in five adult male cats. Intra-colonic catheters were surgically placed, stimulating electrodes were sutured to the colonic serosa and a laminectomy with spinal cord clamping at a T4 level was done to induce spinal cord injury (SCI). Twenty radiopaque markers were inserted through an intra-colonic catheter located 1 cm distal to the cecum and were monitored with daily fluoroscopy as a measure of colonic transit. Transit measurements were compared before SCI, after SCI and after SCI with electrical stimulation of 40 pps, 1 ms, and 0-50 mA. Colonic transit following SCI was significantly prolonged (P<0.05) when compared to the transit before SCI. Electrical stimulation following SCI improved colonic transit to values not significantly different from those before SCI. Spontaneous colonic phasic motor activity was similar both before and after SCI. Manometric defection patterns were also observed to be similar before SCI and after SCI with electrical stimulation. Based on our scoring criteria, the most frequent response to electrical stimulation was an abdominal contraction. These findings demonstrate that colonic transit is prolonged following SCI and that direct electrical stimulation of the colon following SCI improves colonic transit in an animal model. PMID:9881734

  14. Comprehensive assessment of HIV target cells in the distal human gut suggests increasing HIV susceptibility toward the anus

    PubMed Central

    McElrath, MJ.; Smythe, K.; Randolph-Habecker, J.; Melton, KR.; Goodpaster, TA.; Hughes, S.; Mack, M.; Sato, A.; Diaz, G.; Steinbach, G.; Novak, R.; Curlin, M.; Lord, JD.; Maenza, J.; Duerr, A.; Frahm, N.; Hladik, F.

    2013-01-01

    Background Prevention of rectal HIV transmission is a high priority goal for vaccines and topical microbicides because a large fraction of HIV transmissions occurs rectally. Yet, little is known about the specific target cell milieu in the human rectum other than inferences made from the colon. Methods We conducted a comprehensive comparative in situ fluorescence study of HIV target cells (CCR5-expressing T cells, macrophages and putative dendritic cells) at 4 and 30 cm proximal of the anal canal in 29 healthy individuals, using computerized analysis of digitized combination stains. Results Most strikingly, we find that more than three times as many CD68+ macrophages express the HIV co-receptor CCR5 in the rectum than the colon (p=0.0001), and as such rectal macrophages appear biologically closer to the HIV-susceptible CCR5high phenotype in the vagina than the mostly HIV-resistant CCR5low phenotype in the colon. Putative CD209+ dendritic cells are generally enriched in the colon compared to the rectum (p=0.0004), though their CCR5 expression levels are similar in both compartments. CD3+ T cell densities and CCR5 expression levels are comparable in the colon and rectum. Conclusions Our study establishes the target cell environment for HIV infection in the human distal gut and demonstrates in general terms that the colon and rectum are immunologically distinct anatomical compartments. Greater expression of CCR5 on rectal macrophages suggests that the most distal sections of the gut may be especially vulnerable to HIV infection. Our findings also emphasize that caution should be exercised when extrapolating data obtained from colon tissues to the rectum. PMID:23392465

  15. Complications After Open Distal Clavicle Excision

    PubMed Central

    Chronopoulos, Efstathis; Gill, Harpreet S.; Freehill, Michael T.; Petersen, Steve A.

    2008-01-01

    Isolated distal clavicle excision performed as an open procedure has been considered safe and, in the literature, has been considered the standard for comparison with arthroscopic distal clavicle excisions. However, we noticed isolated open distal clavicle excision was associated with a number of complications. We therefore raised two questions about the complication rate in a cohort of our patients who had undergone this procedure: (1) What was the complication rate and how did it compare to that in the existing literature on this subject? and (2) Were the complications in our cohort similar to those previously reported? We studied 42 patients who underwent an isolated distal clavicle excision between 1992 and 2003. There were 27 complications (64%), which was substantially higher than rates previously reported. Complications in our cohort not previously reported included continued acromioclavicular joint tenderness and scar hypertrophy. Our study suggests complications after open distal clavicle excisions may be more frequent than and may differ from previously reported rates and types. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18264853

  16. 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

  17. Laparoscopic hemicolectomy in a patient with situs inversus totalis after open distal gastrectomy.

    PubMed

    Sumi, Yasuo; Tomono, Ayako; Suzuki, Satoshi; Kuroda, Daisuke; Kakeji, Yoshihiro

    2013-02-27

    Situs inversus totalis (SIT) is a rare anomaly in which the abdominal and thoracic cavity structures are opposite their usual positions. Occasionally, a few patients with a combination of this condition and malignant tumors have been encountered. Recently, several laparoscopic operations have been reported in patients with SIT. We report a case of an 83-year-old man with situs inversus totalis who developed colon cancer after open distal gastrectomy. Laparoscopic hemicolectomy with radical lymphadenectomy in such a patient was successfully performed by careful consideration of the mirror-image anatomy. Techniques themselves was not different from those in ordinary cases. Thus, curative laparoscopic surgery for colon cancer in the presence of situs inversus totalis is feasible and safe. PMID:23515492

  18. Outcome Following Acute Primary Distal Ulna Resection for Comminuted Distal Ulna Fractures at the Time of Operative Fixation of Unstable Fractures of the Distal Radius

    Microsoft Academic Search

    David E. Ruchelsman; Keith B. Raskin; Michael E. Rettig

    2009-01-01

    Optimal acute management of the highly comminuted distal ulna head\\/neck fracture sustained in conjunction with an unstable\\u000a distal radius fracture requiring operative fixation is not well established. The purpose of the present study was to determine\\u000a the clinical, radiographic, and functional outcomes following acute primary distal ulna resection for comminuted distal ulna\\u000a fractures performed in conjunction with the operative fixation

  19. The Laparoscopic Approach in the Treatment of Diverticular Colon Disease

    PubMed Central

    del Olmo, J. C. Martin; Blanco, J. I.; de la Cuesta, C.; Atienza, R.

    1998-01-01

    Background and Objectives: The experience with treatment of diverticular colon disease (DCD) by the laparoscopic method is analyzed. Methods: Between January 1994 and July 1997, a group of 22 patients with criteria for symptomatic diverticular disease in the descending and sigmoid colon underwent laparoscopy with average resections of 40 cm. Intra-abdominal mechanical anastomosis completed the procedure. Results: The operative morbidity was 28%. Two cases, in acute diverticulitis phase, were reconverted to open surgery, and three cases presented postoperative rectorrhagia which ceased spontaneously. No long-term complications have been found. Postoperative hospitalization was 4-8 days (mean 5.5) and mean operative time was 165 minutes (range 120-240). Conclusions: Nevertheless, the learning curve precise to practice this type of surgery, the acceptable morbity-mortality rates which the laparoscopic method presents, especially with these high-risk groups of patients (age > 65, high blood pressure, etc), encouraged us to modified the criteria indicating surgery for the disease, offering first choice operative treatment with efficiency and safety. However, we feel that those patients with acute complications of diverticular colon disease must be excluded initially for laparoscopic approach. PMID:9876730

  20. 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

  1. Acute murine colitis reduces colonic 5-aminosalicylic acid metabolism by regulation of N-acetyltransferase-2.

    PubMed

    Ramírez-Alcántara, Verónica; Montrose, Marshall H

    2014-06-01

    Pharmacotherapy based on 5-aminosalicylic acid (5-ASA) is a preferred treatment for ulcerative colitis, but variable patient response to this therapy is observed. Inflammation can affect therapeutic outcomes by regulating the expression and activity of drug-metabolizing enzymes; its effect on 5-ASA metabolism by the colonic arylamine N-acetyltransferase (NAT) enzyme isoforms is not firmly established. We examined if inflammation affects the capacity for colonic 5-ASA metabolism and NAT enzyme expression. 5-ASA metabolism by colonic mucosal homogenates was directly measured with a novel fluorimetric rate assay. 5-ASA metabolism reported by the assay was dependent on Ac-CoA, inhibited by alternative NAT substrates (isoniazid, p-aminobenzoylglutamate), and saturable with Km (5-ASA) = 5.8 ?M. A mouse model of acute dextran sulfate sodium (DSS) colitis caused pronounced inflammation in central and distal colon, and modest inflammation of proximal colon, defined by myeloperoxidase activity and histology. DSS colitis reduced capacity for 5-ASA metabolism in central and distal colon segments by 52 and 51%, respectively. Use of selective substrates of NAT isoforms to inhibit 5-ASA metabolism suggested that mNAT2 mediated 5-ASA metabolism in normal and colitis conditions. Western blot and real-time RT-PCR identified that proximal and distal mucosa had a decreased mNAT2 protein-to-mRNA ratio after DSS. In conclusion, an acute colonic inflammation impairs the expression and function of mNAT2 enzyme, thereby diminishing the capacity for 5-ASA metabolism by colonic mucosa. PMID:24742986

  2. Acute murine colitis reduces colonic 5-aminosalicylic acid metabolism by regulation of N-acetyltransferase-2

    PubMed Central

    Ramírez-Alcántara, Verónica

    2014-01-01

    Pharmacotherapy based on 5-aminosalicylic acid (5-ASA) is a preferred treatment for ulcerative colitis, but variable patient response to this therapy is observed. Inflammation can affect therapeutic outcomes by regulating the expression and activity of drug-metabolizing enzymes; its effect on 5-ASA metabolism by the colonic arylamine N-acetyltransferase (NAT) enzyme isoforms is not firmly established. We examined if inflammation affects the capacity for colonic 5-ASA metabolism and NAT enzyme expression. 5-ASA metabolism by colonic mucosal homogenates was directly measured with a novel fluorimetric rate assay. 5-ASA metabolism reported by the assay was dependent on Ac-CoA, inhibited by alternative NAT substrates (isoniazid, p-aminobenzoylglutamate), and saturable with Km (5-ASA) = 5.8 ?M. A mouse model of acute dextran sulfate sodium (DSS) colitis caused pronounced inflammation in central and distal colon, and modest inflammation of proximal colon, defined by myeloperoxidase activity and histology. DSS colitis reduced capacity for 5-ASA metabolism in central and distal colon segments by 52 and 51%, respectively. Use of selective substrates of NAT isoforms to inhibit 5-ASA metabolism suggested that mNAT2 mediated 5-ASA metabolism in normal and colitis conditions. Western blot and real-time RT-PCR identified that proximal and distal mucosa had a decreased mNAT2 protein-to-mRNA ratio after DSS. In conclusion, an acute colonic inflammation impairs the expression and function of mNAT2 enzyme, thereby diminishing the capacity for 5-ASA metabolism by colonic mucosa. PMID:24742986

  3. Recent advances in distal tubular potassium handling

    PubMed Central

    Rodan, Aylin R.; Cheng, Chih-Jen

    2011-01-01

    It is well known that sodium reabsorption and aldosterone play important roles in potassium secretion by the aldosterone-sensitive distal nephron. Sodium- and aldosterone-independent mechanisms also exist. This review focuses on some recent studies that provide novel insights into the sodium- and aldosterone-independent potassium secretion by the aldosterone-sensitive distal nephron. In addition, we discuss a study reporting on the regulation of the mammalian potassium kidney channel ROMK by intracellular and extracellular magnesium, which may be important in the pathogenesis of persistent hypokalemia in patients with concomitant potassium and magnesium deficiency. We also discuss outstanding questions and propose working models for future investigation. PMID:21270092

  4. Distal-Selective Hydroformylation using Scaffolding Catalysis

    PubMed Central

    2015-01-01

    In hydroformylation, phosphorus-based directing groups have been consistently successful at placing the aldehyde on the carbon proximal to the directing group. The design and synthesis of a novel catalytic directing group are reported that promotes aldehyde formation on the carbon distal relative to the directing functionality. This scaffolding ligand, which operates through a reversible covalent bond to the substrate, has been applied to the diastereoselective hydroformylation of homoallylic alcohols to afford ?-lactones selectively. Altering the distance between the alcohol and the olefin revealed that homoallylic alcohols gives the distal lactone with the highest levels of regioselectivity. PMID:24902624

  5. Distal-selective hydroformylation using scaffolding catalysis.

    PubMed

    Joe, Candice L; Blaisdell, Thomas P; Geoghan, Allison F; Tan, Kian L

    2014-06-18

    In hydroformylation, phosphorus-based directing groups have been consistently successful at placing the aldehyde on the carbon proximal to the directing group. The design and synthesis of a novel catalytic directing group are reported that promotes aldehyde formation on the carbon distal relative to the directing functionality. This scaffolding ligand, which operates through a reversible covalent bond to the substrate, has been applied to the diastereoselective hydroformylation of homoallylic alcohols to afford ?-lactones selectively. Altering the distance between the alcohol and the olefin revealed that homoallylic alcohols gives the distal lactone with the highest levels of regioselectivity. PMID:24902624

  6. 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

  7. Internal iliac artery aneurysmo-colonic fistula after endovascular stent-graft repair: a case report.

    PubMed

    Yanase, Yohsuke; 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

  8. Distal Radius Fractures: Choice of Treatment Procedures

    Microsoft Academic Search

    S. Pechlaner

    2003-01-01

    Summary BACKGROUND: Distal radius fractures are no longer injuries typical of elderly patients with osteoporosis. Driving at high speed and high-speed sports activities are responsible for causing such injuries in an increasing number of younger people. Although the kind of fracture suffered, bone density, and personal needs and requirements of patients demand an individualized treatment concept, a surgical approach for

  9. Current status of laparoscopic distal pancreatectomy.

    PubMed

    Rosales-Velderrain, A; Stauffer, J A; Bowers, S P; Asbun, H J

    2012-09-01

    Distal pancreatectomy is the therapeutic option of choice for patients with a benign or malignant lesion located in the body and/or tail of the pancreas when surgical intervention is indicated. With recent advances in and wide spread use of imaging studies, lesions of the pancreas are being diagnosed more commonly and it is likely that this will translate into an increased number of patients undergoing surgical resection. The laparoscopic approach to pancreatic resections has not been adopted as rapidly as it has for most other general surgical procedures. This is despite the fact that the current literature appears to validate laparoscopy as an acceptable and safe approach for distal pancreatectomy in patients with benign lesions, and has demonstrated the known benefits inherent to the laparoscopic technique. These benefits include lower intraoperative blood loss, less pain and analgesic requirements, earlier return of bowel function, and shorter recovery and hospital stay. Yet controversy still exists for the role of laparoscopy in the resection of malignant lesions. Recent reports however, have shown that laparoscopic distal pancreatectomy can safely be performed in known malignancies and, most importantly, after a laparoscopic oncological resection, the oncological benchmarks that have been related to survival, (such as negative surgical margins and number of peripancreatic lymph nodes resected), can also be accomplished. We sought to review the current literature on distal pancreatectomy, specifically the indications, laparoscopic approaches, splenectomy and spleen-preserving techniques, intraoperative and short-term outcomes, morbidity, mortality and oncological outcomes. PMID:22971634

  10. Piroxicam decreases postirradiation colonic neoplasia in the rat

    SciTech Connect

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

    1990-12-01

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

  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. 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. 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.

  14. Colon diverticula - series (image)

    MedlinePLUS

    ... can cause problems. The most common problem is diverticulitis, which occurs when a small, hard piece of ... Treatment of diverticulitis and diverticular bleeding involves surgical removal of the segment of colon containing the diverticula. While the patient is ...

  15. Successful treatment of a colonic ulcer penetrating the urinary bladder caused by the administration of calcium polystyrene sulfonate and sorbitol.

    PubMed

    Shioya, Takeshi; Yoshino, Masanori; Ogata, Masao; Shibuya, Tetsuo; Tokunaga, Akira; Matsumoto, Koshi; Tajiri, Takashi

    2007-10-01

    A 77-year-old woman was urgently admitted for the treatment of diabetic ketoacidosis and a duodenal ulcer hemorrhage in March 1999. She had a history of diabetes and angina pectoris. After admission, she received oral calcium polystyrene sulfonate and sorbitol to treat hyperkalemia. Nine days later, severe abdominal pain developed. A colonoscopic examination revealed a sigmoid colonic ulcer and stenosis; the patient was treated conservatively. At a 1-year follow-up examination, the colonic stenosis was found have worsened; pneumaturia developed in January 2001. The patient was found to have a sigmoidovesical fistula and underwent sigmoidectomy and partial resection of the ileum and urinary bladder. The histological findings were a benign colonic ulcer with the infiltration of inflammatory cells, mainly lymphocytes. Rhomboidal, dark violet Kayexalate crystals were observed on microscope examination in the submucosa in both the first and second colonic biopsy specimens. We concluded that the colonic ulcer and the sigmoidovesical fistula had been caused by the administration of calcium polystyrene sulfonate and sorbitol. Reports of colonic perforation as a result of the administration of calcium polystyrene sulfonate and sorbitol are rare. Here, we report the successful treatment of a colonic ulcer that had penetrated the urinary bladder. PMID:17965530

  16. [Destructive mastoiditis with thrombosis of the sigmoid sinus in a 8 year-old child presenting with concomitant chicken pox].

    PubMed

    Bogomil'ski?, M R; Polunin, M M; Ivanenko, A M; Poliakov, A A

    2014-01-01

    The specific clinical feature of mastoidities that developed in a patient presenting with chicken pox was the rapid progress in temporal bone destruction with partial thrombosis of the sigmoid sinusis in the absence of typical manifestations of mastoiditis. The pronounced destructive changes found in a series of CT images were regarded as the indications for urgent antromastoidotomy with the puncture of the sigmoid sinusis. PMID:25734315

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

    PubMed

    Roseau, Gilles

    2014-11-16

    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

  18. 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

  19. Surgical management of dural arteriovenous fistulas of the transverse-sigmoid sinus in 42 patients.

    PubMed

    Eftekhar, Behzad; Morgan, Michael Kerin

    2013-04-01

    A retrospective study was performed to analyse a prospectively collected database from a single surgeon (M.K.M.) of transverse-sigmoid sinus dural arteriovenous fistulas (DAVF) between 1991 and August 2011. During the study period, 144 patients with 160 DAVF were managed. Sixty-five of the DAVF were located in the transverse-sigmoid sinus and 42 were treated with surgery, or embolisation and surgery. All patients who underwent surgery were symptomatic with retrograde cortical venous drainage. The average follow-up period was 18months (range, 2-82months). Total elimination of the DAVF was achieved in all instances, including two patients (5%) who required further surgery after postoperative cerebral angiography showed that some venous drainage had persisted after the first operation. There was no new permanent neurological deficit or mortality attributable to surgery. Our institutional experience shows that in selected patients with transverse-sigmoid sinus DAVF, the involved sinus can be surgically resected with a high success rate and it is as safe as many alternative options. We suggest that this definitive treatment option should be offered to patients, and the outcome should be compared to other treatment modalities. PMID:23352348

  20. [Pseudarthroses after distal radius fractures. What is the role of the distal radioulnar joint?].

    PubMed

    Prommersberger, K J; van Schoonhoven, J; Laubach, S

    2000-11-01

    Non-union following distal radial fracture is extremely rare. Therefore, the patterns are not completely understood. Recently, it was suggested that an associated distal ulna shaft fracture increases the risk to develop a non-union for comminuted fractures of the distal radius. The purpose of this study was to review our 15 cases with this condition to investigate the role of an associated distal ulna shaft fracture and/or an associated lesion of the distal radioulnar joint. The second goal was to evaluate the success of the surgical treatment in relation to the extent of the metaphyseal subchondral bone supporting the articular surface distal to the site of the non-union. We reviewed our 15 cases which were operated on for non-union of the distal radius since 1992. In all cases, the radiographs could be reviewed. Twelve patients could actually be re-examined. The investigated criteria were: initial, pre- and postoperative X-ray findings, other medical conditions, range of motion, grip strength, and pain relief. Clinical outcome was evaluated using the DASH-questionnaire. According to the AO classification system, there were two type A3 and 13 type C3 fractures. There were seven associated distal ulna fractures. The distal radioulnar joint was involved in twelve cases. The other medical conditions in the patients with non-union after distal radial fracture included allergy, hypothyroidism, diabetes mellitus, peripheral neuropathy, and bronchial asthma. Four patients were tobacco smokers. Only one patient was initially treated non-operatively. In all cases, the distal radius was restored preserving wrist motion. Bony union was achieved in 14 cases. The range of motion has improved in all planes. Grip strength increased but still remained over 50% below the level of the opposite side. Postoperatively, the majority of patients was pain free. In four cases, complications were seen postoperatively. Three of these patients had less than 6 mm of metaphyseal subchondral bone beneath the articular surface. Three of the four patients were tobacco smokers. Inadequate treatment of a comminuted distal radial fracture associated with a special local situation--such as an additional distal ulna shaft fracture and/or an associated lesion of the distal radioulnar joint--combined with a general medical condition, adversely affects fracture healing, increasing the risk for non-union. From the review of the records of these 15 cases, we recommend that non-union with more than 5 mm of subchondral bone supporting the articular surface distal to the non-union site undergo reconstruction of the radius. Non-union with less than 5 mm subchondral bone supporting the articular surface requires an individual decision. A good bone stock and stable fixation allows for reconstruction of the radius, otherwise wrist fusion is a useful salvage procedure. PMID:11189891

  1. Intestinal colonization resistance

    PubMed Central

    Lawley, Trevor D; Walker, Alan W

    2013-01-01

    Dense, complex microbial communities, collectively termed the microbiota, occupy a diverse array of niches along the length of the mammalian intestinal tract. During health and in the absence of antibiotic exposure the microbiota can effectively inhibit colonization and overgrowth by invading microbes such as pathogens. This phenomenon is called ‘colonization resistance’ and is associated with a stable and diverse microbiota in tandem with a controlled lack of inflammation, and involves specific interactions between the mucosal immune system and the microbiota. Here we overview the microbial ecology of the healthy mammalian intestinal tract and highlight the microbe–microbe and microbe–host interactions that promote colonization resistance. Emerging themes highlight immunological (T helper type 17/regulatory T-cell balance), microbiota (diverse and abundant) and metabolic (short-chain fatty acid) signatures of intestinal health and colonization resistance. Intestinal pathogens use specific virulence factors or exploit antibiotic use to subvert colonization resistance for their own benefit by triggering inflammation to disrupt the harmony of the intestinal ecosystem. A holistic view that incorporates immunological and microbiological facets of the intestinal ecosystem should facilitate the development of immunomodulatory and microbe-modulatory therapies that promote intestinal homeostasis and colonization resistance. PMID:23240815

  2. Screw prominences related to palmar locking plating of distal radius

    Microsoft Academic Search

    T. S. Sügün; N. Karabay; Y. Gürbüz; K. Özaksar; T. Toros; M. Kayalar

    2011-01-01

    Fixation of unstable distal radius fractures with palmar locking plates provides a stable reduction and early return of function, but complications arising from unrecognized dorsally prominent screws penetrating the extensor compartments are increasingly reported. Standard radiographs and fluoroscopy may not adequately visualize screw lengths, owing to the complex shape of the dorsum of the distal radius. We examined 46 distal

  3. Carpal Canal Pressures after Volar Plating of Distal Radius Fractures

    Microsoft Academic Search

    D. A. FULLER; M. BARRETT; R. K. MARBURGER; R. HIRSCH

    2006-01-01

    Elevated pressures within the carpal canal are known to occur after distal radius fractures. Controversy exists regarding prophylactic carpal tunnel release after open reduction with internal fixation of distal radius fractures. The purpose of this study was to determine the tissue pressures within the carpal canal after volar plating of distal radius fractures. This study was a prospective, observational, IRB

  4. Early active rehabilitation for operatively stabilized distal radius fractures

    Microsoft Academic Search

    Mark H Henry; K BROU

    2004-01-01

    From the young to the elderly, distal radius fractures are very common. Extensive literature has been written regarding surgical management of distal radius fractures, but the same degree of attention has not been given to the critical rehabilitation that follows. Successful functional outcomes for distal radius fractures are a result of appropriate surgical treatment as well as timely and specific

  5. 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

  6. The Epidemiology of Distal Radius Fractures

    PubMed Central

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

    2012-01-01

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

  7. Aerotactile Integration from Distal Skin Stimuli

    PubMed Central

    Derrick, Donald; Gick, Bryan

    2015-01-01

    Tactile sensations at extreme distal body locations can integrate with auditory information to alter speech perception among uninformed and untrained listeners. Inaudible air puffs were applied to participants' ankles, simultaneously with audible syllables having aspirated and unaspirated stop onsets. Syllables heard simultaneously with air puffs were more likely to be heard as aspirated. These results demonstrate that event-appropriate information from distal parts of the body integrates in speech perception, even without frequent or robust location-specific experience. In addition, overall performance was significantly better for those with hair on their ankles, which suggests that the presence of hair may help establish signal relevance, and so aid in multi-modal speech perception. PMID:24649526

  8. Laparoscopic distal pancreatosplenectomy for pancreatic ductal adenocarcinoma.

    PubMed

    Kuroki, Tamotsu; Eguchi, Susumu

    2014-08-26

    Laparoscopic distal pancreatectomy (LDP) including laparoscopic distal pancreatosplenectomy has rapidly developed as a minimally invasive surgery. LDP is mainly indicated for benign disease and low-grade malignancy during the initial period. In recent years, an increasing number of LDPs for pancreatic ductal adenocarcinoma (PDAC) have been reported. However, the benefits of LPD for PDAC, especially in view of the oncological benefits, are unclear and remain controversial. In this review of the literature, we note that LDP has been found to be a technically feasible and safe surgical procedure in selected patients and that LDP has the advantages expected of a minimally invasive surgery. In addition, LDP has oncological feasibility for PDAC in light of its favorable rate of R0 resection and lymph node harvest compared to conventional laparotomy. Large randomized and controlled prospective studies are needed to determine the clinical advantages of LDP for left-sided PDAC. PMID:25156008

  9. Twenty four hour manometric recording of colonic motor activity in healthy man.

    PubMed Central

    Narducci, F; Bassotti, G; Gaburri, M; Morelli, A

    1987-01-01

    The motor activity of the transverse, descending, and sigmoid colon was recorded for 24 hours in 14 healthy volunteers with a colonoscope positioned catheter. During the study the patients ate two 1000 kcal mixed meals and one continental breakfast. Colonic motor activity was low before meals and minimal during sleep; the motility index increased significantly after meals and at morning awakening. Most of the motor activity was represented by low amplitude contractions present singly or in bursts, which showed no recognisable pattern. All but two subjects also showed isolated high amplitude (up to 200 mmHg) contractions that propagated peristaltically over long distances at approximately 1 cm/sec. Most of these contractions occurred after morning awakening, and some in the late postprandial period, with a mean of 4.4/subject/24 h. The peristaltic contractions were often felt as an urge to defecate or preceded defecation, and could represent the manometric equivalent of the mass movements. PMID:3817580

  10. [A case of ovarian metastasis from colon cancer successfully treated with multidisciplinary therapy].

    PubMed

    Ebisui, Chikara; Ohkubo, Keita; Akitake, Hironori; Ohtsuka, Masahisa; Maekawa, Takayo; Yoshioka, Shinichi; Hama, Naoki; Kashiwazaki, Masaki; Taniguchi, Masaaki; Tsujie, Masaki; Konishi, Muneharu; Fujimoto, Takayoshi

    2010-11-01

    An 80-year-old female patient was undergone sigmoidectomy with D2 lymph node dissection for type 2 sigmoid colon cancer in February 2007. A post operative pathological finding of cancer was SS, N0, P0, H0, M0 (Stage II), curative A. Twelve months after the operation, elevated CEA level was observed. CT scan and MRI revealed a mass of 10 cm in diameter with multiple cysts in the pelvic cavity, which was diagnosed a malignant ovarian tumor. In May 2008, total hysterectomy, bilateral oophorectomy, and partial omentectomy were performed and its pathological finding was metastatic ovarian tumor originating from colon cancer. Adjuvant chemotherapy was administered, as cancer cells were detected in the ascites. The patient has been in good health without recurrence for 25 months after the second operation. PMID:21224633

  11. Distribution of 5-HT3, 5-HT4, and 5-HT7 Receptors Along the Human Colon

    PubMed Central

    Yaakob, Nor S; Chinkwo, Kenneth A; Chetty, Navinisha; Coupar, Ian M; Irving, Helen R

    2015-01-01

    Background/Aims Several disorders of the gastrointestinal tract are associated with abnormal serotonin (5-HT) signaling or metabolism where the 5-HT3 and 5-HT4 receptors are clinically relevant. The aim was to examine the distribution of 5-HT3, 5-HT4, and 5-HT7 receptors in the normal human colon and how this is associated with receptor interacting chaperone 3, G protein coupled receptor kinases, and protein LIN-7 homologs to extend previous observations limited to the sigmoid colon or the upper intestine. Methods Samples from ascending, transverse, descending, and sigmoid human colon were dissected into 3 separate layers (mucosa, longitudinal, and circular muscles) and ileum samples were dissected into mucosa and muscle layers (n = 20). Complementary DNA was synthesized by reverse transcription from extracted RNA and expression was determined by quantitative or end point polymerase chain reaction. Results The 5-HT3 receptor subunits were found in all tissues throughout the colon and ileum. The A subunit was detected in all samples and the C subunit was expressed at similar levels while the B subunit was expressed at lower levels and less frequently. The 5-HT3 receptor E subunit was mainly found in the mucosa layers. All splice variants of the 5-HT4 and 5-HT7 receptors were expressed throughout the colon although the 5-HT4 receptor d, g, and i variants were expressed less often. Conclusions The major differences in 5-HT receptor distribution within the human colon are in relation to the mucosa and muscular tissue layers where the 5-HT3 receptor E subunit is predominantly found in the mucosal layer which may be of therapeutic relevance. PMID:26130632

  12. Distal renal tubular acidosis with hereditary spherocytosis.

    PubMed

    Sinha, Rajiv; Agarwal, Indira; Bawazir, Waleed M; Bruce, Lesley J

    2013-07-01

    Hereditary spherocytosis (HS) and distal renal tubular acidosis (dRTA), although distinct entities, share the same protein i.e. the anion exchanger1 (AE1) protein. Despite this, their coexistence has been rarely reported. We hereby describe the largest family to date with co-existence of dRTA and HS and discuss the molecular basis for the co-inheritance of these conditions. PMID:23942433

  13. Surgical approaches to the distal radius

    Microsoft Academic Search

    Asif M. Ilyas

    2011-01-01

    Introduction  Fractures of the distal radius are among the most common fractures seen. They encompass a myriad of presentations and fracture\\u000a patterns that often benefit from various open reduction and internal fixation techniques—including volar plating, dorsal plating,\\u000a radial plating, intramedullary nailing, and fragment-specific fixation. In order to obtain optimal reduction of these fractures,\\u000a surgeons require a thorough understanding of the anatomy

  14. Fractures of Distal Radius: An Overview

    PubMed Central

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

    2014-01-01

    Fractures of distal radius account for up to 20% of all fractures treated in emergency department. Initial assessment includes a history of mechanism of injury, associated injury and appropriate radiological evaluation. Treatment options include conservative management, internal fixation with pins, bridging and non-bridging external fixation, dorsal or volar plating with/without arthroscopy assistance. However, many questions regarding these fractures remain unanswered and good prospective randomized trials are needed. PMID:25657938

  15. Distal Embolic Protection for Renal Arterial Interventions

    SciTech Connect

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

    2008-01-15

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

  16. Distally based dorsal forearm fasciosubcutaneous flap.

    PubMed

    Kim, Kwang Seog

    2004-08-01

    Use of a local flap is often required for the reconstruction of a skin defect on the dorsum of the hand. For this purpose, a distally based dorsal forearm fasciosubcutaneous flap based on the perforators of the posterior interosseous artery was developed. From 1997 until 2002, this flap was used to reconstruct skin defects on the dorsum of the hand in nine patients at Chonnam National University Medical School. The sizes of these flaps ranged from 10 to 14 cm in length and from 5 to 7 cm in width. The flaps survived in all patients. Marginal loss over the distal edge of the flap was noted in one patient. Three flaps that developed minimal skin-graft loss were treated successfully with a subsequent split-thickness skin graft. The long-term follow-up showed good flap durability and elasticity. The distally based dorsal forearm fasciosubcutaneous flap is a convenient and reliable alternative for reconstructing skin defects of the dorsum of the hand involving vital structure exposure. It obviates the need for more complicated and time-consuming procedures. PMID:15277804

  17. Localization of the Sensory Neurons and Mechanoreceptors Required for Stretch-Evoked Colonic Migrating Motor Complexes in Mouse Colon

    PubMed Central

    Zagorodnyuk, Vladimir P.; Spencer, Nick J.

    2011-01-01

    The pacemaker and pattern generator that underlies the cyclical generation of spontaneous colonic migrating motor complexes (CMMCs) has recently been identified to lie within the myenteric plexus and/or muscularis externa. Neither the mucosa, nor the release of substances from the mucosa were found to be required for the spontaneous generation of CMMCs. However, it is known that stretch applied to the colonic wall can also evoke CMMCs and since stretch of the gut wall is known to stimulate the mucosa, it is not clear whether release of substances from the mucosa and/or submucosal plexus are required for stretch-evoked CMMCs. Therefore, the aim of this study was to determine whether circumferential stretch-evoked CMMCs require the presence of the mucosa and/or submucosal plexus in isolated mouse colon. Spontaneous CMMCs were recorded from full length sheet preparations of colon in vitro. Graded circumferential stretch (at a rate of 100??m/s) applied to a 15-mm segment of mid–distal colon reliably evoked a CMMC, which propagated to the oral recording site. Sharp dissection to remove the mucosa and submucosal plexus from the entire colon did not prevent spontaneous CMMCs and circumferential stretch-evoked CMMCs were still reliably evoked by circumferential stretch, even at significantly lower thresholds. In contrast, in intact preparations, direct stimulation of the mucosa (without accompanying stretch) proved highly inconsistent and rarely evoked a CMMC. These observations lead to the inescapable conclusion that the sensory neurons activated by colonic stretch to initiate CMMCs lie in the myenteric plexus, while the mechanoreceptors activated by stretch, lie in the myenteric ganglia and/or muscularis externa. Stretch activation of these mechanoreceptors does not require release of any substance(s) from the mucosa, or neural inputs arising from submucosal ganglia. PMID:22203805

  18. Single-incision laparoscopic rectopexy (Wells) with simultaneous sigmoidectomy in a case of complete rectal prolapse and a sigmoid tumor: report of a case.

    PubMed

    Miyo, Masaaki; Takemasa, Ichiro; Mokutani, Yukako; Uemura, Mamoru; Nishimura, Junichi; Hata, Taishi; Mizushima, Tsunekazu; Yamamoto, Hirofumi; Doki, Yuichiro; Mori, Masaki

    2015-06-01

    Recently, the technique of single-incision laparoscopic surgery for colorectal disease has rapidly disseminated in association with improvements in instrumentation and procedures, offering a less invasive procedure and excellent cosmetic results. We herein present the case of a 74-year-old female who suffered complete rectal prolapse with a pedunculated polyp (20 mm) in the sigmoid colon; the stalk of the polyp was too thick to perform endoscopic mucosal resection, which is associated with a high risk of bleeding. The patient was successfully managed using single-incision laparoscopic rectopexy (Wells) with simultaneous sigmoidectomy, a procedure that has not been reported in the literature to date. There were no perioperative complications. The patient's constipation caused by the rectal prolapse improved, and no recurrence was observed for 2 months after the operation. This case emphasizes that complete rectal prolapse is a benign disease occurring in elderly patients that is well suited to treatment with minimally invasive single-incision laparoscopic surgery. PMID:24998595

  19. Amoeboma of colon mimicking colonic carcinoma

    PubMed Central

    Saha, Kaushik; Sengupta, Moumita; Mitra, Sumit; Ray, Suchandra

    2014-01-01

    Entamoeba histolytica is a major cause of diarrhea in the developing countries and it can present with a wide range of gastrointestinal symptoms depending on the phase of the infection. We describe a case of 65-year-old male patient presented with abdominal pain and vomiting. On the clinical and radiological examination provisional diagnosis of colonic carcinoma was suspected. After resection of perforated caecal growth, histopathological sections showed numerous trophozoites of E. histolytica in a background of abundant necrosis. This case revealed differentiation between amoeboma and carcinoma is critical. PMID:25250235

  20. Parathyroid Hormone is Related to Dysplasia and a Higher Rate of Distal Colorectal Adenoma in Women but Not Men.

    PubMed

    Aigner, Elmar; Stadlmayr, Andreas; Huber-Schönauer, Ursula; Zwerina, Jochen; Husar-Memmer, Emma; Niederseer, David; Eder, Sebastian K; Stickel, Felix; Pirich, Christian; Schett, Georg; Patsch, Wolfgang; Datz, Christian

    2015-08-01

    Molecular and clinical observations provide evidence for a potential role of parathyroid hormone (PTH) in colorectal cancer development. We therefore aimed to assess the association of PTH with regard to colorectal cancer precursor lesions. A cohort of 1432 participants, 777 men, 58.4?±?9.6 years and 701 women, 59.1?±?10.6 years, undergoing screening colonoscopy were allocated to PTH serum concentrations either above or below 55 ng/L. The number, localization, size, and histology of the polypoid lesions detected during screening colonoscopy were recorded according to PTH serum concentrations. Serum PTH concentrations were not different between men and women. Women with PTH serum concentrations above the cut-off had significantly more adenomas (13/40; 32.5 %) of the distal colon compared to women below the cut-off (91/659; 13.8 %; P?=?0.001). Additionally, the rate of dysplasia in adenomas of the distal colon was higher in women with high compared to low PTH concentrations (P?=?0.001). These findings remained robust after adjustments for serum vitamin D, age, plasma creatinine, BMI, diabetes, and liver steatosis. No associations were observed between serum PTH concentrations and colorectal lesions in men. These data suggest that elevated PTH serum concentrations might have a role in colorectal cancer development as indicated by higher rates of adenomas, specifically with dysplasia, in women. The role of PTH in colon carcinogenesis and its sex specificity deserve further study. PMID:26021763

  1. Laparoscopic colostomy for acute left colon obstruction caused by diverticular disease in high risk patient: A case report

    PubMed Central

    Palladino, Elisa; Cappiello, Antonio; Guarino, Vincenzo; Perrotta, Nicola; Loffredo, Domenico

    2015-01-01

    Introduction The colostomy is often necessary in complicated divertcular disease. The laparoscopic colostomy is not widely used for the treatment of complicated diverticular disease. Its use in patients with high operative risk is still on debate. The aim of this case report was to present the benefits of laparoscopic colostomy in patients with high peri-and postoperative risk factors. Presentation of case We present a case of 76-year-old female admitted to emergency unit for left colonic obstruction. The patient had a past history of liver cirrhosis HCV-related with a severe malnutrition, hypertrophic cardiomyopathy, diverticular disease, hiatal ernia, previous appendectomy. Patient was classified according to their preoperative risk ASA 3 (classification of the American society of Anestesia-ASA score). Contrast-enhanced abdominal CT revealed a marked thickening in the sigmoid colon and a marked circumferential stenosis in the sigmoid colon in absence of neoplasm, and/or abscess. The laparoscopic procedure is proposed as first intention. Discussion The operation time was 50 min, and the hospital stay was 4 days. Post operative complications grade I according to the Clavien Dindo Classification. Conclusions Laparoscopic colostomy is safe and feasible procedure in experienced hands. It is associated with low morbidity and short stay in hospital and should be considered a good alternative to a laparotomy. PMID:26036456

  2. 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

  3. Morphologic and molecular characterization of traditional serrated adenomas of the distal colon and rectum.

    PubMed

    Wiland, Homer O; Shadrach, Bonnie; Allende, Daniela; Carver, Paula; Goldblum, John R; Liu, Xiuli; Patil, Deepa T; Rybicki, Lisa A; Pai, Rish K

    2014-09-01

    Of the serrated polyps, the origin, morphologic features, molecular alterations, and natural history of traditional serrated adenomas (TSAs) are the least understood. Recent studies suggest that these polyps may arise from precursor lesions. The frequencies of KRAS and BRAF mutations vary between these studies, and only 1 small study has measured CpG island methylation using current markers of methylation. Mutations in GNAS, a gene commonly mutated in colorectal villous adenomas, have not been fully evaluated in TSAs. Finally, the expression of annexin A10 (ANXA10), a recently discovered marker of sessile serrated adenomas/polyps, has not been studied in these polyps. To further characterize these polyps, 5 gastrointestinal pathologists reviewed 55 left-sided polyps diagnosed as TSA at a single institution. Pathologists assessed various histologic features including cytoplasmic eosinophilia, ectopic crypt foci, presence of conventional dysplasia, and presence of precursor serrated lesions. KRAS, BRAF, and GNAS mutational analysis was performed, as well as CpG island methylation and ANXA10 immunohistochemistry. Ectopic crypt foci were seen in 62% of TSAs. Precursor lesions were seen in 24% of the study polyps, most of which were hyperplastic polyps. KRAS and BRAF mutations were common and were present in 42% and 48% of polyps, respectively. GNAS mutations occurred in 8% of polyps, often in conjunction with a BRAF mutation. Unlike sessile serrated adenomas/polyps, TSAs rarely had diffuse expression of ANXA10. Importantly, BRAF-mutated TSAs had more widespread methylation of a 5-marker CpG island panel compared with KRAS-mutated polyps. However, ectopic crypt foci, a proposed defining feature of TSA, were not associated with any specific molecular alteration. PMID:25127095

  4. Endovascular management of dural arteriovenous fistulas of the transverse and sigmoid sinus in 150 patients

    Microsoft Academic Search

    M. Kirsch; T. Liebig; D. Kühne; H. Henkes

    2009-01-01

    Introduction  This study aimed to evaluate the safety and efficiency of the endovascular treatment of transverse–sigmoid sinus dural arteriovenous\\u000a fistulas (TS_dAVF).\\u000a \\u000a \\u000a \\u000a Methods  A total of 150 consecutive patients and 348 procedures were evaluated.\\u000a \\u000a \\u000a \\u000a Results  Pulsatile tinnitus (81%), headache (15%), and intracranial hemorrhage (10%) were the most frequent manifestations of the TS_dAVFs.\\u000a More than half of the affected sinuses were partially or completely thrombosed.

  5. 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.

  6. Endovascular treatment of pulsatile tinnitus associated with transverse sigmoid sinus aneurysms and jugular bulb anomalies.

    PubMed

    Trivelato, Felipe Padovani; Araújo, João Francisco Santoro; Dos Santos Silva, Rodrigo; Rezende, Marco Túlio Salles; Ulhôa, Alexandre Cordeiro; Castro, Guilherme Duarte

    2015-08-01

    Pulsatile tinnitus of vascular origin may arise in arterial or venous structures. Many authors have reported the association of pulsatile tinnitus with anomalies of dural venous sinuses and the jugular bulb. In such circumstances, mainly concomitantly with disabling tinnitus, endovascular treatment has been successfully employed. We describe here a new case of jugular bulb diverticulum associated with transverse sigmoid sinus stenosis, in a patient presenting with disabling pulsatile tinnitus. She was treated with dural sinus stenting and selective embolization of the diverticulum. In addition, we performed a literature review aiming to identify possible risk factors for developing the symptoms, as well as the safety and results of endovascular treatment. PMID:26111983

  7. Hyperammonaemia with distal renal tubular acidosis

    PubMed Central

    Miller, S; Schwartz, G

    1997-01-01

    ?? The case is reported of an infant with hyperammonaemia secondary to severe distal renal tubular acidosis. A clinical association between increased concentrations of ammonia in serum and renal tubular acidosis has not previously been described. In response to acidosis the infant's kidneys presumably increased ammonia synthesis but did not excrete ammonia, resulting in hyperammonaemia. The patient showed poor feeding, frequent vomiting, and failure to thrive, but did not have an inborn error of metabolism. This case report should alert doctors to consider renal tubular acidosis in the differential diagnosis of severely ill infants with metabolic acidosis and hyperammonaemia.?? PMID:9487970

  8. Distal radius-ulna fractures in children.

    PubMed

    Pannu, Gurpal S; Herman, Marty

    2015-04-01

    Fractures involving the distal radius and ulna are commonly seen in children and adolescents. Management of these injuries in pediatric patients should include assessment of the neurovascular status of the extremity, associated soft-tissue injury, and, most importantly, possible involvement of the physes of the radius and ulna. Treatment of these injuries may vary from simple casting and radiographic follow-up to urgent reduction and surgical fixation. Regardless of the initial treatment plan, the treating surgeon must remain aware of the potential for both early and late complications that may affect outcomes. PMID:25771318

  9. 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.

  10. [Reconstruction of digestive tract after distal gastrectomy].

    PubMed

    Hu, Xiang

    2014-05-01

    There are various types of digestive tract reconstruction techniques after distal gastrectomy. Among them, Billroth I and II are still the predominant option in China at present. In recent years, Roux-en-Y configuration, jejunal interposition, J-pouch interposition (JPI), double-tract reconstruction, pylorus-preserving method, and laparoscopic reconstruction and anastomosis techniques have gained more attention in recent years. Although there is no universal and explicit guideline, the current consensus is that the reconstruction style should be adopted by the principles of digestive tract reconstruction, based on patient's condition, socioeconomic status and surgeon's experience. PMID:24859945

  11. Creation of distal canine limb lymphedema

    SciTech Connect

    Chen, H.C.; Pribaz, J.J.; O'Brien, B.M.; Knight, K.R.; Morrison, W.A.

    1989-06-01

    A canine model of distal limb lymphedema was established in order to study the treatment of this condition by lymph node transfer. This model was more difficult to establish than whole-limb lymphedema. Significant edema was achieved by a combination of preoperative irradiation and circumferential removal of skin from the irradiated areas followed by removal of the contents of the popliteal fossa. Despite these measures, it was not possible to produce lymphedema in every case, possibly because of the presence of lymphaticovenous shunts and panvascular compensation mechanisms.

  12. Serotonin and colonic motility.

    PubMed

    Kendig, D M; Grider, J R

    2015-07-01

    The role of serotonin (5-hydroxytryptamine [5-HT]) in gastrointestinal motility has been studied for over 50 years. Most of the 5-HT in the body resides in the gut wall, where it is located in subsets of mucosal cells (enterochromaffin cells) and neurons (descending interneurons). Many studies suggest that 5-HT is important to normal and dysfunctional gut motility and drugs affecting 5-HT receptors, especially 5-HT3 and 5-HT4 receptors, have been used clinically to treat motility disorders; however, cardiovascular side effects have limited the use of these drugs. Recently studies have questioned the importance and necessity of 5-HT in general and mucosal 5-HT in particular for colonic motility. Recent evidence suggests the importance of 5-HT3 and 5-HT4 receptors for initiation and generation of one of the key colonic motility patterns, the colonic migrating motor complex (CMMC), in rat. The findings suggest that 5-HT3 and 5-HT4 receptors are differentially involved in two different types of rat CMMCs: the long distance contraction (LDC) and the rhythmic propulsive motor complex (RPMC). The understanding of the role of serotonin in colonic motility has been influenced by the specific motility pattern(s) studied, the stimulus used to initiate the motility (spontaneous vs induced), and the route of administration of drugs. All of these considerations contribute to the understanding and the controversy that continues to surround the role of serotonin in the gut. PMID:26095115

  13. Pharmacologically Mediated Colon Ischemia

    Microsoft Academic Search

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

    2007-01-01

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

  14. Colonic pericryptal fibroblasts

    Microsoft Academic Search

    A.-P. Sappino; P.-Y. Dietrich; O. Skalli; S. Widgren; G. Gabbiani

    1989-01-01

    Experimental evidence has shown that fetal gut mesenchymal cells can modulate epithelial cell differentiation. It is postulated that reciprocal stromal-epithelial interactions in the digestive tract are maintained beyond embryonic life. The mature colonic mucosa contains pericryptal fibroblasts (PCF), a stromal cell type exhibiting smooth muscle morphological features, which are thought to regulate the growth and differentiation of adjacent epithelial cells.

  15. 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

  16. 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.

  17. Glycosylation and sulphation of colonic mucus glycoproteins in patients with ulcerative colitis and in healthy subjects.

    PubMed Central

    Morita, H; Kettlewell, M G; Jewell, D P; Kent, P W

    1993-01-01

    Studies have been made of mucus glycoprotein biosynthesis in different regions of the lower gastrointestinal tract in normal patients and those with ulcerative colitis (UC), active or inactive, by means of 3H-glucosamine (3H-GlcNH2)--35S-sulphate double labelling of epithelial biopsy specimens under culture conditions. The time based rate of 3H-GlcNH2 labelling of mucus in rectal tissue was similar to that in active or inactive UC whereas the rate of 35SO4(2) labelling was significantly increased in active disease. The 3H specific activities measuring the amount of isotopic incorporation into surface and tissue mucus glycoproteins were increased in patients with active UC compared with normal or inactive subjects. The 35S specific activities did not differ significantly between patients with active UC and those in remission. In the rectum, glycosylation of mucus glycoproteins decreases with the increasing age of the patient. Regional differences in 3H-labelling of mucus components are reported for ascending colon, transverse colon, sigmoid colon, and rectum. Sulphation (35S-labelling) was higher in all parts of the colon in left sided UC. Results point to accelerated glycosylation of core proteins in the active phase of UC. PMID:8344580

  18. Inhibition of the colonic motor response to eating by pinaverium bromide in irritable bowel syndrome patients.

    PubMed

    Fioramonti, J; Frexinos, J; Staumont, G; Bueno, L

    1988-01-01

    The effect of pinaverium bromide on the colonic motor response to eating was investigated in 10 irritable bowel syndrome patients, by means of an intraluminal probe supporting 8 groups of electrodes. At each site examined from transverse to sigmoid colon, the electromyograms exhibited 2 kinds of spike bursts: short spike bursts (SSB) localized at one electrode, and long spike bursts (LSB), isolated, propagated orally or aborally over a few centimeters, or aborally propagated over the whole length of the colon investigated (migrating long spike bursts, MLSB). Recordings were continuously performed over 24 hr. Each patient received at 7.00 p.m. on day 1 and at noon on day 2 an 800-1000 Kcal meal preceded by IV administration of pinaverium bromide (4 mg) or placebo. After placebo administration, the duration of LSB activity and the number of MLSB were significantly increased over 3 postprandial hr by comparison with the 2 hr preceding the meal. After pinaverium injection no significant postprandial change in LSB and MLSB activity was noted. The SSB activity was not modified after the meals preceded by placebo or pinaverium injection. These results suggest that the inhibitory action of pinaverium bromide on postprandial colonic motility may support the clinical efficacy of this agent in the treatment of the irritable bowel syndrome. PMID:3371838

  19. Unraveling the genetics of distal hereditary motor neuronopathies

    Microsoft Academic Search

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

    2006-01-01

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

  20. Anatomical and radiological study applied to distal radius surgery

    Microsoft Academic Search

    N. Gasse; D. Lepage; R. Pem; C. Bernard; J. M. Lerais; P. Garbuio; L. Obert

    Purpose  The purpose of this study was to determine, during anterior plating of the distal radius, the length of a screw above which\\u000a there is a risk for the extensor tendons and the optimal shape of an anterior plate. It was also to determine the projection\\u000a of the axis of the distal third of the radius on the distal articular surface

  1. 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.

  2. Color Enhancement in Endoscopic Images Using Adaptive Sigmoid Function and Space Variant Color Reproduction

    PubMed Central

    Imtiaz, Mohammad S.; Wahid, Khan A.

    2015-01-01

    Modern endoscopes play an important role in diagnosing various gastrointestinal (GI) tract related diseases. The improved visual quality of endoscopic images can provide better diagnosis. This paper presents an efficient color image enhancement method for endoscopic images. It is achieved in two stages: image enhancement at gray level followed by space variant chrominance mapping color reproduction. Image enhancement is achieved by performing adaptive sigmoid function and uniform distribution of sigmoid pixels. Secondly, a space variant chrominance mapping color reproduction is used to generate new chrominance components. The proposed method is used on low contrast color white light images (WLI) to enhance and highlight the vascular and mucosa structures of the GI tract. The method is also used to colorize grayscale narrow band images (NBI) and video frames. The focus value and color enhancement factor show that the enhancement level in the processed image is greatly increased compared to the original endoscopic image. The overall contrast level of the processed image is higher than the original image. The color similarity test has proved that the proposed method does not add any additional color which is not present in the original image. The algorithm has low complexity with an execution speed faster than other related methods. PMID:26089969

  3. 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.

  4. 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.

  5. 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

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

    PubMed Central

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

    2008-01-01

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

  7. Distal Xq duplication and functional Xq disomy

    PubMed Central

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

    2009-01-01

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

  8. Sphingolipids in colon cancer

    PubMed Central

    García-Barros, Mónica; Coant, Nicolas; Truman, Jean-Philip; Snider, Ashley J.

    2013-01-01

    Colorectal cancer is one of the major causes of death in the western world. Despite increasing knowledge of the molecular signaling pathways implicated in colon cancer, therapeutic outcomes are still only moderately successful. Sphingolipids, a family of N-acyl linked lipids, have not only structural functions but are also implicated in important biological functions. Ceramide, sphingosine and sphingosine-1-phosphate are the most important bioactive lipids, and they regulate several key cellular functions. Accumulating evidence suggests that many cancers present alterations in sphingolipids and their metabolizing enzymes. The aim of this review is to discuss the emerging roles of sphingolipids, both endogenous and dietary, in colon cancer and the interaction of sphingolipids with WNT/?-catenin pathway, one of the most important signaling cascades that regulate development and homeostasis in intestine PMID:24060581

  9. 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

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

    PubMed Central

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

    2014-01-01

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

  11. Defining Residual Radial Translation of Distal Radius Fractures: A Potential Cause of Distal Radioulnar Joint Instability

    PubMed Central

    Ross, Mark; Di Mascio, Livio; Peters, Susan; Cockfield, Allen; Taylor, Fraser; Couzens, Greg

    2014-01-01

    Background?The aim of this paper is twofold: to raise awareness of the potential problems of leaving residual radial translation of the distal fragment in distal radius fracture fixation and to provide a reproducible, accurate and simple radiographic parameter to define this reduction. The primary goal of all of this is to raise awareness of the malreduction to decrease problems with distal radial ulnar joint instability and to decrease the incidence of what the Authors consider to be unnecessary surgery on the ulnar side of the wrist when the surgeon is confronted with distal radio ulnar joint instability after fixation of a distal radial fracture. The idea is to make the surgeon look at reduction of the radius instead of fixing the ulnar side. We know that in the overwhelming majority of cases in our clinical experience, intraoperative correction of this deformity has avoided the need for ulnar styloid or TFC repair, which we otherwise would have performed had we not been aware of this malreduction. We have deliberately used the word potential in the title to reflect that we are proposing a hypothesis, and that only 40–50 percent of patients have a discrete distal band of the IOM. We have extensive experience over a 15-year period with internal fixation of distal radius fractures and have clearly observed this phenomenon. It is our belief, therefore, that we should be able to present this hypothesis in tandem with the radiographic parameter that we are advocating, to raise awareness of this malreduction of the radius. The radiographic parameter has little relevance unless put into this context. We would consider that the impact and value of this paper would be substantially weakened by removing this component of the title. Patients and Methods?In this study, 100 normal wrist radiographs were reviewed by three fellowship-trained orthopedic surgeons to develop a simple and reproducible technique to measure radial translation. Results?Utilizing the method described, the point of intersection between the ulnar cortex of the shaft of the radius and the lunate left a mean average of 45.48% (range 25–73.68%) of the lunate remaining on the radial side. In the majority of cases more of the lunate resided ulnar to this line. High levels of agreement with inter-rater (intraclass coefficients?=?0.967) and intra-rater (intraclass coefficients?=?0.79) reliability was observed. Conclusions?The results of this study can be used to define a normal standard against which residual radial translation can be measured to assess the reduction of distal radius fractures. This new parameter aids in the development of surgical techniques to correct residual radial translation deformity. In addition, awareness and correction of this potential malreduction at the time of surgery may decrease the need for other procedures on the ulnar side of the wrist to improve DRUJ stability, such as ulnar styloid fixation, TFCC repair, or ligamentous grafting. Level of Evidence?Level II (Diagnostic) PMID:24533242

  12. Obesity Is an Independent Prognostic Variable in Colon Cancer Survivors

    PubMed Central

    Sinicrope, Frank A.; Foster, Nathan R.; Sargent, Daniel J.; O’Connell, Michael J.; Rankin, Cathryn

    2010-01-01

    Purpose Obesity is associated with an increased risk of colon cancer. However, the influence of body mass index (BMI) on the prognosis of colon cancer survivors and its relationship to gender remains unknown. Experimental Design BMI (kg/m2) was categorized in patients with tumor-node-metastasis stage II and III colon carcinomas (n = 4,381) enrolled in seven randomized trials of 5-fluorouracil–based adjuvant chemotherapy. Cox proportional hazards models were used to determine the association of BMI with disease-free survival (DFS) and overall survival (OS). Results Among colon cancer patients, 868 (20%) were obese (BMI, ?30 kg/m2), of which 606 were class 1 (BMI, 30–34 kg/m2) and 262 were class 2,3 (BMI, ?35 kg/m2). Obese versus normal-weight patients were more likely to be younger, have distal tumors, show intact DNA mismatch repair, and have more lymph node metastases (P < 0.017). In a multivariate analysis, BMI was significantly associated with both DFS (P = 0.030) and OS (P = 0.0017). Men with class 2,3 obesity showed reduced OS compared with normal-weight men [hazard ratio, 1.35; 95% confidence interval, 1.02–1.79; P = 0.039]. Women with class I obesity had reduced OS [hazard ratio, 1.24; 95% confidence interval, 1.01–1.53; P = 0.045] compared with normal-weight women. Overweight status was associated with improved OS in men (P = 0.006), and underweight women had significantly worse OS (P = 0.019). BMI was not predictive of therapeutic benefit. Conclusions Obesity is an independent prognostic variable in colon cancer survivors and shows gender-related differences. These data suggest that obesity-related biological factors can influence clinical outcome. PMID:20215553

  13. Fluid absorption in isolated perfused colonic crypts.

    PubMed Central

    Singh, S K; Binder, H J; Boron, W F; Geibel, J P

    1995-01-01

    A spatial segregation of ion transport processes between crypt and surface epithelial cells is well-accepted and integrated into physiological and pathophysiological paradigms of small and large intestinal function: Absorptive processes are believed to be located in surface (and villous) cells, whereas secretory processes are believed to be present in crypt cells. Validation of this model requires direct determination of fluid movement in intestinal crypts. This study describes the adaptation of techniques from renal tubule microperfusion to hand-dissect and perfuse single, isolated crypts from rat distal colon to measure directly fluid movement. Morphologic analyses of the isolated crypt preparation revealed no extraepithelial cellular elements derived from the lamina propria, including myofibroblasts. In the basal state, crypts exhibited net fluid absorption (mean net fluid movement = 0.34 +/- 0.01 nl.mm-1.min-1), which was Na+ and partially HCO3- dependent. Addition of 1 mM dibutyryl-cyclic AMP, 60 nM vasoactive intestinal peptide, or 0.1 mM acetylcholine to the bath (serosal) solution reversibly induced net fluid secretion (net fluid movement approximately -0.35 +/- 0.01 nl.mm-1.min-1). These observations permit speculation that absorption is a constitutive transport function in crypt cells and that secretion by crypt cells is regulated by one or more neurohumoral agonists that are released in situ from lamina propria cells. The functional, intact polarized crypt described here that both absorbs and secretes will permit future studies that dissect the mechanisms that govern fluid and electrolyte movement in the colonic crypt. Images PMID:7593625

  14. Proximal versus Distal Validity Coefficients for Teacher Observational Instruments

    ERIC Educational Resources Information Center

    Marzano, Robert J.

    2014-01-01

    This study examined the use of measures of student learning computed using end-of-year assessments (distal measures) versus measures of student learning associated with a single lesson (proximal measures) as criterion scores for the validity of observations of teachers' pedagogical skills. The validity coefficients computed using distal

  15. 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

  16. Cutaneous Mycobacterium chelonae Infection Extending Distally in a Hemodialysed Patient

    Microsoft Academic Search

    Athanassios Kolivras; Pierre-André De Berdt; Anne Theunis; Luc Hooghe; Josiane De Maubeuge; Max Dratwa; Micheline Song

    2002-01-01

    We report a case of a cutaneous Mycobacterium chelonae infection on the dorsum of the forearm of a patient undergoing chronic hemodialysis. The infection showed a linear and distal extension. This unusual distal dissemination was apparently secondary to a venous reflux, a circulatory repercussion of the patient’s arteriovenous fistula.

  17. Intraoperative sentinel lymph node mapping guides laparoscopic-assisted distal gastrectomy for distal gastric cancer

    PubMed Central

    Liu, Naiqing; Niu, Zhengchuan; Niu, Wei; Peng, Cheng; Zou, Xueqing; Sun, Shuxiang; Shinichi, Obo; Shahbaz, Muhammad; Sun, Qinli; Jun, Niu

    2015-01-01

    Aims: The aim of this retrospective study is to explore the effects of sentinel lymph node (SLN) mapping guided laparoscopic-assisted distal gastrectomy (LADG) for distal gastric cancer. Methods: Two hundred patients were enrolled in this study. One hundred and one patients undergoing SLN guided LADG were designated as the SLN group. Ninety-nine patients having conventional LADG with D1 or D2 lymph node dissection were designated as the control group. Intraoperative and postoperative indicators such as the number of lymph nodes dissected, intraoperative and postoperative conditions, flow cytometry analysis of T lymphocyte subsets and natural killer (NK) cells, survival rates, recurrence rates and postoperative complications were investigated between these two groups. Results: The number of lymph nodes dissected in the SLN group was significantly lesser than that in the control group. Furthermore, in the SLN group, the patients achieved better immunization status, improved intraoperative and postoperative conditions and decreased postoperative complications. There were no significant differences were found in the positive lymph nodes detected, the distance between proximal and distal cutting edge, postoperative survival or recurrence rates. Conclusions: SLN guided LADG for gastric cancer is a safe and effective method and could achieve an equal clinical effect as traditional laparoscopic D1 or D2 radical operation with less operation trauma and better recovery.

  18. Ileum and colon perforation following peritoneal dialysis-related peritonitis and high-dose calcium polystyrene sulfonate.

    PubMed

    Kao, Chih-Chin; Tsai, Yi-Chiun; Chiang, Wen-Chih; Mao, Tsui-Lien; Kao, Tze-Wah

    2013-04-17

    A rare but severe complication, intestinal necrosis, has been reported after sodium polystyrene sulfonate (SPS; Kayexalate) and sorbitol intake. Some case reports described bowel perforation following calcium polystyrene sulfonate (CPS; Kalimate) administration. We report a case of ileum and colon perforation following peritoneal dialysis-related peritonitis and high-dose Kalimate in a 59-year-old female patient. The patient had a history of hypertension, diabetes mellitus, and end-stage renal disease (ESRD). During hospitalization for peritoneal dialysis-related peritonitis, she developed hyperkalemia, and Kalimate was administered orally. However, severe abdominal distension and pain occurred just one day after Kalimate intake. An urgent surgery disclosed several perforations in the ileum and sigmoid colon. Pathology of the resected gut showed transmural necrosis and perforation with basophilic angulated crystals. The patient finally expired during hospitalization due to refractory septic shock. PMID:23602017

  19. Laparoscopic distal, subtotal gastrectomy for advanced gastric cancer.

    PubMed

    Ben-David, Kfir; Tuttle, Rebecca; Kukar, Moshim; Oxenberg, Jacqueline; Hochwald, Steven N

    2015-02-01

    The objective of this study was to show laparoscopic subtotal, distal gastrectomy with D2 lymphadenectomy as a safe and appropriate method for the resection of advanced gastric cancer. This study was conducted at a designated NCI Cancer Center. Subjects of the study were patients with advanced gastric malignancy, including transmural penetration of the tumor and/or nodal disease, requiring subtotal, distal gastrectomy. The main outcome measure is a description of the technique of a laparoscopic subtotal, distal gastrectomy for antral and distal body tumors. In conclusion, the laparoscopic approach to advanced gastric malignancy with a subtotal, distal gastrectomy and D2 lymphadenectomy is a safe, oncologically appropriate procedure which provides excellent outcomes. PMID:25338659

  20. Matrix metalloproteinase-9 overexpression is closely related to poor prognosis in patients with colon cancer

    PubMed Central

    2014-01-01

    Background Matrix metalloproteinase-9 (MMP-9) is an important member of the matrix metalloproteinase family and is considered to be involved in the invasion and metastasis of cancer cells. This study analyzed the expression of MMP-9 in colon cancer patients and the relationship between this expression and clinicopathological features and survival. Methods We immunohistochemically investigated 68 specimens of colon cancer tissues and corresponding distal normal mucosa tissues using MMP-9 antibody. Then, the correlation between MMP-9 expression and clinicopathological features and its prognostic relevance were determined. Results The expression rate of MMP-9 in colon cancer tissues was significantly higher than that in distal normal mucosa (69.1% versus 2.9%, P colon cancer. PMID:24476461

  1. Colonic strictures: dilation and stents.

    PubMed

    Adler, Douglas G

    2015-04-01

    Colonic strictures, both benign and malignant, are commonly encountered in clinical practice. Benign strictures are most commonly treated by balloon dilation and less frequently with stents. Balloon dilation can help forestall or obviate surgery in some patients. Colonic strictures of malignant etiology generally need to be managed by stents and/or surgery. This article reviews endoscopic approaches to the management of colonic strictures. PMID:25839690

  2. 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

  3. A sigmoidal model for biosorption of heavy metal cations from aqueous media.

    PubMed

    Özen, Rümeysa; Sayar, Nihat Alpagu; Durmaz-Sam, Selcen; Sayar, Ahmet Alp

    2015-07-01

    A novel multi-input single output (MISO) black-box sigmoid model is developed to simulate the biosorption of heavy metal cations by the fission yeast from aqueous medium. Validation and verification of the model is done through statistical chi-squared hypothesis tests and the model is evaluated by uncertainty and sensitivity analyses. The simulated results are in agreement with the data of the studied system in which Schizosaccharomyces pombe biosorbs Ni(II) cations at various process conditions. Experimental data is obtained originally for this work using dead cells of an adapted variant of S. Pombe and represented by Freundlich isotherms. A process optimization scheme is proposed using the present model to build a novel application of a cost-merit objective function which would be useful to predict optimal operation conditions. PMID:25916890

  4. Difference equations with the Allee effect and the periodic Sigmoid Beverton-Holt equation revisited.

    PubMed

    Gaut, Garren R J; Goldring, Katja; Grogan, Francesca; Haskell, Cymra; Sacker, Robert J

    2012-01-01

    In this paper, we investigate the long-term behaviour of solutions of the periodic Sigmoid Beverton-Holt equation [Formula: see text] where the a ( n ) and ?( n ) are p-periodic positive sequences. Under certain conditions, there are shown to exist an asymptotically stable p-periodic state and a p-periodic Allee state with the property that populations smaller than the Allee state are driven to extinction while populations greater than the Allee state approach the stable state, thus accounting for the long-term behaviour of all initial states. This appears to be the first study of the equation with variable ?. The results are discussed with possible interpretations in Population Dynamics with emphasis on fish populations and smooth cordgrass. PMID:22928770

  5. Studies of mucus in mouse stomach, small intestine, and colon. III. Gastrointestinal Muc5ac and Muc2 mucin O-glycan patterns reveal a regiospecific distribution

    PubMed Central

    Holmén Larsson, Jessica M.; Thomsson, Kristina A.; Rodríguez-Piñeiro, Ana M.; Karlsson, Hasse

    2013-01-01

    The mouse intestinal mucus is mainly made up by the gel-forming Muc2 mucin and the stomach surface mucus Muc5ac, both extensively O-glycosylated. The oligosaccharide diversity provides a vast library of potential recognition sites for both commensal and pathogenic organisms. The mucin glycans are thus likely very important for the selection and maintenance of a stable intestinal flora. Here we have explored the O-glycan patterns of the mouse gastrointestinal tract mucins. The mucins from the mucus of the distal and proximal colon, ileum, jejunum, duodenum, and stomach of conventionally raised wild-type (C57BL/6) mice were separated by composite gel electrophoresis. The O-linked glycans were released by reductive elimination and structurally characterized by liquid chromatography-mass spectrometry. The mucins glycans were mostly core 2 type [Gal?1–3(GlcNAc?1–6)GalNAcol], but also core 1 (Gal?1–3GalNAcol). In the stomach about half of the Muc5ac mucin O-glycans were neutral and many monosulfated, but with a low grade of sialylation and fucosylation. Mouse ileum, jejunum, and duodenum had similar glycan patterns dominated by sialylated and sulfated core 2 glycans, but few fucosylated. Colon was on the other hand dominated by highly charged fucosylated glycans. The distal colon is different from the proximal colon because different biosynthetic pathways are utilized, although sialylated and sulfated glycans were highly abundant in both parts. The sulfation was higher in the distal colon, whereas sialic acid was more common in the proximal colon. Many fucosylated glycans were found in both the proximal and distal colon. Thus the mucin O-glycans vary along the mouse gastrointestinal tract. PMID:23832516

  6. 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

  7. Distal Expression of knotted1 in Maize Leaves Leads to Reestablishment of Proximal/Distal Patterning and Leaf Dissection

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Maize (Zea mays) leaves provide a useful system to study how proximal/distal patterning is established because of the distinct tissues found in the distal blade and the proximal sheath. Several mutants disrupt this pattern, including the dominant knotted1-like homeobox (knox) mutants. knox genes enc...

  8. Dietary Fiber Down-Regulates Colonic Tumor Necrosis Factor and Nitric Oxide Production in Trinitrobenzenesulfonic Acid-Induced Colitic Rats1,2

    Microsoft Academic Search

    Maria Elena Rodriguez-Cabezas; Julio Galvez; Maria Dolores Lorente; Angel Concha; Desiree Camuesco; Shamira Azzouz; Antonio Osuna; Luis Redondo; Antonio Zarzuelo

    Previous studies have revealed the beneficial effects exerted by dietary fiber in human inflammatory bowel disease, which were associated with an increased production of SCFA in distal colon. The aim of the present study was to elucidate the probable mechanisms involved in the beneficial effects of a fiber-supplemented diet (5% Plantago ovata seeds) in the trinitrobenzenesulfonic acid (TNBS) model of

  9. Luminal oxidants selectively modulate electrogenic ion transport in rat colon

    PubMed Central

    Mayol, Julio M; Adame-Navarrete, Yolanda; Alarma-Estrany, Pilar; Molina-Roldan, Elena; Huete-Toral, Fernando; Fernandez-Represa, Jesus A

    2006-01-01

    AIM: To investigate the effects of luminal exposure to H2O2 and two related thiol oxidizing agents on basal and stimulated chloride secretion in native colon using electrophysiological and pharmacological approaches. METHODS: Unstripped rat distal colon segments were mounted in Ussing chambers. Potential difference, calculated resistance and short-circuit current across unstripped colon segments were monitored with a dual voltage/current clamp. Paracellular permeability was assessed by measuring the mucosa-to-serosa flux of a fluorescent probe (FITC). RESULTS: Luminal exposure to hydrogen peroxide transitorily stimulated chloride secretion without altering barrier function. This stimulatory effect could be blocked by basolateral atropine but not indomethacin. The cysteine and methionine oxidizing compounds, phenylarsine oxide and chloramine T respectively, mimicked the effect of H2O2, except for a drop in transcolonic resistance after 30 min. In contrast to the observed stimulatory effect on basal secretion, cAMP-stimulated electrogenic ion transport was blunted by luminal H2O2. However, the Ca2+-activated response remained unchanged. CONCLUSION: H2O2 may be an important selective modulator of intestinal ion and water secretion in certain pathologic conditions such as inflammation or ischemia-reperfusion by multiple mechanisms. PMID:17006992

  10. Autonomic Neurotransmitters Modulate Immunoglobulin A Secretion in Porcine Colonic Mucosa

    PubMed Central

    Schmidt, Lisa D.; Xie, Yonghong; Lyte, Mark; Vulchanova, Lucy; Brown, David R.

    2007-01-01

    Secretory immunoglobulin A (sIgA) plays a crucial role in mucosal surface defense. We tested the hypothesis that colonic sIgA secretion is under enteric neural control. Immunohistochemistry of the porcine distal colonic mucosa revealed presumptive cholinergic and adrenergic nerve fibers apposed to secretory component (SC)-positive crypt epithelial cells and neighboring IgA+ plasmacytes. The cholinomimetic drug carbamylcholine elicited rapid, atropine-sensitive IgA secretion into the luminal fluid bathing mucosal explants mounted in Ussing chambers. The adrenergic receptor agonist norepinephrine also increased IgA secretion, an action inhibited by phentolamine. These effects were independent of agonist-induced anion secretion. In Western blots of luminal fluid, both agonists increased the density of protein bands co-immunoreactive for IgA and SC. Mucosal exposure to enterohemorrhagic Escherichia coli did not affect IgA secretion, and carbamylcholine treatment did not affect mucosal adherence of this enteropathogen. Acetylcholine and norepinephrine, acting respectively through muscarinic cholinergic and alpha-adrenergic receptors in the colonic mucosa, stimulate sIgA secretion and may enhance mucosal defense in vivo. PMID:17320195

  11. Concomitant non-Hodgkin’s lymphoma in colon and liver: report of a rare case and review of literature

    PubMed Central

    Peng, Jian-Xin; Wang, Ling-Zhi; Tan, Zhi-Jian; Zhong, Xiao-Sheng; Huang, You-Xing; Diao, Jing-Fang; He, Jun-Ming

    2015-01-01

    A 58-year-old male patient was admitted with right upper abdominal pain. Initial hematologic evaluation revealed mildly elevated serum carcinoembryonic antigen and carbohydrate antigen (CA) 19-9 tests, while an abdominal CT-scan showed a circumferential mass along the distal ascending colon and the right flexure of colon, simultaneously a liver lesion in segment 8 is considered metastases from colorectal. colonoscopic examination revealed a circumferential growth tumor in the right flexure of colon and the colonoscopy can not reach the proximal of the tumor. We performed a right hemihepatoectomy and a right hemicolectomy associated with loco-regional lymphadenectomy. Histological examination showed diffuse large B-cell lymphomas in resected right colon as well as liver tumors. The patient received six courses of chemotherapy with CHOP-based regimens. At 14-month follow-up before this report, the patient is still alive and free of disease. PMID:26045849

  12. [Jejunal pouch interposition and distal gastrectomy].

    PubMed

    Miwa, K; Kinami, S; Sahara, H; Matsumoto, H; Segawa, M; Michiwa, Y; Miyazaki, I

    1997-06-01

    We developed a new technique of reconstruction in Billroth 1 gastrectomy, jejunal pouch interposition (JPI). The interposed jejunal segment consists of a proximally double-plicated pouch and a distally isoperistaltic conduit. From 1987 to 1994, the JPI was performed on 102 patients with gastric carcinoma. The postoperative functional assay was carried out at least one year later after surgery. Sixty-five patients with the conventional Billroth 1 reconstruction (B-1) during the same period were employed as the control. Gastric emptying time estimated with scinti-scanning was significantly delayed in the JPI group compared with the B-1 group (p < 0.05). All individuals with JPI had meals three times a day whereas 13% of those with B-1 required those more than three times (p < 0.05). The incidence of dumping syndrome was significantly lower in the JPI group (6%) than the B-1 group (20%) (p < 0.05). The reflux of bile into the residual stomach was observed in the scintiscanning at 78% of patients with B-1 whereas 10% of those with JPI (p < 0.01). Endoscopy revealed that regurgitation gastritis was significantly decreased in the JPI group compared with that in the B-1 group (p < 0.01). These results suggest that the JPI prevents small stomach syndrome, dumping syndrome and alkaline reflux gastritis after the B-1 reconstruction. PMID:9255808

  13. Pathways to Colonization

    NASA Technical Reports Server (NTRS)

    Smitherman, David V., Jr.

    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. Findings will be drawn from the author s previous work on space colony design, space infrastructure workshops, and various studies that addressed space policy. In conclusion, this paper will note that significant progress has been made on space facility construction through the International Space Station program, and that significant efforts are needed in the development of new reusable Earth to Orbit transportation systems. The next key steps will include reusable in space transportation systems supported by in space propellant depots, the continued development of inflatable habitat and space elevator technologies, and the resolution of policy issues that will establish a future vision for space development.

  14. Two-wave propagation in in vitro swine distal ulna

    NASA Astrophysics Data System (ADS)

    Mano, Isao; Horii, Kaoru; Matsukawa, Mami; Otani, Takahiko

    2015-07-01

    Ultrasonic transmitted waves were obtained in an in vitro swine distal ulna specimen, which mimics a human distal radius, that consists of interconnected cortical bone and cancellous bone. The transmitted waveforms appeared similar to the fast waves, slow waves, and overlapping fast and slow waves measured in the specimen after removing the surface cortical bone (only cancellous bone). In addition, the circumferential waves in the cortical bone and water did not affect the fast and slow waves. This suggests that the fast-and-slow-wave phenomenon can be observed in an in vivo human distal radius.

  15. 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

  16. A comparison of linaclotide and lubiprostone dosing regimens on ion transport responses in human colonic mucosa

    PubMed Central

    Kang, Sang Bum; Marchelletta, Ronald R; Penrose, Harrison; Docherty, Michael J; McCole, Declan F

    2015-01-01

    Linaclotide, a synthetic guanylyl cyclase C (GC-C) agonist, and the prostone analog, Lubiprostone, are approved to manage chronic idiopathic constipation and constipation-predominant irritable bowel syndrome. Lubiprostone also protects intestinal mucosal barrier function in ischemia. GC-C signaling regulates local fluid balance and other components of intestinal mucosal homeostasis including epithelial barrier function. The aim of this study was to compare if select dosing regimens differentially affect linaclotide and lubiprostone modulation of ion transport and barrier properties of normal human colonic mucosa. Normal sigmoid colon biopsies from healthy subjects were mounted in Ussing chambers. Tissues were treated with linaclotide, lubiprostone, or vehicle to determine effects on short-circuit current (Isc). Subsequent Isc responses to the cAMP agonist, forskolin, and the calcium agonist, carbachol, were also measured to assess if either drug caused desensitization. Barrier properties were assessed by measuring transepithelial electrical resistance. Isc responses to linaclotide and lubiprostone were significantly higher than vehicle control when administered bilaterally or to the mucosal side only. Single versus cumulative concentrations of linaclotide showed differences in efficacy while cumulative but not single dosing caused desensitization to forskolin. Lubiprostone reduced forskolin responses under all conditions. Linaclotide and lubiprostone exerted a positive effect on TER that was dependent on the dosing regimen. Linaclotide and lubiprostone increase ion transport responses across normal human colon but linaclotide displays increased sensitivity to the dosing regimen used. These findings may have implications for dosing protocols of these agents in patients with constipation.

  17. Non-genomic regulation of intermediate conductance potassium channels by aldosterone in human colonic crypt cells

    PubMed Central

    Bowley, K A; Morton, M J; Hunter, M; Sandle, G I

    2003-01-01

    Background: Aldosterone has a rapid, non-genomic, inhibitory effect on macroscopic basolateral K+ conductance in the human colon, reducing its capacity for Cl? secretion. The molecular identity of the K+ channels constituting this aldosterone inhibitable K+ conductance is unclear. Aim: To characterise the K+ channel inhibited by aldosterone present in the basolateral membrane of human colonic crypt cells. Methods: Crypts were isolated from biopsies of healthy sigmoid colon obtained during colonoscopy. The effect of aldosterone on basolateral K+ channels, and the possible involvement of Na+:H+ exchange, were studied by patch clamp techniques. Total RNA from isolated crypts was subjected to reverse transcriptase-polymerase chain reaction (RT-PCR) using primers specific to intermediate conductance K+ channels (KCNN4) previously identified in other human tissues. Results: In cell attached patches, 1 nmol/l aldosterone significantly decreased the activity of intermediate conductance (27 pS) K+ channels by 31%, 53%, and 54% after 1, 5 and 10, minutes, respectively. Increasing aldosterone concentration to 10 nmol/l produced a further 56% decrease in channel activity after five minutes. Aldosterone 1–10 nmol/l had no effect on channel activity in the presence of 20 ?mol/l ethylisopropylamiloride, an inhibitor of Na+:H+ exchange. RT-PCR identified KCNN4 mRNA, which is likely to encode the 27 pS K+ channel inhibited by aldosterone. Conclusion: Intermediate conductance K+ channels (KCNN4) present in the basolateral membranes of human colonic crypt cells are a target for the non-genomic inhibitory effect of aldosterone, which involves stimulation of Na+:H+ exchange, thereby reducing the capacity of the colon for Cl? secretion. PMID:12740342

  18. Gene expression in colon cancer: A focus on tumor site and molecular phenotype.

    PubMed

    Slattery, Martha L; Pellatt, Daniel F; Mullany, Lila E; Wolff, Roger K; Herrick, Jennifer S

    2015-09-01

    Hundreds to thousands of genes are differentially expressed in tumors when compared to nontumor colonic tissue samples. We evaluated gene expression patterns to better understand differences in colon cancer by tumor site and tumor molecular phenotype. We analyzed RNA-seq data from tumor/normal paired samples from 175 colon cancer patients. We implemented a cross validation strategy with nonparametric tests to identify genes which displayed varying expression characteristics related to paired tumor/nontumor tissue across proximal and distal colon sites and by tumor molecular phenotypes, that is, TP53, KRAS, CpG Island Methylator Phenotype (CIMP), and microsatellite instability (MSI). We used Ingenuity Pathway Analysis (IPA) to determine networks associated with deregulated genes in our data. Genes showed significant differences in expression characteristics at the 0.01 level in both validation groups between tumor subsite (116 genes), CIMP high versus CIMP low (79 genes), MSI versus microsatellite stable (MSS) (49 genes), TP53-mutated versus not mutated (17genes), and KRAS-mutated versus not mutated (1 gene). Deregulated genes for CIMP high and MSI tumors were often down-regulated. In contrast to CIMP high and MSI tumors, genes that were deregulated in TP53 were likely to be up-regulated. ERK1, WNT, growth factors and inflammation-related factors were focal points of both CIMP and MSI IPA networks. The MUC family of genes was up-regulated MSI networks. Numerous genes showed differences in expression between proximal and distal tumors, nontumor proximal and distal tissue, and tumor molecular phenotype. Deregulated mucin genes appear to play an important role in MSI tumors. © 2015 Wiley Periodixzcals, Inc. PMID:26171582

  19. Filiform polyposis associated with sigmoid diverticulitis in a patient without inflammatory bowel disease

    Microsoft Academic Search

    Hyun-Soo Kim; Kil Yeon Lee; Youn Wha Kim

    2010-01-01

    Filiform polyposis (FP) of the colon is an uncommon entity that is occasionally encountered in patients with inflammatory bowel disease (IBD). FP is morphologically characterized by multiple slender worm-like projections consisting of submucosal cores lined with normal mucosa. To date, only two cases of FP have been reported in patients with inflammatory conditions of the gastrointestinal tract other than ulcerative

  20. Crohn's disease of the distal ileum.

    PubMed Central

    Higgens, C S; Allan, R N

    1980-01-01

    A clinical and statistical analysis has been undertaken in a consecutive series of 227 patients with Crohn's disease involving the distal ileum under long-term review between 1944 and 1978. We have determined the long-term prognosis, cumulative reoperation rates after each resection, mortality rates, and their causes. Actuarial analysis has shown that the reoperation rates are similar after first, second, and third resections. There was no evidence that additional operations increase the risk of yet more resections. Reoperation rates were very little influenced by the age at diagnosis of the underlying Crohn's disease. A short interval from diagnosis of Crohn's disease to the first resection tended to increase the reoperation rate in the short term but there was no overall long-term effect. There was a two-fold increase in mortality risk when compared with the general population. Half the deaths were unrelated to the underlying Crohn's disease and, in this group, the incidence and causes were similar to those expected in the general population matched for age, sex, and years at risk. Of the disease related deaths many occurred in the early years of experience. Only four patients in the series have died of Crohn's disease in the last 10 years. One hundred and ninety-three patients are still alive after a mean interval of 16.1 years from the diagnosis of Crohn's disease. Full information is available on 185, of whom 161 are well and symptom free. Seven have minor problems, while 17 are unwell (nine with radiological evidence of recurrent disease). PMID:7450558

  1. Influence of gilaburu (Viburnum opulus) juice on 1,2-dimethylhydrazine (DMH)-induced colon cancer.

    PubMed

    Ulger, Harun; Ertekin, Tolga; Karaca, Omur; Canoz, Ozlem; Nisari, Mehtap; Unur, Erdo?an; Elmal?, Ferhan

    2013-10-01

    In this study, the effects of gilaburu (Viburnum opulus) juice on colon tumorogenesis were investigated. Eight weeks old Balb-C male mice received subcutaneous injections of 1,2-dimethylhydrazine (DMH) (20 mg/kg body weight) once a week for 12 weeks. Both the sham control (group 1) and the DMH control (group 2) groups received drinking water alone, whereas the mice of groups 3 and 4 received gilaburu juice for 30 weeks (started with first DMH injection) and for 18 weeks (started after last DMH injection), respectively. Eighteen weeks after the last DMH injection, all mice were killed and the histogenesis of colon tumors was investigated from the paraffin-embedded sections of colon, which were stained with hematoxylin-eosin. The sites and incidences of tumoral lesions (low-grade dysplasia, high-grade dysplasia, intramucosal carcinoma and invasive carcinoma) were analyzed and compared with control. The results showed that the body weights of the mice were similar in all the groups. No tumoral lesions were found in group 1. Colon tumors developed in all DMH-treated mice (groups 2, 3 and 4). In these groups, the greatest numbers of tumor lesions were detected in the distal colon, followed by the mid-colon and only a few in the proximal colon. There was a reduction in the mean total number of tumor lesion in groups 3 (8.5) and 4 (8.3), when compared to group 2 (11.3). The incidence of invasive carcinoma in group 3 was significantly lower than group 2 (p < 0.05). On the basis of these results, we conclude that gilaburu juice may be useful for the prevention of colon cancer at the initiation stage. PMID:22546843

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

    PubMed

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

    2014-08-29

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

  3. 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

  4. 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.

  5. Split cord malformation type I distal to segmental myelomeningocele.

    PubMed

    Addas, Bassam M

    2014-12-01

    The coexistence of myelomeningocele (MMC) and split cord malformation (SCM) is a well-known phenomenon. The SCM is usually above or at the level of the MMC. Split cord malformation distal to the MMC is considered to be the rarest form of such a combination. We report a case of SCM (type I) distal to the MMC diagnosed pre-operatively. Repair of the MMC and the SCM were carried out in the same setting. PMID:25551117

  6. Radiographic Predictors of DRUJ Instability with Distal Radius Fractures

    PubMed Central

    Omokawa, Shohei; Iida, Akio; Fujitani, Ryotaro; Onishi, Tadanobu; Tanaka, Yasuhito

    2014-01-01

    Because the distal radioulnar joint (DRUJ) is an inherently unstable joint, the diagnosis and treatment of DRUJ instability is often difficult in a clinical hand surgery practice. Several soft tissue stabilizers are recognized, of which the deep limbs of the radioulnar ligament are primary stabilizers. This article discusses the predictors of DRUJ instability in distal radius fractures based on our clinical and biomechanical analyses. PMID:24533238

  7. Radiographic Predictors of DRUJ Instability with Distal Radius Fractures.

    PubMed

    Omokawa, Shohei; Iida, Akio; Fujitani, Ryotaro; Onishi, Tadanobu; Tanaka, Yasuhito

    2014-02-01

    Because the distal radioulnar joint (DRUJ) is an inherently unstable joint, the diagnosis and treatment of DRUJ instability is often difficult in a clinical hand surgery practice. Several soft tissue stabilizers are recognized, of which the deep limbs of the radioulnar ligament are primary stabilizers. This article discusses the predictors of DRUJ instability in distal radius fractures based on our clinical and biomechanical analyses. PMID:24533238

  8. Extended distal pancreatectomy for advanced pancreatic neck cancer

    PubMed Central

    Park, Shin-Young; Shin, Woo Young; Choe, Yun-Mee; Ahn, Seung-Ik

    2014-01-01

    Backgrounds/Aims We investigated the clinical application of extended distal pancreatectomy in patients with pancreatic neck cancer accompanied by distal pancreatic atrophy. In this study, we have emphasized on the technical aspects of using the linear stapling device for a bulky target organ. Methods From March 2010 to September 2013, 46 patients with pancreatic adenocarcinoma, who underwent pancreatic resection with radical intent at our institute, were reviewed retrospectively. Among them, three patients (6.5%) underwent extended distal pancreatectomy. A linear stapling device and vise-grip locking pliers were used for en bloc resection of the distal pancreas, first duodenal portion, and distal common bile duct. The results were compared with those after standard pancreatectomy. Results All three patients presented with jaundice, and the ratio of pancreatic duct to parenchymal thickness of the pancreatic body was greater than 0.5. Grade A pancreatic fistula developed in all of the cases, but none of these fistulae were lethal. Pathological staging was T3N1M0 in all of the patients. The postoperative daily serum glucose fluctuations and insulin requirements were comparable to those in patients who received pancreaticoduodenectomy or distal pancreatectomy. At the last follow-up, two patients were alive with liver metastasis at 4 and 10 months postoperatively, respectively, and one patient died of liver metastasis at 5 months postoperatively. Conclusions While the prognosis of advanced pancreatic neck adenocarcinoma is still dismal, extended distal pancreatectomy is a valid treatment option, especially when there is atrophy of the distal pancreas. Also, the procedure is technically feasible, and further refinement is necessary to improve patient survival.

  9. Endovascular treatment for ruptured distal anterior inferior cerebellar artery aneurysm.

    PubMed

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

    2014-03-01

    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

  10. 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

  11. Distal attribution and distance perception in sensory substitution.

    PubMed

    Siegle, Joshua H; Warren, William H

    2010-01-01

    In sensory substitution, the user may be directly aware of distal objects, as in everyday perception, or make explicit cognitive inferences based on an awareness of the proximal stimulation. Anecdotal evidence supports the experience of distal attribution, but so far there have been few rigorous experimental tests of the claim. In this study, blindfolded participants observed a target light using a device consisting of a finger-mounted photodiode that drives tactile vibra-tion on the back. With the blindfold off and the target removed, participants moved a reference object to match the perceived egocentric distance of the target. Participants who were instructed to attend to the distal target improved significantly during 2 h of practice, whereas those instructed to attend to proximal variables showed no improvement. Unsigned error increased with ratings of proximal attention, but decreased with ratings of target object solidity, consistent with distal attribution. Performance transferred to the non-dominant arm and to a rotated body orientation, demonstrating that learning did not depend on a joint-specific sensorimotor relationship between target distance and arm configuration. The results experimentally confirm that distal attribution can occur in sensory substitution, based on a perceptual strategy rather than an explicit cognitive strategy. Moreover, they suggest that the informational basis for distal attribution is not a joint-specific sensorimotor relation, but a more abstract spatial invariant. PMID:20402243

  12. 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

  13. Retrograde Intramedullary Nailing for Distal Femur Fracture with Osteoporosis

    PubMed Central

    Kim, Jihyeung; Nam, Kyungpyo; Rhee, Seung Hwan; Won, Jong Won; Han, Hyuk-Soo

    2012-01-01

    Background The incidence of distal femur fracture in the elderly has been increasing recently, and commonly occurs with osteoporosis. Retrograde intramedullary nailing has been considered a good surgical option for distal femur fracture. The purpose of the present study was to present our surgical results with retrograde intramedullary nailing for distal femur fractures with osteoporosis. Methods Thirteen patients diagnosed with extra-articular distal femur fracture and osteoporosis and managed with retrograde intramedullary nailing were retrospectively reviewed. Cement augmentation was used in four patients, shape memory alloy was used in eight patients and both were used in one patient. All patients were followed up for more than 2 years. Radiologic alignments were scored and Tegner and the Lysholm activity score was used for a functional assessment. Results The average time to clinical union was 13 weeks (range, 10 to 15 weeks). In 12 of our cases, the total alignment scores were excellent. At the last follow-up, the mean range of motion was 116° (range, 110° to 125°). The average functional score at postoperative 1 year was 2.6 (range, 1 to 5). Conclusions Retrograde intramedullary nailing is a good surgical option for distal femur fracture with osteoporosis. Cement augmentation and shape memory alloy can also be used for added mechanical stability. This surgical technique is very useful for distal femur fracture with osteoporosis as it promotes fracture healing and early rehabilitation. PMID:23205241

  14. Comparison between cerebral state index and bispectral index as measures of electroencephalographic effects of sevoflurane using combined sigmoidal Emax model

    Microsoft Academic Search

    Dong Woo Han; Olinto-Jose Linares-Perdomo; Jong Seok Lee; Jun Ho Kim; Steven E Kern

    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

  15. A Radical-Partitioned Neural Network System Using a Modified Sigmoid Function and a Wight-Dotted Radical Selector for Large-Volume Chinese Characters Recognition VLSI

    Microsoft Academic Search

    James B. Kuo; B. Y. Chen; Mark W. Mao

    1994-01-01

    This paper presents a radical-partitioned neural network system using a modified sigmoid function and a weight-dotted radical selector for a large-volume Chinese characters recognition VLSI. With a modified sigmoid function and the weight-dotted radical selector, the recognition rate of 1000 radical-partitioned Chinese characters can be enhanced to 90% from 70% for the input samples with 15% random errors as compared

  16. Transvenous embosurgery of a left sigmoid sinus dural arteriovenous fistula via a retrograde approach from the superior ophthalmic vein, cavernous and inferior petrosal sinuses.

    PubMed

    Patel, D V; Rangaswamy, R; Lesley, W S; Hester, J L; McDonald, D K; Tsai, J H

    2011-09-01

    The efficacy and safety of transvenous embosurgery for sigmoid sinus dural arteriovenous fistula (DAVF) using the internal jugular vein approach is well known. Embosurgery of cavernous sinus DAVF has also been described utilizing a superior ophthalmic vein approach. The first report of a sigmoid sinus DAVF endosurgical repair via a superior ophthalmic vein approach in a patient without internal jugular vein access is presented. PMID:21990830

  17. Colonic fermentation: metabolic and clinical implications

    Microsoft Academic Search

    K. H. Soergel

    1994-01-01

    Colonic SCFA formation from fermentable carbohydrate is important for the maintenance of morphologic and functional integrity of the colonic epithelium. Carbohydrate-induced diarrhea occurs when the amount of carbohydrate entering the colon exceeds its fermentation capacity. Deficient availability or utilization of SCFA, mainly of n-butyrate, is the cause of diversion colitis and may play important roles in colonic carcinogenesis, in starvation

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

    NASA Astrophysics Data System (ADS)

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

    2014-01-01

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

  19. Use of Magnetic Field Modeling and Topology Analysis in Understanding the Evolution and Eruption of Coronal Sigmoids

    NASA Astrophysics Data System (ADS)

    Savcheva, A. S.

    2014-12-01

    Coronal sigmoids, generally ovserved in X-rays and EUV, are S-shaped active regions that have been shown to possess high probability for eruption. They present a direct evidence of the existence of flux ropes in the corona prior to the impulsive phase of eruptions. In order to gain insight into their eruptive behavior and how they get destabilized we need to know their 3D magnetic field structure. We have performed highly data-constrained non-linear force-free field (NLFFF) models over the lifetime of several sigmoidal active regions and more specifically have captured their magnetic field structure around the times of major flares. We present this analysis of one region. We also look at the topology analysis for several sigmoidal regions and we show the probable sites of reconnection and put forward a scenario for eruption. We demonstrate the use of this topology analysis to reconcile the observed eruption features with the standard flare model. Finally, we show a glimpse of how such a NLFFF model of an erupting region can be used to initiate a CME in a global MHD code in an unprecedented realistic manner.

  20. Formation and eruption of an active region sigmoid. I. A study by nonlinear force-free field modeling

    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)

    2014-01-01

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

  1. 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

  2. Antiseptic impregnated endotracheal tubes for the prevention of bacterial colonization.

    PubMed

    Pacheco-Fowler, V; Gaonkar, T; Wyer, P C; Modak, S

    2004-06-01

    The effect of endotracheal tubes (ETTs) impregnated with chlorhexidine (CHX) and silver carbonate (antiseptic ETTs) against Staphylococcus aureus, methicillin-resistant S. aureus (MRSA), Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacter aerogenes [organisms associated with ventilator-associated pneumonia (VAP)], was evaluated in a laboratory airway model. Antiseptic ETTs and control ETTs (unimpregnated) were inserted in culture tubes half-filled with agar media (airway model) previously contaminated at the surface with 10(8) cfu/mL of the selected test organism. After five days of incubation, bacterial colony counts on all ETT segments were determined. Swabs of proximal and distal ends of the agar tract in antiseptic and control models were subcultured. The initial and residual CHX levels, (five days post-implantation in the model) were determined. Cultures of antiseptic ETTs revealed colonization by the tested pathogens ranging from 1-100 cfu/tube, compared with approximately 10(6) cfu/tube for the control ETTs (P < 0.001). Subcultures from proximal and distal ends of the agar tract showed minimal or no growth in the antiseptic ETTs compared with the control ETTs (P < 0.001). The amount of CHX retained in the antiseptic ETTs after five days of implantation was an average of 45% of the initial level. Antiseptic ETTs prevented bacterial colonization in the airway model and also retained significant amounts of the antiseptic. These results indicate that the effectiveness of antiseptic-impregnated ETTs in preventing the growth of bacterial pathogens associated with VAP may vary with different organisms. PMID:15183249

  3. Functional and manometric outcomes after a congenital pouch colon reconstruction: report of a case.

    PubMed

    Sangkhathat, Surasak; Patrapinyokul, Sakda; Chiengkriwate, Piyawan

    2012-02-01

    Congenital pouch colon is a form of anorectal malformation, rarely reported outside north India. Hallmarks of this malformation are a short colon containing a large distal pouch with a fistula connecting to the urinary system. Herein, the authors report the case of a Thai male neonate with a congenital pouch colon type II who was initially misdiagnosed as a common imperforate anus. As a result, urinary tract infection and metabolic acidosis developed after a colostomy. A definitive surgery consisting of a tabularized coloplasty and an abdominoperineal pull-through was performed at one month of age. After closure of the colostomy, the child experienced transient loose stool with perineal excoriation for about three months and then gradually improved. At three years of age, the patient had normal bowel movements and adequate sensation, and a contrast enema showed a normal sized neorectum. An anal endosonogram revealed good localization of the rectum. A rectal manometry showed spontaneous rectal contraction and a complete rectoanal inhibitory reflex. The present case provides evidence suggesting that preservation of the native pouch colon is not contraindicated in this type of congenital pouch colon syndrome. PMID:22435259

  4. Chronic inflammation alters the contribution of neurokinin receptor subtypes to epithelial function in rat colon.

    PubMed

    Appleyard, Caroline B; Morales, Marangelie; Santiago, Cariluz

    2008-01-01

    We have previously shown that neurokinin-1 (NK1) receptors predominantly mediate substance P-induced secretion of the non-inflamed rat colonic mucosa in vitro with a gradient in the magnitude of these responses. The aim of this study was to examine the effects of chronic inflammation on the contributions of different neurokinin receptor subtypes to colonic mucosal secretion. Colitis was induced by the intracolonic administration of 2,4,6-trinitrobenzene sulfonic acid in rats, reactivated 6 weeks later. Segments of proximal, mid- and distal colon were stripped of muscularis propria and mounted in Ussing chambers for measurement of short-circuit current. Use of selective agonists suggests that in the chronically inflamed rat colon NK1 receptors play a greater role in neurokinin-mediated mucosal secretion than do either NK2 or NK3. Selective antagonism implies that this is region-specific, with the inflammatory process altering the relative contribution of the neurokinin receptor subtypes within each region of the rat colon. PMID:17510797

  5. Mast cells and histamine contribute to bile acid-stimulated secretion in the mouse colon.

    PubMed Central

    Gelbmann, C M; Schteingart, C D; Thompson, S M; Hofmann, A F; Barrett, K E

    1995-01-01

    Certain dihydroxy bile acids cause secretory diarrhea when present in the colonic lumen at inappropriately high concentrations. However, the mechanism underlying the secretagogue activity has not been fully elucidated. Experiments were performed to test whether mast cells and one of their major mediators, histamine, might contribute to the secretory effect. Chenodeoxycholic acid, a secretory bile acid, and ursodeoxycholic acid, a nonsecretory, hydrophilic bile acid, were compared for their ability to induce chloride secretion across segments of mouse colon mounted in Ussing chambers. Chenodeoxycholic acid, but not ursodeoxycholic acid, induced dose-dependent, biphasic chloride secretion that was greater after serosal than mucosal addition and was greater in distal versus proximal colonic segments. The secretory effect of chenodeoxycholic acid was inhibited by H1 histamine receptor antagonists and modified by the cyclooxygenase inhibitor indomethacin. However, it was unaffected by an H2 histamine receptor antagonist or by atropine. Secretory effects of chenodeoxycholic acid were diminished in magnitude and delayed in colonic tissues from mice with a genetic deficiency of tissue mast cells. Concentrations of chenodeoxycholic acid inducing secretion also released histamine from tissue segments. These data indicate that mast cells and histamine-mediated processes contribute significantly to the secretory effects of dihydroxy bile acids in the murine colon. Images PMID:7769123

  6. Spleen-Preserving Distal Pancreatectomy for Pancreatic Trauma: A Series of Six Cases

    Microsoft Academic Search

    Thakur Deen Yadav; Sabareesh Kumar Natarajan; Venkata Murali; Gottapu Kishore

    Context Spleen-preserving distal pancreatectomy is a well-accepted procedure for benign tumors of the distal pancreas. Its safety and feasibility have been proven. However many doctors have not used this procedure due to the trauma involved. Objective We present our experience of six cases of distal pancreatic trauma where we managed to preserve the spleen during distal pancreatectomy in an emergency

  7. Defining a molecularly normal colon.

    PubMed

    Murphy, K J; Nielson, K R; Albertine, K H

    2001-05-01

    As techniques evolve that allow molecular characterization of disease processes such as cancer, definition of "normal" at a molecular level becomes increasingly important. Increasingly large numbers of mutations are found at the genomic level, but whether all of those mutations contribute to the malignant state of a carcinoma cell is not clear. Without knowledge of what constitutes normality on the proteomic level in an organ or cell, we cannot determine what genomic changes are physiologically important. Traditionally, colon cancer is identified and classified by histological criteria. Margins of the colon are defined as "grossly uninvolved" when the histology is indistinguishable from that of normal (free from disease) colon. By using molecular pathology techniques and working backward from colon adenocarcinoma to hypoplastic polyps to presumably normal mucosa, we defined some of those protein differences. Our results may provide a molecular basis for identifying tumor formation and progression in situ.(J Histochem Cytochem 49:667-668, 2001) PMID:11304807

  8. Hydrodynamic consequences of barnacle colonization

    Microsoft Academic Search

    J. C. Thomason; J. M. Hills; A. S. Clare; A. Neville; M. Richardson

    1998-01-01

    The aim of this project was to study the hydrodynamic consequences of substratum colonization by barnacles. Replicas of individual\\u000a barnacles and barnacle colonies, and living colonies were studied in a 5 m seawater flume using tracer dyes, macro video-photography\\u000a and image digitization and in a small flume fitted with differential pressure sensors. Using replicas, colonization densities\\u000a were manipulated to determine

  9. [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

  10. Ammonium transport in the colonic crypt cell line, T84: role for Rhesus glycoproteins and NKCC1.

    PubMed

    Worrell, Roger T; Merk, Lisa; Matthews, Jeffrey B

    2008-02-01

    Although colonic lumen NH(4)(+) levels are high, 15-44 mM normal range in humans, relatively few studies have addressed the transport mechanisms for NH(4)(+). More extensive studies have elucidated the transport of NH(4)(+) in the kidney collecting duct, which involves a number of transporter processes also present in the distal colon. Similar to NH(4)(+) secretion in the renal collecting duct, we show that the distal colon secretory model, T84 cell line, has the capacity to secrete NH(4)(+) and maintain an apical-to-basolateral NH(4)(+) gradient. NH(4)(+) transport in the secretory direction was supported by basolateral NH(4)(+) loading on NKCC1, Na(+)-K(+)-ATPase, and the NH(4)(+) transporter, RhBG. NH(4)(+) was transported on NKCC1 in T84 cells nearly as well as K(+) as determined by bumetanide-sensitive (86)Rb-uptake. (86)Rb-uptake and ouabain-sensitive current measurement indicated that NH(4)(+) is transported by Na(+)-K(+)-ATPase in these cells to an equal extent as K(+). T84 cells expressed mRNA for the basolateral NH(4)(+) transporter RhBG and the apical NH(4)(+) transporter RhCG. Net NH(4)(+) transport in the secretory direction determined by (14)C-methylammonium (MA) uptake and flux occurred in T84 cells suggesting functional RhG protein activity. The occurrence of NH(4)(+) transport in the secretory direction within a colonic crypt cell model likely serves to minimize net absorption of NH(4)(+) because of surface cell NH(4)(+) absorption. These findings suggest that we rethink the present limited understanding of NH(4)(+) handling by the distal colon as being due solely to passive absorption. PMID:18032481

  11. Magnolol inhibits colonic motility through down-regulation of voltage-sensitive L-type Ca2+ channels of colonic smooth muscle cells in rats.

    PubMed

    Zhang, Man; Zang, Kai-Hong; Luo, Jia-Lie; Leung, Fung-Ping; Huang, Yu; Lin, Cheng-Yuan; Yang, Zhi-Jun; Lu, Ai-Ping; Tang, Xu-Dong; Xu, Hong-Xi; Sung, Joseph Jao-yiu; Bian, Zhao-Xiang

    2013-11-15

    This study aimed to investigate the effect of magnolol (5,5'-diallyl-2,2'-biphenyldiol) on contraction in distal colonic segments of rats and the underlying mechanisms. Colonic segments were mounted in organ baths for isometric force measurement. Whole-cell voltage-sensitive L-type Ca(2+) currents were recorded on isolated single colonic smooth muscle cells using patch-clamp technique. The spontaneous contractions and acetylcholine (ACh)- and Bay K 8644-induced contractions were inhibited by magnolol (3-100 ?M). In the presence of Bay K8644 (100 nM), magnolol (10-100 ?M) inhibited the contraction induced by 10 ?M ACh. By contrast, tetrodotoxin (100 nM) and N?-nitro-L-arginine methyl ester (L-NAME 100 ?M) did not change the inhibitory effect of magnolol (10 ?M). In addition, magnolol (3-100 ?M) inhibited the L-type Ca(2+) currents. The present results suggest that magnolol inhibits colonic smooth muscle contraction through downregulating L-type Ca(2+) channel activity. PMID:23972358

  12. Fasting and postprandial volumes of the undisturbed colon: normal values and changes in diarrhea-predominant irritable bowel syndrome measured using serial MRI

    PubMed Central

    Pritchard, S E; Marciani, L; Garsed, K C; Hoad, C L; Thongborisute, W; Roberts, E; Gowland, P A; Spiller, R C

    2014-01-01

    Background Previous assessments of colon morphology have relied on tests which were either invasive or used ionizing radiation. We aimed to measure regional volumes of the undisturbed colon in healthy volunteers (HV) and patients with diarrhea-predominant irritable bowel syndrome (IBS-D). Methods 3D regional (ascending, transverse, and descending) colon volumes were measured in fasting abdominal magnetic resonance (MR) images of 75 HVs and 25 IBS-D patients. Thirty-five of the HV and all 25 IBS-D subjects were fed a standard meal and postprandial MRI data obtained over 225 min. Key Results Colonic regions were identified and 3D maps from cecum to sigmoid flexure were defined. Fasted regional volumes showed wide variation in both HVs being (mean ± SD) ascending colon (AC) 203 ± 75 mL, transverse (TC) 198 ± 79 mL, and descending (DC) 160 ± 86 mL with no difference from IBS-D subjects (AC 205 ± 69 mL, TC 232 ± 100 mL, and DC 151 ± 71 mL, respectively). The AC volume expanded by 10% after feeding (p = 0.007) in the 35 HV possibly due to increased ileo-colonic inflow. A later rise in AC volume occurred from t = 90 to t = 240 min as the meal residue entered the cecum. In contrast, IBS-D subjects showed a much reduced postprandial response of the AC (p < 0.0001) and a greater increase in TC volume after 90 min (p = 0.0244) compared to HV. Conclusions & Inferences We have defined a normal range of the regional volumes of the undisturbed colon in fasted and fed states. The AC in IBS-D appeared less able to accommodate postprandial inflow which may account for faster colonic transit. PMID:24131490

  13. [Effect of the bile and bile acids on the motility of the innervated rabbit colon].

    PubMed

    Radymska-Wawrzyniak, K; Szember-Nyrka, B; Rybka, A

    1987-01-01

    The studies have been carried out in vitro on the colons of 25 rabbits. The material was collected according to the Garry and Gillespie technique. The preparations consisted of the distal region of the colon together with the branches of parasympathetic nerves (pelvic ones) and with the sympathetic nerve (hypogastric). The conductivity was studied by the method of stimulation of these nerves branches with the 10 V impulses, 5 s long frequency 50-100 Hz, every 2-4 minutes. Spontaneous colon motoricity was registered on the kymograph in the chamber with oxyzenized Krebs fluid, according to the Magnus method. 0.3-10.0 ml of the bile per 1 l of the Krebs fluid was administered to the chamber. The same quantities of the physiological salt solution were administered to the chamber as the control. As for the chemically pure biliary acids, the cholic, deoxycholic and chenodeoxycholic acids (Light) were administered in quantities 500-1500 mumoles/l of the Krebs solution, as well as litocholic acid (Serva) in the concentration 300-500 mumoles/l. The control was carried out exactly as previously described. It has been found out that bile can inhibit or stimulate the colon motoricity and the nerves conductivity, depending on its concentration. At the small concentration (0.3 ml/l of the Krebs fluid) the bile stimulated the spontaneous colon motoricity and the conductivity of the sympathetic as well as the parasympathetic nerves. The high concentration (10 ml/l) had the inhibition effect on the colon motoricity and suppressed the nerves conductivity. As for the biliary acids, the strongest inhibitory effect had the litocholic acid, the weaker inhibitory effect had the cholic and deoxycholic acids. The chenodeoxycholic acid suppressed the nerves conductivity but stimulated the colon motoricity and increased the constriction amplitude. PMID:3508522

  14. Predictive value of urine cultures in evaluation of bacterial colonization of ureteral stents.

    PubMed

    Rahman, M A; Alam, M M; Shahjamal, S; Islam, M R; Haque, M E

    2012-04-01

    To evaluate the predictive value of urine cultures in the assessment of ureteral stent colonization and to investigate the frequency of double J stent colonization and stent associated bacteriuria. This observational study was conducted in the department of Urology, Dhaka Medical College Hospital from December 2006 to March 2009. A total of 100 patients (mean age 39.2 ± 9.9 years, range 18-60 years, 69 male and 31 female) needing internal ureteral stent placement for different sorts of urinary tract operations were included in the study. Sterile urine samples were obtained from each patient before stenting and all patients had been given short-term prophylactic antibiotic (5-12 days). On the day of stent removal midstream urine were obtained from all patients for microbiological culture. Stents removed by aseptic precaution. Proximal and distal tip segments (3-5 cm) were also sent for culture. The lowest and highest durations of stenting were 10 and 86 days respectively (median 35 days). Both bacteriuria and bacterial colonization was significantly higher as duration of stenting increases (p=0.045 and p<0.001). E. coli was the most common microorganism isolated from both urine and stent culture. However, colonization rate of stents was much higher (45%) than positive urine cultures (21%) indicating that urine culture is less sensitive to diagnose stent colonization (k-value = 0.49). The study concludes that bacterial colonization significantly increases with indwelling time of stent and sterile culture of urine does not rule out that the stent itself is colonized. PMID:22561775

  15. Mucinous cystadenoma of the appendix associated with adenocarcinoma of the sigmoid colon and hepatocellular carcinoma of the liver: Report of a case

    Microsoft Academic Search

    Srdjan P Djuranovic; Milan M Spuran; Nada V Kovacevic; Milenko B Ugljesic; Dragutin M Kecmanovic; Marjan T Micev

    Mucinous cystadenoma of the appendix is a rare condition and represents one of the three entities with the common name mucocele of the appendix. It is characterized by a cystic dilatation of the lumen with stasis of mucus inside it. Histopathologically mucocele is divided into three groups: focal or diffuse mucosal hyperplasia, mucinous cystadenoma and mucinous cystadenocarcinoma. This condition is

  16. 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

  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. Concurrent caecal and transverse colonic tuberculosis masquerating synchronous colonic carcinoma

    PubMed Central

    Demetriou, George A; Nair, Manojkumar S; Navaratnam, Romi

    2013-01-01

    We present a 46-year-old Somalian woman, who attended our hospital, with 1?week history of worsening epigastric pain and vomiting, worse after eating on a background of 3?months history of four stones loss of weight, malaise and decreased appetite. CT scan of the abdomen revealed an annular 10?cm long mass of the right transverse colon with a second mass of the caecum raising concerns of a synchronous colonic cancer. She underwent an extended right hemi-colectomy due to the development of obstruction from the transverse colon lesion. The histology revealed caseating, transmural granulomatous inflammation consistent with tuberculosis. She had an uneventful recovery and was discharged on the tenth postoperative day on antituberculosis (anti-TB) medications. She reports complete resolution of her symptoms 4?months after discharge. PMID:23661658

  19. 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

  20. Induction of tumors in the colon and liver of the immunodeficient (SCID) mouse by 2-amino-3-methylimidazo[4,5-f ]quinoline (IQ)-modulation by long-chain fatty acids.

    PubMed

    Salim, Elsayed I; Wanibuchi, Hideki; Morimura, Keiichirou; Murai, Takashi; Makino, Susumu; Nomura, Taisei; Fukushima, Shoji

    2002-09-01

    We have recently shown that immunodeficient (SCID) mice, which lack functional T and B cells, are highly susceptible to low dose site specific induction of colon aberrant crypt foci (ACF), surrogates for colon tumors, by 2-amino-3-methylimidazo[4,5-f ]quinoline (IQ). To test whether long-term exposure to a high dose in the diet might prove carcinogenic to the SCID mouse colon, in contrast to other mice strains tested to date, the compound was administered at 300 p.p.m. in the diet to female 6-7-week-old SCID mice for 32 weeks. IQ induced high numbers of ACF, hyperplastic polyps, dysplasia, and colon adenomas, as well as hepatocellular altered foci and liver adenomas. Induction of colon tumors did not correlate with the main sites where ACF developed, the proximal colon, however, being seen mainly in the mid and distal colon. Induction of colon tumors correlated significantly with the incidence of dysplasia, crypt height, the mitotic index, cell proliferation and numbers of 8-hydroxydeoxyguanosine (8-OHdG)-positive cells in the colon crypt, particularly in mid and distal colon. Administration of 20% omega-6 polyunsaturated fatty acids (corn oil), omega-3 polyunsaturated fatty acids (perilla oil), or monounsaturated fatty acids (olive oil) simultaneously with IQ in the diet resulted in: (i) inhibition of colon and liver tumor induction by corn and perilla oil, whereas olive oil showed no effects; (ii) no reduction in total numbers of ACF by corn oil or perilla oil but significant suppression in the olive oil treated group; (iii) inhibition of tumor development particularly by omega-3 polyunsaturated fatty acids in perilla oil, correlating significantly with decreased cell proliferation in both colon and liver and a marked decrease in crypt heights and mitotic indices. Selective reduction in the numbers of 8-OHdG-positive nuclei, mainly in the middle and distal colon crypts, was also found to correlate with tumor inhibition. Thus, the results indicate carcinogenicity of IQ in the colon of the SCID mouse and preventive effects of polyunsaturated fatty acids. PMID:12189196

  1. Carcinoid tumors of the alimentary tract. II. Angiographic diagnosis of small intestinal and colonic lesions.

    PubMed

    Kinkhabwala, M; Balthazar, E J

    1978-04-15

    The angiographic findings of five small intestinal and two colonic carcinoids are described and illustrated, together with a review of the pertinent literature. It is pointed out that the demonstration of a complex of angiographic findings related to the primary site, mesentery, and liver is highly specific. It helps in the preoperative diagnosis as well as in the localization and stage of development of the gastrointestinal carcinoid. The triad of findings is composed of: (a) faint to moderate staining at the primary site; (b) narrowing, obstruction of the distal mesenteric arcade, cluster of irregular kinked vessels, and encasement in the more central areas of mesentery; and (c) hypervascular liver metastasis. The colonic lesions examined are unique in the literature, and exhibited angiographic findings similar to the small bowel carcinoids. PMID:669167

  2. [Motility disorders of the colon].

    PubMed

    Müller-Lissner, S

    2015-06-01

    The motility of the colon is modulated by the enteric nervous system. It is very complex, governing backward and forward movements of the feces. Primary megacolon and megarectum are clinically diverse. Megacolon refractory to laxative treatment may be subject to colectomy, while megarectum should be treated by consistent laxation. Acute colonic pseudo-obstruction may occur with severe systemic diseases and electrolyte disturbances or it may be postoperatively and/or medically induced. A small proportion of chronically constipated patients suffer from slow transit constipation, others from disordered defecation. In the remaining patients no objective cause of the complaints may be found. In slow transit constipation, propulsive colonic motility is disturbed, dietary fiber is ineffective, and the response to bisacodyl is blunted. Pelvic floor dyssynergia is characterized by a voluntary (although unconscious) contraction of the anal sphincter simultaneously with the abdominal muscles. It can be treated by avoiding straining and by sphincter training. PMID:25940144

  3. 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

  4. 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

  5. A laparoscopic high anterior resection for sigmoid cancer with extraction through incarcerated left inguinal hernia repaired with Permacol mesh.

    PubMed

    Carr, William Reginald Joseph; O'Dair, Graham

    2012-01-01

    A 65-year-old man presented to the general surgical outpatients with an incarcerated left inguinal hernia. Initial investigations revealed an iron deficiency anaemia that was investigated with a colonoscopy and gastroscopy. This revealed a sigmoid cancer and the staging CT scan confirmed a tumour incarcerated in the sac of the left inguinal hernia. We proceeded with a laparoscopic high anterior resection using the inguinal hernia as the extraction site. The hernia was repaired using Permacol mesh. No postoperative complications occurred. PMID:23001089

  6. Regulation of colonic apical potassium (BK) channels by cAMP and somatostatin

    PubMed Central

    Perry, M. D.; Sandle, G. I.

    2009-01-01

    High-conductance apical K+ (BK) channels are present in surface colonocytes of mammalian (including human) colon. Their location makes them well fitted to contribute to the excessive intestinal K+ losses often associated with infective diarrhea. Since many channel proteins are regulated by phosphorylation, we evaluated the roles of protein kinase A (PKA) and phosphatases in the modulation of apical BK channel activity in surface colonocytes from rat distal colon using patch-clamp techniques, having first increased channel abundance by chronic dietary K+ enrichment. We found that PKA activation using 50 ?mol/l forskolin and 5 mmol/l 3-isobutyl-1-methylxanthine stimulated BK channels in cell-attached patches and the catalytic subunit of PKA (200 U/ml) had a similar effect in excised inside-out patches. The antidiarrheal peptide somatostatin (SOM; 2 ?mol/l) had a G protein-dependent inhibitory effect on BK channels in cell-attached patches, which was unaffected by pretreatment with 10 ?mol/l okadaic acid (an inhibitor of protein phosphatase type 1 and type 2A) but completely prevented by pretreatment with 100 ?mol/l Na+ orthovanadate and 10 ?mol/l BpV (inhibitors of phosphoprotein tyrosine phosphatase). SOM also inhibited apical BK channels in surface colonocytes in human distal colon. We conclude that cAMP-dependent PKA activates apical BK channels and may enhance colonic K+ losses in some cases of secretory diarrhea. SOM inhibits apical BK channels through a phosphoprotein tyrosine phosphatase-dependent mechanism, which could form the basis of new antidiarrheal strategies. PMID:19407217

  7. Distal biceps reconstruction 13 years post-injury.

    PubMed

    Burrus, M Tyrrell; Chhabra, A Bobby

    2015-04-01

    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

  8. Injectable calcium phosphate in the treatment of distal radial fractures

    Microsoft Academic Search

    P. Kopylov; K. Jonsson; K. G. Thorngren; P. Aspenberg

    1996-01-01

    An injectable material which hardened in situ to form a carbonated hydroxyapatite, Norian SRS (Norian Corp., Cupertino, USA), was used as the only treatment of unstable distal radial fractures in six patients. Except for an external dorsal splint for 2 weeks, no other treatment was used. The material maintained reduction except in one case in which there were technical problems

  9. Proximate and Distal Variables in the Demography of Rendille Pastoralists

    Microsoft Academic Search

    Eric Abella Roth

    1999-01-01

    Following the widespread application and success of Bongaarts' proximate fertility framework in the 1980s, anthropologists and demographers have shown increased interest in the delineation of distal fertility variables, alternatively called higher-order by cultural ecologists or ultimate variables by evolutionary ecologists. This shift in focus raises at least four immediate issues: (1) confusion over the role and effect of culture on

  10. Distal chronic spinal muscular atrophy involving the hands

    Microsoft Academic Search

    D J OSullivan; J G McLeod

    1978-01-01

    Six patients are described with a history of slowly progressive wasting of the muscle of the hands and forearms extending over periods of up to 20 years. The clinical, radiological, and electrophysiological findings were consistent with a diagnosis of chronic anterior horn cell degeneration. It is suggested that the patients are affected by a form of distal chronic spinal muscular

  11. Endoscopic Distal Soft Tissue Procedure in Hallux Valgus Surgery

    Microsoft Academic Search

    Tun Hing Lui; Shek Ng; Kwok-bill Chan

    2005-01-01

    The distal soft tissue procedure is the basis of surgical hallux valgus correction. It involves release of the transverse metatarsal ligament, adductor hallucis, and lateral joint capsule, which permits the proximal phalanx to be realigned on the metatarsal head. The attenuated medial capsule is plicated after the medial bony prominence has been excised. We describe a new endoscopic approach for

  12. Fisioterapia en fracturas de radio distal: revisión sistemática

    Microsoft Academic Search

    H. Gutiérrez Espinoza; U. Herrera Rivas; R. Aguilera Eguía; R. Gutiérrez Monclus

    The distal radius fracture is a common clinical problem that mainly affects elderly women. The use of different modalities of physiotherapy has recently become a routine indication in rehabilitation process in these patients. A synthesis of the evidence is made using a Systematic Review of Randomized Clinical Trials.

  13. Afferent Input Regulates the Formation of Distal Dendritic Branches

    E-print Network

    Libersat, Frederic

    organs called cerci provide the major Grant sponsor: Israel Academy of Sciences and Humanities; Grant numAfferent Input Regulates the Formation of Distal Dendritic Branches ADI MIZRAHI* AND FREDERIC LIBERSAT Zlotowski Center for Neuroscience and Department of Life Sciences, Ben-Gurion University

  14. Familial distal trisomy 8(q24.13----qter)

    Microsoft Academic Search

    D R Romain; R A Bloxham; L M Columbano-Green; C J Chapman; R G Parfitt; R H Smythe; H Cairney

    1989-01-01

    Trisomy for the distal part of the long arm of chromosome 8(q24.13----qter) is described in three sibs. The anomaly arose as an adjacent 1 meiotic segregation from a balanced reciprocal translocation t(1;8)(q44; q24.13)mat.

  15. Challenges in robotic distal pancreatectomy: systematic review of current practice.

    PubMed

    Guerra, F; Pesi, B; Amore Bonapasta, S; Di Marino, M; Perna, F; Annecchiarico, M; Coratti, A

    2015-08-01

    Over the last decade, robotics has gained popularity and is increasingly employed to accomplish several abdominal surgical procedures. Nevertheless, pancreatectomies are regarded as demanding procedures for which the application of minimally-invasive surgery is still limited and its effectiveness has not been conclusively established. We aimed to investigate the current role of robot-assisted surgery to perform distal pancreatectomy. A systematic review of the English-language literature was conducted for articles dealing with robotic-assisted distal pancreatectomies. All relevant papers were evaluated on surgical and oncological outcomes. A total of 10 articles reporting on robotic distal pancreatectomies were finally considered in the analysis, including 259 patients. Mean operative time was 271 minutes (range 181-398); mean blood loss was 210 mL (range 104-361), in 11.6% of cases conversion to laparotomy occurred, spleen preservation was accomplished in 51.4% of procedures, mean time of postoperative hospital stay was 7 days. Overall, postoperative mortality and morbidity were 0% and 23.4% respectively, the mean number of lymph nodes harvested was 12.7. In all included series, no case of R1 resection was reported. Despite its relatively recent introduction in clinical practice, robotic-assisted surgery has been widely employed to perform distal pancreatectomy worldwide and it should be considered a safe and effective procedure. Both surgical and pathologic data support its application in the management of pancreatic lesions of the body and tail. PMID:25916194

  16. Distal embolization from medial cystic degeneration of the popliteal artery.

    PubMed

    Richards, J; Stuart, W P

    2011-08-01

    This is the first reported case of medial cystic degeneration of the popliteal artery presenting as distal embolization and contains a high-definition photo of the cyst in situ. Duplex ultrasound and magnetic resonance angiography are useful adjuncts to diagnosis. Based on the published literature, resection and interposition grafting appears to be the most efficacious treatment modality. PMID:21873730

  17. Open reduction and internal fixation of the distal radius

    Microsoft Academic Search

    David S. Ruch; T. Adam Ginn

    2003-01-01

    Fractures of the distal radius are one of the most common problems treated by orthopaedic surgeons. The managementof unstable fractures is now almost routinely surgical, and multiple techniques have been developed to accomplish this including pins and plaster, external fixation, and internal fixation. Recent studies and classification systems have stressed the importance of identification of specific fracture fragments. Given that

  18. Functional results and complications of locked distal radius volar plates

    Microsoft Academic Search

    M. R. Sánchez-Crespo; F. del Canto-Álvarez; F. Peñas-Díaz; V. de Diego-Gutiérrez; M. Gutiérrez-Santiago; P. Sánchez-Juan

    2009-01-01

    Introduction and purposeIn the last few years, there has been increased aggressiveness in the treatment of distal radius fractures by means of internal fixation. Locked plates prevent metaphyseal collapse even in the presence of osteoporotic or comminuted bone; they also maintain reduction and allow early motion. Nevertheless, there is as yet not enough evidence as to what may be the

  19. Planning Correction of Distal Radial Fractures R. Zanibbi1

    E-print Network

    Zanibbi, Richard

    Length: length difference along long axis of model bone 5 Subsampling Condition: ICP using registrationPlanning Correction of Distal Radial Fractures Using ICP R. Zanibbi1 , B. Ma1 , Y. Chen1 , D. R selection factors above examined Metrics Observed After Alignment: 1. Angle between long axes in anterior

  20. Perceptions and Realities for Distal Freehand Interlocking of Intramedullary Nails

    PubMed Central

    Ostrum, Robert F.

    2015-01-01

    There is a perception that distal freehand interlocking (DFHI) of intramedullary nails can be difficult and time consuming. This study consists of a survey of surgeons' practices for DFHI screws and their reasons for not using this technique. A survey was sent to 1400 orthopaedic surgeons who were asked to agree or disagree with statements regarding the difficulty and indications for the usage of distal freehand interlocking screws. The results were analyzed by practice demographics, resident availability, and completion of an orthopaedic trauma fellowship. Overall, 316 surgeons (22.6%) responded to the survey. Fellowship trained surgeons were 60% less likely to find DFHI difficult when compared to nonfellowship surgeons and surgeons with residents were 76% less likely to perceive DFHI as difficult than surgeons without residents. In all groups, 40–43% of surgeons used distal interlocking based on their comfort with the technique and not the fracture pattern. Distal freehand interlocking is perceived as difficult by community orthopaedic surgeons without residents and surgeons who have not done an orthopaedic trauma fellowship. Forty percent of surgeons based their usage of DFHI screws on their comfort with the technique and not the fracture pattern. PMID:25945259

  1. 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

  2. Repair of distal biceps tendon ruptures in athletes

    Microsoft Academic Search

    Donald F. DAlessandro; Clarence L. Shields; James E. Tibone; Robert W. Chandler

    1993-01-01

    Ten athletes with distal biceps tendon ruptures that had been anatomically repaired with a double-incision technique were reviewed to determine their functional recovery. All of the patients were men, with an average age of 40 years (range, 25 to 49). Eight of the 10 patients were weight lifters or body builders, and 7 had participated on a competitive level at

  3. Local excision and postoperative radiotherapy for distal rectal cancer

    Microsoft Academic Search

    Richard Benson; C. Shun Wong; Bernard J Cummings; James Brierley; Pamela Catton; Jolie Ringash; Mohamed Abdolell

    2001-01-01

    Purpose: To assess the outcome following local excision and postoperative radiotherapy (RT) for distal rectal carcinoma.Materials and Methods: Seventy-three patients received postoperative radiotherapy following local surgery for primary rectal carcinoma at Princess Margaret Hospital from 1983 to 1998. Selection factors for postoperative RT were patient preference, poor operative risks, and “elective” where conservative therapy was regarded as optimal therapy. Median

  4. 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…

  5. 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...

  6. Drugs Approved for Colon and Rectal Cancer

    MedlinePLUS

    ... Questions to Ask Your Doctor about Treatment Research Drugs Approved for Colon and Rectal Cancer This page ... Rectal Cancer Drugs Approved for Gastroenteropancreatic Neuroendocrine Tumors Drugs Approved for Colon Cancer Adrucil (Fluorouracil) Avastin (Bevacizumab) ...

  7. Evolving colon injury management: a review.

    PubMed

    Greer, Lauren T; Gillern, Suzanne M; Vertrees, Amy E

    2013-02-01

    The colon is the second most commonly injured intra-abdominal organ in penetrating trauma. Management of traumatic colon injuries has evolved significantly over the past 200 years. Traumatic colon injuries can have a wide spectrum of severity, presentation, and management options. There is strong evidence that most non-destructive colon injuries can be successfully managed with primary repair or primary anastomosis. The management of destructive colon injuries remains controversial with most favoring resection with primary anastomosis and others favor colonic diversion in specific circumstances. The historical management of traumatic colon injuries, common mechanisms of injury, demographics, presentation, assessment, diagnosis, management, and complications of traumatic colon injuries both in civilian and military practice are reviewed. The damage control revolution has added another layer of complexity to management with continued controversy. PMID:23336650

  8. 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

  9. Colonic fermentation: metabolic and clinical implications.

    PubMed

    Soergel, K H

    1994-10-01

    Colonic SCFA formation from fermentable carbohydrate is important for the maintenance of morphologic and functional integrity of the colonic epithelium. Carbohydrate-induced diarrhea occurs when the amount of carbohydrate entering the colon exceeds its fermentation capacity. Deficient availability or utilization of SCFA, mainly of n-butyrate, is the cause of diversion colitis and may play important roles in colonic carcinogenesis, in starvation and enterotoxigenic diarrhea, and in idiopathic UC. PMID:7865976

  10. Posterior interosseous nerve incarceration with endobutton repair of distal biceps.

    PubMed

    Van den Bogaerde, James; Shin, Edward

    2015-01-01

    Distal biceps ruptures are uncommon injuries that comprise approximately 3% of all biceps pathology. This injury is most commonly seen in 40- to 60-year-old men, and the mechanism of injury involves a forceful extension movement to a flexed elbow. Without surgical intervention, patients are left with measurable weakness in elbow flexion and supination as well as a cosmetic deformity that often leaves them dissatisfied. Consequently, early surgical repair is advocated for physically active individuals. A variety of surgical approaches and fixation devices are currently used for distal biceps repair. The single-incision cortical button repair for distal biceps avulsions has become popular since Bain introduced the technique in 2000. The advantage of the cortical button biceps repair technique is the significantly higher failure strength than either the 2-incision technique or the suture anchor repair. The initial repair strength of the cortical button technique allows immediate active elbow range of motion and accelerated rehabilitation. Additionally, the single-incision anterior approach is less invasive than the 2-incision biceps repair and results in a lower incidence of heterotopic ossification. One disadvantage of this approach, however, is the risk of injury to the posterior interosseous nerve. The authors report a case in which the posterior interosseous nerve was incarcerated between the cortical button and the radius during acute distal biceps repair, resulting in complete posterior interosseus nerve palsy. This case report details the surgery leading to the nerve palsy and the subsequent nerve exploration that identified the cause of the nerve palsy. Recommendations are made on how to avoid this complication during distal biceps tendon repairs. PMID:25611423

  11. Distal radius malunion and forearm rotation: a cadaveric study.

    PubMed

    Bronstein, Andrew; Heaton, Dennis; Tencer, Allan F; Trumble, Thomas E

    2014-02-01

    Background?Malunions following distal radius fractures are common, with shortening, translation, and rotation occurring. The patients frequently lose forearm rotation, but there is no data to indicate whether this is due to mechanical misalignment between the radius and the ulna or to contracture of the soft tissues. Material and Methods?Seven fresh cadaveric specimens were used to determine the loss of forearm rotation with varying simulated distal radius fracture malalignment patterns. Uniplanar malunion patterns consisting of dorsal tilt, radioulnar translation, or radial shortening were simulated by creating an osteotomy at the distal end of the radius. Description of Technique?By orienting the distal fragment position using an external fixator and maintaining the position with wedges and a T-plate, varying degrees of malunion of the distal radius could be simulated. Rotation of the forearm was produced by fixing the elbow in a flexed position and applying a constant torque to the forearm using deadweights. Forearm rotation was measured with a protractor. Results?Dorsal tilt to 30° and radial translation to 10?mm led to no significant restriction in forearm pronation or supination ranges of motion. A 5-mm ulnar translation deformity resulted in a mean 23% loss of pronation range of motion. Radial shortening of 10?mm reduced forearm pronation by 47% and supination by 29%. Conclusion?Because a severe osseous misalignment was required to produce a significant loss in rotation, contracture of the soft tissues is most likely the cause of the loss of rotation in most cases. PMID:24533239

  12. 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

  13. Lubiprostone Decreases Mouse Colonic Inner Mucus Layer Thickness and Alters Intestinal Microbiota

    PubMed Central

    Musch, Mark W.; Wang, Yunwei; Claud, Erika C.

    2013-01-01

    Background Lubiprostone has been used to treat constipation through its effects to stimulate Cl? secretion, resulting in water and electrolyte secretion. Aim Potential associated changes in intestinal mucus and the colonizing bacteria (microbiome) have not been studied. As mucus obstructions may play a role in cystic fibrosis, the hypothesis that lubiprostone alters intestinal mucus and the microbiome was investigated. Methods Ion transport studies were performed ex vivo. For mucus and microbiome studies, mice were gavaged daily with lubiprostone or vehicle. Mucin from intestinal sections was analyzed in Carnoy’s fixed tissues stained with Alcian blue. Microbiome composition was analyzed by 16S rRNA gene-based sequencing. Results Lubiprostone stimulated short circuit current in all mouse intestinal segments after both serosal and mucosal additions, albeit at lower concentrations in the latter. Current was Cl-dependent and blocked by mucosal diphenylcarboxylic acid, serosal bumetanide, and serosal Ba++. The CFTR inhibitor CFTRinh172 had a marginal effect. Mucus near epithelial cells (inner layer mucus) was not present in the small intestine of any mice. Proximal colon inner mucus layer was thicker in ?F/?F compared with +/?F and +/+ mice. Lubiprostone decreased inner mucus layer thickness in both proximal and distal colon of all mice. Furthermore, lubiprostone altered the intestinal microbiome by increasing abundance of Lactobacillus and Alistipes. Conclusions Lubiprostone activates non-CFTR Cl? secretion and alters the colonic inner mucus layer, which is associated with changes in the composition of the enteric microbiome. PMID:23329012

  14. KINEMATIC AND MECHANICAL CHANGES IN THE DISTAL RADIOULNAR JOINT (DRUJ) OF PATIENTS WITH MALUNITED DISTAL RADIUS FRACTURES

    E-print Network

    Laidlaw, David

    DISTAL RADIUS FRACTURES +*Crisco, JJ; **Marai, GE; **Laidlaw, DH; *Moore, DC; *Akelman, E +*Department challenging. Using markerless bone registration [1], we recently demonstrated that in patients with no ulnar ultimately affect long- term clinical outcome. To test this hypothesis, we developed a novel technique

  15. Acute colonic pseudo-obstruction.

    PubMed

    Veekmans, P; Broos, P; Stuyck, J; Kerremans, R; Yap, P; Ponette, E

    1992-06-01

    We present two cases of acute colonic pseudo-obstruction, one complicated with perforation. Orthopedic surgery was the pathogenetic factor in both cases. Recovery was successful in both patients after appropriate treatment. The importance of conventional X-ray techniques, and more specially the plain X-ray of the abdomen, is stressed regarding early diagnosis and follow-up. PMID:1400146

  16. 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

  17. Pharmacogenetic Trial of a Cannabinoid Agonist Shows Reduced Fasting Colonic Motility in Patients with Non-Constipated Irritable Bowel Syndrome

    PubMed Central

    Wong, Banny S.; Camilleri, Michael; Busciglio, Irene; Carlson, Paula; Szarka, Lawrence A.; Burton, Duane; Zinsmeister, Alan R.

    2011-01-01

    Background Cannabinoid receptors are located on cholinergic neurons. Genetic variants that affect endocannabinoid metabolism are associated with colonic transit in patients with irritable bowel syndrome with diarrhea (IBS-D). We compared the effects of dronabinol, a non-selective agonist of the cannabinoid receptor, with those of placebo on colonic motility and sensation in patients with IBS, and examined the effects of IBS subtype and specific genetic variants in cannabinoid mechanisms. Methods Seventy-five individuals with IBS (35 with IBS with constipation [IBS-C], 35 with IBS-D, and with 5 IBS-alternating [IBS-A]) were randomly assigned to groups that were given 1 dose of placebo or 2.5 mg or 5.0 mg dronabinol. We assessed left colonic compliance, the motility index (MI), tone, and sensation, during fasting and after a meal. We analyzed the single nucleotide polymorphisms CNR1 rs806378, FAAH rs324420, and MGLL rs11538700. Results In all patients, dronabinol decreased fasting proximal left colonic MI, compared with placebo (overall P=.05; for 5 mg dronabinol, P=.046), decreased fasting distal left colonic MI (overall P=.08; for 5 mg, P=.13), and increased colonic compliance (P=.058). The effects of dronabinol were greatest in patients with IBS-D or -A (proximal colonic MI, overall P=.022; compliance, overall, P=.03). Dronabinol did not alter sensation or tone. CNR1 rs806378 (CC vs CT/TT) appeared to affect fasting proximal MI in all patients with IBS (P=.075). Dronabinol affected fasting distal MI in patients, regardless of FAAHrs324420 variant (CA/AA vs CC) (P=.046); the greatest effects were observed among IBS-C patients with the FAAH CC variant (P=.045). Dronabinol affected fasting proximal MI in patients with IBS-D or -A with the variant FAAH CA/AA (P=.013). Conclusion In patients with IBS-D or -A, dronabinol reduces fasting colonic motility; FAAH and CNR1 variants could influence the effects of this drug on colonic motility. PMID:21803011

  18. Collet-Sicard Syndrome from Thrombosis of the Sigmoid-Jugular Complex: A Case Report and Review of the Literature

    PubMed Central

    Handley, Tom P. B.; Miah, Mohammed S.; Majumdar, Samit; Hussain, S. S. Musheer

    2010-01-01

    Purpose. Collet-Sicard syndrome is a very rare condition characterised by unilateral palsy of the IX–XII cranial nerves. It is distinguished from Villaret syndrome by lack of presence of sympathetic involvement. Current literature contains only two cases of Collet-Sicard syndrome due to idiopathic internal jugular vein thrombosis. Method and Results. We report the case of Collet-Sicard syndrome in a 30-year-old man who presented with delayed development of XIth nerve dysfunction, due to internal jugular vein-sigmoid sinus thrombosis. A multidisciplinary team approach was employed in the management of this patient. At three-month followup, he had significantly improved swallowing, and repeat computed tomography neck scan showed partial recanalisation of the right internal jugular vein. Conclusion. In suspected Collet-Sicard syndrome, a focal primary lesion or metastasis to the temporal bone must be excluded, and sigmoid-jugular complex thrombosis should be considered in the differential diagnosis. Early recognition and treatment may result in significant functional recovery. PMID:20706543

  19. Increased proliferation activity measured by immunoreactive Ki67 is associated with survival improvement in rectal/recto sigmoid cancer

    PubMed Central

    Salminen, Eeva; Palmu, Salla; Vahlberg, Tero; Roberts, Peter J.; Söderström, Karl-Owe

    2005-01-01

    AIM: To assess the expression of Ki67 as prognosticator in rectal/recto sigmoid cancer. METHODS: Samples from 146 patients with rectal and recto sigmoid cancer were studied for expression of Ki67 and its prognostic significance in comparison with clinico-pathological predictors of survival. Formalin-fixed, paraffin-embedded tissues from 6 (4.1%) patients with T1, 26 (17.8%) with T2, 94 (64.4%) with T3, and 20 (13.7%) with T4 tumors were studied. Ki67 expression was determined immunohistochemically. Samples were divided according to mean value into high (>40%) and low (?40%) expression. Areas of extensive proliferation (>50%) were defined as ‘hot spot’ areas. RESULTS: Hot spot areas were present in samples regardless of histopathological grade. Lower TNM and Dukes stage and higher expression of Ki67 and presence of Ki67 hot spot areas in histopathological samples were associated with better survival, whereas no association was observed with histopathological grade (P = 0.78). In Cox multivariate regression analysis, significant prognostic factors were Dukes stage (P<0.001), presence of lymph node metastases (P = 0.015), age (P = 0.035) and presence of Ki67 hot spot areas (P = 0.044). CONCLUSION: Proliferative activity as measured by Ki67 in rectal cancer is associated with survival improvement compared with patients with low Ki67. Areas of prognostically significant increased proliferation were found independently of histopathological tumor grade. PMID:15929175

  20. 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.

  1. A New Device for Sentinel Node Detection in Laparoscopic Colon Resection

    PubMed Central

    Rubino, Francesco; Sowinska, Malgozarta; Henri, Margaret; Dutson, Erik; Ceulemans, Robrecht; Garcia, Alain; Arenas, Mara; Leroy, JoËL; Marescaux, Jacques

    2004-01-01

    Objective: To test the feasibility of using a newly developed device for laparoscopic lymphatic mapping of the colon by simultaneous and quantitative detection of both tissue coloration and radioactivity. Methods: Four pigs were used in this study. In each animal, both blue dye and radioisotope injections were utilized. Lymphatic mapping was performed laparoscopically in the sigmoid mesocolon and in the right mesocolon. A solution containing a mix of 35 microcuries of Technetium Tc-99 sulfur Colloid and 1 mL of a vital blue dye was administered subserosally by percutaneous insertion of a 25 gauge needle under laparoscopic control. The new device for automated sentinel-node detection consists of a gamma-probe coupled with a laser device and can be passed through a regular 10-mm trocar. The device detects simultaneously both radioactivity and quantitative tissue coloration. Nodes showing a radioactivity at least 5 times higher than that of the background or that had a blue colorant concentration were considered our sentinel nodes. Results: Laparoscopic simultaneous and quantitative detection of sentinel nodes was feasible in all pigs. One or more sentinel nodes were identified by either the blue dye or radioisotopic technique in both the sigmoid and right mesocolon. Quantitative tissue coloration detection led to the recognition of additional nodes that were not apparently colored to the naked eye. Conclusion: Laparoscopic sentinel node detection using a device combining gamma and color detection is feasible in the porcine model. The significance of nodes apparently clear but positive with the quantitative detection technique should be further evaluated. PMID:15554278

  2. [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

  3. Perforation of the Distal End of the Ventriculoperitoneal Shunt into the Bladder with Calculus Formation

    Microsoft Academic Search

    K. V. Ramana Murthy; S. Jayaram Reddy; D. V. S. R. K. Prasad

    2009-01-01

    The placement of a ventriculoperitoneal (VP) shunt is the most common form of treatment for hydrocephalus.The distal end of the VP shunt is commonly placed in the peritoneal cavity. Various complications of the distal end of the shunt have been described in the literature.We report an unusual case of perforation of the distal end of the VP shunt into the

  4. Reduction of triceps muscle force after shortening of the distal humerus: A computational model

    Microsoft Academic Search

    Richard E. Hughes; Alberto G. Schneeberger; Kai-Nan An; Bernard F. Morrey; Shawn W. O'Driscoll

    1997-01-01

    Bone deficiency resulting in shortening of the distal humerus may occur after fractures, treatment of nonunions, or revision of total elbow arthroplasty. A biomechanical model of the triceps muscle and tendon was used to investigate the effect of distal humeral shortening on triceps force production. The analysis indicated that shortening of the distal humerus primarily influences the media head of

  5. Fractures of the bilateral distal radius and scaphoid: a case report

    Microsoft Academic Search

    Korhan Ozkan; Ender Ugutmen; Koray Unay; O?uz Poyanli; Melih Guven; Abdullah Eren

    2008-01-01

    INTRODUCTION: Bilateral fractures of the distal radius and scaphoid are extremely rare injuries. CASE PRESENTATION: A patient with bilateral comminuted, displaced distal fractures of the radius and bilateral fractures of the scaphoid was treated via internal fixation of the scaphoid fractures with Herbert screws and internal fixation of the distal radius fractures with locked volar plating. CONCLUSION: Rigid internal fixation

  6. Non-union of Fracture of Distal Radius: A Case Report and Literature Review

    Microsoft Academic Search

    Koo Siu-Cheong Jeffrey Justin; Ho Sheung-Tung

    2011-01-01

    Non-union of distal radius fracture is uncommon. Promising results in dorsally displaced fractures of distal radius were reported with the use of volar fixed-angle fixation. We report about a 75-year-old woman with non-union of distal radius, treated successfully by using volar locking compression plate.

  7. External and internal fi xation for comminuted intra-articular fractures of distal radius

    Microsoft Academic Search

    Pradhan RL; Lakhey S; Pandey BK; Manandhar RR; Rijal KP; Sharma S

    2009-01-01

    Background: Distal radius fractures are a common injury and without proper treatment leads to high functional impairment and frequent complications. Objective: The aim of this study was to see the functional outcome in patients with comminuted distal radius fractures treated with combined external fi xation and open reduction with volar plating. Materials and methods: All comminuted distal radius fractures classifi

  8. The "mini-elephant trunk" technique of distal anastomosis in total arch replacement through a median sternotomy for a distal aortic arch aneurysm.

    PubMed

    Takami, Y; Ina, H

    2001-01-01

    A median sternotomy is considered to have several advantages over a left thoracotomy as a route for the surgical treatment of a distal aortic arch aneurysm, including less pain and less lung damage. In a median sternotomy, distal anastomosis is such an important problem that we herein present a useful technique to prevent surgical bleeding from it. An invaginated 40-mm-long graft is inserted into the distal aorta, sutured to the aortic wall, unfolded, and anastomosed with a four-limbed tube graft. We applied this "mini-elephant trunk" technique to total arch replacement for both a saccural distal aneurysm, where the distal aorta was transected, and a fusiform aneurysm, where the invaginated graft was sutured by the "inclusion" method. This technique enables a greater surface contact area between the graft and the aortic wall at the distal anastomosis, thus resulting in a reduced risk of bleeding. PMID:11428617

  9. Nonunion of distal radius fracture and distal radioulnar joint injury: a modified Sauvé–Kapandji procedure with a cubitus proradius transposition as autograft

    Microsoft Academic Search

    Angel Villamor; Antonio Rios-Luna; Manuel Villanueva-Martínez; Homid Fahandezh-Saddi

    2008-01-01

    The Sauvé–Kapandji (SK) procedure is indicated in distal radius nonunion or malunion and distal radioulnar joint (DRUJ) instability.\\u000a It can also be used to treat the rheumatoid wrist with severe degenerative changes in the DRUJ. The main objective is to allow\\u000a a pain-free range of movement. We present a patient with rheumatoid arthritis and distal radius nonunion who, after three

  10. 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.

  11. [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

  12. Oral fluticasone propionate in active distal ulcerative colitis.

    PubMed Central

    Angus, P; Snook, J A; Reid, M; Jewell, D P

    1992-01-01

    Fluticasone propionate is a new corticosteroid with low systemic bioavailability. This study reports the outcome of a double blind clinical trial comparing oral fluticasone propionate (5 mg four times daily) with placebo for the treatment of active distal ulcerative colitis. Sixty patients were treated for four weeks, with assessments at two and four weeks. One patient was withdrawn when she was found to have amoebiasis. Thus, results are presented for 29 patients who received placebo and 30 who received fluticasone propionate. The two groups were well matched for age, sex, length of history, and extent of disease. After four weeks of therapy the clinical, sigmoidoscopic, and histological responses were similar in the two groups. It is concluded that fluticasone propionate (5 mg four times daily) is not effective treatment for active distal ulcerative colitis. PMID:1612492

  13. Distal enhancers: new insights into heart development and disease.

    PubMed

    Wamstad, Joseph A; Wang, Xinchen; Demuren, Olukunle O; Boyer, Laurie A

    2014-05-01

    Advances in genome research have provided an unprecedented opportunity to investigate the function of non-coding DNA regulatory regions that control transcription. Large-scale studies have recently identified hundreds of thousands of distal enhancer elements; their discovery has revealed new insights into the mechanistic details of how tissue-specific gene expression patterns are established and maintained during development. Emerging evidence indicates that lineage-specific transcription factors and chromatin regulators coordinate the activation of distal enhancers to ensure robust control of gene expression programs in a cell type-specific manner. We discuss recent progress in the field and emphasize examples related to the cardiac lineage, where possible, as a model for understanding the contribution of enhancer biology to development and how disruption of enhancer function leads to disease. PMID:24321408

  14. Management of the distal radioulnar joint in rheumatoid arthritis.

    PubMed

    Lee, Steve K; Hausman, Michael R

    2005-11-01

    The DRUJ frequently is involved in RA and can be a source of major disability. Nonoperative treatment consists of adequate hand/occupational therapy, judicious splinting, and pharmacologic management. If unacceptable pain and dysfunction persists or if there is tendon rupture, surgery is indicated. Surgical treatment ranges from debridement and soft tissue balancing if the joint is preserved to osseous procedures ranging from Darrach resection, Sauve-Kapandji procedure, hemiresection, to distal ulna replacement. Tendon ruptures usually require tendon transfers. If an osseous procedure is required, the authors prefer the Sauve-Kapandji procedure in the younger, active adult. Darrach distal ulna resection is recommended for the older, sedentary patient. For either procedure, if there is evidence of pre-existing radiocarpal instability, partial or total wrist arthrodesis or arthroplasty should bea concomitant procedure. PMID:16274868

  15. Fibrin Glue Sandwich Prevents Pancreatic Fistula following Distal Pancreatectomy

    Microsoft Academic Search

    Susumu Ohwada; Tetsushi Ogawa; Yoshifumi Tanahashi; Seiji Nakamura; Izumi Takeyoshi; Toshihiro Ohya; Toshiroh Ikeya; Kenji Kawashima; Yoshiyuki Kawashima; Yasuo Morishita

    1998-01-01

    . Pancreatic fistula is a major form of morbidity following pancreatic resection. We conducted a nonrandomized clinical\\u000a trial comparing the sealing and sandwich techniques of spraying fibrin glue to prevent pancreatic fistula following distal\\u000a pancreatectomy. The pancreas was transected with a scalpel to identify and suture the main pancreatic duct and its small branches.\\u000a In the sealing group, fibrin glue

  16. Analysis of Emboli during Carotid Stenting with Distal Protection Device

    Microsoft Academic Search

    Chin-I Chen; Yasuyuki Iguchi; Zsolt Garami; Marc D. Malkoff; Richard W. Smalling; Morgan S. Campbell; Andrei V. Alexandrov

    2006-01-01

    Background: The newly developed multi-frequency transcranial Doppler (TCD) is able to differentiate gaseous from solid emboli. Our goal was to apply this technology to initially characterize emboli detected during carotid stenting with distal protection. Methods: Patients undergoing carotid angiography and stenting were monitored with 2–2.5 MHz TCD (Embo-Dop, DWL) over the middle cerebral artery unilateral to stent deployment. Sonographers insured

  17. Distal vertebral artery reconstruction: Long-term outcome

    Microsoft Academic Search

    Edouard Kieffer; Barbara Praquin; Laurent Chiche; Fabien Koskas; Amine Bahnini

    2002-01-01

    Purpose: The purpose of this article was to report our long-term results of distal vertebral artery (DVA) reconstruction. Method: From 1978 to 2001 we performed 352 DVA reconstructions on 323 patients (177 men, 148 women; mean age, 60.0 ± 12.1 years). Symptoms of vertebrobasilar insufficiency were present in 332 cases (94.3%). Bypass grafting using mostly saphenous vein graft was performed

  18. Dorsal capsuloplasty for dorsal instability of the distal ulna.

    PubMed

    Kouwenhoven, S T P; de Jong, T; Koch, A R

    2013-05-01

    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

  19. 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

  20. Biomechanical Evaluation of Volar Locking Plates for Distal Radius Fractures

    Microsoft Academic Search

    Scott M. Levin; Cory O. Nelson; Jonathan D. Botts; Glenn A. Teplitz; Yong Kwon; Fred Serra-Hsu

    2008-01-01

    Purpose  Fixed-angle devices have been a major advancement in orthopedic fracture care and have become an attractive option for fixation\\u000a of distal radius fractures. Several volar locking plates exist, but there is insufficient literature comparing the strengths\\u000a of these plates. This study compares the biomechanical strength of two popular volar locking plate systems (Synthes LCP and\\u000a Hand Innovations DVR-A) along with

  1. 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.

  2. Rotational deformity affects radiographic measurements in distal radius malunion

    Microsoft Academic Search

    Eftal Gudemez; Ozgur Cetik; Mehmet Turker; Fatih Eksioglu

    2011-01-01

    Malunited distal radius fractures are 3D deformities. The preoperative evaluation of the deformity and surgical planning are\\u000a usually depended on plain radiographic measurements for corrective osteotomies. In most of the cases, the rotational deformity\\u000a is disregarded in preoperative planning. We aimed to clarify the effect of rotational deformity on radial inclination and\\u000a dorsal or volar tilt measurements, which are commonly

  3. Distal Radius Fractures in Older Patients: Is Anatomic Reduction Necessary?

    Microsoft Academic Search

    Andrew J. Synn; Eric C. Makhni; Melvin C. Makhni; Tamara D. Rozental; Charles S. Day

    2009-01-01

    The relationship between radiographic and functional outcomes in older patients with distal radius fractures is controversial.\\u000a We explored this relationship by assessing the influence of radiographic displacement and fracture comminution on the functional\\u000a outcomes of these fractures. We also asked whether operative intervention and demographic factors (age, gender, duration of\\u000a followup) influenced outcome. We examined 53 patients older than 55 years

  4. 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

  5. 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

  6. 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

    2015-06-01

    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

  7. Single-incision laparoscopic-assisted surgery for colon cancer via a periumbilical approach using a surgical glove: initial experience with 9 cases.

    PubMed

    Ishida, Hideyuki; Okada, Norimichi; Ishibashi, Keiichiro; Ohsawa, Tomonori; Kumamoto, Kensuke; Haga, Norihiro

    2011-01-01

    Our initial experience of performing a single-incision laparoscopic-assisted (SILS) colectomy using a "home-made" multichannel port system is presented. Nine patients (5 women) with a median age of 67 years (range, 55-72 years) and a median body mass index of 21.2 kg/m(2) (range, 17.8-26.7 kg/m(2)) underwent the SILS colectomy for colon cancer between September 2009 and March 2010. The sites of the primary tumor were the ascending colon (n=2), hepatic flexure (n=1), transverse colon (n=2), and sigmoid colon (n=4). Each trocar was introduced intraperitoneally through each finger of a surgical glove attached to the wound protector, which was applied to a midline fasciotomy made via a ¾-circular periumbilical incision. If necessary, one to three radial splits were added to the incision. The colon was mobilized intracorporeally, and the vessels were ligated intra- or extracorporeally. All the patients underwent a curative segmental colectomy without conversion to a standard multiport laparoscopy or open surgery. The median operative time and blood loss were 140 min (range, 135-165 min) and 50 mL (range, 20-225 mL), respectively. The median number of harvested lymph nodes was 18 (range, 6-31). The pathological stages included stage 0 (n=2), stage I (n=6), and stage III (n=1). The median number of postoperative analgesic use was one (range, 0-6). No intra- or postoperative complications occurred in this series. Our SILS colectomy procedure seems feasible and safe in selected patients with colon cancer. PMID:21029796

  8. Removal of an entrapped large metallic dilator from the sigmoid neovagina in a male-to-female transsexual using a laparoscopic approach

    PubMed Central

    Aminsharifi, A.; Afsar, F.; Jafari, M.; Tourchi, A.

    2012-01-01

    Introduction To describe the role of laparoscopy for removal of entrapped vaginal metallic dilator (20 cm in length and 3.5 cm in diameter) in a case of male-to-female transsexual. Presentation of the case The patient was a 24-year old male-to-female transsexual, presented with entrapment and upward migration of the vaginal metallic dilator 1 week before admission. She underwent gender reassignment surgery with sigmoid vaginoplasty 8 month before admission. After 3-port transperitoneal laparoscopic abdominopelvic exploration, through an incision over the sigmoid vagina the dilator was extracted. The sigmoid vagina was repaired with free-hand intracorporeal laparoscopic suturing and knot-tying techniques in two layers and the dilator was removed by extending the site of umbilical port. The operative time was 70 min. Discussion Up to 60% of rectosigmoidal or vaginal foreign bodies can be extracted transanally or transvaginally with adequate sedation. When surgical exploration is indicated, a longitudinal laparatomy is performed to extract the foreign body. To reduce the associated morbidity of an open procedure in our patient, we performed a laparoscopic approach for complete abdominal exploration for possible presence of intestinal or sigmoidal injuries together with removal of this large metalic dilator. Conclusion Laparoscopic approaches in cases of neovaginal foreign body are useful when the endovaginal approaches have failed, especially in transsexual patients, to prevent another major open surgery. PMID:22504480

  9. Transcriptional recapitulation and subversion of embryonic colon development by mouse colon tumor models and human colon cancer

    Microsoft Academic Search

    Sergio Kaiser; Young-Kyu Park; Jeffrey L Franklin; Richard B Halberg; Ming Yu; Walter J Jessen; Johannes Freudenberg; Xiaodi Chen; Kevin Haigis; Anil G Jegga; Sue Kong; Bhuvaneswari Sakthivel; Huan Xu; Timothy Reichling; Mohammad Azhar; Gregory P Boivin; Reade B Roberts; Anika C Bissahoyo; Fausto Gonzales; Greg C Bloom; Steven Eschrich; Scott L Carter; Jeremy E Aronow; John Kleimeyer; Michael Kleimeyer; Vivek Ramaswamy; Stephen H Settle; Braden Boone; Shawn Levy; Jonathan M Graff; Thomas Doetschman; Joanna Groden; William F Dove; David W Threadgill; Timothy J Yeatman; Robert J Coffey Jr; Bruce J Aronow

    2007-01-01

    BACKGROUND: The expression of carcino-embryonic antigen by colorectal cancer is an example of oncogenic activation of embryonic gene expression. Hypothesizing that oncogenesis-recapitulating-ontogenesis may represent a broad programmatic commitment, we compared gene expression patterns of human colorectal cancers (CRCs) and mouse colon tumor models to those of mouse colon development embryonic days 13.5-18.5. RESULTS: We report here that 39 colon tumors

  10. Increased levels of promutagenic etheno-DNA adducts in colonic polyps of FAP patients.

    PubMed

    Schmid, K; Nair, J; Winde, G; Velic, I; Bartsch, H

    2000-07-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) can regress adenomas in patients with familial adenomatous polyposis (FAP), and the mechanism involves inhibition of cyclooxygenases (COX). Reactive intermediates formed during the arachidonic acid cascade, notably by COX-2, which is upregulated in polyps of FAP patients, may promote various stages of the polyp --> adenoma --> carcinoma sequence. Etheno-DNA adducts can be derived from reactive intermediates generated during arachidonic acid metabolism and lipid peroxidation. We tested this hypothesis in colonic polyps from FAP patients and colorectal tissue from cancer patients to see whether increased formation of etheno-DNA adducts occurs. Using an ultra-sensitive and specific immunoaffinity/(32)P-postlabelling method, 1, N(6)-ethenodeoxyadenosine (straightepsilondA) and 3, N(4)-ethenodeoxycytidine (straightepsilondC) were quantitated in epithelial cell DNA from asymptomatic colon, FAP polyps and colon tumor tissues. Mean adduct levels in FAP polyps were 65 straightepsilondA/10(9) and 59 straightepsilondC/10(9) parent nucleotides, being 2 to 3 times higher than in unaffected colon tissue (p < 0.02 for straightepsilondA; p < 0.05 for straightepsilondC). Adduct levels in colonic epithelia decreased in the order: FAP polyps > tumor-adjacent tissue > tumor, normal and tumor-distal tissue. Based on this study, requiring confirmation in a larger number of patients and in experimental models, we have demonstrated the formation of promutagenic etheno-DNA adducts in adenomatous polyps of FAP patients that may contribute to genetic instability and cancer progression. PMID:10861445

  11. Morphology and putative function of the colon and cloaca of marine and freshwater snakes.

    PubMed

    Babonis, Leslie S; Womack, Molly C; Evans, David H

    2012-01-01

    Among tetrapods, evidence for postrenal modification of the urine by the distal digestive tract (including the colon and cloaca) is highly variable. Birds and bladderless reptiles are of interest because the colon and cloaca represent the only sites from which water and ions can be reclaimed from the urine secreted by the kidney. For animals occupying desiccating environments (e.g., deserts and marine environments), postrenal modification of the urine may directly contribute to the maintenance of hypo-osmotic body fluids. We compared the morphology and distribution of key proteins in the colon, cloaca, and urogenital ducts of watersnakes from marine (Nerodia clarkii clarkii) and freshwater (Nerodia fasciata) habitats. Specifically, we examined the epithelia of each tissue for evidence of mucus production by examining the distribution of mucopolysaccharides, and for evidence of water/ion regulation by examining the distribution of Na(+) /K(+) -ATPase (NKA), Na(+) /K(+) /Cl(-) cotransporter (NKCC), and aquaporin 3 (AQP3). NKCC localized to the basolateral epithelium of the colon, urodeal sphincter, and proctodeum, consistent with a role in secretion of Na(+), Cl(-) , and K(+) from the tissue, but NKA was not detected in the colon or any compartment of the cloaca. Interestingly, NKA was detected in the basolateral epithelium of the ureters, suggesting the urothelium may play a role in active ion transport. AQP3 was detected in the ureters and coprodeal complex, consistent with a role in urinary and fecal dehydration or, potentially, in the production of the watery component of the mucus secreted by the coprodeal complex. Since no differences in general cloacal morphology, production of mucus, or the distribution of ion transporters/water channels were detected between the two species, cloacal osmoregulation may either be regulated by proteins not examined in this study or may not be responsible for the differential success of N. c. clarkii and N. fasciata in marine habitats. PMID:21935975

  12. [Dural arteriovenous fistula of the sigmoid sinus with a clinical expression on the opposite eye: A case report].

    PubMed

    Tellouck, L; Schweitzer, C; Barreau, X; Colin, J

    2012-03-01

    We report the case of an 87-year-old patient who developed a dural arteriovenous fistula of the sigmoid sinus with progressive exophthalmia in the opposite eye. The patient had a unilateral decrease in visual acuity; the vessels of the conjunctiva were dilated, and a progressive central retinal vein occlusion occurred in the left eye. A dural carotid cavernous fistula of the right sigmoid sinus was diagnosed with an angiography exam and was successfully treated with embolization of the arteriovenous shunt using Onyx(®). A central partial facial nerve paralysis occurred after embolization and spontaneously resolved in 6 months. Six months after the treatment, visual acuity improved to 7/10 and the exophthalmia and central retinal vein occlusion signs regressed. Dural arteriovenous fistulae are abnormal shunts between a collateral vessel of the carotid artery and the cavernous sinus; the unilateral pulsating exophthalmia is the most frequent associated symptom. Cerebral MRI is useful to analyze indirect signs of the arteriovenous shunt showing an abnormal dilatation of the veins, but angiography of the carotid artery is essential to confirm the diagnosis. Furthermore, it allows treatment of the fistula at the same time, the main complication being the embolization of normal vessels close to the abnormal shunt. The clinical expression of the dural arteriovenous fistula on the opposite eye is infrequent and is related to the presence of complex septae within the cavernous sinus, resulting in a bilateral drainage of the cerebral venous system. The early diagnosis and management of the disease is necessary to improve the visual prognosis. PMID:21907447

  13. Metabolism links bacterial biofilms and colon carcinogenesis.

    PubMed

    Johnson, Caroline H; Dejea, Christine M; Edler, David; Hoang, Linh T; Santidrian, Antonio F; Felding, Brunhilde H; Ivanisevic, Julijana; Cho, Kevin; Wick, Elizabeth C; Hechenbleikner, Elizabeth M; Uritboonthai, Winnie; Goetz, Laura; Casero, Robert A; Pardoll, Drew M; White, James R; Patti, Gary J; Sears, Cynthia L; Siuzdak, Gary

    2015-06-01

    Bacterial biofilms in the colon alter the host tissue microenvironment. A role for biofilms in colon cancer metabolism has been suggested but to date has not been evaluated. Using metabolomics, we investigated the metabolic influence that microbial biofilms have on colon tissues and the related occurrence of cancer. Patient-matched colon cancers and histologically normal tissues, with or without biofilms, were examined. We show the upregulation of polyamine metabolites in tissues from cancer hosts with significant enhancement of N(1), N(12)-diacetylspermine in both biofilm-positive cancer and normal tissues. Antibiotic treatment, which cleared biofilms, decreased N(1), N(12)-diacetylspermine levels to those seen in biofilm-negative tissues, indicating that host cancer and bacterial biofilm structures contribute to the polyamine metabolite pool. These results show that colonic mucosal biofilms alter the cancer metabolome to produce a regulator of cellular proliferation and colon cancer growth potentially affecting cancer development and progression. PMID:25959674

  14. Polymers for Colon Targeted Drug Delivery

    PubMed Central

    Rajpurohit, H.; Sharma, P.; Sharma, S.; Bhandari, A.

    2010-01-01

    The colon targeted drug delivery has a number of important implications in the field of pharmacotherapy. Oral colon targeted drug delivery systems have recently gained importance for delivering a variety of therapeutic agents for both local and systemic administration. Targeting of drugs to the colon via oral administration protect the drug from degradation or release in the stomach and small intestine. It also ensures abrupt or controlled release of the drug in the proximal colon. Various drug delivery systems have been designed that deliver the drug quantitatively to the colon and then trigger the release of drug. This review will cover different types of polymers which can be used in formulation of colon targeted drug delivery systems. PMID:21969739

  15. Molecular determinants of rhizosphere colonization by Pseudomonas.

    PubMed

    Lugtenberg, B J; Dekkers, L; Bloemberg, G V

    2001-01-01

    Rhizosphere colonization is one of the first steps in the pathogenesis of soilborne microorganisms. It can also be crucial for the action of microbial inoculants used as biofertilizers, biopesticides, phytostimulators, and bioremediators. Pseudomonas, one of the best root colonizers, is therefore used as a model root colonizer. This review focuses on (a) the temporal-spatial description of root-colonizing bacteria as visualized by confocal laser scanning microscopal analysis of autofluorescent microorganisms, and (b) bacterial genes and traits involved in root colonization. The results show a strong parallel between traits used for the colonization of roots and of animal tissues, indicating the general importance of such a study. Finally, we identify several noteworthy areas for future research. PMID:11701873

  16. Use of the remnant stomach for oesophagoplasty in patients following distal gastrectomy.

    PubMed

    Shiryajev, Yuri N

    2013-01-01

    Oesophageal replacement in patients following distal gastrectomy (DGE) remains a surgical challenge, and the standard option is the colonic or jejunal transplant. However, in some cases, it is possible (or mandatory) to utilize the remnant stomach for oesophagoplasty (EP). This method preserves some advantages of the gastric EP in comparison with the bowel EP. During recent years, several papers have been published in English regarding remnant stomach EP, and different aspects of this procedure have been discussed. However, there is still no comprehensive literature review analysing the possible EP approaches using the remnant stomach. A multilingual literature search (database and manual) to collect and classify the currently available data regarding remnant stomach EP following DGE and its subsequent analysis was carried out. There are a number of principally different methods of a remnant stomach EP: (1) mobilization of the remnant stomach with the spleen and tail of the pancreas with its transposition into the left hemithorax; (2) mobilization of the remnant stomach after splenectomy; (3) implementation of a reversed gastric tube, tailored from the major curve; (4) the use of a transplant fed from the right gastric and right gastroepiploic arteries; (5) the use of a transplant fed from the left gastric and short gastric arteries; (6) complete mobilization of the remnant stomach; (7) direct revascularization of the gastric stump conduit. The excellent plastic potential and rich vascularization of the stomach justify its use for EP, even after prior DGE. The majority of the methods of gastric stump EP are less well developed but should be investigated further. PMID:22761506

  17. Variability of acetylcholinesterase hyperinnervation patterns in distal rectal suction biopsy specimens in Hirschsprung disease.

    PubMed

    Pacheco, M Cristina; Bove, Kevin E

    2008-01-01

    Variability in cholinergic innervation may contribute to false-negative and false-positive evaluations for Hirschsprung disease (HD). We compared intraspecimen variability of histochemical acetylcholinesterase (ACE) activity in 62 distal rectal mucosal biopsy specimens from 33 patients with short-segment HD (SSHD), 14 patients with short-segment HD/Down syndrome (SSHD/DS), 10 patients with total colonic aganglionosis (HDTC), and 45 ganglionated control specimens obtained because of clinical suspicion for HD. Specimens were evaluated in 1-mm linear segments for abnormal distribution and abnormal intensity of staining reaction in the lamina propria (LP), muscularis mucosae (MM), numerical excess of small submucosal nerves (SSN), and presence or absence of large submucosal nerves (LSN) defined as >35 microns in diameter. Patients with HD and controls were predominantly infant males. Aggregate length of specimens was 186 mm in HD and 136 mm in controls. We defined multiple patterns and relative frequencies of normal and abnormal ACE reactivity in the muscularis mucosae, submucosal nerves, and innervation in the lamina propria. We verified a hyperinnervation pattern more common in neonates within each subset of HD. Large submucosal nerves >35 microns in diameter are relatively less common in SSHD/DS and HDTC. Eleven of 57 patients with HD had at least 1 mm of normal muscularis mucosae accounting for 19/186 mm examined. Ten percent of control mm had at least 1 submucosal nerve >35 microns in diameter. Intraspecimen variability in ACE patterns, when extreme, can usually be resolved by findings elsewhere in an adequate specimen, minimizing the need for repeat procedures. PMID:18078369

  18. Colonic Lymphangiomatosis Resolved after Excisional Biopsy

    PubMed Central

    Lee, Young Soo; Kim, Gyu Won; Cho, Hye Jae

    2015-01-01

    Lymphangioma is an uncommon malformation of the lymphatic system that involves a benign proliferation of the lymphatics, with no established treatment method. Multiple colonic lymphangioma, or colonic lymphangiomatosis, is an extremely rare condition. We report a case of colonic lymphangiomatosis that was detected during a colonoscopic examination conducted as part of a general health check-up. The lesion completely resolved after excisional biopsy. PMID:25674533

  19. Quantitative measurement of feline colonic transit

    SciTech Connect

    Krevsky, B.; Somers, M.B.; Maurer, A.H.; Malmud, L.S.; Knight, L.C.; Fisher, R.S.

    1988-10-01

    Colonic transit scintigraphy, a method for quantitatively evaluating the movement of the fecal stream in vivo, was employed to evaluate colonic transit in the cat. Scintigraphy was performed in duplicate in five cats and repeated four times in one cat. After instillation of an 111In marker into the cecum through a surgically implanted silicone cecostomy tube, colonic movement of the instillate was quantitated for 24 h using gamma scintigraphy. Antegrade and retrograde motion of radionuclide was observed. The cecum and ascending colon emptied rapidly, with a half-emptying time of 1.68 +/- 0.56 h (mean +/- SE). After 24 h, 25.1 +/- 5.2% of the activity remained in the transverse colon. The progression of the geometric center was initially rapid, followed later by a delayed phase. Geometric center reproducibility was found to be high when analyzed using simple linear regression (slope = 0.92; r = 0.73; P less than 0.01). Atropine (0.1 mg/kg im) was found to delay cecum and ascending colon emptying and delay progression of the geometric center. These results demonstrate both 1) the ability of colonic transit scintigraphy to detect changes in transit induced by pharmacological manipulation and 2) the fact that muscarinic blockade inhibits antegrade transit of the fecal stream. We conclude that feline colonic transit may be studied in a quantitative and reproducible manner with colonic transit scintigraphy.

  20. The Colonizer, the Colonized… and the Colonists: Empire and Settlement on Assyria's Anatolian Frontier

    Microsoft Academic Search

    Bradley J. Parker

    Traditionally colonial situations have been seen as the interaction between two groups: the colonizer and the colonized. Although many scholars have acknowledged that cultural influence often flows in both directions between these groups, the colonizers are usually seen as dominating a culturally and\\/or politically inferior indigenous population in and around their frontier settlements. Seen from the center looking toward the

  1. A human colonic commensal promotes colon tumorigenesis via activation of T helper type 17 T cell responses

    Microsoft Academic Search

    Shaoguang Wu; Ki-Jong Rhee; Emilia Albesiano; Shervin Rabizadeh; Xinqun Wu; Hung-Rong Yen; David L Huso; Frederick L Brancati; Elizabeth Wick; Florencia McAllister; Drew M Pardoll; Franck Housseau; Cynthia L Sears

    2009-01-01

    The intestinal flora may promote colon tumor formation. Here we explore immunologic mechanisms of colonic carcinogenesis by a human colonic bacterium, enterotoxigenic Bacteroides fragilis (ETBF). ETBF that secretes B. fragilis toxin (BFT) causes human inflammatory diarrhea but also asymptomatically colonizes a proportion of the human population. Our results indicate that whereas both ETBF and nontoxigenic B. fragilis (NTBF) chronically colonize

  2. [Urinary diversion in patients treated with pelvic irradiation: transverse colon conduit revisited].

    PubMed

    Matsui, Yoshiyuki; Kanematsu, Akihiro; Negoro, Hiromitsu; Kobayashi, Takashi; Terada, Naoki; Sugino, Yoshio; Yamasaki, Toshinari; Inoue, Takahiro; Kamba, Tomomi; Yoshimura, Koji; Ogawa, Osamu

    2014-08-01

    In patients receiving pelvic irradiation for gynecological or genitourinary malignancies, urinary diversion is sometimes required for complete resection of malignancies or treatment of urological complications by irradiation. We report our attempts to promote healing and prevent complications by urinary diversion using a transverse colon conduit in cases in which urinary reconstruction was performed with irradiated lower abdominal organs such as small intestine or distal ureters. Between 2008 and 2012, 9 patients with pelvic irradiation received transverse colon conduit urinary diversion. Six patients received diversion for genitourinary complications, while 3 patients received complete resection of pelvic malignancies. Colostomy formation and lithotripsy of vesical stones were simultaneously performed in 4 cases. Wallace method was adopted for ureterointestinal anastomosis. There was no operative mortality. Although acute pyelonephritis, ileus, wound dehiscence and pelvic abscess formation were seen as postoperative complications, all but two improved without any additional procedure. Cases of pelvic abscess or wound dehiscence were treated by abscess drainage. In observation periods, no patients required urinary stent placement and none suffered from defecation problems. We think that transverse colon conduit can be a viable option for patients with pelvic irradiation history, affording them reasonable quality of life postoperatively. PMID:25179985

  3. Regulatory volume increase after secretory volume decrease in colonic epithelial cells under muscarinic stimulation.

    PubMed

    Manabe, Ken-ichi; Shimizu, Takahiro; Morishima, Shigeru; Okada, Yasunobu

    2004-09-01

    To address the question of whether colonic secretory cells change their volume in response to carbachol (CCh) stimulation and, if so, the mechanisms involved therein, we used two-photon laser scanning microscopy to measure the volume of individual epithelial cells in the fundus region of crypts isolated from the guinea-pig distal colon. We also measured the volume of human colonic epithelial T84 cells using an electronic sizing technique. Both types of colonocytes responded to stimulation by CCh with shrinkage and then underwent a regulatory volume increase (RVI), even during continued stimulation by CCh. The secretory volume decrease (SVD) induced by CCh was antagonized by atropine, BAPTA loading and niflumic acid, a blocker of Ca(2+)-activated Cl(-) channels. An increase in the intracellular free [Ca(2+)] was observed with fura-2 during these volume responses to CCh. Removal of all Na(+) or K(+) or of most of the Cl(-) from the extracellular solution abolished the RVI, but not the preceding SVD. The RVI, but not the preceding SVD, was abolished by bumetanide, a blocker of the Na(+)-K(+)-2Cl(-) cotransporter. We conclude that guinea-pig crypt colonocytes and human T84 cells exhibit a cytosolic Ca(2+)-dependent SVD and undergo a subsequent RVI that is dependent on the operation of Na(+)-K(+)-2Cl(-) cotransporters. PMID:15243741

  4. Sodium transporters in the distal nephron and disease implications

    Microsoft Academic Search

    Carolyn A. Ecelbarger; Swasti Tiwari

    2006-01-01

    The post-macula densa segments of the renal tubule—that is, the distal convoluted tubule, connecting tubule, and collecting\\u000a duct—play a central role in determining final urine sodium excretion. The major regulated sodium transporters and channels\\u000a in these cell types include the thiazide-sensitive (Na-Cl) cotransporter (NCC), the epithelial sodium channel (ENaC), and\\u000a Na-K-ATPase. Furthermore, although not involved in sodium reabsorption, the anion

  5. Intermediate syndrome with delayed distal polyneuropathy from ethyl parathion poisoning.

    PubMed

    Nisse, P; Forceville, X; Cezard, C; Ameri, A; Mathieu-Nolf, M

    1998-12-01

    An acute poisoning in a 44-y-old female who ingested 50 ml of ethyl parathion concentrate (25 g) is described. She was treated by gastric lavage, administration of pralidoxime and atropine, and mechanical ventilation. As signs of intoxication disappeared at day 3, treatment was discontinued. The patient had a relapse of acute cholinergic crisis at day 4, and the same treatment was applied again. The acute poisoning phase was followed by an intermediate syndrome and delayed distal polyneuropathy. The clinical course of this severe ethyl parathion poisoning was favorable after 40 d. PMID:9830697

  6. Osteosynthesis of distal radius fractures with the Micronail ®

    Microsoft Academic Search

    Raoul van VugtRon; Ron W. P. M. Geerts; Andries J. Werre

    2010-01-01

    Introduction  The Micronail® is a minimally invasive intramedullar titanium locking screw fixation for two-part dislocated extra-articular fractures and\\u000a average displaced intra-articular fractures.\\u000a \\u000a \\u000a \\u000a \\u000a Patients and methods  In a retrospective study we analyzed the outcome of 20 distal radius fractures in 18 patients (17 female, mean age 78 years),\\u000a which were treated by Micronail®. Average follow-up time was 4 months. We describe the operative technique. All

  7. 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

  8. Mother–offspring competition promotes colonization success

    PubMed Central

    Cote, J.; Clobert, J.; Fitze, P. S.

    2007-01-01

    Colonization is the crucial process underlying range expansions, biological invasions, and metapopulation dynamics. Which individuals leave their natal population to colonize empty habitats is a crucial question and is presently unresolved. Dispersal is the first step in colonization. However, not all dispersing individuals are necessarily good colonizers. Indeed, in some species, the phenotype of dispersers differs depending on the selective pressures that induce dispersal. In particular, kin-based interactions, a factor driving social evolution, should induce different social response profiles in nondispersing and dispersing individuals. Kin competition (defined here as between the mother and offspring) has been proven to produce dispersers with a particular phenotype that may enhance their colonizing ability. By using the common lizard (Lacerta vivipara), we conducted a multipopulation experiment to study the effect of kin competition on dispersal and colonization success. We manipulated mother–offspring interactions, which are the most important component of kin competition in the studied species, at the family and population levels and measured the consequences on colonization success. We demonstrate that mother–offspring competition at the population level significantly influences colonization success. Increased competition at the population level enhanced the colonization rate of the largest juveniles as well as the growth and survival of the colonizers. Based on these results, we calculated that kin-induced colonization halves the extinction probability of a newly initiated population. Because interactions between relatives are likely to affect the ability of a species to track habitat modifications, kin-based dispersal should be considered in the study of invasion dynamics and metapopulation functioning. PMID:17522252

  9. [Proximal and distal ruptures of the biceps brachii tendon].

    PubMed

    Klonz, A; Loitz, D; Reilmann, H

    2003-09-01

    Proximal ruptures. Ruptures of the long head of the M. biceps humeri are commonly caused by degenerative changes within the tendon. Non-operative treatment gives good results, the loss of power regarding elbow flexion and supination amounts to only 8-21%. Refixation may be indicated for cosmetic reasons and offers a small but evident improvement of flexion and supination power. Deformity of the slipped muscle can be corrected effectively. Residual complaints after conservative treatment often result from associated subacromial problems. Distal ruptures. Ruptures of the distal tendon should be treated operatively. The loss of power after conservative treatment is evident (30-40% for flexion, >50% for supination). Extra-anatomical tenodesis to the brachialis muscle or anatomical fixation to the radial tuberosity can be applied. Flexion power and cosmesis can be addressed by both techniques. If supination strength is to be restored, the tendon has to be fixed anatomically. Preparation of the tuberosity bears the risk of heterotopic ossification or nerve damage. Mini-open techniques, using only a limited anterior approach, may decrease risks. PMID:14959750

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

    PubMed

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

    2010-04-01

    Distal tibia fractures are complex injuries with a high complication rate. In this retrospective and multicentre study we attempted to detail complications and outcomes of this type of injury in order to determine predictive factors of poor results. Between 2002 and 2004, 104 patients were admitted for 105 distal tibia fractures. One hundred patients (101 fractures) were reviewed with an average follow-up of 19 months (range, 12-46). Internal fixation, external fixation, limited internal fixation (K-wires or screws), intramedullary nailing and conservative treatment were used. Outcome parameters included occurrence of complications, radiographic analysis, evaluation of the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score and measures of the ankle range of motion. The average functional score was 76 points (range, 30-100 points), and complications occurred in 30 patients. Predictive factors of poor results were fracture severity, complications, malunion and the use of external fixation. We believe that external fixation must be reserved for trauma with severe skin injury, as a temporary solution in a two-staged protocol. For other cases, we recommend ORIF with early mobilisation. PMID:19554328

  11. In Vitro Fermentation of NUTRIOSE® FB06, a Wheat Dextrin Soluble Fibre, in a Continuous Culture Human Colonic Model System

    PubMed Central

    Hobden, Mark R.; Martin-Morales, Agustin; Guérin-Deremaux, Laetitia; Wils, Daniel; Costabile, Adele; Walton, Gemma E.; Rowland, Ian; Kennedy, Orla B.; Gibson, Glenn R.

    2013-01-01

    Wheat dextrin soluble fibre may have metabolic and health benefits, potentially acting via mechanisms governed by the selective modulation of the human gut microbiota. Our aim was to examine the impact of wheat dextrin on the composition and metabolic activity of the gut microbiota. We used a validated in vitro three-stage continuous culture human colonic model (gut model) system comprised of vessels simulating anatomical regions of the human colon. To mimic human ingestion, 7 g of wheat dextrin (NUTRIOSE® FB06) was administered to three gut models, twice daily at 10.00 and 15.00, for a total of 18 days. Samples were collected and analysed for microbial composition and organic acid concentrations by 16S rRNA-based fluorescence in situ hybridisation and gas chromatography approaches, respectively. Wheat dextrin mediated a significant increase in total bacteria in vessels simulating the transverse and distal colon, and a significant increase in key butyrate-producing bacteria Clostridium cluster XIVa and Roseburia genus in all vessels of the gut model. The production of principal short-chain fatty acids, acetate, propionate and butyrate, which have been purported to have protective, trophic and metabolic host benefits, were increased. Specifically, wheat dextrin fermentation had a significant butyrogenic effect in all vessels of the gut model and significantly increased production of acetate (vessels 2 and 3) and propionate (vessel 3), simulating the transverse and distal regions of the human colon, respectively. In conclusion, wheat dextrin NUTRIOSE® FB06 is selectively fermented in vitro by Clostridium cluster XIVa and Roseburia genus and beneficially alters the metabolic profile of the human gut microbiota. PMID:24204753

  12. Non-neuronal release of ACh plays a key role in secretory response to luminal propionate in rat colon

    PubMed Central

    Yajima, Takaji; Inoue, Ryo; Matsumoto, Megumi; Yajima, Masako

    2011-01-01

    Colonic chloride secretion is induced by chemical stimuli via the enteric nervous reflex. We have previously demonstrated that propionate stimulates chloride secretion via sensory and cholinergic systems of the mucosa in rat distal colon. In this study, we demonstrate non-neuronal release of ACh in the secretory response to propionate using an Ussing chamber. Mucosa preparations from the colon, not including the myenteric and submucosal plexuses, were used. Luminal addition of propionate and serosal addition of ACh caused biphasic changes in short-circuit current (Isc). TTX (1 ?m) had no effects, while atropine (10 ?m) significantly inhibited the Isc response to propionate and abolished that to ACh. In response to luminal propionate stimulation, ACh was released into the serosal fluid. A linear relationship was observed between the maximal increase in Isc and the amounts of ACh released 5 min after propionate stimulation. This ACh release induced by propionate was not affected by atropine and bumetanide, although both drugs significantly reduced the Isc responses to propionate. Luminal addition of 3-chloropropionate, an inactive analogue of propionate, abolished both ACh release and Isc response produced by propionate. RT-PCR analysis indicated that isolated crypt cells from the distal colon expressed an enzyme of ACh synthesis (ChAT) and transporters of organic cation (OCTs), but not neuronal CHT1 and VAChT. The isolated crypt cells contained comparable amounts of ACh to the residual muscle tissues including nerve plexuses. In conclusion, the non-neuronal release of ACh from colonocytes coupled with propionate stimulation plays a key role in chloride secretion, via the paracrine action of ACh on muscarinic receptors of colonocytes. PMID:21135046

  13. Colon Cases - MP/H Rules

    Cancer.gov

    Colon Case 1 SURGICAL PATHOLOGY REPORT #1 Surgical Pathology Report November 16, 2007 Gross: The specim en is received in formalin. The container is labeled "colon mass biopsy." It consists of three gray-tan, 0.2 cm mucosal fragments which are

  14. Invertebrate colonization of granular activated carbon filters

    Microsoft Academic Search

    H. Schreiber; D. Schoenen; W. Traunspurger

    1997-01-01

    Results of biological sampling of granular activated carbon (GAC) filtrate taken between May 1994 and August 1995 at three different treatment plants along the river Rhine indicate that GAC filters are colonized by invertebrates. Dominating organism groups were rotifers and nematodes. Depending on operational characteristics, mainly regeneration intervals and backwashing procedures, the filter colonization can lead to an output of

  15. Treatment Options (by Stage) for 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 ...

  16. Fiber type, meal frequency and colonic cytokinetics

    E-print Network

    Zhang, Jianhu

    1993-01-01

    The effects of dietary fiber type (cellulose, pectin or oat bran) and meal frequency (gorge or nibble) on colonic short chain fatty acids (SCFAs), in vivo colonic pH and epithelial cell proliferation were examined in male Sprague-Dawley rats...

  17. Epidemiology of Pneumocystis Colonization in Families

    PubMed Central

    Spencer, LaShonda; Ukwu, Michelle; Alexander, Travis; Valadez, Karri; Liu, Lora; Frederick, Toni; Kovacs, Andrea; Morris, Alison

    2008-01-01

    Whether Pneumocystis colonization is transmitted in families with HIV-infected members is unknown. Using nested polymerase chain reaction of oropharyngeal or nasopharyngeal samples, we detected colonization in 11.4% of HIV-infected adults and 3.3% of their children, but there was no evidence of clustering. PMID:18444861

  18. Epidemiology of Pneumocystis colonization in families.

    PubMed

    Spencer, LaShonda; Ukwu, Michelle; Alexander, Travis; Valadez, Karri; Liu, Lora; Frederick, Toni; Kovacs, Andrea; Morris, Alison

    2008-04-15

    Whether Pneumocystis colonization is transmitted in families with human immunodeficiency virus (HIV)-infected members is unknown. Using nested polymerase chain reaction of oropharyngeal or nasopharyngeal samples, we detected colonization in 11.4% of HIV-infected adults and in 3.3% of their children, but there was no evidence of clustering. PMID:18444861

  19. QUANTITATIVE ECOLOGY Modeling Colonization of Overwintered Immigrant

    E-print Network

    (2004) ABSTRACT Colonization of potato (Solanum tuberosum [L.]) Þelds by Colorado potato beetle potato beetle, colonization, immigration, mapping THE COLORADO POTATO BEETLE, Leptinotarsa decemlin- eata edge along a radial vector from the Þeld center. The frequency of beetles captured within 1-m distance

  20. Colonic lymphoma in the transplant patient

    Microsoft Academic Search

    Daniel L. Phillips; Emmet B. Keeffe; Kent G. Benner; Rita M. Braziel

    1989-01-01

    Summary A 64-year-old male renal transplant recipient developed rectal bleeding caused by a primary lymphoma of the colon, an unusual site for initial disease involvement. Renal transplant recipients may be at increased risk for the development of primary colonic lymphoma, a diagnosis that should be considered in transplant patients who develop abdominal pain, rectal bleeding, or intestinal perforation. The unique

  1. Response of the Distal Tubule and Cortical Collecting Duct to Vasopressin in the Rat

    PubMed Central

    Woodhall, Philip B.; Tisher, C. Craig

    1973-01-01

    Renal micropuncture observations in the rat suggest that the entire “distal tubule” (defined by the micropuncturist as that portion of the renal tubule extending between the macula densa and its first junction with another (renal tubule) may be responsive to vasopressin. However, this portion of the renal tubule contains two segments that are morphologically dissimilar. The “early” distal tubule is lined by epithelium characteristic of the distal convoluted tubule, while the “late” distal tubule is lined by epithelium characteristic of the cortical collecting duct. Thus, the present study was initiated to identify the most proximal site of action of vasopressin in the distal renal tubule. A water diuresis was established in rats with hereditary hypothalamic diabetes insipidus. In one-half of the animals the diuresis was interupted by an i.v. infusion of exogenous vasopressin. Morphological preservation of the kidneys was initiated after induction of vasopressin-induced antidiuresis or during maximum water diuresis. Cell swelling and dilatation of intercellular spaces, morphological findings indicative of vasopressin responsiveness, were observed in the cortical collecting duct including the late segment of the distal tubule, a segment that has also been described by morphologists as the initial collecting tubule. Morphological evidence of vasopressin-responsiveness was not observed in the early distal tubule (distal convoluted tubule). Additional morphological studies in Wistar, Long-Evans, and Sprague-Dawley rats demonstrated a marked difference in the random availability of distal convoluted tubules versus initial collecting tubules potentially available for micropuncture just beneath the renal capsule. The results suggest that hypotonic tubular fluid entering the early distal tubule (distal convoluted tubule) remains hypotonic to plasma until it enters the late distal tubule (initial collecting tubule) and that vasopressin-induced osmotic equilibration is a function of the latter segment alone. The findings emphasize the importance of morphological characterization of those segments of the renal tubule that are subjected to physiological investigation. Images PMID:4750443

  2. Hand numbness and carpal tunnel syndrome after volar plating of distal radius fracture

    Microsoft Academic Search

    Angela Wing Hang Ho; S. T. Ho; S. C. Koo; K. H. Wong

    2011-01-01

    We report the incidence of late onset post-operative carpal tunnel syndrome (late carpal tunnel syndrome) and late median\\u000a nerve neuropathy after volar plating of distal radius fracture by conducting a retrospective study on volar plating for distal\\u000a radius fracture performed during 2002 to 2006. Two hundred eighty-two volar plating were performed for acute distal radius\\u000a fracture after exclusion. Post-operative hand

  3. Proctocolectomy with jejunal pouch-distal rectal anastomosis: An alternative to ileal pouch reconstruction

    Microsoft Academic Search

    Michinaga Takahashi; James W. Williams; Keith A. Kelly

    1998-01-01

    The aim of this study was to determine whether a jejunal pouch would have a lower resting pressure, be more distensible, and\\u000a have more interdigestive migrating myoelectric complexes and less fecal bacterial overgrowth than would an ileal pouch after\\u000a proctocolectomy and pouch-distal rectal anastomosis. In six conscious dogs with a jejunal pouch-distal rectal anastomosis\\u000a and six with an ileal pouch-distal

  4. Collision tumor of low-grade B-cell lymphoma and adenocarcinoma with tuberculosis in the colon: a case report and literature review

    PubMed Central

    2014-01-01

    This report presents a case of collision tumors of low-grade B-cell lymphoma and adenocarcinoma in the sigmoid colon of an 81-year-old man. All surgically resected regional mesenteric lymph nodes were found to be occupied by low-grade B-cell lymphoma, and one lymph node showed the presence of adenocarcinoma. Low-grade B-cell lymphoma was also observed in the resected spleen. Moreover, concurrent tuberculosis infection in the resected colon was proven by the presence of positive results obtained with polymerase chain reaction analysis of the mycobacterial DNA. Systemic chemotherapy was administered for advanced colon cancer with lung metastasis, and anti-tuberculosis treatment was also prescribed. The occurrence of synchronous lymphoma and adenocarcinoma of the colorectal region is rare. Furthermore, collisions of these different entities are also extremely unusual. The accurate clinical determination of the dominant tumor and a timely follow-up are required for the proper treatment of these cases. PMID:24885098

  5. Evolution of phenotypic plasticity in colonizing species.

    PubMed

    Lande, Russell

    2015-05-01

    I elaborate an hypothesis to explain inconsistent empirical findings comparing phenotypic plasticity in colonizing populations or species with plasticity from their native or ancestral range. Quantitative genetic theory on the evolution of plasticity reveals that colonization of a novel environment can cause a transient increase in plasticity: a rapid initial increase in plasticity accelerates evolution of a new optimal phenotype, followed by slow genetic assimilation of the new phenotype and reduction of plasticity. An association of colonization with increased plasticity depends on the difference in the optimal phenotype between ancestral and colonized environments, the difference in mean, variance and predictability of the environment, the cost of plasticity, and the time elapsed since colonization. The relative importance of these parameters depends on whether a phenotypic character develops by one-shot plasticity to a constant adult phenotype or by labile plasticity involving continuous and reversible development throughout adult life. PMID:25558898

  6. Late radiation injury of the colon and rectum. Surgical management and outcome

    SciTech Connect

    Kimose, H.H.; Fischer, L.; Spjeldnaes, N.; Wara, P. (Aarhus Municipal Hospital (Denmark))

    1989-08-01

    After a median latency of 2 years, the initial late colorectal radiation injuries in 182 patients were: stricture (37 percent), minor lesions (36 percent), rectovaginal fistula (22 percent), and gangrene or other fistulas (5 percent). Due to progression, new colorectal injuries, primarily stricture (55 percent) and fistula (42 percent), occurred in 68 patients (37 percent). Resection provided the best results. However, the resectability rate was low (46 percent) and resection was primarily performed in patients with a circumscript well-defined stricture of the proximal rectum or sigmoid colon with an anastomotic leakage rate of 5 percent. The prevailing management of 78 patients with fistula or stricture with synchronous fistula was defunctioning colostomy, primarily end-sigmoidostomy, providing fair results in half of the patients. Stomal complications occurred in 15 percent. The radiation-induced colorectal mortality was 8 percent. Colorectal fistula and associated radiation injuries of the urinary tract, and especially of the small bowel, were the major determinants of fatal outcome, yielding an overall radiation-induced mortality of 25 percent. After a median observation time of 13 years, half of the patients were alive at follow-up; 56 percent of these had a fair outcome whereas the remaining patients continued to have mild symptoms responding to conservative measures (34 percent) or disabling symptoms (10 percent).

  7. Techniques in distal access of wide-necked giant intracranial aneurysms during treatment with flow diversion

    PubMed Central

    Kan, Peter; Wakhloo, Ajay Kumar; Mokin, Maxim; Puri, Ajit

    2015-01-01

    Background: Accessing the normal distal vessel in treatment of wide-necked giant intracranial aneurysms with flow diversion can be difficult. Case Description: Through illustrative cases, the authors present several useful techniques in distal access of wide-necked giant aneurysms during flow diversion treatment. Obtaining an optimal projection that separates the outflow limb from the aneurysm is most critical. Each of the three techniques described enabled the distal access to giant intracranial aneurysms during treatment with flow diversion. Conclusion: The looped-around technique, balloon-assisted technique, and retrograde access are valuable strategies in crossing the aneurysm if direct distal access cannot be obtained.

  8. Involvement of dachshund and Distal-less in distal pattern formation of the cricket leg during regeneration.

    PubMed

    Ishimaru, Yoshiyasu; Nakamura, Taro; Bando, Tetsuya; Matsuoka, Yuji; Ohuchi, Hideyo; Noji, Sumihare; Mito, Taro

    2015-01-01

    Cricket nymphs have the remarkable ability to regenerate a functional leg following amputation, indicating that the regenerating blastemal cells contain information for leg morphology. However, the molecular mechanisms that underlie regeneration of leg patterns remain poorly understood. Here, we analyzed phenotypes of the tibia and tarsus (three tarsomeres) obtained by knockdown with regeneration-dependent RNA interference (rdRNAi) against Gryllus dachshund (Gb'dac) and Distal-less (Gb'Dll). We found that depletion of Gb'Dll mRNA results in loss of the tarsal segments, while rdRNAi against Gb'dac shortens the tibia at the two most distal tarsomeres. These results indicate that Gb'Dll expression is indispensable for formation of the tarsus, while Gb'dac expression is necessary for elongation of the tibia and formation of the most proximal tarsomere. These findings demonstrate that mutual transcriptional regulation between the two is indispensable for formation of the tarsomeres, whereas Gb'dac is involved in determination of tibial size through interaction with Gb'ds/Gb'ft. PMID:25669615

  9. Excessive distal migration of fiber-mesh coated femoral stems

    PubMed Central

    2011-01-01

    Background The surface texture, localization, and magnitude of the surface material applied to the femoral stem can facilitate bone ingrowth and influence the survival of total hip arthroplasties. Clinical and radiographic studies have shown superior bone ingrowth in proximally porous-coated stems with a diaphyseal grit-blasted surface in comparison to a smooth diaphyseal surface. Surface textures—especially porous surface material—have been suggested to have a sealing effect against migration of polyethylene debris along the implant-bone interface and to reduce the inflammatory response, leading to a prolonged implant survival. Patients and methods Between 2004 and 2006, we conducted a randomized, controlled trial (RCT) involving 50 patients with non-inflammatory arthritis. They received either a distally tapered, extended coated stem or a straight, proximally coated stem. During surgery, tantalum markers were inserted into the greater and lesser trochanter. Implant migration was evaluated at 3, 12, and 24 months postoperatively by radiostereometric analysis. The primary endpoint was stem migration 2 years after surgery. Results All femoral components in both groups showed pronounced distal translation, with the highest rate of translation occurring between 0 and 3 months. After 2 years, the mean distal translation was 2.67 (95% CI: –3.93 to –1.42) mm for the tapered, extended coated stem and 1.80 (–2.45 to –1.15) mm for the straight, proximally coated stem. Half of the tapered, extended coated stems and two-thirds of the straight, proximally coated stems had migrated more than 1 mm. No difference between the 2 stems could be seen with regard to translation or rotation at any time point. After 2 years, 2 hips have been reoperated due to mechanical loosening of the stem. Interpretation An excessive amount of migration of both stem types was seen 2 years postoperatively. It is of vital importance to follow this patient cohort since radiostereometric analysis is known to be predictive of late implant failure, especially in this study where pronounced early migration was observed. We recommend longer follow-up of both stem types. PMID:21504304

  10. Development of HIV-1 Rectal-Specific Microbicides and Colonic Tissue Evaluation

    PubMed Central

    Dezzutti, Charlene S.; Russo, Julie; Wang, Lin; Abebe, Kaleab Z.; Li, Jie; Friend, David R.; McGowan, Ian M.; Rohan, Lisa C.

    2014-01-01

    The gastrointestinal tract is structurally and functionally different from the vagina. Thus, the paradigm of topical microbicide development and evaluation has evolved to include rectal microbicides (RMs). Our interest was to create unique RM formulations to safely and effectively deliver antiretroviral drugs to mucosal tissue. RMs were designed to include those that spread and coat all surfaces of the rectum and distal colon rapidly (liquid) and those that create a deformable, erodible barrier and remain localized at the administration site (gel). Tenofovir (TFV) (1%) was formulated as an aqueous thermoreversible fluid and a carbopol-based aqueous hydrogel. Lipid-based liquid and gel formulations were prepared for UC781 (0.1%) using isopropyl myristate and GTCC (Caprylic/Capric Triglycerides), respectively. Formulations were characterized for pH, viscosity, osmolality, and drug content. Pre-clinical testing incorporated ex vivo colonic tissue obtained through surgical resections and flexible sigmoidoscopy (flex sig). As this was the first time using tissue from both sources side-by-side, the ability to replicate HIV-1 was compared. Efficacy of the RM formulations was tested by applying the products with HIV-1 directly to polarized colonic tissue and following viral replication. Safety of the formulations was determined by MTT assay and histology. All products had a neutral pH and were isoosmolar. While HIV-1BaL and HIV-1JR-CSF alone and in the presence of semen had similar replication trends between surgically resected and flex sig tissues, the magnitude of viral replication was significantly better in flex sig tissues. Both TFV and UC781 formulations protected the colonic tissue, regardless of tissue source, from HIV-1 and retained tissue viability and architecture. Our in vitro and ex vivo results show successful formulation of unique RMs. Moreover, the results of flex sig and surgically resected tissues were comparable suggesting the incorporation of both in pre-clinical testing algorithms. PMID:25025306

  11. Cloning and identification of tissue-specific expression of KCNN4 splice variants in rat colon.

    PubMed

    Barmeyer, Christian; Rahner, Christoph; Yang, Youshan; Sigworth, Frederick J; Binder, Henry J; Rajendran, Vazhaikkurichi M

    2010-08-01

    KCNN4 channels that provide the driving force for cAMP- and Ca(2+)-induced anion secretion are present in both apical and basolateral membranes of the mammalian colon. However, only a single KCNN4 has been cloned. This study was initiated to identify whether both apical and basolateral KCNN4 channels are encoded by the same or different isoforms. Reverse transcriptase-PCR (RT-PCR), real-time quantitative-PCR (RT-QPCR), and immunofluorescence studies were used to clone and identify tissue-specific expression of KCNN4 isoforms. Three distinct KCNN4 cDNAs that are designated as KCNN4a, KCNN4b, and KCNN4c encoding 425, 424, and 395 amino acid proteins, respectively, were isolated from the rat colon. KCNN4a differs from KCNN4b at both the nucleotide and the amino acid level with distinct 628 bp at the 3'-untranslated region and an additional glutamine at position 415, respectively. KCNN4c differs from KCNN4b by lacking the second exon that encodes a 29 amino acid motif. KCNN4a and KCNN4b/c are identified as smooth muscle- and epithelial cell-specific transcripts, respectively. KCNN4b and KCNN4c transcripts likely encode basolateral (40 kDa) and apical (37 kDa) membrane proteins in the distal colon, respectively. KCNN4c, which lacks the S2 transmembrane segment, requires coexpression of a large conductance K(+) channel beta-subunit for plasma membrane expression. The KCNN4 channel blocker TRAM-34 inhibits KCNN4b- and KCNN4c-mediated (86)Rb (K(+) surrogate) efflux with an apparent inhibitory constant of 0.6 +/- 0.1 and 7.8 +/- 0.4 muM, respectively. We conclude that apical and basolateral KCNN4 K(+) channels that regulate K(+) and anion secretion are encoded by distinct isoforms in colonic epithelial cells. PMID:20445171

  12. The Nav1.9 channel regulates colonic motility in mice

    PubMed Central

    Copel, Carine; Clerc, Nadine; Osorio, Nancy; Delmas, Patrick; Mazet, Bruno

    2013-01-01

    The colonic migrating motor complex (CMMC) is a major pattern of motility that is entirely generated and organized by the enteric nervous system. We have previously demonstrated that the Nav1.9 channel underlies a tetrodotoxin-resistant sodium current which modulates the excitability of enteric neurons. The aim of this study was to observe the effect of loss of the Nav1.9 channel in enteric neurons on mouse colonic motility in vitro. The mechanical activity of the circular muscle was simultaneously recorded from three sites, namely, proximal, mid- and distal, along the whole colon of male, age-matched wild-type and Nav1.9 null mice. Spontaneous CMMCs were observed in all preparations. The mean frequency of CMMCs was significantly higher in the Nav1.9 null mice (one every 2.87 ± 0.1 min compared to one every 3.96 ± 0.23 min in the wild type). The mean duration of CMMCs was shorter and the mean area-under-contraction was larger in the Nav1.9 null mice compared to the wild type. In addition, CMMCs propagated preferentially in an aboral direction in the Nav1.9 null mice. Our study demonstrates that CMMCs do occur in mice lacking the Nav1.9 channel, but their characteristics are significantly different from controls. Up to now, the Nav1.9 channel was mainly associated with nociceptive neurons and involved in their hyperexcitability after inflammation. Our result shows for the first time a role for the Nav1.9 channel in a complex colonic motor pattern. PMID:23596386

  13. Periluminal Distribution of HIV-Binding Target Cells and Gp340 in the Oral, Cervical and Sigmoid/Rectal Mucosae: A Mapping Study

    PubMed Central

    Patyka, Mariia; Malamud, Daniel; Weissman, Drew; Abrams, William R.; Kurago, Zoya

    2015-01-01

    Studies have shown that the transmission of HIV is most likely to occur via rectal or vaginal routes, and rarely through oral exposure. However, the mechanisms of virus entry at mucosal surfaces remain incompletely understood. Prophylactic strategies against HIV infection may be attainable once gaps in current knowledge are filled. To address these gaps, we evaluated essentially normal epithelial surfaces and mapped the periluminal distribution of CD4+ HIV target cells, including T cells and antigen-presenting cells, and an HIV-binding molecule gp340 that can be expressed by epithelial cells in secreted and cell-associated forms. Immunohistochemistry for CD4, CD16, CD3, CD1a and gp340 in human oral, rectal/sigmoid and cervical mucosal samples from HIV-negative subjects demonstrated that periluminal HIV target cells were more prevalent at rectal/sigmoid and endocervical surfaces lined by simple columnar epithelium, than at oral and ectocervical surfaces covered by multilayered stratified squamous epithelium (p<0.001). gp340 expression patterns at these sites were also distinct and strong in oral minor salivary gland acini and ducts, including ductal saliva, in individual rectum/sigmoid and endocervix periluminar columnar cells, and in ectocervix squamous cells. Only weak expression was noted in the oral non-ductal squamous epithelium. We conclude that periluminal HIV target cells, together with periluminal epithelial cell-associated gp340 appear to be most accessible for HIV transmission at rectal/sigmoid and endocervical surfaces. Our data help define vulnerable structural features of mucosal sites exposed to HIV. PMID:26172445

  14. Enterohemorrhagic Escherichia coli colonization of human colonic epithelium in vitro and ex vivo.

    PubMed

    Lewis, Steven B; Cook, Vivienne; Tighe, Richard; Schüller, Stephanie

    2015-03-01

    Enterohemorrhagic Escherichia coli (EHEC) is an important foodborne pathogen causing gastroenteritis and more severe complications, such as hemorrhagic colitis and hemolytic uremic syndrome. Pathology is most pronounced in the colon, but to date there is no direct clinical evidence showing EHEC binding to the colonic epithelium in patients. In this study, we investigated EHEC adherence to the human colon by using in vitro organ culture (IVOC) of colonic biopsy samples and polarized T84 colon carcinoma cells. We show for the first time that EHEC colonizes human colonic biopsy samples by forming typical attaching and effacing (A/E) lesions which are dependent on EHEC type III secretion (T3S) and binding of the outer membrane protein intimin to the translocated intimin receptor (Tir). A/E lesion formation was dependent on oxygen levels and suppressed under oxygen-rich culture conditions routinely used for IVOC. In contrast, EHEC adherence to polarized T84 cells occurred independently of T3S and intimin and did not involve Tir translocation into the host cell membrane. Colonization of neither biopsy samples nor T84 cells was significantly affected by expression of Shiga toxins. Our study suggests that EHEC colonizes and forms stable A/E lesions on the human colon, which are likely to contribute to intestinal pathology during infection. Furthermore, care needs to be taken when using cell culture models, as they might not reflect the in vivo situation. PMID:25534942

  15. Distally based perforator sural flaps for foot and ankle reconstruction

    PubMed Central

    Chang, Shi-Min; Li, Xiao-Hua; Gu, Yu-Dong

    2015-01-01

    Distally based perforator sural flaps from the posterolateral or posteromedial lower leg aspect are initially a neurofasciocutaneous flap that can be transferred reversely to the foot and ankle region with no need to harvest and sacrifice the deep major artery. These flaps are supplied by a perforating artery issued from the deep peroneal artery or the posterior tibial artery, and the chain-linked adipofascial neurovascular axis around the sural/saphenous nerve. It is a versatile and reliable technique for soft-tissue reconstruction of the heel and ankle region with 180-degrees rotation. In this paper, we present its developing history, vascular basis, surgical techniques including flap design and elevation, flap variations in pedicle and component, surgical indications, and illustrative case reports with different perforating vessels as pivot points for foot and ankle coverage. PMID:25893175

  16. Laparoscopic distal pancreatectomy: Up-to-date and literature review

    PubMed Central

    Iacobone, Maurizio; Citton, Marilisa; Nitti, Donato

    2012-01-01

    Pancreatic surgery represents one of the most challenging areas in digestive surgery. In recent years, an increasing number of laparoscopic pancreatic procedures have been performed and laparoscopic distal pancreatectomy (LDP) has gained world-wide acceptance because it does not require anastomosis or other reconstruction. To date, English literature reports more than 300 papers focusing on LDP, but only 6% included more than 30 patients. Literature review confirms that LDP is a feasible and safe procedure in patients with benign or low grade malignancies. Decreased blood loss and morbidity, early recovery and shorter hospital stay may be the main advantages. Several concerns still exist for laparoscopic pancreatic adenocarcinoma excision. The individual surgeon determines the technical conduction of LDP, with or without spleen preservation; currently robotic pancreatic surgery has gained diffusion. Additional researches are necessary to determine the best technique to improve the procedure results. PMID:23082049

  17. Fibroepithelial polyp of distal ureter with periodic prolapse into bladder.

    PubMed

    Baltogiannis, Dimitrios; Kafetsoulis, Apostolos; Kafetzoulis, Apostolos; Giannakis, Dimitrios; Saito, Motoaki; Miyagawa, Ikuo; Sofikitis, Nikolaos

    2008-01-01

    Ureteric fibroepithelial polyp is a rare disease; it is of mesodermal origin and exhibits benign characteristics. Hydronephrosis occurs in rare cases, and it is generally accepted that it may result in an obstruction without causing alterations of renal function. In many cases it is difficult to differentiate from transitional cell carcinomas. Nowadays, endoscopic evaluation is the means of treatment and management. In our case study we report a patient with a long fibroepithelial polyp of the distal ureter prolapsing into the bladder in a periodic pattern. Cystoscopy revealed that movement of the polyp was moving forward and backward in the right ureteric orifice. Cold-cut biopsy established the diagnosis. The patient underwent ureteroscopic excision and remains asymptomatic a year later. PMID:18480645

  18. Stable encoding of finite-state machines in discrete-time recurrent neural nets with sigmoid units.

    PubMed

    Carrasco, R C; Forcada, M L; Valdés-Muñoz, M A; Neco, R P

    2000-09-01

    There has been a lot of interest in the use of discrete-time recurrent neural nets (DTRNN) to learn finite-state tasks, with interesting results regarding the induction of simple finite-state machines from input-output strings. Parallel work has studied the computational power of DTRNN in connection with finite-state computation. This article describes a simple strategy to devise stable encodings of finite-state machines in computationally capable discrete-time recurrent neural architectures with sigmoid units and gives a detailed presentation on how this strategy may be applied to encode a general class of finite-state machines in a variety of commonly used first- and second-order recurrent neural networks. Unlike previous work that either imposed some restrictions to state values or used a detailed analysis based on fixed-point attractors, our approach applies to any positive, bounded, strictly growing, continuous activation function and uses simple bounding criteria based on a study of the conditions under which a proposed encoding scheme guarantees that the DTRNN is actually behaving as a finite-state machine. PMID:10976142

  19. 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

  20. Abdominal Wall Abscess due to Acute Perforated Sigmoid Diverticulitis: A Case Report with MDCT and US Findings.

    PubMed

    Rafailidis, Vasileios; Vasileios, Rafailidis; Gavriilidou, Anna; Anna, Gavriilidou; Liouliakis, Christos; Christos, Liouliakis; Tsimitri, Asimina; Asimina, Tsimitri; Paschaloudi, Sofia; Sofia, Paschaloudi; Karadimou, Vasiliki; 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