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1

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

PubMed Central

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

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

2006-01-01

2

Hybrid 2-port hand-assisted laparoscopic surgery for the 2-stage treatment of a complete bowel obstruction by distal sigmoid colon cancer: a case report.  

PubMed

In July 2008, a 40-year-old man presented to his local physician with diffuse abdominal pain and severe abdominal distension. Impending bowel rupture due to colonic obstruction was strongly suspected. Complete obstruction of the distal sigmoid colon by a tumor was diagnosed, and emergency surgery was performed. A sigmoid colon loop colostomy was created within the range of subsequent resection to relieve the obstruction. After his general condition had improved and the risks were assessed, curative resection including removal of the stoma was performed by hybrid 2-port hand-assisted laparoscopic surgery. The tumor showed invasion of the serosa without lymph node metastasis, and its pathological diagnosis was stage II. Postoperatively, mild wound infection occurred at the hand access site (stoma), but it resolved with conservative treatment, and the patient was discharged on postoperative day 13. This case is reported here because of the good results. PMID:19360295

Mukai, Masaya; Kishima, Kyoko; Iizuka, Shin-Ichi; Fukumitsu, Hiroshi; Fukasawa, Maki; Yazawa, Naoki; Tajima, Takayuki; Nakamura, Masato; Makuuchi, Hiroyasu

2009-05-01

3

Radiological anatomy of the sigmoid colon  

Microsoft Academic Search

Background  The variable incidence of sigmoid volvulus, which depends on the presence of an elongated sigmoid colon, suggests the possibility\\u000a of variations in the length of the sigmoid colon. This study was undertaken among the three major population groups to prove\\u000a this hypothesis.\\u000a \\u000a \\u000a \\u000a Patients and methods  Radiological films of patients of the three population groups (African, Indian and White) undergoing barium enema

T. E. Madiba; M. R. Haffajee; M. H. Sikhosana

2008-01-01

4

Vaginal agenesis: Experience with sigmoid colon neovaginoplasty  

PubMed Central

Aim: Objective of this study is to report our experience with sigmoid vaginoplasty in adolescents. Materials and Methods: A retrospective study of children with vaginal atresia and Mayer–Rokitansky–Kuster–Hauser syndrome. The sigmoid segment was used for vaginoplasty in all the cases. Results: Eight children were studied over a period of 7 years. The postoperative complications were ileus in 2, mucosal prolapse of the neovagina in 1, and minor wound infection in 1 patient. Seven patients are on regular follow-up. All the neovaginas were patent and functional. One patient had unacceptable perineal appearance, that is, badly scarred perineum as a late complication. None of the patients had vaginal stenosis or excessive mucus discharge, during follow-up visits. Out of the 7 patients, 2 patients are sexually active and satisfied. Conclusions: Sigmoid vaginoplasty is a safe and acceptable procedure for vaginal agenesis with good cosmetic results and acceptable complications rate. Sigmoid colon vaginoplasty is the treatment of choice because of its large lumen, thick walls resistant to trauma, adequate secretion allowing lubrication, not necessitating prolonged dilatation, and short recovery time.

Rawat, Jiledar; Ahmed, Intezar; Pandey, Anand; Khan, Tanvir R.; Singh, Sarita; Wakhlu, Ashish; Kureel, Shiv N.

2010-01-01

5

Small intestinal complications of diverticulitis of the sigmoid colon  

SciTech Connect

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

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

1986-12-19

6

Sphincter-saving procedure for treatment of diffuse cavernous hemangioma of the rectum and sigmoid colon  

Microsoft Academic Search

Two cases of diffuse cavernous hemangioma of the rectum and rectosigmoid colon are reported. Sphincter-saving procedures were\\u000a applied as the surgical treatment for these two patients. The diseased rectum and distal sigmoid colon were resected 3 cm\\u000a above the pectinate line. The mucosa of the rectal stump was extirpated. All visible residue from the hemangiomatous tissues\\u000a on the muscular cuff,

Chen-Hwu Wang

1985-01-01

7

Adenocarcinoma of the Sigmoid Colon Seeding a Chronic Anal Fistula  

Microsoft Academic Search

Damaged mucosal sites seem to be vulnerable to tumor cell implantation. We describe a case of exfoliated tumor cells from a sigmoid colon cancer seeding a long-standing anal fistula. The implications of this finding are reviewed.

Neil Hyman; Masatoski Kida

2003-01-01

8

Volvulus of the sigmoid colon in Jordan  

Microsoft Academic Search

This report discusses 27 patients with sigmoid volvulus treated at Jordan University Hospital (JUH) during a 15-year period. These patients represented 4.7 percent of adult patients treated for intestinal obstruction in the same period. The average age was 54.5 years, and none of the patients was institutionalized. Twenty-five patients presented with acute symptoms, and two had chronic symptoms. Sigmoidoscopic detorsion

Ahmad S. Sroujieh; Ghassan R. Farah; Samir K. Jabaiti; Husam H. El-Muhtaseb; Mohammad S. Qudah; Mahmoud M. Abu-Khalaf

1992-01-01

9

Elastosis in diverticular disease of the sigmoid colon  

Microsoft Academic Search

Diverticular disease of the sigmoid colon is an increasingly common clinical problem in the ageing population of western industrialised countries but the mechanism by which the disease develops remains unknown. The muscular abnormality is the most striking and consistent feature and this has been studied by light and electron microscopy in 25 surgical specimens of uncomplicated diverticular disease and in

J Whiteway; B C Morson

1985-01-01

10

Clostridium septicum aortitis with associated sigmoid colon adenocarcinoma.  

PubMed

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

Ge, Phillip S; de Virgilio, Christian

2012-02-01

11

Volvulus of the sigmoid colon in Jordan.  

PubMed

This report discusses 27 patients with sigmoid volvulus treated at Jordan University Hospital (JUH) during a 15-year period. These patients represented 4.7 percent of adult patients treated for intestinal obstruction in the same period. The average age was 54.5 years, and none of the patients was institutionalized. Twenty-five patients presented with acute symptoms, and two had chronic symptoms. Sigmoidoscopic detorsion was achieved in 15 patients. Emergency resection was required in two of these patients: for the development of gangrene a few hours after detorsion in one patient and for recurrence within 24 hours in the other despite the presence of a rectal tube. Early recurrence occurred in two other patients and was managed endoscopically. Emergency surgery was performed in 10 other patients: for a failed endoscopic detorsion in three patients, for ulcerated and bleeding mucosa forecasting gangrene in another, and as a primary treatment in six patients who were either misdiagnosed or suspected to have gangrenous bowel. Elective resection was performed in 13 patients. The mortality rate was 15 percent (4/27) for the whole series and 33.3 percent (1/3) for those with gangrenous bowel. PMID:1733686

Sroujieh, A S; Farah, G R; Jabaiti, S K; el-Muhtaseb, H H; Qudah, M S; Abu-Khalaf, M M

1992-01-01

12

The Association of Anisakiasis in the Ascending Colon with Sigmoid Colon Cancer: CT Colonography Findings  

PubMed Central

The association of anisakiasis of the colon with colon cancer is rare and difficult to diagnose. Only one case of this type has been reported to date. In this study, we report a case of synchronous colon cancer and colonic anisakiasis. A 50-year-old woman was admitted for abdominal pain, and a volume-rendered surface-shaded image of CT colonography (CTC) revealed a concentric narrowing in the sigmoid colon and a segmental fold thickening in the ascending colon. A total colectomy was performed and the diagnosis of synchronous sigmoid colon cancer and anisakiasis of the ascending colon was confirmed. This case is the first reported visualization of synchronous colon cancer and colonic anisakiasis on a CTC.

Yoo, Hye Jin; Lee, Jeong Min; Kim, Min A; Han, Joon Koo; Choi, Byung Ihn

2008-01-01

13

Elastosis in diverticular disease of the sigmoid colon.  

PubMed Central

Diverticular disease of the sigmoid colon is an increasingly common clinical problem in the ageing population of western industrialised countries but the mechanism by which the disease develops remains unknown. The muscular abnormality is the most striking and consistent feature and this has been studied by light and electron microscopy in 25 surgical specimens of uncomplicated diverticular disease and in 25 controls. This is the first ultrastructural study of human colonic muscle to be published and shows that the muscle cells in diverticular disease are normal; neither hypertrophy nor hyperplasia is present. There is, however, an increase in the elastin content of the taeniae coli by greater than 200% compared with controls: elastin is laid down between the muscle cells and the normal fascicular pattern of the taeniae coli is distorted. There is no alteration in the elastin content of the circular muscle. As elastin is laid down in a contracted form, this elastosis may be responsible for the shortening or 'contracture' of the taeniae which in turn leads to the characteristic concertina-like corrugation of the circular muscle. Such a structural change could explain the altered behaviour of the colon wall in diverticular disease and its failure to change on treatment with bran. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6

Whiteway, J; Morson, B C

1985-01-01

14

Peristalsis in the rabbit distal colon  

PubMed Central

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

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

1972-01-01

15

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

PubMed Central

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.

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

1995-01-01

16

Case of a sigmoid colon cancer with metachronous metastases to the mesorectum and the abdominal wall  

Microsoft Academic Search

BACKROUND: Sigmoid colon cancer metachronous metastases commonly occur in the liver and lungs with sporadic reports also to the spleen, stomach, thyroid gland, abdominal wall and upper urinary tract. This is a rare case of metachronous metastases invading the mesorectum and the abdominal wall. CASE PRESENTATION: A 72-year-old female underwent sigmoidectomy for stage I (T2N0 M0) sigmoid colon cancer in

John Kalaitzis; George Filippou; Adamantia Zizi-Sermpetzoglou; Athanasios Marinis; Andreas Hadjimarcou; Nikolaos Paschalidis; Spyros Rizos

2010-01-01

17

Solitary Adrenal Metastasis in a Patient with Sigmoid Colon Cancer; Report of a Case  

Microsoft Academic Search

A 73-year-old man had sigmoidectomy for sigmoid colon cancer in December 2001. Although he was followed regularly with chemotherapy,\\u000a his serum carcinoembryonic antigen (CEA) increased on August 2002. Abdominal computed tomography and magnetic resonance imaging\\u000a showed a right adrenal mass and no other abnormality. The preoperative diagnosis was a solitary adrenal metastasis from sigmoid\\u000a colon cancer; the lesion was removed

Y. Shoji; M. Dohke; T. Masuda; F. Nakamura; T. Yano; H. Niizeki; N. Kashimura; O. Matsunami

2006-01-01

18

TisN0M1 Sigmoid Colon Cancer: A Case Report  

PubMed Central

Distant metastasis of a colon carcinoma in situ has not yet been reported. We experienced a case of a sigmoid colon carcinoma in situ with common hepatic lymph node metastasis. After the first operation, we diagnosed dual intramucosal adenocarcinomas of the sigmoid colon without any regional lymph node metastasis. After the second operation, a metastatic adenocarcinoma was found in the common hepatic lymph nodes. We suggest that metastasis in cases of a colonic carcinoma in situ is rare, but possible. The parallel progression model of tumors can explain this early metastasis.

Lee, Kyung Ha; Kim, Jin Su; Cheon, Kwang Sik; Song, In Sang; Kang, Dae Young

2014-01-01

19

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

PubMed

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

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

20

Case of a sigmoid colon cancer with metachronous metastases to the mesorectum and the abdominal wall  

PubMed Central

Backround Sigmoid colon cancer metachronous metastases commonly occur in the liver and lungs with sporadic reports also to the spleen, stomach, thyroid gland, abdominal wall and upper urinary tract. This is a rare case of metachronous metastases invading the mesorectum and the abdominal wall. Case presentation A 72-year-old female underwent sigmoidectomy for stage I (T2N0 M0) sigmoid colon cancer in May 2008. In June 2009, an abdominal computed tomography scan revealed a tumor 2 cm in size at the lower anterior mesorectum and a second mass 2 cm in size at the anterior abdominal wall midline. Total colonoscopy showed no mucosal lesion. The serum carcinoembryonic antigen level was normal. A biopsy of the mesorectum tumor showed similar histologic characteristics with the primary tumor. Since no other site of recurrence was identified, an abdominoperineal resection was attempted. During the operation and after the removal of the incision recurrence, sinus bradycardia and signs of myocardial ischemia were noticed. A loop transverse colostomy was immediately perfomed and the operation was terminated. Postoperative cardiologic examination revealed an acute myocardium infract. Chemo-radiation of the mesorectum tumor and re-evaluation for surgical excision was decided. Conclusion Metachronous metastasis of the mesorectum from sigmoid colon cancer is extremely rare. Although patterns of lymphatic spread from rectal cancer to sigmoid colon have recently been demonstrated, there is no evidence of metachronous mesorectum invasion from sigmoid colon cancer. This could be the issue for future trials.

2010-01-01

21

[A case of pedunculated colonic adenoma with pseudocarcinomatous invasion and squamous metaplasia occurring in the sigmoid colon].  

PubMed

A case of pedunculated colonic adenoma with pseudocarcinomatous invasion and squamous metaplasia occurring in the sigmoid colon is reported. The patient was a 65-year-old man who visited our hospital for further evaluation of a positive fecal occult blood test. Colonoscopy revealed a pedunculated polyp with a thick swollen stalk in the sigmoid colon. EUS revealed a hyperechoic lesion in the stalk. However, endosonographically, the third and fourth layers of the colonic wall were shown to be normal. It was suspected to be a colonic adenoma with pseudocarcinomatous invasion from these endoscopic findings. Endoscopic polypectomy was performed. Histological examination of the specimen revealed tubular adenoma with moderate epithelial atypia and submucosal displacement of adenomatous glands with variable cystic changes. Squamous metaplasia and hemosiderin deposition were also seen in the mucosal and submucosal layer, respectively. This polyp was diagnosed as a colonic adenoma with pseudocarcinomatous invasion with squamous metaplasia. PMID:21389668

Hirasaki, Shoji; Kubo, Motoharu; Inoue, Atsushi; Oshiro, Hisako; Goji, Takahiro; Tada, Saori; Suwaki, Kin-Ichiro; Ikeda, Keisuke; Iwashita, Akinori

2011-03-01

22

Surgical treatment of perforated diverticulitis of the sigmoid colon  

Microsoft Academic Search

A retrospective review of 1353 cases of acute perforated sigmoid diverticulitis treated surgically demonstrates that those\\u000a operations that resect or exteriorize the perforated segment at the first operation are associated with a lower operative\\u000a mortality rate than procedures that fail to remove the perforated segment at the initial operation. These results are true\\u000a for both diffuse peritonitis and localized abscess.

Jon M. Greif; Gregory Fried; Charles K. McSherry

1980-01-01

23

Sigmoid colon cancer arising in a diverticulum of the colon with involvement of the urinary bladder: a case report and review of the literature  

PubMed Central

Background Colon cancer can arise from the mucosa in a colonic diverticulum. Although colon diverticulum is a common disease, few cases have been previously reported on colon cancer associated with a diverticulum. We report a rare case of sigmoid colon cancer arising in a diverticulum with involvement of the urinary bladder, which presented characteristic radiographic images. Case presentation A 73-year-old man was admitted to our hospital for macroscopic hematuria. Computed tomography and magnetic resonance imaging revealed a sigmoid colon tumor that protruded into the urinary bladder lumen. The radiographs showed a tumor with a characteristic dumbbell-shaped appearance. Colonoscopy showed a type 1 cancer and multiple diverticula in the sigmoid colon. A diagnosis of sigmoid colon cancer with involvement of the urinary bladder was made based on the pathological findings of the biopsied specimens. We performed sigmoidectomy and total resection of the urinary bladder with colostomy and urinary tract diversion. Histopathological findings showed the presence of a colovesical fistula due to extramurally growing colon cancer. Around the colon cancer, the normal colon mucosa was depressed sharply with lack of the muscular layer, suggesting that the colon cancer was arising from a colon diverticulum. Conclusion The present case is the first report of sigmoid colon cancer arising in a diverticulum with involvement of the urinary bladder. Due to an accurate preoperative radiological diagnosis, we were able to successfully perform a curative resection for sigmoid colon cancer arising in a diverticulum with involvement of the urinary bladder.

2014-01-01

24

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

PubMed Central

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

2012-01-01

25

[A case of Stage IV sigmoid colon cancer cured with radical combined modality therapy].  

PubMed

The patient was a 54-year-old man who had undergone resection of the sigmoid colon for unresectable sigmoid colon cancer with multiple liver( H1), lymph node, and lung metastases at the previous hospital. Chemotherapy with 5-fuorouracil, Leucovorin, and oxaliplatin (mFOLFOX6) plus bevacizumab was initiated after surgery. The outcome was partial response. The patient was introduced to our hospital because he had relocated. Based on the findings of the patient's computed tomography( CT) and positron emission tomography( PET)-CT scans, we decided to perform radical resection. We performed partial hepatectomy( S7 and S8) and pancreatoduodenectomy for metastases to the hepatoduodenal ligament lymph node. After confirming that there was no recurrence, he underwent right partial pneumonectomy. Currently, the patient shows no signs of recurrence. The therapy for colon cancer should include aggressive radical surgery to control metastasis. PMID:24393978

Babaya, Akihito; Fukunaga, Mutsumi; Yamamoto, Tameyoshi; Oda, Kazuyuki; Nakata, Ken; Ohzato, Hiroki

2013-11-01

26

Toxic Megacolon and Acute Ischemia of the Colon due to Sigmoid Stenosis Related to Diverticulitis  

PubMed Central

We present a rare case of toxic megacolon accompanied by necrosis of the colon due to chronic dilation caused by stenosis of the sigmoid colon as a complication of diverticulitis. The patient presented at the emergency department with diffuse abdominal pain, fever (38.8°C) and tachycardia (120 beats/min). Physical examination revealed distension and tenderness on deep palpation on the left lower quadrant without peritoneal signs. Abdominal computed tomography showed located stenosis in the sigmoid colon and marked dilation of the descending (12 cm diameter) and transverse (7.5 cm diameter) colon. A few hours later, the patient developed severe septic shock with electrolyte abnormalities. He had a history of two prior admissions to our hospital due to crises of acute diverticulitis. Based on Jalan's criteria the diagnosis was compatible with toxic megacolon. The patient's condition deteriorated suddenly and an emergency colectomy was performed. The operative findings revealed a necrotic colon. Histology examination confirmed the diagnosis of ischemia of the colon. To our knowledge this is the first published report in the literature which refers to a rare complication of diverticulitis, namely chronic stenosis which complicated to colonic ischemia and toxic megacolon.

Antonopoulos, P.; Almyroudi, M.; Kolonia, V.; Kouris, S.; Troumpoukis, N.; Economou, N.

2013-01-01

27

The effect of intravenous prostaglandin F2 alpha and E2 on the motility of the sigmoid colon.  

PubMed Central

The effect of a 20-min intravenous infusion of prostaglandin E2 (0-08 mug kg-1 min-1) or of prostaglandin F2 alpha (0-8 mug kg-1 min-1) on the segmental pressures in the sigmoid colon was studied in 12 patients. Prostaglandin F2 alpha had no measurable effect, but prostaglandin E2 significantly inhibited sigmoid motility.

Hunt, R H; Dilawari, J B; Misiewicz, J J

1975-01-01

28

Left pneumothorax secondary to colonoscopic perforation of the sigmoid colon: a case report.  

PubMed

We present here the case of a 75-year-old woman who complained of acute abdominal pain after a diagnostic colonoscopy. Abdominal x-rays demonstrated pneumoperitoneum, whereas chest x-rays showed pneumomediastinum and left pneumothorax. A chest drain was placed and subsequently an exploratory laparoscopy was performed, during which air was found in the subserosa of the sigmoid colon and in the mesosigmoid secondary to perforation of a sigmoid diverticulum. The perforation was repaired and a protective loop colostomy was fashioned. The patient was discharged 8 days postoperatively in a good general condition. Although numerous cases of pneumoretroperitoneum and pneumomediastinum secondary to iatrogenic perforation of the colon have been described, reports of pneumothorax are much rarer. We, therefore, discuss the anatomic bases and the possible physiopathologic mechanisms responsible for this clinical complication. PMID:17318062

Lovisetto, Federico; Zonta, Sandro; Rota, Emanuela; Mazzilli, Massimiliano; Faillace, Giuseppe; Bianca, Alessandro; Fantini, Alessio; Longoni, Mauro

2007-02-01

29

Active potassium absorption in rat distal colon.  

PubMed Central

1. Active potassium (K+) absorption in rat distal colon was investigated by measuring mucosal-to-serosal (JK, ms) and serosal-to-mucosal (JK, sm) 42K+ fluxes (mu equiv h-1 cm-2) across isolated stripped mucosa under short-circuit conditions in normal and dietary Na-depleted animals. As previously demonstrated, removal of Na+ from both mucosal and serosal solutions bathing the normal colon slightly increased net K+ absorption as a result of inhibition of JK, sm without affecting JK, ms, while in the Na-depleted group net K+ secretion (-0.54 +/- 0.11) was converted to a marked net K+ absorption (1.68 +/- 0.30, P less than 0.001). 2. In both groups of animals in Na(+)-free Ringer solution, JK, ms exhibited saturable and linear components, while JK, sm was a linear function of [K+]. Estimated affinity constants (mM) for saturable net K+ absorption were similar in normal (0.52 +/- 0.12) and Na-depleted (0.67 +/- 0.11) animals; however, there was a greater than 3-fold increase in the saturable flux (Jmax) from 0.54 +/- 0.04 in the normal colon to 1.78 +/- 0.08 mu equiv h-1 cm-2 in Na-depleted animals. 3. Mucosal orthovanadate (100 microM) inhibited JK, ms in both normal (control, 0.66 +/- 0.05 vs. orthovanadate, 0.36 +/- 0.03 mu equiv h-1 cm-2, P less than 0.001) and Na-depleted animals (control 1.20 +/- 0.13 vs. orthovanadate 0.77 +/- 0.07 mu equiv h-1 cm-2, P less than 0.01) without affecting JK, sm or the short-circuit current. In the Na-depleted group mucosal omeprazole or SCH28080 (100 microM), inhibitors of gastric K(+)-H(+)-ATPase, insignificantly or slightly reduced (by 10%) JK, ms respectively; in contrast, mucosal ouabain (1 mM) markedly inhibited JK, ms (control, 1.61 +/- 0.16 vs. ouabain, 0.83 +/- 0.98 mu equiv h-1 cm-2, P less than 0.001). 4. Mucosal Na+ appeared to be a competitor of K+ uptake across the apical membrane. 5. These results indicate that dietary Na-depletion increases electroneutral K+ absorption by increasing its transport capacity and suggest that the mechanism of this active K+ absorption process may involve an apical K(+)-ATPase with properties that are unlike the gastric K(+)-H(+)-ATPase but similar, in part, to Na(+)-K(+)-ATPase.

Sweiry, J H; Binder, H J

1990-01-01

30

Small Solitary Pulmonary Metastasis Detected Before Primary Sigmoid Colon Cancer: Report of a Case  

Microsoft Academic Search

We report the case of a 60-year-old woman referred to us after chest X-ray and mobile computed tomography screening detected an 8-mm nodule in right S2. Transbronchial aspiration cytology suggested a pulmonary metastasis from colorectal cancer. Therefore, we performed a colonoscopy and found a polypoid lesion, 2?cm in diameter, in the sigmoid colon. An analysis of a biopsy specimen from

Aki Ishikawa; Shinichiro Motohashi; Kiyoshi Shibuya; Masayuki Baba; Tetsuya Toyosaki; Hidemi Ohwada; Norio Saito; Kiminori Suzuki; Takehiko Fujisawa

2003-01-01

31

Solitary myofibroma of the sigmoid colon: case report and review of the literature  

PubMed Central

A 58-year-old woman presented with a solitary myofibroma that arose in the sigmoid colon. Computed tomography revealed a highly enhanced intramural mass (1.3-cm maximum diameter) in the proximal sigmoid colon. Histologically, the tumor exhibited a biphasic growth pattern, which comprised haphazardly arranged, interwoven fascicles of plump, myoid-appearing spindle cells with elongated nuclei and abundant eosinophilic cytoplasm, and more cellular areas of primitive-appearing polygonal cells that were arranged in a hemangiopericytomatous pattern. The tumor cells were positive for smooth muscle actin (SMA), and negative for desmin, h-caldesmon, CD34, cytokeratin, S100 protein, and CD117. The Ki-67 labeling index was not high (up to 7%). Based on these histologic and immunohistochemical features, our patient was diagnosed with a myofibroma of the sigmoid colon. The presence of solitary myofibroma in the intestine of an adult requires attention to avoid misdiagnosis as a more aggressive mesenchymal tumor. Virtual Slides The virtual silde(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2096403796957687

2013-01-01

32

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

PubMed Central

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

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

2013-01-01

33

A Case of Malignant Granular Cell Tumor in the Sigmoid Colon  

PubMed Central

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

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

2014-01-01

34

Massive gastrointestinal bleeding and obstruction of the ureter caused by the migration of a swallowed toothpick from the sigmoid colon--a case report.  

PubMed

In this study, a case of an ingested toothpick partially migrating from the sigmoid colon, causing massive lower gastrointestinal bleeding due to arterial-colic fistula, and stricture of the left ureter is presented. A 70-year-old male was admitted to the emergency department after having feces mixed with fresh and coagulated blood for the past two days. Computed tomography and retrograde ureteropyelography showed the stricture of the left ureter, 1.5 cm below the branching of iliac artery, without any signs of malignancy. Colonoscopy showed fresh blood in the rectum and sigmoid colon up to the neoplasm like granulation tissue mixed with fresh and coagulated blood, which almost obstructed the lumen. Explorative laparotomy showed a foreign body (toothpick) perforating the sigmoid colon through the mesenterial wall, and being stocked with one-third into the left internal iliac artery, causing arterial-colic fistula. The remaining part of the toothpick was surrounded by granulation tissue and chronic inflammatory process, pressing on the distal third of the left ureter. We conclude that a swallowed toothpick may cause a significant gastrointestinal injury with a wide variety of clinical manifestations, and it must be treated with caution. The imaging studies are often inadequate in detecting toothpicks, and thus, we insist on a physical examination, as the best indicator of injury. PMID:18494220

Maras-Simuni?, Marina; Grandi?, Leo; Brni?, Darko; Simuni?, Miroslav; Druzijani?, Nikica

2008-03-01

35

Management of patients with stercoral perforation of the sigmoid colon: Report of five cases  

PubMed Central

To our knowledge, stercoral perforation of the colon is rarely seen with fewer than 90 cases reported in the literature till date. We explored the principles of management to prevent impending mortality in five patients with this condition. Five patients, two males and three females, whose median age was 64 years, had sustained stercoral perforation of the sigmoid colon. Chronic constipation was the common symptom among these patients. Three patients underwent a Hartmann’s procedure and another two were treated with segmental colectomy with anastomosis and diverting colostomy. There was one surgical mortality and the other patients had an uneventful hospital stay. Timely intervention to prevent and/or treat any associated sepsis along with extensive peritoneal lavage and surgical intervention to remove diseased colonic tissue at the primary stercoral ulceration site coupled with aggressive therapy for peritonitis are key treatment modalities in salvaging patients presenting with stercoral perforation of the colon.

Huang, Wen-Shih; Wang, Chia-Siu; Hsieh, Ching-Chuan; Lin, Paul Y; Chin, Chih-Chien; Wang, Jeng-Yi

2006-01-01

36

The distal colon provides reserve storage capacity during colonic fluid overload  

PubMed Central

Background—In addition to its absorptive function the capacity of the colon to retain fluid might be relevant in compensating for increased fluid loads and prevention of diarrhoea. The distal colon is considered to be mainly a conduit without extensive storage function. ?Aims—To evaluate colonic volume capacity in a model of pure osmotic diarrhoea. ?Methods—A non-absorbable, iso-osmotic solution (OS) containing polyethylene glycol (500 ml) was infused into the caecum of nine healthy volunteers; the control group (n=5) received an equal amount of an easily absorbable electrolyte solution (ES). Fluids were radiolabelled with technetium-99m and gamma camera images were obtained for 48 hours. Counts in the proximal and distal colon were measured and regional and overall colonic transit and stool output were quantified. ?Results—After OS, in contrast to ES, faecal output was increased significantly (p<0.05), but colonic transit after OS was not different from transit after ES (p>0.05). This indicates storage of OS in the colon: after OS infusion, counts in the proximal colon decreased linearly while the distal colon stored approximately 30% of radioactivity for the whole 48 hour study period. After OS, stool output correlated with distal (p<0.01), but not with proximal (p>0.05), colonic transit. In constrast, after ES, stool output was determined by proximal colonic transit (p<0.05) but not by transit through the distal colon (p>0.05). ?Conclusion—The distal colon retains non-absorbable fluid volumes extensively. In our model transit through the distal colon—but not the proximal colon—determined the time at which diarrhoea occurred. ?? Keywords: osmotic diarrhoea; colonic transit; storage capacity; colonic scintigraphy

Hammer, J; Pruckmayer, M; Bergmann, H; Kletter, K; Gangl, A

1997-01-01

37

Dietary restriction sensitizes the rat distal colon to aldosterone.  

PubMed Central

1. The effects of starvation and undernutrition were assessed on rat colonic electrogenic Na+ absorption in fed controls, 72 h starved and acute undernourished (fed one-third of the control group's daily food intake for up to 9 days). The basal short-circuit currents (Isc) of three segments of rat colon (proximal, mid- and distal), stripped of their external muscle layers were monitored before and during addition of 0.1 mM-mucosal amiloride. The decrease in Isc was used as the measure of the electrogenic Na+ absorption. 2. Acute undernutrition and to a lesser extent 72 h starvation elevated the basal Isc only in the distal colon. The increase was inhibited by amiloride (0.1 mM, mucosal) indicating that it was due to electrogenic Na+ transport. 3. Allowing the 9 days acute undernourished rats to drink 0.9% NaCl failed to prevent the increase in the basal Isc in the distal colon but it was reduced by administration of spironolactone. 4. Adrenalectomy completely abolished the increased basal Isc in the distal colon induced by the 9 day undernutrition. However, the plasma aldosterone levels in the fed and 9 day undernutrition groups were not significantly different. 5. Injection of aldosterone into adrenalectomized rats drinking 0.9% NaCl and which were undernourished for 9 days induced a large increase in their distal colonic Isc which was inhibited by mucosal amiloride. Similar treatment of sham-operated rats on 0.9% NaCl or adrenalectomized control fed rats on 0.9% NaCl had no effect on the distal colonic Isc. 6. The results indicate that acute undernutrition for 9 days makes the distal colonic epithelium more sensitive to the prevailing plasma aldosterone level allowing an enhanced electrogenic Na+ absorptive capacity to be induced.

Nzegwu, H C; Levin, R J

1992-01-01

38

Association between alcohol consumption and cancer of the sigmoid colon: observations from a Japanese cohort study.  

PubMed

A 17-year follow up of 265,118 Japanese adults aged 40 years and above revealed a close association between cancer of the sigmoid colon (n = 91) and alcohol consumption: relative risk (RR) for drinkers versus non drinkers was 4.38 (90% CI 1.75-10.97) in men and 1.92 (1.13-3.26) in women. In men, attributable risk was 74% and RRs in non, infrequent, occasional, and daily drinkers were 1.00, 2.03, 3.83, and 5.42, respectively. RRs of daily consumption versus non-consumption in men for cancers of mouth, pharynx, oesophagus, stomach, proximal colon, sigmoid colon, and rectum were 2.27, 2.44, 2.29, 0.92, 0.98, 5.42, and 1.39, respectively. A combined effect of alcohol and smoking was evident for cancers of the upper digestive tract but almost absent for those of the lower digestive tract. PMID:2570969

Hirayama, T

1989-09-23

39

Infection of the sigmoid colon during TNF? antagonist therapy for chronic inflammatory joint disease.  

PubMed

We report 7 cases of sigmoid colon infection in patients taking TNF? antagonist therapy to treat chronic inflammatory joint disease. There were 5 women and 2 men with a mean age of 57.5years (range, 21-77years). The presenting symptoms were abdominal pain, bowel habit changes, and a fever. These symptoms developed within 6months after starting TNF? antagonist therapy in 5 of the 7 patients. Empirical antibiotic therapy was used in all 7 patients. Surgical colectomy was performed in 4 patients, including 1 who required a temporary Hartmann's procedure. The risk of infection associated with TNF? antagonist therapy is well documented. However, few cases of colon infection have been reported and little is known about this potentially severe complication. Glucocorticoids or non-steroidal anti-inflammatory drugs may worsen the infection, particularly as they can attenuate the clinical symptoms, thereby delaying the diagnosis. A history of sigmoid colon infection, diverticulosis, and/or diverticulitis must be sought before starting treatment with a biological agent. Prophylactic treatment may be considered if such a history is found. Diagnostic investigations are in order to develop a standardized management strategy in patients with a history of intestinal tract infection. PMID:24176737

Moyano, Chantal; Beldjerd, Mounir; Pécourneau, Virginie; Billey, Thierry; Lassoued, Slim

2014-05-01

40

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

NASA Astrophysics Data System (ADS)

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

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

2010-09-01

41

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

PubMed

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

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

2014-02-01

42

Urethral metastasis from a sigmoid colon carcinoma: a quite rare case report and review of the literature  

PubMed Central

Background Urethral metastatic adenocarcinoma is extremely rare. Moreover, only 9 previous cases with metastases from colorectal cancer have been reported to date, and not much information on urethral metastases from colorectum is available so far. Case presentation We report our experience in the diagnosis and the management of the case with urethral metastasis from a sigmoid colon cancer. A 68-year-old man, who underwent laparoscopic sigmoidectomy for sigmoid colon carcinoma four years ago, presented gross hematuria with pain. Urethroscopy identified a papillo-nodular tumor 7 mm in diameter in the bulbar urethra. CT-scan imaging revealed the small mass of bulbous portion of urethra and solitary lung metastasis. Histological examination of the tumor obtained by transurethral resection showed moderately differentiated adenocarcinoma, which was diagnosed as a metastasis of a sigmoid colon carcinoma pathologically by morphological examination. Immunohistochemical analysis of the urethral tumor revealed the positive for cytokertin 20 and CDX2, whereas negative for cytokertin 7. These features were consistent with metastatic adenocarcinoma of the sigmoid colon cancer. As the management of this case with urethral and lung metastasis, 6-cycle of chemotherapy with fluorouracil with leucovorin plus oxaliplatin was administered to the patient, and these metastases were disappeared with no recurrence of disease for 34 months. Conclusion Urethral metastasis from colorectal cancer is a very rare occurrence. However, in the presence of urinary symptoms, the possibility of the urethral metastasis should be considered.

2014-01-01

43

Antisecretory Mechanisms of Peptide YY in Rat Distal Colon  

Microsoft Academic Search

Peptide YY (PYY) is a potent regulator ofintestinal secretion. These studies investigated therole of Y1 and Y2 receptor subtypes in mediating theantisecretory effects of PYY on mucosa-submucosapreparations of rat distal colon. Addition of vasoactiveintestinal peptide (VIP) to these tissues resulted in a140 ± 18% increase in basal short-circuit current(Isc) and the induction of Cl-secretion. VIP-stimulated increases in Isc were abolished

Edward E. Whang; Oscar J. Hines; Joseph R. Reeve; Daniel Grandt; James A. Moser; Anton J. Bilchik; Michael J. Zinner; David W. Mcfadden; Stanley W. Ashley

1997-01-01

44

Spontaneous rupture of a sigmoid colon gastrointestinal stromal tumor manifesting as pneumoretroperitoneum with localized peritonitis: report of a case.  

PubMed

Colonic gastrointestinal stromal tumors (GISTs) account for only 5%-10% of tumors arising in the digestive tract. Spontaneous rupture is a very rare manifestation of a GIST; however, we report what to our knowledge is the first documented case of pneumoretroperitoneum caused by the rupture of a GIST. A 77-year-old woman was admitted to our hospital with acute abdominal pain and hematochezia. Colonoscopy showed luminal narrowing in the sigmoid colon, but no definite mucosal defect. Computed tomography (CT) showed an air-containing heterogeneous mass, 9.7 × 9.3 cm, in the pelvic cavity and a small amount of air in the retroperitoneum. Emergency laparotomy revealed a ruptured sigmoid colonic GIST with localized peritonitis. Pathologic examination confirmed that the tumor was composed mainly of round epithelioid cells. It was immunohistochemically positive for CD34 and negative for C-kit protein. This report describes how we successfully managed pneumoretroperitoneum with localized peritonitis caused by the spontaneous rupture of an epithelioid GIST originating from the sigmoid colon. PMID:21773897

Hwangbo, Young; Jang, Jae Young; Kim, Hyoung Jung; Kim, Youn Wha; Park, Soon Do; Shim, Jaejun; Dong, Seok Ho; Kim, Hyo Jong; Kim, Byung Ho; Chang, Young Woon; Chang, Rin

2011-08-01

45

Distal ileum and colon: targeted sites for 5-ASA release.  

PubMed

Sulphasalazine, used in the treatment of ulcerative colitis, is cleaved in the colon by the metabolic action of colonic bacteria on the diazo bond to release 5-Aminosalicylic acid (5-ASA) and sulpharidine. Whilst the former has been demonstrated to be active moiety, the latter is reputed to be responsible for toxicity associated with sulphasalazine therapy. A new multi-particulate formulation of 5-ASA has been designed (Asalan) to achieve targeted release of the drug in both the distal small intestine and colon and hence may be beneficial in the treatment of not only Ulcerative Colitis but also Crohn's disease. An imaging study was performed with beads formulated with barium sulphate using the same procedure employed to prepare 5-ASA beads. This study suggested 5-ASA capsule disintegration and bead dispersal in both the distal ileum and colon. This targetting was confirmed in two further in vivo studies using the 5-ASA formulation itself. In the first study comparison of plasma ASA levels following treatment with sulphasalazine treatment confirmed that 5-ASA release was occurring proximal to the colon. Despite this earlier release, the percentage of administered dose that was unabsorbed (dose-urinary recovery) was approximately 90%. In a second study a comparison was made with a single unit tablet of 5-ASA. A greater consistency and accuracy of targetting, as revealed by the appearance of plasma ASA levels, was confirmed for the capsule formulation. These separate studies were undertaken to evaluate the in vivo intestinal release characteristics of this new 5-ASA formulation in healthy volunteers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1820897

Devane, J; Mulligan, S; Martin, M

1991-01-01

46

[A case in which chemotherapy-resistant sigmoid colon cancer was controlled effectively by radiotherapy and resection].  

PubMed

A 53-year-old woman underwent sigmoid colectomy for sigmoid colon cancer with peritoneal metastasis. Liver and intrapelvic metastases were found upon examination 6 months after surgery during adjuvant chemotherapy with XELOX plus bevacizumab. After hepatic subsegmentectomy, the patient received S-1 treatment in combination with radiotherapy for the intrapelvic metastasis. One year after the second surgery, abdominoperineal rectal resection was performed as the intrapelvic tumor had increased in size. At 16 months after the third surgery, computed tomography( CT) revealed a small lung nodule that gradually increased in size. The patient underwent partial lung resection. The nodule was a recurrence of the sigmoid colon cancer. During this period, the patient was treated again with S-1 combined with radiotherapy because 2 intrapelvic metastases had been identified. At present, these metastases have been well controlled for 3 years after the initial recurrence. Thus, it is suggested that aggressive radiotherapy and resection are effective therapies for recurrence of chemotherapy-resistant colon cancer. PMID:24393991

Sato, Nariatsu; Mukubo, Hideyo; Nakanuma, Shinichi; Yasui, Toshiaki; Kita, Ichiro; Takanaka, Tsuyoshi

2013-11-01

47

[Delayed perforation of the cecum and sigmoid colon after blunt abdominal trauma in a patient with multiple injuries].  

PubMed

Blunt abdominal trauma can damage the intestinal vasculature and may occasionally lead to delayed intestinal perforation, associated with a combined rate of morbidity and mortality of 25%. The diagnosis of such complications is hindered by sedation in critical patients, however, and morbimortality in this population is therefore higher. We report the case of a man with multiple injuries admitted to the intensive care unit, where delayed perforations of the sigmoid colon and cecum were diagnosed. The management of blunt abdominal trauma is reviewed and the possible causes, diagnostic approaches, and treatment options for colon injuries are discussed. PMID:17695949

Miranda, E; Arroyo, A; Ronda, J M; Muñoz, J L; Alonso, C; Martínez-Peñuelas, F; Martí-Viaño, J L

2007-01-01

48

A Case of Mucosa-Associated Lymphoid Tissue Lymphoma of the Sigmoid Colon Presenting as a Semipedunculated Polyp  

PubMed Central

Mucosa-associated lymphoid tissue (MALT) lymphomas are characterized by lymphoepithelial lesions pathologically. Colonic MALT lymphomas are relatively rarer than lymphomas of the stomach or small intestine. Endoscopically, colonic MALT lymphoma frequently appears as a nonpedunculated protruding polypoid mass and/or an ulceration in the cecum and/or rectum. We report a unique case of a colonic MALT lymphoma presenting as a semipedunculated polyp. A 54-year-old man was found to have a 2-cm semipedunculated polyp in the sigmoid colon during screening colonoscopy. The polyp was removed by endoscopic mucosal resection. Histologic examination of the resected polyp revealed diffuse epithelial infiltration by discrete aggregates of lymphoma cells. We diagnosed the tumor as low-grade B-cell MALT lymphoma by immunohistochemical staining.

Kim, Myung Hwan; Kim, Eui Jung; Kim, Tae Won; Kim, Seon Young; Kwon, Joong Goo; Kim, Eun Young; Sung, Woo Jung

2014-01-01

49

Effects of calcium concentration, acetate, and propionate on calcium absorption in the human distal colon  

Microsoft Academic Search

Previous studies have shown that the short-chain fatty acids acetate (Ac) and propionate (Pr) enhance the absorption of calcium (Ca) in the rectum and distal colon of humans, with Pr being more effective than Ac. To investigate the effect of Ac and Pr on the kinetics of Ca absorption from the human rectum and distal colon, six healthy subjects were

Trinidad P Trinidad; Thomas M. S Wolever; Lilian U Thompson

1999-01-01

50

Modulation of Ion Transport Across Rat Distal Colon by Cysteine  

PubMed Central

The aim of this study was to identify the actions of stimulation of endogenous production of H2S by cysteine, the substrate for the two H2S-producing enzymes, cystathionine-?-synthase and cystathionine-?-lyase, on ion transport across rat distal colon. Changes in short-circuit current (Isc) induced by cysteine were measured in Ussing chambers. Free cysteine caused a concentration-dependent, transient fall in Isc, which was sensitive to amino-oxyacetate and ?-cyano-L-alanine, i.e., inhibitors of H2S-producing enzymes. In contrast, Na cysteinate evoked a biphasic change in Isc, i.e., an initial fall followed by a secondary increase, which was also reduced by these enzyme inhibitors. All responses were dependent on the presence of Cl? and inhibited by bumetanide, suggesting that free cysteine induces an inhibition of transcellular Cl? secretion, whereas Na cysteinate – after a transient inhibitory phase – activates anion secretion. The assumed reason for this discrepancy is a fall in the cytosolic pH induced by free cysteine, but not by Na cysteinate, as observed in isolated colonic crypts loaded with the pH-sensitive dye, BCECF. Intracellular acidification is known to inhibit epithelial K+ channels. Indeed, after preinhibition of basolateral K+ channels with tetrapentylammonium or Ba2+, the negative Isc induced by free cysteine was reduced significantly. In consequence, stimulation of endogenous H2S production by Na cysteinate causes, after a short inhibitory response, a delayed activation of anion secretion, which is missing in the case of free cysteine, probably due to the cytosolic acidification. In contrast, diallyl trisulfide, which is intracellularly converted to H2S, only evoked a monophasic increase in Isc without the initial fall observed with Na cysteinate. Consequently, time course and amount of produced H2S seem to strongly influence the functional response of the colonic epithelium evoked by this gasotransmitter.

Pouokam, Ervice; Diener, Martin

2012-01-01

51

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

PubMed

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

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

1997-01-01

52

Effects of butyrate on active sodium and chloride transport in rat and rabbit distal colon  

PubMed Central

Short chain fatty acids, particularly butyrate, stimulate electroneutral NaCl absorption from the colon. Their effect in colonic epithelia lacking basal electroneutral NaCl absorption is unknown. Butyrate is also reported to inhibit active Cl? secretion in the colon. The present studies were undertaken to investigate the inter-relationships between the effects of butyrate on active Na+ and Cl? transport in the colon. Studies were carried out in rabbit distal colon (known to have predominant electrogenic Na+ absorption), rat distal colon (characterised by electroneutral Na+ absorption), and hyperaldosteronaemic rat distal colon (characterised by electrogenic Na+ absorption). The effect of cholera toxin (CT) was also noted. Potential difference, short-circuit current (ISC) and fluxes of Na+ and Cl? were measured in stripped mucosa under voltage-clamp conditions. Butyrate stimulated electroneutral Na+ and Cl? absorption in distal colon of normal and salt-depleted rats, and stimulated Na+ absorption in rabbit distal colon. Amiloride (10?4m) or CT did not inhibit this process. In rabbit distal colon, stimulation of Na+ absorption by butyrate was not dependent on the presence of Cl? in the medium. Butyrate significantly decreased conductance, decreased flux of sodium from serosa to mucosa (particularly in rabbit distal colon), and decreased ISC. Net Cl? secretion, induced by CT, was completely inhibited by butyrate. Stimulation of Na+ absorption was independent of exposure to CT. Bumetanide reversed net Cl? secretion to net absorption, but did not alter Na+ or Cl? fluxes in tissues exposed to butyrate. Thus butyrate stimulates active Na+ absorption in colonic epithelia, with or without expression of basal Na+-H+ exchange. Independently, butyrate inhibits active Cl? secretion induced by cAMP in these epithelia.

Vidyasagar, S; Ramakrishna, B S

2002-01-01

53

Potassium microclimate at the mucosal surface of the proximal and the distal colon of guinea pig  

Microsoft Academic Search

K+ concentrations were measured with K+ sensitive liquid ion exchanger microelectrodes in situ and in vitro in the mucus layer at the luminal cell surface of the proximal and the distal colon in guinea pig.

W. v. Engelhardt; U. Kück; M. Krause

1986-01-01

54

Mechanisms of action of hydrogen sulfide in relaxation of mouse distal colonic smooth muscle  

Microsoft Academic Search

Hydrogen sulfide (H2S) has been suggested as a gaseous neuromodulator in mammals. The aim of this study was to examine the influence of H2S on contractility in mouse distal colon. The effect of sodium hydrogen sulfide (NaHS; H2S donor) on prostaglandin F2? (PGF2?)-contracted circular muscle strips of mouse distal colon was investigated. In addition, tension and cytosolic calcium concentration ([Ca2+]cyt)

Ingeborg Dhaese; Inge Van Colen; Romain A. Lefebvre

2010-01-01

55

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

PubMed

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

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

2013-09-01

56

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

PubMed Central

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

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

2013-01-01

57

Foreign body impaction in the sigmoid colon: A twenty euro bet  

PubMed Central

Foreign body ingestion is a common clinical problem in early childhood. However, it may occur even in adults, unknowingly. Most ingested foreign bodies entering the stomach pass through the gastrointestinal tract uneventfully. Here we report on a 13-year-old boy who presented with chronic abdominal pain, weight loss and occult gastrointestinal bleeding for 6 mo. Colonoscopy was negative; however, a ballpoint pen was impacted in the sigmoid region. Subsequently, the child admitted swallowing a pen as a 20-euro bet 6 mo previously. Crohn’s disease is a chronic relapsing inflammatory gastrointestinal disease. It is often difficult to diagnose due to the fact that there is no single pathognomonic sign or symptom. This case is a description of an adolescent with chronic gastrointestinal symptoms due to a foreign body. Therefore, an ingested foreign body should be included in the differential diagnostic procedure related to gastrointestinal symptoms.

Muller, Katalin E; Arato, Andras; Lakatos, Peter Laszlo; Papp, Maria; Veres, Gabor

2013-01-01

58

Implantation metastasis from adenocarcinoma of the sigmoid colon into a perianal fistula: a case report  

PubMed Central

Implantation metastasis from a colorectal cancer into a perianal fistula is very rare. Such lesions are commonly mistaken as benign perianal abscesses or fistulas and diagnosed only after pathological analysis of surgically excised fistulas. Once diagnosed, the management of this condition remains controversial. We report a case of perianal fistula that was unexpectedly found to harbor adenocarcinoma on biopsy. Further investigation by colonoscopy and computed tomography scan revealed a sigmoid adenocarcinoma. Abdominoperineal resection was performed. Histology and immunohistochemical staining was identical in both primary and metastatic tumors. We herein review the literature on the metastasis of colorectal cancer to a benign perianal fistula presumably acquired through implantation of viable malignant cells shed from the primary tumor and discuss the approach to this rare scenario in colorectal cancer surgery.

Gomes, Rachel M.; Kumar, Rajiv K.; Desouza, Ashwin; Saklani, Avanish

2014-01-01

59

Virchow lymph node metastatic recurrence of sigmoid colon cancer with severe lymph node metastases successfully treated using systemic chemotherapy combined with radiotherapy.  

PubMed

Metastatic recurrence of colon cancer in the left supraclavicular lymph node (Virchow lymph node) is rare, and to date there are no reports on radiotherapy as treatment. We report on a case of metastatic recurrence of sigmoid colon cancer in the Virchow lymph node with severe lymph node metastases successfully treated with a combined modality therapy of systemic chemotherapy and radiotherapy. The case is of a 58-year-old man, who underwent sigmoid excision and lymph node excision, and subsequently received systemic chemotherapy. After left supraclavicular lymph node recurrence appeared he later received radiotherapy. Complete response was achieved, and there has been no further recurrence, to date, 10 months after the radiotherapy. Radiotherapy was effective as a local treatment, and local control of distant metastasis of colonic cancer may lead to a good prognosis. PMID:23780983

Ohchi, Takafumi; Akagi, Yoshito; Kinugasa, Tetsushi; Ishibashi, Yoshiaki; Tanaka, Natsuki; Fujino, Shinya; Kibe, Shiro; Yuge, Kotaro; Sasatomi, Teruo; Mizobe, Tomoaki; Oka, Yosuke; Hong, Kawang Dae; Shirouzu, Kazuo

2013-07-01

60

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

PubMed Central

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.

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

2009-01-01

61

Piriformospora indica Root Colonization Triggers Local and Systemic Root Responses and Inhibits Secondary Colonization of Distal Roots  

PubMed Central

Piriformosporaindica is a basidiomycete fungus colonizing roots of a wide range of higher plants, including crop plants and the model plant Arabidopsis thaliana. Previous studies have shown that P. indica improves growth, and enhances systemic pathogen resistance in leaves of host plants. To investigate systemic effects within the root system, we established a hydroponic split-root cultivation system for Arabidopsis. Using quantitative real-time PCR, we show that initial P. indica colonization triggers a local, transient response of several defense-related transcripts, of which some were also induced in shoots and in distal, non-colonized roots of the same plant. Systemic effects on distal roots included the inhibition of secondary P. indica colonization. Faster and stronger induction of defense-related transcripts during secondary inoculation revealed that a P. indica pretreatment triggers root-wide priming of defense responses, which could cause the observed reduction of secondary colonization levels. Secondary P. indica colonization also induced defense responses in distant, already colonized parts of the root. Endophytic fungi therefore trigger a spatially specific response in directly colonized and in systemic root tissues of host plants.

Pedrotti, Lorenzo; Mueller, Martin J.; Waller, Frank

2013-01-01

62

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

SciTech Connect

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

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

2009-05-22

63

Sigmoidorectal intussusception of adenoma of sigmoid colon treated by laparoscopic anterior resection after sponge-on-the-stick-assisted manual reduction  

PubMed Central

We present herein a case report of sigmoidorectal intussusception as an unusual case of sigmoid adenomatous polyp. The patient was a 56-year-old man who suffered from rectal bleeding for one day. He initially visited his general practitioner and was diagnosed as having an intraluminal mass of 15 cm from the anal verge. Several hours after admission to our coloproctology clinic, he suddenly presented with lower abdominal cramping pain with rectal bleeding during his bowel preparation using polyethylene glycol electrolyte solution. An emergency colonoscopy revealed that the invaginated colon with polypoid mass was protruded to the lower rectum. Gastrograffin enema showed that the invaginated bowel segment was 3 cm from the anal verge. CT scan showed the typical finding of intussusception. We performed laparoscopic anterior resection and anastomosis after the sponge-on-the-stick-assisted manual reduction. The permanent pathologic finding showed villotubular adenoma of the sigmoid colon.

Park, Ki-Jae; Choi, Hong-Jo; Kim, Sung-Heun; Han, Sang-Young; Hong, Sook-Hee; Cho, Jin-Han; Kim, Hyung-Ho

2006-01-01

64

[A case of Stage IV sigmoid colon cancer that achieved long-term survival with oral anticancer drugs].  

PubMed

An 80-year-old man presenting with abdominal distension was admitted to our hospital. He was diagnosed with sigmoid cancer with multiple liver and lung metastases. We first performed a sigmoidectomy to avoid obstruction, and then initiated chemotherapy with S-1(120mg/day). The tumor showed a complete clinical response after 10 courses, but we had to change the regimen after 18 courses because of growth of the lung metastases. After 10 courses of capecitabine(4,200mg/ day)treatment, we again observed growth of the lung metastases; a new nodule, which was also considered to be a metastasis, appeared on the abdominal wall. We then decided to administer mFOLFOX6(5-fluorouracil+Leucovorin+oxaliplatin) after the patient had received oral anticancer drugs for 3 years 4 month. In conclusion, oral chemotherapy drugs may prevent tumor growth over a long period and improve quality of life(QOL)in elderly patients with Stage IV colon cancer. PMID:24743289

Hasegawa, Yako; Iwata, Hideyuki; Hatanaka, Masayuki

2014-03-01

65

Long-Term Survival After Repeat Resections of Metastases in Liver, Lung, and Stomach from Sigmoid Colon Cancer: Report of a Case  

Microsoft Academic Search

A 74-year-old female patient underwent a simultaneous colectomy and hepatectomy for sigmoid colon cancer and its hepatic metastases.\\u000a Six months later she underwent a hepatectomy for recurrent hepatic metastases; then 10 months later, a pulmonary resection\\u000a for pulmonary metastasis; and 24 months later, a partial gastrectomy for gastric metastasis. As of December 2005, at 7 years\\u000a 6 months after the

Fuyo Yoshimi; Yuji Asato; Akifumi Suzuki; Moriyuki Kiyoshima; Yasukazu Shioyama; Johji Imura; Masayuki Itabashi

2007-01-01

66

Factors associated with the risk of adenoma recurrence in distal and proximal colon  

PubMed Central

Background/Aims Colonoscopy may be less effective in preventing cancer in proximal colon. We evaluated whether risk factors for adenoma recurrence exhibit differential effect on adenoma recurrence by colon subsite. Methods We examined the association of age, sex, body mass index, smoking status and use of non-steroidal anti-inflammatory drugs (NSAIDs) on proximal and distal adenoma recurrence among 1,864 participants in the Polyp Prevention Trial. We used multinomial logistic regression models to calculate relative risk ratios (RRR) and 95% confidence intervals (CI). Results 733 (39.3%) participants had adenoma recurrence (228 distal only, 369 proximal only and 136 synchronous proximal and distal adenoma). When compared to participants without adenoma recurrence, no factor was associated with an increased risk of distal only adenoma recurrence. Age 65-69 years (RRR=1.47; 95%CI: 1.00-2.16), age ?70 years (RRR=2.24; 95%CI: 1.57-3.20), and male sex (RRR=1.73; 95%CI: 1.32-2.27) were positively associated with proximal only adenoma recurrence. NSAIDs use was associated with a reduced risk of adenoma recurrence by similar magnitude in distal (RRR=0.78; 95%CI: 0.58-1.07) and proximal colon (RRR=0.77; 95%CI: 0.60-1.00). Conclusions We did not find any modifiable risk factor that differentially increases proximal as compared to distal adenoma recurrence to be clinically useful for targeted intervention.

Laiyemo, Adeyinka O.; Doubeni, Chyke; Pinsky, Paul F.; Doria-Rose, V. Paul; Marcus, Pamela M.; Schoen, Robert E.; Lanza, Elaine; Cross, Amanda J.

2013-01-01

67

Potassium microclimate at the mucosal surface of the proximal and the distal colon of guinea pig.  

PubMed

K+ concentrations were measured with K+ sensitive liquid ion exchanger microelectrodes in situ and in vitro in the mucus layer at the luminal cell surface of the proximal and the distal colon in guinea pig. In a first series of experiments K+ concentrations were increased in the luminal solution from 0 to 70 mmol X l-1; the serosal K+ concentrations were kept in vitro at 5.4 mmol X l-1. In the proximal colon mean K+ concentration in the microclimate was in vitro 7.9 +/- 3.5 mmol X l-1, and independent from mucosal concentrations. In the distal colon in vitro, and in situ in the proximal as well as in the distal colon, K+ concentrations in the microclimate were increased slightly when K+ concentrations were elevated in the luminal solution up to 70 mmol X l-1. In a second series of in vitro studies K+ concentrations were also altered in the serosal fluid. In the proximal and in the distal colon K+ concentrations increased linearly with elevated K+ concentrations in the serosal solutions. A temporarily interrupted mucosal blood flow resulted in a significant increase in the K+ concentration in the microclimate. A paracellular shunt pathway and a high preepithelial diffusion barrier for K+ would explain the observed K+ concentrations in the microclimate at the luminal cell surface. PMID:3797216

von Engelhardt, W; Kück, U; Krause, M

1986-12-01

68

Transcriptional Profiling of mRNA Expression in the Mouse Distal Colon  

PubMed Central

Background & Aims Intestinal epithelial cells and the myenteric plexus of the mouse gastrointestinal tract contain a circadian clock–based intrinsic timekeeping system. Because disruption of the biological clock has been associated with increased susceptibility to colon cancer and gastrointestinal symptoms, we aimed to identify rhythmically expressed genes in the mouse distal colon. Methods Microarray analysis was used to identify genes that were rhythmically expressed over a 24-hour light/dark cycle. The transcripts were then classified according to expression pattern, function, and association with physiologic and pathophysiologic processes of the colon. Results A circadian gene expression pattern was detected in approximately 3.7% of distal colonic genes. A large percentage of these genes were involved in cell signaling, differentiation, and proliferation and cell death. Of all the rhythmically expressed genes in the mouse colon, approximately 7% (64/906) have been associated with colorectal cancer formation (eg, B-cell leukemia/lymphoma-2 [Bcl2]) and 1.8% (18/906) with various colonic functions such as motility and secretion (eg, vasoactive intestinal polypeptide, cystic fibrosis transmembrane conductance regulator). Conclusions A subset of genes in the murine colon follows a rhythmic expression pattern. These findings may have significant implications for colonic physiology and pathophysiology.

HOOGERWERF, WILLEMIJNTJE A.; SINHA, MALA; CONESA, ANA; LUXON, BRUCE A.; SHAHINIAN, VAHAKN B.; CORNELISSEN, GERMAINE; HALBERG, FRANZ; BOSTWICK, JONATHON; TIMM, JOHN; CASSONE, VINCENT M.

2009-01-01

69

Octreotide Acetate Inhibits Motility in the Rabbit Distal Colon  

Microsoft Academic Search

Octreotide, the long-acting somatostatin analogue, has been reported to modulate gastrointestinal motility in both animals and humans. A role in colonic peristalsis and a possible clinical application in common disorders, such as chronic constipation and irritable bowel syndrome, have not been evaluated. It has been previously suggested that octreotide promotes the descending relaxation of the peristaltic reflex arc. We hypothesized

K.-D. John; G. H. Ballantyne; I. M. Modlin

1997-01-01

70

Metabolic syndrome, lifestyle risk factors, and distal colon adenoma: A retrospective cohort study  

PubMed Central

AIM: To investigate relationships between colorectal adenoma incidence, metabolic syndrome (MS) components and lifestyle factors. METHODS: We conducted a retrospective cohort study using data from individuals who had multiple sigmoidoscopies for colon cancer at the Health Promotion Center of Ulsan University Hospital in Korea from 1998 to 2007. RESULTS: By multivariate analysis, the incidence of distal colon adenoma was increased by more than 1.76 times in individuals with at least one component of MS compared to those without a component of MS. After adjustment for age, gender, smoking, drinking, and physical exercise, only high body mass index (BMI) was significantly associated with the incidence of distal colon adenoma (Hazard ratio 1.66, 95% confidence interval 1.05-2.62). CONCLUSION: Our results suggest that high BMI may increase the risk of colorectal adenoma in Korean adults.

Kim, Moon-Chan; Kim, Chang-Sup; Chung, Tae-Heum; Park, Hyoung-Ouk; Yoo, Cheol-In

2011-01-01

71

Inhibitory responses to exogenous adenosine in murine proximal and distal colon  

PubMed Central

The aims of the present study were firstly, to characterize pharmacologically the subtypes of P1 purinoreceptors involved in the inhibitory effects induced by exogenous adenosine in longitudinal smooth muscle of mouse colon, and secondly, to examine differences in the function and distribution of these receptors between proximal and distal colon. Adenosine (100??M–3?mM) caused a concentration-dependent reduction of the amplitude of spontaneous contractions in the proximal colon, and muscular relaxation in the distal colon. In the proximal colon, adenosine effects were antagonized by a selective A1 receptor antagonist, 1,3-dipropyl-8-cyclopentylxanthine (DPCPX, 10?nM), but were not modified by 3,7-dimethyl-1-propargylxanthine (DMPX, 10??M) or by 9-chloro-2-(2-furanyl)-5-((phenylacetyl)amino)- [1,2,4]triazolo[1,5-c]quinazoline (MRS 1220, 0.1??M), selective A2 and A3 receptor antagonists, respectively. In the distal colon, adenosine effects were antagonized by DPCPX, DMPX, and by a selective A2B receptor antagonist, 8-[4-[((4-cyanophenyl)carbamoylmethyl)oxy]phenyl]-1,3-di(n-propyl) xanthine (MRS 1754, 10??M), but not by 8-(3-chlorostyryl)-caffeine (CSC, 10??M), a selective A2A receptor antagonist, or by MRS 1220. Tetrodotoxin (TTX 1??M), the nitric oxide (NO) synthase inhibitor, N?-nitro-L-arginine methyl ester (L-NAME, 100??M), or 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (10??M), an inhibitor of soluble guanylyl cyclase, reduced adenosine effects only in distal colon. In addition, L-NAME induced a further reduction of adenosine relaxation in the presence of DPCPX, but not in the presence of MRS 1754. From these results we conclude that, in the murine proximal colon, adenosine induces inhibitory effects via TTX-insensitive activation of A1 receptor. In the distal colon, adenosine activates both A1 and A2B receptors, the latter located on enteric inhibitory neurons releasing NO.

Zizzo, Maria Grazia; Mule, Flavia; Serio, Rosa

2006-01-01

72

Endoscopic reduction of a volvulus of the sigmoid colon in pregnancy: case report and a comprehensive review of the literature  

PubMed Central

Sigmoid volvulus is a rare, but serious, complication that can occur during pregnancy. We present a case of a 33-year-old pregnant female in the third trimester with a sigmoid volvulus. Detorsion of the volvulus was performed during colonoscopy. The patient underwent an elective sigmoidectomy at a later date. Prompt diagnosis of the volvulus sigmoid is critical to minimize fetal and maternal morbidity and mortality. Sigmoidoscopic detorsion or surgical resection are the treatment options, depending on bowel viability. A review of the literature was done.

2014-01-01

73

Effects of calcium concentration, acetate, and propionate on calcium absorption in the human distal colon.  

PubMed

Previous studies have shown that the short-chain fatty acids acetate (Ac) and propionate (Pr) enhance the absorption of calcium (Ca) in the rectum and distal colon of humans, with Pr being more effective than Ac. To investigate the effect of Ac and Pr on the kinetics of Ca absorption from the human rectum and distal colon, six healthy subjects were studied. Solutions containing various concentrations of CaCl2.H2O with 56.3 mmol/L Ac, Pr, or NaCl were rectally infused to each subject. Rectal fluid was sampled at the end of the infusion (0 min), and 30 min later colonic contents were collected. Ca absorption for all treatments increased linearly with Ca concentration. For Ca + NaCl, the slope of regression line was 62 mumol.mmol-1.L Ca. With Ac + Ca, the slope of Ca absorption increased significantly to 113 mumol.mmol-1.L Ca, and with Pr + Ca, the slope increased to 159 mumol.mmol-1.L (P = 0.043 versus Ac + Ca) Ac and Pr absorption were increased by Ca. The data suggest that, over a physiologic range of Ca concentration, in the absence or presence of Ac and Pr, Ca is absorbed in the human rectum and distal colon by a non-saturable diffusion process, and that Ca absorption is enhanced by Ac and Pr. The data also suggest that both Ac and Pr absorption is stimulated by Ca. PMID:10422081

Trinidad, T P; Wolever, T M; Thompson, L U

1999-01-01

74

Intracerebroventricular administration of apelin-13 inhibits distal colonic transit in mice.  

PubMed

Apelin is a novel bioactive peptide as the endogenous ligand for the orphan G-protein-coupled receptor (GPCR), APJ, a receptor distributed in various tissues such as the hypothalamus and the gastrointestinal tract. Recent reports showed that apelin regulated many biological functions, including blood pressure, neuroendocrine, drinking behavior and food intake. However, the role of apelin in regulating gastrointestinal motility remains unknown. The present study aimed to investigate the actions of intracerebroventricularly administered apelin-13 on colonic transit as well as the actions of apelin-13 on the contraction of isolated distal colon in vitro. Intracerebroventricular (i.c.v.) injection of apelin-13 (0.3, 0.5, 1 and 3 ?g/mouse) dose-dependently inhibited fecal pellet output and bead expulsion. This effect was significantly antagonized by the APJ receptor antagonist apelin-13(F13A), indicating an APJ receptor-mediated mechanism. Furthermore, naloxone could also reverse the inhibitory effect of apelin-13 on fecal pellet output and bead expulsion, suggesting the involvement of opioid receptors in the suppressive effect of apelin-13 on distal colon transit. However, apelin-13 (10??-10?? M) did not affect distal colonic contractions in vitro. PMID:20849897

Yang, Yan-Jie; Lv, Shuang-Yu; Xiu, Ming-Hui; Xu, Ning; Chen, Qiang

2010-12-01

75

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

PubMed Central

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.

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

2014-01-01

76

Aldosterone induction of electrogenic sodium transport in the apical membrane vesicles of rat distal colon  

SciTech Connect

Na-H exchange is present in apical membrane vesicles (AMV) isolated from distal colon of normal rats. Because in intact tissue aldosterone both induces amiloride-sensitive electrogenic sodium transport and inhibits electroneutral sodium absorption, these studies with AMV were designed to establish the effect of aldosterone on sodium transport. An outward-directed proton gradient stimulated 22Na uptake in AMV isolated from distal colon of normal and dietary sodium depleted (with elevated aldosterone levels) experimental rats. Unlike normal AMV, proton gradient-dependent 22Na uptake in experimental AMV was inhibited when uptake was measured under voltage-clamped conditions. 10 microM amiloride inhibited the initial rate of proton gradient-dependent 22Na uptake in AMV of normal and experimental rats by 30 and 75%, respectively. In contrast, 1 mM amiloride produced comparable inhibition (90 and 80%) of 22Na uptake in normal and experimental AMV. Intravesicular-negative potential stimulated 22Na uptake in experimental but not in normal AMV. This increase was inhibited by 90% by 10 microM amiloride. An analogue of amiloride, 5-(N-ethylisopropyl) amiloride (1 microM), a potent inhibitor of electroneutral Na-H exchange in AMV of normal rat distal colon, did not alter potassium diffusion potential-dependent 22Na uptake. Increasing sodium concentration saturated proton gradient-dependent 22Na uptake in normal AMV. However, in experimental AMV, 22Na uptake stimulated by both proton gradient and potassium diffusion potential did not saturate as a function of increasing sodium concentration. We conclude from these results that an electrically sensitive conductive channel, not electroneutral Na-H exchange, mediates 22Na uptake in AMV isolated from the distal colon of aldosterone rats.

Rajendran, V.M.; Kashgarian, M.; Binder, H.J. (Yale Univ., New Haven, CT (USA))

1989-11-05

77

Impaired propulsive motility in the distal but not proximal colon of BK channel ?1-subunit knockout mice  

PubMed Central

Background Large conductance Ca2+-activated K+ (BK) channels regulate smooth muscle tone. The BK channel ?1-subunit increases Ca2+ sensitivity of the ?-subunit in smooth muscle. We studied ?1-subunit knockout (KO) mice to determine if gastrointestinal (GI) motility was altered. Methods Colonic and intestinal longitudinal muscle reactivity to bethanechol and colonic migrating motor complexes (CMMCs) were measured in vitro. Gastric emptying and small intestinal transit were measured in vivo. Colonic motility was assessed in vivo by measuring fecal output and glass bead expulsion time. Myoelectric activity of distal colon smooth muscle was measured in vitro using intracellular microelectrodes. Main findings Bethanechol-induced contractions were larger in the distal colon of ?1-subunit KO compared to WT mice; there were no differences in bethanechol reactivity in the duodenum, ileum or proximal colon of WT vs. ?1-subunit KO mice. There were more retrogradely propagated CMMCs in the distal colon of ?1-subunit KO compared to WT mice. GI transit was unaffected by ?1-subunit KO. Fecal output was decreased and glass bead expulsion times were increased in ?1-subunit KO mice. Membrane potential of distal colon smooth muscle cells from ?1-subunit KO mice was depolarized with higher action potential frequency compared to WT mice. Paxilline (BK channel blocker) depolarized smooth muscle cells and increased action potential frequency in WT distal colon. Conclusions and inferences BK channels play a prominent role in smooth muscle function only in the distal colon of mice. Defects in smooth muscle BK channel function disrupt colonic motility causing constipation.

France, Marion; Bhattarai, Yogesh; Galligan, James J.; Xu, Hui

2012-01-01

78

[A case of sigmoid colon cancer with a sigmoidovesical fistula treated with preoperative XELOX+bevacizumab therapy and urinary bladder-conserving surgery].  

PubMed

A 64-year-old man presented with abdominal pain, diarrhea, urinary pain, and frequent urination.He was diagnosed with locally advanced sigmoid colon cancer accompanied by a sigmoidovesical fistula, which was determined to require total cystectomy for curative resection.Expecting tumor shrinkage and conservation of the urinary bladder, we performed loop ileostomy followed by preoperative mFOLFOX6+bevacizumab therapy.After 1 course of administration, the implanted port became infected.Therefore, the regimen was changed to 4 courses of XELOX+bevacizumab therapy.After the treatment, there was no longer any evidence of sigmoidovesical fistula.We performed a urinary bladder-conserving sigmoidectomy and finally achieved pathological curative resection.After adjuvant chemotherapy, no findings suggestive of recurrence were noted during 10 postoperative months.Preoperative XELOX+bevacizumab therapy may be worth considering as a therapeutic option for conserving the urinary bladder in cases of locally advanced colon cancer. PMID:24743290

Miura, Takuya; Aoki, Kazunori; Suto, Akiko; Yoshikawa, Toru; Ikenaga, Shojiro Kazunori; Kawashima, Hiroaki; Shibasaki, Itaru; Endo, Masaaki

2014-03-01

79

Combined general-epidural anesthesia with continuous postoperative epidural analgesia preserves sigmoid colon perfusion in elective infrarenal aortic aneurysm repair  

PubMed Central

Background: In elective open infrarenal aortic aneurysm repair the use of epidural anesthesia and analgesia may preserve splanchnic perfusion. The aim of this study was to investigate the effects of epidural anesthesia on gut perfusion with gastrointestinal tonometry in patients undergoing aortic reconstructive surgery. Methods: Thirty patients, scheduled to undergo an elective infrarenal abdominal aortic reconstructive procedure were randomized in two groups: the epidural anesthesia group (Group A, n=16) and the control group (Group B, n=14). After induction of anesthesia, a transanally inserted sigmoid tonometer was placed for the measurement of sigmoid and gastric intramucosal CO2 levels and the calculation of regional–arterial CO2 difference (?PCO2). Additional measurements included mean arterial pressure (MAP), cardiac output (CO), systemic vascular resistance (SVR), and arterial lactate levels. Results: There were no significant intra- and inter-group differences for MAP, CO, SVR, and arterial lactate levels. Sigmoid pH and PCO2 increased in both the groups, but this increase was significantly higher in Group B, 20 min after aortic clamping and 10 min after aortic declamping. Conclusions: Patients receiving epidural anesthesia during abdominal aortic reconstruction appear to have less severe disturbances of sigmoid perfusion compared with patients not receiving epidural anesthesia. Further studies are needed to verify these results.

Panaretou, Venetiana; Siafaka, Ioanna; Theodorou, Dimitrios; Manouras, Andreas; Seretis, Charalampos; Gourgiotis, Stavros; Katsaragakis, Stylianos; Sigala, Fragiska; Zografos, George; Filis, Konstantinos

2012-01-01

80

Faecal bulking index: A physiological basis for dietary management of bulk in the distal colon.  

PubMed

Bulk in the distal colon provides protection against a range of large bowel disorders, but a simple standardized measure of the relative bulking efficacy of foods, for use in dietary management of distal colonic bulk, has not been available. This paper describes a faecal bulking index (FBI) for standardized measurement of the relative colonic bulking efficacy of foods relative to a reference material. Faecal bulking index is defined as the mass of fully rehydrated faecal matter accumulated by the distal colon per gram of a food consumed, as a percentage of the matter accumulated from the same weight of a reference food. The FBI of foods was measured after feeding adult rats at moderate levels by partially or completely replacing sucrose in a baseline diet already containing mixed dietary fiber. Faeces were collected, dried, weighed, allowed to imbibe water until fully rehydrated, reweighed and their mass and water holding capacity measured. The FBI was calculated as the increase over baseline in rehydrated faecal mass induced by a test food as a percentage of the increase due to wheat bran (reference). The FBI values were measured for 69 diets including breakfast cereals, breads and other bakery products, fruits, vegetables, food ingredients and polysaccharides. Values for most foods ranged between almost zero for some starch-based foods to about 50 for wheat bran-enriched breakfast cereals, but laxatives based on fermentation-resistant hydrated polysaccharide had FBI values well in excess of 100 (FBI for psyllium = 500). The FBI values allow foods to be ranked according to their faecal bulking efficacy on an equal edible weight basis. They can also be used to calculate the bulking action of any amount of food in terms of equivalents to a reference material such as wheat bran. Wheat bran equivalents allow the cumulative intake of potential distal colonic bulk to be monitored for single foods or mixed meals, and shortfalls to be quantified for dietary modification or supplementation. Measures such as FBI or wheat bran equivalents would prove more useful than dietary fiber in controlling 'functional foods' promoted as effective bulking agents. PMID:24394391

Monro, J A

2000-06-01

81

Effect of acetate and propionate on calcium absorption from the rectum and distal colon of humans.  

PubMed

To determine the effects of acetate and propionate on calcium absorption from the human distal colon and rectum, six healthy human subjects were given rectal infusions containing 50 mmol CaCl2/L on four separate occasions. Addition of 56.3 mmol acetate/L, 18.7 mmol propionate/L, or acetate and propionate together increased calcium disappearance (expressed as the change in the ratio of calcium to polyethylene glycol) from -5.5 +/- 1.4 to -22.6 +/- 2.8, -23.2 +/- 3.2, and -19.7 +/- 4.6, respectively; P < 0.05. To determine the effects of different acetate and propionate concentrations, six different subjects were studied further. The effects of 18.7 or 56.3 mmol acetate/L on calcium absorption were the same as those of 18.7 mmol propionate/L (-15.7 +/- 1.4), and less than those of 56.3 mmol propionate/L (-20.3 +/- 2.4, P < 0.05). We conclude that both acetate and propionate enhance calcium absorption from the human distal colon, but that propionate has a greater effect at higher concentrations. Further studies are needed to determine the mechanism of calcium absorption from the colon. PMID:8599322

Trinidad, T P; Wolever, T M; Thompson, L U

1996-04-01

82

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

SciTech Connect

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).

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

1988-09-01

83

Evaluation of the longitudinal musculature of segments of the distal colon interposed following extended jejunum-ileum resection.  

PubMed

Several morbid conditions may necessitate extensive intestinal resection, leading to short-bowel syndrome. When clinical treatment becomes inefficient, a surgical approach is necessary. Distal colon interposition is one of the viable techniques. The interposition of colon segments between remnants of the small bowel improved lifestyle, increased transit time, and diminished diarrhea. The aim of this study is to observe the longitudinal muscular contractions after distal colon interposition. Sixteen male Wistar rats (EPM-1) were submitted to an 80% small bowel resection associated with a partial colectomy of the distal colon immediately after the bifurcation of the middle colic artery followed by a 3-cm isoperistaltic distal colon interposition. After 70 days, the animals were submitted to euthanasia and segments of the jejunum, ileum, remnant colon, and interposed colon were prepared for pharmacological tests. The isometric contractions were measured by a polygraph. After 30 minutes, the dose/effect curves were obtained for both metacholine and barium chloride stimulation through the extraluminal surface (serosa). After this period, we observed a significant increase in the length, diameter, and thickness of the intestinal wall. Regarding the sensibility (pD(2)), no difference was found (interposed colon = 7.21 +/- 0.2; remnant colon = 7.65 +/- 0.1; remnant jejunum 7.46 +/- 0.1; and remnant ileum 7.57 +/- 0.1), even though the animals were submitted to different procedures. In relation to the maximal effect (E(max)), the longitudinal muscle contraction responses (interposed colon = 11.79 +/- 0.1; remnant jejunum = 15.42 +/- 0.2; and remnant ileum = 11.48 +/- 0.2) were lower than those of the remnant colon (E(max) = 22.42 +/- 0.1). This means that there was a possible adaptation of colonic segments to their new location. PMID:10586192

Taha, M O; Ribeiro, M A; de Oliveira Gomes, P; Montero Frasson, E; Plapler, H; Ferreira, R; Lapa, A J; Soucar, C

1999-01-01

84

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

PubMed Central

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

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

2014-01-01

85

Modulation of distal colonic epithelial barrier function by dietary fibre in normal rats  

PubMed Central

BACKGROUND—Dietary fibre influences the turnover and differentiation of the colonic epithelium, but its effects on barrier function are unknown. ?AIMS—To determine whether altering the type and amount of fibre in the diet affects paracellular permeability of intestinal epithelium, and to identify the mechanisms of action. ?METHODS—Rats were fed isoenergetic low fibre diets with or without supplements of wheat bran (10%) or methylcellulose (10%), for four weeks. Paracellular permeability was determined by measurement of conductance and 51Cr-EDTA flux across tissue mounted in Ussing chambers. Faecal short chain fatty acid (SCFA) concentrations were assessed by gas chromatography, epithelial kinetics stathmokinetically, and mucosal brush border hydrolase activities spectrophotometrically. ?RESULTS—Body weight was similar across the dietary groups. Conductance and 51Cr-EDTA flux were approximately 25% higher in animals fed no fibre, compared with those fed wheat bran or methylcellulose in the distal colon, but not in the caecum or jejunum. Histologically, there was no evidence of epithelial injury or erosion associated with any diet. The fibres exerted different spectra of effects on luminal SCFA concentrations and pH, and on mucosal indexes, but both bulked the faeces, were trophic to the epithelium, and stimulated expression of a marker of epithelial differentiation. ?CONCLUSIONS—Both a fermentable and a non-fermentable fibre reduce paracellular permeability specifically in the distal colon, possibly by promoting epithelial cell differentiation. The mechanisms by which the two fibres exert their effects are likely to be different. ?? Keywords: colon; differentiation; epithelium; fibre; paracellular permeability; proliferation

Mariadason, J; Catto-Smith, A; Gibson, P

1999-01-01

86

Cyclic AMP-induced K+ secretion occurs independently of Cl? secretion in rat distal colon  

PubMed Central

cAMP induces both active Cl? and active K+ secretion in mammalian colon. It is generally assumed that a mechanism for K+ exit is essential to maintain cells in the hyperpolarized state, thus favoring a sustained Cl? secretion. Both Kcnn4c and Kcnma1 channels are located in colon, and this study addressed the questions of whether Kcnn4c and/or Kcnma1 channels mediate cAMP-induced K+ secretion and whether cAMP-induced K+ secretion provides the driving force for Cl? secretion. Forskolin (FSK)-enhanced short-circuit current (indicator of net electrogenic ion transport) and K+ fluxes were measured simultaneously in colonic mucosa under voltage-clamp conditions. Mucosal Na+ orthovanadate (P-type ATPase inhibitor) inhibited active K+ absorption normally present in rat distal colon. In the presence of mucosal Na+ orthovanadate, serosal FSK induced both K+ and Cl? secretion. FSK-induced K+ secretion was 1) not inhibited by either mucosal or serosal 1-[(2-chlorophenyl) diphenylmethyl]-1H-pyrazole (TRAM-34; a Kcnn4 channel blocker), 2) inhibited (92%) by mucosal iberiotoxin (Kcnma1 channel blocker), and 3) not affected by mucosal cystic fibrosis transmembrane conductance regulator inhibitor (CFTRinh-172). By contrast, FSK-induced Cl? secretion was 1) completely inhibited by serosal TRAM-34, 2) not inhibited by either mucosal or serosal iberiotoxin, and 3) completely inhibited by mucosal CFTRinh-172. These results indicate that cAMP-induced colonic K+ secretion is mediated via Kcnma1 channels located in the apical membrane and most likely contributes to stool K+ losses in secretory diarrhea. On the other hand, cAMP-induced colonic Cl? secretion requires the activity of Kcnn4b channels located in the basolateral membrane and is not dependent on the concurrent activation of apical Kcnma1 channels.

Sandle, Geoffrey I.

2012-01-01

87

Cyclic AMP-induced K+ secretion occurs independently of Cl- secretion in rat distal colon.  

PubMed

cAMP induces both active Cl(-) and active K(+) secretion in mammalian colon. It is generally assumed that a mechanism for K(+) exit is essential to maintain cells in the hyperpolarized state, thus favoring a sustained Cl(-) secretion. Both Kcnn4c and Kcnma1 channels are located in colon, and this study addressed the questions of whether Kcnn4c and/or Kcnma1 channels mediate cAMP-induced K(+) secretion and whether cAMP-induced K(+) secretion provides the driving force for Cl(-) secretion. Forskolin (FSK)-enhanced short-circuit current (indicator of net electrogenic ion transport) and K(+) fluxes were measured simultaneously in colonic mucosa under voltage-clamp conditions. Mucosal Na(+) orthovanadate (P-type ATPase inhibitor) inhibited active K(+) absorption normally present in rat distal colon. In the presence of mucosal Na(+) orthovanadate, serosal FSK induced both K(+) and Cl(-) secretion. FSK-induced K(+) secretion was 1) not inhibited by either mucosal or serosal 1-[(2-chlorophenyl) diphenylmethyl]-1H-pyrazole (TRAM-34; a Kcnn4 channel blocker), 2) inhibited (92%) by mucosal iberiotoxin (Kcnma1 channel blocker), and 3) not affected by mucosal cystic fibrosis transmembrane conductance regulator inhibitor (CFTR(inh)-172). By contrast, FSK-induced Cl(-) secretion was 1) completely inhibited by serosal TRAM-34, 2) not inhibited by either mucosal or serosal iberiotoxin, and 3) completely inhibited by mucosal CFTR(inh)-172. These results indicate that cAMP-induced colonic K(+) secretion is mediated via Kcnma1 channels located in the apical membrane and most likely contributes to stool K(+) losses in secretory diarrhea. On the other hand, cAMP-induced colonic Cl(-) secretion requires the activity of Kcnn4b channels located in the basolateral membrane and is not dependent on the concurrent activation of apical Kcnma1 channels. PMID:22648950

Sandle, Geoffrey I; Rajendran, Vazhaikkurichi M

2012-08-01

88

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

PubMed

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

Jöres, A P W; Probst, P

2011-09-01

89

Likelihood of missed and recurrent adenomas in the proximal versus the distal colon  

PubMed Central

Background Colonoscopy may be less efficacious in reducing colorectal cancer mortality in the proximal as compared with the distal colon. A greater likelihood for missed and recurrent adenomas in the proximal colon may contribute to this phenomenon. Objective To examine whether a proximal adenoma is associated with the risk and location of missed and recurrent adenomas. Design Prospective Setting Polyp Prevention Trial Participants 1,864 patients with adenoma at baseline underwent a follow-up colonoscopy four years later (adenoma recurrence). Of these, 1,731 underwent a clearing colonoscopy one year after the baseline examination (missed adenoma). Measurements Association of baseline adenoma location with the risk and location of adenomas found at colonoscopy performed one year and four years later. Results At the year 1 colonoscopy, 598 (34.6%) patients had an adenoma (missed adenoma). Compared with those with distal only adenoma at baseline, patients with proximal only adenoma at baseline were more likely to have any missed adenoma (relative risk (RR)=1.28; 95% confidence interval (CI): 1.09–1.49) and proximal only missed adenoma (RR=2.05; 95%CI: 1.49–2.80). At the year 4 colonoscopy, 733 (39.3%) patients had an adenoma recurrence. Patients with baseline proximal only adenoma were more likely to have any adenoma recurrence (RR=1.14; 95%CI: 1.00–1.31) and proximal only adenoma recurrence (RR=1.52; 95%CI: 1.15–2.02). Sensitivity analyses involving missed adenomas did not materially affect the risk or location of recurrent adenomas at year four colonoscopy. Limitation Lesions may still be missed with repeated colonoscopies. Conclusions Missed and recurrent adenomas are more likely to be in the proximal colon.

Laiyemo, Adeyinka O.; Doubeni, Chyke; Sanderson, Andrew K.; Pinsky, Paul F.; Badurdeen, Dilhana S.; Doria-Rose, V. Paul; Marcus, Pamela M.; Schoen, Robert E.; Lanza, Elaine; Schatzkin, Arthur; Cross, Amanda J.

2011-01-01

90

Colonic ischemia reveals thromboangiitis obliterans (Buerger's disease)  

Microsoft Academic Search

Two years before the appearance of distal peripheral manifestations of thromboangiitis obliterans (Buerger's disease), a young man had acute peritonitis attributable to an ischemic perforation of the sigmoid colon. Only the histological examination of excised tissue was able to differentially diagnose this entity unambiguously. (Gastroenterology 1996 Mar;110(3):900-3)

F Sauvaget; M Debray; JP Herve de Sigalony; JM Fichelle; D Farge; M Lemann; J Rouffy

1996-01-01

91

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

Microsoft Academic Search

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

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

1999-01-01

92

Effects of carbon monoxide on ion transport across rat distal colon.  

PubMed

The aim of the present study was to investigate whether carbon monoxide (CO) induces changes in ion transport across the distal colon of rats and to study the mechanisms involved. In Ussing chamber experiments, tricarbonyldichlororuthenium(II) dimer (CORM-2), a CO donor, evoked a concentration-dependent increase in short-circuit current (I(sc)). A maximal response was achieved at a concentration of 2.5·10(-4) mol/l. Repeated application of CORM-2 resulted in a pronounced desensitization of the tissue. Anion substitution experiments suggest that a secretion of Cl(-) and HCO(3)(-) underlie the CORM-2-induced current. Glibenclamide, a blocker of the apical cystic fibrosis transmembrane regulator channel, inhibited the I(sc) induced by the CO donor. Similarly, bumetanide, a blocker of the basolateral Na(+)-K(+)-2Cl(-) cotransporter, combined with 4-acetamido-4'-isothiocyanato-stilbene-2,2'-disulfonic acid sodium salt, an inhibitor of the basolateral Cl(-)/HCO(3)(-) exchanger, inhibited the CORM-2-induced I(sc). Membrane permeabilization experiments indicated an activation of basolateral K(+) and apical Cl(-) channels by CORM-2. A partial inhibition by the neurotoxin, tetrodotoxin, suggests the involvement of secretomotor neurons in this response. In imaging experiments at fura-2-loaded colonic crypts, CORM-2 induced an increase of the cytosolic Ca(2+) concentration. This increase depended on the influx of extracellular Ca(2+), but not on the release of Ca(2+) from intracellular stores. Both enzymes for CO production, heme oxygenase I and II, are expressed in the colon as observed immunohistochemically and by RT-PCR. Consequently, endogenous CO might be a physiological modulator of colonic ion transport. PMID:21088233

Steidle, Julia; Diener, Martin

2011-02-01

93

Giant Sigmoid Diverticulum: A Case Report  

Microsoft Academic Search

Objectives: To report an unusual presentation of a giant sigmoid diverticulum in the colon. Clinical Presentation and Intervention: The patient presented with an abdominal mass, altered bowel habits, and increasing weight. The provisional diagnosis was made by barium enema and CT scan. The patient underwent laparotomy, revealing a perforated giant sigmoid diverticulum that was excised using Hartmann’s procedure. The perforation

Ali I. Mohammad; Abdel-Mohsen Ben-Nakhi; Mousa Khoursheed

2009-01-01

94

Modulatory activity of GABAB receptors on cholinergic tone in guinea-pig distal colon.  

PubMed

The effect of gamma-aminobutyric acid (GABA) administration was studied in both in vitro and in vivo preparations of the guinea-pig distal colon. In in vitro preparations GABA (10(-7) - 10(-3) M) elicited a dose-dependent relaxation; a decrease in the spontaneous contractions was sometimes observed. The effect of GABA was mimicked by (-)-baclofen, which gave a dose-response curve overlapping that of GABA, while (+)-baclofen was about one hundred times less potent. The relaxation responses induced by the above drugs were antagonized by 5-aminovaleric acid (5 X 10(-4) M), which did not affect adenosine-induced relaxation, but they were insensitive to bicuculline (10(-5) M) and picrotoxin (10(-5) M). Moreover, they were prevented by tetrodotoxin (6 X 10(-7) M). In hyoscine (10(-7) M)-pretreated preparations, GABA still evoked a small relaxation response (approx. 10% of the maximum) that was bicuculline-sensitive. Desensitization to GABA (10(-5) M) was observed. A specific cross-desensitization occurred between GABA (10(-5) M) and (-)-baclofen (10(-5) M). In in vivo preparations, GABA (10 mumol kg-1) and (-)-baclofen (5 mumol kg-1) produced a dose-related inhibition of basal tone, while (+)-baclofen (5 mumol kg-1) had much less effect (about 25%). A decrease in the spontaneous contractions was sometimes observed. The relaxant effect of GABA and (-)-baclofen persisted in guinea-pigs pretreated (1-2 min) with picrotoxin (1.6 mumol kg-1), whereas it was significantly reduced in animals injected 1 min beforehand with 5-aminovaleric acid (0.2 mmol). The maximal relaxant effect induced by GABA and (-)-baclofen did not differ from that of atropine (0.9 mumol kg-1) and after atropine administration GABA had no further inhibitory effect. Relaxation responses induced by GABA and (-)-baclofen still occurred after blockade of nicotinic receptors by hexamethonium (0.17 mmol kg-1), which itself caused an increase in the basal tone. When the tone was increased by topical application of physostigmine (40 micrograms), GABA and (-)-baclofen induced a greater relaxation than that obtained in basal conditions. It is concluded that GABA, both in vitro and in vivo administration, inhibits cholinergic tone in guinea-pig distal colon and that this effect is mediated mainly by activation of GABAB receptors. Further experiments are required to ascertain the possible physiological role of a GABA-releasing neuronal system in the colon in vivo. PMID:2988682

Giotti, A; Luzzi, S; Maggi, C A; Spagnesi, S; Zilletti, L

1985-04-01

95

Actions of hydrogen sulphide on ion transport across rat distal colon  

PubMed Central

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.

Hennig, B; Diener, M

2009-01-01

96

Secretory activation of basolateral membrane Cl- channels in guinea pig distal colonic crypts.  

PubMed

Cell-attached recordings revealed Cl(-) channel activity in basolateral membrane of guinea pig distal colonic crypts isolated from basement membrane. Outwardly rectified currents ((gp)Cl(or)) were apparent with a single-channel conductance (gamma) of 29 pS at resting membrane electrical potential; another outward rectifier with gamma of 24 pS was also observed ( approximately 25% of (gp)Cl(or)). At a holding potential of -80 mV gamma was 18 pS for both (gp)Cl(or) currents, and at +80 mV gamma was 67 and 40 pS, respectively. Identity as Cl(-) channels was confirmed in excised patches by changing bath ion composition. From reversal potentials, relative permeability of K(+) over Cl(-) (P(K)/P(Cl)) was 0.07 +/- 0.03, with relative permeability of Na(+) over Cl(-) (P(Na)/P(Cl)) = 0.08 +/- 0.04. A second type of Cl(-) channel was seen with linear current-voltage (I-V) relations ((gp)Cl(L)), having subtypes with gamma of 21, 13, and 8 pS. Epinephrine or forskolin increased the number of open (gp)Cl(or) and (gp)Cl(L). Open probabilities (P(o)) of (gp)Cl(or), (gp)Cl(L21), and (gp)Cl(L13) were voltage dependent in cell-attached patches, higher at more positive potentials. Kinetics of (gp)Cl(or) were more rapid with epinephrine activation than with forskolin activation. Epinephrine increased P(o) at the resting membrane potential for (gp)Cl(L13). Secretagogue activation of these Cl(-) channels may contribute to stimulation of electrogenic K(+) secretion across colonic epithelium by increasing basolateral membrane Cl(-) conductance that permits Cl(-) exit after uptake via Na(+)-K(+)-2Cl(-) cotransport. PMID:12505791

Li, Yingjun; Halm, Susan Troutman; Halm, Dan R

2003-04-01

97

Mechanisms of actions of hydrogen sulphide on rat distal colonic epithelium  

PubMed Central

BACKGROUND AND PURPOSE The aim of this study was to clarify the mechanisms by which hydrogen sulphide (H2S) affects ion secretion across rat distal colonic epithelium. EXPERIMENTAL APPROACH Changes in short-circuit current induced by the H2S-donor, sodium hydrosulphide (NaHS; 10 mmol·L?1), were measured in Ussing chambers after permeabilization of the apical membrane with nystatin. Cytosolic Ca2+ concentration ([Ca2+]i) and Ca2+ in intracellular stores were measured with fluorescent dyes. Changes in mitochondrial membrane potential were estimated with rhodamine 123. KEY RESULTS NaHS had a biphasic effect on overall currents across the basolateral membrane: an initial inhibition followed by a secondary stimulation. Both a scilliroside-sensitive action on the Na+-K+-ATPase and modulation of glibenclamide-sensitive and tetrapentylammonium-sensitive (i.e. ATP-sensitive and Ca2+-dependent) basolateral K+ channels were involved in this action. Experiments with rhodamine 123 revealed that NaHS induced a hyperpolarization of the mitochondrial membrane. NaHS evoked a biphasic change in [Ca2+]i, an initial decrease followed by a secondary increase, known to be mediated by the release of stored Ca2+. Initial falls in [Ca2+]i were not mediated by a sequestration of Ca2+ in intracellular Ca2+ storing organelles, as the Mag-Fura-2 signal was unaffected by NaHS. Falls in [Ca2+]i were inhibited by 2?,4?-dichlorobenzamil, an inhibitor of the Na+-Ca2+-exchanger, and attenuated in Na+-free buffer, suggesting a transient stimulation of Ca2+ outflow by this transporter, directly demonstrated by Mn2+ quenching experiments. CONCLUSIONS AND IMPLICATIONS ATP-sensitive and Ca2+-dependent basolateral K+ conductances, the basolateral Na+-K+-pump as well as Ca2+ transporters were involved in the action of H2S in regulating colonic ion secretion.

Pouokam, E; Diener, M

2011-01-01

98

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

PubMed

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

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

2014-01-01

99

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

PubMed Central

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

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

2014-01-01

100

EVALUATION OF THE NITRERGIC MYENTERIC NEURONS IN THE DISTAL COLON OF DIABETIC RATS TREATED WITH ACETYL-L-CARNITINE  

Microsoft Academic Search

In this work, we evaluated the effect of acetyl-L-carnitine supplementation on the presence of NADPH-diaphorase positive myenteric neurons in the distal colon of rats with diabetes mellitus induced by streptozotocin. Rats 105 days old were divided into four groups: normoglycemic, normoglycemic supplemented with acetyl-L-carnitine, diabetic and diabetic supplemented with acetyl-L-carnitine. Diabetes was induced by the administration of streptozotocin (35 mg\\/kg,

Cristina Elena; Prado Teles Fregonesi; Sônia Lucy Molinari; Ângela Maria Pereira Alves; Marli Aparecida Defani; Jacqueline Nelisis Zanoni; Roberto Barbosa Bazotte

101

Arginine vasopressin, via activation of post-junctional V1 receptors, induces contractile effects in mouse distal colon.  

PubMed

The aim of this study was to analyze whether arginine vasopressin (AVP) may be considered a modulator of intestinal motility. In this view, we evaluated, in vitro, the effects induced by exogenous administration of AVP on the contractility of mouse distal colon, the subtype(s) of receptor(s) activated and the action mechanism. Isometric recordings were performed on longitudinal and circular muscle strips of mouse distal colon. AVP (0.001 nM-100 nM) caused concentration-dependent contractile effects only on the longitudinal muscle, antagonized by the V1 receptor antagonist, V-1880. AVP-induced effect was not modified by tetrodotoxin, atropine and indomethacin. Contractile response to AVP was reduced in Ca(2+)-free solution or in the presence of nifedipine, and it was abolished by depletion of calcium intracellular stores after repetitive addition of carbachol in calcium-free medium with addition of cyclopiazonic acid. U-73122, an inhibitor of the phospholipase C, effectively antagonized AVP effects, whilst it was not affected by an adenylyl cyclase inhibitor. Oxytocin induced an excitatory effect in the longitudinal muscle of distal colon at very high concentrations, effect antagonized by V-1880. The results of this study shown that AVP, via activation of V1 receptors, is able to modulate positively contractile activity of longitudinal muscle of mouse distal colon, independently by enteric nerve activation and prostaglandin synthesis. Contractile response is achieved by increase in cytoplasmatic Ca(2+) concentration via extracellular Ca(2+) influx from L-type Ca(2+) channels and via Ca(2+) release from intracellular stores through phospholipase C pathway. No modulation has been observed on the contractility of the circular muscle. PMID:24185041

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

2013-11-10

102

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

Microsoft Academic Search

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

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

103

Dietary potassium modulates active potassium absorption and secretion in rat distal colon  

SciTech Connect

To determine the effect of variations in body stores of potassium on the rate of active potassium transport in the large intestine, unidirectional 42K fluxes were performed under short-circuit conditions across isolated distal colonic mucosa of control, dietary potassium-depleted and dietary potassium-loaded rats. Potassium depletion stimulated net potassium absorption (JK net) (0.87 +/- 0.19 vs. 0.49 +/- 0.04 mu eq X h-1 X cm-2, P less than 0.025) due to a 40% increase in mucosal-to-serosal potassium transport (JK m----s). In sodium-free Ringer solution JK net in the potassium-depleted group was also significantly greater than in controls (1.93 +/- 0.26 vs. 1.01 +/- 0.11 mu eq X h-1 X cm-2, P less than 0.005). In contrast, in chloride-free Ringer solution JK net was identical in the control and potassium-depleted groups (0.39 +/- 0.05 vs. 0.46 +/- 0.07 mu eq X h-1 X cm-2, P = NS). Potassium loading reversed net potassium absorption to net potassium secretion (-0.76 +/- 0.08 mu eq X h-1 X cm-2, P less than 0.001) as the result of a decrease in JK m----s and an increase in serosal-to-mucosal potassium transport (JK s----m). Net potassium secretion was abolished in the absence of either sodium or chloride from the bathing solution but not by mucosal amiloride. In sodium-free Ringer solution JK net was similar in control and potassium-loaded groups, respectively.

Foster, E.S.; Sandle, G.I.; Hayslett, J.P.; Binder, H.J.

1986-11-01

104

Localization of TRPV1 and contractile effect of capsaicin in mouse large intestine: high abundance and sensitivity in rectum and distal colon.  

PubMed

We investigated immunohistochemical differences in the distribution of TRPV1 channels and the contractile effects of capsaicin on smooth muscle in the mouse rectum and distal, transverse, and proximal colon. In the immunohistochemical study, TRPV1 immunoreactivity was found in the mucosa, submucosal, and muscle layers and myenteric plexus. Large numbers of TRPV1-immunoreactive axons were observed in the rectum and distal colon. In contrast, TRPV1-positive axons were sparsely distributed in the transverse and proximal colon. The density of TRPV1-immunoreactive axons in the rectum and distal colon was much higher than those in the transverse and proximal colon. Axons double labeled with TRPV1 and protein gene product (PGP) 9.5 were detected in the myenteric plexus, but PGP 9.5-immunoreactive cell bodies did not colocalize with TRPV1. In motor function studies, capsaicin induced a fast transient contraction, followed by a large long-lasting contraction in the rectum and distal colon, whereas in the transverse and proximal colon only the transient contraction was observed. The capsaicin-induced transient contraction from the proximal colon to the rectum was moderately inhibited by an NK1 or NK2 receptor antagonist. The capsaicin-induced long-lasting contraction in the rectum and distal colon was markedly inhibited by an NK2 antagonist, but not by an NK1 antagonist. The present results suggest that TRPV1 channels located on the rectum and distal colon play a major role in the motor function in the large intestine. PMID:19497956

Matsumoto, Kenjiro; Kurosawa, Emi; Terui, Hiroyuki; Hosoya, Takuji; Tashima, Kimihito; Murayama, Toshihiko; Priestley, John V; Horie, Syunji

2009-08-01

105

Laparoscopic resection of sigmoid diverticulitis  

Microsoft Academic Search

Background: In the large bowel, resection of the sigmoid colon is the most commonly performed laparoscopic intervention because large\\u000a bowel lesions often are located in this part of the bowel and the procedure technically is the most favorable one. A number\\u000a of publications involving case series or the results of highly experienced individual surgeons already have confirmed the\\u000a feasibility of

F. Köckerling; C. Schneider; M. A. Reymond; H. Scheuerlein; J. Konradt; H. P. Bruch; C. Zornig; L. Köhler; E. Bärlehner; A. Kuthe; G. Szinicz; H. A. Richter; W. Hohenberger

1999-01-01

106

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

PubMed

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

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

2014-05-15

107

Basolateral PAR-2 receptors mediate KCl secretion and inhibition of Na+ absorption in the mouse distal colon  

PubMed Central

Proteinase-activated receptor-2 (PAR-2) may participate in epithelial ion transport regulation. Here we examined the effect of mouse activating peptide (mAP), a specific activator of PAR-2, on electrogenic transport of mouse distal colon using short-circuit current (ISC) measurements. Under steady-state conditions, apical application of amiloride (100 ?m) revealed a positive ISC component of 74.3 ± 6.8 ?A cm?2 indicating the presence of Na+ absorption, while apical Ba2+ (10 mm) identified a negative ISC component of 26.2 ± 1.8 ?A cm?2 consistent with K+ secretion. Baseline Cl? secretion was minimal. Basolateral addition of 20 ?m mAP produced a biphasic ISC response with an initial transient peak increase of 11.2 ± 0.9 ?A cm?2, followed by a sustained fall to a level 31.2 ± 2.6 ?A cm?2 (n = 43) below resting ISC. The peak response was due to Cl? secretion as it was preserved in the presence of amiloride but was largely reduced in the presence of basolateral bumetanide (20 ?m) or in the absence of extracellular Cl?. The secondary decline of ISC was also attenuated by bumetanide and by Ba2+, indicating that it is partly due to a stimulation of K+ secretion. In addition, the amiloride-sensitive ISC was slightly reduced by mAP, suggesting that inhibition of Na+ absorption also contributes to the ISC decline. Expression of PAR-2 in mouse distal colon was confirmed using RT-PCR and immunocytochemistry. We conclude that functional basolateral PAR-2 is present in mouse distal colon and that its activation stimulates Cl? and K+ secretion while inhibiting baseline Na+ absorption.

Cuffe, John E; Bertog, Marko; Velazquez-Rocha, Sara; Dery, Olivier; Bunnett, Nigel; Korbmacher, Christoph

2002-01-01

108

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

PubMed Central

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

2013-01-01

109

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

PubMed

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

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

2005-09-01

110

A smooth muscle tone-dependent stretch-activated migrating motor pattern in isolated guinea-pig distal colon  

PubMed Central

We have investigated the tone dependence of the intrinsic nervous activity generated by localized wall distension in isolated segments of guinea-pig distal colon using mechanical recordings and video imaging of wall movements. A segment of colon was threaded through two partitions, which divided the colon for pharmacological purposes into oral, stimulation and anal regions. An intraluminal balloon was located in the stimulation region between the two partitions (12 mm apart). Maintained colonic distension by an intraluminal balloon or an artificial faecal pellet held at a fixed location generated rhythmic (frequency 0.3 contractions min?1; duration ˜60 s) peristaltic waves of contraction. Video imaging of colonic wall movements or the selective application of pharmacological agents suggested that peristaltic waves originated just oral (? 4 mm) to the pellet and propagated both orally (˜11 mm s?1) and anally (˜1 mm s?1). Also, during a peristaltic wave the colon appears to passively shorten in front of a pellet, as a result of an active contraction of the longitudinal muscle oral to the pellet. Faecal pellet movement only occurred when a rhythmic peristaltic wave was generated. Rhythmic peristaltic waves were abolished in all regions by the smooth muscle relaxants isoproterenol (1 ?M), nicardipine (1 ?M) or papavarine (10 ?M), and by the neural antagonists tetrodotoxin (TTX; 0.6 ?M), hexamethonium (100 ?M) or atropine (1 ?M), when added selectively to the stimulation region. Nicardipine, atropine, TTX, or hexamethonium (100 ?M) also blocked the evoked peristaltic waves when selectively added to the oral region. N?-nitro-L-arginine (L-NA; 100 ?M) added to the anal region reduced the anal relaxation but increased the anal contraction, leading to an increase in the apparent conduction velocity of each peristaltic wave. In conclusion, maintained distension by a fixed artificial pellet generates propulsive, rhythmic peristaltic waves, whose enteric neural activity is critically dependent upon smooth muscle tone. These peristaltic waves usually originate just oral to the pellet, and their apparent conduction velocity is generated by activation of descending inhibitory nerve pathways.

Smith, Terence K; Oliver, Gavin R; Hennig, Grant W; O'Shea, Deirdre M; Berghe, Pieter Vanden; Kang, Sok Han; Spencer, Nick J

2003-01-01

111

Short-Chain Fatty Acid (SCFA) Volume Regulation in Proximal and Distal Rabbit Colon is Different  

Microsoft Academic Search

.   SCFAs increase the volume of many different cell types rarely exposed to significant concentrations of these weak electrolytes.\\u000a SCFAs swell isolated cells from colonic carcinoma cell lines, but the mechanism(s) of volume regulation in normal colonocytes,\\u000a which are generally exposed to >100 mm SCFAs, has not been well characterized. Aims: To determine the effect of SCFAs on volume regulation

J. Sellin; H. Shelat

1996-01-01

112

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

PubMed Central

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.

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

113

[Cecal and sigmoid volvulus].  

PubMed

The Authors present the etio-pathogenetic, clinical and diagnostic aspects of cecal and sigmoid volvulus. They discuss the therapeutic indications and possibilities comparing advantages and disadvantages of conservative and surgical treatment. Two cases of cecal volvulus and two of sigmoid volvulus, are presented and their peculiar aspects underlined as well as the surgical technique. PMID:7279253

Parca, S; Rossini, L; Tobaldi, F; Stroppa, L; Fracassini, E

1981-09-22

114

Evidence that ATP or a related purine is an excitatory neurotransmitter in the longitudinal muscle of mouse distal colon  

PubMed Central

Background and purpose: This study analysed the contribution of the purinergic system to enteric neurotransmission in the longitudinal muscle of mouse distal colon. Experimental approach: Motor responses to exogenous ATP and to nerve stimulation in vitro were assessed as changes in isometric tension. Key results: ATP induced a concentration-dependent contraction, reduced by 4-[[4-formyl-5-hydroxy-6-methyl-3-[(phosphonooxy)methyl]-2-pyridinyl]azo]-1,3-benzene disulphonic acid (PPADS), suramin, P2Y purinoreceptor desensitisation with adenosine 5'-O-2-thiodiphosphate (ADP?S), and atropine, but unaffected by P2X purinoceptor desensitisation with ?,?-methylene ATP (?,?-meATP) and by 2,2-dimethyl-propionic acid 3-(2-chloro-6-methylaminopurin-9-yl)-2-(2,2-dimethyl-propionyloxymethyl)-propyl ester (MRS 2395), a P2Y12 selective antagonist. The response to ATP was increased by 2?-deoxy-N6-methyl adenosine 3?,5?-diphosphate (MRS 2179), a P2Y1 selective antagonist, tetrodotoxin (TTX) or N?-nitro-L-arginine methyl ester (L-NAME). ADP?S, a P2Y-purinergic agonist, induced muscular contraction, with the same pharmacological profile as the ATP-induced contraction. ADP, a natural ligand for P2Y1 receptors, induced muscular relaxation, antagonized by MRS 2179 and by TTX or L-NAME. Nerve stimulation elicited a transient nitrergic relaxation, followed by contraction. Contractile responses was reduced by atropine, PPADS, suramin, P2Y purinoceptor desensitisation, but not by P2X purinoceptor desensitisation, MRS 2179 or MRS 2395. None of the purinergic antagonists modified the nerve-evoked relaxation. Conclusions and implications: In the longitudinal muscle of mouse distal colon, ATP, through ADP?S-sensitive P2Y purinoceptors, contributed to the excitatory neurotransmission acting directly on smooth muscle and indirectly via activation of cholinergic neurons. Moreover, P2Y1 purinoceptors appear to be located on nitrergic inhibitory neurons. This study provides new insights into the role of purines in the mechanism inducing intestinal transit in mouse colon.

Zizzo, M G; Mule, F; Serio, R

2007-01-01

115

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

PubMed

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

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

2014-04-01

116

Colonic transit studies with 99mTc-rhenium sulfide colloid in live rats. A preliminary study.  

PubMed

Abnormal colonic motility is associated with clinical relevant conditions such as irritable bowel syndrome or constipation. Accurate assessment of colonic transit in an animal model would be useful in studying these conditions and screen potential drug candidates. The aim of this study was to assess if scintigraphic analyses could reliably evaluate total and segmental colonic transit as a measure of colonic motility of a non-absorbable radiotracer in rats. Normal Lewis rats (250-300 g) were given oral technetium-99m-rhenium sulfide colloid (15-20 MBq; 0.5 mL; n=4) followed by a rinse with water for injection (1.0 mL). Rats were fed and hydrated ad libitum. After 30 min, each rat was contained inside an 'imaging' tube then placed on a g-camera collimator. Whole body 5 min static images were acquired every 30 min up to 9 h, and then finally at 25 hours. Region of interest analyses were applied to the caecum/proximal colon, sigmoidal loop and distal colon/rectum. The tracer entered into the colon at approximately 4 hours, and the rats remained static to permit 'live' imaging. At 4 hours the % whole body activity was: 51% caecum/proximal colon, 39% sigmoidal loop, 6% distal colon/rectum; at 8 hours, 30% caecum/proximal colon, 13% sigmoidal loop, 7% distal colon/rectum. In the whole colon there was < or =1% of total activity present at 25 hours, and the half clearance time was determined as 4.0 hours. These results suggest this is a reliable technique of measuring regional colonic transit as a measure of colonic motility in normal rats. This methodology might be well suited to screen potential motility effects of drug candidates. PMID:18815663

Tsopelas, Chris; Adam, Birgit; Liebregts, Tobias; Holtmann, Gerald; Bartholomeusz, F Dylan L

2008-01-01

117

Actions of Angeli's salt, a nitroxyl (HNO) donor, on ion transport across mucosa-submucosa preparations from rat distal colon.  

PubMed

The aim of this study was to investigate whether nitroxyl (HNO), a redox variant of the radical gasotransmitter nitric oxide (NO) with therapeutically promising properties, affects colonic ion transport. Changes in short-circuit current (Isc) induced by the HNO donor Angeli's salt were recorded in Ussing chambers. Cytosolic Ca(2+) concentration was measured with fura-2. The nitroxyl donor induced a concentration-dependent increase in Isc across rat distal colon which was due to a stimulation of chloride secretion. The secretion induced by Angeli's salt (5×10(-4)mol/l) was not altered by the NO scavenger 2-(4-carboxyphenyl)-4,5-dihydro-4,4,5,5-tetramethyl-1H-imidazolyl-1-oxy-3-oxide (carboxy-PTIO), but was abolished by the HNO scavenger l-cysteine. The response was not dependent on the activity of soluble guanylate cyclase or enteric neurons, but was inhibited by indomethacin. Experiments with apically permeabilized epithelia revealed the activation of basolateral K(+) channels and a stimulation of the current carried by the basolateral Na(+)-K(+)-pump by Angeli's salt. The secretion induced by Angeli's salt was reduced in the absence of extracellular Ca(2+). A prominent increase in the cytosolic Ca(2+) concentration was evoked by Angeli's salt predominantly in subepithelial cells within the submucosa, which had the same dependence on extracellular Ca(2+) as the Angeli's salt-induced Cl(-) secretion. Consequently, Angeli's salt induces a soluble guanylate cyclase-independent, Ca(2+)-dependent Cl(-) secretion via activation of the Na(+)-K(+)-ATPase and of basolateral K(+) channels. Cyclooxygenase metabolites produced within the submucosa seem to be involved in this response. PMID:23747594

Pouokam, Ervice; Bell, Anna; Diener, Martin

2013-09-01

118

Activation of P2Y receptors by ATP and by its analogue, ADP?S, triggers two calcium signal pathways in the longitudinal muscle of mouse distal colon  

Microsoft Academic Search

Our previous research showed that ATP and adenosine 5?-O-2-thiodiphosphate (ADP?S) induce contractile effects in the longitudinal muscle of mouse distal colon via activation of P2Y receptors which are not P2Y1 or P2Y12 subtypes. This study investigated the nature of the P2Y receptor subtype(s) and the mechanisms leading to the intracellular calcium concentration increase necessary to trigger muscular contraction. Motor responses

Maria Grazia Zizzo; Flavia Mulè; Rosa Serio

2008-01-01

119

Complete colonic duplication in children  

PubMed Central

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

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

2012-01-01

120

Complete colonic duplication in children.  

PubMed

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

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

2012-01-01

121

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

PubMed Central

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.

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

2014-01-01

122

Giant Sigmoid Diverticulum: A Rare Presentation of a Common Pathology  

PubMed Central

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.

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

123

Aldosterone induces active K? secretion by enhancing mucosal expression of Kcnn4c and Kcnma1 channels in rat distal colon.  

PubMed

Although both Kcnn4c and Kcnma1 channels are present on colonic mucosal membranes, only Kcnma1 has been suggested to mediate K(+) secretion in the colon. Therefore, studies were initiated to investigate the relative roles of Kcnn4c and Kcnma1 in mediating aldosterone (Na-free diet)-induced K(+) secretion. Mucosal to serosal (m-s), serosal to mucosal (s-m), and net (86)Rb(+) (K(+) surrogate) fluxes as well as short circuit currents (I(sc); measure of net ion movement) were measured under voltage clamp condition in rat distal colon. Active K(+) absorption, but not K(+) secretion, is present in normal, while aldosterone induces active K(+) secretion (1.04 ± 0.26 vs. -1.21 ± 0.15 ?eq·h(-1)·cm(-2); P < 0.001) in rat distal colon. Mucosal VO(4) (a P-type ATPase inhibitor) inhibited the net K(+) absorption in normal, while it significantly enhanced net K(+) secretion in aldosterone animals. The aldosterone-induced K(+) secretion was inhibited by the mucosal addition of 1) either Ba(2+) (a nonspecific K(+) channel blocker) or charybdotoxin (CTX; a common Kcnn4 and Kcnma1 channel blocker) by 89%; 2) tetraethyl ammonium (TEA) or iberiotoxin (IbTX; a Kcnma1 channel blocker) by 64%; and 3) TRAM-34 (a Kcnn4 channel blocker) by 29%. TRAM-34, but not TEA, in the presence of IbTX further significantly inhibited the aldosterone-induced K(+) secretion. Thus the aldosterone-induced Ba(2+)/CTX-sensitive K(+) secretion consists of IbTX/TEA-sensitive (Kcnma1) and IbTX/TEA-insensitive fractions. TRAM-34 inhibition of the IbTX-insensitive fraction is consistent with the aldosterone-induced K(+) secretion being mediated partially via Kcnn4c. Western and quantitative PCR analyses indicated that aldosterone enhanced both Kcnn4c and Kcnma1? protein expression and mRNA abundance. In vitro exposure of isolated normal colonic mucosa to aldosterone also enhanced Kcnn4c and Kcnma1? mRNA levels, and this was prevented by exposure to actinomycin D (an RNA synthesis inhibitor). These observations indicate that aldosterone induces active K(+) secretion by enhancing mucosal Kcnn4c and Kcnma1 expression at the transcriptional level. PMID:22322970

Singh, Satish K; O'Hara, Bryan; Talukder, Jamilur R; Rajendran, Vazhaikkurichi M

2012-05-01

124

Congenital pouch colon syndrome in a Saudi Arabian neonate.  

PubMed

Congenital pouch colon syndrome is partial or complete replacement of the colon by a pouch-like structure and anorectal malformation. Commonly reported from northern India, we believe this is the first report of congenital pouch colon syndrome in a Saudi Arabian neonate. He was referred with an imperforate anus and diagnosed as having a high anorectal malformation. The patient underwent a sigmoid colostomy. Continued abdominal distension after the colostomy prompted sonography and computed tomography, which showed an air- and fluid-containing cystic structure in the abdomen. Exploration revealed a thick-walled cystic structure in continuity with the distal colostomy and with a blood supply mainly from the superior mesenteric artery. The ureters were dilated and tortuous and the pouch opened into the posterior vesical wall. The pouch was resected and an end colostomy fashioned. The etiopathogenesis classification and management of the congenital pouch colon syndrome are discussed. PMID:18206446

Donkol, Ragab H; Jetley, Nishith Kumar; Al Mazkary, Mufareh H

2008-01-01

125

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

PubMed

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

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

2013-04-01

126

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

PubMed Central

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

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

2013-01-01

127

Geoeffective CMEs, Filaments, and Sigmoids  

Microsoft Academic Search

Coronal mass ejections--particularly those with flux rope structures--have the potential to trigger geomagnetic storms, depending on the properties of the flux ropes. Eruptions of both filaments and coronal sigmoids have been indicated as important drivers of space weather, and both filaments and sigmoids have been modeled with flux rope structure. However, the analysis reported by Leamon et al. (2002) suggested

D. E. McKenzie; R. J. Leamon

2004-01-01

128

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

PubMed Central

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

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

2013-01-01

129

Effect of short-chain fatty acids on cell volume and intracellular pH in rat distal colon  

Microsoft Academic Search

Superfusion of isolated crypts from the rat colon with sodium-butyrate-containing solutions induced an increase in the crypt diameter indicating a swelling of the crypt cells. The response to butyrate (50 mmol 1-1) was not uniform along the crypt axis, the most pronounced swelling being observed in the upper third of the crypt. The butyrate effect was concentration-dependent and was completely

M. Diener; C. Helmle-Kolb; H. Murer; E. Scharrer

1993-01-01

130

Rapid non-genomic activation of cytosolic cyclic AMP-dependent protein kinase activity and [Ca2+]i by 17?-oestradiol in female rat distal colon  

PubMed Central

In this study, the effect of 17?-oestradiol on adenosine 3??:?5?-cyclic monophosphate (cyclic AMP)-dependent protein kinase (PKA) activity was investigated. Rapid (within 15?min) activation of basal PKA activity was observed in cytosolic fractions by 17?-oestradiol but not by 17?-oestradiol, progesterone or testosterone. This stimulation was abolished by the specific PKA inhibitor PKI but not by the classical oestrogen receptor antagonist tamoxifen. 17?-Oestradiol did not stimulate basal PKA activity in membrane fractions or in cytosolic fractions from male rats. The increase in cytosolic PKA activity was indirect as (i) it was inhibited by the adenylyl cyclase inhibitor SQ22536, (ii) it was mimicked by forskolin and (iii) 17?-oestradiol did not cause a stimulation of basal PKA activity in either type?I or type?II commercially available PKA holoenzymes. Protein kinase?C? (PKC?) was directly activated by 17?-oestradiol. The specific PKC inhibitor, bisindolylmaleimide?I (GF 109203X), abolished the 17?-oestradiol-induced PKA activation. 17?-Oestradiol stimulated an increase in free intracellular calcium ion concentration ([Ca2+]i) in isolated female but not male rat colonic crypts. This was inhibited by verapamil, nifedipine and zero extracellular [Ca2+] but unaffected by tamoxifen. 17?-Oestradiol, testosterone and progesterone failed to increase [Ca2+]i. PKC and PKA inhibitors abolished the 17?-oestradiol-induced increase in [Ca2+]i. These results demonstrate the existence of a novel 17?-oestradiol-specific PKA and Ca2+ signalling pathway, which is both sex steroid- and gender-specific, in rat distal colonic epithelium.

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

2000-01-01

131

Sigmoid diverticulitis: US findings  

PubMed Central

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

2013-01-01

132

Sigmoid diverticular perforation complicating lung transplantation.  

PubMed

We present three lung transplant recipients who had sigmoid colonic diverticular perforation within 4 weeks of transplantation, giving an overall incidence of 8.6% (3 of 35) in our population. Our cases are unusual because they all occurred in the early posttransplantation period and because the incidence of perforation is substantially higher than that reported in other transplant populations. The reason for the apparent increased incidence of perforation in our lung transplant recipients is unclear, but it is likely related to the short follow-up period, intense posttransplantation immunosuppression, perioperative hypoperfusion, and increased intraluminal pressure from the use of narcotics and bowel stimulants. We discuss these potential causes and comment on preventive measures being undertaken at our program. PMID:9229300

Fenton, J J; Cicale, M J

1997-06-01

133

Percutaneous endoscopic colostomy (PEC): an effective alternative in high risk patients with recurrent sigmoid volvulus.  

PubMed

Treatment of recurrent sigmoid volvulus is a major challenge in frail and elderly patients with multiple co-morbidities. Early management involves endoscopic decompression with high success rate, however, its recurrence make it a real challenge as most of these patients are not suitable for major colonic resection. The aim of this study was to assess the role of percutaneous endoscopic colostomy (PEC) in the treatment of recurrent sigmoid volvulus in these patients. Twelve PEC procedures were performed in 8 patients under our care. This prevented major colonic resection in 7 patients. One patient underwent sigmoid resection and died with postoperative complications. Two patients experienced minor complications. Three patients required repeat procedures for permanent PEC tube placement. Six patients managed permanently with PEC procedure. PEC is an effective treatment for recurrent sigmoid volvulus in high-risk elderly patients. PMID:24169390

Khan, Muhammad Aamir Saeed; Ullah, Sana; Beckly, David; Oppong, Fielding Christian

2013-11-01

134

Multivariate sigmoidal neural network approximation.  

PubMed

Here we study the multivariate quantitative constructive approximation of real and complex valued continuous multivariate functions on a box or RN, N?N, by the multivariate quasi-interpolation sigmoidal neural network operators. The "right" operators for our goal are fully and precisely described. This approximation is derived by establishing multidimensional Jackson type inequalities involving the multivariate modulus of continuity of the engaged function or its high order partial derivatives. Our multivariate operators are defined by using a multidimensional density function induced by the logarithmic sigmoidal function. The approximations are pointwise and uniform. The related feed-forward neural network is with one hidden layer. PMID:21310590

Anastassiou, George A

2011-05-01

135

Distribution of voltage-dependent and intracellular Ca2+ channels in submucosal neurons from rat distal colon.  

PubMed

We recently observed a bradykinin-induced increase in the cytosolic Ca2+ concentration in submucosal neurons of rat colon, an increase inhibited by blockers of voltage-dependent Ca2+ (Ca(v)) channels. As the types of Ca(v) channels used by this part of the enteric nervous system are unknown, the expression of various Ca(v) subunits has been investigated in whole-mount submucosal preparations by immunohistochemistry. Submucosal neurons, identified by a neuronal marker (microtubule-associated protein 2), are immunoreactive for Ca(v)1.2, Ca(v)1.3 and Ca(v)2.2, expression being confirmed by reverse transcription plus the polymerase chain reaction. These data agree with previous observations that the inhibition of L- and N-type Ca2+ currents strongly inhibits the response to bradykinin. However, whole-cell patch-clamp experiments have revealed that bradykinin does not enhance Ca2+ inward currents under voltage-clamp conditions. Consequently, bradykinin does not directly interact with Ca(v) channels. Instead, the kinin-induced Ca2+ influx is caused indirectly by the membrane depolarization evoked by this peptide. As intracellular Ca2+ channels on Ca(2+)-storing organelles can also contribute to Ca2+ signaling, their expression has been investigated by imaging experiments and immunohistochemistry. Inositol 1,4,5-trisphosphate (IP3) receptors (IP3R) have been functionally demonstrated in submucosal neurons loaded with the Ca(2+)-sensitive fluorescent dye, fura-2. Histamine, a typical agonist coupled to the phospholipase C pathway, induces an increase in the fura-2 signal ratio, which is suppressed by 2-aminophenylborate, a blocker of IP3 receptors. The expression of IP3R1 has been confirmed by immunohistochemistry. In contrast, ryanodine, tested over a wide concentration range, evokes no increase in the cytosolic Ca2+ concentration nor is there immunohistochemical evidence for the expression of ryanodine receptors in these neurons. Thus, rat submucosal neurons are equipped with various types of high-voltage activated Ca(v) channels and with IP3 receptors for intracellular Ca2+ signaling. PMID:23807706

Rehn, Matthias; Bader, Sandra; Bell, Anna; Diener, Martin

2013-09-01

136

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

PubMed

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

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

2013-06-14

137

A Rare Case Presentation of a Perforated Giant Sigmoid Diverticulum  

PubMed Central

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

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

2013-01-01

138

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

PubMed Central

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

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

2014-01-01

139

The Primary Sauve–Kapandji Procedure—For Treatment of Comminuted Distal Radius and Ulnar Fractures  

Microsoft Academic Search

We have performed primary Sauve–Kapandji procedures on four patients with severe open comminuted fractures of both the distal radius and ulna. The fragmented distal ulna was fixed to the sigmoid notch in order to stabilize the ulnar side of the carpus, and a proximal pseudoarthrosis was maintained for forearm rotation. All the distal radial fractures united without major complications. The

E. HORII; T. OHMACHI; R. NAKAMURA

2005-01-01

140

Malt in Combination with Lactobacillus rhamnosus Increases Concentrations of Butyric Acid in the Distal Colon and Serum in Rats Compared with Other Barley Products but Decreases Viable Counts of Cecal Bifidobacteria123  

PubMed Central

Several substances, including glutamine and propionic acid but in particular butyric acid, have been proposed to be important for colonic health. ?-Glucans lead to the formation of comparatively high amounts of butyric acid, and germinated barley foodstuff obtained from brewer’s spent grain (BSG), containing high amounts of ?-glucans and glutamine, has been reported to reduce the inflammatory response in the colon of patients with ulcerative colitis. The present study examines how 3 barley products, whole grain barley, malt, and BSG, affect SCFA in the hindgut and serum of rats and whether the addition of Lactobacillus rhamnosus 271 to each of these diets would have further effects. Amino acids in plasma and the cecal composition of the microbiota were also analyzed. The butyric acid concentration in the distal colon and serum was higher in the malt groups than in the other groups as was the serum concentration of propionic acid. The concentrations of propionic and butyric acids were higher in the cecum and serum of rats given L. rhamnosus than in those not given this strain. The proportion of plasma glutamine and the cecal number of bifidobacteria were lower in the malt groups than in the other groups. L. rhamnosus decreased the number of cecal bifidobacteria, whereas plasma glutamine was unaffected. We conclude that malt together with L. rhamnosus 271 had greater effects on propionic and butyric acid concentrations in rats than the other barley products. This is interesting when developing food with effects on colonic health.

Branning, Camilla E.; Nyman, Margareta E.

2011-01-01

141

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

PubMed Central

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

2014-01-01

142

Distal cholangiocarcinoma.  

PubMed

Cholangiocarcinoma involving the distal common bile duct (distal cholangiocarcinoma [DCC]) is a periampullary neoplasm that is less common than, but often difficult to distinguish from, pancreatic adenocarcinoma (PDA). The prognosis and cure rate of DCC is improved over that of PDA, but it remains a highly lethal disease. Although the diagnostic and therapeutic management of DCC is not dissimilar from PDA, the pathophysiology is, in many instances, distinctly different. A multi-disciplinary approach toward DCC is important. PMID:24679424

Dickson, Paxton V; Behrman, Stephen W

2014-04-01

143

"Internal anal sphincter relaxation associated with bisacodyl-induced colonic high amplitude propagating contractions in children with constipation: a colo-anal reflex?"  

PubMed Central

Objectives Describe the association of internal anal sphincter (IAS) relaxation with colonic high amplitude peristaltic contractions (HAPCs). Methods Retrospective review of colon manometry tracings of children with constipation to determine the IAS relaxation characteristics associated to HAPC’s (HAPC-IASR) events and compare them to the those seen during the performance of the anorectal manometry (ARM-RAIR) events. Results A total of 70 HAPC- IASRs were observed in 15 patients, 65 after bisacodyl, 2 during fasting and 3 after a meal. In 64% of events the IAS relaxation started when the HAPC reached left colon and in 36% as proximal as the hepatic flexure. HAPC propagation seems to be important in HAPC-IASR characteristics; those propagating distal to sigmoid colon demonstrated larger and longer IAS relaxation as well as lower residual pressure but equivalent resting pressure compared to HAPC’s ending proximal to sigmoid colon. While IAS resting pressure was comparable for ARM-RAIRs and HAPC-IASRs, the duration and magnitude of anal relaxation was higher and the anal residual pressure was lower in HAPC-IASRs. Conclusions We demonstrated that IAS relaxation in constipated children is associated with HAPCs migrating in the proximal and distal colon; in most cases starting when peristalsis is migrating through left colon and in an important proportion while migrating proximally. We also demonstrated that HAPC-IASRs are different from ARM-RAIRs suggesting a neurally mediated reflex. Lastly, the IAS relaxation characteristics are highly dependent on the degree of propagation of HAPCs, which could have important implications in the understanding of defecation disorders.

Rodriguez, Leonel; Siddiqui, Anees; Nurko, Samuel

2012-01-01

144

Sigmoid diverticulitis with perforation and generalized peritonitis  

Microsoft Academic Search

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

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

1985-01-01

145

Clinical considerations and therapeutic strategy for sigmoid volvulus in the elderly: A study of 33 cases  

PubMed Central

AIM: To evaluate different types of treatment for sigmoid volvulus and clarify the role of endoscopic intervention versus surgery. METHODS: A retrospective review of the clinical presentation and imaging characteristics of 33 sigmoid volvulus patients was presented, as well as their diagnosis and treatment, in combination with a literature review. RESULTS: In 26 patients endoscopic detorsion was achieved after the first attempt and one patient died because of uncontrollable sepsis despite prompt operative treatment. Seven patients had unsuccessful endoscopic derotation and were operated on. On two patients with gangrenous sigmoid, Hartmann’s procedure was performed. In five patients with viable colon, a sigmoid resection and primary anastomosis was carried out. Three patients had a lavage “on table” prior to anastomosis, while in the remaining 2 patients a diverting stoma was performed according to the procedure of the first author. Ten patients were operated on during their first hospital stay (3 to 8 d after the deflation). All patients had viable colon; 7 patients had a sigmoid resection and primary anastomosis, 2 patients had sigmoidopexy and one patient underwent a near-total colectomy. Two patients (sigmoidectomy-sigmoidopexy) had recurrences of volvulus 43 and 28 mo after the initial surgery. Among 15 patients who were discharged from the hospital after non-operative deflation, 3 patients were lost to follow-up. Of the remaining 12 patients, 5 had a recurrence of volvulus at a time in between 23 d and 14 mo. All the five patients had been operated on and in four a gangrenous sigmoid was found. Three patients died during the 30 d postoperative course. The remaining seven patients were admitted to our department for elective surgery. In these patients, 2 subtotal colectomies, 3 sigmoid resections and 2 sigmoidopexies were carried out. One patient with subtotal colectomy died. Taken together of the results, it is evident that after 17 elective operations we had only one death (5.9%), whereas after 15 emergency operations 6 patients died, which means a mortality rate of 40%. CONCLUSION: Although sigmoid volvulus causing intestinal obstruction is frequently successfully encountered by endoscopic decompression, however, the principal therapy of this condition is surgery. Only occasionally in patients with advanced age, lack of bowel symptoms and multiple co-morbidities might surgical repair not be considered.

Safioleas, Michael; Chatziconstantinou, Constantinos; Felekouras, Evangelos; Stamatakos, Michael; Papaconstantinou, Ioannis; Smirnis, Anastasios; Safioleas, Panagiotis; Kostakis, Alkiviades

2007-01-01

146

The Evolution of Sigmoidal Active Regions  

NASA Astrophysics Data System (ADS)

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.

Savcheva, Antonia

2013-07-01

147

Rectal and sigmoid atresia: transanal approach.  

PubMed

We report 2 patients with rectal and low sigmoid atresia operated on, respectively, at 6 and 3 months of age using the transanal approach, similar to the transanal technique for Hirschsprung disease, after exploratory laparotomy with colostomy at birth. There were no intraoperative or postoperative complications after a follow-up time of 2 years. After closure of the colostomy, both patients had no fecal incontinence. The transanal approach is a safe and effective technique in the management of rectal and sigmoid atresia. PMID:22703823

Hamzaoui, M; Ghribi, A; Makni, W; Sghairoun, N; Gasmi, M

2012-06-01

148

Laparoscopic vs open colectomy for sigmoid diverticulitis  

Microsoft Academic Search

Background: The aim of this prospective comparative study was to assess the outcome of laparoscopic and open colectomy for sigmoid diverticulitis\\u000a in patients aged ?75 years.\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a Methods: From January 1993 to December 1998, all patients 75 years of age and older undergoing an elective colectomy for sigmoid diverticulitis\\u000a were included in the study. The patients were divided into the following

J.-J. Tuech; P. Pessaux; C. Rouge; N. Regenet; R. Bergamaschi; J.-P. Arnaud

2000-01-01

149

Steroid-Induced Sigmoid Diverticular Perforation in a Patient with Temporal Arteritis: A Rare Clinical Pathology  

PubMed Central

Corticosteroids are used in the treatment of many rheumatological diseases including temporal arteritis. The gastrointestinal perforation during corticosteroid treatment is a serious complication. Colon perforation after steroid use was first reported by Beck et al in 1950.1 Although the pathophysiological mechanism is not understood clearly, it is claimed that steroids probably by disturbing the intestinal mucosal barrier, facilitate the intestinal perforation. The long term treatment with corticosteroids increases the risk of colon perforation. We are presenting a patient who was taking corticosteroid due to temporal arteritis for two years and operated with sigmoid diverticular perforation.

Kaya, Bulent; Aras, Orhan; Bat, Orhan; Bulut, Nuriye Esen; Memisoglu, Kemal

2012-01-01

150

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

PubMed Central

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

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

2014-01-01

151

Prevalence of Perforated Sigmoid Diverticulitis Is Increasing  

Microsoft Academic Search

INTRODUCTION: The population of Finland is aging fast, and dietary fiber consumption has decreased during the past few decades; the prevalence of sigmoid diverticular perforation can therefore be anticipated to increase. This study presents our experience concerning the outcome of 133 patients admitted to a university hospital for diverticular perforation during a 15-year period. METHODS: One hundred thirty-three patients admitted

Jyrki Mäkelä; Heikki Kiviniemi; Seppo Laitinen

2002-01-01

152

Segmentation and segment connection of obstructed colon  

NASA Astrophysics Data System (ADS)

Segmentation of colon CT images is the main factor that inhibits automation of virtual colonoscopy. There are two main reasons that make efficient colon segmentation difficult. First, besides the colon, the small bowel, lungs, and stomach are also gas-filled organs in the abdomen. Second, peristalsis or residual feces often obstruct the colon, so that it consists of multiple gas-filled segments. In virtual colonoscopy, it is very useful to automatically connect the centerlines of these segments into a single colon centerline. Unfortunately, in some cases this is a difficult task. In this study a novel method for automated colon segmentation and connection of colon segments' centerlines is proposed. The method successfully combines features of segments, such as centerline and thickness, with information on main colon segments. The results on twenty colon cases show that the method performs well in cases of small obstructions of the colon. Larger obstructions are mostly also resolved properly, especially if they do not appear in the sigmoid part of the colon. Obstructions in the sigmoid part of the colon sometimes cause improper classification of the small bowel segments. If a segment is too small, it is classified as the small bowel segment. However, such misclassifications have little impact on colon analysis.

Medved, Mario; Truyen, Roel; Likar, Bostjan; Pernus, Franjo

2004-05-01

153

Transfemoral, Transvenous Embolisation of Dural Arteriovenous Fistula Involving the Isolated Transverse-Sigmoid Sinus from the Contralateral Side  

Microsoft Academic Search

Summary.  \\u000a ?Background: A dural arteriovenous fistula (AVF) involving the transverse-sigmoid (T-S) sinus which is occluded at its proximal and distal\\u000a ends i.e., an isolated sinus, runs the risk of haemorrhaging or causing serious neurological deficits as a result of its retrograde\\u000a leptomeningeal venous drainage. While lesions of this type have not been considered to be treatable by percutaneous, transvenous\\u000a embolisation,

M. Komiyama; T. Ishiguro; Y. Matsusaka; T. Yasui; A. Nishio

2002-01-01

154

Colonic and anal metastases from pancreato-biliary malignancies.  

PubMed

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

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

2014-04-01

155

Colonic and anal metastases from pancreato-biliary malignancies  

PubMed Central

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

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

2014-01-01

156

FIP bias in a sigmoidal active region  

NASA Astrophysics Data System (ADS)

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

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

2014-01-01

157

Position paper: management of perforated sigmoid diverticulitis.  

PubMed

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

Moore, Frederick A; Catena, Fausto; Moore, Ernest E; Leppaniemi, Ari; Peitzmann, Andrew B

2013-01-01

158

Position paper: management of perforated sigmoid diverticulitis  

PubMed Central

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.

2013-01-01

159

Long-term results of sigmoid vaginoplasty in a consecutive series of 62 patients  

Microsoft Academic Search

We performed a historical cohort study of 62 consecutive patients who underwent abdomino-perineal vaginal re-construction\\u000a with a segment of the sigmoid colon during a 25-year period. A dedicated database was reviewed for the aetiology of vaginal\\u000a malformation, surgical complications and post-operative follow-up. Follow-up visits were scheduled 2, 6 and 12 months after\\u000a discharge from hospital and annually thereafter. Fifty-eight (93.5%) patients

Emilio Imparato; Alessandro Alfei; Giovanni Aspesi; Anton Livio Meus; Arsenio Spinillo

2007-01-01

160

[Perioperative morbidity and mortality of colon resection in colonic carcinoma].  

PubMed

An analysis of the local and systemic perioperative complications is conducted to explore the risk of resection of colon cancer. In a retrospective study we analyzed 231 consecutive patients operated on between 1984 and 1988. The mean age was 70 (37-91) years. The operations consisted in 3 ileocecal resections, 144 right hemicolectomies, 10 resections of the transverse colon, 22 left hemicolectomies, 77 resections of the sigmoid colon and 5 subtotal colonic resections. 2 patients (0.9%) had a clinical leakage of the anastomosis. 3 patients were reoperated: one because of anastomotic leakage and two because of ileus due to small bowel adhesions. 2 patients with uncomplicated local healing died within 30 days after the operation from systemic complications (mortality 0.9%). It is concluded that with standardized preoperative bowel preparation, prophylactic perioperative antibiotics and modern anesthesia, the resection of colon cancer is today possible with minimal perioperative risk. PMID:1626249

Messmer, P; Thöni, F; Ackermann, C; Herzog, U; Schuppisser, J P; Tondelli, P

1992-06-27

161

[Perioperative morbidity and mortality in colon resection for colon cancer].  

PubMed

The operative risk of colon resections was evaluated by a retrospective analysis of 231 according patients who were operated on between 1984 and 1988. Mean age of the patients was 70 years with a range from 37 to 91 years. Colonic resection consisted of ileocecal resection in 3 cases, right hemicolectomy in 144 cases, segmental resection of transverse colon in 10 cases, left hemicolectomy in 22 cases, resection of sigmoid colon in 77 cases and 5 times a subtotal colectomy was performed. In two patients (0.9%) an anastomotic leak occurred. Three patients were reoperated on: one due to an anastomotic disruption, two others due to a mechanical small bowel obstruction. Two patients (0.9%) died due to systemic complications without any evidence of anastomotic or wound problems. Thus a low morbidity and mortality of colonic resection is documented in our study. Factors contributing to these results are a standardized bowel preparation, perioperative antibiotics and modern anaesthetic techniques. PMID:8226035

Messmer, P; Thöni, F; Ackermann, C; Herzog, U; Schuppisser, J P; Tondelli, P

1993-09-01

162

An Unusual Complication of a Colonic Wallstent  

SciTech Connect

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.

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

163

Sentinel node procedure of the sigmoid using indocyanine green: feasibility study in a goat model  

PubMed Central

Background The sentinel lymph node (SLN) procedure alter the strategy for the treatment of patients with colon cancer. New techniques emerge that may provide the surgeon with a tool for accurate intraoperative detection of the SLNs. Methods An SLN procedure of the sigmoid was used in six goats. During laparoscopy, the near-infrared dye indocyanine green (ICG) was injected into the subserosa of the sigmoid via a percutaneously inserted needle during four experiments and in the submucosa during colonoscopy in two experiments. After injection, the near-infrared features of a newly developed laparoscope were used to detect the lymph vessels and SLNs. At the end of the procedure, 2 h after injection, all the goats were killed, and autopsy was performed. During postmortem laparotomy, the sigmoid was removed and used for confirmation of ICG node uptake. Results In all the procedures, the lymph vessels were easily detected by their bright fluorescent emission. In the first two experiments, no lymph nodes were detected. In the subsequent four experiments, human serum albumin was added to the ICG solution before injection to enable better lymph node entrapment. In all four experiments, at least one bright fluorescent lymph node was found after the lymph vessels had been tracked by their fluorescent guidance. The mean time between injection and SLN identification was 10 min. In two cases, the SLNs were located up to 5 mm into the fat tissue of the mesentery and were not seen by regular vision of the laparoscope. By switching on the near-infrared features of the scope, a clear bright dot became visible, which increased in intensity after opening of the mesentery. Conclusion The SLN procedure for the sigmoid using near-infrared laparoscopy in the goat is a very promising technique. Achievements described in this report justify a clinical trial on the feasibility of ICG-guided SLN detection in humans.

van Dongen, G. A. M. S.; Cailler, F.; Pelegrin, A.; Meijerink, W. J. H. J.

2010-01-01

164

Results using the biofragmentable anastomotic ring for colon anastomosis.  

PubMed

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

Wood, J S; Frost, D B

1993-10-01

165

Hyponatremia Is a Specific Marker of Perforation in Sigmoid Diverticulitis or Appendicitis in Patients Older Than 50 Years  

PubMed Central

Introduction. This study aimed to evaluate symptoms and signs, inflammation markers, electrolytes, and ECG signs of increased vagal tone as markers of colon perforation in sigmoid diverticulitis or appendicitis. Methods. The records of all patients older than fifty years (only these had routine ECG done) admitted to our emergency station between January 2008 and December 2010 with sigmoid diverticulitis (n = 198, diagnosed by computer tomography) or appendicitis (n = 84, diagnosed intraoperatively) were retrospectively evaluated. Pain score, heart rate, blood pressure, and body temperature were assessed at presentation. Before starting infusion therapy, blood was taken to do a blood count and to analyze CRP, the electrolytes, and creatinine levels. Then an ECG was done. Results. The perforation rate was 37% (n = 103). Body temperature, heart rate, sodium, CRP, and leukocytes correlated significantly with infectious colon perforation. However, only body temperature, CRP, and sodium correlated significantly with infectious colon perforation if compared by logistic regression analysis. The prevalence of hyponatremia (sodium level <136?mmol/L) was 29% in the group with infectious colon perforation and 16% in the group without (P = 0.013). Conclusion. Hyponatremia is a specific marker of infectious colon perforation in patients older than fifty years.

Kaser, S. A.; Furler, R.; Evequoz, D. C.; Maurer, C. A.

2013-01-01

166

Pyogenic liver abscess secondary to asymptomatic sigmoid diverticulitis.  

PubMed Central

A patient with multiple pyogenic abscesses in both lobes of the liver secondary to asymptomatic sigmoid diverticulitis is presented. The rarity of this illness is noted. It is suggested that barium enema be performed in patients who present with pyogenic liver abscess of unknown etiology because of the association with asymptomatic sigmoid diverticulitis. Images Fig. 1. Fig. 2. Fig. 3.

Wallack, M K; Brown, A S; Austrian, R; Fitts, W T

1976-01-01

167

Determinants of Recurrence After Sigmoid Resection for Uncomplicated Diverticulitis  

Microsoft Academic Search

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

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

2003-01-01

168

A case of bone metastasis of colon cancer that markedly responded to S-1\\/CPT11 combination chemotherapy and became curable by resection  

Microsoft Academic Search

ABSTRACT: BACKGROUND: An oral combined fluoropyrimidine anticancer drug, tegafur\\/gimeracil\\/oteracil potassium (S-1), has recently been used alone or in combination for colon cancer. CASE PRESENTATION: The patient was a 42-year-old man with sigmoid colon cancer with direct invasion of the urinary bladder and multiple costal metastases. A diagnosis of T4, M1, stage IV sigmoid colon cancer was made, and curative resection

Kazunari Mado; Yukimoto Ishii; Takero Mazaki; Masaya Ushio; Hideki Masuda; Tadatoshi Takayama

2006-01-01

169

Vault prolapse of sigmoid neovagina 26 years after vaginoplasty in Mayer-Rokitansky-Küster-Hauser syndrome: a case report.  

PubMed

Various operative methods have been devised to create a neovagina for patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Sigmoid vaginoplasty, a common modality for vaginal reconstruction, is believed to have satisfactory long-term anatomical and functional results. We herein report a patient with MRKH syndrome and vault prolapse of a sigmoid neovagina 26 years after vaginoplasty. Biopsies from the neovagina revealed colonic mucosa. Bilateral iliococcygeus fascia fixation of the neovaginal vault was performed vaginally. The patient had a low Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12) score preoperatively, which further decreased postoperatively. Therefore, the surgery failed to achieve a good functional result. No recurrence of the prolapse was observed 2 years postoperatively. PMID:22527553

Zhu, Lan; Chen, Na; Lang, JingHe

2013-01-01

170

Giant Ascending Colonic Diverticulum Presenting With Intussusception  

PubMed Central

Diverticular disease of the colon is a common disease, and its incidence is increasing gradually. A giant colonic diverticulum (GCD) is a rare entity and is defined as a diverticulum greater than 4 cm in size. It mainly arises from the sigmoid colon, and possible etiology is a ball-valve mechanism permitting progressive enlargement. A plain abdominal X-ray can be helpful to make a diagnosis initially, and a barium enema and abdominal computed tomography may confirm the diagnosis. Surgical intervention is a definite treatment for a GCD. We report a case of an ascending GCD presenting with intussusception in a young adult.

Kim, Ho Jin; Kim, Jin Ha; Moon, Ok In

2013-01-01

171

Hinode XRT observations of a long-lasting coronal sigmoid  

NASA Astrophysics Data System (ADS)

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

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

2008-04-01

172

Sigmoid volvulus in pregnancy: early diagnosis and intervention are important.  

PubMed

Bowel obstruction is rare in pregnancy, and delay in recognition can lead to serious maternal and fetal complications. Most reported causes of bowel obstruction in pregnancy (adhesions, intussusception, hernia, and carcinoma) require surgical intervention. Sigmoid volvulus is an acute surgical cause that can now be managed successfully without surgery. We report the case of 33-year-old lady who presented with a sigmoid volvulus that was successfully managed with urgent endoscopic decompression. PMID:24355771

Ahmad, Anis; Shing, Koh Kai; Tan, Khim Khee; Krasu, Mary; Bickle, Ian; Chong, Vui Heng

2014-05-01

173

Semiconstrained Distal Radioulnar Joint Prosthesis  

PubMed Central

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

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

2013-01-01

174

Prolapsed sigmoid intussusception per anus in an elderly man: a case report  

PubMed Central

Background Intussusception in pediatrics is widely documented and well described. On the basis of the literature, however, adult intussusception is a rare entity with a prevalence of from 1% to 5%. The majority of adult patients with intussusception have an underlying pathology that needs to be identified by performing a proper physical examination and a wide array of investigations. Case presentation We present a case of a 66-year-old African man who presented to our emergency department with a mass protruding per anus with obstipation. During laparotomy, we found that the sigmoid colon had intussuscepted into the rectum and out from the anus. Other abdominal viscera were normal and without any obvious mesenteric lymphadenopathy. Sigmoid colectomy and spectacle colostomy were performed. Grossly, the excised bowel looked normal, but the histologic results showed features of necrosis and chronic inflammation. Conclusion While 70% to 90% of cases of adult intussusception have an identifiable cause or lesion, most pediatric intussusceptions are idiopathic. The presentation in an adult described herein was of an uncommon idiopathic type with no identifiable cause found on the basis of the history, physical examination, or histological findings.

2011-01-01

175

Sigmoid CME Source Regions at the Sun: Some Recent Results  

NASA Technical Reports Server (NTRS)

Identifying Coronal Mass Ejection (CME) precursors in the solar corona would be an important step in space weather forecasting, as well as a vital key to understanding the physics of CMEs. Twisted magnetic field structures are suspected of being the source of at least some CMEs. These features can appear sigmoid (S or inverse-S) shaped in soft X-ray (SXR) images. We review recent observations of these structures and their relation to CMEs, using soft X-ray (SXR) data from the Soft X-ray Telescope (SXT) on the Yohkoh satellite, and EUV data from the EUV Imaging Telescope (EIT) on the SOHO satellite. These observations indicate that the pre-eruption sigmoid patterns are more prominent in SXRs than in EUV, and that sigmoid precursors are present in over 50% of CMEs. These findings are important for CME research, and may potentially be a major component to space weather forecasting. So far, however, the studies have been subject to restrictions that will have to be relaxed before sigmoid morphology can be used as a reliable predictive tool. Moreover, some CMEs do not display a SXR sigmoid structure prior to eruption, and some others show no prominent SXR signature of any kind before or during eruption.

Sterling, Alphonse C.; Rose, M. Franklin (Technical Monitor)

2000-01-01

176

Sigmoid CME Source Regions at The Sun: Some Recent Results  

NASA Technical Reports Server (NTRS)

Identifying coronal mass ejection (CME) precursors in the solar corona would be an important step in space weather forecasting, as well as a vital key to understanding the physics of CMEs. Twisted magnetic field structures are suspected of being the source of at least some CMEs. These features can appear sigmoid (S or inverse-S) shaped in soft X-ray, (SXR) images. We review recent observations of these structures and their relation to CMEs. using SXR data from the Soft X-ray Telescope (SXT) on the Yohkoh satellite, and EUV data from the EUV Imaging Telescope (EIT) on the SOHO satellite. These observations indicate that the pre-eruption sigmoid patterns are more prominent in SXRs than in EUV, and that sigmoid precursors are present in over 50% of CMEs. These findings are important for CME research, and may potentially be a major component to space weather forecasting. So far, however, the studies have been subject to restrictions that will have to be relaxed before sigmoid morphology can be used as a reliable predictive too[. Moreover, some CMEs do not display a SXR sigmoid structure prior to eruption, and some others show no prominent SXR signature of any kind before or during eruption.

Sterling, Alphonse C.

2000-01-01

177

Appropriate treatment of acute sigmoid volvulus in the emergency setting  

PubMed Central

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

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

2013-01-01

178

Synchronous adenocarcinoma and extranodal natural killer/T-cell lymphoma of the colon: a case report and literature review.  

PubMed

Extranodal natural killer/T-cell lymphoma (ENKTL) is a distinct subtype of non-Hodgkin's lymphoma and is rare in the colon. Synchronous adenocarcinoma and ENKTL of the colon has not been reported in the literature. In the present study, we report a 63-year-old male who suffered from intermittent bloody stools for 2 mo. He did not have fever, body weight loss or night sweat. Endoscopic and imaging studies revealed a 4.5-cm ulcerative mass in the ascending colon and a 3.0-cm polypoid, easy bleeding mass in the sigmoid colon, respectively. Thought to have double carcinoma of the colon, he received simultaneous right hemicolectomy and sigmoidectomy. The pathological diagnosis was a synchronous ENKTL (ascending colon) and adenocarcinoma (sigmoid colon). The literature on synchronous adenocarcinoma and malignant lymphoma of the colon was also reviewed. PMID:23555176

Tseng, Chih-En; Shu, Ta-Wen; Lin, Chih-Wen; Liao, Kai-Sheng

2013-03-21

179

Synchronous adenocarcinoma and extranodal natural killer/T-cell lymphoma of the colon: A case report and literature review  

PubMed Central

Extranodal natural killer/T-cell lymphoma (ENKTL) is a distinct subtype of non-Hodgkin’s lymphoma and is rare in the colon. Synchronous adenocarcinoma and ENKTL of the colon has not been reported in the literature. In the present study, we report a 63-year-old male who suffered from intermittent bloody stools for 2 mo. He did not have fever, body weight loss or night sweat. Endoscopic and imaging studies revealed a 4.5-cm ulcerative mass in the ascending colon and a 3.0-cm polypoid, easy bleeding mass in the sigmoid colon, respectively. Thought to have double carcinoma of the colon, he received simultaneous right hemicolectomy and sigmoidectomy. The pathological diagnosis was a synchronous ENKTL (ascending colon) and adenocarcinoma (sigmoid colon). The literature on synchronous adenocarcinoma and malignant lymphoma of the colon was also reviewed.

Tseng, Chih-En; Shu, Ta-Wen; Lin, Chih-Wen; Liao, Kai-Sheng

2013-01-01

180

Potential of short chain fatty acids to modulate the induction of DNA damage and changes in the intracellular calcium concentration by oxidative stress in isolated rat distal colon cells  

Microsoft Academic Search

and the calcium-sensitive fluorescent dye Fura-2. The mic- rogel electrophoresis technique (COMET assay) was used to assess oxidative DNA damage. Individual SCFA and physiological SCFA mixtures were investigated for their potential to prevent DNA and cell damage induced by H2O2. For this, freshly isolated colon cells were treated with H2O2 (100-500 mM) and 6.25 mM SCFA. We have found 100-500

S. L. Abrahamse; B. L. Pool-Zobel; G. Rechkemmer

1999-01-01

181

Extensive subcutaneous emphysema due to colonic perforation following colonoscopy.  

PubMed

During colonoscopy, subcutaneous emphysema may occur as a result of colonic perforation into retroperitoneal area. In this report, a 54-year-old woman with sigmoid colon perforation following colonoscopy is described. Subcutaneous emphysema was the first manifestation of the perforation in this case. Initially, the patient received supportive, non-surgical treatment, but due to development of acute abdominal signs and symptoms in later stages, the patient underwent surgical treatment. PMID:19486580

Fazeli, Mohammad Sadegh; Keramati, Mohammad Reza; Lebaschi, Amir Hossein; Bashashati, Mohammad

2009-06-01

182

Hinode/XRT Observations of a Coronal Sigmoid  

NASA Astrophysics Data System (ADS)

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

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

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

2007-05-01

183

Hinode Observations of an Eruption from a Sigmoidal Active Region  

NASA Astrophysics Data System (ADS)

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

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

2012-08-01

184

Absolute constipation caused by sigmoid volvulus in a young man.  

PubMed

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

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

2013-01-01

185

Estimation and classification by sigmoids based on mutual information  

NASA Technical Reports Server (NTRS)

An estimate of the probability density function of a random vector is obtained by maximizing the mutual information between the input and the output of a feedforward network of sigmoidal units with respect to the input weights. Classification problems can be solved by selecting the class associated with the maximal estimated density. Newton's s method, applied to an estimated density, yields a recursive maximum likelihood estimator, consisting of a single internal layer of sigmoids, for a random variable or a random sequence. Applications to the diamond classification and to the prediction of a sun-spot process are demonstrated.

Baram, Yoram

1994-01-01

186

Cancer of the colon and rectum in a Jamaican population: diagnostic implications of the changing frequency and subsite distribution.  

PubMed

The aim of this study was to examine the clinical and pathological characteristics of colorectal cancer in Jamaica, to determine whether there was a change in the anatomic distribution and clinical presentation and to discuss the options for diagnosis and management. A comprehensive retrospective review of patients newly diagnosed with colorectal carcinoma was conducted at The University Hospital of the West Indies by reviewing both patient records and pathological data. These data were compared with previous reports of patients with colorectal cancer seen in Jamaica. One hundred and forty-seven patients were studied There were 85 females and 62 males with a female to male ratio of 1.37:1. The median age was 65.5 years (range 19 to 94 years). The predominant symptoms were abdominal pain in 91 patients, change in bowel habit in 77 patients and rectal bleeding in 74 patients. Sixty patients presented with weight loss and 28 with a rectal mass. The most common tumours were right-sided colonic cancers in 42 patients (28.5%) followed by sigmoid colon in 30 (20.4%) rectum in 34 (23.1%) and left and transverse colon accounting for 16 and 10 cases respectively. Most of the tumours were well or moderately differentiated adenocarcinomas. Only eight patients presented with Dukes' A disease, 50 with Dukes'B, 53 with Dukes'C disease and 34 with advanced disease. The findings showed that sigmoid and rectal tumours accounted for 43.5% of cancers. The colon/rectum ratio in this series was 3.3:1 indicating a significant proximal shift of colorectal cancers in this population in keeping with recent reports. The results of the current study suggest that the sub-site location of colorectal cancers seen is similar to that reported in high incidence countries such as the United States of America and parts of Europe but differs from the African continent which has a high proportion of rectal tumours. This right-sided preponderance also differs from previous studies in Jamaica, which report a higher incidence of rectal lesions The detection of early colorectal carcinoma will require screening at a stage when the disease is asymptomatic in order to improve the chance for cure. The data presented here imply that screening programmes should allow evaluation of the entire colon rather than the distal 25 cm. PMID:15352746

McFarlane, M E C; Rhoden, A; Fletcher, P R; Carpenter, R

2004-06-01

187

Colon cancer  

MedlinePLUS

Colorectal cancer; Cancer - colon; Rectal cancer; Cancer - rectum; Adenocarcinoma - colon; Colon - adenocarcinoma ... Colorectal cancer is one of the leading causes of cancer-related deaths in the United States. Early diagnosis, ...

188

Biotin absorption by distal rat intestine  

SciTech Connect

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

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

1987-12-01

189

[A case of polypoid solitary colonic plasmocytoma].  

PubMed

One case of polypoid solitary plasmacytoma in the sigmoid colon of a 60 year-old woman is presented. Plasmacytomas are rarely observed in the gastrointestinal tract and are especially uncommon in the côlon. Eight cases were published since 1972. They show a mean age of 46.3 years, a sex-ratio of 1/1, varying revealing symptoms, and no preferential colonic location. Two differential diagnosis must be discussed: an inflammatory pseudotumor, and a multiple myeloma related tumor. Multiple myeloma must be ruled out by a complete radiographic and biological research. Surgery is the only therapy described and seems to be efficient. PMID:7916753

Wendum, D; Vissuzaine, C; Bellanger, J; Le Goff, J Y; Benhamou, G; Potet, F

1994-01-01

190

Universal approximation bounds for superpositions of a sigmoidal function  

Microsoft Academic Search

Approximation properties of a class of artificial neural networks are established. It is shown that feedforward networks with one layer of sigmoidal nonlinearities achieve integrated squared error of order O (1\\/n), where n is the number of nodes. The approximated function is assumed to have a bound on the first moment of the magnitude distribution of the Fourier transform. The

Andrew R. Barron

1993-01-01

191

The primary Sauve-Kapandji procedure--for treatment of comminuted distal radius and ulnar fractures.  

PubMed

We have performed primary Sauve-Kapandji procedures on four patients with severe open comminuted fractures of both the distal radius and ulna. The fragmented distal ulna was fixed to the sigmoid notch in order to stabilize the ulnar side of the carpus, and a proximal pseudoarthrosis was maintained for forearm rotation. All the distal radial fractures united without major complications. The mean wrist flexion/extension arc was 76 degrees , the mean pronation/supination arc was 135 degrees, and grip strength was 64% of the contralateral side. All patients returned to their work or daily activities within short time period without any additional surgical treatment, except for removal of implants in three patients. The primary Sauve-Kapandji procedure is effective for the reconstruction of severely combined distal radius and ulnar fractures. PMID:15620494

Horii, E; Ohmachi, T; Nakamura, R

2005-02-01

192

Colon cancer  

Microsoft Academic Search

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

Edward Kassira; Linda Parent; George Vahouny

1976-01-01

193

Magnetohydrodynamic Simulation of a Sigmoid Eruption of Active Region 11283  

NASA Astrophysics Data System (ADS)

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

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

2013-07-01

194

MAGNETOHYDRODYNAMIC SIMULATION OF A SIGMOID ERUPTION OF ACTIVE REGION 11283  

SciTech Connect

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

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

2013-07-10

195

Idiopathic non-familial rectal and colonic varices requiring sigmoidorectal resection and coloanal anastomosis.  

PubMed

A 32-year-old male patient presenting with huge varices involving the sigmoid colon and the entire rectum down to the dentate line is described. There was no familial history of gastrointestinal bleeding. No particular aetiology was identified. Marked anaemia due to recurrent bleeding required resection of the sigmoid colon and rectum. Restoration of the intestinal continuity was performed by a coloanal anastomosis. The patient did well and bleeding has not recurred. To our knowledge, no similar case of such varices requiring extensive rectal surgery to control bleeding has been described in the literature. PMID:8930572

Detry, R J; Kartheuser, A; Moisse, R; Ramdani, B; Wery, D; Lagneau, G; Hoang, P

1996-10-01

196

Cellular Schwannoma Arising from Sigmoid Mesocolon Presenting as Torsion  

PubMed Central

Schwannomas are a type of peripheral nerve sheath tumors with clinically indolent behavior. Though, they can occur anywhere in body, the incidence in retroperitoneum, mediastinum, and pelvis is exceedingly rare. We present a case of a 58-year-old female with a massive twisted tumor arising from sigmoid mesocolon. The tumor was diagnosed to be a case of cellular schwannoma, an exceedingly rare tumor in this location with rare presentation.

Adlekha, S; Chadha, T

2013-01-01

197

On the Circuit Complexity of Sigmoid Feedforward Neural Networks.  

PubMed

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

Taylor, John G.; Beiu, Valeriu

1996-10-01

198

Intrapulmonary Solitary Fibrous Tumor Masquerade Sigmoid Adenocarcinoma Metastasis  

PubMed Central

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

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

2013-01-01

199

Segmentation algorithm of colon based on multi-slice CT colonography  

NASA Astrophysics Data System (ADS)

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

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

2012-02-01

200

Distal tibiofibular radiological overlap  

PubMed Central

Objectives Overlap between the distal tibia and fibula has always been quoted to be positive. If the value is not positive then an injury to the syndesmosis is thought to exist. Our null hypothesis is that it is a normal variant in the adult population. Methods We looked at axial CT scans of the ankle in 325 patients for the presence of overlap between the distal tibia and fibula. Where we thought this was possible we reconstructed the images to represent a plain film radiograph which we were able to rotate and view in multiple planes to confirm the assessment. Results The scans were taken for reasons other than pathology of the ankle. We found there was no overlap in four patients. These patients were then questioned about previous injury, trauma, surgery or pain, in order to exclude underlying pathology. Conclusion We concluded that no overlap between the tibia and fibula may exist in the population, albeit in a very small proportion.

Sowman, B.; Radic, R.; Kuster, M.; Yates, P.; Breidiel, B.; Karamfilef, S.

2012-01-01

201

Distal biceps tendon rupture  

Microsoft Academic Search

The authors report a rupture of the distal tendon of biceps brachii in a 42-year-old athlete. Magnetic resonance imaging confirmed the injury. Early surgical repair was performed by reinsertion of the tendon on the radial tuberosity according to modified Boyd-Anderson technique. Indomethacin was administered prophylactically. No complications were noted. At the latest follow-up, the patient had full elbow range of

Olga D. Savvidou; Panayiotis J. Papagelopoulos; Andreas F. Mavrogenis; Antonios A. Partsinevelos; Evangelos J. Karadimas; Demetrios S. Korres

2004-01-01

202

Colon Cancer  

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... blood in the stools. A routine and simple test is now available to detect blood in the ... of the colon called the ascending colon. This test is more thorough than a sigmoidoscopy. Depending on ...

203

Colonic Diseases  

MedlinePLUS

Your colon, also known as the large intestine, is part of your digestive system. It's a long, hollow tube ... makes and stores stool. Many disorders affect the colon's ability to work properly. Some of these include ...

204

Colonic Polyps  

MedlinePLUS

... piece of tissue that grows inside your body. Colonic polyps grow in the large intestine, or colon. Most polyps are not dangerous. However, some polyps may turn into cancer or already be cancer. To be safe, doctors ...

205

Effects of lactulose and other laxatives on ileal and colonic pH as measured by a radiotelemetry device  

Microsoft Academic Search

Using a pH-sensitive radiotelemetering device the effect of lactulose on luminal pH in the ileum, colon, and rectum has been compared with that of two other laxative agents.Lactulose produced marked acidification of proximal colonic contents but this effect was not consistently maintained into the distal colon. Sodium sulphate acidified distal rather than proximal colonic contents. However, for a similar degree

R. L. Bown; J. A. Gibson; G. E. Sladen; B. Hicks; A. M. Dawson

1974-01-01

206

Contracting and Erupting Components of Sigmoidal Active Regions  

NASA Astrophysics Data System (ADS)

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.

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

2012-10-01

207

FIELD TOPOLOGY ANALYSIS OF A LONG-LASTING CORONAL SIGMOID  

SciTech Connect

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

Savcheva, A. S. [Astronomy Department, Boston University, 725 Commonwealth Avenue, Boston, MA 02215 (United States); Van Ballegooijen, A. A.; DeLuca, E. E., E-mail: savcheva@bu.edu [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States)

2012-01-01

208

Pylephlebitis of a variant mesenteric vein complicating sigmoid diverticulitis  

PubMed Central

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

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

2014-01-01

209

Field Topology Analysis of a Long-lasting Coronal Sigmoid  

NASA Astrophysics Data System (ADS)

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

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

2012-01-01

210

Atomic bomb survivors and the sigmoidal response model  

SciTech Connect

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

Kondo, S. [Kinki Univ. (Japan)

1994-12-31

211

Familial distal dysautonomia.  

PubMed Central

A patient is described who presented with painful feet on exercise. He had no evidence of peripheral vascular disease but did have anhidrosis and failure of vasodilatation in the hands and feet suggesting peripheral dysautonomia. Examination of his mother and a cousin and clinical histories of blood relatives suggested that his problem was a severe presentation of a familial distal dysautonomia. In other family members this was represented by dry hands and feet and variable vasomotor symptoms. This condition appeared to be autosomal dominant.

Robinson, B; Johnson, R; Abernethy, D; Holloway, L

1989-01-01

212

Distal radius fractures.  

PubMed

Distal radius fractures are a common injury, particularly in the elderly population. Severity of these fractures is directly related to the bone mineral density of the patient, and clinical results are dependent on this parameter as well. In terms of treatment, several options exist. Nonoperative management consists of closed treatment with casting. Operative treatment options include intrafocal pinning, nonbridging and bridging external fixation, arthroscopic-assisted external fixation, and various methods of open reduction internal fixation. When operative intervention is indicated, considerations include the characteristics of the fracture and the experience of the surgeon with the treatment modalities. PMID:19858984

Liporace, Frank A; Adams, Mark R; Capo, John T; Koval, Kenneth J

2009-01-01

213

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

PubMed Central

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.

2014-01-01

214

Radionuclide measurement of colon transit in man  

SciTech Connect

Scintigraphy was used to measure colonic transit in 10 normal subjects. Following 3 days of a fixed diet, an oral catheter was advanced to the cecum under fluoroscopic control and 50 ..mu..Ci of In-111 DTPA in 8 ml of electrolyte was injected as a bolus. Movement of the cecal instrillate was monitored with a large field of view camera and computer for 48 hours. Initial cecal-ascending colon emptying was exponential. Ninety percent of the bolus had emptied at 194 +- 26 min. Dividing the colon into seven regions: cecum (1), hepatic flexure (2), transverse colon (3), splentic flexure (4), descending colon (5), signoid colon and rectum (6), excreted feces (7) the mean percent of the instillate with time at each location was calculated. Antegrade and retrograde movement of the colonic contents was documented. The results show that emptying of the proximal colon is exponential and the distal colon is linear. The authors conclude that colonic scintigraphy can be used to quantify regional colonic motility.

Maurer, A.H.; Krevsky, B.; Siegel, J.A.; D'Ercole, F.; Fisher, R.S.; Malmud, L.S.

1985-05-01

215

Plasma Composition in a Sigmoidal Anemone Active Region  

NASA Astrophysics Data System (ADS)

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

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

2013-11-01

216

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

PubMed Central

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

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

2014-01-01

217

Spontaneous colon perforations associated with a vascular type of ehlers-danlos syndrome.  

PubMed

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

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

2014-05-01

218

Colonic motility abnormality in patients with irritable bowel syndrome exhibiting abdominal pain and diarrhea  

Microsoft Academic Search

OBJECTIVES:Although colon dysmotility is recognized as a pathophysiological factor in irritable bowel syndrome (IBS), it has not been characterized. We have investigated motility patterns in IBS patients with abdominal pain and frequent defecation or diarrhea and in healthy volunteers.METHODS:A recording catheter that had six polyvinyl tubes with infusion ports was placed in the transverse, descending, and sigmoid colon under fluoroscopy.

William Y. Chey; Hai Ou Jin; Mun Ho Lee; Sung Wu Sun; Kae Yol Lee

2001-01-01

219

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

PubMed

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

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

1997-01-01

220

Deviation Theorems For Solutions Of Linear Ordinary Differential Equations And Applications To Parallel Complexity Of Sigmoids  

Microsoft Academic Search

. By a sigmoid with a depth d we mean a computational circuit with d layers in which rationaloperations are admitted at each layer, and to jump to the next layer the substitution of a functioncomputed at the previous layer into an arbitrary real solution of a linear ordinary differential equation withthe polynomial coefficients is admitted. Sigmoids appear as a

D. Yu. Grigoriev

221

Emergency resection and primary anastomosis for sigmoid volvulus in an African population  

Microsoft Academic Search

We report 30 patients who underwent operation for sigmoid volvulus during a two year period at the St. Francis Hospital, Tanzania. Five patients were managed initially by non-operative reduction. They all underwent elective resection of the sigmoid during the same hospitalisation with one operative death. Twnety-five patients underwent emergency laparotomy, 12 of them having gangrenous bowel. Resection was carried out

A. Keller; P. Aeberhard

1990-01-01

222

Function estimation by feedforward sigmoidal networks with bounded weights  

SciTech Connect

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.

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

223

Perforated Sigmoid Diverticulitis in the Presence of Toxic Epidermal Necrolysis  

PubMed Central

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

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

2014-01-01

224

Laparoscopic right hemicolectomy for ascending colon cancer with persistent mesocolon  

PubMed Central

Persistent ascending or descending mesocolon is an embryological anomaly that occurs during the final process of intestinal development in organogenesis. Specifically, the primitive dorsal mesocolon fails to fuse with the parietal peritoneum in the fifth month of gestation. Herein, we describe a case of ascending colon cancer with persistent ascending and descending mesocolon treated by laparoscopic right hemicolectomy. Preoperative computed tomography imaging of the abdomen demonstrated that the descending colon shifted at the midline of the abdomen and the sigmoid colon was located under the ascending colon. The detailed preoperative imaging examination revealed malpositioning of the large intestine and aided in the procedural planning. Because persistent mesocolon may result in the formation of abnormal adhesions, an accurate preoperative diagnosis is essential. We propose that it is important to consider this anomaly when making the preoperative imaging diagnosis to ensure a safe operation.

Tsuruta, Atsushi; Kawai, Akimasa; Oka, Yasuo; Okumura, Hideo; Matsumoto, Hideo; Hirai, Toshihiro; Nakamura, Masafumi

2014-01-01

225

Pneumomediastinum caused by colonic diverticulitis perforation  

PubMed Central

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

2011-01-01

226

Colon Adenocarcinoma  

MedlinePLUS

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

227

ALTERATIONS IN MUCOSAL IMMUNITY IDENTIFIED IN THE COLON OF PATIENTS WITH IRRITABLE BOWEL SYNDROME  

PubMed Central

BACKGROUND & AIMS Irritable bowel syndrome (IBS) has been associated with mucosal dysfunction,, mild inflammation, and altered colonic bacteria. We used microarray expression profiling of sigmoid colon mucosa to assess whether there are stably expressed sets of genes that suggest there are objective molecular biomarkers associated with IBS. METHODS Gene expression profiling was performed using Affymetrix GeneChips with RNA from sigmoid colon mucosal biopsies from 36 IBS patients and 25 healthy control subjects. RTQ-PCR was used to confirm the data in 12 genes of interest. Statistical methods for microarray data were applied to search for differentially expressed genes, and to assess the stability of molecular signatures in IBS patients. RESULTS Mucosal gene expression profiles were consistent across different sites within the sigmoid colon and were stable on repeat biopsy over ~3 months. Differentially expressed genes suggest functional alterations of several components of the host mucosal immune response to microbial pathogens. The most strikingly increased expression involved a yet uncharacterized gene, DKFZP564O0823. Identified specific genes suggest the hypothesis that molecular signatures may enable distinction of a subset of IBS patients from healthy controls. Using 75% of the biopsies as a validation set to develop a gene profile, the test set (25%) was correctly predicted with ~70% accuracy. CONCLUSIONS Mucosal gene expression analysis shows there are relatively stable alterations in colonic mucosal immunity in IBS. These molecular alterations provide the basis to test the hypothesis that objective biomarkers may be identified in IBS and enhance understanding of the disease.

Aerssens, Jeroen; Camilleri, Michael; Talloen, Willem; Thielemans, Leen; Gohlmann, Hinrich W. H.; Wyngaert, Ilse Van den; Thielemans, Theo; de Hoogt, Ronald; Andrews, Christopher N.; Bharucha, Adil E.; Carlson, Paula J.; Busciglio, Irene; Burton, Duane D.; Smyrk, Thomas; Urrutia, Raul; Coulie, Bernard

2008-01-01

228

Endoscopic measurements of canine colonic mucosal blood flow using hydrogen gas clearance  

SciTech Connect

We have examined the feasibility of hydrogen (H/sub 2/) clearance for endoscopic measurements of colonic mucosal blood flow in anesthetized dogs. In 6 animals, measurements of H2 clearance did not differ significantly in different regions of the sigmoid colon and they were highly reproducible on different days. In a total of 12 dogs, measurements of H2 clearance correlated closely with those obtained using radioactive microspheres under resting conditions and, in 4 dogs, during infusion of vasopressin. In 8 dogs, ligation of the major arteries supplying the sigmoid colon resulted in an acute 60% decrease in sigmoid mucosal blood flow; however, in 5 animals that survived the procedure, mucosal blood flow returned nearly to control levels as early as 3 days after operation. Endoscopic H/sub 2/ clearance thus appears to be feasible for measuring mucosal blood flow in the colon. Serial measurements of H/sub 2/ clearance may prove useful in characterizing the role of mucosal blood flow in the pathogenesis of various forms of human colonic disease.

Soybel, D.I.; Wan, Y.L.; Ashley, S.W.; Yan, Z.Y.; Ordway, F.S.; Cheung, L.Y.

1987-04-01

229

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

PubMed

A 15-year-old girl who had chronic constipation presented with peritonitis caused by sigmoid colon perforation. After her sigmoid colon was resected and an end colostomy performed, as there were no apparent causes for perforation, she was followed-up. After the second colonic perforation proximal to the end colostomy, as the pathologic findings revealed myopathic changes, the connective tissue disorders were evaluated. Her molecular biology studies revealed an undefined missense mutation in the COL3A1 gene, confirming the diagnosis of vascular Ehlers-Danlos syndrome (EDS). As she refused a permanent stoma, total colectomy and ileorectal anastomosis were performed, but the postoperative complications resulted in a fatal progression. The typical progression of vascular EDS will be discussed with the presented case by means of a review of the English medical literature on children diagnosed with vascular EDS. PMID:16863833

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

2006-08-01

230

Imaging of the Distal Airways  

PubMed Central

Imaging techniques of the lung continues to advance with improving ability to image the more distal airways. Two imaging techniques are reviewed, computerized tomography and magnetic resonance with hyperpolarized helium-3.

Tashkin, Donald P.; de Lange, Eduard E.

2009-01-01

231

Chronic Constipation in the Elderly: An Unusual Presentation of Colonic Dysmotility in an Elderly Patient  

PubMed Central

Introduction. Chronic constipation is common in the elderly, and often no underlying pathology is found. Primary colonic dysmotility has been described in children but is rare in the elderly. Case report. We present an 82-year-old female with long standing constipation presenting acutely with large bowel obstruction. Laparotomy and Hartman's procedure was performed, and a grossly distended sigmoid colon was resected. Histology revealed a primary myopathic process. Conclusion. Primary colonic myopathy should be considered in elderly patients presenting with large bowel obstruction and a long preceding history of constipation, particularly when previous endoscopic examinations were normal.

Peravali, R.; Kranenburg, H.; Martin, J. E.; Keeling, N.

2013-01-01

232

Two episodes of cytomegalovirus-associated colon perforation after heart transplantation with successful result.  

PubMed

A patient with end-stage heart disease was discharged from the hospital on postoperative day 7 after orthotopic heart transplantation. Three weeks from the day of operation, he developed sigmoid colon perforation, which required Hartmann's procedure, and 2 weeks later he had cecal disruption. A pathologic specimen showed underlying diverticular disease with associated cytomegalovirus colitis. Subsequently, the patient had multiple complications. Three months after colon perforation, the patient left the hospital, and now 1 year after transplantation he continues to do well. To the best of our knowledge, this is the first reported case of a patient who survived multiple colon perforations soon after heart transplantation. PMID:2848938

Gangahar, D M; Liggett, S P; Casey, J; Carveth, S W; Reese, H E; Buchman, R J; Breiner, M A

1988-01-01

233

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

PubMed

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

Burgold, Steffen; Filser, Severin; Dorostkar, Mario M; Schmidt, Boris; Herms, Jochen

2014-01-01

234

Periodic solutions of gene networks with steep sigmoidal regulatory functions  

NASA Astrophysics Data System (ADS)

We address the question of existence and stability of periodic solutions in gene regulatory networks. The threshold-dependent network dynamics divides the phase space into domains and a qualitative description can be derived, specifying which transitions between domains can occur. Any periodic solution must follow a cyclic sequence of domains, but the problem of determining when such a cyclic sequence of domains contains a periodic solution, and when it is stable, has not been completely resolved, though results have been obtained before for restricted classes of networks. Here, we develop a method by which existence or non-existence of such solutions can be demonstrated analytically in any given example of a general class of gene networks with steep sigmoidal interactions, under the assumption that any gene product that regulates multiple other genes does so at distinct thresholds. Our method determines qualitative stability, but we also give a procedure that, where applicable, allows determination of quantitative stability of a periodic solution. This complements the previous development of a local analysis method for this class of systems, which allows computation of trajectories through any sequence of domains. Together the previous and current work form the basis for rigorous computer-aided assessment of qualitative dynamics of a very general class of gene network models. The ability to handle periodic solutions will also increase the applicability of such a computational tool to the design of synthetic networks.

Edwards, Roderick; Ironi, Liliana

2014-07-01

235

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

PubMed Central

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

2014-01-01

236

[The surgical case of a 34-year-old female patient with a metastatizing double colon tumor with different hystological structure, causing mechanical obstruction].  

PubMed

We would like to present the case of a young woman (age 34) who was admitted to our department due to unbearable colicky pain, which started one week prior to her hospitalization. Examinations revealed mechanical obstruction, which is very unusual in her age without surgical history. During emergency surgery, we found descending colon tumour which was invading the abdominal wall with pelvic carcinomatosis at the border of the sigmoid colon. Due to extreme colonic dilation and impending rupture of the colonic serosa, we performed a subtotal colectomy with ileosigmoid anastomosis. In addition, pelvic peritonectomy was carried out, too. The histopathological examination of the resected part demonstrated adenocarcinoma of the descending-sigmoid colon, as well as another - histologically different - tumour (a well-differentiated neuroendocrine carcinoma [NEC]), which would not have been discovered, because it was invisible and impalpable. However, this latter tumour was responsible for the peritoneal metastases. PMID:24747403

Bartók, Ádám; Banai, Zoltán; Berczi, Lajos

2014-04-01

237

Flat and sigmoidally curved contact zones in vesicle-vesicle adhesion  

PubMed Central

Using the membrane-bending elasticity theory and a simple effective model of adhesion, we study the morphology of lipid vesicle doublets. In the weak adhesion regime, we find flat-contact axisymmetric doublets, whereas at large adhesion strengths, the vesicle aggregates are nonaxisymmetric and characterized by a sigmoidally curved, S-shaped contact zone with a single invagination and a complementary evagination on each vesicle. The sigmoid-contact doublets agree very well with the experimentally observed shapes of erythrocyte aggregates. Our results show that in identical vesicles with large to moderate surface-to-volume ratio, the sigmoid-contact shape is the only bound morphology. We also discuss the role of sigmoid contacts in the formation of multicellular aggregates such as erythrocyte rouleaux.

Ziherl, P.; Svetina, S.

2007-01-01

238

Prolapsed giant sigmoid lipoma: a rare cause of adult ischaemic intussusception.  

PubMed

Intussusception is a rare cause of obstruction in adults and has a variable, non-specific presentation. Adult intussusception is usually associated with an underlying organic pathology, such as a benign or malignant tumour which acts as the lead point. Prolapse of the lead-point mass through the anal canal is an extremely rare presentation with very few reported cases in the literature. We describe a case of a 67-year-old man who presented with rectal prolapse of a large soft tissue mass. CT of the abdomen and barium enema revealed partial intussusception of an upper sigmoid lipomatous polyp. Examination under anaesthesia was performed and the prolapse reduced. A laparoscopic sigmoid colectomy was planned. The patient subsequently re-presented clinically unwell with a recurrent necrotic prolapsing mass. Laparotomy and sigmoid colectomy was performed and the patient recovered fully. The resected mass was a 7×4.5×4.0?cm necrotic sigmoid lipoma. PMID:24855078

Elliott, Mark; Martin, Jennifer; Mullan, Fred

2014-01-01

239

[Colonic diverticulosis and its complications: pathogenesis, classification and clinical implications].  

PubMed

Current understanding of the pathogenesis of colonic diverticulosis and its complications has certain implications for current therapy concepts, which are summarised here. Colonic diverticula in the Western world are pseudodiverticula predominating in the sigmoid colon. Pathogenesis is multifactorial and includes low-fibre diet, dysmotility, increased intraluminal pressure and morphological changes. Uncomplicated diverticulitis results from microperforations, contradicting the hypothesis of the "abscessed diverticulum". Administration of antibiotics for treatment is controversial. Complicated sigmoid diverticulitis is characterised by an intensive inflammatory infiltrate with macrophages. Immunosuppression and especially steroid intake are identified as risk factors. Nowadays, elective or emergency resection is generally recommended as therapy of first choice. However, contrary concepts with merely conservative treatment or drainage--even for perforated diverticulitis--are emerging. The pathogenesis of chronically recurrent diverticulitis is poorly understood and concepts are changing. Resection after the second episode is replaced by a risk-adapted strategy. Diverticular bleeding occurs due to rupture of a vas rectum at the fundus of the diverticulum. Conservative and endoscopic management is the first line and surgical resection plays a role as salvage-strategy in case of recurrent and life-threatening bleeding. Localising the bleeding, i.e., with angiography, is crucial prior to surgery. The pathophysiology of colonic diverticulosis is complex and incompletely understood and linked with several controversial issues, regarding treatment strategies. PMID:23824623

von Rahden, B H A; Germer, C-T

2013-12-01

240

Colonic interposition.  

PubMed

Intrathoracic colonic interposition in children with esophageal atresia has been used for the past 36 years. The preferred routes have been via the left pleural cavity and retrosternally. Over the past 13 years the author has developed a method using the posterior mediastinum (normal esophageal route) for the colonic interposition. An analysis of 19 personal cases using this method is presented. A further nine cases using either the retrosternal or the Waterston routes and six cases using a modified neonatal operation are included. The evolution of the method currently used by the author is traced. Major problems remain, and further modifications relating to the optimal timing for the colonic interposition, length of colon graft, and sitting of the lower cologastric anastomosis continue to be tried and are discussed. The function of the graft has been studied with ten patients using 99Tc-labeled milk. The results of this study (unpublished) are presented. Gravity is shown to be the major factor influencing the onward passage of milk and food between the colon and stomach. PMID:3081963

Freeman, N V

1986-01-01

241

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

NASA Astrophysics Data System (ADS)

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

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

2009-02-01

242

Pictorial review: Subperitoneal spaces of the broad ligament and sigmoid mesocolon--imaging findings.  

PubMed

In this report, we illustrate the imaging findings of diseases in the subperitoneal space of the broad ligament and sigmoid mesocolon and discuss the pathways of subperitoneal spread of disease. The subperitoneal space of the broad ligament and sigmoid mesocolon is continuous with that of the parietal peritoneum overlying the pelvic wall. Extraperitoneal diseases originating in the pelvis can extend, via the abdominopelvic vasculature or fascial-defined compartment, superiorly into the retroperitoneal compartments of the abdomen. PMID:9867270

Hashimoto, M; Okane, K; Hirano, H; Watarai, J

1998-12-01

243

Laparoscopic sigmoid vaginoplasty in women with Mayer-Rokitansky-Kuster-Hauser syndrome  

Microsoft Academic Search

The feasibility and clinical therapeutic effects of laparoscopic sigmoid vaginoplasty in women with Mayer-Rokitansky-Kuster-Hauser\\u000a syndrome (MRKHs) were explored. The records of 11 MRKHs patients who underwent laparoscopic sigmoid vaginoplasty from 2003\\u000a to 2005 were reviewed, and long-term results were evaluated by follow-up. The mean operating time was 234 min (range, 130–300\\u000a min), the mean hospital stay was 9.4 days (range,

Yi Shen; Guobin Wang; Zhoufang Xiong; Kaixiong Tao; Zehua Wang

2009-01-01

244

Successful Endovascular Treatment of Pulsatile Tinnitus Caused by a Sigmoid Sinus Aneurysm  

PubMed Central

Summary We describe the case of a 48-year-old woman who presented with a sigmoid sinus aneurysm. These rare entities have only recently been described in the literature and the ideal treatment approach has not been elucidated. This report represents additional evidence in a growing body of literature that suggests that endovascular therapy is a safe and effective therapeutic alternative to surgical reconstruction of the sigmoid sinus in selected cases of intractable pulsatile tinnitus.

Gard, A.P.; Klopper, H.B.; Thorell, W.E.

2009-01-01

245

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

NASA Astrophysics Data System (ADS)

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

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

2010-05-01

246

Therapeutical options in sigmoid diverticulitis. When should we operate?  

PubMed

Colonic diverticulosis is a benign disease whose incidence has been steadily increasing throughout the world, especially in the economically developed countries in Western Europe. This increase is connected to the population ageing process, the diverticulosis being characteristic in the elderly, and with nowadays' eating habits. Frequently, colonic diverticuli may cause complications, such as hemorrhage or diverticulitis, with pericolic abscesses or peritonitis. Consequently, efforts are being made to set up a therapeutic algorithm appropriate for the diverticular disease, the predominance of the conservative or surgical attitude being continuously adjusted. We have analyzed the therapeutic options, their advantages and their limitations, based on both the experience of the "Prof. I. Juvara" Surgical Department of the "Dr. I. Cantacuzino" Clinical Hospital and the latest data in medical literature. PMID:23294948

P?tra?cu, Tr; Doran, H; Catrina, E; Mihalache, O

2012-01-01

247

[Sigmoid diverticulitis. Extent of resection and choice of procedure].  

PubMed

Diverticular disease of the colon ranks in prevalence equal to diabetes or coronary heart disease. Surgical treatment of colonic diverticulitis is in general very successful. Therapeutic options have broadened in recent years: while improved diagnostic modalities allow a pre-surgical containment of the disease process by percutaneous techniques, minimally-invasive surgical procedures can replace conventional surgery in many cases without a change in the risk of complications. However, there is no proof of a general superiority of the laparoscopic approach. Surgical morbidity and mortality mainly derives from perforations with diffuse peritonitis. As a rule, these cases should be treated by a Hartmann procedure. In selected cases it is also possible to perform a primary anastomosis. This decision should be guided by well-known scoring systems. PMID:12242977

Kasperk, R; Müller, S A; Schumpelick, V

2002-07-01

248

Learning about Colon Cancer  

MedlinePLUS

... Interim Follow-Up . . . 1997 News Release Learning About Colon Cancer What do we know about heredity and colon ... Cancer What do we know about heredity and colon cancer? Colon cancer, a malignant tumor of the large ...

249

Colonic myoelectrical activity in IBS painless diarrhoea.  

PubMed Central

Colonic myoelectrical activity was recorded during 24 hours in 23 patients with painless diarrhoea and compared with a control group of 10 healthy subjects without digestive functional disorders. Diurnal fasting activity showed no significant difference in the total long spike bursts activity (LSB lasting greater than 7 seconds), but short spike bursts activity (SSB, lasting less than 7 seconds) was significantly lower (p less than 0.05) in diarrhoeal patients. A striking difference was observed in colonic response to eating, with an increased number of migrating long spike bursts (MLSB: mass movements) during the first postprandial hour in diarrhoeal patients (p less than 0.001), while short spike bursts (segmental activity) were almost absent in the rectosigmoid area. A marked decrease in the retrograde LSB activity was also observed in eight patients. During the night (from 2200 h to 0600 h) the number of migrating long spike bursts was increased in the diarrhoea group, but almost absent in controls (p less than 0.001). This study shows that colonic motor activity was altered in painless diarrhoea. These disturbances were not limited to the decreased SSB activity in the sigmoid, but involved the whole colon, with lower SSB activity and abnormal increase of migrating long spike bursts activity (MLSB) in postprandial and nocturnal periods.

Frexinos, J; Fioramonti, J; Bueno, L

1987-01-01

250

Sigmoidal equilibria and eruptive instabilities in laboratory magnetic flux ropes  

NASA Astrophysics Data System (ADS)

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

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

2013-12-01

251

Structural and functional differences in various divisions of the rabbit colon  

Microsoft Academic Search

The rabbit colon displays a diversity of form and function along its proximo-distal axis. Morphologically, four regions can be discerned based on macroscopic and microscopic criteria: 1) the initial portion of the colon immediately distal to the cecum (P1), in which wart-like protrusions characterize the surface topography, is 10cm in length and endowed with three teniae. 2) The adjoining portion

R. L. Snipes; W. Clauss; A. Weber; H. Hörnicke

1982-01-01

252

Space colonization.  

PubMed

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

2002-12-01

253

Mechanical properties of the colon: comparison of the features of the African and European colon in vitro.  

PubMed Central

The tensile properties of the colon have been examined using methods which gave repeatable results. They showed little change after storage in salt for up to five weeks. The burst strength remained unchanged along the length of the colon. The tensile strength fell distally, as the thickness of the colonic wall increased. The width at burst decreased distally as did the internal diameter. The visco-elastic property of stress relaxation was constant in all regions. The tensile property of the colon was well developed at birth, but fell with age as did the width at burst and the internal diameter. Stress relaxation was unaffected. Because there may be a mechanical abnormality of the colonic wall in diverticular disease and as Europeans are prone to this condition while Africans are not commonly affected, European and African colons were compared. The tensile strength in a Kampala group was greater than in an Edinburgh one, but fell significantly in both groups with age. The width at burst was greater in the Kampala group, but also declined with age. Stress-relaxation was similar in both groups. In view of the similar properties in childhood of colons from Edinburgh and Kampala, the strength of the adult African compared with European colons may derive later from environmental factors such as diet. There were, however, no differences between the colons with and without diverticular disease in European subjects over the age of 50 years.

Watters, D A; Smith, A N; Eastwood, M A; Anderson, K C; Elton, R A; Mugerwa, J W

1985-01-01

254

Colonic stenosis caused by infection of an intraperitoneal access port system: a rare complication of intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis  

PubMed Central

Background Intraperitoneal (IP) chemotherapy is garnering attention as an effective treatment for gastric cancer with peritoneal metastasis. We report the case of a patient who developed colonic stenosis caused by infection of an IP access port system during IP chemotherapy. It was difficult to differentiate whether the extrinsic colonic stenosis arose from a catheter infection or peritoneal metastasis of the gastric cancer. Case presentation A 66-year-old Japanese man underwent total gastrectomy for gastric cancer. Because the intraoperative findings revealed peritoneal metastasis, a port system was implanted for subsequent IP chemotherapy. Two months after initiation of chemotherapy, he complained of vomiting and abdominal pain. A computed tomography scan revealed marked thickening of the sigmoid colon wall adjacent to the catheter of the IP access port system. A barium enema demonstrated extrinsic irregular stenosis of the sigmoid colon. Although it was difficult to distinguish whether infection or peritoneal metastasis had caused the colonic stenosis, we removed the port system to obtain a therapeutic diagnosis. Coagulase-negative staphylococci were detected by catheter culture. The wall thickening and stenosis of the sigmoid colon completely resolved after removal of the port system. Conclusions We report the case of a rare complication in association with an IP access port system. Infection of the port system should be considered as a differential diagnosis when colonic stenosis adjacent to the catheter is observed during IP chemotherapy.

2014-01-01

255

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

PubMed

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

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

2014-04-01

256

A case of perforated sigmoid diverticulitis in which gram staining of ascitic fluid was useful for diagnosis.  

PubMed

An 85-year-old woman was admitted to our hospital for steroid therapy for relapsing nephrotic syndrome. During hospitalization, she complained of sudden epigastric pain at night. Although there were signs of peritoneal irritation, CT showed a large amount of ascitic fluid, but no free intraperitoneal gas. Gram staining of ascitic fluid obtained by abdominal paracentesis showed Gram-negative rods, which raised a strong suspicion of gastrointestinal perforation and peritonitis. Therefore, emergency surgery was performed. Exploration of the colon showed multiple sigmoid diverticula, one of which was perforated. The patient underwent an emergency Hartmann's procedure. Imaging studies failed to reveal any evidence of gastrointestinal perforation, presenting a diagnostic challenge. However, a physician performed rapid Gram staining of ascitic fluid at night when laboratory technicians were absent, had a strong suspicion of gastrointestinal perforation, and performed emergency surgery. Gram staining is superior in rapidity, and ascitic fluid Gram staining can aid in diagnosis, suggesting that it should be actively performed. We report this case, with a review of the literature on the significance of rapid diagnosis by Gram staining. PMID:24716075

Tsuchida, Junko; Fujita, Shouhei; Kawano, Fumihiro; Tsukamoto, Ryoichi; Honjo, Kunpei; Naito, Shigetoshi; Ishiyama, Shun; Miyano, Shozo; Machida, Michio; Kitabatake, Toshiaki; Fujisawa, Minoru; Kojima, Kuniaki; Ogura, Kanako; Matsumoto, Toshiharu

2014-01-01

257

A Case of Perforated Sigmoid Diverticulitis in Which Gram Staining of Ascitic Fluid Was Useful for Diagnosis  

PubMed Central

An 85-year-old woman was admitted to our hospital for steroid therapy for relapsing nephrotic syndrome. During hospitalization, she complained of sudden epigastric pain at night. Although there were signs of peritoneal irritation, CT showed a large amount of ascitic fluid, but no free intraperitoneal gas. Gram staining of ascitic fluid obtained by abdominal paracentesis showed Gram-negative rods, which raised a strong suspicion of gastrointestinal perforation and peritonitis. Therefore, emergency surgery was performed. Exploration of the colon showed multiple sigmoid diverticula, one of which was perforated. The patient underwent an emergency Hartmann's procedure. Imaging studies failed to reveal any evidence of gastrointestinal perforation, presenting a diagnostic challenge. However, a physician performed rapid Gram staining of ascitic fluid at night when laboratory technicians were absent, had a strong suspicion of gastrointestinal perforation, and performed emergency surgery. Gram staining is superior in rapidity, and ascitic fluid Gram staining can aid in diagnosis, suggesting that it should be actively performed. We report this case, with a review of the literature on the significance of rapid diagnosis by Gram staining.

Fujita, Shouhei; Kawano, Fumihiro; Tsukamoto, Ryoichi; Honjo, Kunpei; Naito, Shigetoshi; Ishiyama, Shun; Miyano, Shozo; Machida, Michio; Kitabatake, Toshiaki; Fujisawa, Minoru; Ogura, Kanako; Matsumoto, Toshiharu

2014-01-01

258

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

PubMed Central

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

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

2014-01-01

259

Coincidental Colonization  

NSDL National Science Digital Library

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

Sciences, California A.

2008-01-01

260

Colon ischemia  

Microsoft Academic Search

CI is the most common cause of mesenteric ischemia, and encompasses a wide clinical spectrum from mild, reversible disease\\u000a to life-threatening colonic gangrene. While most commonly seen in elderly patients, younger patients are also at risk, especially\\u000a if an underlying risk factor such as vasculitis, hyper-coagulability, or certain medication use such as oral contraceptives,\\u000a pseudoephedrine, cocaine, or ergot, is present.

SETH E. PERSKYAND; Lawrence J. Brandt

261

Loop oscillations and an extreme ultraviolet wave associated with a micro-sigmoid eruption  

NASA Astrophysics Data System (ADS)

Taking advantage of the high temporal and spatial resolution observations of the Solar Dynamics Observatory, we present an extreme ultraviolet (EUV) wave associated with a micro-sigmoid eruption, which took place on 2012 October 4. The micro-sigmoid underwent a typical sigmoid-to-arcade evolution via tether-cutting reconnection, accompanied by a micro-flare, a filament eruption. The twin coronal dimmings at the footpoints of the sigmoid indicate the existence of the associated micro-coronal mass ejection that likely triggered a small-scale EUV wave. The wave onset was nearly simultaneous with the start of the eruption and the associated flare. The wave had a nearly circular front, and propagated at initial velocities of 300-360 km s-1. Because the sigmoid was located in the non-quiet region, the generated wave interacted with the ambient loops, and triggered transverse loop oscillations, resulting in many loop-shaped dimmings. Moreover, the interaction between the wave and one large loop led not only to the oscillation but also to the downward plasma flow along the loop, inducing loop footpoints to brighten. Another small loop was nearly intact after the wave passed. In some directions, the wave was refracted by the loops, and the refracted speeds increased, decreased, or vanished in different directions. All results provide evidence that the EUV wave was a fast-mode magnetohydrodynamic wave.

Zheng, R.-S.; Jiang, Y.-C.; Yang, J.-Y.; Hong, J.-C.; Bi, Y.; Yang, B.; Yang, D.

2013-05-01

262

An Extreme Ultraviolet Wave Associated with a Micro-sigmoid Eruption  

NASA Astrophysics Data System (ADS)

Taking advantage of the high temporal and spatial resolution of the Solar Dynamics Observatory (SDO) observations, we present an extreme ultraviolet (EUV) wave associated with a micro-sigmoid eruption on 2010 October 21. The micro-sigmoid underwent a typical "sigmoid-to-arcade" evolution via tether-cutting reconnection, accompanied by a B1.7 flare, a filament eruption, and coronal twin dimmings. In the eruption, the newly formed sigmoidal loops expanded quickly, and the expansion likely triggered an EUV wave. The wave onset was nearly simultaneous with the start of the eruption and the associated flare. The wave had a nearly circular front and propagated at a constant velocity of 270-350 km s-1 with very little angular dependence. Remarkably, in some direction, the wave encountered a small loop and refracted at a higher speed. All the results provide evidences that the wave was a fast-mode magnetohydrodynamic (MHD) wave. Owing to the close temporal and spatial relationship between the wave and the expanding loops, we believe that the wave was most likely triggered by the fast expansion of the newly formed sigmoidal loops, which evolved into the leading front of the invisible micro-coronal mass ejection.

Zheng, Ruisheng; Jiang, Yunchun; Yang, Jiayan; Bi, Yi; Hong, Junchao; Yang, Dan; Yang, Bo

2012-07-01

263

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

PubMed

Recurrent networks are ubiquitous in the brain, where they enable a diverse set of transformations during perception, cognition, emotion, and action. It has been known since the 1970's how, in rate-based recurrent on-center off-surround networks, the choice of feedback signal function can control the transformation of input patterns into activity patterns that are stored in short term memory. A sigmoid signal function may, in particular, control a quenching threshold below which inputs are suppressed as noise and above which they may be contrast enhanced before the resulting activity pattern is stored. The threshold and slope of the sigmoid signal function determine the degree of noise suppression and of contrast enhancement. This article analyses how sigmoid signal functions and their shape may be determined in biophysically realistic spiking neurons. Combinations of fast, medium, and slow after-hyperpolarization (AHP) currents, and their modulation by acetylcholine (ACh), can control sigmoid signal threshold and slope. Instead of a simple gain in excitability that was previously attributed to ACh, cholinergic modulation may cause translation of the sigmoid threshold. This property clarifies how activation of ACh by basal forebrain circuits, notably the nucleus basalis of Meynert, may alter the vigilance of category learning circuits, and thus their sensitivity to predictive mismatches, thereby controlling whether learned categories code concrete or abstract information, as predicted by Adaptive Resonance Theory. PMID:21779754

Palma, Jesse; Versace, Massimiliano; Grossberg, Stephen

2012-04-01

264

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

PubMed Central

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

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

2014-01-01

265

Distal intramural spread of rectal carcinomas  

Microsoft Academic Search

Forty-three consecutive specimens of resected rectal carcinomas, 16 abdominoperineal and 27 anterior resections, were examined\\u000a for distal intramural spread. Thirty-four of the resections were considered curative and nine palliative. Eighteen carcinomas\\u000a (42 percent) showed no distal spread, and 14 (33 percent) showed very limited distal spread (0–5 mm). In the remaining cases,\\u000a 11 (25 percent) had distal spread of more

Per M. Madsen; John Christiansen

1986-01-01

266

Distal myopathy of Gowers: a reappraisal.  

PubMed

This article argues against the general idea that the patient described by Gowers as distal myopathy in 1902 may have suffered from myotonic dystrophy. A case of distal myopathy with markedly atrophic sternocleidomastoids is presented. Patients of distal myopathy with absence of sternocleidomastoids, sometimes accompanied by facial weakness, are recorded in the literature. All these cases are sporadic and may be called distal myopathy of Gowers, which is different from Welander's cases. PMID:6468454

Furukawa, T; Odajima, N; Watabiki, S; Tsukagoshi, H

1984-01-01

267

Mediastinal lymph node metastasis of colon cancer: Report of a case  

Microsoft Academic Search

We herein describe a patient with mediastinal lymph node metastases which occurred after both a primary sigmoid colon cancer\\u000a and metachronous ovarian metastasis had been resected. The most likely route of metastases to the mediastinum in this case\\u000a is the paravertebral venous plexus probably connected to the ovarian metastasis, or so-called remetastasis. This case illustrates\\u000a that the mediastinum is thus

Hiroshi Kura; Norihiro Sato; Akihiko Uchiyama; Yuji Nakafusa; Ryuichi Mibu; Kouichirou Yoshida; Kentaro Kuroiwa; Masao Tanaka

1999-01-01

268

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

SciTech Connect

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.

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

269

What is the role of the kink instability in eruption of X-ray sigmoids?  

NASA Astrophysics Data System (ADS)

Observers see ample evidence of helical structures in erupting solar filaments, X-ray sigmoids and CMEs. It has been argued that the total amount of twist in a given loop is a factor in its MHD stability [Priest, 1984]. A simple model illustrates this point. Consider a cylindrical force-free magnetic field with constant ? = T /L, where L is the length of the tube and T is the total twist contained within it. The tube is stable to the MHD kink instability for total twist below a critical value Tc ~ 2 ? . Rust and Kumar [1996] compared the shape of 49 transient, bright sigmoid structures to the signature of a helically kinked flux rope. From a study of the aspect ratios of these transient sigmoid brightenings, they inferred that the cause of CMEs is the eruption of an unstable, kinked magnetic field. We have analyzed 155 X-ray sigmoids in the the Yohkoh SXT data, measuring the angle ? at which the sigmoid crosses its central axis and the length of the sigmoid along that axis (which is not identical to L, but is closely related to it). In a simple 2D force-free analysis, Pevtsov et al. [1997] showed that ? = ( ? / L ) sin ? , implying that sin ? is a measure of the total twist T. By simple visual inspection of the Yohkoh SXT movies, we have identified well-known signatures of eruption, i.e., X-ray cusps and arcades. We find no relationship between the frequency of occurrence of such signatures of eruption and sin ? . {Pevtsov, A. A.}, {Canfield, R. C.}, and {McClymont, A. N.}, Astrophys J., 481, 973, 1997. {Priest, E. R.}, {Solar Magneto-Hydrodynamics}, {Reidel: Dordrecht}, {1984}. {Rust, D. M.}, and {Kumar, A.}, Astrophys J., 464, L199, 1996.

Leamon, R.; Canfield, R.; Blehm, Z.; Pevtsov, A.

2002-05-01

270

The "Sigmoid Sniffer” and the "Advanced Automated Solar Filament Detection and Characterization Code” Modules  

NASA Astrophysics Data System (ADS)

We present two pattern recognition algorithms, the "Sigmoid Sniffer” and the "Advanced Automated Solar Filament Detection and Characterization Code,” that are among the Feature Finding modules of the Solar Dynamic Observatory: 1) Coronal sigmoids visible in X-rays and the EUV are the result of highly twisted magnetic fields. They can occur anywhere on the solar disk and are closely related to solar eruptive activity (e.g., flares, CMEs). Their appearance is typically synonym of imminent solar eruptions, so they can serve as a tool to forecast solar activity. Automatic X-ray sigmoid identification offers an unbiased way of detecting short-to-mid term CME precursors. The "Sigmoid Sniffer” module is capable of automatically detecting sigmoids in full-disk X-ray images and determining their chirality, as well as other characteristics. It uses multiple thresholds to identify persistent bright structures on a full-disk X-ray image of the Sun. We plan to apply the code to X-ray images from Hinode/XRT, as well as on SDO/AIA images. When implemented in a near real-time environment, the Sigmoid Sniffer could allow 3-7 day forecasts of CMEs and their potential to cause major geomagnetic storms. 2)The "Advanced Automated Solar Filament Detection and Characterization Code” aims to identify, classify, and track solar filaments in full-disk H? images. The code can reliably identify filaments; determine their chirality and other relevant parameters like filament area, length, and average orientation with respect to the equator. It is also capable of tracking the day-by-day evolution of filaments as they traverse the visible disk. The code was tested by analyzing daily H? images taken at the Big Bear Solar Observatory from mid-2000 to early-2005. It identified and established the chirality of thousands of filaments without human intervention.

Raouafi, Noureddine; Bernasconi, P. N.; Georgoulis, M. K.

2010-05-01

271

Triplane fracture of the distal radius.  

PubMed

We report the case of a 14-year-old boy who sustained a displaced triplane fracture of the distal radius. This was treated with closed reduction and application of a cast with good clinical and radiological results. We discuss (for the first time) the reasons for the rarity of this fracture at the distal radius compared to the distal tibia. PMID:24765336

Pearce, Christopher; Chung, Raymond

2011-07-01

272

Fractures of the distal radius and ulna  

Microsoft Academic Search

Associated fractures of the distal ulnar metaphysis were present in 19 of 320 distal radial fractures requiring either closed manipulation or surgical treatment over a 2-year period. Four morphological patterns of ulnar fracture were encountered, the commonest being the type 1 simple extra-articular fracture of the distal end of ulna with minimal comminution (eight out of 19). 15 patients were

A. Biyani; A. J. M. Simison; L. Klenerman

1995-01-01

273

[Minimally aggressive surgery in advanced cancer of the colon].  

PubMed

We evaluated minimally aggressive surgery in the treatment of metastasic cancer of the colon in 6 patients: 2 females and 4 males, with an average age of 71.8. Preoperative studies showed cancer of the colon (right colon = 4; sigmoid colon = 2) with multiple hepatic metastasis. In all cases laparoscopic mobilization and extracorporeal resection with end-to-end anastomosis was performed employing a biofragmentable anastomotic ring. In two patients laparoscopy discovered peritoneal carcinomatosis. One patient was operated using conventional surgery. Intestinal segments with an average length of 21.3 cm were removed, with a mean of 13.5 lymph-nodes per patient, 70.3% of which had metastasis. Eleven of the 12 resection lines were tumor-free (91.6%). Hospital stay averaged 7.8 days, and mean survival has been 4.5 months. Only two patients, those with peritoneal carcinomatosis, had post-operative complications. If an appropriate patient selection is followed: cancer of the colon with hepatic metastasis and no peritoneal spread, laparoscopic surgery is a reliable and effective treatment for advaned cancer of the colon. PMID:8338706

Rosell Pradas, J; Astruc Hoffmann, A; Ruiz de Adana, A; Vara Thorbeck, R

1993-06-01

274

Autonomic Nerve Regulation of Colonic Peristalsis in Guinea Pigs  

PubMed Central

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.

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

2014-01-01

275

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 ...

276

Paleomagnetic investigation of a sigmoidal fold in the Zagros-Makran syntaxis (Souther Iran) and kinematic implication  

Microsoft Academic Search

The deformation in the tertiary sedimentary cover of the Zagros fold belt is expressed as elongated folds with commonly curved or sigmoidal shapes. In order to understand the folding process in relation to the magnetization acquisition time, we performed a paleomagnetic study of a sigmoidal fold, the Minab anticline, outcroping in the eastern part of the Zagros-Makran syntaxis. The two

S. Smith; A. Aubourg; G. Guezou; N. Nazari; B. Braud; G. Guya

2003-01-01

277

Overtreatment of sigmoid diverticulitis: plea for a less aggressive approach.  

PubMed

A less invasive approach to the treatment of left-sided colonic diverticulitis has emerged in the last decade. The standard of care for perforated or complicated diverticulitis evolved from a Hartmann's procedure, to resection and primary anastomosis, to treatment with antibiotics and percutaneous drainage in a carefully selected (Hinchey grade 2) patient subset. Recently, laparoscopic lavage emerged as a promising less invasive treatment for selected cases of Hinchey 3 patients. Likewise, for nonperforated or uncomplicated diverticulitis the approach is becoming less aggressive with a change from intravenous antimicrobial therapy, starvation and admission, to oral antibiotics and finally to observation and outpatient treatment. This less invasive or aggressive approach is due to expanding evidence on optimal treatment and is congruent with an increasing understanding that diverticulitis comprises different disease entities with heterogeneity between patients. The disease should be targeted by specific approaches, after a meticulous assessment of the diverticulitis stage, and tailored to an individual basis. Avoidance of overtreatment has obvious benefits: less in-hospital treatment, cost reduction, diminished development of antimicrobial resistance, reduction in complication rate and side effects and presumably a better quality of life for the patient. In conclusion, one might say we have overtreated the majority of diverticulitis patients for decades. More research is needed to explain the pathogenesis and multifactorial etiology and in the near future hopefully several unanswered questions regarding the optimal management of patients with different stages of diverticulitis will be answered by various ongoing trials. PMID:22572693

Daniels, L; de Korte, N; Winter, D; Boermeester, M A; Stockmann, H B A C

2012-01-01

278

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

NASA Astrophysics Data System (ADS)

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.

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

2014-01-01

279

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

Microsoft Academic Search

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

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

1997-01-01

280

Emergency resection and primary anastomosis for sigmoid volvulus in an African population.  

PubMed

We report 30 patients who underwent operation for sigmoid volvulus during a two year period at the St. Francis Hospital, Tanzania. Five patients were managed initially by non-operative reduction. They all underwent elective resection of the sigmoid during the same hospitalisation with one operative death. Twenty-five patients underwent emergency laparotomy, 12 of them having gangrenous bowel. Resection was carried out in 21 patients, 18 of whom had a primary anastomosis without protective colostomy. In spite of the high incidence of gangrenous bowel (57%), there was only one operative death (5%) in the 18 patients. Initial management of sigmoid volvulus should consist of non-operative attempts at reduction provided that the bowel is viable. Elective resection should be performed during the same hospitalisation. Where non-operative therapy fails or bowel gangrene is present, emergency laparotomy has to be carried out. In the authors' experience resection of the sigmoid and primary anastomosis can be performed safely in this situation. PMID:2286804

Keller, A; Aeberhard, P

1990-12-01

281

Long-Term Follow-Up After First Acute Episode of Sigmoid Diverticulitis: Is Surgery Mandatory?  

Microsoft Academic Search

PURPOSE: This study was designed to evaluate the long-term natural history of sigmoid diverticulitis in patients treated nonoperatively after a first acute episode and to assess the role of elective colectomy. METHODS: Between 1986 and 1991, 144 patients were admitted for acute diverticulitis diagnosed by abdominal computed tomography and had a successful nonoperative treatment. Remote complications (persisting or recurring diverticulitis)

R. C. Chautems; P. Ambrosetti; A. Ludwig; B. Mermillod; Ph. Morel; C. Soravia

2002-01-01

282

Clinico-pathological study in patients with transverse-sigmoid sinus dural arteriovenous malformations  

Microsoft Academic Search

Treatment modalities and histopathological findings of transverse-sigmoid sinus dural arteriovenous malformations (AVMs) were evaluated. Twenty-eight patients with this disease were treated with a variety of treatment modalities. Ten patients were treated surgically. Of these patients, 3 were treated with sinus isolation, 4 with sinus removal and 3 with palliative operation. Ten patients underwent endovascular surgery. Of these patients, 3 were

M Nishijima; N Kuwayama; S Endo; A Takaku

1998-01-01

283

Effect of 5-hydroxytryptamine and its antagonists on colonic smooth muscle of the rabbit.  

PubMed

The effect of 5-hydroxytryptamine (5HT) was studied in circular and longitudinal muscle from the proximal and distal colon of New Zealand white rabbits. 5HT stimulated a dose-dependent isometric contraction of distal and proximal circular muscle that was greater than in distal longitudinal muscle (P less than 0.01). 5HT did not stimulate taenia coli longitudinal muscle. The EC50 for 5HT stimulation of distal circular muscle (-7.0 +/- 0.1), distal longitudinal muscle, and proximal circular muscle was similar. Methysergide dose-dependently inhibited the 5HT stimulation of both proximal and distal circular muscle. The IC50 for methysergide inhibition of 5HT (5 x 10(-7) M) stimulation was -5.5 +/- 0.2. Ketanserine and ICS 205-930 did not inhibit 5HT stimulation of colonic muscle. Tetrodotoxin (TTX) decreased the potency, but not the efficacy of 5HT stimulation of proximal and distal circular muscle. Atropine decreased the potency (EC50 = -6.6 +/- 0.1) (P less than 0.05) and the efficacy by 40%. Electrical field stimulation (EFS) caused an on-contraction and off-contraction of distal circular muscle and an on-contraction of proximal circular muscle. 5HT decreased the off-contraction of the distal circular muscle but did not affect the on-contraction of the other muscle strips. 5HT receptor antagonists did not affect EFS of the tissue. The studies suggest: (1) 5HT stimulates circular colonic muscle with greater efficacy than longitudinal muscle, (2) 5HT stimulates circular muscle through a 5HT1 receptor, (3) there is atropine-sensitive and atropine-insensitive 5HT stimulation of circular colonic muscle, (4) 5HT inhibits neurons responsible for the off-contraction in distal circular muscle without affecting the on-contraction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1988260

Ng, W W; Jing, J; Hyman, P E; Snape, W J

1991-02-01

284

Direct Arthroscopic Distal Clavicle Resection  

PubMed Central

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.

Lervick, Gregory N

2005-01-01

285

Operative treatment of volar intra-articular fractures of the distal end of the radius.  

PubMed

We retrospectively reviewed the results of operative treatment of forty-nine volar marginal intra-articular fractures of the distal end of the radius. According to the Comprehensive Classification of Fractures, there were two B3.1 fractures (characterized by a small volar fragment, with the sigmoid notch intact), three B3.2 fractures (characterized by a large volar fragment that included the sigmoid notch), and forty-four B3.3 fractures (characterized by comminution of the volar fragment). Although all fractures healed and only nine patients had evidence of osteoarthrosis on follow-up radiographs, there were six early and fourteen late complications, some of which adversely influenced the over-all outcome. After an average of fifty-one months (range, twenty-four to 117 months), there were thirty-one excellent, ten good, and eight fair results according to the system described by Gartland and Werley, and thirty-two excellent, nine good, five fair, and three poor results according to the modified system of Green and O'Brien. Two factors were found to have a significant association with a fair or poor outcome: evidence of osteoarthrosis on the most recent follow-up radiographs and reversal of the normal volar tilt of the distal end of the radius. The age of the patient, the interval from the injury to the operation, a concomitant injury of the ipsilateral upper extremity, an associated fracture of the ulnar styloid process, the radio-ulnar index, ulnar angulation, the classification of the fracture, comminution of the volar fragment, and articular incongruity were not significantly associated with the outcome. PMID:8986658

Jupiter, J B; Fernandez, D L; Toh, C L; Fellman, T; Ring, D

1996-12-01

286

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

PubMed Central

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

Dai, Wei

2012-01-01

287

[A case of relapsed colon cancer successfully treated by capecitabine].  

PubMed

We report a case of advanced relapsed colon cancer, which had multiple liver and spleen metastasis, controlled for about two years by capecitabine therapy. A 60-year-old female had been diagnosed with ileus due to sigmoid colon cancer in August, 2005. She received sigmoidectomy and adjuvant chemotherapy (Leucovorin/5-fluorouracil therapy). In postoperative observation, multiple liver and spleen metastasis were detected by computed tomography in February, 2008. Therefore, she was administered twenty courses of FOLFOX therapy. However, a peripheral nerve disturbance appeared. There fore chemotherapy was changed from FOLFOX therapy to FOLFIRI therapy. After 2 courses of FOLFIRI therapy, she had severe nausea, vomiting, appetite loss and diarrhea. Therefore, chemotherapy was changed from FOLFIRI therapy to capecitabine therapy. After capecitabine therapy, her multiple liver and spleen metastasis disappeared, and complete response has continued for about 2 years. She has remained on capecitabine therapy and has a good quality of life. PMID:23848025

Hashimoto, Toshio; Yokoyama, Moriyoshi; Kimura, Shingo; Usuba, Osamu; Toyono, Mitsuru

2013-04-01

288

[Dysphonia as early presentation symptom in colonic perforation].  

PubMed

We report two cases with similar main complaints: dysphonia and subcutaneous cervical emphysema. After diagnosis procedures we identified pneumomediastinum, pneumoperitoneum and pneumoretroperitoneum caused by colonic perforation. Both patients underwent surgical treatment at Hospital Campo Arañuelo, Navalmoral de la Mata. Dysphonia and subcutaneous cervical emphysema are infrequent symptoms of presentation for occult gastrointestinal tract perforation or any retroperitoneal condition. Subcutaneous emphysema due to colonic perforation is extremely uncommon but it must to be considerate as a cause when its etiology remains unknown. Non iatrogenic subcutaneous emphysema is very rare in publications and is mostly associated with perforated sigmoid diverticulitis or carcinoma and the prognosis is poor Both patients underwent surgical treatment and also a wide spectrum antibiotic course. One of them needed respiratory support in the intensive care unit, and, in the outcome, he required a second surgical procedure to evacuate a residual abscess before discharge. PMID:22476128

Barrera Melgarejo, Elizabeth; Joya Vázquez, Rebeca; Sánchez Antonio, Molina; López López, Angeles; Gómez García, Olga; Bengochea Cantos, José

2011-01-01

289

Role of anaerobic bacteria in the metabolic welfare of the colonic mucosa in man.  

PubMed Central

Suspensions of isolated epithelial cells (colonocytes) from the human colon were used to assess utilisation of respiratory fuels which are normally available to the colonic mucosa in vivo. Cells were prepared from operative specimens of the ascending colon (seven) and descending colon (seven). The fuels that were used were the short chain fatty acid n-butyrate, produced only by anaerobic bacteria in the colonic lumen, together with glucose and glutamine, normally present in the circulation. The percentage oxygen consumption attributable to n-butyrate, when this was the only substrate, was 73% in the ascending colon and 75% in the descending colon. In the presence of 10 mM glucose these proportions changed to 59% and 72%. Aerobic glycolysis was observed in both the ascending and descending colon. Glucose oxidation accounted for 85% of the oxygen consumption in the ascending colon and 30% in the descending colon. In the presence of 10 mM n-butyrate these proportions decreased to 41% in the ascending colon and 16% in the descending colon. Based on the assumption that events in the isolated colonocytes reflect utilization of fuels in vivo, the hypothesis is put forward that fatty acids of anaerobic bacteria are a major source of energy for the colonic mucosa, particularly of the distal colon.

Roediger, W E

1980-01-01

290

Isolated colonic tuberculosis  

Microsoft Academic Search

Two cases of isolated colonic tuberculosis are reported, and recent literature on this field is reviewed. Isolated colonic tuberculosis is defined as a tuberculosis which exists in the colon except for ileocaecum, without focus in any other organ. The morphological changes are tuberculous granulation primarily located to the submucosa layer of the colon with smooth surfaces of both mucous and

Y. A. Wang; W. Y. Yu

1987-01-01

291

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

Microsoft Academic Search

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

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

1991-01-01

292

ALDH as a Marker for Enriching Tumorigenic Human Colonic Stem Cells  

PubMed Central

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

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

2014-01-01

293

[Remission due to CYVADIC chemotherapy of primary leiomyosarcoma derived from mesentelium of the sigmoid colon: a case report].  

PubMed

We report a case of leiomyosarcoma of mesenthelium origin, which was successfully treated with a combination of cyclophosphamide, vincristine, adriamycin and dacarbazine (CYVADIC). A 56-year-old woman received three courses of adjuvant CYVADIC chemotherapy after initial surgery consisting of tumorectomy, sigmoidectomy, descending colostomy, cystectomy and ureterostomy. A six-month disease-free period was attained obtained. A recurrent tumor showed remarkable reduction after three courses of CYVADIC chemotherapy. This case may be the first report of successful chemotherapy against a leiomyosarcoma of mesenthelium origin in Japan. PMID:10500540

Takano, M; Kita, T; Kikuchi, Y; Nagata, I

1999-09-01

294

Anti-inflammatory Efficiency of Ankaferd Blood Stopper in Experimental Distal Colitis Model  

PubMed Central

Background/Aim: Ankaferd blood stopper (ABS) is a herbal extract that enhances mucosal healing. In this study, we aimed to investigate the efficiency of ABS in the treatment of experimental distal colitis. Materials and Methods: Twenty one male albino rats were divided into three groups: Sham control (Group 1), colitis induced by acetic acid and treated with saline (Group 2), colitis induced by acetic acid and treated with ABS (Group 3). At end of the 7th day of induction, all the rats were lightly anesthetized with intramuscular ketamine (8 mg/kg) and thereafter laparotomy and total colectomy were performed. The distal colon segment was assessed macroscopically and microscopically. In addition malondialdehyde (MDA), superoxide dismutase (SOD) and nitric oxide (NO) levels of the colonic tissue and changes in body weight were measured. Results: The MDA and NO levels of the colonic tissues and weight loss were significantly higher in Group 2 compared to Group 1 and Group 3. Microscopic and macroscopic damage scores were significantly higher in Group 2 and Group 3 than Group 1 (P: 0.001, P: 0.004, respectively). Although the microscopic and macroscopic damage scores in Group 3 were slightly lower than Group 2, the difference was not statistically significant. The SOD levels of the colonic tissues were not different between the three groups. Conclusion: Weight alterations and high-levels of the colonic tissue MDA and NO suggested that ABS might have anti-inflammatory effects on experimental distal colitis. However, this suggestion was not supported by histopathological findings.

Kocak, Erdem; Akbal, Erdem; Tas, Adnan; Koklu, Seyfettin; Karaca, Gokhan; Can, Murat; Kosem, Bahad?r; Ustun, Huseyin

2013-01-01

295

Homocysteine, Cysteine, and Glutathione in Human Colonic Mucosa: Elevated Levels of Homocysteine in Patients with Inflammatory Bowel Disease  

Microsoft Academic Search

The present study was performed to evaluate the levels of the amino thiols cysteine, homocysteine, and glutathione in the colonic mucosa of patients with various intestinal diseases, especially chronic inflammatory bowel disease. Colonic biopsies of macroscopically normal mucosa out of a proximal and distal segment were collected from 187 patients with various intestinal diseases. Protein was assayed in duplicate by

I. Morgenstern; M. T. M. Raijmakers; W. H. M. Peters; H. Hoensch; W. Kirch

2003-01-01

296

Grave's disease with transverse and sigmoid sinus thrombosis needing surgical intervention.  

PubMed

Thrombosis of venous sinuses associated with thyrotoxicosis is rare, and isolated transverse and sigmoid sinus thrombosis is rarer and reported only once previously. We present a case of Graves disease, who suffered unilateral sigmoid and transverse sinus thrombosis with intracranial hemorrhage. A 42-year-old female, a diagnosed case of Graves disease, presented to us with headache, drowsiness, and hemiparesis. Computed Tomography revealed a large right temporo-parieto-occipital venous infarct. The patient needed surgical intervention in the form of decompressive craniotomy following which she improved, and on follow-up is having no deficits. Thrombophilia profile showed a low Protein S and Anti thrombin III (AT III) levels. Deranged thrombophilia profile in combination with the hypercoagulable state in thyrotoxicosis, most likely precipitated the thrombotic event. Timely surgical intervention can be offered in selective cases with a good clinical outcome. PMID:24403961

Srikant, Banumathy; Balasubramaniam, Srikant

2013-07-01

297

Grave's disease with transverse and sigmoid sinus thrombosis needing surgical intervention  

PubMed Central

Thrombosis of venous sinuses associated with thyrotoxicosis is rare, and isolated transverse and sigmoid sinus thrombosis is rarer and reported only once previously. We present a case of Graves disease, who suffered unilateral sigmoid and transverse sinus thrombosis with intracranial hemorrhage. A 42-year-old female, a diagnosed case of Graves disease, presented to us with headache, drowsiness, and hemiparesis. Computed Tomography revealed a large right temporo-parieto-occipital venous infarct. The patient needed surgical intervention in the form of decompressive craniotomy following which she improved, and on follow-up is having no deficits. Thrombophilia profile showed a low Protein S and Anti thrombin III (AT III) levels. Deranged thrombophilia profile in combination with the hypercoagulable state in thyrotoxicosis, most likely precipitated the thrombotic event. Timely surgical intervention can be offered in selective cases with a good clinical outcome.

Srikant, Banumathy; Balasubramaniam, Srikant

2013-01-01

298

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

PubMed

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

Park, Y-H; Kwon, H-J

2011-09-01

299

PHOTOSPHERIC FLUX CANCELLATION AND THE BUILD-UP OF SIGMOIDAL FLUX ROPES ON THE SUN  

SciTech Connect

In this study we explore the scenario of photospheric flux cancellation being the primary formation mechanism of sigmoidal flux ropes in decaying active regions. We analyze magnetogram and X-ray observations together with data-driven non-linear force-free field (NLFFF) models of observed sigmoidal regions to test this idea. We measure the total and canceled fluxes in the regions from MDI magnetograms, as well as the axial and poloidal flux content of the modeled NLFFF flux ropes for three sigmoids-2007 February, 2007 December, and 2010 February. We infer that the sum of the poloidal and axial flux in the flux ropes for most models amounts to about 60%-70% of the canceled flux and 30%-50% of the total flux in the regions. The flux measurements and the analysis of the magnetic field structure show that the sigmoids first develop a strong axial field manifested as a sheared arcade and then, as flux cancellation proceeds, form long S-shaped field lines that contribute to the poloidal flux. In addition, the dips in the S-shaped field lines are located at the sites of flux cancellation that have been identified from the MDI magnetograms. We find that the line-of-sight-integrated free energy is also concentrated at these locations for all three regions, which can be liberated in the process of eruption. Flare-associated brightenings and flare loops coincide with the location of the X-line topology that develops at the site of most vigorous flux cancellation.

Savcheva, A. S.; Van Ballegooijen, A. A.; DeLuca, E. E. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Green, L. M., E-mail: asavcheva@cfa.harvard.edu [Mullard Space Science Laboratory, University College London, Dorking (United Kingdom)

2012-11-10

300

Laparoscopic Transhiatal Esophagectomy for ‘Sigmoid’ Megaesophagus Following Failed Cardiomyotomy: Experience of 11 Patients  

Microsoft Academic Search

Introduction Laparoscopic myotomy is a widely used procedure and is now considered to be the treatment of choice for achalasia. Esophagectomy\\u000a for achalasia is usually performed only for megaesophagus. We present our experiences with laparoscopic transhiatal esophagectomy\\u000a for ‘sigmoid’ megaesophagus due to failed Heller’s myotomy. Materials and Methods We managed a total of 11 patients with megaesophagus in our institute

Chinnusamy Palanivelu; Muthukumaran Rangarajan; Priyadarshan Anand Jategaonkar; Gobi Shanmugam Maheshkumaar; Natesan Vijay Anand

2008-01-01

301

New practical landmarks to determine sigmoid sinus free zones for suboccipital approaches: an anatomical study.  

PubMed

Literature defines the landmarks to identify the courses and locations of the transverse and sigmoid sinuses on the outer surface of the skull and inner surface of the scalp. These natural landmarks may only be helpful after skin incision and are inadequate to determine the length and size of the skin incision. Still, there is a need to identify palpable landmarks easily to determine the ideal location to open the initial burr hole before an operation. Twenty-eight dried adult human skulls and 2 cadavers were evaluated. The zygomatic root, the inion, and the mastoid process were identified on the external, and the grooves for sigmoid and transverse sinuses, on the internal surfaces. The distances between the 3 landmarks and the midpoints, and the shortest distances of the midpoints to the border of the groove for sigmoid sinus and groove for transverse sinus were measured. Statistically significant differences were evaluated for both sides. Based on the measurements, the defined "artificial landmarks" can be considered safe points that involve no vascular structures and may be used to perform the initial burr hole during posterolateral approaches. Identification of the midpoints and palpation of the defined landmarks easily before the operation render the study feasible and practical unlike with natural landmarks. To avoid venous injury, the midpoints of mastoid-inion line and zygomatic root-inion line can be used safely in skin incision during posterior fossa approaches and craniotomy. PMID:24036786

Ugur, Hasan Caglar; Dogan, Ihsan; Kahilogullari, Gokmen; Al-Beyati, Eyyub S M; Ozdemir, Mevci; Kayaci, Selim; Comert, Ayhan

2013-09-01

302

Liver Colonization Competence Governs Colon Cancer Metastasis  

NASA Astrophysics Data System (ADS)

Tumors that metastasize do so to preferred target organs. To explain this apparent specificity, Paget, >100 years ago, formulated his seed and soil hypothesis; i.e., the cells from a given tumor would "seed" only favorable "soil" offered by certain organs. The hypothesis implies that cancer cells must find a suitable "soil" in a target organ-i.e., one that supports colonization-for metastasis to occur. We demonstrate in this report that ability of human colon cancer cells to colonize liver tissue governs whether a particular colon cancer is metastatic. In the model used in this study, human colon tumors are transplanted into the nude mouse colon as intact tissue blocks by surgical orthotopic implantation. These implanted tumors closely simulate the metastatic behavior of the original human patient tumor and are clearly metastatic or nonmetastatic to the liver. Both classes of tumors were equally invasive locally into tissues and blood vessels. However, the cells from each class of tumor behave very differently when directly injected into nude mouse livers. Only cells from metastasizing tumors are competent to colonize after direct intrahepatic injection. Also, tissue blocks from metastatic tumors affixed directly to the liver resulted in colonization, whereas no colonization resulted from nonmetastatic tumor tissue blocks even though some growth occurred within the tissue block itself. Thus, local invasion (injection) and even adhesion to the metastatic target organ (blocks) are not sufficient for metastasis. The results suggest that the ability to colonize the liver is the governing step in the metastasis of human colon cancer.

Kuo, Tsong-Hong; Kubota, Tetsuro; Watanabe, Masahiko; Furukawa, Toshiharu; Teramoto, Tatuso; Ishibiki, Kyuya; Kitajima, Masaki; Rahim Moosa, A.; Penman, Sheldon; Hoffman, Robert M.

1995-12-01

303

Colon cancer screening  

MedlinePLUS

Screening for colon cancer; Colonoscopy - screening; Sigmoidoscopy - screening; Virtual colonoscopy - screening ... Colon cancer screening can detect polyps and early cancers in the intestines. This type of screening can find ...

304

Colon drug delivery.  

PubMed

Oral drug delivery to the colon has attracted significant attention during the past 20 years. Colon targeting is recognised to have several therapeutic advantages, such as the oral delivery of drugs that are destroyed by the stomach acid and/or metabolised by pancreatic enzymes. Sustained colonic release of drugs can be useful in the treatment of nocturnal asthma, angina and arthritis. Local treatment of colonic pathologies, such as ulcerative colitis, colorectal cancer and Crohn's disease, is more effective with the delivery of drugs to the affected area. Likewise, colonic delivery of vermicides and colonic diagnostic agents requires smaller doses. This article aims to provide an insight into the design and manufacturing considerations, and an evaluation of colonic drug delivery systems in order to understand why there are still few delivery technologies that have reached the market, despite intensive research in this field. For this purpose, various approaches to colon-specific drug delivery are discussed. PMID:16370944

Van den Mooter, Guy

2006-01-01

305

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

PubMed

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

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

2013-10-01

306

Colon cancer - Series (image)  

MedlinePLUS

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

307

Effects of nociceptin/orphanin FQ on rats with cathartic colon  

PubMed Central

AIM: To demonstrate the change and effect of nociceptin/orphanin FQ in the colon of rats with cathartic colon. METHODS: The cathartic colon model was established by feeding rats rhubarb for 3 mo, the changes of colonic electromyography were investigated by both suspension muscle strips test and serosal recordings of colonic myoelectrical activity. Immunohistochemical staining (S-P methods) and image analysis were used to determine the changes of nociceptin/orphanin FQ in the proximal colon and distal colon of rats with cathartic colon. RESULTS: Suspension muscle strips test in vitro showed OFQ (10-9-10-6 mol/L) concentration dependently caused an immediate tonic contraction in the isolated colon. But the increase of tension in cathartic colon was less than control groups (P < 0.01). Intravenous administration of OFQ (1 ?g/kg) caused phasic contractions in the proximal colon, while the amplitude of phasic contractions caused by OFQ in cathartic colon was much lower than that in the control groups (2.58 ± 0.41 vs 4.16 ± 0.53, t = -2.6, P = 0.012). OFQ was highly expressed in the myenteric plexus of the rat colon but not in the muscle cells. The immunoreactivity of OFQ in the proximal colon in cathartic colon rats decreased significantly compared with the control group (P = 0.001). CONCLUSION: Colonic smooth muscle of cathartic colon showed low sensitivity to the stimulation of OFQ, suggesting that it might be caused by the abnormal distribution of OFQ or the abnormalities of receptors, leading to the disorganization of dynamic and incoordinated contractions.

Li, Hai-Yan; Yan, Xiang; Xue, Quan-Lai; Zhou, Yong-Ning; Gao, Yan; Wang, Rui; Liu, Yong-Ming; Ran, Jun-Tao

2007-01-01

308

Unilateral molar distalization: a nonextraction therapy.  

PubMed

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

Prasad, M Bhanu; Sreevalli, S

2012-01-01

309

Unilateral Molar Distalization: A Nonextraction Therapy  

PubMed Central

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

Prasad, M. Bhanu; Sreevalli, S.

2012-01-01

310

Laparoscopic radical distal gastrectomy for ca stomach.  

PubMed

Gastric cancer remains an important cause of cancer-related deaths and a complete margin-negative (R0) resection remains the only potentially curative treatment for gastric adenocarcinoma. We report a case of carcinoma of distal stomach in a 48-year-old male patient who was diagnosed on UGI endoscopy and CT scan. He had symptoms suggestive of gastric outlet obstruction due to stenosing lesion. He was successfully treated with laparoscopic distal gastrectomy with D2 lymphadenectomy. Laparoscopic distal gastrectomy is justified by its feasibility, early recovery, oncological safety, and improved quality of life in cancer stomach. PMID:24426619

Deo, Sadhana V; Puntambekar, Shailesh P

2013-06-01

311

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

PubMed Central

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

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

2011-01-01

312

Diverticular disease of the colon presenting as pyometra: a case report  

PubMed Central

Introduction Pyometra can be caused by various etiologies. We present a rare case of diverticular disease of the colon presenting as pyometra. This type of presentation can be challenging even for an astute clinician. Case presentation A 74-year-old Caucasian woman with a history of pyometra was referred to our gynecology clinic as an urgent case. She was obese, diabetic and hypertensive. Due to the patient profile and the clinical presentation, clinicians were misled toward a diagnosis of possible endometrial cancer. After further investigations, she was found to have colouterine fistula secondary to a diverticular abscess of the sigmoid colon. Conclusions Persistent vaginal discharge due to pyometra can be caused by diverticular disease of the colon. Clinicians should be aware of this important differential diagnosis.

2014-01-01

313

A noninvasive radionuclide assessment of colonic transit of nondigestible solids in man  

SciTech Connect

A reproducible, noninvasive, scintigraphic, large-intestinal-transit-time quantification technique was developed that provides low radiation dose, unlimited information content and high patient acceptance. The proposed technique, called the Large Intestinal Transit (Encapsulated), or LITE, uses a total of 100 microcuries of In-111 encapsulated in ten 2-centimeter long nondigestible capsules which are ingested after a 6 hour fast. 250 microcuries of Tc-99m sulfur colloid was given to outline the gastrointestinal tract. Images were acquired at 4 hour intervals for 72 hours (except overnight) or until all capsules were excreted. Ten subjects consumed a standardized diet 2 days prior to and during imaging, in order to control dietetic variables. The LITE technique provided a simple, quantitative measure of the variables associated with colonic function. Mouth-to-anus transit was measured along with detailed transit times in each of the colon's six anatomical segments: ascending colon, hepatic flexure, transverse colon, splenic flexure, descending colon and recto-sigmoid colon. The radiation absorbed dose to the large intestine, for the LITE technique, was found to be over 50% lower than that associated with previously existing methods of large intestinal transit time measurement. The LITE method represents a major advancement in that it requires no invasive medical procedures. Finally, the LITE technique holds tremendous clinical promise for diagnosing segmental colonic disorders and studying therapeutic pharmaceutical efficacy.

Stubbs, J.B.

1989-01-01

314

Distal Embolic Protection for Renal Arterial Interventions  

Microsoft Academic Search

Distal or embolic protection has intuitive appeal for its potential to prevent embolization of materials generated during\\u000a interventional procedures. Distal protection devices (DPDs) have been most widely used in the coronary and carotid vascular\\u000a beds, where they have demonstrated the ability to trap embolic materials and, in some cases, to reduce complications. Given\\u000a the frequency of chronic kidney disease in

Gregory J. Dubel; Timothy P. Murphy

2008-01-01

315

FORMATION OF TORUS-UNSTABLE FLUX ROPES AND ELECTRIC CURRENTS IN ERUPTING SIGMOIDS  

SciTech Connect

We analyze the physical mechanisms that form a three-dimensional coronal flux rope and later cause its eruption. This is achieved by a zero-beta magnetohydrodynamic (MHD) simulation of an initially potential, asymmetric bipolar field, which evolves by means of simultaneous slow magnetic field diffusion and sub-Alfvenic, line-tied shearing motions in the photosphere. As in similar models, flux-cancellation-driven photospheric reconnection in a bald-patch (BP) separatrix transforms the sheared arcades into a slowly rising and stable flux rope. A bifurcation from a BP to a quasi-separatrix layer (QSL) topology occurs later on in the evolution, while the flux rope keeps growing and slowly rising, now due to shear-driven coronal slip-running reconnection, which is of tether-cutting type and takes place in the QSL. As the flux rope reaches the altitude at which the decay index -partial derivln B/partial derivln z of the potential field exceeds approx3/2, it rapidly accelerates upward, while the overlying arcade eventually develops an inverse tear-drop shape, as observed in coronal mass ejections (CMEs). This transition to eruption is in accordance with the onset criterion of the torus instability. Thus, we find that photospheric flux-cancellation and tether-cutting coronal reconnection do not trigger CMEs in bipolar magnetic fields, but are key pre-eruptive mechanisms for flux ropes to build up and to rise to the critical height above the photosphere at which the torus instability causes the eruption. In order to interpret recent Hinode X-Ray Telescope observations of an erupting sigmoid, we produce simplified synthetic soft X-ray images from the distribution of the electric currents in the simulation. We find that a bright sigmoidal envelope is formed by pairs of J-shaped field lines in the pre-eruptive stage. These field lines form through the BP reconnection and merge later on into S-shaped loops through the tether-cutting reconnection. During the eruption, the central part of the sigmoid brightens due to the formation of a vertical current layer in the wake of the erupting flux rope. Slip-running reconnection in this layer yields the formation of flare loops. A rapid decrease of currents due to field line expansion, together with the increase of narrow currents in the reconnecting QSL, yields the sigmoid hooks to thin in the early stages of the eruption. Finally, a slightly rotating erupting loop-like feature (ELLF) detaches from the center of the sigmoid. Most of this ELLF is not associated with the erupting flux rope, but with a current shell that develops within expanding field lines above the rope. Only the short, curved end of the ELLF corresponds to a part of the flux rope. We argue that the features found in the simulation are generic for the formation and eruption of soft X-ray sigmoids.

Aulanier, G.; Toeroek, T.; Demoulin, P. [LESIA, Observatoire de Paris, CNRS, UPMC, Universite Paris Diderot, 5 place Jules Janssen, 92190 Meudon (France); DeLuca, E. E. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02139 (United States)

2010-01-01

316

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

NASA Astrophysics Data System (ADS)

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

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

2010-01-01

317

Prostaglandin e 2 : actions on the circular and longitudinal contractions of the canine colon  

Microsoft Academic Search

The effect of prostaglandin E2 (PGE2 on the circular and longitudinal contractions of the canine colon was studied in chronic conditions. A mechanical transducer\\u000a capable of recording simultaneously the variations of length in two perpendicular directions at 90° to each other was developed\\u000a and implanted on the canine colon 10 cm distal to the ileocaecal junction. The recording sessions started

T. Wittmann; O. Sanches; A. Lambert; G. Buliard; J. F. Grenier

1997-01-01

318

Long-term follow-up on the effects of sigmoid- rectal pouch for urinary diversion.  

PubMed

Purpose: The aim of this study was to investigate the long-term clinical effects of sigmoidrectal pouch for urinary diversion. Materials and Methods: A total of 45 patients, including 40 males and 5 females, underwent sigmoid-rectal pouch procedure. The patients aged from 38 to 70 years with a mean age of 59 years. The postoperative follow-up ranged from 6 months to 19 years with an average of 6 years. Postoperative continence and voiding were analyzed, urinary reservoir pressure was measured and the complications of upper urinary tract were determined. The index of quality of life (QoL) in the International Prostate Symptom Score (IPSS) was used to evaluate the degree of satisfaction to urinate. Results: Forty patients had slight incontinence in the early postoperative stage and could control urination well 30 days postoperatively. The volume of pouch was 270-600 mL with an average of 375 mL. The basic pressure during filling period was 6-20 cmH2O with an average 15 cmH2O, the maximum filling pressure was 15-30 cmH2O with an average 26 cmH2O. The compliance of sigmoid-rectal pouch was fine with an average of 30 (range 18-40) mL/ cmH2O. There were no severe complications such as hyperchloremic acidosis or retrograde pyelonephritis. Six patients had slight hydronephrosis. The index of QoL were 0-2 in 20 patients, 3 in five patients and 4 in two patients. Conclusion: The sigmoid-rectal pouch operation was simple and acceptable by surgeons and patients. It may be an ideal urinary diversion for patients with muscle-invasive bladder cancer, especially for patients on whom urethrectomy should be done.  PMID:25015609

Sun, Bin; Yan, Jing-Min; Li, Jian-Ye; Guo, He-Qing; Hong, Quan; Yao, Zhi-Yong; Zhou, Gao-Biao; Pan, Guang-Xin; Li, Xian-Chu

2014-01-01

319

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

NASA Astrophysics Data System (ADS)

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

Savcheva, Antonia; van Ballegooijen, Adriaan

2009-10-01

320

Immediate postoperative parastomal end sigmoid hernia resulting in evisceration and strangulation.  

PubMed

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

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

2014-01-01

321

Immediate postoperative parastomal end sigmoid hernia resulting in evisceration and strangulation  

PubMed Central

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

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

2014-01-01

322

Speed of traveling fronts in a sigmoidal reaction-diffusion system  

NASA Astrophysics Data System (ADS)

We study a sigmoidal version of the FitzHugh-Nagumo reaction-diffusion system based on an analytic description using piecewise linear approximations of the reaction kinetics. We completely describe the dynamics of wave fronts and discuss the properties of the speed equation. The speed diagrams show front bifurcations between branches with one, three, or five fronts that differ significantly from the classical FitzHugh-Nagumo model. We examine how the number of fronts and their speed vary with the model parameters. We also investigate numerically the stability of the front solutions in a case when five fronts exist.

Zemskov, E. P.; Kassner, K.; Tsyganov, M. A.; Epstein, I. R.

2011-03-01

323

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

NASA Astrophysics Data System (ADS)

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

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

2013-12-01

324

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

PubMed Central

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

Obrador, S; Soto, M; Silvela, J

1975-01-01

325

Pneumomediastinum as a presenting symptom of perforated sigmoid cancer: a case report  

PubMed Central

We report a rare case of spontaneous pneumomediastinum due to perforation of sigmoid cancer in a patient suffering from Vogt-Koyanagi-Harada syndrome and temporal arteritis, two rare diseases. This patient, who generally receives corticosteroid and methotrexate therapy, was admitted to hospital with vague abdominal and left flank pain, urinary disorders and low grade fever one day prior to admission. Initial evaluation including X-ray and laboratory tests was normal. Several hours later a repeat chest X-ray showed pneumomediastinum. Chest and abdominal Computed Tomgraphy were performed because of worsening abdominal pain, and revealed a perforated sigma due to carcinoma.

Makhoul, Nicola

2009-01-01

326

Long-Term Survival Achieved by Resection of Metastases in the Liver and Lung in a Patient with Recurrent Colonic Cancer: Report of a Case  

Microsoft Academic Search

A 58-year-old man who underwent a potentially curative resection of cancer of the sigmoid colon at another hospital was subsequently\\u000a followed up at our hospital. A lateral segmentectomy was per-formed for a solitary hepatic metastasis, and partial resection\\u000a of right S1 was later carried out for a pulmonary metastasis. Another pulmonary metastasis was found 6 years after his third\\u000a operation

Makoto Suzuki; Chikabumi Kadoyama; Mizuto Otsuji; Toshiyuki Sugiura; Fumio Kimura; Toshikazu Suwa; Takehiko Fujisawa

2000-01-01

327

[Continent heterotopic derivation of urine in a partially isolated segment of the sigmoid intestine after cystprostatectomy].  

PubMed

From 1992 to 2006 cystprostatectomy with continent heterotopic urine derivation in a partially isolated segment of the sigmoid intestine was made in 37 males aged 39-78 years. The patients had the following tumor stages: 2 patients with T2NXM0, 20 patients with T3NXM0, 6 patients with T3N1M0, 9 patients with T3-4N1MX. Thirty patients (81%) had no complications in an early postoperative period, 7 (19%) had complications: purulent pyelonephritis (n = 2), wound suppuration (n = 3), intestinal eventration (n = 1), interintestinal abscess (n = 1). There were two lethal outcomes early after operation: one patient died of bilateral purulent pyelonephritis and the other one--of acute cardiac failure. For 3 years 27 (77%) of 35 patients had satisfactory quality of life. Thus, urine derivation by simple methods one of which is creation of a partially isolated reservoir from a sigmoid segment with transanal urine derivation is indicated after cystprostatectomy for elderly males with a high risk of postoperative complications and lethality (stage T2-T3NXMX) and unclear distant metastases. PMID:19670817

Bavil'ski?, V F; Saetov, M N; Plaksin, O F; Plaksin, V V; Salaznikov, A V

2009-01-01

328

Modularity of biochemical filtering for inducing sigmoid response in both inputs in an enzymatic AND gate.  

PubMed

We report the first systematic study of designed two-input biochemical systems as information processing gates with favorable noise transmission properties accomplished by modifying the gate's response from a convex shape to sigmoid in both inputs. This is realized by an added chemical "filter" process, which recycles some of the output back into one of the inputs. We study a system involving the biocatalytic function of the enzyme horseradish peroxidase, functioning as an AND gate. We consider modularity properties, such as the use of three different input chromogens that when oxidized yield signal detection outputs for various ranges of the primary input, hydrogen peroxide. We also examine possible uses of different filter effect chemicals (reducing agents) to induce the sigmoid response. A modeling approach is developed and applied to our data, allowing us to describe the enzymatic kinetics in the framework of a formulation suitable for evaluating the noise-handling properties of the studied systems as logic gates for information processing steps. PMID:23906353

Bakshi, Saira; Zavalov, Oleksandr; Halámek, Jan; Privman, Vladimir; Katz, Evgeny

2013-08-29

329

Segmental colonic transit time  

Microsoft Academic Search

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

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

1981-01-01

330

Imaging in colonic cancer.  

PubMed

Whilst the diagnosis of colonic cancer is always based on visually guided flexible colonoscopy, which is the only technique that provides a histological diagnosis, the pre-treatment assessment of the cancer involves computed tomography. This can determine the exact site of the cancer in the colon, its dimensions and juxta-colonic extension and is used to investigate for liver, mesenteric or lung metastases. PMID:24703379

Ridereau-Zins, C

2014-05-01

331

Colonic carcinoma after ureterosigmoidostomy  

PubMed Central

Urinary carcinogens promote late malignant transformation of the colon after a ureterosigmoidostomy. An unusual case is presented where, despite the early removal of the latter and hence cessation of urine flow, a colonic carcinoma developed at the site of previous anastomosis. The importance of surveillance of all patients who have undergone this procedure to avoid an iatrogenic cancer is emphasised.???Keywords: rhabdomyosarcoma; ureterosigmoidostomy; colonic carcinoma

Huang, A; McPherson, G

2000-01-01

332

Florid Cystic Endosalpingiosis Presenting as an Obstructive Colon Mass Mimicking Malignancy: Case Report and Literature Review  

Microsoft Academic Search

Case Report  We report a case of transmural florid cystic endosalpingiosis of the colon with tumor-like obstruction in a 90-year-old woman\\u000a with abdominal distention and obstruction.\\u000a \\u000a \\u000a \\u000a Pathological Findings  Colonoscopy examination revealed an obstructive luminal mass. Pathologic examination of the sigmoid colectomy specimen revealed\\u000a a transmural, florid proliferation of mostly cystically dilated glands that were lined by epithelium that varied from flattened\\u000a to

John J. Liang; Anais Malpica; Russell R. Broaddus

2007-01-01

333

Delayed Colon Perforation after Palliative Treatment for Rectal Carcinoma with Bare Rectal Stent: A Case Report  

PubMed Central

In order to relieve mechanical obstruction caused by rectal carcinoma, a bare rectal stent was inserted in the sigmoid colon of a 70-year-old female. The procedure was successful, and for one month the patient made good progress. She then complained of abdominal pain, however, and plain radiographs of the chest and abdomen revealed the presence of free gas in the subdiaphragmatic area. Surgical findings showed that a spur at the proximal end of the bare rectal stent had penetrated the rectal mucosal wall. After placing a bare rectal stent for the palliative treatment of colorectal carcinoma, close follow-up to detect possible perforation of the bowel wall is necessary.

Lee, Jeong-Min; Lee, Tae-Hoon

2000-01-01

334

Distal Ulna Hook Plate: Angular Stable Implant for Fixation of Distal Ulna  

PubMed Central

Distal ulna fractures, especially styloid injuries, classically have not been repaired, and only recently have these injuries been considered important. Certain fracture patterns of the distal ulna contribute to distal radioulnar joint (DRUJ) incongruity and potential instability. Appropriate fixation of the distal ulna is frequently difficult for several reasons: (1) high incidence of osteoporois in the affected patient population, (2) proximity of the injury to articular surfaces, and (3) lack of a proper implant to treat these injuries. The 2.0-mm locking compression distal ulna plate (LC-DUP) is an anatomically contoured implant with a low profile and fixed angle that provides proper stability to treat injuries of the distal ulna. The plate was designed for the treatment of distal ulna fractures, but its success has led to an extension of its indications to be used in treating symptomatic basistyloid ulnar nonunions and in ulnar shortening osteotomy for ulnocarpal abutment syndrome. The authors' description of the techniques used for each indication as well as their perspectives in the treatment of distal ulna injuries are described in detail in this report.

Nunez, Fiesky A.; Li, Zhongyu; Campbell, Douglas; Nunez, Fiesky A.

2013-01-01

335

A new approach in maxillary molar distalization: Intraoral bodily molar distalizer  

Microsoft Academic Search

The objectives of our study were to achieve bodily molar distalization, avoid distal tipping of molars, eliminate the need for patient cooperation (no headgear, no elastics, and no esthetic and social concern), and finally to minimize the treatment period and maximize the treatment efficiency. The study was carried out on 5 males and 10 females, a total of 15 patients.

Ahmet Keles; Korkmaz Sayinsu

2000-01-01

336

Complications After Open Distal Clavicle Excision  

PubMed Central

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.

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

2008-01-01

337

Recurrent Explosive Eruptions and the "Sigmoid-to-arcade" Transformation in the Sun Driven by Dynamical Magnetic Flux Emergence  

NASA Astrophysics Data System (ADS)

We report on three-dimensional MHD simulations of recurrent mini coronal mass ejection (CME)-like eruptions in a small active region (AR), which is formed by the dynamical emergence of a twisted (not kink unstable) flux tube from the solar interior. The eruptions develop as a result of the repeated formation and expulsion of new flux ropes due to continuous emergence and reconnection of sheared field lines along the polarity inversion line of the AR. The acceleration of the eruptions is triggered by tether-cutting reconnection at the current sheet underneath the erupting field. We find that each explosive eruption is followed by reformation of a sigmoidal structure and a subsequent "sigmoid-to-flare arcade" transformation in the AR. These results might have implications for recurrent CMEs and eruptive sigmoids/flares observations and theoretical studies.

Archontis, V.; Hood, A. W.; Tsinganos, K.

2014-05-01

338

COLON TARGETED DRUG DELIVERY SYSTEMS  

Microsoft Academic Search

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

Ceyda Tuba

339

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

PubMed

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

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

2014-02-15

340

Changes in the Muscarinic Receptors on the Colonic Smooth Muscles of Rats with Spinal Cord Injury  

PubMed Central

Objective To investigate changes in (1) the colonic response to acetylcholine (Ach), (2) the muscarinic (M) receptors in the colon, and (3) the levels of colonic contraction-related proteins after a spinal cord injury (SCI). Method We divided 16 Sprague-Dawley rats into 2 groups: the control group and the SCI group. A spinal cord transection was performed surgically at the T10 vertebral level. After 1 week, the entire colon was divided into 2 segments, the proximal and distal colon. Each segment was mounted in a longitudinal or circular muscle direction in a 10-ml organ bath. We determined the intergroup differences as percentage changes in contractility after Ach treatment alone, Ach treatment with M2 receptor antagonist (AQ-RA741) pretreatment, and Ach treatment with M3 receptor antagonist (4-DAMP) pretreatment. Western blot analyses were performed to determine the expression level of RhoA, and heat shock protein 27 (HSP27). Results Compared to the control rats, the SCI rats showed an increased response to Ach along both the directions in the proximal colon (p<0.05). Compared to the control group, in the SCI group, the Ach response was significantly different in the proximal segment under AQ-RA741 pretreatment (p<0.05) and in the distal segment under 4-DAMP pretreatment (p<0.05). Findings of the western blot analyses showed a significant decrease in the level of protein gene product 9.5 in the proximal and distal colon and a significant increase in the level of RhoA and HSP27 in the proximal colon of the SCI rats. Conclusion Our results suggest that changes in colonic contractility after SCI are partly attributable to changes in the M receptor subtypes.

Joo, Min Cheol; Kim, Yong Sung; Choi, Eul Sik; Oh, Jung Taek; Park, Hyun Joon

2011-01-01

341

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

SciTech Connect

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

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

2010-11-01

342

A sigmoidal fit for pressure-volume curves of idiopathic pulmonary fibrosis patients on mechanical ventilation: clinical implications  

PubMed Central

OBJECTIVE: Respiratory pressure-volume curves fitted to exponential equations have been used to assess disease severity and prognosis in spontaneously breathing patients with idiopathic pulmonary fibrosis. Sigmoidal equations have been used to fit pressure-volume curves for mechanically ventilated patients but not for idiopathic pulmonary fibrosis patients. We compared a sigmoidal model and an exponential model to fit pressure-volume curves from mechanically ventilated patients with idiopathic pulmonary fibrosis. METHODS: Six idiopathic pulmonary fibrosis patients and five controls underwent inflation pressure-volume curves using the constant-flow technique during general anesthesia prior to open lung biopsy or thymectomy. We identified the lower and upper inflection points and fit the curves with an exponential equation, V?=?A-B.e-k.P, and a sigmoid equation, V?=?a+b/(1+e-(P-c)/d). RESULTS: The mean lower inflection point for idiopathic pulmonary fibrosis patients was significantly higher (10.5±5.7 cm H2O) than that of controls (3.6±2.4 cm H2O). The sigmoidal equation fit the pressure-volume curves of the fibrotic and control patients well, but the exponential equation fit the data well only when points below 50% of the inspiratory capacity were excluded. CONCLUSION: The elevated lower inflection point and the sigmoidal shape of the pressure-volume curves suggest that respiratory system compliance is decreased close to end-expiratory lung volume in idiopathic pulmonary fibrosis patients under general anesthesia and mechanical ventilation. The sigmoidal fit was superior to the exponential fit for inflation pressure-volume curves of anesthetized patients with idiopathic pulmonary fibrosis and could be useful for guiding mechanical ventilation during general anesthesia in this condition.

Ferreira, Juliana C; Bensenor, Fabio E M; Rocha, Marcelo J J; Salge, Joao M; Harris, R Scott; Malhotra, Atul; Kairalla, Ronaldo A; Kacmarek, Robert M; Carvalho, Carlos R R

2011-01-01

343

Colonic inflammation and secondary bile acids in alcoholic cirrhosis.  

PubMed

Alcohol abuse with/without cirrhosis is associated with an impaired gut barrier and inflammation. Gut microbiota can transform primary bile acids (BA) to secondary BAs, which can adversely impact the gut barrier. The purpose of this study was to define the effect of active alcohol intake on fecal BA levels and ileal and colonic inflammation in cirrhosis. Five age-matched groups {two noncirrhotic (control and drinkers) and three cirrhotic [nondrinkers/nonalcoholics (NAlc), abstinent alcoholic for >3 mo (AbsAlc), currently drinking (CurrAlc)]} were included. Fecal and serum BA analysis, serum endotoxin, and stool microbiota using pyrosequencing were performed. A subgroup of controls, NAlc, and CurrAlc underwent ileal and sigmoid colonic biopsies on which mRNA expression of TNF-?, IL-1?, IL-6, and cyclooxygenase-2 (Cox-2) were performed. One hundred three patients (19 healthy, 6 noncirrhotic drinkers, 10 CurrAlc, 38 AbsAlc, and 30 NAlc, age 56 yr, median MELD: 10.5) were included. Five each of healthy, CurrAlc, and NAlc underwent ileal/colonic biopsies. Endotoxin, serum-conjugated DCA and stool total BAs, and secondary-to-primary BA ratios were highest in current drinkers. On biopsies, a significantly higher mRNA expression of TNF-?, IL-1?, IL-6, and Cox-2 in colon but not ileum was seen in CurrAlc compared with NAlc and controls. Active alcohol use in cirrhosis is associated with a significant increase in the secondary BA formation compared with abstinent alcoholic cirrhotics and nonalcoholic cirrhotics. This increase in secondary BAs is associated with a significant increase in expression of inflammatory cytokines in colonic mucosa but not ileal mucosa, which may contribute to alcohol-induced gut barrier injury. PMID:24699327

Kakiyama, Genta; Hylemon, Phillip B; Zhou, Huiping; Pandak, William M; Heuman, Douglas M; Kang, Dae Joong; Takei, Hajime; Nittono, Hiroshi; Ridlon, Jason M; Fuchs, Michael; Gurley, Emily C; Wang, Yun; Liu, Runping; Sanyal, Arun J; Gillevet, Patrick M; Bajaj, Jasmohan S

2014-06-01

344

Osteochondritis of the Distal Tibial Epiphysis  

PubMed Central

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

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

2012-01-01

345

Operative treatment of distal radius fractures.  

PubMed

The incidence of distal radius fractures is increasing together with the average age of population. Intra-articular incongruity is the most probable cause of unsatisfactory outcome of distal radius fractures in younger and more active patients. Thus, the main goal in the treatment of distal radius fractures should be restoration of articular congruence. A computed tomography (CT) is recommended to help surgeon in preoperative planning in the treatment of comminuted intra-articular fractures. New implants have been designed to provide stable enough fixation for early mobilisation after surgery and to lower rather high complication rates related to conventional fixation methods such as external fixation and dorsal plating. The most common complications related to volar fixed angle plating such as flexor and extensor tendon problems, median nerve neuropathy, and screw diplacement into the radiocarpal joint are surgeon related and are avoidable with proper education. More randomized prospective studies are needed to prove superiority of any fixation method to another. PMID:19211382

Vasenius, J

2008-01-01

346

Distal Cervical Internal Carotid Artery Stenosis  

PubMed Central

This report describes a case of distal cervical internal carotid artery (ICA) occlusive lesion managed by saphenous interposition vein graft after exposure of the ICA up to the skull base. The skull base approach described herein emphasizes the mobilization of the mandible without mandibular osteotomy or disarticulation. Instead, the stylomandibular and stylosphenoidal ligaments are resected to allow mandibular mobilization. In addition, the distal ICA lesion represented a form of diffuse intimal thickening without any plaque formation. This required the resection of the thickened, stenotic segment and reconstruction of the distal cervical ICA with a saphenous interposition graft. The surgical management implications of diffuse intimal thickening are discussed. ImagesFigure 1Figure 4Figure 5Figure 6p114-b

Awasthi, Deepak; Smith, Roger

1994-01-01

347

Colonic motor responses in the pony: relevance of colonic stimulation by opiate antagonists.  

PubMed

The electrical and mechanical activity of the digestive tract and its response to the administration of opiate agonists and antagonists was assessed from electrodes and strain gauges chronically implanted on the jejunum and the cecocolonic segments in 3 ponies given a diet of hay and concentrates. Before the drugs were given, 10 to 17 migrating myoelectric complexes/day were recorded on the small intestine, and a rhythmic motor activity (base line) was observed on the proximal portion of the colon at the rate of 3.5 to 6.6/hour. Propagated contractions from the proximal to the distal portion of the colon occurred at the rate of 1.5 to 2.3/hour. Each pony was used as its own control and was given morphine (0.5 or 1 mg/kg of body weight, IV) or fentanyl (0.01 or 0.05 mg, IV) at weekly intervals. After an early phase of inhibition of the overall activity that lasted from 0.5 to 3 hours, depending on the dose, the resting muscle tone of the colonic activity was increased for a dose-dependent period. Propagated contractions only reappeared at the end of this 2nd phase. The opiate antagonist naloxone (0.5 mg/kg, IV) elicited a marked propulsive activity on the left replicated colonic segment, characterized by an increase in the number of propagated contractions. The N-methyl-quaternary analog of naloxone (methylnaloxone, which presumably entails selective action at opiate receptors outside the CNS) was also effective, indicating peripheral effects at the dosage level used (0.5 mg/kg, IV). Seemingly, an inhibitory opioid system exists in the control of colonic motor function in ponies and the possible usefulness of opiate antagonists to relieve hypomotility resulting in colonic impaction and constipation. PMID:3970439

Roger, T; Bardon, T; Ruckebusch, Y

1985-01-01

348

Unilateral molar distalization with a modified slider.  

PubMed

Although there are numerous publications on bilateral non-compliance molar distalization appliances, there is limited information on problems such as asymmetrical unilateral Class II malocclusions. The aim of the present investigation was to examine the distalization of molars unilaterally in patients with a unilateral Class II molar relationship utilizing a Keles Slider, designed without a bite plane. Ten girls (mean age 13.94 +/- 2.13 years) and seven boys (mean age 13.12 +/- 1.51 years) comprised the study material. Following insertion of the appliance, the patients were seen monthly and the screw was reactivated every 2 months. After a super-Class I molar relationship was achieved, the appliance was removed and the molars were stabilized with a Nance appliance for 2 months before the second-phase of orthodontic treatment. The Nance appliance was maintained in the palate until the end of canine distalization. Lateral cephalometric radiographs were obtained before and immediately after insertion of the molar distalizer. The results showed that the maxillary first molars were distalized bodily on average by 2.85 mm. The maxillary first premolars moved forward bodily 2 mm and were extruded 2.03 mm. In all, 1.32 mm of protrusion, 1.12 mm of extrusion, and 1.79 degrees of proclination of the upper incisors were observed. The mandibular incisors and mandibular molars erupted 0.83 and 0.95 mm, respectively. The unilateral Keles Slider distalized molars successfully to a Class I molar relationship. PMID:16648210

Sayinsu, Korkmaz; Isik, Fulya; Allaf, Ferdi; Arun, Tülin

2006-08-01

349

A sodium hyaluronate carboxymethylcellulose bioresorbable membrane prevents postoperative small-bowel adhesive obstruction after distal gastrectomy  

Microsoft Academic Search

Purpose  It is predictable that since distal gastrectomy (DG) with Billroth I anastomosis involves no procedures caudal to transverse\\u000a colon, the effects of the surgical wound are the main cause of adhesive obstruction. Thus, it is an appropriate operation\\u000a to test the efficiency of a synthetic absorbable adhesion barrier (Seprafilm).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The subjects were 282 patients diagnosed with gastric cancer who underwent

Hideki Kawamura; Ryoichi Yokota; Kentaro Yokota; Hiroshi Watarai; Yoshihiko Tsunoda; Hideki Yamagami; Tsunetake Hata; Koichi Tanaka; Hiroyuki Masuko; Hiroyuki Ishizu; Kuniaki Okada; Takehiko Adachi; Yukifumi Kondo

2010-01-01

350

Recent advances in distal tubular potassium handling  

PubMed Central

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.

Rodan, Aylin R.; Cheng, Chih-Jen

2011-01-01

351

Torsion of wandering spleen and distal pancreas  

SciTech Connect

Wandering spleen is the term applied to the condition in which a long pedicle allows the spleen to lie in an abnormal location. Torsion of a wandering spleen is an unusual cause of an acute abdomen and is rarely diagnosed preoperatively. Associated torsion of the distal pancreas is even more uncommon. The authors describe a patient with torsion of a wandering spleen and distal pancreas, who was correctly diagnosed, and define the merits of the imaging methods used. The initial examination should be /sup 99//sup m/Tc-sulfur colloid liner-spleen scanning.

Sheflin, J.R.; Lee, C.M.; Kretchmar, K.A.

1984-01-01

352

Distal-Selective Hydroformylation using Scaffolding Catalysis.  

PubMed

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

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

2014-06-18

353

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

PubMed Central

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

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

2014-01-01

354

Forward-viewing radial-array echoendoscope for staging of colon cancer beyond the rectum  

PubMed Central

AIM: To evaluate feasibility of the novel forward-viewing radial-array echoendoscope for staging of colon cancer beyond rectum as the first series. METHODS: A retrospective study with prospectively entered database. From March 2012 to February 2013, a total of 21 patients (11 men) (mean age 64.2 years) with colon cancer beyond the rectum were recruited. The novel forward-viewing radial-array echoendoscope was used for ultrasonographic staging of colon cancer beyond rectum. Ultrasonographic T and N staging were recorded when surgical pathology was used as a gold standard. RESULTS: The mean time to reach the lesion and the mean time to complete the procedure were 3.5 and 7.1 min, respectively. The echoendoscope passed through the lesions in 13 patients (61.9%) and reached the cecum in 10 of 13 patients (76.9%). No adverse events were found. The lesions were located in the cecum (n = 2), ascending colon (n = 1), transverse colon (n = 2), descending colon (n = 2), and sigmoid colon (n = 14). The accuracy rate for T1 (n = 3), T2 (n = 4), T3 (n = 13) and T4 (n = 1) were 100%, 60.0%, 84.6% and 100%, respectively. The overall accuracy rates for the T and N staging of colon cancer were 81.0% and 52.4%, respectively. The accuracy rates among traversable lesions (n = 13) and obstructive lesions (n = 8) were 61.5% and 100%, respectively. Endoscopic ultrasound and computed tomography had overall accuracy rates of 81.0% and 68.4%, respectively. CONCLUSION: The echoendoscope is a feasible staging tool for colon cancer beyond rectum. However, accuracy of the echoendoscope needs to be verified by larger systematic studies.

Kongkam, Pradermchai; Linlawan, Sittikorn; Aniwan, Satimai; Lakananurak, Narisorn; Khemnark, Suparat; Sahakitrungruang, Chucheep; Pattanaarun, Jirawat; Khomvilai, Supakij; Wisedopas, Naruemon; Ridtitid, Wiriyaporn; Bhutani, Manoop S; Kullavanijaya, Pinit; Rerknimitr, Rungsun

2014-01-01

355

Insulin and colon cancer  

Microsoft Academic Search

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

Edward Giovannucci

1995-01-01

356

Colon Hydrotherapy Device.  

National Technical Information Service (NTIS)

A colon hydrotherapy device that includes a multi-chambered housing, a specially designed nozzle for creating a water vortex within the subject's colon for removing impacted fecal matter, and an insertion rod for facilitating the insertion of the device i...

C. W. Waychoff

2004-01-01

357

Cat Scratch Colon  

PubMed Central

Over the past few years, we have read several publications regarding the term “cat scratch colon.” This neologism was developed to define some bright red linear markings seen in the colonic mucosa that resemble scratches made by a cat. We would like to communicate a recent case attended at our institution.

Ruiz-Rebollo, M. Lourdes; Velayos-Jimenez, Benito; Prieto de Paula, Jose Maria; Alvarez Quinones, Maria; Gonzalez Hernandez, Jose Manuel

2011-01-01

358

Sodium-Coupled Transport of the Short Chain Fatty Acid Butyrate by SLC5A8 and Its Relevance to Colon Cancer  

Microsoft Academic Search

Introduction  SLC5A8, expressed predominantly in the colon, is a Na+-coupled transporter for short-chain fatty acids. In this paper, we report on the characterization of butyrate transport by\\u000a SLC5A8 and the relevance of SLC5A8-mediated butyrate transport to colon cancer.\\u000a \\u000a \\u000a \\u000a Results  SLC5A8 transports butyrate via a Na+-dependent electrogenic process. Na+ activation of the transport process exhibits sigmoidal kinetics, indicating involvement of more than one

Muthusamy Thangaraju; Gail Cresci; Shiro Itagaki; John Mellinger; Darren D. Browning; Franklin G. Berger; Puttur D. Prasad; Vadivel Ganapathy

2008-01-01

359

The distal hindlimb musculature of the cat  

Microsoft Academic Search

Summary  Chronic recordings were made of electromyographic (EMG) activity, tension, and length of distal hindlimb muscles in six cats performing a variety of normal motor tasks. Muscles studied thoroughly or in part were medial gastrocnemius, lateral gastrocnemius, plantaris, soleus, flexor digitorum brevis, flexor digitorum longus, flexor hallucis longus, tibialis posterior, tibialis anterior, extensor digitorum longus, peroneus longus, and peroneus brevis. Postural

L. D. Abraham; G. E. Loeb

1985-01-01

360

Molar distalization with the Herbst appliance  

Microsoft Academic Search

This article reviews the dental effects of the Herbst appliance as well as itslong-term effects on the dentition. The Herbst appliance exhibits a pronounced high-pull headgear effect on the maxillary molars. Without retention, the molars tend to return to their former anteroposterior positions after the removal of the appliance. These distal movements of the maxillary molars are favorable in Class

Meson Lai

2000-01-01

361

Distal upper extremity motion during keyboarding  

Microsoft Academic Search

Abnormal computer keyboard typing patterns have been associated with musculoskeletal disorders of the upper extremities. Threshold values for quantifying abnormal distal upper extremity function during typing have been established to identify typing behaviors that may place the computer user at risk for developing an injury. In this paper, the joint displacements of repeated typing tasks were normalized using previously collected

E. J. Bill; D. R. Peterson

2007-01-01

362

Outcome and prognostic factors of morbidity and mortality in perforated sigmoid diverticulitis.  

PubMed

The aim of this study was to assess the outcomes after treatment of patients with this condition and to identify prognostic factors of morbidity and mortality. From 1986 to 2005, the charts of 114 consecutive patients who were treated for perforated sigmoid diverticulitis were retrospectively reviewed. Thirty-three patients (28.9%) were treated conservatively, and 81 (71.1%) underwent surgery. Postoperative major morbidity and mortality rates were 35.8% and 6.2%, respectively. Age > 70 years, female sex, associated diseases, low serum albumin level, high American Society of Anesthesiologists class, and Mannheim Peritonitis Index score of 21 or more were factors linked with a poor outcome. Perforated diverticulitis carries substantial morbidity and occasional mortality. To achieve improvements in outcomes, the surgical procedure should be chosen on the basis of the presence of prognostic factors. Moreover, intensive treatment after surgery in patients with risk factors is recommended. PMID:20187519

Alvarez, José A; Baldonedo, Ricardo F; Bear, Isabel G; Otero, Jorge; Pire, Gerardo; Alvarez, Paloma; Jorge, José I

2009-01-01

363

Urachal-sigmoid fistula in an adult male without urachal cyst.  

PubMed

Urachal anomalies are uncommon defects arising either by incomplete obliteration of the urachus during the foetal period or by its reopening after postnatal regression. Five anomalies have been described: congenital patent urachus, urachal cyst, umbilical-urachal sinus, vesico-urachal diverticulum, and alternating sinus. Only congenital patent urachus is present at childbirth. The other forms are usually acquired disorders. Nevertheless, they commonly appear in children, being less common in the adult. Colic-urachal fistulas are quite uncommon findings. Only three cases have been reported thus far. The aim of this study is to report the fourth case of sigmoid-urachal fistula, and the first one appearing without an urachal cyst. PMID:12432840

Gómez Barbadillo, J; Plata Rosales, J; Espinosa Guzmán, E; Castilla Cabezas, J; Díaz López, C; Soria Alvarez, C; Ramos Cejudo, F; Gutiérrez Sainz, J

2002-07-01

364

Transfemoral Transvenous Embolization of Dural Arteriovenous Fistulas Involving the Isolated Transverse-Sigmoid Sinus  

PubMed Central

Summary Dural arteriovenous fistulas involving the transverse-sigmoid sinus (T-S dAVFs) are sometimes isolated because this affected sinus is often thrombosed. It is difficult to perform to microcatheter cannulation to the isolated sinus through the thrombosed portion. We are now treating these T-S dAVFs by transfemoral transvenous embolization via the ipsilateral side even if the affected sinus is thrombosed and isolated or not. We use a triaxial system (6Fr. guiding catheter / 4Fr. diagnostic catheter / microcatheter) to emphasize the pushability and handling of the microcatheter. And we insert 4 Fr. Catheter into the affected sinus. So we can perform microcatheter cannulation into the isolated and affected sinus for treatment by coil embolization with various detachable coils.

Kiura, Y.; Ohba, S.; Shibukawa, M.; Sakamoto, S.; Okazaki, T.; Kurisu, K.

2007-01-01

365

Transfemoral transvenous embolization of dural arteriovenous fistulas involving the isolated transverse-sigmoid sinus.  

PubMed

Summary: Dural arteriovenous fistulas involving the transverse-sigmoid sinus (T-S dAVFs) are sometimes isolated because this affected sinus is often thrombosed. It is difficult to perform to microcatheter cannulation to the isolated sinus through the thrombosed portion. We are now treating these T-S dAVFs by transfemoral transvenous embolization via the ipsilateral side even if the affected sinus is thrombosed and isolated or not. We use a triaxial system (6Fr. guiding catheter / 4Fr. diagnostic catheter / microcatheter) to emphasize the pushability and handling of the microcatheter. And we insert 4Fr. Catheter into the affected sinus. So we can perform microcatheter cannulation into the isolated and affected sinus for treatment by coil embolization with various detachable coils. PMID:20566087

Kiura, Y; Ohba, S; Shibukawa, M; Sakamoto, S; Okazaki, T; Kurisu, K

2007-03-15

366

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

PubMed Central

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

Kim, Taeyun

2013-01-01

367

Sporadic colon cancer murine models demonstrate the value of autoantibody detection for preclinical cancer diagnosis  

PubMed Central

Although autoantibody detection has been proposed for diagnosis of colorectal cancer, little is known about their initial production and development correlation with cancer progression. Azoxymethane/dextran sodium sulfate (AOM/DSS)-treated mice developed colon adenocarcinoma in the distal colon similar to human sporadic colon cancer. We assessed this model together with AOM and DSS-only models for their applicability to early detection of cancer. All AOM/DSS-treated mice produced autoantibodies to tumor-associated antigens analogous to those observed in human colon cancer patients. Autoantibody response was related to tumor antigen overexpression. Cancer autoantibodies were detected 21 days after starting treatment, when no malignant histopathological features were detectable, and they increased according to tumor progression. When carcinogenesis was induced separately by AOM or DSS, only those mice that developed malignant lesions produced significant levels of autoantibodies. These findings demonstrate that autoantibody development is an early event in tumorigenesis and validates its use for preclinical colon cancer diagnosis.

Barderas, Rodrigo; Villar-Vazquez, Roi; Fernandez-Acenero, Maria Jesus; Babel, Ingrid; Pelaez-Garcia, Alberto; Torres, Sofia; Casal, J. Ignacio

2013-01-01

368

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

NASA Astrophysics Data System (ADS)

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

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

2014-07-01

369

SIGMOID-TO-FLUX-ROPE TRANSITION LEADING TO A LOOP-LIKE CORONAL MASS EJECTION  

SciTech Connect

Sigmoids are one of the most important precursor structures for solar eruptions. In this Letter, we study a sigmoid eruption on 2010 August 1 with EUV data obtained by the Atmospheric Imaging Assembly (AIA) on board the Solar Dynamic Observatory (SDO). In AIA 94 A (Fe XVIII; 6 MK), topological reconfiguration due to tether-cutting reconnection is unambiguously observed for the first time, i.e., two opposite J-shaped loops reconnect to form a continuous S-shaped loop, whose central portion is dipped and aligned along the magnetic polarity inversion line (PIL), and a compact loop crossing the PIL. A causal relationship between photospheric flows and coronal tether-cutting reconnections is evidenced by the detection of persistent converging flows toward the PIL using line-of-sight magnetograms obtained by the Helioseismic and Magnetic Imager on board SDO. The S-shaped loop remains in quasi-equilibrium in the lower corona for about 50 minutes, with the central dipped portion rising slowly at {approx}10 km s{sup -1}. The speed then increases to {approx}60 km s{sup -1} about 10 minutes prior to the onset of a GOES-class C3.2 flare, as the S-shaped loop speeds up its transformation into an arch-shaped loop, which eventually leads to a loop-like coronal mass ejection. The AIA observations combined with H{alpha} filtergrams as well as hard X-ray imaging and spectroscopy are consistent with most flare loops being formed by reconnection of the stretched legs of less-sheared J-shaped loops that envelopes the rising flux rope, in agreement with the standard tether-cutting scenario.

Liu Rui; Liu Chang; Wang Shuo; Deng Na; Wang Haimin, E-mail: rui.liu@njit.ed [Space Weather Research Laboratory, Center for Solar-Terrestrial Research, NJIT, Newark, NJ 07102 (United States)

2010-12-10

370

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

PubMed

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

Ramírez-Alcántara, Verónica; Montrose, Marshall H

2014-06-01

371

Immunoelectron microscopic localisation of transforming growth factor alpha in rat colon.  

PubMed Central

Transforming growth factor alpha (TGF alpha) is a polypeptide, which binds to the epidermal growth factor receptor to carry out its function related to cell proliferation and differentiation. The ultrastructural localisation of TGF alpha was studied in both the proximal and the distal colon. The columnar cells, lining the surface epithelium of the proximal colon, showed a strong immunoreactivity in the polyribosomes and in the interdigitations of the lateral membrane. The columnar cells of the crypts and the goblet cells in both the proximal and the distal colon showed the immunostaining in the cis and trans cisternae of the Golgi apparatus. TGF alpha seems to be processed differently in the surface columnar cells and in the crypt columnar cells and goblet cells. Moreover, it probably has different roles in proliferation and differentiation. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7

Perez-Tomas, R; Cullere, X; Asbert, M; Diaz-Ruiz, C

1994-01-01

372

Colon water transport in transgenic mice lacking aquaporin-4 water channels  

PubMed Central

Transgenic null mice were used to test the hypothesis that water channel aquaporin-4 (AQP4) is involved in colon water transport and fecal dehydration. AQP4 was immunolocalized to the basolateral membrane of colonic surface epithelium of wild-type (+/+) mice and was absent in AQP4 null (?/?) mice. The transepithelial osmotic water permeability coefficient (Pf) of in vivo perfused colon of +/+ mice, measured using the volume marker 14C-labeled polyethylene glycol, was 0.016 ± 0.002 cm/s. Pf of proximal colon was greater than that of distal colon (0.020 ± 0.004 vs. 0.009 ± 0.003 cm/s, P < 0.01). Pf was significantly lower in ?/? mice when measured in full-length colon (0.009 ± 0.002 cm/s, P < 0.05) and proximal colon (0.013 ± 0.002 cm/s, P < 0.05) but not in distal colon. There was no difference in water content of cecal stool from +/+ vs. ?/? mice (0.80 ± 0.01 vs. 0.81 ± 0.01), but there was a slightly higher water content in defecated stool from +/+ mice (0.68 ± 0.01 vs. 0.65 ± 0.01, P < 0.05). Despite the differences in water permeability with AQP4 deletion, theophylline-induced secretion was not impaired (50 ± 9 vs. 51 ± 8 ?l · min?1 · g?1). These results provide evidence that transcellular water transport through AQP4 water channels in colonic epithelium facilitates transepithelial osmotic water permeability but has little or no effect on colonic fluid secretion or fecal dehydration.

WANG, KASPER S.; MA, TONGHUI; FILIZ, FERDA; VERKMAN, A. S.; BASTIDAS, J. AUGUSTO

2012-01-01

373

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

PubMed

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

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

2005-11-01

374

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

SciTech Connect

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

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

1991-07-01

375

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

PubMed

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

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

2014-02-01

376

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

PubMed Central

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.

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

1987-01-01

377

Cortagine, a CRF1 agonist, induces stresslike alterations of colonic function and visceral hypersensitivity in rodents primarily through peripheral pathways  

PubMed Central

Corticotropin-releasing factor (CRF) 1 receptor (CRF1) activation in the brain is a core pathway orchestrating the stress response. Anatomical data also support the existence of CRF signaling components within the colon. We investigated the colonic response to intraperitoneal (ip) injection of cortagine, a newly developed selective CRF1 peptide agonist. Colonic motor function and visceral motor response (VMR) were monitored by using a modified miniaturized pressure transducer catheter in adult conscious male Sprague-Dawley rats and C57Bl/6 mice. Colonic permeability was monitored by the Evans blue method and myenteric neurons activation by Fos immunohistochemistry. Compared with vehicle, cortagine (10 ?g/kg ip) significantly decreased the distal colonic transit time by 45% without affecting gastric transit, increased distal and transverse colonic contractility by 35.6 and 66.2%, respectively, and induced a 7.1-fold increase in defecation and watery diarrhea in 50% of rats during the first hour postinjection whereas intracerebroventricular (icv) cortagine (3 ?g/rat) had lesser effects. Intraperitoneal (ip) cortagine also increased colonic permeability, activated proximal and distal colonic myenteric neurons, and induced visceral hypersensitivity to a second set of phasic colorectal distention (CRD). The CRF antagonist astressin (10 ?g/kg ip) abolished ip cortagine-induced hyperalgesia whereas injected icv it had no effect. In mice, cortagine (30 ?g/kg ip) stimulated defecation by 7.8-fold, induced 60% incidence of diarrhea, and increased VMR to CRD. Stresslike colonic alterations induced by ip cortagine in rats and mice through restricted activation of peripheral CRF1 receptors support a role for peripheral CRF1 signaling as the local arm of the colonic response to stress.

Larauche, Muriel; Gourcerol, Guillaume; Wang, Lixin; Pambukchian, Karina; Brunnhuber, Stefan; Adelson, David W.; Rivier, Jean; Million, Mulugeta; Tache, Yvette

2009-01-01

378

Brain metastases from colon cancer  

Microsoft Academic Search

Between 1977 and 1980 we evaluated 40 patients who developed brain metastases from colon cancer (4% of total patients with colon cancer). The brain metastasis was discovered in only one patient prior to cancer diagnosis; all others had known colon cancer for 2 to 48 months (median 24.5 months) prior to neurologic presentation. The colon tumor was left-sided in 32;

T. L. Cascino; J. M. Leavengood; N. Kemeny; J. B. Posner

1983-01-01

379

Composition of human colonic mucin. Selective alteration in inflammatory bowel disease.  

PubMed Central

Human colonic mucin has been isolated from mucosal scrapings of fresh surgical specimens of normal controls as well as patients with Crohn's colitis and ulcerative colitis. Following sonication and ultracentrifugation, mucin fractions were separated from other soluble colonic glycoproteins by Sepharose 4B chromatography. After nuclease digestion, cesium chloride gradient centrifugation of the excluded material yielded colonic mucin with an average buoyant density of 1.52 g/ml. Subsequent chromatography of the apparently homogeneous colonic mucin on DEAE-cellulose revealed the presence of at least six distinct mucin species (mucin I-VI). Each mucin species was found to have a distinctive hexose, hexosamine, sialic acid, and sulfate content as well as blood group substance activities. Mucin from five patients with Crohn's colitis was found to represent a mixture of at least six discrete species comparable to those isolated from normal colonic specimens. However, in mucin from eight patients with ulcerative colitis there was a marked and selective reduction of one component mucin subclass, designated species IV. Normal mucin and mucin from patients with Crohn's disease contained 48 +/- 17 and 42 +/- 12 mg of species IV/g, while mucin from patients with ulcerative colitis had 5 +/- 3 mg/g solubilized glycoprotein. The selective absence of species IV was found in preparations from both sigmoid (n = 7) and ascending (n = 4) colon and could not be accounted for by an overall decrease in total mucin content. The selective reduction of species IV was also found in mucin isolated from relatively noninflamed colonic mucosa of patients with ulcerative colitis. The carbohydrate composition and blood group activities of the remaining five mucin species were similar to their normal counterparts. Based on the results to date, there appears to be an underlying selective decrease of one colonic mucin subclass in ulcerative colitis.

Podolsky, D K; Isselbacher, K J

1983-01-01

380

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

PubMed

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

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

2014-04-01

381

Microsatellite instability: impact on cancer progression in proximal and distal colorectal cancers.  

PubMed

Whilst individual planning of treatment and follow-up in every colorectal cancer case is an increasing demand, prognostic markers are needed for predicting cancer progression in the primary phase. We studied the effect of replication error (RER)-positivity on colorectal cancer progression by analysing 255 colorectal cancer specimens by polymerase chain reaction (PCR) and fragment analysis and correlating the results with the clinical and histological features of the tumour and with patient outcome. RER-positivity was detected in 12% (28/235) of cases. It was associated with proximal location of the tumour (P < 0.001), poor differentiation (P = 0.001) and large tumour size (P = 0.009). The 5-year cumulative survival rate of the patients with RER-positive cancer of the proximal colon was markedly better (100%) than that of those with RER-negative proximal cancer (74%), whilst in cases of cancer of the distal colon or rectum, RER-positivity (21%) indicated poorer survival than RER-negativity (57%). Thus, it is suggested that RER-positivity has an opposite impact on cancer progression in cases of proximal and distal cancers. RER-positivity appears to indicate improved prognosis only in cases of proximally located cancer, in which it could accordingly be useful as a prognostic marker. PMID:10448259

Jernvall, P; Mäkinen, M J; Karttunen, T J; Mäkelä, J; Vihko, P

1999-02-01

382

An in vivo comparison of intestinal pH and bacteria as physiological trigger mechanisms for colonic targeting in man  

Microsoft Academic Search

Targeting the colon for site-specific oral delivery can exploit one of two main physiological triggers; the intestinal pH changes or the increase in bacterial numbers in the distal gut. This study aimed to assess how these triggers compared in vivo to determine which concept provides better colon-specific release. Pellets were prepared using theophylline (model drug) and coated with methacrylic acid\\/methylmethcrylate

Emma L. McConnell; Michael D. Short; Abdul W. Basit

2008-01-01

383

Causes, Inheritance: Colon cancer  

NSDL National Science Digital Library

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

2009-12-26

384

Minimally Invasive Colon Surgery  

MedlinePLUS Videos and Cool Tools

... multidisciplinary approach to screening. We obviously involve our primary care physicians. They’re the physicians who see the patients first and talk to them about their family histories and the need for colon cancer screening. We ...

385

Pathways to Colonization.  

National Technical Information Service (NTIS)

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...

D. V. Smitherman

2003-01-01

386

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 ...

387

Colonic stenting in 2011.  

PubMed

Self expanding metal stents (SEMS) are an established treatment in the management of malignant obstructing lesions throughout the gastrointestinal tract. SEMS have been utilized both as palliation in and as a bridge to surgical resection for malignant colonic obstruction. Many studies have demonstrated that placement of SEMS for malignant colonic obstruction is both efficacious, with high technical and clinical success rates, and safe with a low complication rate. In contrast, there is a paucity of data on the role of SEMS in the management of benign colonic obstruction, an indication which remains controversial. This review outlines the most recent developments in colonic stenting, their current indications, and the evidence to support their use in these indications. PMID:21587148

Donnellan, F; Moosavi, S; Byrne, M F

2011-06-01

388

Surgical treatment of distal biceps rupture.  

PubMed

Rupture of the distal biceps tendon accounts for 10% of all biceps brachii ruptures. Injuries typically occur in the dominant elbow of men aged 40 to 49 years during eccentric contraction of the biceps. Degenerative changes, decreased vascularity, and tendon impingement may precede rupture. Although nonsurgical management is an option, healthy, active persons with distal biceps tendon ruptures benefit from early surgical repair, gaining improved strength in forearm supination and, to a lesser degree, elbow flexion. Biomechanical studies have tested the strength and displacement of various repairs; the suspensory cortical button technique exhibits maximum peak load to failure in vitro, and suture anchor and interosseous screw techniques yield the least displacement. Surgical complications include sensory and motor neurapraxia, infection, and heterotopic ossification. Current trends in postoperative rehabilitation include an early return to motion and to activities of daily living. PMID:20190104

Sutton, Karen M; Dodds, Seth D; Ahmad, Christopher S; Sethi, Paul M

2010-03-01

389

Experimental distal subluxation in the glenohumeral joint.  

PubMed

In an experimental set-up including ten shoulder specimens, increments in the acromiohumeral distance (the subacromial space) were measured on an X-ray radioscope after the vertical stabilizing structures of the glenohumeral joint had been cut. It was found that when only the supraspinatus tendons were cut, the acromiohumeral space only increased by a few millimeters. When first the coracohumeral ligament and then the proximal one-third of the anterior capsule were cut, the acromiohumeral distance was doubled in each case. Distal subluxation did not occur when only the anterior capsule was cut. When the coracohumeral ligament was also cut, the acromiohumeral distance was more than doubled. It is concluded that the most important structures in the pathogenesis of distal subluxation are first the coracohumeral ligament and then the proximal part of the glenohumeral capsule. PMID:4051701

Ovesen, J; Nielsen, S

1985-01-01

390

Piroxicam decreases postirradiation colonic neoplasia in the rat  

SciTech Connect

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

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

1990-12-01

391

Mini-Incision Distal Biceps Tendon Repair  

Microsoft Academic Search

\\u000a Stark first described distal biceps tendon rupture in 1843.1 The earliest reports of surgical repair was in 1897 by Johnson and later in 1898 by Acquaviva.1, 2 Fischer and Shepanek in 19563 and Meherin and Kilgore in 19604 reported on a single incision for reattachment of the biceps to the radial tuberosity. This was shown to significantly improve\\u000a flexion and

Jason A. Schneider; Peter D. McCann

392

Distal tibial triplane fractures: diagnosis with CT.  

PubMed

Distal tibial triplane features, which constitute 6%-10% of epiphyseal injuries, are most accurately delineated and analyzed with computed tomography (CT). This is directly related to the special geometry of these fractures that have important transverse components. CT, with its transaxial orientation, is the only radiographic technique that directly images the otherwise inaccessible, horizontally oriented tibial plafond, the integrity of which largely determines the prognosis. CT is the method of choice for preoperative and postoperative evaluation of these injuries. PMID:3602382

Feldman, F; Singson, R D; Rosenberg, Z S; Berdon, W E; Amodio, J; Abramson, S J

1987-08-01

393

A simple distal radioulnar joint orthosis.  

PubMed

These authors describe an orthosis they have successfully used in their clinic to treat patients with distal radioulnar joint instability. In addition to describing how they fabricate the orthosis, these authors also describe how they determine if the patient needs volar or dorsal support, and how they then incorporate this support into the orthosis - Victoria Priganc, PhD, OTR, CHT, CLT, Practice Forum Editor. PMID:23692968

O'Brien, Virginia H; Thurn, Jennifer

2013-01-01

394

Laparoscopic distal pancreatectomy with splenic preservation  

Microsoft Academic Search

Background  The technique of distal pancreatectomy has been well described, both with en bloc resection of the spleen and with splenic\\u000a preservation. Splenic preservation during pancreatic tail resection is desirable when oncologically appropriate, yet it is\\u000a technically challenging, particularly with laparoscopic approaches. Skeletonization of the splenic artery and vein is associated\\u000a with longer operative times and greater potential for bleeding. The

A. Pryor; J. R. Means; T. N. Pappas

2007-01-01

395

Floating distal interphalangeal joint injury: case report.  

PubMed

A 37-year-old man sustained a floating distal interphalangeal (DIP) joint injury to the left index finger. The diagnosis was not confirmed until 3 months after the injury because of minimal deformity of the injured finger. Open reduction and internal fixation of the dorsally displaced floating DIP joint was carried out. Bone union was achieved but radiographs revealed osteoarthritis of the DIP joint. PMID:20724082

Kawamura, Kenji; Omokawa, Shohei; Shimizu, Takamasa; Tanaka, Yasuhito

2010-09-01

396

Distal Embolic Protection for Renal Arterial Interventions  

SciTech Connect

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

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

2008-01-15

397

Novel topical therapies for distal colitis  

PubMed Central

Distal colitis (DC) can be effectively treated with topical 5ASA agents. Suppositories target the rectum while enemas can reliably reach the splenic flexure. Used in combination with oral 5ASAs, the control of the inflammation is even more effective. Unfortunately, resistant DC does occur and can be extremely challenging to manage. In these patients, the use of steroids, immunosuppressants and the anti-tumor necrosis factor ? agents are often required. These, however, can be associated with systemic side effects and are not always effective. The investigation of new topical therapeutic agents is thus required as they are rarely associated with significant blood drug levels and side effects are infrequent. Some of the agents that have been proposed for use in resistant distal colitis include butyrate, cyclosporine and nicotine enemas as well as tacrolimus suppositories and tacrolimus, ecabet sodium, arsenic, lidocaine, rebamipide and Ridogrel® enemas. Some of these agents have demonstrated impressive results but the majority of the agents have only been assessed in small open-labelled patient cohorts. Further work is thus required with the investigation of promising agents in the context of randomized double-blinded placebo controlled trials. This review aims to highlight those potentially effective therapies in the management of resistant distal colitis and to promote interest in furthering their investigation.

Lawrance, Ian Craig

2010-01-01

398

Distal phalangeal metastasis of extramammary Paget's disease.  

PubMed

A rare case of phalangeal metastasis of extramammary Paget's disease in a 68-year-old man is described. The patient developed an erythematous, slightly elevated area in the pubic region. A biopsy specimen demonstrated numerous, large, rounded cells with ample pale-staining cytoplasm proliferating in the epidermis. With a diagnosis of extramammary Paget's disease, he underwent wide local excision and inguinal node dissection. Eleven months postoperatively, the patient developed a tender, red, swollen right ring finger. Bone X-ray showed that the distal phalanx of the ring finger had completely dissolved. Histopathological examination demonstrated proliferation of tumor cells in the adipose tissue. They had poorer and darker cytoplasm than the Paget's cells in the epidermis of the pubic region. Immunohistochemically, these cells showed the same staining pattern as did the Paget's cells at the primary site. Accordingly, the patient was diagnosed with distal phalangeal metastasis of extramammary Paget's disease. Two weeks after the appearance of the distal phalangeal metastasis, the patient died of cancerous pleurisy. It has been reported that patients with phalangeal metastasis have a very poor prognosis. PMID:14739508

Umebayashi, Yoshihiro

2004-01-01

399

A novel TRPV1 receptor antagonist JNJ-17203212 attenuates colonic hypersensitivity in rats.  

PubMed

This study examined the efficacy of a novel TRPV1 antagonist, JNJ-17203212, in two experimental rat models that exhibit a hypersensitive visceral motor response (VMR) to colorectal distension (CRD). In the first model, intraluminal administration of acetic acid (1% solution) into the distal colon produced an acute colonic hypersensitivity. In the second model, intraluminal administration of 2,4,6-trinitrobenzenesulfonic acid (TNBS) into the distal colon produced a chronic, post-inflammatory colonic hypersensitivity 30 days post-TNBS administration. Throughout this study, colonic sensitivity was assessed via quantification of VMR to CRD in rats following a single, oral administration of JNJ-17203212 (3, 10 or 30 mg/kg) or vehicle. Intraluminal administration of acetic acid and TNBS resulted in increased VMR to CRD when compared to controls. In both groups, VMR to CRD was significantly reduced by administration of JNJ-17203212 at 30 mg/kg. The results of this study show that the selective TRPV1 antagonist, JNJ-17203212, reduces sensitivity to luminal distension in both an acute, noninflammatory and a chronic, post-inflammatory rodent model of colonic hypersensitivity. These data indicate that TRPV1 is involved in the pathogenesis of visceral hypersensitivity and that JNJ-17203212 may be a potential therapeutic agent for functional bowel disorders characterized by abdominal hypersensitivity, such as irritable bowel syndrome. PMID:21132125

Wiskur, B J; Tyler, K; Campbell-Dittmeyer, K; Chaplan, S R; Wickenden, A D; Greenwood-Van Meerveld, B

2010-10-01

400

The early days of diverticula of the colon.  

PubMed

As a 17 year old first-year medical student at Oxford University in 1943, busily dissecting a cadaver in the Anatomy Department, I could not help noticing a series of peculiar pea-sized swellings along the course of the sigmoid colon. I showed these to our Professor of Anatomy, the much respected Sir Wilfred Le Gros Clarke FRS, who said 'Those are diverticula, my boy. As an Oxford student you should know, (which, in fact, I did not!), that the word 'diverticulum' is Latin for a 'wayside house of ill fame or ill repute', and well do they deserve that descriptive term'. I carefully excised the affected piece of colon, put it in a bottle of formalin and, at the end of term, put it onto the mantelpiece of my bedroom at home. A few years later, my mother, in a clearing-up mode, threw the dusty bottle away. What a pity that I am unable to produce a photograph of my specimen to illustrate this article! PMID:22324120

Ellis, Harold

2012-01-01

401

Trichuriasis: localized inflammatory responses in the colon.  

PubMed

Most patients with trichuriasis have light worm burdens. Data regarding the inflammatory response to Trichuris worms in the colon of lightly infected persons are scant. Nine patients whose Trichuris infection was found by colonoscopy had biopsies taken from a site adjacent to visible worms and from a second site some 20 cm distally. The biopsies were studied by routine and immunohistochemical methods. None of the biopsies showed mucosal ulceration, significant congestion, fibrosis, gland distortion or goblet cell mucin depletion. There was no difference between worm and worm-free sites in terms of edema, lymphoid follicles or epithelial slough. Worm sites had higher numbers of eosinophils, neutrophils and total inflammatory cells and lower numbers of plasma cells. However there was no difference in lymphocyte, mast cell, and B- and T-cell counts between the two sites. This suggests that the T. trichiura worm incites a local inflammatory response involving eosinophils and neutrophils, even when the colon has only a light burden of worms. PMID:12236416

Kaur, Gurjeet; Raj, S Mahendra; Naing, Nyi Nyi

2002-06-01

402

Simulating the Formation of a Sigmoidal Flux Rope in AR10977 from SOHO/MDI Magnetograms  

NASA Astrophysics Data System (ADS)

The modeling technique of Mackay et al. is applied to simulate the coronal magnetic field of NOAA active region AR10977 over a seven day period (2007 December 2-10). The simulation is driven with a sequence of line-of-sight component magnetograms from SOHO/MDI and evolves the coronal magnetic field though a continuous series of non-linear force-free states. Upon comparison with Hinode/XRT observations, results show that the simulation reproduces many features of the active region's evolution. In particular, it describes the formation of a flux rope across the polarity inversion line during flux cancellation. The flux rope forms at the same location as an observed X-ray sigmoid. After five days of evolution, the free magnetic energy contained within the flux rope was found to be 3.9 × 1030 erg. This value is more than sufficient to account for the B1.4 GOES flare observed from the active region on 2007 December 7. At the time of the observed eruption, the flux rope was found to contain 20% of the active region flux. We conclude that the modeling technique proposed in Mackay et al.—which directly uses observed magnetograms to energize the coronal field—is a viable method to simulate the evolution of the coronal magnetic field.

Gibb, G. P. S.; Mackay, D. H.; Green, L. M.; Meyer, K. A.

2014-02-01