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Sigmoid volvulus after laparoscopic surgery for sigmoid colon cancer.  


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

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



Colouterine Fistula Caused by Diverticulitis of the Sigmoid Colon  

PubMed Central

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



Giant sigmoid colonic diverticulitis: case report  

Microsoft Academic Search

Giant colonic diverticulum is a rare condition, and the usual site is the sigmoid colon. In this report, magnetic resonance imaging was performed in a patient with lower abdominal pain. The modality was useful for the evaluation of giant sigmoid colonic diverticulitis and the differential diagnosis.

S. Sugihara; S. Fujii; T. Kinoshita; T. Ogawa



A Case of Sigmoid Colon Tuberculosis Mimicking Colon Cancer  

PubMed Central

Tuberculosis of the sigmoid colon is a rare disorder. An 80-year-old man visited Bongseng Memorial Hospital for medical examination. A colonoscopy was performed, and a lesion in the sigmoid colon that was suspected to be colon cancer was found. A biopsy was performed, and tuberculous enteritis with chronic granulomatous inflammation was diagnosed. Intestinal tuberculosis is most frequent in the ileocecal area, followed by the ascending colon, transverse colon, duodenum, stomach, and sigmoid colon, in descending order. Hence, we report a case of intestinal tuberculosis in the sigmoid colon, which is rare and almost indistinguishable from colon cancer.

Yu, Seong-Min; Kim, Min-Dae; Lee, Hee-Ryong; Jung, Peel; Ryu, Tae-Hyun; Choi, Seung-Ho; Lee, Il-Seon



Tumours of the sigmoid colon following ureterosigmoidostomy  

Microsoft Academic Search

A case of bilateral adenomatous polyps and a case of adenocarcinoma of the sigmoid colon following ureterosigmoidostomy are described. The recent literature is reviewed. The possible causes and the mucosal changes of the large bowel after ureterosigmoidostomy are briefly discussed.

W. M. Lien



Inflammatory fibroid polyp of sigmoid colon  

Microsoft Academic Search

Summary  A case of inflammatory fibroid polyp of the sigmoid colon is presented. This is the eighth case of this type of polyp in the\\u000a colon and, to the best of our knowledge, the first one involving the sigmoid and producing intussusception.\\u000a \\u000a Symptomatology of the inflamed fibroid polyp in this part of the gut closely simulates gastrointestinal malignancy. The treatment\\u000a is

Oscar Lifschitz; Silvia Lew; Misha Witz; Raphael Reiss; Benjamin Griffel



Giant transmural lipoma of the sigmoid colon.  


Lipomas of the colon are relatively rare benign tumors of mesenchymatic origin. They are usually asymptomatic but as they become larger they can cause symptoms including abdominal pain, diarrhea, nausea, constipation, haematochezia, loss of body weight, anemia or even intussusception and colonic obstruction. We present a 52 year old male patient who visited the emergency room complaining of constipation, rectal bleeding, mucus in stools and a palpable rectal mass. Colonoscopy revealed a polypoid mass of the sigmoid colon lying about 30 cm from the anal verge. Sigmoidectomy was performed. The postoperative recovery was uneventful and he was discharged five days later. At follow up a month after surgery the patient was asymptomatic. The pathological examination revealed a transmural tumor of the sigmoid colon measuring a 9x5x2.5cm and histologically compatible with a lipoma. PMID:23935299

Tsiaousidou, A; Chatzitheoklitos, E; Hatzis, I; Alatsakis, M; Katsourakis, A



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

PubMed Central

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

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



Acute volvulus of the sigmoid colon  

Microsoft Academic Search

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

G. H. Welch; J. R. Anderson



Giant diverticulum of the sigmoid colon  

Microsoft Academic Search

While diverticulosis of the colon is a relatively common disease, a solitary giant diverticulum (GD) of the sigmoid is rare. Although there exist some theories about the formation of a GD, none is really conclusive. Sym[toms are similar to diverticular disease, and diagnosis is easy with the aid of radiology. Early surgical treatment is necessary since the complication rate is

A. Naber; A.-M. Sliutz; H. Freitas



[Sigmoid colon duplication: an adult case report.].  


Colonic duplication is a very uncommon congenital malformation. Most cases are detected during childhood and may occur with other systemic malformations. Since 1950, less than 90 cases of colonic duplication have been reported. In this study, we report the case of a 33-year-old female who was referred to our coloproctology service for evaluation. Since 16 years ago, she has noticed an intermittent left side painless abdominal mass that sometimes spontaneously disappears. In the last months, she reported that the frequency of this complaint has been more frequent. A barium enema X ray study revealed a significant dilation of the descendent and sigmoid colon. An exploratory laparotomy was performed and sigmoid colon duplication was found. The abnormal segment was removed and an end-to-end anastomosis was performed. There were no complications in the postoperative period and she was discharged at day 7. This case describes the difficulties in detecting this rare malformation that should be considered as part of the differential diagnosis of abdominal masses in adult patients. PMID:19858020

Vargas-de la Llata, R G; García-Huerta, G; Gutiérrez-Mata, Felipe; Noriega-Maldonado, O; Dorantes-González, H J; López-Giacoman, C



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.



Adenocarcinoma in tubular duplication of the sigmoid colon.  


A rare case of mucus-secreting adenocarcinoma in a tubular duplication of the sigmoid colon is presented. The pertinent radiographic manifestations were: a calcium containing soft tissue mass located at the blind end of a 20 cm barium filled tubular duplication originating at the sigmoid colon. PMID:210081

Arkema, K K; Calenoff, L



Functional activity of the sigmoid colon and rectum  

Microsoft Academic Search

Summary  The incomplete information in the literature on the mechanism of sigmoid storage and evacuation and its relation to the rectum\\u000a has prompted our study in 18 mongrel dogs. A condom-ended catheter was introduced into the sigmoid and infused with carbon\\u000a dioxide (CO2) at 2 rates: slow and rapid. The pressure responses of sigmoid colon, rectosigmoid junction (RSJ), rectum and rectal

A. Shafik



Sigmoid colon fistula complicating ovarian cystadenocarcinoma: A rare finding  

Microsoft Academic Search

A case of sigmoid colon fistula complicating ovarian cystadenocarcinoma is reported. The entity demonstrated a large air-filled, thin-walled cystic lesion during barium enema examination. The differential diagnosis of distended air-filled cystic lesions is discussed and expanded to include colonic fistula complicating ovarian neoplasms.

Hiroshi Honda; Charles H. Lu; Thomas J. Barloon; Kimio Hashimoto



Volvulus of the sigmoid colon in Delhi, India  

Microsoft Academic Search

Summary  The cases of 44 patients who had 49 episodes of volvulus of the sigmoid colon have been reviewed. Volvulus of the sigmoid\\u000a accounted for 3.2 per cent of causes of intestinal obstruction. The mortality rate was 36.7 per cent and was directly proportional\\u000a to the duration of symptoms. Merits and demerits of various methods of management are discussed. Primary resection

S. M. Gulati; N. K. Grover; N. K. Tagore; O. P. Taneja



Perforated sigmoid colon carcinoma in an irreducible inguinoscrotal hernia.  


Inguinal (inguinoscrotal) hernia and colon cancer are common conditions. However, it is rare for primary colon cancer to exist in an inguinal hernia sac and even rarer for it to perforate. We report such an event in our patient, who had an irreducible left inguinoscrotal hernia containing a sigmoid colon carcinoma that had perforated. This clinical picture can be easily confused with hernia strangulation unless the clinician is alert to the presence of certain sinister symptoms and signs. PMID:24112486

Tan, A; Taylor, G; Ahmed, T



Intestinal occlusion caused by endometriosis of the sigmoid colon.  


Endometriosis (E) is an estrogen-dependent inflammatory disorder that is observed in approximately 10% of women in childbearing age, and is the most common benign gynecological disorder requiring hospitalization. In 5% of cases, there is an involvement of the gastrointestinal tract, for the most part of the sigmoid colon and rectum (~ 90%). However intestinal obstruction due to severe stenosis of the sigmoid colon, as in the case described by the authors, is rare. The differential diagnosis should include cancer, inflammatory diseases and actinic colitis which has a similar clinical picture to E. Surgical treatment - resection and anastomosis or conservative procedures - provides better results especially when a multidisciplinary approach is used (colorectal surgeon, gynecologist, urologist). The authors report a case of obstruction of the sigmoid colon due to endometriosis and analyze the pathophysiology, diagnosis and surgical management of this disorder. PMID:22610080

Conzo, Giovanni; Docimo, Giovanni; Candela, Giancarlo; Palazzo, Antonietta; Della Pietra, Cristina; Mauriello, Claudio; Santini, Luigi


Polypoid lesions associated with diverticular disease of the sigmoid colon.  


Colonscopy performed in five patients because of narrowing of the sigmoid colon with intramural diverticula revealed several bright red, slightly elevated patches. In three patients, some bright red polypoid structures 1 cm in size and hemispherical in shape were also present. On light microscopy the polyps showed the features of transitional mucosa but revealed a different pattern of mucus secretion. PMID:4007438

Franzin, G; Fratton, A; Manfrini, C



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



Effect of Sigmoid Colon Distension on the Rectosigmoid Junction  

Microsoft Academic Search

Purpose The sigmoid colon (SC) is the site of stool storage. The stools accumulate in the SC until, at a certain volume, the mechanoreceptors in the SC wall are stimulated, evoking the sigmoidorectal junction inhibitory reflex with a resulting SC contraction, rectosigmoid junction (RSJ) relaxation and passage of the stools to the rectum. However, the RSJ status during stool accumulation

A. Shafik; O. El-Sibai



[Synchronous sigmoid colon and breast cancers in man].  


We report the case of 72-year-old man with sigmoid colon cancer associated with synchronous right breast cancer. However, in the present case, we found breast cancer insidiously at physical exam. The patient died after six months after the dissemination of the breast cancer. PMID:18353581

Abboud, B; Nassif, J; Jaoude, J B; Chahine, G



Primary vs. secondary anastomosis after sigmoid colon resection for perforated diverticulitis (Hinchey Stage III and IV)  

Microsoft Academic Search

PURPOSE: Our hypothesis was that in patients with perforated sigmoid colon diverticulitis and peritonitis (Hinchey Stage III and IV) a one-stage sigmoid colon resection is safe and cost effective when performed by an experienced colorectal surgeon. We evaluated outcome and cost of one-stagevs. two-stage sigmoid colon resection after diverticulitis perforation and peritonitis. METHODS: Patients undergoing emergency resection for perforated sigmoid

Martin K. Schilling; Christoph A. Maurer; Otto Kollmar; Markus W. Bfichler



Psychosensory modulation of colonic sensation in the human transverse and sigmoid colon  

Microsoft Academic Search

Background & Aims: Psychosensory stimulation increases the perception of stimuli in different regions of the human colon. The aim of this study was to determine the perception of pain and gas during distention of two colonic regions in healthy volunteers during stress and relaxation. Methods: In 22 healthy subjects, phasic distentions of transverse and sigmoid colon were performed using infinitely

Michael J. Ford; Michael Camilleri; Alan R. Zinsmeister; Russell B. Hanson



Transverse and Sigmoid Colon Motility in Healthy Humans: Effects of Eating and of Cimetropium Bromide  

Microsoft Academic Search

There have been few studies of the motility of the colon proximal to the recto-sigmoid area. For this purpose we evaluated (1) fasting and postprandial transverse and sigmoid colon motor activity and (2) the effects of a new nonselective anticholinergic drug, cimetropium bromide, on transverse and sigmoid motor responses to eating. Two paired studies were carried out in 11 healthy

Gabrio Bassotti; Bruno Pietro Imbimbo; Manuela Gaburri; Sergio Daniotti; Antonio Morelli



Clinical significance of diminutive polyps of the rectum and sigmoid colon  

Microsoft Academic Search

A retrospective review of 637 consecutive colonoscopies with polypectomy in 526 patients was performed to determine the association of small polyps of the rectum and sigmoid colon with more proximal colonic neoplasms. All colonic polyps were proximal to the sigmoid colon in 117 procedures. Proximal neoplasms were found in 32 percent of patients with a single polyp in the rectum

Colon Neal Ellis; H. Whitney Boggs; Gene W. Slagle; Philip A. Cole; Dan J. Coyle



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

PubMed Central

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

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



A rare case of primary choriocarcinoma in the sigmoid colon  

PubMed Central

Primary colorectal choriocarcinoma is an extremely rare neoplasm and is usually associated with a poor prognosis. Only 13 cases of colorectal choriocarcinoma have previously been reported. There is no standard chemotherapeutic regimen for this tumor type. A 68-year-old man presented with melena and was diagnosed with sigmoid colonic adenocarcinoma with multiple liver metastases. He underwent a laparoscopic sigmoidectomy. Pathology revealed choriocarcinoma with a focal component of moderately differentiated adenocarcinoma of colon origin. Based on the collagen gel droplet-embedded culture drug sensitivity test (CD-DST) results, mFOLFOX6 and bevacizumab were administered, which suppressed aggressive tumor growth for 4 mo. The patient died 9 mo after the initial diagnosis. Our study results suggest that the standard chemotherapy regimen for colorectal cancer might have suppressive effects against primary colorectal choriocarcinoma. Moreover, CD-DST may provide, at least in part, therapeutic insight for the selection of appropriate antitumor agents for such patients.

Maehira, Hiromitsu; Shimizu, Tomoharu; Sonoda, Hiromichi; Mekata, Eiji; Yamaguchi, Tomoharo; Miyake, Tohru; Ishida, Mitsuaki; Tani, Tohru



Neobladder construction using completely detubularized sigmoid colon after radical cystoprostatectomy.  


To improve the quality of life of the patient we used completely detubularized sigmoid colon for bladder reconstruction along with radical cystoprostatectomy in 6 men with invasive bladder cancer. Followup was 8 to 20 months. Postoperatively, all of the patients were continent during the day but only 4 (66.7%) were continent at night, although they had to awaken twice to remain dry. Neocystourethroscopy in 4 of the 6 patients revealed no tumor and no stricture at the urethrocolonic anastomosis. However, a stone in the neobladder was found in 1 patients. Urodynamic study of the neobladder showed a low pressure (mean 16.7 cm. water) at the filling phase of water cystometry and an adequate maximal urethral closure pressure (mean 52.0 cm. water) and functional profile length (mean 3.8 cm.). The uroflow rate in all patients was good (1 patient even had a maximal uroflow rate of 31 ml. per second). There was no reflux in any patient. One patient had intestinal obstruction 5 months postoperatively and died 5 months later of widespread metastasis. The remaining 5 patients are alive with a satisfactory quality of life. In conclusion, use of completely detubularized sigmoid colon may be an ideal operation for neobladder construction after radical cystoprostatectomy. PMID:1856923

Chen, K K; Chang, L S; Chen, M T



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

PubMed Central

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

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



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

Microsoft Academic Search

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.

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



Vaginal reconstruction utilizing sigmoid colon: Complications and long-term results  

Microsoft Academic Search

Background\\/Purpose: The use of sigmoid colon segments to repair congenital deformities of the vagina is well established. There are little data, however, on complications or functional results in these patients. The purpose of this study was to evaluate complication rates and long-term patient outcomes in the use of sigmoid segments in vaginal reconstruction for congenital anomalies. Methods: The authors identified

J. Kellogg Parsons; Susan L. Gearhart; John P. Gearhart



Motor effect of dopamine on human sigmoid colon evidence for specific receptors  

Microsoft Academic Search

The effect of dopamine on human sigmoid motility has been studied in 26 subjects. To record mechanical activity of the sigmoid colon, two small, air-filled balloons mounted on a probe introduced through a sigmoidoscope were used. The recordings were made at a distance of 25 and 15 cm from the anal edge. Dopamine was infused for 10 min after a

Giorgio Assuero Lanfranchi; Leonardo Marzio; Claudio Cortini; Eduardo Moreno Osset



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

Microsoft Academic Search

The relationship between cigarette smoking, alcohol use, and dietary factors and the risk of adenomas of the sigmoid colon was examined in male self-defense officials who received a preretirement health examination at three Self-Defense Forces hospitals in Japan. In the comparison between 228 patients with sigmoid adenomas and 1484 control subjects with normal colonoscopy findings (? 60 cm from the

Isao Todoroki; Suminori Kono; Koichi Shinchi; Satoshi Honjo; Yutaka Sakurai; Kazuo Wakabayashi; Koji Imanishi; Hiroshi Nishikawa; Shinsaku Ogawa; Mitsuhiko Katsurada



The aetiology and management of sigmoid volvulus in the UK: how much colon need be excised?  

PubMed Central

The case notes of 15 patients undergoing colonic resection for sigmoid volvulus at St Mark's Hospital over 25 years have been reviewed. Eight patients underwent sigmoid colectomy, four left hemicolectomy and three total colectomy. Although 12 of the 15 patients complained of a constipated bowel habit for 'all their lives' prior to operation, all but two had a much improved bowel habit thereafter, regardless of the extent of the resection. If there is evidence of acute or recent sigmoid volvulus at operation, sigmoid colectomy alone is recommended in the first instance.

Mellor, S. G.; Phillips, R. K.



A Case of Congenital Infantile Fibrosarcoma of Sigmoid Colon Manifesting as Pneumoperitoneum in a Newborn  

PubMed Central

Congenital infantile fibrosarcoma (CIF) is a rare soft-tissue tumor in the pediatric age group and seldom involves the gastrointestinal tract. A 2-day-old boy was transferred to our hospital with a pneumpoperitoneum. After emergency operation, we could find a solid mass wrapping around a sigmoid colon and performed a segmental resection of sigmoid colon including a mass. Histopathologic examination showed an infantile fibrosarcoma origining from the muscular layer of colon. The baby was discharged on the 17th hospital day and followed for 1 yr without recurrence.

Kim, Hae Young; Byun, Shin Yun; Park, Kyung Hee



Ischemic necrosis of the sigmoid colon after antegrade sclerotherapy of idiopathic varicocele: a case report.  


A 34-year-old man affected by grade IV idiopathic varicocele with mild testicolar pain, severe oligoasthenozoospermia and infertility, underwent an antegrade sclerotherapy according to Tauber surgical technique. After 5 days, the patient underwent a laparoscopic left colon resection with colonstomy due to a segmental infarction of the sigmoid colon. PMID:23423678

Fulcoli, Vittorio; Costa, Giuseppe; Gigli, Francesca; Laurini, Lucio



Effects of beta-adrenoceptor blocking drugs on human sigmoid colonic motility  

Microsoft Academic Search

Effects of propranolol and metoprolol on sigmoid colonic motility were studied in 12 healthy volunteers in a double-blind randomized fashion. Colonic pressure was recorded 15–18 cm from anus and contractile activity quantified for periods of 25 min. On separate days propranolol, metoprolol, and placebo, respectively, was administered intravenously preceded by a control period. After propranolol, 10 mg intravenously, pressure activity

Hasse Abrahamsson; Ebbe Lyrenäs; Gerhard Dotevall



Sensory and Biomechanical Responses to Distension of the Normal Human Rectum and Sigmoid Colon  

Microsoft Academic Search

Background: Visceral pain is a major clinical problem. The aim of the present study was to compare the pain and biomechanical responses to standardized distension of the human colon. Methods: The relation between pain intensity and pressure, cross-sectional area (CSA) and tension-strain relations of the rectum and sigmoid colon were studied in 11 normal subjects following standardized distension using impedance

Poul Petersen; Chunwen Gao; Petra Rössel; Peter Qvist; Lars Arendt-Nielsen; Hans Gregersen; Asbjřrn Mohr Drewes



Retroperitoneal abscess complicated with necrotizing fasciitis of the thigh in a patient with sigmoid colon cancer  

Microsoft Academic Search

BACKGROUND: Necrotizing fasciitis of the thigh due to the colon cancer, especially during chemotherepy, has not been previously reported. CASE PRESENTATION: A 67-year-old man admitted to the hospital was diagnosed with sigmoid colon cancer that had spread to the left psoas muscle. Multiple hepatic metastases were also found, and combination chemotherapy with irinotecan and S-1 was administered. Four months after

Yuji Takakura; Satoshi Ikeda; Masanori Yoshimitsu; Takao Hinoi; Daisuke Sumitani; Haruka Takeda; Yasuo Kawaguchi; Manabu Shimomura; Masakazu Tokunaga; Masazumi Okajima; Hideki Ohdan



Volvulus of the sigmoid colon in Brazil: A report of 230 cases  

Microsoft Academic Search

Summary  Etiologic and physiopathologic aspects of volvulus of the sigmoid colon in Brazil are presented. It is believed that sigmoidal\\u000a volvulus in Brazil is a frequent complication of megacolon caused by Chagas' disease, differing in some characteristics from\\u000a volvulus found in other countries.\\u000a \\u000a A review of 230 cases treated between 1938 and 1974 in the Surgical Department of Hospital das Clínicas,

Angelita Habr Gama; Jorge Haddad; Oscar Simonsen; Paulo Warde; Angelino Manzione; José Hyppölito da Silva; Massahiro Ioshimoto; Daher Cutait; Arrigo Raia



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



A Rare Case of Metastases to the Maxillary Sinus from Sigmoid Colon Adenocarcinoma  

Microsoft Academic Search

Metastases of malignant tumors to the nasal cavity and paranasal sinuses are rare. A review of the world’s literature reports only four cases of antral metastases from carcinoma of gastrointestinal tract. We present a case of a stenosing adenocarcinoma of the sigmoid colon with metastases within the maxillary sinus. The ENT physical examination revealed a mass involving the right alveolar

Elona Cama; Stefania Agostino; Riccardo Ricci; Emanuele Scarano



Motor activity of the sigmoid colon in chronic constipation: comparative study with normal subjects  

Microsoft Academic Search

Manometric studies of the sigmoid colon were performed on 17 healthy volunteers and on 49 constipated patients, after a long period of fasting (18--20 hours). Motility was recorded using perfused catheters at basal level during 45 minutes, then 60 minutes after a 0.5 mg intravenous injection of neostigmine, and, finally, 30 minutes during and after a meal. Motor activity was

P Meunier; A Rochas; R Lambert



Adenocarcinoma of the sigmoid colon with focal choriocarcinoma metaplasia: A case report  

Microsoft Academic Search

A case of adenocarcinoma of the sigmoid colon with focal choriocarcinoma metaplasia is documented. Pathogenesis is briefly\\u000a discussed, and clinical conditions, unrelated to trophoblastic diseases, associated with an increased level of serum human\\u000a chorionic gonadotropin (hCG) are reviewed.

Gia-Khanh Nguyen



Cronkhite-Canada syndrome associated with carcinoma of the sigmoid colon: Report of a case  

Microsoft Academic Search

Cronkhite-Canada syndrome is generally accepted as being a benign disorder. We herein present a 66-year-old-male patient with Cronkhite-Canada syndrome who had a carcinoma of the sigmoid colon along with multiple colonic polyps, which included juvenile-type polyps, adenomas, and hyperplastic polyps. In the world literature, there have been 34 cases of Cronkhite-Canada syndrome associated with colorectal carcinoma among the 280 reported

Naoki Nakatsubo; Rinichiro Wakasa; Katsumi Kiyosaki; Kazuhiro Matsui; Fumio Konishi



Effect of coffee on distal colon function.  

PubMed Central

Ninety nine healthy young volunteers (58 men, 34 women, aged 17-27 years) answered a questionnaire concerning their bowel habit with particular reference to the effects of beverages. Twenty nine per cent (63% women) claimed that coffee induced a desire to defecate. The rectosigmoid motor responses to black, unsweetened coffee were then investigated by multiport manometry in 14 healthy-subjects (12 men, two women, eight of whom claimed coffee caused a desire to defecate (responders). Results revealed an increase in motility index within four minutes after ingestion of both regular and decaffeinated coffee (p less than 0.05) in the eight responders, but not in the six non-responders. The increase in rectosigmoid motility induced by coffee lasted at least 30 minutes. There was no increase in the motility index in any subject after a drink of hot water. These results suggest that drinking coffee can stimulate a motor response of the distal colon in some normal people.

Brown, S R; Cann, P A; Read, N W



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.



Retroperitoneal abscess complicated with necrotizing fasciitis of the thigh in a patient with sigmoid colon cancer  

PubMed Central

Background Necrotizing fasciitis of the thigh due to the colon cancer, especially during chemotherepy, has not been previously reported. Case presentation A 67-year-old man admitted to the hospital was diagnosed with sigmoid colon cancer that had spread to the left psoas muscle. Multiple hepatic metastases were also found, and combination chemotherapy with irinotecan and S-1 was administered. Four months after the initiation of chemotherapy, the patient developed gait disturbance and high fever and was therefore admitted to the emergency department of our hospital. Blood examination revealed generalized inflammation with a high C-reactive protein level. Computed tomography of the abdomen and pelvis showed gas and fluid collection in the retroperitoneum adjacent to the sigmoid colon cancer. The abscess was locally drained under computed tomographic guidance; however, the infection continued to spread and necrotizing fasciitis developed. Consequently, emergent debridement was performed. The patient recovered well, and the primary tumor was resected after remission of the local inflammation. Conclusion Necrotizing fasciitis of the thigh due to the spread of sigmoid colon cancer is unusual, but this fatal complication should be considered during chemotherapy for patients with unresectable colorectal cancer.

Takakura, Yuji; Ikeda, Satoshi; Yoshimitsu, Masanori; Hinoi, Takao; Sumitani, Daisuke; Takeda, Haruka; Kawaguchi, Yasuo; Shimomura, Manabu; Tokunaga, Masakazu; Okajima, Masazumi; Ohdan, Hideki



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


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

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



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.



Potassium transport across guinea pig distal colon  

SciTech Connect

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

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



Laparoscopic Treatment of Cystadenocarcinoma of the Appendix Penetrating in the Sigmoid Colon  

PubMed Central

Adenocarcinoma of the vermiform appendix is a rare neoplasm of the gastrointestinal tract that most commonly presents as right lower abdominal pain, mimicking acute appendicitis. Presentation caused by loco-regional spread with involvement of adjacent structures is rare. An accurate and complete preoperative diagnosis has been rare in the past; however, modern imaging techniques allow recognition of most complications and associated conditions. The diagnosis is confirmed postoperatively. Aggressive surgical management is the treatment of choice in appendicular adenocarcinoma. We report the case of appendicular mucinous cystadenocarcinoma in a 55-year-old lady with penetration of the sigmoid colon treated with laparoscopic-assisted sigmoid and en block right hemicolectomy. It was possible to manage this complex case by using a laparoscopic procedure with all the known benefits of minimally invasive surgery.

Karamehmedovic, Zenan; Elgazwi, Khaled; Baca, Ivo



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


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. PMID:20808031

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



Secondary hyperaldosteronism stimulates acidification in rat distal colon  

Microsoft Academic Search

Recent studies from this laboratory have determined that colonic K+ absorption is altered by the PCO2 and by secondary hyperaldosteronism. Partial inhibition by vanadate and mucosal ouabain suggested the operation of an H+\\/K+ exchange pump. To determine the mechanism of acidification in rat distal colon, we measured in vitro acidification using the pH-stat technique by voltage-clamped segments of colonic epithelium

Margaret L. McLaughlin; David E. McBride; Ronald D. Perrone



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


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

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



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

PubMed Central

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

Birkenkamp-Demtroder, K; Olesen, S H; S?rensen, F B; Laurberg, S; Laiho, P; Aaltonen, L A; ?rntoft, T F



A case of osteonecrosis of the jaw during treatment by bevacizumab for sigmoid colon cancer.  


A 67-year-old man was diagnosed to have sigmoid colon cancer with peritonitis carcinomatosa. The cancer was surgically resected, and he thereafter underwent chemotherapy with mFOLFOX6+bevacizumab. He complained of gingival swelling throughout treatment and osteonecrosis of the jaw was noted. The bevacizumab therapy was therefore discontinued and the necrotic tissue removed. No recurrent necrosis has occurred. The addition of bevacizumab to the FOLFOX or FOLFIRI chemotherapy regimens has been shown to improve the survival rate and response rate in colorectal cancer. Osteonecrosis of the jaw is a rare toxicity of bevacizumab. Bevacizumab might compromise the microvessel integrity in the jaw, which thus may lead to bone necrosis. Osteonecrosis of the jaw in this case recovered after the discontinuation of bevacizumab and the removal of the necrotic tissue. The pathogenesis and treatment of osteonecrosis have not been elucidated. PMID:23558129

Sato, Manabu; Ono, Fuminori; Yamamura, Akihiro; Onochi, Shoichi



Giant gas-filled cyst of sigmoid colon. Report of a case and review of the literature  

Microsoft Academic Search

The largest recorded gas-filled cyst of the sigmoid colon, in a man of 67, is presented. The literature of the other recorded cases is reviewed. The gas in the cyst was analysed and a suggestion put forward that bacteria play some part in the aetiology of the gas in the cyst.

D. E. Sibson; A. J. Edwards



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

Microsoft Academic Search

Intraluminal pressure activity has been recorded in the unprepared true sigmoid colon of seven normal controls (mean age 37 years, range 22-55, three men) and seven patients with irritable bowel syndrome (IBS) (45 years, 24-75, four men) for 30 minutes before and 100 minutes after a standard 1000 kcal meal. Results differ from previously published data by showing much higher

J Rogers; M M Henry; J J Misiewicz



Role of vasopressin in rat distal colon function  

PubMed Central

The specific role of vasopressin in colonic crypt function and its possible synergistic action with aldosterone were studied. Sprague-Dawley rats fed a high-Na+ (HS; 150 mm NaCl) or a low-Na+ (LS; 150 ?m NaCl) diet were deprived of water or infused with vasopressin, and some animals were treated with specific vasopressin receptor subtype V1 and V2 antagonists. The expression of the epithelial Na+ channel (ENaC), ?-smooth muscle actin (?-SMA) and aquaporin-2 (AQP-2) were determined by immunolocalization in distal colonic mucosa. The pericryptal Na+ concentration was determined by confocal microscopy, using a low-affinity Na+-sensitive fluorescent dye (sodium red) and crypt permeability was measured by the rate of escape of fluorescein isothiocyanate-labelled dextran (10 kDa) from the crypt lumen into the pericryptal space in isolated rat distal colonic mucosa. A high plasma concentration of vasopressin raised ?-SMA expression in the pericryptal sheath (P < 0.05), increased the pericryptal Na+ accumulation in this space (P < 0.01) and caused a reduction of crypt wall permeability (P < 0.01). All these effects were reversed by selective blockade of V1 and V2 receptors. No synergistic effects with aldosterone were observed. Dehydration and vasopressin infusion increased AQP-2 expression in distal colonic mucosa (P < 0.05). This action of vasopressin was prevented by tolvaptan, a specific V2 receptor antagonist (P < 0.05). It is concluded that vasopressin has trophic effects in the rat distal colon, increasing pericryptal myofibroblast growth which affects crypt absorption, and these effects are independent of the presence of aldosterone.

Cristia, Esther; Amat, Concepcio; Naftalin, Richard J; Moreto, Miquel



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


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



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



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


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

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



Endoscopic crescentic fold disease of the sigmoid colon: the clinical and histopathological spectrum of a distinctive endoscopic appearance  

Microsoft Academic Search

In this paper we describe an endoscopic appearance of the sigmoid colon characterised by mucosal swelling, erythema and haemorrhage strictly localised to the crescentic mucosal folds. In a 5-year period these changes were seen in 34 (1.42%) of 2380 colonoscopies and fibreoptic sigmoidoscopies. The majority of patients were middle-aged or elderly. Diverticular disease was present in most (82%) but the

S. Gore; N. A. Shepherd; S. P. Wilkinson



Control of Ion Transport in Mouse Proximal and Distal Colon by Prolactin  

Microsoft Academic Search

The lactogenic hormone prolactin (PRL) has been known to affect Ca2+ and electrolyte transport in the intestinal epithelium. In the present study we analyzed ion transport in mouse proximal and distal colon, and acute changes induced by PRL. In the proximal colon, carbachol activated a Ca2+ dependent Cl- secretion that was sensitive to DIDS and NFA. In the distal colon,

Supaporn Puntheeranurak; Rainer Schreiber; Melanie Spitzner; Jiraporn Ousingsawat; Nateetip Krishnamra; Karl Kunzelmann



Safety and Efficacy of Single-Port Colectomy for Sigmoid Colon Cancer: A Phase II Clinical Trial.  


Abstract Background: Recently, single-port surgery for colon cancer has been increasingly attempted. However, prospective studies investigating the efficacy of single-port colectomy for colon cancer are lacking. The aim of this study is to determine whether single-port colectomy for sigmoid colon cancer is a safe and effective surgical option. Subjects and Methods: Forty-eight patients were enrolled for this prospective single-arm Phase II trial. All patients underwent single-port laparoscopic-assisted sigmoidectomy through the umbilicus. The primary outcome was the number of retrieved lymph nodes. Secondary measures included the conversion rate, postoperative morbidities, mortalities, and short-term clinical outcomes. Results: The mean number of retrieved lymph nodes was 21.1 (95% confidence interval, 18.1-23.99). The conversion rate was 14.6% (open conversion, 4.2%), and the overall proportion of morbidity was 31.2%. The majority of complications involved wound problems (18.8%); the mortality rate was 0%. The median postoperative hospital stay was 8 days (range, 7-12 days), and the median time from surgery until the first episode of flatus was 3 days (range, 1-5 days). Conclusions: Single-port colectomy for sigmoid colon cancer is safe and oncologically feasible in selected patients. Considering the relatively high conversion rates, improvement of the instruments for single-port colectomy is needed. PMID:23937142

Park, Ji Won; Sohn, Dea Kyung; Park, Sohee; Park, Sung Chan; Chang, Hee Jin; Son, Hae-Jung; Oh, Jae Hwan




Microsoft Academic Search

Purpose:Sigmoid vaginoplasty is an alternative technique for vaginal replacement. We describe the successful use of laparoscopy for reconstruction of a vagina in patients with the Mayer-Rokitansky-Kuster-Hauser syndrome.




An Algorithm for the Management of Sigmoid Colon Volvulus and the Safety of Primary Resection: Experience with 827 Cases  

Microsoft Academic Search

\\u000a Purpose  This study was designed to review the outcomes of emergent treatment of sigmoid colon volvulus.\\u000a \\u000a \\u000a \\u000a Methods  The records of 827 patients were reviewed retrospectively.\\u000a \\u000a \\u000a \\u000a Results  The mean age was 57.9 years (range, 10 weeks to 98 years), and 688 patients (83.2 percent) were male. Nonoperative reduction\\u000a was applied in 575 patients (barium enema in 13, rigid sigmoidoscopy in 351, and flexible sigmoidoscopy in 211, with

Durkaya Ören; S. Selçuk Atamanalp; Bülent Aydinli; M. ?lhan Yildirgan; Mahmut Ba?o?lu; K. Yalç?n Polat; Ömer Önba?



Anisakidosis of the sigmoid colon disguising as metastatic carcinoma: a case report and review of the literature.  


Intestinal anisakidosis is a rare nematode infestation caused by the ingestion of larvae-infected raw or undercooked fish. Most cases are incidentally diagnosed during surgery for other reasons. We present such a case of anisakid larvae seen in a patient's sigmoid colon resected for adenocarcinoma, where a subserosal nodule caused by the inflammatory reaction to the worm was presumed to be a lymph node involved by metastatic tumor. With the increasing popularity of raw fish consumption, the incidence of this parasitic infection is bound to increase, requiring surgical pathologists to be cognizant of its existence and aware of its histologic appearance. PMID:22658479

Hernandez-Prera, Juan Carlos; Polydorides, Alexandros D



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



[Asymptomatic longterm survival in a patient with sigmoid colon lymph node metastasis with cancerous ascites of unknown origin].  


A 63-year-old man bearing a palpable tumor had a lymph node metastasis adjacent to the sigmoid colon that was detected by computed tomography and positron emission tomography. The sigmoid colon and enlarged lymph nodes were surgically resected, and cancerous ascites were present. Pathologically, the tumor in the lymph node was a poorly-differentiated adenocarcinoma that was positive for CA19-9 as well as CK7(-/+), CK20(+/-), VEGF(+), p 53(+)and MIB-1 (>10%). We treated this case as a pancreatic or bile duct carcinoma due to the patient's markedly elevated serum levels of CA19-9 and SPan-1. However, we could not make a conclusive diagnosis. Gemcitabine-based chemotherapy was administered, and the patient had no signs of recurrence for 24 months after the operation. Then, a recurrence was identified by imaging studies, and the chemotherapy was changed to paclitaxel and carboplatin. The patient had stable disease until tumor regrowth was identified 38 months after the operation, chemotherapy was then stopped. However, at 48 months after the operation, the patient remains well and has no symptoms. Our case suggests that surgery and the appropriate choice of anticancer drugs may contribute to the long-term survival of patients with cancer of an unknown primary origin. PMID:23986064

Miki, Hisanori; Toyoda, Masao; Senzaki, Hideto; Yanagimoto, Hiroaki; Kwon, Masanori; Tsubura, Airo



Trimethyltin chloride induced chloride secretion across rat distal colon.  


TMT (trimethyltin chloride), an organotin, is ubiquitous in the environment. The consumption of contaminated food may cause exposure of the human diet to this toxic compound. The present study was to investigate the effects of TMT on the regulation of ion transport across the rat distal colon. The rat colonic mucosa was mounted in Ussing chambers. The effects of TMT were assessed using the Isc (short-circuit current). Both apical and basolateral TMT induced, dose-dependently, an increase in Isc, which was due to a stimulation of Cl- secretion as measured using ion substitution experiments and pharmacological manoeuvres. The secretion was also inhibited by several K+ channel blockers administrated at the basolateral side. When the apical side was permeabilized by nystatin, the TMT-induced K+ conductance was effectively blocked by tetrapentylammonium, a Ca2+-sensitive K+ channel blocker. The response of TMT was sensitive to the basolateral Ca2+ and the intracellular Ca2+ store, which could be disclosed by applying the inhibitors of ryanodine receptors and inositol 1,4,5-trisphosphate receptors. In conclusion, TMT led to Cl- secretion, which was essentially regulated by basolateral Ca2+-sensitive K+ channels. These results suggest the importance of K+ channels in the toxicity hazard of TMT. PMID:19947937

Yu, Haijie; Chen, Siliang; Yang, Zihuan; Pan, Ao; Zhang, Geng; Shan, Jiajie; Tang, Xiaojiang; Zhou, Wenliang



Decreased interstitial cells of Cajal in the sigmoid colon of patients with slow transit constipation  

Microsoft Academic Search

Background and aims Slow transit constipation (STC) is a colonic motor disorder that is characterized by measurably delayed movement of materials through the colon. Although abnormalities in the neuronal networks of the colon have been demonstrated in patients with STC, the etiology of STC remains unclear. Interstitial cells of Cajal (ICC) have been shown to be the pacemaker cells of

Wei-Dong Tong; Bao-Hua Liu; Lian-Yang Zhang; Sheng-Ben Zhang; Ying Lei



Beta-arrestin2 is involved in the increase of distal colonic contraction in diabetic rats.  


Colonic dysmotility occurs in diabetes and the patients exhibit diarrhea or constipation. The pathogenetic mechanisms underlying colonic dysmotility in diabetic patients remain poorly understood. The effects of ?-arrestin2 on colonic contraction in diabetic rats were investigated for the first time. Male SD rats were treated with a single intraperitoneally injected dose of streptozotocin, and those displaying sustained high blood glucose were selected as diabetes mellitus models. Longitudinal muscle strips of the distal colon were prepared to monitor contraction of the colon in vitro. Expression of ?-arrestin2 was investigated by Western blot analysis. Anti-?-arrestin2 antibody had no direct effect on the contraction of distal colonic strips in both normal and diabetic rats. Carbachol-induced contractions of distal colonic strips were higher in diabetic rats than in normal rats. Anti-?-arrestin2 antibody partly blocked carbachol-induced increases of distal colonic strips in diabetic rats. The expression level of ?-arrestin2 protein in the colon was higher in diabetic rats than in normal rats. These results suggest that ?-arrestin2 is involved in the increase of distal colonic contraction in diabetic rats. PMID:23816471

Xie, Dong-Ping; Li, Sen; Li, Liang; Chang, Xin-Wen; Xi, Tao-Fang; Yang, Xiao; Jin, Zhi; Zeng, Ying



Population-Based Incidence of Complicated Diverticular Disease ofthe Sigmoid Colon Based on Gender and Age  

Microsoft Academic Search

PURPOSE: The purpose of this study was to characterize the\\u000agender and age differences in patients with clinically symptomatic\\u000asigmoid diverticular disease requiring surgery.\\u000aMETHODS: All surgical patients hospitalized with proven\\u000adiverticular disease requiring sigmoid resection from January\\u000a1988 to January 1998 were reviewed. RESULTS: A total\\u000aof 934 patients requiring surgical resection for diverticular\\u000adisease were admitted. There were

Elizabeth J. McConnell; Deron J. Tessier; Bruce G. Wolff



Ca2+-induced Cl- efflux at rat distal colonic epithelium.  


With the aid of the halide-sensitive dye 6-methoxy-N-ethylquinolinium iodide (MEQ), changes in intracellular Cl(-) concentration were measured to characterize the role of Ca(2+)-dependent Cl(-) channels at the rat distal colon. In order to avoid indirect effects of secretagogues mediated by changes in the driving force for Cl(-) exit (i.e., mediated by opening of Ca(2+)-dependent K(+) channels), all experiments were performed under depolarized conditions, i.e., in the presence of high extracellular K(+) concentrations. The Ca(2+)-dependent secretagogue carbachol induced a stilbene-sensitive Cl(-) efflux, which was mimicked by the Ca(2+) ionophore ionomycin. Surprisingly, the activation of Ca(2+)-dependent Cl(-) efflux was resistant against blockers of classical Ca(2+) signaling pathways such as phospholipase C, protein kinase C and calmodulin. Hence, alternative pathways must be involved in the signaling cascade. One possible signaling molecule seems to be nitric oxide (NO) as the NO donor sodium nitroprusside could induce Cl(- )efflux. Vice versa, the NO synthase inhibitor N-omega-monomethyl-arginine (L: -NMMA) reduced the carbachol-induced Cl(- )efflux. This indicates that NO may be involved in part of the signaling cascade. In order to test the ability of the epithelium to produce NO, the expression of different isoforms of NO synthase was verified by immunohistochemistry. In addition, the cytoskeleton seems to play a role in the activation of Ca(2+)-dependent Cl(-) channels. Inhibitors of microtubule association such as nocodazole and colchicine as well as jasplakinolide, a drug that enhances actin polymerization, inhibited the carbachol-induced Cl(-) efflux. Consequently, the activation of apical Cl(-) channels by muscarinic receptor stimulation differs in signal transduction from the classical phospholipase C/protein kinase C way. PMID:18217180

Hennig, B; Schultheiss, G; Kunzelmann, K; Diener, M



Foreign body impaction in the sigmoid colon: a twenty euro bet.  


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. PMID:23840130

Müller, Katalin E; Arató, András; Lakatos, Péter László; Papp, Mária; Veres, Gábor



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


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



[Synchronous adenocarcinoma of the sigmoid colon and multifocal intraductal papillary mucinous neoplasm of the pancreas in an elderly patient].  


Intraductal papillary mucinous neoplasms are a well-recognized pathologic entity of the pancreas that is being reported with increasing frequency. These tumours carry a relatively favourable prognosis and are frequently associated with extrapancreatic malignancies. The combination of advanced age and co-existence of two neoplasms challenges the planning of the best treatment option. A 78-year-old man presented with rectal bleeding which led to the diagnosis of a stenosing adenocarcinoma of the sigmoid colon. No metastatic lesions were present but a 30 mm intraductal papillary mucinous neoplasm with mural nodules was detected in the uncinate process of the pancreas. Small diffused dilations of the side branches were present in the body and tail of the gland. A two-stage procedure was planned: an R0 sigmoid resection was undertaken first with an uneventful postoperative course. Forty-five days later a pancreaticoduodenectomy was performed and the postoperative course was again uneventful apart from delayed gastric emptying. Histology showed a combined-type intraductal papillary mucinous neoplasm with foci of non-invasive carcinoma. The patient is still alive without evidence of cancer recurrence 33 month after the pancreatico-duodenectomy. The co-existence of a potentially malignant pancreatic tumour with an extra-pancreatic overt malignancy in elderly patients poses difficulties in the attempt to cure the patient with minimal morbidity. In the present case we considered a staged surgical procedure with the aim of reducing the perioperative risk, since the excision of the pancreatic neoplasm required a pancreaticoduodenectomy in an elderly patient. PMID:19694240

Mirarchi, Mariateresa; De Raffele, Emilio; Lega, Stefania; Calculli, Lucia; Vaccari, Samuele; Cola, Bruno


Piriformospora indica root colonization triggers local and systemic root responses and inhibits secondary colonization of distal roots.  


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. PMID:23922705

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



[A case of sigmoid colon cancer with lymphangitis carcinomatosa successfully treated with chemotherapies including molecular targeting drugs].  


A 51-year-old man was referred to our hospital with adenocarcinoma of sigmoid colon with multiple lymph node metastasis. At the time of admission, he had dyspnea, and computed tomography (CT) showed typical signs of lymphangitis carcinomatosa of the lung. Combination of mFOLFOX6 and bevacizumab was started. After start of the therapy, CT revealed an improvement in lymphangitis carcinomatosa. 8 months later, the tumor assessment became progressive disease. FOLFIRI was started as the second-line chemotherapy, but the patient did not respond. Then, dyspnea emerged again, and CT indicated the lymphangitis carcinomatosa had become worse. So as the third-line chemotherapy, combination of irinotecan and cetuximab was started. Dyspnea immediately disappeared, and CT showed an improvement of lymphangitis carcinomatosa. In the previous literature, malignant tumor cases which accompany lymphangitis carcinomatosa might always have a poor course. Our case dramatically responded to the chemotherapy including molecular targeting drug and showed a long survival. So we conclude that aggressive chemotherapy including a molecular targeting drug may be recommended in a case of colorectal cancer which accompanies lymphangitis carcinomatosa of the lung. PMID:20332699

Sogabe, Susumu; Yuki, Satoshi; Takagi, Tomofumi; Miyazaki, Takuji; Takano, Hironobu; Kawamoto, Yasuyuki; Nakatsumi, Hiroshi; Sasaki, Takahide; Iwanaga, Ichiro; Uehata, Yasuko; Asaka, Masahiro; Komatsu, Yoshito



Increasing butyrate concentration in the distal colon by accelerating intestinal transit  

PubMed Central

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

Lewis, S; Heaton, K



Eosinophilic Gastroenteritis Involving the Distal Small Intestine and Proximal Colon  

Microsoft Academic Search

Eosinophilic gastroenteritis (EG) is an unusual disorder. It is characterized by eosinophil infiltration of the gut wall histologically and is manifested by gastrointestinal (GI) symptoms clinically. This disease entity preferentially affects the stomach and proxi- mal small intestine. Mucosal layer disease is the most common form of this uncommon dis- ease. We present a case of EG with transmural distal

Guan-Yeow Ong; Chia-Chang Hsu; Chi-Sin Changchien; Sheng-Nan Lu; Shun-Chen Huang


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.




[Case report of long-term survival obtained for advanced sigmoid colon cancer with para-aortic lymph nodes by resection and chemotherapy].  


The patient was a 66-year-old male. He underwent sigmoidectomy with D1 for an advanced sigmoid colon cancer with massive metastasis to the para-aortic lymph nodes. After the resection he underwent chemotherapy, and CT showed that the para-aortic lymph node metastasis had disappeared. However, CT showed other lymph node(No. 252, No. 273 lt)swelling. We therefore resected No. 252 and No. 273 lt lymph nodes. Two years after the resection the patient is alive and shows no sign of recurrence while being without chemotherapy. PMID:23986062

Dan, Nobuhiro; Miura, Kotaro; Tendo, Masanari; Hori, Takeshi; Nishino, Hiroji



Colonic gene expression profile in NHE3-deficient mice: evidence for spontaneous distal colitis.  


Na+/H+ exchanger 3 (NHE3) provides a major route for intestinal Na+ absorption. NHE3 has been considered a target of proinflammatory cytokines and enteropathogenic bacteria, and impaired NHE3 expression and/or activity may be responsible for inflammation-associated diarrhea. However, the possibility of loss of NHE3 function reciprocally affecting gut immune homeostasis has not been investigated. In this report, we describe that NHE3-deficient mice spontaneously develop colitis restricted to distal colonic mucosa. NHE3(-/-) mice housed in a conventional facility exhibited phenotypic features such as mild diarrhea, occasional rectal prolapse, and reduced body weight. Genomewide microarray analysis identified not only a large group of transport genes that potentially represent an adaptive response, but also a considerable number of genes consistent with an inflammatory response. Histological examination demonstrated changes in the distal colon consistent with active inflammation, including crypt hyperplasia with an increased number of 5-bromo-2'-deoxyuridine-positive cells, diffuse neutrophilic infiltrate with concomitant 15-fold increase in matrix metalloproteinase 8 expression, an increased number of pSer276-RelA-positive cells, and a significant decrease in periodic acid-Schiff-positive goblet cells. Real-time PCR demonstrated elevated expression of inducible nitric oxide synthase (38-fold), TNF-alpha (6-fold), macrophage inflammatory protein-2 (48-fold), and IL-18 (3-fold) in the distal colon of NHE3(-/-) mice. NHE3(-/-) mice showed enhanced bacterial adhesion and translocation in the distal colon. Colitis was ameliorated by oral administration of broad-spectrum antibiotics. In conclusion, NHE3 deficiency leads to an exacerbated innate immune response, an observation suggesting a potentially novel role of NHE3 as a modifier gene, which when downregulated during infectious or chronic colitis may modulate the extent and severity of colonic inflammation. PMID:18467500

Laubitz, Daniel; Larmonier, Claire B; Bai, Aiping; Midura-Kiela, Monica T; Lipko, Maciej A; Thurston, Robert D; Kiela, Pawel R; Ghishan, Fayez K



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))



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



Effects of the 5-HT3 antagonist cilansetron vs placebo on phasic sigmoid colonic motility in healthy man: a double-blind crossover trial  

PubMed Central

Aims 5-hydroxytryptamine3 receptor antagonists act antiemetically and slow colonic transit. This study evaluated effects of the high-affinity 5-HT3 antagonist, cilansetron, on fasting, meal-and anticholinesterase-stimulated phasic contractile activity of the human sigmoid colon as well as on bowel habits and stool consistency. Methods Five female and seven male healthy volunteers received, during three 7 day periods separated by 7 day wash-out periods, 4 mg cilansetron, 8 mg cilansetron or placebo three times daily orally under random, double-blind, crossover conditions. On day 8 of each treatment period, motility 20–40 cm from the anal verge was recorded using five pressure sensors spaced at 5 cm intervals. After a basal 30 min, subjects swallowed a further dose of the scheduled treatment; 60 min later, blood was taken for the determination of plasma cilansetron levels. Thereafter, subjects ingested a 4200 kJ meal and 250 ml sweetened mallow tea (166 kJ); 90 min after meal onset, 1 mg neostigmine was administered intramuscularly and motility recording was continued for 60 min Results Phasic contractile activity and intraluminal base-line pressure increased postprandially and more so after neostigmine. With cilansetron, the area under the pressure curve as the primary outcome variable and the number of contractions were significantly greater than with placebo (P = 0.005), amplitude and duration of contractions and base-line pressure were not affected. The effects of the two cilansetron dosages did not differ. With cilansetron, stool tended to become firmer. No adverse effects were observed. Plasma levels were highest with 8 mg cilansetron. Conclusions Cilansetron slightly augments meal-stimulated and markedly neostigmine-stimulated phasic motility of the sigmoid colon. When administered over 7 days, it tends to increase stool consistency and is well tolerated.

Stacher, Georg; Weber, Ute; Stacher-janotta, Giselheid; Bauer, Peter; Huber, Kurt; Holzapfel, Antje; Krause, Gunter; Steinborn, Claus



How many lymph nodes are necessary to stage early and advanced adenocarcinoma of the sigmoid colon and upper rectum?  

Microsoft Academic Search

The lymph-node yields in specimens resected for colorectal adenocarcinoma show considerable variations, raising the question whether the minimum lymph-node number recommended by the UICC (International Union Against Cancer) for pN0 classification represents an appropriate quality standard for specimen work-up. The number of pericolic lymph nodes recovered from 568 archival surgical colorectal carcinoma specimens located in the sigmoid or upper rectum

Sebastian Leibl; Oleksiyy Tsybrovskyy; Helmut Denk



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


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

Feng, Bin; Brumovsky, Pablo R; Gebhart, Gerald F



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))



Hepatic abscess in a pre-existed simple hepatic cyst as a late complication of sigmoid colon ruptured diverticula: a case report  

PubMed Central

Introduction Hepatic abscesses have been reported as a rare complication of diverticulitis of the bowel. This complication is recognized more commonly at the time of the diagnosis of diverticulitis, or ruptured diverticula, but also can be diagnosed prior to surgery, or postoperatively. Case presentation This report describes a man who developed an hepatic abscess within a simple hepatic cyst, two months after operation for ruptured diverticula of the sigmoid colon. The abscess was drained surgically and the patient made a complete recovery. Conclusion The development of an hepatic abscess in a pre-existing hepatic cyst, secondary to diverticulitis, is a rare complication. A high degree of clinical suspicion is required for immediate diagnosis and treatment.

Chatzipetrou, Maria; Avgerinos, Efthimios; Christianakis, Efstratios; Barmparas, Galinos; Pashalidis, Nikolaos; Stathoulopoulos, Athanasios; Tsatsoulis, Panayiotis; Smailis, Dimitrios; Filippou, Dimitrios



Management of sigmoid volvulus avoiding sigmoid resection.  


Acute sigmoid volvulus is typically caused by an excessively mobile and redundant segment of colon with a stretched mesenteric pedicle. When this segment twists on its pedicle, the result can be obstruction, ischemia and perforation. A healthy, 18-year-old Caucasian woman presented to the emergency department complaining of cramping abdominal pain, distention, constipation and obstipation for the last 72 h, accompanied by nausea, vomiting and abdominal tenderness. The patient had tympanitic percussion tones and no bowel sounds. She was diagnosed with acute sigmoid volvulus. Although urgent resective surgery seems to be the appropriate treatment for those who present with acute abdominal pain, intestinal perforation or ischemic necrosis of the intestinal mucosa, the first therapeutic choice for clinically stable patients in good general condition is considered, by many institutions, to be endoscopic decompression. Controversy exists on the decision of the time, the type of definitive treatment, the strategy and the most appropriate surgical technique, especially for teenagers for whom sigmoid resection can be avoided. PMID:22754489

Katsikogiannis, Nikolaos; Machairiotis, Nikolaos; Zarogoulidis, Paul; Sarika, Eirini; Stylianaki, Aikaterini; Zisoglou, Maria; Zervas, Vasilis; Bareka, Metaxia; Christofis, Christos; Iordanidis, Alkis



Muscarinic down-regulation of cAMP-stimulated potassium ion secretion by rabbit distal colon  

Microsoft Academic Search

The sustained effects of the cholinergic agonist carbachol (CCh) on electrolyte transport across the isolated, short-circuited rabbit distal colon were examined in the absence and presence of secretagogue (di-butyryl cyclic-adenosine monophosphate, dB-cAMP). Steady-state, basal absorption of 22Na+, 42K+ (86Rb+), and 36Cl- were not significantly altered by addition of the CCh (10-4 mmol\\/l) to the serosal reservoir. Stimulation with dB-cAMP (1.0

Robert W. Freel; N. D. Vaziri; Marguerite Hatch



Sigmoid volvulus in the Middle East.  


Little is known about sigmoid volvulus in the Middle East despite textbooks referring to the region as part of the "volvulus belt." Our objectives were to assess the prevalence, clinical presentations, radiological findings, operative treatments, and postoperative outcomes of patients managed for sigmoid volvulus in Jordan as a model for the region. The medical records of patients with large bowel obstruction who were managed at King Abdullah University Hospital and its affiliated institutes, northern Jordan, over a 6-year period between January 2001 and January 2007 were retrospectively reviewed to identify patients with a confirmed diagnosis of sigmoid volvulus. Sigmoid volvulus was responsible for 9.2% of all cases of large bowel obstruction seen during the study period. There were 32 patients with sigmoid volvulus, 24 (75%) of whom were men. The median age of the patients was 59 years (range 21-83 years). Abdominal pain and distention were the main presentations. Colonoscopic detorsion was applied in 25 patients, which was achieved in 17 (68%) of them after the first attempt. Six patients had a gangrenous sigmoid colon, four of which required resection and a Hartmann procedure. Sigmoid resection with primary anastomosis was performed in 28 patients, including 2 with a gangrenous colon. Postoperative complications were observed in five patients, including one patient with viable colon who develop an anastomotic leak. Two patients died, making the mortality rate 6%. Sigmoid volvulus is uncommon in Jordan. Resection of the sigmoid colon with primary anastomosis appears to be the preferred procedure. PMID:18196324

Heis, Hussein A; Bani-Hani, Kamal E; Rabadi, Daher K; Elheis, Mwaffaq A; Bani-Hani, Bayan K; Mazahreh, Tagleb S; Bataineh, Ziyad A; Al-Zoubi, Nabeil A; Obeidallah, Mohammed S



The treatment of internal fistulae that complicate diverticular disease of the sigmoid colon by laparoscopically assisted colectomy  

Microsoft Academic Search

Seven patients with internal fistulae complicating colonic diverticular disease were treated by laparoscopic assisted colectomy over a 24-month period. Prospective review of these patients was carried out to ascertain efficacy of the treatment. No intraoperative complications were encountered and return of gastrointestinal function was apparent within two days in all cases. Postoperative hospital stay was limited to an average of

P. J. Hewett; R. Stitz



Activation of nonselective cation channels in the basolateral membrane of rat distal colon crypt cells by prostaglandin E 2  

Microsoft Academic Search

Ion channels in the basolateral membrane of colonic crypts were investigated with the patch-clamp technique during stimulation of secretion. Intact crypts were isolated from rat distal colon and the cell potential was recorded by addition of nystatin to the pipette solution. The cell resting potential in the base of the crypt was -74±1 mV (n=90). Addition of 100 µM carbachol

Christiane Siemer; Heinz Gögelein



Clinical significance of distal colon polyps for the prediction of an advanced proximal neoplasm: the KASID prospective multicenter study  

Microsoft Academic Search

Background\\/aims  The possibility of proximal lesion without distal polyps is a weak point of sigmoidoscopic colon cancer screening, but the\\u000a clinical significance of distal findings for advanced proximal neoplasm (APN) is uncertain. The aim of this study was to assess\\u000a the significance of a distal finding as a predictor of APN.\\u000a \\u000a \\u000a \\u000a Materials and methods  Asymptomatic patients ?50 years old were enrolled from among

Mun Su Kang; Dong Il Park; Yoon Tae Jeen; Bora Keum; Jai Hyun Choi; Sung-Ae Jung; Hyun Soo Kim; Young-Ho Kim; Won Ho Kim; Tae Il Kim; Hyo Jung Kim; Suk Kyun Yang; Seung Jae Myung; Jeong Sik Byeon; Moon Sung Lee; Il Kwon Jung; Moon Kwan Chung; Hwang Choi; Dong Soo Han; Jae Suk Song



Factors affecting the potassium concentration at the mucosal surface of the proximal and the distal colon of guinea pig.  


K+ concentrations were measured in vitro with K+ sensitive microelectrodes in the microclimate at the luminal cell surface of the colon of guinea pigs. The serosal K+ concentration was mostly 5.4 mmol/1, the mucosal K+ concentrations were changed (0, 5, 50, or 70 mmol/l). Under control conditions K+ concentrations in the microclimate of the proximal colon were also low (6-9 mmol/l) and rather independent from K+ concentrations in the bulk luminal solution. In the distal colon K+ concentrations in the microclimate increased from 3.7 mmol/l when no K+ was in the luminal solution, up to 22 mmol/l when the mucosal K+ concentrations was 70 mmol/l. Attempts to decrease K+ conductance of the apical membrane with Ba++, to impair K+ transport with ouabain and to increase the paracellular shunt with deoxycholic acid did not affect K+ concentrations in the microclimate of the proximal colon but decreased K+ concentrations in the distal colon. When valinomycin or triaminopyrimidine were added to the mucosal solution at high K+ concentrations in the luminal solutions the K+ concentration in the microclimate was raised. At low luminal K+ concentrations valinomycin had no effect, triaminopyrimidine significantly diminished K+ concentrations at the cell surface. Regional differences in paracellular shunt conductance and in the preepithelial diffusion barrier are thought to be responsible for the observed differences between the proximal and the distal colon. Obviously, however, further unknown mechanisms have to be involved. PMID:2108077

Kück-Biere, U; von Engelhardt, W



Characterization of circular muscle motor neurons of the duodenum and distal colon in the Australian brush-tailed possum.  


The motor innervation of the duodenum and distal colon remains uncharacterized within the same species. Our aim was to compare the projections and neurochemical properties of duodenal and distal colon circular muscle motor neurons. Circular muscle motor neurons were retrogradely traced by using a neural tracer in vitro, processed for choline acetyltransferase (ChAT) and nitric oxide synthase (NOS) immunoreactivity and then visualized by using indirect immunofluorescence. A mean of 372 +/- 64 and 156 +/- 23 neurons (mean +/- SEM) were tracer-labeled within the duodenum and colon, respectively. The ChAT+/NOS- neurons comprised 57.6 +/- 6.6% and 39.6 +/- 4.4% of all labeled cells in the duodenum and colon, respectively, and projected mainly in the oral direction. Of all labeled cells, the ChAT-/NOS+ neurons comprised 8.5 +/- 2.3% in the duodenum and 46.6 +/- 5.0% in the distal colon and projected mainly in the anal direction. Of the remainder, 20.6 +/- 5.0% and 8.2 +/- 2.4% were ChAT+/NOS+ and 13.2 +/- 0.9% and 5.6 +/- 1.4% were ChAT-/NOS- in the duodenum and distal colon, respectively. Within both regions, the distribution of the ChAT+/NOS- and ChAT-/NOS+ neurons are consistent with the ascending excitatory and descending inhibitory reflexes. The proportion of ChAT-/NOS+ neurons is greater within the colon in comparison with the duodenum. A considerable proportion of duodenal motor neurons were ChAT+/NOS+ and ChAT-/NOS-. These two classes may underlie nonperistaltic motor patterns, which predominate within the duodenum. These findings demonstrate regional differences in the innervation of intestinal circular muscle. PMID:11793344

Konomi, Hiroyuki; Meedeniya, Adrian C B; Simula, Maria E; Toouli, James; Saccone, Gino T P



A patient who showed a pathologically complete response after undergoing treatment with XELOX plus bevacizumab for synchronous liver metastasis of grade H2 from sigmoid colon cancer  

PubMed Central

We herein report the case of a patient who showed a pathological complete response after undergoing chemotherapy with capecitabine, oxaliplatin and bevacizumab. The patient presented with synchronous solitary liver metastasis from sigmoid colon cancer. The maximum diameter of the liver deposit was 5.7 cm and the grade of the liver metastasis was H2 according to the Japanese classification. Deferred hepatectomy after sigmoidectomy was performed, followed by the administration of neoadjuvant chemotherapy. After undergoing sigmoidectomy, the patient received 1,000 mg/m2 of capecitabine and 130 mg/m2 of oxaliplatin without bevacizumab as the first cycle of chemotherapy followed by eight cycles of chemotherapy with bevacizumab (7.5 mg/kg) every three weeks. The liver deposit was reduced to 2.2 cm in diameter and the patient showed a partial response to chemotherapy. The patient then underwent metastasectomy of segment 8 of the liver instead of the central hepatectomy that was possibly needed before chemotherapy. Histopathologically, the tumor consisted of fibrous tissue, and no cancer cells were detected in the resected specimen. A pathological complete response in a patient with H2 liver metastasis is considered rare and suggests that capecitabine, oxaliplatin and bevacizumab are efficacious as neoadjuvant chemotherapy.

Hisatsune, Yasuhito; Mihara, Yoshitaka; Tobe, Naotaka; Ishibashi, Kazuyoshi; Shimamura, Tsukasa; Tanaka, Kei-ichi; Aida, Yoshio; Otsubo, Takehito



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


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

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



Percutaneous endoscopic sigmoid colostomy for irrigation in the management of bowel dysfunction of adults with central neurologic disease  

Microsoft Academic Search

Background  Bowel dysfunction results in a major lifestyle disruption for many patients with severe central neurologic disease. Percutaneous\\u000a endoscopic sigmoid colostomy for irrigation (PESCI) allows antegrade irrigation of the distal large bowel for the management\\u000a of both incontinence and constipation. This study prospectively assessed the safety and efficacy of PESCI.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A PESCI tube was placed endoscopically in the sigmoid colon of

A. Ramwell; M. Rice-Oxley; A. Bond; J. N. L. Simson


Butyrate delivered by butyrylated starch increases distal colonic epithelial apoptosis in carcinogen-treated rats.  


Animal studies show that increasing large bowel butyrate concentration through ingestion of butyrylated or resistant starches opposes carcinogen-induced tumorigenesis, which is consistent with population data linking greater fiber consumption with lowered colorectal cancer (CRC) risk. Butyrate has been shown to regulate the apoptotic response to DNA damage. This study examined the impact of increasing large bowel butyrate concentration by dietary butyrylated starch on the colonic epithelium of rats treated with the genotoxic carcinogen azoxymethane (AOM). Four groups of 10 male rats were fed AIN-93G based-diets containing either low amylose maize starch (LAMS), LAMS with 3% tributyrin, 10% high amylose maize starch (HAMS) or 10% butyrylated HAMS (HAMSB). HAMS and HAMSB starches were cooked by heating in water. After 4 weeks, rats were injected once with AOM and killed 6 h later. Rates of apoptosis and proliferation were measured in colonic epithelium. Short-chain fatty acid concentrations in large bowel digesta and hepatic portal venous plasma were higher in HAMSB than all other groups. Apoptotic rates in the distal colon were increased by HAMSB and correlated with luminal butyrate concentrations but cellular proliferation rates were unaffected by diet. The increase in apoptosis was most marked in the base and proliferative zone of the crypt. Regulation of luminal butyrate using HAMSB increases the rates of apoptotic deletion of DNA-damaged colonocytes. We propose this pro-apoptotic function of butyrate plays a major role reducing tumour formation in the AOM-treated rat and that these data support a potential protective role of butyrate in CRC. PMID:22080572

Clarke, Julie M; Young, Graeme P; Topping, David L; Bird, Anthony R; Cobiac, Lynne; Scherer, Benjamin L; Winkler, Jessica G; Lockett, Trevor J



Butyrate delivered by butyrylated starch increases distal colonic epithelial apoptosis in carcinogen-treated rats  

PubMed Central

Animal studies show that increasing large bowel butyrate concentration through ingestion of butyrylated or resistant starches opposes carcinogen-induced tumorigenesis, which is consistent with population data linking greater fiber consumption with lowered colorectal cancer (CRC) risk. Butyrate has been shown to regulate the apoptotic response to DNA damage. This study examined the impact of increasing large bowel butyrate concentration by dietary butyrylated starch on the colonic epithelium of rats treated with the genotoxic carcinogen azoxymethane (AOM). Four groups of 10 male rats were fed AIN-93G based-diets containing either low amylose maize starch (LAMS), LAMS with 3% tributyrin, 10% high amylose maize starch (HAMS) or 10% butyrylated HAMS (HAMSB). HAMS and HAMSB starches were cooked by heating in water. After 4 weeks, rats were injected once with AOM and killed 6 h later. Rates of apoptosis and proliferation were measured in colonic epithelium. Short-chain fatty acid concentrations in large bowel digesta and hepatic portal venous plasma were higher in HAMSB than all other groups. Apoptotic rates in the distal colon were increased by HAMSB and correlated with luminal butyrate concentrations but cellular proliferation rates were unaffected by diet. The increase in apoptosis was most marked in the base and proliferative zone of the crypt. Regulation of luminal butyrate using HAMSB increases the rates of apoptotic deletion of DNA-damaged colonocytes. We propose this pro-apoptotic function of butyrate plays a major role reducing tumour formation in the AOM-treated rat and that these data support a potential protective role of butyrate in CRC.

Clarke, Julie M.; Young, Graeme P.; Topping, David L.; Bird, Anthony R.; Cobiac, Lynne; Scherer, Benjamin L.; Winkler, Jessica G.; Lockett, Trevor J.



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

SciTech Connect

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

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



Regulation of the Basolateral Na(+), K(+)-ATPase in the Activation of Electrogenic Na(+) Absorption Induced by Isoproterenol in the Rat Distal Colon.  


We investigated the effects of cAMP on the basolateral Na(+), K(+)-ATPase and apical amiloride-sensitive Na(+) channel in the rat distal colon. Under mucosal treatment with nystatin, isoproterenol and forskolin increased the basolateral Na(+) pump current. Under serosal treatment with ouabain, both agents slightly increased the amiloride-sensitive Na current, but not to a significant level. We concluded that cAMP activates the basolateral Na(+), K(+)-ATPase in the rat distal colon. PMID:24018672

Tsuchiya, Yo; Suzuki, Yuichi



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



Ileal and colonic epithelial metabolism in quiescent ulcerative colitis: increased glutamine metabolism in distal colon but no defect in butyrate metabolism.  

PubMed Central

Previous studies have shown that butyrate is an important energy source for the distal colon, and that its metabolism may be defective in ulcerative colitis (UC). A similar metabolic defect in the ileum might account for the occurrence of 'pouchitis' in UC patients after colectomy. A method has been developed that allows the measurement of metabolism in ileocolonoscopic biopsy specimens, and this has been used to assess butyrate and glutamine metabolism in quiescent UC and controls. Preliminary experiments showed optimal metabolism of butyrate at 1 mmol/l. In controls glutamine metabolism was greater in the ascending (mean (SD)) (4.9 (3.2) nmol/h/micrograms protein) than in the descending colon (1.4 0.7)) (p < 0.05, Mann-Whitney U test), but butyrate metabolism was similar in the two regions (ascending 62.6 (44.2), descending 51.5 (32.0)). Consequently ratios of butyrate/glutamine metabolism were higher in the descending colon (20.6 (14.3)) than in the ascending colon (14.3 (9.6)) (p < 0.05). In UC, rates of butyrate metabolism were similar in the ascending (92.5 (58.3) nmol/h/micrograms protein) and descending (93.3 (115)) colon, and these were not significantly different from controls. In UC, glutamine metabolism was similar in the ascending (6.2 (7.7) nmol/h/micrograms protein) and descending colon (7.8 (7.9)); the metabolism in the descending colon was significantly greater than in controls (p < 0.01). Butyrate (135 (56) nmol/h/microgram protein) and glutamine (24.1 (16.2)) metabolism in the ileum in UC, were not significantly different from control values (butyrate 111 (57), glutamine 15.5 (15.6)). These results confirm that there is regional variation of nutrient utilisation throughout the colon, but they do not support the hypothesis that UC is caused by a deficiency of butyrate metabolism.

Finnie, I A; Taylor, B A; Rhodes, J M



Prospective Evaluation of Laparoscopy-assisted Colectomy versusLaparotomy with Resection for Management of Complex Polyps of theSigmoid Colon  

Microsoft Academic Search

  Laparoscopy-assisted colectomy istechnically feasible, but objective evidence of its benefits remainsscarce. This study was\\u000a done to evaluate the outcomes and operativestress of laparoscopy-assisted colectomy versus the traditional openmethod in the\\u000a management of sigmoid complex polyps that cannot besafely or adequately removed by colonofibroscopy. Between January 1997and\\u000a December 1999, a total of 42 patients were equally randomizedto the laparoscopy group and

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



Severe Defects in Absorptive Ion Transport in Distal Colons of Mice that Lack ClC-2 Channels  

PubMed Central

Background & Aims The fluid secretion model predicts that intestinal obstruction disorders can be alleviated by promoting epithelial Cl? secretion. The cAMP-activated anion channel CFTR mediates Cl?-dependent fluid secretion in the intestine. Although the role of the ClC-2 channel has not been determined in the intestine, this voltage-gated Cl? channel might compensate for the secretory defects observed in patients with cystic fibrosis and other chronic constipation disorders. We investigated whether mice that lack ClC-2 channels (Clcn2?/?) have defects in intestinal ion transport. Methods Immunolocalization and immunoblot analyses were used to determine the cellular localization and the amount of ClC-2 expressed in mouse early (EDC) and late distal colon (LDC). Colon sheets from wildtype and Clcn2?/? littermates were mounted in Ussing chambers to determine transepithelial bioelectrical parameters and Na+, K+ and Cl? flux. Results Expression of ClC-2 was higher in the basolateral membrane of surface cells in the EDC, compared to the LDC, with little expression in crypts. Neither cAMP nor Ca2+-induced secretion of Cl? was affected in the EDC or LDC of Clcn2?/? mice, whereas the amiloride-sensitive short circuit current (ISC) was increased approximately 3-fold in Clcn2?/? EDC, compared to that of control littermates. Conversely, electroneutral Na+, K+ and Cl? absorption were dramatically reduced in colons of Clcn2?/? mice. Conclusions Basolateral ClC-2 channels are required for colonic electroneutral absorption of NaCl and KCl. The increase in the amiloride-sensitive ISC in Clcn2?/? mice revealed a compensatory mechanism that is activated in the colons of mice that lack the ClC-2 channel.

Catalan, Marcelo A.; Flores, Carlos A.; Gonzalez-Begne, Mireya; Zhang, Yan; Sepulveda, Francisco V.; Melvin, James E.



Characterization of a calcitonin gene-related peptide release assay in rat isolated distal colon  

Microsoft Academic Search

The release of calcitonin gene-related peptide (CGRP) plays a key role gastrointestinal tract homeostasis. We aimed to investigate\\u000a mechanisms that mediate CGRP release from the rat colon in vitro. Colon segments were stimulated and the amount of CGRP released was measured using an enzyme immunoassay. Capsaicin and low\\u000a pH induced significant increases in CGRP release which was shown to be

Rejbinder Kaur; Celestine T. O’Shaughnessy; Emma M. Jarvie; Wendy J. Winchester; Peter G. Mclean



Bacterial colonization of distal airways in healthy subjects and chronic lung disease: a bronchoscopic study  

Microsoft Academic Search

In contrast to the healthy population, distal airway bacterial colo- nization may occur in patients with chronic lung diseases, who often have altered pulmonary defences. However, the information dealing with this issue is insuffi- cient and is based mainly on nonspecific samples, such as sputum cultures. Using quantitative cultures of bronchoscopic protected specimen brush (PSB) and bronchoalveolar lavage (BAL) samples,

H. Cabello; A. Torres; R. Celis; M. El-Ebiary; J. Puig de la Bellacasa; A. Xaubet; J. González; C. Agustí; N. Soler



Sigmoidoscopic reduction of sigmoid volvulus.  


Twenty-six patients were treated for a volvulus of the sigmoid colon between January, 1971, and June, 1979. Eight patients had an emergency resection and, although there was a high postoperative morbidity, there were no deaths in this group. An attempt to decompress the volvulus by means of a rigid sigmoidoscope was made in 18 patients. This was successful in 14 patients. Six of these patients suffered a recurrence, and perforation occurred in four patients, three of whom subsequently died. Because of the high risk of perforation, care should be taken with this procedure. PMID:7464624

Knight, J; Bokey, E L; Chapius, P H; Pheils, M T



Age-related changes in melatonin release in the murine distal colon.  


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

Diss, Lucy B; Robinson, Stephen D; Wu, Yukyee; Fidalgo, Sara; Yeoman, Mark S; Patel, Bhavik Anil



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


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


Synchronous movements of the longitudinal and circular muscle during peristalsis in the isolated guinea-pig distal colon  

PubMed Central

Peristalsis, which involves enteric nervous reflexes, is the co-ordinated movements of the longitudinal (LM) and circular (CM) muscle layers that propel intraluminal contents down the bowel. Although the movements of the CM during peristalsis are reasonably clear the relative movements of the LM are poorly understood. We studied the oral and anal movements of the LM and CM during a peristaltic wave in isolated segments of guinea-pig distal colon. Dissection techniques were used to prevent mechanical interactions between the LM and CM; also, the colonic segment was passed through a partition to prevent mechanical disturbances created by a peristaltic wave in the bulk of the colon from influencing the end from which recordings were made. Peristalsis was generated by slowly filling the lumen of the colon with fluid. At threshold, the LM and CM synchronously contracted oral (ascending excitation) to, and relaxed anal (descending inhibition) to, a peristaltic wave. The anal relaxation was followed by a contraction (descending excitation) of both muscle layers. Atropine (1 ?m) in the recording chamber reduced both the oral (LM by 40% and CM by 27%) and anal (LM by 36% and CM by 36%) contractile responses as well as the anal relaxation response in both muscle layers. Hexamethonium (300 ?m) almost blocked the oral contractile responses of the LM and CM but had no affect on the anal responses of either muscle layer. N?-nitro-l-arginine (l-NA; 100 ?m) reduced the oral contractile response of the LM and CM by 50%, the anal contractile response of the LM by 30%, and the anal relaxation response of the LM and CM by about 30%. The anal contractile response of the CM was unaffected by l-NA. Apamin (0.5 ?m) also reduced the evoked anal relaxation of both the LM and CM by about 50%. Further addition of l-NA nearly abolished the relaxation response in the LM, but did not cause any further reduction in the relaxation response of the CM observed in apamin alone. It is concluded, that the LM and CM exhibit synchronous movements during peristalsis in the colon. Also, peristalsis consists of activation of ascending excitatory, and descending inhibitory and excitatory nervous pathways to the LM and CM, which are cholinergic and non-cholinergic, respectively. Nitric oxide is an important neuromodulator within the intrinsic nervous pathways.

Smith, Terence K; Robertson, William J



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


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

Resta, G; Scagliarini, L; Bandi, M; Vedana, L; Marzetti, A; Ferrocci, G; Santini, M; Anania, G; Cavallesco, G; Baccarini, M


Role of neuronal nitric oxide synthase in colonic distension-induced hyperalgesia in distal colon of neonatal maternal separated male rats  

PubMed Central

Background Nitric oxide (NO) is implicated in the pathogenesis of irritable bowel syndrome (IBS) but the underlying mechanism is unclear. Thus, the aim of the present study is to examine the role of NO synthase (NOS) expression in the distal colon of neonatal maternal separation (NMS) model rats employed in IBS studies. Methods Male neonates of Sprague-Dawley rats were randomly assigned into NMS and normal control (N) groups. Rats of NMS group were subjected to 3-hr daily maternal separation on postnatal day 2–21. Rats were administrated non-selective NOS inhibitor L-NAME (100mg/kg), selective neuronal NOS (nNOS) inhibitor 7NINA (10mg/kg), selective inducible NOS (iNOS) inhibitor, endothelial NOS (eNOS) inhibitor (10mg/kg) or Vechicle (Veh; distilled water) intraperitoneally 1 hour prior to the experiment for the test and control groups, respectively. Key results The amount of NO was significantly higher in the NMS Veh rats compared with unseparated N rats. Western-blotting and real-time quantitative PCR studies showed that protein and mRNA expression of nNOS were higher in the NMS group than that in the N rats; whereas no significant change in iNOS and eNOS was found in either groups. NMS Veh rats showed low pain threshold and increased electromyogram (EMG) activity in response to colonic distension stimuli. L-NAME and 7NINA increased pain threshold pressure and attenuated EMG activity in the NMS rats. In addition, L-NAME and 7-NINA substantially reduced oxidative marker malondialdehyde level in NMS rats. Conclusions & Inferences NMS increased the NO generation by nNOS upregulation that interact with reactive oxygen species contributing to the visceral hypersensitivity in IBS.

Tjong, Yung-Wui; Ip, Siu-Po; Lao, Lixing; Wu, Justin; Fong, Harry HS; Sung, Joseph JY; Berman, Brian; Che, Chun-Tao



Prediction of the development of sigmoid ischemia on the day of aortic operations. Indirect measurements of intramural pH in the colon.  


A deviation in an indirect measurement of intramural pH below the limits of normality (6.86) was used as a diagnostic test for sigmoid ischemia in 25 high-risk patients undergoing abdominal aortic operations. The clinical diagnosis of ischemic colitis was made by the attending physicians in only two of the 25, on the day after operation in one and three months after operation in another. In neither was the ischemic colitis considered to have been a causative factor in their subsequent deaths. In contrast, six patients developed pH evidence of ischemia on the day of operation. All six subsequently developed a transient episode of guaiac-positive diarrhea, four developed physical signs consistent with ischemic colitis, and four died. Of 19 who did not develop pH evidence of ischemia, none developed guaiac-positive diarrhea, none developed any signs of ischemic colitis, and none died. Stepwise logistic regression showed the duration of pH evidence of ischemia on the day of operation to be the best predictor for the symptoms and signs of ischemic colitis and for death after operation. PMID:3085638

Fiddian-Green, R G; Amelin, P M; Herrmann, J B; Arous, E; Cutler, B S; Schiedler, M; Wheeler, H B; Baker, S



Giant sigmoid diverticulum with coexisting metastatic rectal carcinoma: a case report  

PubMed Central

Introduction Giant diverticulum of the colon is a rare but clinically significant condition, usually regarded as a complication of an already existing colonic diverticular disease. This is the first report of a giant diverticulum of the colon with a co-existing rectal carcinoma. Case presentation We report a case of a 66-year-old Caucasian woman who presented with lower abdominal pain, chronic constipation and abdominal swelling. Preoperative abdominal computed tomography revealed a giant diverticulum of the colon with a coexisting rectal carcinoma and pulmonary metastasis revealed on a further thoracic computed tomography. An en bloc anterior resection of the rectum along with sigmoid colectomy, partial hysterectomy and right salpingoophorectomy was subsequently performed due to extensive adhesions. Conclusion This report shows that the presence of a co-existing distal colorectal cancer can potentially lead to progressive development of a colonic diverticulum to become a giant diverticulum by increasing colonic intra-luminal pressure and through the ball-valve mechanism. This may be of interest to practising surgeons and surgical trainees.



Fast Renewal of the Distal Colonic Mucus Layers by the Surface Goblet Cells as Measured by In Vivo Labeling of Mucin Glycoproteins  

PubMed Central

The enormous bacterial load and mechanical forces in colon create a special requirement for protection of the epithelium. In the distal colon, this problem is largely solved by separation of the bacteria from the epithelium by a firmly attached inner mucus layer. In addition, an outer mucus layer entraps bacteria to be cleared by distal transport. The mucus layers contain a network of Muc2 mucins as the main structural component. Here, the renewal rate of the inner protective mucus layer was studied as well as the production and secretion of Muc2 mucin in the distal colon. This was performed by intraperitoneal injection of N-azidoacetyl-galactosamine (GalNAz) that was in vivo incorporated during biosynthesis of O-glycosylated glycoproteins. The only gel-forming mucin produced in the colon is the Muc2 mucin and as it carries numerous O-glycans, the granulae of the goblet cells producing Muc2 mucin were intensely stained. The GalNAz-labeled glycoproteins were first observed in the Golgi apparatus of most cells. Goblet cells in the luminal surface epithelium had the fastest biosynthesis of Muc2 and secreted material already three hours after labeling. This secreted GalNAz-labeled Muc2 mucin formed the inner mucus layer. The goblet cells along the crypt epithelium accumulated labeled mucin vesicles for a longer period and secretion of labeled Muc2 mucin was first observed after 6 to 8 h. This study reveals a fast turnover (1 h) of the inner mucus layer in the distal colon mediated by goblet cells of the luminal surface epithelium.

Johansson, Malin E. V.



Amiloride sensitivity of the transepithelial electrical potential and of sodium and potassium transport in rat distal colon in vivo.  


1. The effect of amiloride within the gut lumen on the transepithelial electrical potential difference (p.d.) and Na and K transport by the distal colon of adrenalectomized (dexamethasone-maintained), normal, aldosterone-infused and Na-depleted groups of rats was examined. 2. Amiloride had no effect in adrenalectomized rats; in normal rats, only the p.d. was significantly reduced. 3. In the group given a short (2 hr) aldosterone infusion, amiloride reduced the elevated p.d. and K secretion rate to normal levels. There was no change in apparent K permeability of the epithelium. 4. In the Na-depleted group, p.d. and Na absorption were virtually abolished by amiloride but although K secretion was reduced it still remained much above normal levels. Adrenalectomy prevented the effects of Na depletion. 5. P.d. change occurred rapidly when amiloride was added to the perfusate. Increasing the Na concentration in the perfusate reduced the sensitivity to amiloride. Apparent 'Km' values estimated from p.d. changes (luminal Na, 50 mM) were similar for aldosterone-infused (7.6 X 10(-6) M) and Na-depleted (5.4 X 10(-6) M) rats. 6. Aldosterone appears to be essential for the induction of amiloride-sensitive Na paths in the mucosal plasma membrane of rat colonic epithelial cells. Prolonged aldosterone stimulation, as in the Na-depleted rats, increases the amiloride-sensitive Na paths while largely suppressing the amiloride-insensitive Na paths; in addition, the K/Na clearance rate ratio of the epithelium is increased. AMiloride interacts only with one set of Na paths and does not interact directly with K paths. PMID:7277236

Edmonds, C J



Small and maxi K + channels in the basolateral membrane of isolated crypts from rat distal colon: single-channel and slow whole-cell recordings  

Microsoft Academic Search

The patch-clamp technique was used to characterize K+ channel activity in the basolateral membrane of isolated crypts from rat distal colon. In cell-attached patches with KCl in the pipette, channels with conductances ranging from 6 pS to 80 pS appeared. With NaCl in the pipette and KCl in the bath in excised inside-out membrane patches a small-conductance channel with a

Birgitta-Christina Burckhardt; Heinz Gögelein



Re-establish pneumoperitoneum in laparoscopic-assisted sigmoid resection?  

Microsoft Academic Search

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

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



Risk of Proximal Colonic Neoplasms in Asymptomatic Adults Older Than 50 Years Found to Have Distal Hyperplastic Polyps on Routine Colorectal Cancer Screening  

PubMed Central

Purpose: A retrospective case-control study was conducted to evaluate whether hyperplastic polyps (HPs) found in the lower 50 cm of colon could be used as indicators for synchronous proximal neoplasms (SPNs) in the large intestine. Additionally, other characteristics considered included age; sex; ethnicity; history of cancer, cholecystectomy, or appendectomy; current use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs); current use of estrogen or hormone replacement therapy (HRT) in women; current smoking status; and the size, number, and location of the distal HP if present. Methods: Convenience sampling of medical charts and colonoscopy reports compiled during a ten-year period was used to glean the sample of 1792 participants. Results: Distal HPs in the lower 50 cm of colon were not significantly associated with SPN when patients with HPs were compared with those without any distal polyps at all (odds ratio [OR] = 0.94; 95% confidence interval [CI] = 0.73–1.22). However, significant relationships with proximal neoplasms (adenomas, advanced adenomas, and colon cancer) were noted in patients with a prior diagnosis of cancer (OR = 1.62; 95% CI =1.25–2.11), advancing age (OR = 1.02; 95% CI = 1.01–1.03), non-Caucasian (men only) ethnicity (OR = 0.72; 95% CI = 0.55–0.96), a history (men only) of taking aspirin or NSAIDs (OR = 0.73; 95% CI = 0.56–0.95), and a history (women only) of taking estrogen or receiving HRT (OR = 1.51; 95% CI = 1.04–2.20). Conclusion: Routinely recommending a colonoscopy for every patient with distal HPs found only by screening flexible sigmoidoscopy is neither justified nor necessary. Nevertheless, further investigation (ie, colonoscopy) may be warranted in the aforementioned subgroups.

Collins, Bradley D



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

PubMed Central

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

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



Defining the role of laparoscopic-assisted sigmoid colectomy for diverticulitis  

Microsoft Academic Search

PURPOSE: The purpose of this study was to evaluate the safety and efficacy of laparoscopic-assisted sigmoid colectomy for the treatment of diverticulitis. METHODS: The Norfolk Surgical Group Laparoscopic Surgery Registry identified all patients undergoing laparoscopic colon and rectal surgery. Retrospective chart review was performed for all patients undergoing elective sigmoid resection for a final diagnosis of diverticulitis and minimum follow-up

H. David Vargas; Ray T. Ramirez; George C. Hoffman; G. Wilkins Hubbard; Randolph J. Gould; Stephen D. Wohlgemuth; W. Kirkland Ruffin; Jeffrey E. Hatter; Paul Kolm



Laparoscopic Sigmoid Resection for Diverticulitis Decreases Major Morbidity Rates: A Randomized Control Trial Short-term Results of the Sigma Trial  

Microsoft Academic Search

Background: No randomized controlled trial has compared laparoscopic sigmoid resection (LSR) to open sigmoid resection (OSR) for symptomatic diverticulitis of the sigmoid colon. This study tested the hypothesis that LSR is associated with decreased postoperative complication rates as compared with OSR. Methods: This was a prospective, multicenter, double-blind, parallel-arm, randomized controlled trial. Eligible patients were randomized to either LSR or

Bastiaan R. Klarenbeek; Alexander A. Veenhof; Roberto Bergamaschi; Peet van der D. L; Broek van den W. T; Lange de E. S; Willem A. Bemelman; Piet Heres; Antonio M. Lacy; Alexander F. Engel; Miguel A. Cuesta



Emptiness of the left iliac fossa: a new clinical sign of sigmoid volvulus  

PubMed Central

BACKGROUND—Diagnostic difficulties are common in sigmoid volvulus. This diagnostic delay contributes to high morbidity and mortality.?AIM—This paper recognises visible or palpable emptiness of the left iliac fossa as a new clinical sign of sigmoid volvulus. Predictive accuracy of the sign was assessed in this study.?METHODS—519 patients with acute abdomen of non-traumatic origin were prospectively studied.?RESULTS—The new sign was present in 24 out of 86 patients (28%) with sigmoid volvulus. It was absent in all those who did not have sigmoid volvulus. The positive predictive value of the sign was 100%.?CONCLUSION—Emptiness of the left iliac fossa is a valuable diagnostic adjunct. Positive sign is pathognomonic of sigmoid volvulus. Nevertheless, a negative sign warrants further investigations.???Keywords: sigmoid volvulus; diseases of colon; clinical sign

Raveenthiran, V



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

PubMed Central

Simultaneous intracellular recordings were made from myenteric neurons and circular muscle (CM) cells in isolated, stretched segments of guinea-pig distal colon. We have shown previously that maintained stretch generates a repetitive and coordinated discharge of ascending excitatory and descending inhibitory neuronal reflex pathways in the distal colon. In the presence of nifedipine (1–2 ?m) to paralyse the muscle, simultaneous recordings were made from 25 pairs of AH (after-hyperpolarization)-neurons and CM cells separated by 100–500 ?m. In all 25 AH-neurons, proximal process potentials (PPPs) were never recorded, even though at the same time, all recordings from neighbouring CM cells showed an ongoing discharge of inhibitory junction potentials (IJPs) anally, or excitatory junction potentials (EJPs) orally. In fact, 24 of 25 AH-neurons were totally silent, while in one AH-cell, some spontaneous fast excitatory postsynaptic potentials (FEPSPs) were recorded. All 10 electrically silent AH-cells that were injected with neurobiotin were found to be multipolar Dogiel type II neurons. In contrast, when recordings were made from myenteric S-neurons, two distinct electrical patterns of electrical activity were recorded. Recordings from 25 of 48 S-neurons showed spontaneous FEPSPs, the majority of which (22 of 25) showed periods when discrete clusters of FEPSPs (mean duration 88 ms) could be temporally correlated with the onset of EJPs or anal IJPs in the CM. Nine S-neurons were electrically quiescent. The second distinct electrical pattern in 14 S-neurons consisted of bursts, or prolonged trains of action potentials, which could be reduced to proximal process potentials (PPPs) in six of these 14 neurons during membrane hyperpolarization. Unlike FEPSPs, PPPs were resistant to a low Ca2+ –high Mg2+ solution and did not change in amplitude during hyperpolarizing pulses. Mechanosensory S-neurons were found to be uniaxonal or pseudounipolar filamentous neurons, with morphologies consistent with interneurons. No slow EPSPs were ever recorded from AH- or S-type neurons when IJPs or EJPs occurred in the CM. In summary, we have identified a population of mechanosensory S-neurons in the myenteric plexus of the distal colon which appear to be largely stretch sensitive, rather than muscle-tension sensitive, since they generate ongoing trains of action potentials in the presence of nifedipine. No evidence was found to suggest that in paralysed preparations, the repetitive firing in ascending excitatory or descending inhibitory nerve pathways was initiated by myenteric AH-neurons, or slow synaptic transmission.

Spencer, Nick J; Smith, Terence K



Properties of myenteric neurones and mucosal functions in the distal colon of diet-induced obese mice.  


Abstract? Colonic transit and mucosal integrity are believed to be impaired in obesity. However, a comprehensive assessment of altered colonic functions, inflammatory changes and neuronal signalling of obese animals is missing. In mice, we studied the impact of diet-induced obesity (DIO) on: (i) in vivo colonic transit; (ii) signalling in the myenteric plexus by recording responses to nicotine and 2-methyl-5-hydroxytryptamine (2-methyl-5-HT), together with the expression of tryptophan hydroxylase (TPH) 1 and 2, serotonin reuptake transporter, choline acetyltransferase and the paired box gene 4; and (iii) expression of proinflammatory cytokines, epithelial permeability and density of macrophages, mast cells and enterochromaffin cells. Compared with controls, colon transit and neuronal sensitivity to nicotine and 2-methyl-5-HT were enhanced in DIO mice fed for 12 weeks. This was associated with increased tissue acetylcholine and 5-hydroxytryptamine (5-HT) content, and increased expression of TPH1 and TPH2. In DIO mice, upregulation of proinflammatory cytokines was found in fat tissue, but not in the gut wall. Accordingly, mucosal permeability or integrity was unaltered without signs of immune cell infiltration in the gut wall. Body weight showed positive correlations with adipocyte markers, tissue levels of 5-HT and acetylcholine, and the degree of neuronal sensitization. DIO mice fed for 4 weeks showed no neuronal sensitization, had no signs of gut wall inflammation and showed a smaller increase in leptin, interleukin-6 and monocyte chemoattractant protein 1 expression in fat tissue. DIO is associated with faster colonic transit and impacts on acetylcholine and 5-HT metabolism with enhanced responsiveness of enteric neurones to both mediators after 12 weeks of feeding. Our study demonstrates neuronal plasticity in DIO prior to the development of a pathological histology or abnormal mucosal functions. This questions the common assumption that increased mucosal inflammation and permeability initiate functional disorders in obesity. PMID:23940384

Reichardt, François; Baudry, Charlotte; Gruber, Lisa; Mazzuoli, Gemma; Moriez, Raphaël; Scherling, Christian; Kollmann, Patrick; Daniel, Hannelore; Kisling, Sigrid; Haller, Dirk; Neunlist, Michel; Schemann, Michael



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

PubMed Central

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

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



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



Transcolonoscopic decompression of sigmoid volvulus.  


Colonoscopy may decompress a sigmoid volvulus above the reach of a rigid sigmoidoscope. Intraluminal stenting to prevent early recurrence can be accomplished using flexible plastic tubing passed over the colonoscope. PMID:2924673

Procaccino, J; Labow, S B



Transanal intracolonic pulse oximetry as a means of monitoring the adequacy of colonic perfusion.  


Techniques for determining intraoperative compromise in colonic blood flow during aortic reconstruction are inadequate. We investigated the use of transanally recorded oxygen saturation in a porcine model. A Nellcor RS-10 reflectance pulse oximeter probe was attached to the balloon of a Foley catheter and passed transanally to record the oxygen saturation of the sigmoid colonic mucosa. The blood flow rate of the caudal mesenteric artery (CMA) was recorded with a Transonic ultrasonic flowmeter. CMA flow and transanal O2 saturation were recorded simultaneously as CMA flow was progressively decreased by compression of the infrarenal aorta. With unimpeded blood flow the mean O2 saturation in the distal colonic mucosa was 92.9% +/- 2.8. As CMA flow was progressively decreased to 20% of baseline flow, there was a linear decrease in colonic O2 saturation (r = 0.91 P < 0.01). At 20% of basal CMA flow, colonic O2 saturation was 54.0% +/- 4.1. Below 20% of basal CMA flow there was an abrupt loss of signal from the pulse oximeter. This study suggests that transanal pulse oximetry would provide a simple means of continuously monitoring the adequacy of distal colonic blood flow intraoperatively and may prove to be useful during aortic reconstruction when there is concern about the adequacy of blood flow to the distal colon. PMID:7967590

Gardner, G P; LaMorte, W W; Obi-Tabot, E T; Menzoian, J O



Colonic motility in proctalgia fugax.  


Intraluminal pressure recordings were obtained from the rectum and sigmoid colon in two patients experiencing attacks of proctalgia fugax. In each patient the pain appeared to result from contractions of the sigmoid colon, and not from spasm of the levator ani, rectal wall muscle, or anal sphincters, all of which have previously been suggested as the source of such pain. Proctalgia fugax therefore appears, at least in some patients, to be an unusual variant of the irritable bowel syndrome, in which pain is referred from the sigmoid colon to the rectum. PMID:90804

Harvey, R F



Deoxycholate is an important releaser of peptide YY and enteroglucagon from the human colon.  

PubMed Central

Peptide YY (PYY) and enteroglucagon are hormonal peptides found in endocrine cells of the distal intestinal mucosa. Although it is known that plasma concentrations of both peptides increase in response to feeding, the mechanism by which ingested food causes release of colonic hormones is not understood. The release of PYY and enteroglucagon was measured in response to intraluminal stimuli in 176 patients having investigative colonoscopy. Introduction of air, saline (isotonic and hypertonic), glucose (isotonic and hypertonic), oleic acid (without bile salts), and casein hydrolysate all failed to release PYY but glucose caused a small but significant increase in enteroglucagon concentrations. In contrast with the lack of effect of nutrients, infusion of deoxycholic acid produced a rapid and marked dose responsive increase in plasma PYY concentrations when introduced into the sigmoid colon. PYY release was statistically significant at doses between 3.3 mM to 30 mM; for example 10 mM deoxycholate caused a sixfold increase in plasma PYY concentrations. Infusion of 10 mM deoxycholate into the transverse colon or caecum produced an increase of PYY that was similar to the responses in the sigmoid colon. There was also a significant release of enteroglucagon in response to infusion of this bile salt into the sigmoid colon at doses between 3.3 mM and 30 mM. The enteroglucagon response to 10 mM deoxycholate was similar in all three colonic regions. When oleic acid was added to deoxycholate as an emulsion, the release of PYY and enteroglucagon was similar to that seen with the bile salt alone. These findings suggest that bile salts may play an important part in the control of colonic endocrine function and may explain the increased circulating concentrations of colonic regulatory peptides that are seen in malabsorption states and after small bowel resection in humans.

Adrian, T E; Ballantyne, G H; Longo, W E; Bilchik, A J; Graham, S; Basson, M D; Tierney, R P; Modlin, I M



Umbilical incision laparoscopic surgery with one assist port for an elderly patient with recurrent sigmoid volvulus.  


Single-port access laparoscopic surgery has recently emerged as a method to improve morbidity and cosmetic benefit of conventional laparoscopic surgery. Herein, we report the experience of transumbilical incision laparoscopic sigmoidectomy with one assist port in a 71-year-old man who had developed recurrent sigmoid volvulus in these several years since his first visit to the hospital. The patient presented abdominal distension and severe constipation. A plain x-ray film and CT of the abdomen showed grossly distended sigmoid colon loops and stenosis of recto-sigmoid colon. Sigmoid volvulus associated with megacolon was diagnosed and emergence endoscopic decompression was performed. After his condition improved, transumbilical incision laparoscopic sigmoidectomy was carried out as the minimally invasive approach, due to the several risk of patient such as aging and pulmonary disorder. Postoperative course was uneventful and on postoperative visit to the hospital he reported resolution of abdominal distension. PMID:23235104

Matsuoka, Tasuku; Osawa, Naoshi; Yoh, Taiho; Hirakawa, Kosei



Sigmoid Volvulus in 16-year-old Boy with an Associated Anomalous Congenital Band.  


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

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



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


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

Karaki, Shin-ichiro; Kuwahara, Atsukazu



A shift from distal to proximal neoplasia in the colon: a decade of polyps and CRC in Italy  

PubMed Central

Background In the last years a trend towards proximalization of colorectal carcinomas (CRC) has been reported. This study aims to evaluate the distribution of CRC and adenomatous polyps (ADP) to establish the presence of proximalization and to assess the potential predictors. Methods We retrieved histology reports of colonic specimens excised during colonoscopy, considering the exams performed between 1997 and 2006 at Cuneo Hospital, Italy. We compared the proportion of proximal lesions in the period 1997-2001 and in the period 2002-2006. Results Neoplastic lesions were detected in 3087 people. Proximal CRC moved from 25.9% (1997-2001) to 30.0% (2002-2006). Adjusting for sex and age, the difference was not significant (OR 1.23; 95% CI: 0,95-1,58). The proximal ADP proportion increased from 19.2% (1997-2001) to 26.0% (2002-2006) (OR: 1.43; 95% CI: 1.17-1.89). The corresponding figures for advanced proximal ADP were 6.6% and 9.5% (OR: 1.48; 95% CI: 1.02-2.17). Adjusting for gender, age, diagnostic period, symptoms and number of polyps the prevalence of proximal advanced ADP was increased among people ? 70 years compared to those aged 55-69 years (OR 1.49; 95% CI: 1.032.16). The main predictor of proximal advanced neoplasia was the number of polyps detected per exam (> 1 polyp versus 1 polyp: considering all ADP: OR 2.16; 95% CI: 1.59-2.93; considering advanced ADP OR 1.63; 95% CI: 1.08-2.46). Adjusting for these factors, the difference between the two periods was no longer significant. Conclusions CRC do not proximalize while a trend towards a proximal shift in adenomas was observed among people ? 70 years.




Microsoft Academic Search

An equation depending on two shape parameters includes many of the sigmoids found in the literature as special cases. The formulation facilitates the analysis and description of model properties, and can be used to enhance the generality of software and statistical procedures. Some of the models obtained may be new. The relationship between growth curves and differential equations is discussed;




Multidimensional density shaping by sigmoids  

Microsoft Academic Search

An estimate of the probability density function of a random vector is obtained by maximizing the output entropy 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 optimization method, applied to the estimated density, yields a recursive estimator for a

Z. Roth; Y. Baram



Assessment of Colorectal Cancer Molecular Features along Bowel Subsites Challenges the Conception of Distinct Dichotomy of Proximal vs. Distal Colorectum  

PubMed Central

Objective Colorectal cancer is typically classified into proximal colon, distal colon, and rectal cancer. Tumor genetic and epigenetic features differ by tumor location. Considering a possible role of bowel contents (including microbiome) in carcinogenesis, we hypothesized that tumor molecular features might gradually change along bowel subsites, rather than abruptly change at splenic flexure. Design Utilizing 1443 colorectal cancers in two U.S. nationwide prospective cohort studies, we examined the frequencies of molecular features [CpG island methylator phenotype (CIMP), microsatellite instability (MSI), LINE-1 methylation, and BRAF, KRAS, and PIK3CA mutations] along bowel subsites (rectum, rectosigmoid junction, sigmoid, descending colon, splenic flexure, transverse colon, hepatic flexure, ascending colon, and cecum). Linearity and non-linearity of molecular relations along subsites were statistically tested by multivariate logistic or linear regression analysis. Results The frequencies of CIMP-high, MSI-high, and BRAF mutation gradually increased from rectum (<2.3%) to ascending colon (36–40%), followed by falls in the cecum (12–22%). By linearity tests, these molecular relations were significantly linear from rectum to ascending colon (p<0.0001), and there was little evidence for non-linearity (p>0.09). Cecal cancers exhibited the highest frequency of KRAS mutations (52% vs. 27–35% in other sites; p<0.0001). Conclusions The frequencies of CIMP-high, MSI-high, and BRAF mutation in cancer increased gradually along colorectum subsites from rectum to ascending colon. Our novel data challenge the common conception of discrete molecular features of proximal vs. distal colorectal cancers, and have substantial impact on clinical, translational, and epidemiology research, which has typically been performed with dichotomous classification of proximal vs. distal tumors.

Yamauchi, Mai; Morikawa, Teppei; Kuchiba, Aya; Imamura, Yu; Qian, Zhi Rong; Nishihara, Reiko; Liao, Xiaoyun; Waldron, Levi; Hoshida, Yujin; Huttenhower, Curtis; Chan, Andrew T.; Giovannucci, Edward; Fuchs, Charles S.; Ogino, Shuji



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


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

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



Periprosthetic bone resorption and sigmoid notch erosion around ulnar head implants: a concern?  


Metallic ulnar head implants have been proposed not only to solve symptomatic radioulnar impingement after Darrach or Sauvé-Kapandji procedures, but also to prevent such an impingement when treating arthritic distal radioulnar joint. This article prospectively analyzes a series of ulnar head implants with special reference to bone resorption at the prosthesis collar and erosion of the sigmoid notch of the distal radius at an average follow-up of 32 months (minimum 24 months). PMID:20951906

Herzberg, Guillaume



A Case of Colovesical Fistula Induced by Sigmoid Diverticulitis  

PubMed Central

Colonic diverticulosis has continuously increased, noticeably left-sided diseases, in Korea. A colovesical fistula is an uncommon complication of diverticulitis, and its most common cause is diverticular disease. Confirmation of its presence generally depends on clinical findings, such as pneumaturia and fecaluria. The primary aim of a diagnostic workup is not to observe the fistular tract itself but to find the etiology of the disease so that an appropriate therapy can be initiated. We present here the case of a 79-year-old man complaining of pneumaturia and fecaluria. On abdomen and pelvis CT, the patient was diagnosed as having a colovesical fistula due to sigmoid diverticulitis. After division of the adhesion between the sigmoid colon and the bladder, the defect of the bladder wall was repaired by simple closure. The colonic defect was treated with a segmental resection, including the rectosigmoid junction. The patient is doing well at 6 months after the operation and shows no evidence of recurrence of the fistula.

Yang, Hwa-Yeon; Sun, Woo-Young; Lee, Taek-Gu



Antioxidant and DNA methylation-related nutrients and risk of distal colorectal cancer  

PubMed Central

Objective To investigate the relationship between antioxidant nutrients (vitamins C and E, ?-carotene, selenium) and DNA methylation-related nutrients (folate, vitamins B6 and B12) and distal colorectal cancer risk in whites and African Americans and to examine intakes from food only versus total (food plus dietary supplements) intakes. Methods Data are from the North Carolina Colon Cancer Study-Phase II, a case–control study of 945 distal colorectal cancer (including sigmoid, rectosigmoid, and rectum) cases and 959 controls. In-person interviews captured usual dietary intake and various covariates. Multivariate logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (95% CI). Results High intakes of each antioxidant and DNA methylation-related nutrient were significantly associated with lower risk in whites. In African Americans, the highest category of selenium from food only had a marginally significant inverse association with distal colorectal cancer risk (Q4 vs. Q1 OR: 0.55, 95% CI 0.29–1.02). Supplements did not provide additional risk reduction beyond intakes from food. Conclusions Our findings provide evidence that antioxidant and DNA methylation-related nutrients may lower the risk of distal colorectal cancer in whites, and selenium may lower risk in African Americans. Optimal micronutrient intakes from food alone may be more beneficial than supplementation.

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



Isolated adult hypoganglionosis presenting as sigmoid volvulus: a case report  

PubMed Central

Introduction Isolated hypoganglionosis is a rare cause of intestinal innervation defects. It is characterized by sparse and small myenteric ganglia, absent or low acetylcholinesterase activity in the lamina propria and hypertrophy of the muscularis mucosae, principally in the region of the colon and rectum. It accounts for 5% of all intestinal neuronal malformations. To the best of our knowledge, only 92 cases of isolated hypoganglionosis were reported from 1978 to 2009. Isolated hypoganglionosis usually manifests as enterocolitis or poor bowel function, and is diagnosed in infancy or childhood. We report the first case of isolated hypoganglionosis presenting with sigmoid volvulus in a 34-year-old woman. Case presentation A 34-year-old Asian woman had progressively increasing abdominal pain and had not passed stool or flatus for two days. A physical examination revealed a distended abdomen with sluggish gut sounds. A computerized tomography (CT) scan demonstrated gross dilatation of the sigmoid colon (maximal diameter 14.3 cm) suggestive of sigmoid volvulus. During emergency laparotomy, sigmoidectomy with a side-to-side colorectal anastomosis was performed. Histopathology of the resected specimen showed occasional ganglion cells and hypertrophied nerve bundles in the muscle layers, suggesting hypoganglionosis. Colonoscopy was performed, and multiple full-thickness biopsies were taken that showed hypoganglionosis of the entire large bowel. Our patient underwent total colectomy with an ileorectal anastomosis. Subsequently our patient reported a dramatic improvement in her bowel function. Conclusions Isolated hypoganglionosis is a rare cause of intestinal dysganglionosis and cannot be differentiated from Hirschsprung's disease based on clinical presentation. This case report describes an atypical presentation of the disease. A definitive diagnosis requires histopathological analysis of full-thickness intestinal biopsies. Treatment should be tailored to the extent of hypoganglionosis.



Giant sigmoid diverticulum: case report and review of the literature.  


Giant colonic diverticulum is a rare entity first described in 1946 by Bonvin and Bonte. It may be congenital or acquired and the average age of presentation is 65. There are less than 150 reported cases in the literature. A large abdominal mass was detected during a routine physical examination in an 82-year-old man. CT scan showed a large air-filled mass, barium enema showed multiple sigmoid diverticula, but no communication with the mass was found. A diagnosis of giant sigmoid diverticulum was made, elective sigmoidectomy and resection of the diverticulum was performed with no complications. The clinical picture may be different, varying from asymptomatic to acute abdomen, intestinal perforation or fistula. It can be diagnosed with abdominal X-ray, CT scan, barium enema or MRI, but colonoscopy is not effective. There are two accepted theories of the pathophysiology of this entity: first, a congenital origin and second, that inflammatory diverticula are caused by a perforation with a ball-valve that allows gas to enter, but not to leave the cyst, thus, enlarging the false diverticulum, and progressively destroying the bowel layers, causing secondary fibrosis. Elective treatment is a segmental resection of the affected colon with the diverticulum and in cases of acute abdomen two-stage bowel resection is preferred. PMID:18353583

Toiber-Levy, M; Golffier-Rosete, C; Martínez-Munive, A; Baquera, J; Stoppen, M E; D'Hyver, C; Quijano-Orvańanos, F



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

PubMed Central

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

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



Triple metachronous colon cancer.  


A 72-year-old male with an early stage "node-negative" sigmoid colon cancer developed 2 separate "node-negative" early stage colon cancers during a subsequent colonoscopy surveillance regimen, the first in the descending colon 7 years later, and the second in the cecum almost 14 years after the first cancer was resected. After the initial symptomatic cancer, all subsequent neoplastic disease, including malignant cancers were completely asymptomatic. This entity, multiple primary cancers, likely reflected the use of a colonoscopic surveillance regimen. PMID:23885161

Freeman, Hugh J



A New Sigmoid Catalog: Statistical Properties of Sigmoids and Their Evolution  

NASA Astrophysics Data System (ADS)

Sigmoids are sinuous structures located in active regions that have characteristic “s-shaped” or inverted “s-shaped” loops. Active regions containing sigmoids are observed to have higher rates of flaring and CMEs. Previous work detailing the properties of sigmoids has generally focused on specific case studies of a handful of regions. Although such studies are representative of the structure and evolution of these regions, significant insight can be gained by an observational overview approach with systematic and statistical analysis of a large sample of sigmoids. We present a new sample of 72 sigmoidal regions observed in a wide wavelength range and in different parts of the solar atmosphere by various instruments such as the Hinode/XRT, SDO/AIA, STEREO, and LASCO. From this data we compiled a comprehensive list of many different parameters including: size and aspect ratio, presence of Ha or EUV filaments, flare and CME association, number of sunspots, active region and sigmoid lifetimes, etc. Our preliminary results show that sigmoids have a higher eruption rate than other active regions. We also find that the ratio of the long axis to short axis of the sigmoids has a strong peak at 2.5 and the lifetime peaks at 2 days. We also follow the evolution of the magnetic flux in the photosphere and derive whether the sigmoids appear during the emergence or cancellation stages of active region evolution. These results can provide constraints for models of flux rope evolution in global simulations.

McKillop, Sean; Savcheva, A.; Hanson, E.; McCauley, P.; DeLuca, E. E.



Sigmoid volvulus with and without megacolon  

Microsoft Academic Search

Sixty-six consecutive patients, admitted to St. Vincent’s Hospital, Melbourne, with sigmoid volvulus, fell into two groups,\\u000a 60 with-out and six with acquired megacolon. In the former groups, flatus tube decompression was usually successful, and sigmoid\\u000a resection provided a cure. In the group with megacolon, the history was longer; patients more often had bowel symptoms before\\u000a or between acute episodes of

Peter Ryan



Distal Pancreatectomy  

Microsoft Academic Search

\\u000a Resection of the body and tail of the pancreas is commonly referred to as distal pancreatectomy. Although potentially of benefit\\u000a to patients with pancreatic adenocarcinoma confined to the body or tail of the pancreas, such tumors commonly metastasize\\u000a prior to being discovered, and distal pancreatectomy for pancreatic carcinoma is a relatively uncommon procedure even at high\\u000a volume pancreatic surgery centers.

Andrew S. Resnick; Jeffrey A. Drebin


Hirschsprung disease presenting as sigmoid volvulus: a case report and review of the literature.  


While sigmoid volvulus is commonly seen in older patients, it is rarely encountered in children and younger adults. Consequently, heightened awareness of this entity is required to avoid a delay in diagnosis. Among the pediatric and adult cases of colonic volvulus previously reported in the English literature, 23 of the affected individuals have also been diagnosed with Hirschsprung disease (HD). This report describes a 12-year-old male with a history of chronic constipation who presented with vomiting and abdominal distension and was found to have sigmoid volvulus with previously unrecognized HD. The case presentation is followed by a review of the literature describing colonic volvulus secondary to HD in children. PMID:23331823

Zeng, Mary; Amodio, John; Schwarz, Steve; Garrow, Eugene; Xu, Jiliu; Rabinowitz, Simon S



Adenocarcinoma in Colonic Interposition  

PubMed Central

A 59-year-old female with dysphagia presented to our clinic. In childhood, she underwent colonic interposition due to anastomotic stricture after a previous proximal gastrectomy for gastric ulcer perforation. Imaging studies revealed a space-occupying lesion obstructing the distal interposed colon. At surgery, completion gastrectomy with segmental colectomy was carried out, and Roux-en-Y coloenterostomy and enteroenterostomy were performed.

Grunner, Shahar; Gilshtein, Hayim; Kakiashvili, Eliahu; Kluger, Yoram



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



Emphysematous cellulitis of the left thigh caused by sigmoid diverticulum perforation.  


Necrotizing fasciitis and gas gangrene of the lower extremities are two life-threating emergencies and are the most common causes of gas presence in the lower extremity. Rarely the gas presence is secondary to a perforated viscus and especially the colon. Large bowel diverticula are a quiet common disease in western countries and their prevalence increases with age. Also, the possibility of complications is greater in older patients. However, perforated colonic diverticulum seldom presents only with the presence of gas in the lower extremity. We report a case of emphysematous cellulitis of the left thigh caused by a sigmoid diverticulum perforation in a patient with peritoneal carcinomatosis. PMID:21780564

Ioannidis, Orestis; Kakoutis, Emmanouil; Paraskevas, George; Chatzopoulos, Stavros; Kotronis, Anastasios; Papadimitriou, Nikolaos; Konstantara, Athina; Makrantonakis, Apostolos


Tether Cutting Action in Two Sigmoidal Filaments  

NASA Astrophysics Data System (ADS)

The impressive S (or inverse-S) mark appearing on the lower corona, called sigmoid, is known as the manifestation of highly sheared magnetic structures (Rust and Kumar 1996). Recent studies using Yohkoh Soft X-ray Telescope (SXT; Tsuneta et al. 1991) has indicated that soft X-ray sigmoids, i.e., hot (>= 2MK) S-shaped features, are strongly linked with eruptive phenomena, such as filament eruptions, flares, and coronal mass ejections (CMEs) (Sterling and Hudson 1997; Hudson et al. 1998; Canfield et al. 1999). However, previous papers have focused on the magnetic topology (e.g., helicity, shear buildup) of the sigmoid and connection with the resultant CME (e.g., missing mass deduced from dimming), and thus the physical process involved in the sigmoid formation and eruption is still not well addressed (e.g., van Driel-Gesztelyi et al. 2000). In this paper, we present observations of two sigmoidal filaments, in which development of the cool (~104 K) sigmoids was well resolved with the high-cadence H ? and microwave images (<= 30 sec). One is an active region filament and the other is a quiet region filament, whose long term evolution was reported by Glover et al. (2001). Both filaments were overlying the magnetic neutral line and their activities were associated with GOES B class flares. Comparison of SXT images and H ? images illustrates that each filament almost coincides with a soft X-ray long structure that is apparently consisted of two short loops. The key features commonly observed in these filaments can be summarized as follows: i) The initial activity (small brightening) started at the middle of the sigmoidal filament. ii) The activity propagated upward crossing the filament at the junction of the two soft X-ray short loops, suggesting the so-called "tether-cutting" action (Sturrock 1989; Moore and Roumelios 1992). After the flare, the active region filament extended northward and formed an inverse-S structure, which is not visible in soft X-ray, whilst in the quiet region filament, the curved southern half of the filament disappeared but the other half remained. Microwave observation provides information on the heated plasma propagating along the magnetic features. We examine thermal evolution within the sigmoidal filaments and compare the results with the tether-cutting scenario which was proposed for flare/filament eruptions. Possible magnetic reconnection that took place below the filament is discussed.

Hori, K.; Glover, A.; Akioka, M.; Ueno, S.



Collision tumor of the coloncolonic adenocarcinoma and ovarian granulosa cell tumor  

Microsoft Academic Search

BACKGROUND: Collision tumors of the colon are rare. We report the first case, to our knowledge in the English literature, of a collision tumor composed of a colonic adenocarcinoma arising in a sigmoid diverticulum coexisting with a recurrent ovarian granulosa cell tumor. CASE PRESENTATION: A 64-year old woman presented with small bowel obstruction and a large, heterogenous, solid\\/cystic serosal based

Mayur Brahmania; Chandra S Kanthan; Rani Kanthan



Can telomere shortening explain sigmoidal growth curves?  

Microsoft Academic Search

A general branching process model is proposed to describe the shortening of telomeres in eukaryotic chromosomes. The model is flexible and incorporates many special cases to be found in the literature. In particular, we show how telomere shortening can give rise to sigmoidal growth curves, an idea first expressed by Portugal et al. [A computational model for telomere-dependent cell-replicative aging,

Peter Olofsson



Obstructive colonic cancer.  


The records of 121 patients with obstructing cancer of the colon were reviewed. About one-third of the patients had metastatic disease at the time of operation. Primary resection and anastomosis of the intestine was performed for most cancers of the ascending or transverse colon. Hartmann's procedure was performed in most patients with cancer of the sigmoid colon and rectum. Wound infection occurred in 20 patients (16.5%) and anastomotic leakage in six (4.9%). The operative mortality rate was 14.9%. The 5-year survival rate was 13.5%. Acute colonic obstruction is associated with high morbidity and mortality. The high incidence of advanced disease, advanced age, delay in tumour excision and unprepared bowel are some of the factors resulting in the poor prognosis of these patients. PMID:7506782

Papachristodoulou, A; Zografos, G; Markopoulos, C; Fotiadis, C; Gogas, J; Sechas, M; Skalkeas, G



Colonic mucormycosis presented with ischemic colitis in a liver transplant recipient.  


Mucormycosis is an uncommon opportunistic fungal infection with high mortality in liver transplant recipients. Mucormycosis of the gastrointestinal tract can manifest with features similar to ischemic colitis. Typically signs and symptoms of non-gangrenous ischemic colitis resolve spontaneously within 24-48 h. On the other hand, the clinical course of the mucormycosis is commonly fulminant. We encountered a case of invasive fungal colitis presenting with abdominal pain and hematochezia in a liver transplant recipient. Endoscopic examination showed multiple shallow ulcerations and edema with mucosal friabilities on the sigmoid and distal descending colon, which was consistent with ischemic colitis. However, the histological examination obtained from endoscopic biopsies showed fungal hyphae with surrounding inflammatory cells and mucosal necrosis. The patient was successfully managed with antifungal agent without surgical treatment. Thus, early diagnosis and treatment is essential for improving the prognosis of invasive fungal infection after liver transplantation. PMID:23801847

Do, Gi Won; Jung, Seok Won; Jun, Jae-Bum; Seo, Jae Hee; Nah, Yang Won



Endoscopically drained abdominal abscess compressing the sigmoid.  


Intra-abdominal abscesses (IAA) complicate numerous medical and surgical pathologic conditions. Accurate radiological diagnosis combined with percutaneous or surgical drainage and antibiotics is the current standard of care for IAA. We herein report a case of a 52-year-old woman with a 10-day history of fever and abdominal pain. An intra-abdominal abscess externally compressing the sigmoid was revealed and successfully drained during colonoscopy. PMID:22843307

Polymeros, Dimitrios; Sioulas, Athanasios D; Tsiamoulos, Zacharias; Kontopoulou, Christina; Giannitsioti, Efthymia; Triantafyllou, Konstantinos



Mean Field Theory for Sigmoid Belief Networks  

Microsoft Academic Search

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

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



Percutaneous transvenous embolisation through the occluded sinus for transverse-sigmoid dural arteriovenous fistulas with sinus occlusion  

Microsoft Academic Search

We report six cases of transverse-sigmoid dural arteriovenous fistulae (TS DAVF) treated with percutaneous transvenous embolisation\\u000a through the occluded sinus. All patients had sinus occlusive lesions: an isolated sinus in five cases and a distal occlusion\\u000a of the affected sinus in one. Leptomeningeal retrograde venous drainage via the vein of Labbé or the sylvian vein was observed\\u000a in all patients

I. Naito; T. Iwai; H. Shimaguchi; T. Suzuki; S. Tomizawa; M. Negishi; T. Sasaki



[The importance of the distal radioulnar joint for reconstructive procedures in malunited distal radius fracture].  


Clinically most patients complain about ulnar sided wrist pain and limited forearm rotation following malunited distal radius fractures. Possible bony reasons consist of intraarticular incongruency, malalignment of the sigmoid notch of the distal radius or the ulna-plus-situation at the wrist level. A persisting luxation of the distal radioulnar joint (DRUJ) will present itself with complete loss of forearm rotation. The ligamentous or bony detachment of the triangular fibrocartilage complex (TFCC) will lead to instability of the DRUJ. Uncorrected, each of these components will lead to arthrosis of the DRUJ. The presence of arthrosis only allows salvage procedures for the DRUJ and will lead to functional loss. Reconstructive options consist of radius correction osteotomy, ulnar shortening osteotomy, reposition of a luxation and refixation of the TFCC. To chose the necessary reconstructive procedure, the individual pathological situation has to be analysed. PMID:10550435

van Schoonhoven, J; Prommersberger, K; Lanz, U



Colon Polyps  


... CLICK TO ENLARGE Small colon polyps Large colon polyp Colon cancer The last part of your digestive tract ... factors may contribute to the formation of colon polyps and colon cancer. They include: Age. Most people with colon ...


Irritable bowel syndrome: A test of the colonic hyperalgesia hypothesis  

Microsoft Academic Search

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

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



Right-sided perforated ascending colonic diverticulum mimicking acute appendicitis.  


Perforation of the colonic diverticulum is a common reason for emergency laparotomy, especially in older people but is rare in the younger population. While perforation of the sigmoid diverticulum is very common, perforation of the ascending colonic diverticulum is a very rare event. For this reason, the divereticulitis is usually discovered unexpectedly at surgery for suspected appendicitis. PMID:23378699

Bilic Komarica, Edina; Zvizdic, Zlatan




PubMed Central

Perforation of the colonic diverticulum is a common reason for emergency laparotomy, especially in older people but is rare in the younger population. While perforation of the sigmoid diverticulum is very common, perforation of the ascending colonic diverticulum is a very rare event. For this reason, the divereticulitis is usually discovered unexpectedly at surgery for suspected appendicitis.

Bilic Komarica, Edina; Zvizdic, Zlatan



Endoluminal pulse oximetry combined with tonometry to monitor the perfusion of the sigmoid during and after resection of abdominal aortic aneurysm  

Microsoft Academic Search

Early detection of colonic ischaemia after aortic grafting is essential if mortality is to be decreased when this complication develops. The aim of this study was to determine changes in the sigmoid colon during and after abdominal aortic grafting using endoluminal pulse oximetry (SmO2). Oxygen saturation was measured on the mucosa (SmO2) and serosa (SsO2) of 20 sequential patients undergoing

A. C. Vahl; E. N. Ozkaynak-Yilmaz; S. H. M. Nautat; G. J. Scheffert; R. J. M. Felt-Bersma; H. L. F. Brom; J. A. Rauwerda



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)



Schwannoma of the Colon  

PubMed Central

Schwannomas are neoplasms originating from Schwann cells, which are the cells forming nerve sheaths. These neoplasms generally involve peripheral nerves. They rarely affect the gastrointestinal tract and primary colon involvement is extremely rare. The objective of the present paper was to present a case of primary schwannoma of the sigmoid colon, unassociated with von Recklinghausen disease, that was histopathologically confirmed by means of an immunohistochemical panel. The patient was a 71-year-old woman who had had rectal bleeding when evacuating, with pain and tenesmus, for 4 months. She underwent colonoscopy, which identified a raised submucous lesion of 2.8 cm in diameter, located in the sigmoid colon, 30 cm from the anal margin. During examination, loop polypectomy with lesion excision was performed. Histopathological evaluation showed that this was a tumor of stromal origin. Its resection margins were compromised by neoplasia, and colon resection by means of videolaparoscopy was indicated. Conventional histopathological examination using the hematoxylin-eosin technique suggested that the neoplasm was of mesenchymal origin. An immunohistochemical panel was run for etiological confirmation, using anti-CD34 antibodies, desmin, cytokeratins (AE1/AE3), cKit, chromogranin and S-100 protein. The panel showed intense immunoexpression of S-100 protein. Investigation of the proliferative activity rate using Ki-67 antibodies showed that there was a low rate of mitotic activity, thus confirming the diagnosis of primary benign schwannoma of the colon. The patient's postoperative evolution was uneventful and she remains in good health, without signs of tumor recurrence, 15 months after surgical excision.

Nonose, Ronaldo; Lahan, Alberto Youssef; Santos Valenciano, Juliana; Martinez, Carlos Augusto Real



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

Microsoft Academic Search

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

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



Presentation, Management and Outcome of Acute Sigmoid Diverticulitis Requiring Hospitalization  

Microsoft Academic Search

Aim: This study was conducted to assess the presentation, management, and outcomes of patients with acute sigmoid diverticulitis requiring hospitalization. Methods: From 1986 to 2005, the medical records of 265 patients treated for acute sigmoid diverticulitis requiring hospitalization were retrospectively analyzed. Data were collected with regard to patient’s demographics, clinical characteristics, presentations of acute diverticulitis, treatment, morbidity, and mortality. Results:

Jose A. Alvarez; Ricardo F. Baldonedo; Isabel G. Bear; Jorge Otero; Gerardo Pire; Paloma Alvarez; Jose I. Jorge



[Ileocecal Crohn disease with sigmoid involvement].  


This report concerns 14 patients with Morbus Crohn and inflammatory conglomerat tumors between ileo-coecum and sigma. In the case of primary affliction of the ileo-coecum and secondary involvement of the sigma (group A), it is generally sufficient to perform an ileo-coecal resection and suture over the sigma, if a fistula is present. In case of Morbus Crohn afflicting primarily the sigma (group B) or simultaneous involvement of ileo-coecum and sigma (group C), a double resection is necessary. It was always possible to demonstrate the presence of an ileo-sigmoidal fistula by means of barium enema and mostly possible with barium meal or enteroclysis. We consider preoperative colonoscopy with graduated biopsies to be absolutely necessary to determine the exact stage of the illness. Fistulas can be more accurately demonstrated by radiogram than endoscopically. PMID:4085281

Thiele, H; Lorenz, D



Molar distalization with bimetric molar distalization arches.  


The aim of this study was to observe the clinical and cephalometric effects of intra-oral distalization with the maxillary bimetric arches. 3 girls and 1 boy with a mean age of 13.5 years with Class II skeletal and dental relationship were selected. Care was taken to select patients having a normal vertical growth pattern. Lateral cephalograms were taken at the beginning and at the end of the distalization period, which was approximately 3 months. To observe the distal movement, a metal marker was attached to the distal end of the buccal tube of the first molar. On each lateral cephalometric radiograph a reference plane perpendicular to the occlusal plane and passing through the point Sella was drawn to assess the amount of distalization. Cephalometric measurements indicated that the upper molars moved approximately 3 mm distally and that the lower incisors were proclined. PMID:9582621

Küçükkele?, N; Do?anay, A



Colonic explosion during endoscopic polypectomy: avoidable complication or bad luck?  


We were confronted recently by an intraluminal colonic explosion during a colonic polypectomy procedure using snare loop electrocautery, probably caused by the presence of hydrogen and/or methane in combustible concentrations. Our patient needed immediate surgery, when several lacerations were found in the colon: a right hemicolectomy and a partial sigmoid resection with primary anastomoses were performed. Colonic bacteria, rests of fecal fluids, certain cleansing solutions, and oxygen insufflation are the main factors involved in cases of colonic explosion. We describe this dramatic event in our patient and discuss whether this complication might be avoidable in the future. PMID:17019761

Josemanders, D F G M; Spillenaar Bilgen, E J; van Sorge, A A; Wahab, P J; de Vries, R A



Trans-anal barotrauma by compressed air leading to sigmoid perforation due to a dangerous practical joke.  


To present a case report of trans-anal barotrauma by high-pressure compressed air jet as a dangerous practical joke, that is, playful insufflation of high-pressure air jet through the anal orifice resulting in sigmoid perforation. The patient presented to emergency a day later with complaints of severe pain in the abdomen and abdominal distension following insufflation of high-pressure air jet through the anus. On examination, he had signs suggestive of perforation peritonitis and x-ray of the abdomen showed gas under the diaphragm. An emergency exploratory laparotomy was performed which revealed a 4-cm perforation in the sigmoid colon. Resection of the segment containing perforation along with the surrounding devitalised part was done with double-barrel colostomy. Reversal of colostomy was done after 8 weeks. Follow-up was uneventful. PMID:22854240

Pahwa, Harvinder Singh; Kumar, Awanish; Srivastava, Rohit; Rai, Anurag



Laparoscopic promontofixation for the treatment of recurrent sigmoid neovaginal prolapse: case report and systematic review of the literature.  


Prolapse of a sigmoid neovagina, created in patients with congenital vaginal aplasia, is rare. In correcting this condition, preservation of coital function and restoration of the vaginal axis should be of primary interest. A 34-year-old woman with vaginal agenesis underwent vaginoplasty using sigmoid colon. Almost 6 years after the initial operation, she started complaining of a bearing-down sensation and an increase in vaginal discharge. She underwent 2 open surgeries and one vaginal surgery to treat the prolapse with no success. She came to our service and at vaginal examination the neovagina protruded approximately 5 cm beyond the hymen. The prolapse was treated successfully using a laparoscopic approach to suspend the neovagina to the sacral promontory (laparoscopic promontofixation). Prolapse of an artificially created vagina is a rare occurrence, without a standard treatment. Laparoscopy may be an alternative approach to restore the neovagina without compromising its function. PMID:22245040

Kondo, William; Ribeiro, Reitan; Tsumanuma, Fernanda Keiko; Zomer, Monica Tessmann



Estimation and Classification by Sigmoids Based on Mutual Information.  

National Technical Information Service (NTIS)

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...

Y. Baram



Colon Adenocarcinoma  


... to have colon adenocarcinoma? Colon cancer stems from colon polyps that turn cancerous, and individuals who develop polyps ... structure. Polyp: A benign tumor found in the colon. Polyps can become cancerous if undetected or ignored. Malignant: ...


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.



Right-sided sigmoid diverticular perforation.  


Diverticulosis is a common disorder among geriatric patients, of whom 10% to 25% go on to develop diverticulitis. Known complications of diverticulitis include formation of phlegmon, fistula, bowel obstruction, bleeding, perforation, and colonic abscess. A less common complication is perforation with formation of an extra-abdominal necrotizing abscess. This case is a report of an 83-year-old female who presented to the emergency department with a necrotizing abdominal wall abscess secondary to right-sided diverticular microperforation. PMID:22461936

Little, Andrew; Culver, Andy



Right-Sided Sigmoid Diverticular Perforation  

PubMed Central

Diverticulosis is a common disorder among geriatric patients, of whom 10% to 25% go on to develop diverticulitis. Known complications of diverticulitis include formation of phlegmon, fistula, bowel obstruction, bleeding, perforation, and colonic abscess. A less common complication is perforation with formation of an extra-abdominal necrotizing abscess. This case is a report of an 83-year-old female who presented to the emergency department with a necrotizing abdominal wall abscess secondary to right-sided diverticular microperforation.

Little, Andrew; Culver, Andy



Clinicopathologic and molecular features of sporadic early-onset colorectal adenocarcinoma: an adenocarcinoma with frequent signet ring cell differentiation, rectal and sigmoid involvement, and adverse morphologic features.  


Recent literature suggests an increasing incidence of colorectal carcinoma in young patients. We performed a histologic, molecular, and immunophenotypic analysis of patients with sporadic early-onset (?40 years of age) colorectal carcinoma seen at our institution from the years 2000-2010 and compared these tumors to a cohort of consecutively resected colorectal carcinomas seen in patients >40 years of age. A total of 1160 primary colorectal adenocarcinomas were surgically resected for the years 2000 through 2010. Of these, 75 (6%) were diagnoses in patients ?40 years of age of which 13 (17%) demonstrated abnormalities in DNA mismatch repair, 4 (5%) were in patients with known germline genetic disorders (two patients with familial adenomatous polyposis, one patient with juvenile polyposis, and one patient with Li-Fraumeni syndrome), and three patients (4%) had long-standing chronic inflammatory bowel disease. The sporadic early-onset colorectal carcinoma group comprised a total of 55 patients (55/1160, 5%) and were compared with a control group comprising 73 consecutively resected colorectal carcinomas with proficient DNA mismatch repair in patients >40 years of age. For the early-onset colorectal carcinoma group, most cases (33/55, 60%) were diagnosed between the age of 35 and 40 years of age. Compared with the control group, the early-onset colorectal carcinoma group was significantly different with respect to tumor location (P<0.007) with 80% (44/55 cases) identified in either the sigmoid colon (24/55, 44%) or rectum (20/55, 36%). Morphologically, early-onset colorectal carcinomas more frequently displayed adverse histologic features compared with the control colorectal carcinoma group such as signet ring cell differentiation (7/55, 13% vs 1/73, 1%, P=0.021), perineural invasion (16/55, 29% vs 8/73, 11%, P=0.009) and venous invasion (12/55, 22% vs 4/73, 6%, P=0.006). A precursor adenomatous lesion was less frequently identified in the early-onset colorectal carcinoma group compared with the control group (19/55, 35% vs 39/73, 53%, P=0.034). Of the early-onset colorectal carcinomas, only 2/45 cases (4%) demonstrated KRAS mutations compared with 11/73 (15%) of the control group colorectal adenocarcinomas harboring KRAS mutations, although this difference did not reach statistical significance (P=0.13). BRAF V600E mutations were not identified in the early-onset colorectal carcinoma group. No difference was identified between the two groups with regard to tumor stage, tumor size, number of lymph node metastases, lymphatic invasion, tumor budding, mucinous histology, or tumor-infiltrating lymphocytes. Both groups had similar recurrence-free (P=0.28) and overall survival (P=0.73). However, patients in the early-onset colorectal carcinoma group more frequently either presented with or developed metastatic disease during their disease course compared with the control colorectal carcinoma group (25/55, 45% vs 18/73, 25%, P=0.014). In addition, 8/55 patients (15%) in the early-onset colorectal carcinoma group developed local recurrence of their tumor while no patients in the control colorectal carcinoma group developed local recurrence (P<0.001), likely due to the increased incidence of rectal carcinoma in the patients with early-onset colorectal carcinoma. Our study demonstrates that colorectal carcinoma is not infrequently diagnosed in patients ?40 years of age and is not frequently the result of underlying Lynch syndrome or associated with other cancer-predisposing genetic conditions or chronic inflammatory conditions. These tumors have a striking predilection for the distal colon, particularly the sigmoid colon and rectum and are much more likely to demonstrate adverse histologic factors, including signet ring cell differentiation, venous invasion, and perineural invasion. PMID:22481281

Chang, Daniel T; Pai, Rish K; Rybicki, Lisa A; Dimaio, Michael A; Limaye, Maneesha; Jayachandran, Priya; Koong, Albert C; Kunz, Pamela A; Fisher, George A; Ford, James M; Welton, Mark; Shelton, Andrew; Ma, Lisa; Arber, Daniel A; Pai, Reetesh K



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

Microsoft Academic Search

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

F Narducci; G Bassotti; M Gaburri; A Morelli



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

Microsoft Academic Search

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

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



Lymphoepithelioma-like carcinoma of the colon.  


A 70-year-old female underwent follow-up colonoscopy after colonic polypectomy. The colonoscopy revealed the presence of a 7-mm submucosal tumor in the sigmoid colon. The tumor surface was smooth and covered with normal mucosa. It was diagnosed as a submucosal tumor, and polypectomy was performed. Histopathological examination of the resected specimen revealed moderately to poorly differentiated adenocarcinoma measuring 2 × 5 × 3 mm with marked peritumoral lymphocytic infiltration and lymphoid follicle formation. It was diagnosed as carcinoma with lymphoid stroma (lymphoepithelioma-like carcinoma), SM (1,800 ?m), ly2, v0, budding; grade 1. We confirmed the indication for noncurative additional surgical resection and performed laparoscopic sigmoid colectomy. No metastases were observed in the dissected lymph nodes. PMID:23626513

Mori, Yasuharu; Akagi, Kazunari; Yano, Masaaki; Sashiyama, Hiroshi; Tsutsumi, Osamu; Hamahata, Yukihiro; Tsujinaka, Yasunobu; Tsuchida, Akihiko; Matsubayashi, Jun



Transitional polyps of the colon.  


Fourteen polps with the gross appearance of small hyperplastic (metaplastic) polyps, not exceeding five mm in diameter, were removed from the rectum and the sigmoid colon of patients during colonscopy, and from surgical specimens. At light microscopy they were seen to be composed of apparently normal mucosa. In most cases some hyperplastic (metaplastic) and adenomatous polyps were also present. HID-AB stain revealed the polyps to be composed of "transitional" mucosa containing almost exclusively sialomucins, in contrast to normal mucosa, in which sulphomucins predominate. It is suggested that these "transitional" polyps may represent a reservoir of hyperplastic (metaplastic) and adenomatous polps, the different fate depending on different environmental situations. PMID:6180892

Franzin, G; Scarpa, A; Dina, R; Zamboni, G; Fratton, A



Colonic metastasis from renal cell carcinoma: helical-CT demonstration  

Microsoft Academic Search

.   Clinically evident colonic metastasis from renal cell carcinoma (RCC) is rare. In the present study a hypervascular sigmoid\\u000a mass was demonstrated on arterial-phase helical CT using a water enema in a patient who had suffered left nephrectomy 8 years\\u000a previously for RCC. The intense and early enhancement of the lesion suggested the possibility of a solitary colonic metastasis\\u000a from

M. J. Díaz-Candamio; S. Pombo; F. Pombo



Approximation results for neural network operators activated by sigmoidal functions.  


In this paper, we study pointwise and uniform convergence, as well as the order of approximation, for a family of linear positive neural network operators activated by certain sigmoidal functions. Only the case of functions of one variable is considered, but it can be expected that our results can be generalized to handle multivariate functions as well. Our approach allows us to extend previously existing results. The order of approximation is studied for functions belonging to suitable Lipschitz classes and using a moment-type approach. The special cases of neural network operators activated by logistic, hyperbolic tangent, and ramp sigmoidal functions are considered. In particular, we show that for C(1)-functions, the order of approximation for our operators with logistic and hyperbolic tangent functions here obtained is higher with respect to that established in some previous papers. The case of quasi-interpolation operators constructed with sigmoidal functions is also considered. PMID:23587719

Costarelli, Danilo; Spigler, Renato



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.



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.



Colon perforation in renal transplant patients.  


Six patients with spontaneous colonic perforation after cadaveric kidney transplantation are described. Five perforations occurred in a diverticulum of the sigmoid colon, while one was at the suture line after a colotomy performed 5 months previously. Four patients died. Clinical diagnosis was difficult, but on x-ray examination free air in the abdominal cavity was found in 3 patients. Explorative laparotomy should be performed promptly when the diagnosis is suspected. All patients above the age of 4o should be screened with a barium enema prior to transplantation. PMID:775614

Hognestad, J; Flatmark, A



Atypical presentation of perforated sigmoid diverticulitis in a kidney transplant recipient with autosomal dominant polycystic kidney disease.  


Perforated sigmoid diverticulitis, a complication of colonic diverticulosis commonly associated with autosomal dominant polycystic kidney disease (ADPKD), can be life-threatening in allogeneic kidney transplant recipients in the postoperative period. Immunosuppressive medications not only place the patient at risk for intestinal perforation, but also mask classic clinical symptoms and signs of acute abdomen, and subsequently lead to delayed diagnosis and treatment. We report a case of an ADPKD patient post kidney transplantation presenting with nausea, vomiting, and abdominal pain without signs of peritonitis. Chest x-ray revealed free air under the diaphragm consistent with intestinal perforation. Post kidney transplant recipients with ADPKD presenting with abdominal pain should prompt a search for possible perforated colonic diverticulitis in order to diagnose and treat this life-threatening condition early. PMID:23901392

Tantisattamo, Ekamol; Guasch, Antonio



Colonic sensory and motor function in irritable bowel syndrome and diverticular disease  

Microsoft Academic Search

Chapter 1 is a general introduction. \\u000aChapter 2: left-colonic motility patterns were studied in fully ambulant non-constipated IBS patients compared to healthy controls. (HAPCs) were identified. In IBS the descending colon had a decreased overall frequency of phasic contractions and motility index as compared to the sigmoid colon, whereas healthy controls did not show regional differences. In IBS the number

C. H. M. Clemens



Enzymatic Logic Gates with Noise-Reducing Sigmoid Response  

Microsoft Academic Search

Biochemical computing is an emerging field of unconventional computing that attempts to process information with biomolecules and biological objects using digital logic. In this work we survey filtering in general, in biochemical computing, and summarize the experimental realization of an AND logic gate with sigmoid response in one of the inputs. The logic gate is realized with electrode-immobilized glucose-6-phosphate dehydrogenase

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



Shortening of telomeres, sigmoidal growth curves, and general branching processes  

Microsoft Academic Search

A general branching process model is proposed to describe the shortening of telomeres in eukariotic chromosomes. The model is flexible and incorporates many special cases to be found in the literature. In particular, we show how telomere shortening can give rise to sigmoidal growth curves, an idea first expressed by Portugal et al. (2008). We also demonstrate how other types

Peter Olofsson



Why do rotifer populations present a typical sigmoid growth curve?  

Microsoft Academic Search

To determine the underlying processes to population growth in the rotifer Brachionus plicatilis, we conducted an experiment using 1.5 ml cultures for 70 days. All individuals were transferred daily to culture media containing algae, and the number of individuals, clutch sizes and number of deaths were counted. The population dynamics showed a typical sigmoid curve. The population density increased exponentially

Tatsuki Yoshinaga; Atsushi Hagiwara; Katsumi Tsukamoto



Metastasis to the breast from colonic adenocarcinoma.  


A 63-year-old woman was referred to a breast surgeon with a breast mass discovered incidentally during follow-up study after colon cancer surgery. Invasive adenocarcinoma was revealed on core needle biopsy. Wide excision of the breast including the tumor was performed. On standard histological examination the tumor showed features of moderately differentiated adenocarcinoma. The immunohistochemistry study revealed positive results for cytokeratin (CK)20 and CDX2, but negative for CK7. These are typical characteristics for colon cancer. Considering her history of subtotal colectomy for sigmoid colon cancer, it is presumable that the mass in the breast was of colonic origin, and it was an extremely rare case of metastasis to the breast from primary colorectal neoplasm. Although the instance is rare, clinicians should keep the possibility of breast metastasis from colorectal cancer in mind for early and correct diagnosis. PMID:22319737

Noh, Kyoung Tae; Oh, Boyoung; Sung, Sun Hee; Lee, Ryung-Ah; Chung, Soon Sup; Moon, Byung In; Kim, Kwang Ho



Distal Radius Fracture (Colles' Fracture)  


... 2013 American Academy of Orthopaedic Surgeons Distal Radius Fractures (Broken Wrist) The radius is the larger of ... the wrist is called the distal end. A fracture of the distal radius occurs when the area ...


Arthritis of the distal radioulnar joint: from Darrach to total joint arthroplasty.  


The distal radioulnar joint (DRUJ) is a complex structure that contributes to full, painless forearm rotation and weight bearing. Stability requires adequate bony architecture and robust soft-tissue support. Arthritis of the DRUJ between the sigmoid notch of the distal radius and the ulnar head can be caused by traumatic, inflammatory, congenital, and degenerative processes. Initial management of symptomatic DRUJ arthritis is nonsurgical. Surgery is reserved for patients with refractory pain. Although outcomes typically are positive following excision of the distal ulna, serious potential postoperative complications include instability and potentially painful impingement of the residual distal ulnar stump. Procedures used to manage the unstable residual ulna include soft-tissue stabilization techniques and DRUJ implant arthroplasty. PMID:23027692

Zimmerman, Ryan M; Kim, Jaehon M; Jupiter, Jesse B



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

Microsoft Academic Search

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 (P50 for 5HT stimulation of distal circular muscle (-7.0±0.1), distal longitudinal muscle, and proximal circular muscle was

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



Distribution of cytochrome P450 2C, 2E1, 3A4, and 3A5 in human colon mucosa  

PubMed Central

Background Despite the fact that the alimentary tract is part of the body's first line of defense against orally ingested xenobiotica, little is known about the distribution and expression of cytochrome P450 (CYP) enzymes in human colon. Therefore, expression and protein levels of four representative CYPs (CYP2C(8), CYP2E1, CYP3A4, and CYP3A5) were determined in human colon mucosa biopsies obtained from ascending, descending and sigmoid colon. Methods Expression of CYP2C, CYP2E1, CYP3A4, and CYP3A5 mRNA in colon mucosa was determined by RT-PCR. Protein concentration of CYPs was determined using Western blot methods. Results Extensive interindividual variability was found for the expression of most of the genes. However, expression of CYP2C mRNA levels were significantly higher in the ascending colon than in the sigmoid colon. In contrast, mRNA levels of CYP2E1 and CYP3A5 were significantly lower in the ascending colon in comparison to the descending and sigmoid colon. In sigmoid colon protein levels of CYP2C8 were significantly higher by ~73% than in the descending colon. In contrast, protein concentration of CYP2E1 was significantly lower by ~81% in the sigmoid colon in comparison to the descending colon. Conclusion The current data suggest that the expression of CYP2C, CYP2E1, and CYP3A5 varies in different parts of the colon.

Bergheim, Ina; Bode, Christiane; Parlesak, Alexandr



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



Prognostic Factors of Perforated Sigmoid Diverticulitis in the Elderly  

Microsoft Academic Search

Background: The Finnish population is aging fast and the prevalence of perforated sigmoid diverticulitis is simultaneously increasing in northern Finland. The fact that an increasing number of elderly patients, with their age-specific problems, are subjected to emergency surgery for acute diverticulitis underlines the importance of risk stratification.Methods: One hundred and seventy-two patients admitted to Oulu University Hospital because of diverticular

Jyrki Tapani Mäkelä; Heikki Kiviniemi; Seppo Laitinen



Fuzzy neural network based on a Sigmoid chaotic neuron  

NASA Astrophysics Data System (ADS)

The theories of intelligent information processing are urgently needed for the rapid development of modem science. In this paper, a novel fuzzy chaotic neural network, which is the combination of fuzzy logic system, artificial neural network system, and chaotic system, is proposed. We design its model structure which is based on the Sigmoid map, derive its mathematical model, and analyse its chaotic characteristics. Finally the relationship between the accuracy of map and the membership function is illustrated by simulation.

Zhang, Yi; Wang, Xing-Yuan



Uniform persistence for sigmoidal diet selection with keystone prey species  

Microsoft Academic Search

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

Asim Sikder



Septic thrombosis of the transverse and sigmoid sinuses: imaging findings  

Microsoft Academic Search

The purpose of this study was to evaluate the contribution of magnetic resonance imaging (MRI) to the diagnosis of septic thrombosis of transverse and sigmoid sinuses to analyze the different steps of the diagnosis and to identify the origin of the difficulties in diagnosis. This retrospective study included eight patients aged 53–81 years (mean age: 61.9 years) with proven or highly probable

Young-Cheol Weon; Kathlyn Marsot-Dupuch; Denis Ducreux; Pierre Lasjaunias



[Discrete distal gangrene].  


The authors present their statistical findings from 114 cases of discrete distal gangrene. They stress the importance of a rigorous methodology to detect mechanical causes from the thoracic outlet syndrome and immunological causes, predominantly scleroderma, especially in women. It is important not to overlook blood diseases nor those cases which are a presentation of underlying cancer. Finally, the iatrogenic cause is now well known. Treatment depends on the causes of this distal lesion. However, in cases of severe connective tissue disease, the use of plasmapheresis is beginning to give interesting results. PMID:6842102

Cloarec, M; Graisely, B; Dumas, R; Caillard, P; Wurm, M; Le Moigne, C; Solvay, H; Kahn, M



[Reconstruction after distal gastrectomy].  


To select the best reconstruction method after distal gastrectomy, we analyzed the endoscopic features and gastrointestinal quality of life in patients who underwent either Billroth I or Roux-en-Y reconstruction. The Billroth I procedure is simpler, more physiologically normal, and allows easier endoscopic access to the duodenum. Although it is more complex, the Roux-en Y procedure can prevent bile reflux, is safe, and is superior to the Billroth I procedure both functionally and symptomatically. The Roux-en-Y procedure is thus one of the best options after distal gastrectomy. Selection of the reconstruction procedure should be based on clinical evidence. PMID:18939460

Katai, Hitoshi; Nunobe, Souya; Saka, Makoto; Fukagawa, Takeo; Sano, Takeshi



The distal biceps tendon.  


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

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



Distale Protektionsverfahren beim Karotisstent  

Microsoft Academic Search

Zusammenfassung Die endovaskuläre Behandlung von Karotisstenosen findet zunehmende Verbreitung. Bei der Karotisstentimplantation werden häufig temporäre Filter oder Okklusionsballons in die A. carotis interna distal der Stenose eingesetzt, um einen zusätzlichen Schutz vor zerebralen Embolien zu erreichen. Die Notwendigkeit einer solchen distalen Protektion ist wissenschaftlich allerdings immer noch umstritten. Die folgende Übersicht über die bestehenden Techniken und deren Ergebnisse soll eine kritische

J. Berkefeld; R. du Mesnil de Rochemont; M. Sitzer; F. E. Zanella



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

Microsoft Academic Search

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

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


Treatment of recurrent sigmoid volvulus in Parkinson's disease by percutaneous endoscopic colostomy.  


The exact aetiology of sigmoid volvulus in Parkinson's disease (PD) remains unclear. A multiplicity of factors may give rise to decreased gastrointestinal function in PD patients. Early recognition and treatment of constipation in PD patients may alter complications like sigmoid volvulus. Treatment of sigmoid volvulus in PD patients does not differ from other patients and involves endoscopic detorsion. If feasible, secondary sigmoidal resection should be performed. However, if the expected surgical morbidity and mortality is unacceptably high or if the patient refuses surgery, percutaneous endoscopic colostomy (PEC) should be considered. We describe an elderly PD patient who presented with sigmoid volvulus. She was treated conservatively with endoscopic detorsion. Surgery was consistently refused by the patient. After recurrence of the sigmoid volvulus a PEC was placed. PMID:23155325

Toebosch, Susan; Tudyka, Vera; Masclee, Ad; Koek, Ger



Treatment of recurrent sigmoid volvulus in Parkinson's disease by percutaneous endoscopic colostomy  

PubMed Central

The exact aetiology of sigmoid volvulus in Parkinson's disease (PD) remains unclear. A multiplicity of factors may give rise to decreased gastrointestinal function in PD patients. Early recognition and treatment of constipation in PD patients may alter complications like sigmoid volvulus. Treatment of sigmoid volvulus in PD patients does not differ from other patients and involves endoscopic detorsion. If feasible, secondary sigmoidal resection should be performed. However, if the expected surgical morbidity and mortality is unacceptably high or if the patient refuses surgery, percutaneous endoscopic colostomy (PEC) should be considered. We describe an elderly PD patient who presented with sigmoid volvulus. She was treated conservatively with endoscopic detorsion. Surgery was consistently refused by the patient. After recurrence of the sigmoid volvulus a PEC was placed.

Toebosch, Susan; Tudyka, Vera; Masclee, Ad; Koek, Ger



Ogilvie's syndrome (acute colonic pseudo-obstruction)  

Microsoft Academic Search

Four additional cases of Ogilvie's syndrome (acute colonic pseudo-obstruction), representing the first cases described in\\u000a Italy, are reported. The medical literature concerning the subject is also thoroughly reviewed.\\u000a \\u000a Ogilvie's syndrome is an acute massive dilatation of the large bowel without organic obstruction of the distal colon. Three\\u000a hundred and fifty-one cases have been described in the literature to date. Eighty-eight

Ciacinto Nanni; Alberto Garbini; Pierluigi Luchetti; Giuseppe Nanni; Paolo Ronconi; Marco Castagneto




SciTech Connect

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



Giant colonic diverticulum: an unusual abdominal lump.  


Giant colonic diverticulum is a rare complication of diverticular disease of the colon and is thought to result, in most cases, from a "ball-valve" effect. The presentation and clinical course can be variable and confusing. The most common symptoms are abdominal pain and a palpable abdominal lump, with many patients presenting acutely with complications such as perforation and peritonitis. Preoperative diagnosis requires a high degree of suspicion and needs to be differentiated from sigmoid volvulus, caecal volvulus, intestinal duplication cyst, pneumatosis cystoidis intestinalis, and similar conditions. A plain x-ray and computed tomography (CT) scan of the abdomen shows a huge air-filled cyst termed "balloon sign" and confirms the diagnosis. The barium enema shows a communication with the bowel in most cases. In view of the high incidence of complications, treatment is advised even in asymptomatic cases and consists of excision of the cyst with resection of the adjacent colon with primary anastomosis. This treatment would, in most cases, be a sigmoid colectomy. Percutaneous drainage and Hartmann's procedure may be appropriate in some cases who present with a well-formed abscess or gross fecal peritonitis, respectively. A case is described, and the literature is reviewed. PMID:17462210

Praveen, B V; Suraparaju, L; Jaunoo, S S; Tang, T; Walsh, S R; Ogunbiyi, O A


Fatal Retroperitoneal Bleeding Caused by Metastasis of a Sigmoid Carcinoma  

PubMed Central

Retroperitoneal bleeding is relatively rare and a potentially life-threatening condition with significant mortality. Early recognition requires a high index of suspicion. Increased life expectancy, the widespread use of anticoagulants, and the rise of endovascular interventions have caused an increase in the incidence of retroperitoneal bleeding. We present a case of a 74-year-old woman who died because of retroperitoneal bleeding caused by retroperitoneal metastasis of a sigmoid carcinoma with angioinvasive growth into a lumbar artery. In addition we discuss etiology, diagnostic management, and treatment strategy.

Vos, Cornelis G.; Hoksbergen, Arjan W. J.



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)



Benefits of laparoscopic peritoneal lavage for complicated sigmoid diverticulitis  

Microsoft Academic Search

Background  The traditional therapy for perforated sigmoid diverticulitis with peritonitis is emergency colectomy usually with colostomy.\\u000a We report laparoscopic exploration with peritoneal lavage as an alternative in seven patients who required emergency surgery\\u000a for diverticulitis.\\u000a \\u000a \\u000a \\u000a Methods  Six patients presented with diffuse peritonitis and one with a failure of percutaneous therapy. All patients were explored\\u000a laparoscopically and the peritoneal cavity was lavaged with

Joanne Favuzza; John C. Friel; John J. Kelly; Richard Perugini; Timothy C. Counihan



Composite mesh migration into the sigmoid colon following ventral hernia repair.  


Ventral hernia repair is frequently performed with one of a number of mesh products, usually with good results. The current emphasis on laparoscopic repair has resulted in multiple composite mesh products for use in the peritoneal cavity. The addition of a second layer of more inert material to the mesh is intended to prevent adhesions with the underlying viscera, and multiple studies demonstrate effectiveness in doing this. Despite this, occasional complications may still present. We present the case of a 65-year-old man coming to our clinic 5 years after a third ventral hernia repair/revision with composite mesh. PMID:20058043

Nelson, E C; Vidovszky, T J



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

Microsoft Academic Search

Acquired hemophilia A is a rare and potentially fatal condition of coagulopathy caused by autoantibodies against clotting\\u000a factor VIII (factor VIII inhibitor). We report a case of a 63-year-old woman, who presented with a sudden onset of severe\\u000a hemorrhagic tendency with exclusively prolonged activated partial thromboplastin time (APTT). She was diagnosed with acquired\\u000a hemophilia A due to a decrease in

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



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


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

Chauhan, Narvir Singh; Sood, Dinesh



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

PubMed Central

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

Chauhan, Narvir Singh; Sood, Dinesh



Pathologic significance of polyps of the rectum and colon  

Microsoft Academic Search

Conclusions  Since cancers and adenomatous polyps of the colon are indistinguishable except by histologic examination, all rectal and lower\\u000a sigmoidal polypoid tumors seen through a sigmoidoscope should be removed for histologic examination. Juvenile (retention)\\u000a polyps usually require no further treatment. Adenomatous polyps with focal atypia, carcinomain situ and noninvasive cancer are curable by adequate local excision. Villous (papillary) adenomas so frequently

John S. Spratt; Lauren V. Ackerman



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



Laparoscopic-assisted colon resection.  


The popularity and success of laparoscopic biliary tract surgery have persuaded surgeons to explore other applications for rigid endoscopic surgery. From July 1990 to February 1993 a total of 65 patients (mean age 57 years; range 41-82) underwent attempted laparoscopic colon resection. Indications for surgical intervention included cancer (39), adenomatous polyps (14), diverticulosis (10), stricture (1), and foreign-body perforation (1). A laparoscopic-assisted technique whereby the specimen was removed and the anastomosis was completed outside of the abdomen was used in all patients. A dilated umbilical opening was used for right-sided lesions and a left-lower-quadrant muscle-splitting incision for descending and sigmoid colon resections. Two patients required conversion to open laparotomy. There were no deaths and only four complications (pneumonia 1, urinary tract infection 1, prolonged ileus 1, and subfascial abscess 1). The mean postoperative stay was 4.4 days (range 3-8 days) and the average interval for return to normal activity was 8 days. Laparoscopic-assisted colon resection appears to be a safe and beneficial option for many patients with pathologic disorders of the large intestine. Future clinical trials are needed to fully determine the appropriateness of this procedure in patients with localized malignancies. PMID:8153858

Zucker, K A; Pitcher, D E; Martin, D T; Ford, R S



Pre-epithelial mucus layer in the colon of conventional and germ-free rats  

Microsoft Academic Search

Summary  The pre-epithelial mucus layer (PML) and epithelial mucins were studied by mucin histochemistry in 10m-thick celloidinstabilized cryostat sections in the proximal and distal colon of conventional and germ-free rats aged 120 and 350 days. No continuous PML was found in the proximal colon. A continuous mucus blanket, of fairly homogenous thickness, was observed in the distal colon, where the PML-thickness

L. Szentkuti; H. Riedesel; M.-L. Enss; K. Gaertner; W. von Engelhardt



Distal radioulnar joint injuries.  


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

Thomas, Binu P; Sreekanth, Raveendran



Distal radioulnar joint injuries  

PubMed Central

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

Thomas, Binu P; Sreekanth, Raveendran



Clinical value of colonic irrigation in patients with continence disturbances  

Microsoft Academic Search

Continence disturbances, especially fecal soiling, are difficult to treat. Irrigation of the distal part of the large bowel might be considered as a nonsurgical alternative for patients with impaired continence. PURPOSE: This study is aimed at evaluating the clinical value of colonic irrigation. METHODS: Thirty-two patients (16 females; median age, 47 (range, 23–72) years) were offered colonic irrigation on an

J. W. Briel; W. R. Schouten; E. A. Vlot; S. Smits; I. van Kessel



Dynamic scanning defines a colonic defect in severe idiopathic constipation.  

PubMed Central

A technique is described in which a chemical stimulus applied to the mucosa of the right colon is used to assess colonic motor function. Peroral intubation of the right colon was achieved using a fine polyvinylchloride (PVC) tube. Bisacodyl was used to initiate colonic motor activity, and colonic transit was monitored using 99mTc-DPTA and a gamma camera. In normal subjects there was rapid movement of the radiopharmaceutical from the right colon to the rectum. In patients with severe idiopathic constipation, a spectrum of colonic abnormality was observed from slow transit involving the rectum and sigmoid only to slow transit involving the whole colon. The hepatic flexure to rectum transit time for the 'head of the isotope column' in normals ranged from 1-10 minutes (mean 5.3 minutes), whereas in patients the transit time was 14-25 minutes in four patients and radioisotope did not reach the rectum by two hours in three other patients (controls v patients, p less than 0.01). Patients also showed relatively impaired transport of the isotope 'mass'. This technique has shown that the normal colon is capable of rapid effective transport in response to a standard stimulus, and that patients with severe idiopathic constipation have a definable colonic motor disorder. Images Fig. 1 Fig. 2

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



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


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



Dietary patterns and risk of colon cancer and adenoma in a cohort of men (United States)  

Microsoft Academic Search

BackgroundExamining the effects of dietary patterns on cancer risk may provide insights beyond the assessment of individual foods or nutrients. Design: In the health professionals follow-up cohort, associations between the ‘prudent’ and the ‘western’ dietary pattern and risk of colon cancer and adenomas were examined in 561 colon cancer cases and 1207 distal colon adenoma cases. Results: Higher prudent pattern

Kana Wu; Frank B. Hu; Charles Fuchs; Eric B. Rimm; Walter C. Willett; Edward Giovannucci



Environmental constraints and sigmoid utility: implications for value, risk sensitivity, and social status  

Microsoft Academic Search

Friedman and Savage [Journal of Political Economy 4 (1948) 279] proposed sigmoid utility theory to model the relationship between social class and risk sensitivity. Their proposal has not been explicitly modeled to allow for full testing of the concept. We argue that sigmoid utility arises naturally from boundary conditions imposed by finite environmental resources that engender competition. We also present

Lawrence A. Kuznar; William G. Frederick



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

Microsoft Academic Search

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

Antonia Savcheva; E. DeLuca; A. Van Ballegooijen



Applications of Quasi-Separatrix Layer Maps in Understanding an XRT Sigmoid  

NASA Astrophysics Data System (ADS)

We present our recent work on utilizing Quasi-Separatrix Layer (QSL) maps for understanding the structure, evolution, and pre-eruption behavior of the quiescent sigmoid observed with Hinode/XRT in February 2007. QSL maps are created at various heights in the corona and for 10 different observations during the evolution of the long-lasting sigmoid. This is the first QSL analysis based on a non-linear force free field of a sigmoid. We point out some major properties of the QSL topology in the sigmoid and we explore how they change spatially and temporally with the evolution of the sigmoid. We explore how QSL topology and strength relate to current distributions and torsion factors in the moments leading to the B-class flare. While the current distribution in the region is smooth and extended, the QSLs show much finer structure which may prove to be of help in pinpointing possible reconnection or heating sites.

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



Unusual presentation of pheochromocytoma with ischemic sigmoid colitis and stenosis.  


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

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



[Distal femoral fractures].  


Techniques of operative treatment of supra- and intercondylar fractures have changed in recent years. These changes refer to reduction techniques and implant selection. Operative approach concepts, which remained unchanged for several decades were critically evaluated and modified to a minimal invasive osteosynthesis [MIO]. This included for intraarticular fractures a trans-articular joint reconstruction and a retrograde plate osteosynthesis (TARPO). This technique result in better operative visualization and management of intraarticular comminution, saver fracture healing and better functional outcome. For extraarticular fractures a minimally invasive percutaneous plate osteosynthesis (MIPPO) via stab incisions only or retrograde intramedullary nailing is available. Beside that new strategies and techniques for the avoidance of axial malalignment, rotational deformities and leg length discrepancies are described, as well as a new plate generation (LISS: less invasive stabilization system), which behaves more like an internal fixator. The complex nature of combined fractures and soft tissue injuries of the distal femur and proximal tibia needs special attention and specific management. Distal femoral and proximal tibial fractures in young patients are usually caused by a high energy trauma. They are complicated by a high rate of systemic and local injuries to cartilage, ligaments and skin. The patients in this group with severe injuries need a detailed treatment algorithm, because the surgeon's individual skill, enthusiasm and wishful thinking frequently led to unsatisfactory results. A decision making scheme is presented specifically addressing timing and treatment modalities. PMID:9887674

Krettek, C; Schandelmaier, P; Richter, M; Tscherne, H



Colon and rectal carcinoma: spatial distribution and detection.  


Recent studies have challenged the concept that 50% of colon cancers are detectable by digital examination and two-thirds are within reach of the rigid sigmoidoscope. This is an important consideration because of the potential for failure of an otherwise appropriate screening method when evaluating a patient for carcinoma of the colon. An analysis of 2,298 cases of colorectal carcinoma diagnosed over 20 years showed that the most common sites were the rectum (34%) and sigmoid (25%). Over the 20 years, the incidence of cancer in the cecum increased and that in the rectum decreased. Cecal, ascending, and transverse colon cancers accounted for 34% of lesions - all beyond the range of the flexible sigmoidoscope. The changing site distribution emphasizes the need for an accurate and inexpensive technique to evaluate the entire colon. These data suggest that the barium pneumocolon examination should be included in the screening of high-risk patients. PMID:6844602

Maglinte, D D; Keller, K J; Miller, R E; Chernish, S M



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.



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

PubMed Central

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

Shavers, Vickie L.



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.



Distal arthrogryposis syndrome.  


A 5-month-old male infant presented with weak cry, decreased body movements, tightness of whole body since birth, and one episode of generalized seizure on day 4 of life. He was born at term by elective caesarian section performed for breech presentation. The child had failure to thrive, contractures at elbow and knee joints, hypertonia, microcephaly, small mouth, retrognathia, and camptodactyly. There was global developmental delay. Abdominal examination revealed umbilical and bilateral inguinal hernia. Visual evoked response and brainstem evoked response audiometry were abnormal. Nerve conduction velocity was normal. Magnetic resonance imaging of brain revealed paucity of white matter in bilateral cerebral hemispheres with cerebellar and brain stem atrophy. The differential diagnoses considered in the index patient were distal arthrogryposis (DA) syndrome, cerebroculofacioskeletal syndrome, and Pena Shokier syndrome. The index patient most likely represents a variant of DA: Sheldon Hall syndrome. PMID:20300297

Kulkarni, K P; Panigrahi, I; Ray, M; Marwaha, R K



Esophageal cancer with colonic metastasis successfully treated by chemoradiotherapy followed by chemotherapy with S-1 and cisplatin  

Microsoft Academic Search

A 51-year-old man was hospitalized for evaluation of dysphagia and bloody stool. Gastrointestinal endoscopy showed esophageal cancer invading the gastric fundus. A metastatic lesion was demonstrated in the sigmoid colon. The patient agreed to have concurrent chemoradiotherapy for the primary lesion, followed by additional chemotherapy. The first course included 30?Gy of radiotherapy given over 3 weeks, together with daily oral

Hiroaki Iwase; Toshihiko Indo; Masaaki Shimada; Tomoyuki Tsuzuki; Keiko Nakarai; Syogo Kaida; Reiko Doi; Masayuki Okeya; Eriko Kato



Management of Acute Sigmoid Volvulus: An Institution’s Experience Over 9 Years  

Microsoft Academic Search

Introduction  Management of sigmoid volvulus is often challenging because of its prevalence in high-risk patients and the associated perioperative\\u000a morbidity and mortality rates. This study was designed to review the management and outcome of all patients admitted with\\u000a sigmoid volvulus.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A retrospective review of all patients who were admitted for sigmoid volvulus from October 2001 to June 2009 was performed.\\u000a Diagnosis

Ker-Kan Tan; Choon-Seng Chong; Richard Sim



The physical origin of sigmoidal respiratory pressure–volume curves: Alveolar recruitment and nonlinear elasticity  

NASA Astrophysics Data System (ADS)

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

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



Sigmoidal bundles and other tidal features, Curtis Formation (Jurassic), Utah  

SciTech Connect

Recently, a new suite of tide-generated sedimentary structures has been described, principally from sandy shoals and large excavations associated with flood-control structures in tidal estuaries of the Dutch coast. These sedimentary structures can be less ambiguous than criteria previously used to recognized in the North Sea can be applied to the rock record, in this case the Curtis Formation (Jurassic), San Rafael swell, Utah, to significantly enhance our ability to interpret tidal facies. Our discussion centers on the recognition of tidal bundles, the lateral succession of cross-strata generated by the migration of a large-scale bedform during one dominant tidal episode. Tidal bundles in the Curtis consist of two gently dipping sigmoid-shaped pause planes which enclose avalanche forests. They are up to 80 cm (30 in.) thick and 11 m (36 ft) long. Pause planes may be accentuated by erosion of the megaripple by the subordinate tide, by generation of ripples or small megaripples with opposed inclinations, and/or by a drape of fine sediment which settles during slack water. Systematic variability that occurs within bundles is due to increasing then waning current velocity during a tidal episode. Systematic variability among tidal bundles results from regular fluctuations of tidal current velocities during a lunar month (neap/spring cycles). These include changes in bundle thickness, dip of forest, internal geometry, and lateral extent. Recognition of these features in the Curtis leads to an uncontestable interpretation of its tidal origin.

Kreisa, R.D.; Moiola, R.J.



Shear zone deformation determined from sigmoidal tension gashes  

NASA Astrophysics Data System (ADS)

The potential of using sigmoidal tension gashes as strain markers for assessing strain localisation in shear zones is discussed. The appropriate analytical methods for this purpose depend on the assumed mechanism of tension gash formation. Two such models are considered. The first is one in which the curvature of the gash is produced by passive rotation of different segments of the gash in response shear strain gradients across the shear zone. The other model is one in which the curvature of the gashes is governed by the folding of the competent rock bridges between adjacent gashes. In the latter case, the tension gashes progressively grow within spaces created by the buckling bridges and therefore lead to a bulk dilatation of the shear zone. However, for the folded bridge mechanism to continue to operate beyond shear strains greater than unity requires a significant volume loss which in turn may signal the increase of the shear strength of the zone. The geometrical characteristics of gash arrays resulting from these two mechanisms are described and criteria given for the recognition of the two types of gash arrays. A new graphical method is proposed for the analysis of deformation in shear zones containing folded-bridge tension gashes. Tension gash arrays from Marloes, West Wales are used as examples of the procedures for shear zone analysis.

Lisle, Richard J.



Colon Adenomatous Polyps  


... resulting in weight gain. What characterizes colon adenomatous polyps? Colon adenomatous polyps grow slowly but will continue to ... polyp is cancerous. (continued on next page) Colon Polyps Colon Adenomatous Polyps Copyright © 2011. College of American Pathologists. ...


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.



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.



Imaging of the distal airways.  


Imaging techniques of the lung continue to advance, with improving ability to image the more distal airways. Two imaging techniques are reviewed: computed tomography and magnetic resonance with hyperpolarized helium-3. PMID:19962040

Tashkin, Donald P; de Lange, Eduard E



Distal radius fractures: current concepts.  


Despite the frequency of distal radius fractures, the optimal treatment remains without consensus opinion. A trend toward increased distal radius fracture open reduction and internal fixation has been identified, with biomechanical and clinical studies suggesting treatment advantages of certain fixation methods over others. Well-controlled patient trials are still missing to lend objective findings to management algorithms. This article reviews the literature over the past 5 years to guide our management regarding this common upper-extremity injury. PMID:22763062

Schneppendahl, Johannes; Windolf, Joachim; Kaufmann, Robert A



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.



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


Trans-theta logistics: a new family of population growth sigmoid functions.  


Sigmoid functions have been applied in many areas to model self limited population growth. The most popular functions; General Logistic (GL), General von Bertalanffy (GV), and Gompertz (G), comprise a family of functions called Theta Logistic ([Formula: see text] L). Previously, we introduced a simple model of tumor cell population dynamics which provided a unifying foundation for these functions. In the model the total population (N) is divided into reproducing (P) and non-reproducing/quiescent (Q) sub-populations. The modes of the rate of change of ratio P/N was shown to produce GL, GV or G growth. We now generalize the population dynamics model and extend the possible modes of the P/N rate of change. We produce a new family of sigmoid growth functions, Trans-General Logistic (TGL), Trans-General von Bertalanffy (TGV) and Trans-Gompertz (TG)), which as a group we have named Trans-Theta Logistic (T [Formula: see text] L) since they exist when the [Formula: see text] L are translated from a two parameter into a three parameter phase space. Additionally, the model produces a new trigonometric based sigmoid (TS). The [Formula: see text] L sigmoids have an inflection point size fixed by a single parameter and an inflection age fixed by both of the defining parameters. T [Formula: see text] L and TS sigmoids have an inflection point size defined by two parameters in bounding relationships and inflection point age defined by three parameters (two bounded). While the Theta Logistic sigmoids provided flexibility in defining the inflection point size, the Trans-Theta Logistic sigmoids provide flexibility in defining the inflection point size and age. By matching the slopes at the inflection points we compare the range of values of inflection point age for T [Formula: see text] L versus [Formula: see text] L for model growth curves. PMID:21528359

Kozusko, F; Bourdeau, M



Complete Remission of Unresectable Colon Cancer after Preoperative Chemotherapy Selected by Adenosine Triphosphate-Based Chemotherapy Response Assay  

PubMed Central

The adenosine triphosphate-based chemotherapy response assay (ATP-CRA) is a chemosensitivity test that offers the potential of selecting cancer treatments based on the responsiveness of individual tumors. We report a case of 47-yr-old male, presented with sigmoid colon cancer with multiple liver and peritoneal metastases, in which there was a complete response for the primary colon cancer after administration of preoperative chemotherapy selected by ATP-CRA. Oxaliplatin was the most sensitive drug based on the ATP-CRA where the specimen obtained by ultrasound-guided percutaneous liver biopsy was used. After twelve cycles of oxaliplatin-capecitabine chemotherapy, abdominopelvic computed tomography revealed marked shrinkage of the liver metastases and positron emission tomography showed no uptake of 18F-fluoro-deoxy-glucose (FDG) either in the liver or peritoneum except localized uptake in the sigmoid colon. The patient underwent an anterior resection and radiofrequency ablation of the liver metastases, which resulted in a macroscopic curative resection of the cancer cells. Histological examination revealed no residual cancer cells in the resected specimen of the sigmoid colon. This result suggested that preoperative chemotherapy chosen by ATP-CRA may be useful for treating advanced colon cancer with unresectable liver and peritoneal metastases.

Huh, Jung Wook; Park, Yoon Ah; Jung, Eun Joo; Lee, Kang Young; Kwon, Ji Eun



Preliminary Experience with a New Total Distal Radioulnar Joint Replacement  

PubMed Central

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

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



The cost effectiveness of elective laparoscopic sigmoid resection for symptomatic diverticular disease: financial outcome of the randomized control Sigma trial  

Microsoft Academic Search

Background  Direct healthcare costs of patients with symptomatic diverticular disease randomized for either laparoscopic or open elective\\u000a sigmoid resection are compared. Cost-effectiveness analysis of the laparoscopic approach compared with open sigmoid resections\\u000a is presented.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  An economic evaluation of the randomized control Sigma trial was conducted, comparing elective laparoscopic sigmoid resection\\u000a (LSR) to open sigmoid resection (OSR) in patients with symptomatic diverticulitis.

Bastiaan R. Klarenbeek; Veerle M. H. Coupé; Donald L. van der Peet; Miguel A. Cuesta



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.




SciTech Connect

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{sup -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, E-mail: [National Astronomical Observatories/Yunnan Astronomical Observatory, Chinese Academy of Sciences, Kunming 650011 (China)



Influence of a Diverting Colostomy on Epithelial Cell Proliferation in the Colon of Rats  

Microsoft Academic Search

The effect of a transverse colostomy was compared to a sham operation and to transsection of the colon with reanastomosis in rats. The autoradiographic study after labeling with tritiated thymidine showed a significant decrease in proliferative activity at 5 days and at 3 weeks in the colonic segment distal to the colostomy. This observation was confirmed by the occurrence of

G. Delvaux; F. Caes; G. Willems



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

Microsoft Academic Search

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

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



The NSAID sulindac is chemopreventive in the mouse distal colon but carcinogenic in the proximal colon  

Microsoft Academic Search

Background and aimsThe non-steroidal anti-inflammatory drug sulindac is an effective chemopreventive agent in sporadic colorectal cancer but its potential benefit in mismatch repair deficient cancers remains to be defined. We wanted to determine whether genetic defects that are relevant for colorectal cancer, such as Msh2 or p53 deficiency, would influence the efficiency of sulindac chemoprevention or increase the side effects.MethodsMsh2

Dessislava Mladenova; Joseph J Daniel; Jane E Dahlstrom; Elaine Bean; Ruta Gupta; Russell Pickford; Nicola Currey; Elizabeth A Musgrove; Maija R J Kohonen-Corish



Emergency management of sigmoid volvulus--institutional experience over four years.  


Sigmoid volvulus is a serious surgical emergency and a common cause of large bowel obstruction in India. Patients present with abdominal pain, distension and obstipation and abdominal skiagram usually reveals the characteristic omega sign. Non-operative detorsion with early elective sigmoidectomy is the procedure of choice where gut viability is not in doubt and features of peritonitis are absent. The objective of this study was to demonstrate the most suitable procedure for management of patients with sigmoid volvulus needing emergency surgery. Results revealed a high incidence of burst abdomen and anastomotic leak as well as a high mortality rate in patients undergoing resection with primary anastomosis without proximal colostomy. Mortality was least with Hartmann's procedure although there was a higher incidence of wound infection. Thus, in the hospital setting, we consider Hartmann's procedure to be the best emergency surgical procedure for sigmoid volvulus as it limits mortality to the least. PMID:22482315

Gupta, Tamal Kanti Sen; Jha, Jayesh Kumar; Biswas, Ravi Shankar; Chattopadhyay, Shankar Das; Gupta, Naveen Kumar; Kumar, Sushil; Nath, Nemai Chandra; Karmakar, Nisith Chandra



Laparoscopic technique for secondary vaginoplasty in male to female transsexuals using a modified vascularized pedicled sigmoid.  


Between 1995 and 2002, 53 primary sex reassignments in male to female transsexuals were performed at our division. The objective of this procedure is to mimic the female external and part of the internal genitalia both esthetically and functionally. In 11 of the 53 patients, a secondary vaginal lengthening had to be performed due to a short neovagina. This was achieved using a pedicled sigmoid segment, with an open approach in the first 2 patients and using a laparoscopic method in the following 9. This paper focuses on the laparoscopic technique, its benefits and potential complications. Where a primary vaginoplasty, combining inversion of the penile and scrotal skin flaps, yields unsatisfactory functional results, a secondary vaginoplasty using the pedicled sigmoid represents an elegant means to achieve functional improvement. Furthermore, we report a modified surgical approach to the conventional sigmoid transition. PMID:14752211

Wedler, V; Meuli-Simmen, C; Guggenheim, M; Schneller-Gustafsson, M; Künzi, W




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: [School of Space Research, Kyung Hee University, Yongin, Gyeonggi-do 446-701 (Korea, Republic of)



Influence of short-chain fatty acids and osmolality on mucin release in the rat colon  

Microsoft Academic Search

The influence of short-chain fatty acids (SCFA) and osmolality on mucin release in the rat colon was studied histochemically by determining number of stained mucin-containing cells. SCFA did not significantly influence the number of cells staining for mucin. Hypertonic solutions (360 mosm\\/l) did not affect mucin release in the proximal colon, but stimulated mucin release in the distal colon. Solutions

T. Sakata; W. v. Engelhardt



CT differentiation of distal pancreas fat replacement and distal pancreas agenesis  

Microsoft Academic Search

We aimed to describe CT signs useful for differentiation of distal agenesis from distal or dorsal pancreas lipomatosis. Multidetector\\u000a CT (MDCT) studies of five patients with distal pancreas agenesis (n = 2), distal lipomatosis (n = 1), distal short pancreas (n = 1), and distal pancreatectomy (n = 1) were retrospectively reviewed. Agenesis of dorsal pancreas can be diagnosed by the absence of body and tail of pancreas.

Musturay Karcaaltincaba



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

Microsoft Academic Search

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

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



Synchronous adenocarcinomas of the colon presenting as synchronous colocolic intussusceptions in an adult  

PubMed Central

Intussusception is uncommon in adults. To our knowledge, synchronous colocolic intussusceptions have never been reported in the literature. Here we described the case of a 59-year-old female of synchronous colocolic intussusceptions presenting as acute abdomen that was diagnosed by CT preoperatively. Laparotomy with radical right hemicolectomy and sigmoidectomy was undertaken without reduction of the invagination due to a significant risk of associated malignancy. The final diagnosis was synchronous adenocarcinoma of proximal transverse colon and sigmoid colon without lymph nodes or distant metastasis. The patient had an uneventful recovery. The case also emphasizes the importance of thorough exploration during surgery for bowel invagination since synchronous events may occur.



Intramedullary tibial nailing in distal third tibial fractures: distal locking screws and fracture non-union.  


Distal third tibial fractures are prone to non-union following tibial nail insertion. The purpose of this study was to assess the union of distal third tibial fractures in patients who have undergone intra-medullary (IM) tibial nailing with one versus two distal locking screws. Sixty-five patients who had intramedullary tibial nail fixation were retrospectively analysed. Our results showed that 80% of non-unions in distal third fractures had only one distal locking screw compared to 20% who had two distal locking screws. This is statistically significant (p<0.01). We therefore conclude that two distal locking screws are essential for distal third fractures. PMID:17410364

Mohammed, Aso; Saravanan, Ramaswamy; Zammit, Jason; King, Richard



Highly accurate sigmoidal fitting of real-time PCR data by introducing a parameter for asymmetry  

PubMed Central

Background Fitting four-parameter sigmoidal models is one of the methods established in the analysis of quantitative real-time PCR (qPCR) data. We had observed that these models are not optimal in the fitting outcome due to the inherent constraint of symmetry around the point of inflection. Thus, we found it necessary to employ a mathematical algorithm that circumvents this problem and which utilizes an additional parameter for accommodating asymmetrical structures in sigmoidal qPCR data. Results The four-parameter models were compared to their five-parameter counterparts by means of nested F-tests based on the residual variance, thus acquiring a statistical measure for higher performance. For nearly all qPCR data we examined, five-parameter models resulted in a significantly better fit. Furthermore, accuracy and precision for the estimation of efficiencies and calculation of quantitative ratios were assessed with four independent dilution datasets and compared to the most commonly used quantification methods. It could be shown that the five-parameter model exhibits an accuracy and precision more similar to the non-sigmoidal quantification methods. Conclusion The five-parameter sigmoidal models outperform the established four-parameter model with high statistical significance. The estimation of essential PCR parameters such as PCR efficiency, threshold cycles and initial template fluorescence is more robust and has smaller variance. The model is implemented in the qpcR package for the freely available statistical R environment. The package can be downloaded from the author's homepage.

Spiess, Andrej-Nikolai; Feig, Caroline; Ritz, Christian



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


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

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



Use of magnetic resonance imaging and magnetic resonance angiography in diagnosis of sigmoid sinus thrombosis.  


Magnetic resonance angiography is an established radiologic technique which is rapidly becoming useful in imaging the head and neck. Currently, this imaging modality is important in the diagnosis of sigmoid sinus thrombosis caused by otologic disease. Since the introduction of antibiotic therapy, the percentage of deaths attributed to intracranial complications from otitic disease has decreased from 2.5 to approximately 0.25% of documented deaths. Also, the incidence of sinus thrombosis within this group has decreased, but it is still a serious and potentially lethal condition. Sinus thrombosis is suspected clinically when mastoid disease progresses, with picket fence fever pattern, chills, headaches and signs of papilledema. Definitive diagnosis is necessary before surgical treatment. The Queckenstedt test is unreliable, computed tomography is better suited for demonstrating thrombosis of the sagittal sinus rather than the sigmoid sinus, and conventional angiography (although it provides excellent visualization) has the hazard of ionizing radiation and requires vessel puncture and the use of intraarterial contrast agents. We present two cases of thrombosis of the sigmoid sinus as an intracranial otologic complication which were diagnosed definitively with magnetic resonance imaging and magnetic resonance angiography. The combination of magnetic resonance imaging, which showed the thrombosis displaying abnormal signal intensity, and magnetic resonance angiography, which demonstrated the absence of flow in the sinus, was an ideal diagnostic tool. For both patients, treatment consisted of mastoidectomy, sigmoid sinus decompression and antibiotics. PMID:9248135

Davison, S P; Facer, G W; McGough, P F; McCaffrey, T V; Reder, P A



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

PubMed Central

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

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



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

Microsoft Academic Search

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

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



Similarities of error regularization, sigmoid gain scaling, target smoothing, and training with jitter  

Microsoft Academic Search

The generalization performance of feedforward layered perceptrons can, in many cases, be improved either by smoothing the target via convolution, regularizing the training error with a smoothing constraint, decreasing the gain (i.e., slope) of the sigmoid nonlinearities, or adding noise (i.e., jitter) to the input training data, In certain important cases, the results of these procedures yield highly similar results

Russell Reed; Robert J. Marks; Seho Oh



Three-Dimensional Sigmoidal Structure on the Flare-Producing Solar Active Region  

NASA Astrophysics Data System (ADS)

Three-dimensional (3D) magnetic topology is a key process to understand the solar active phenomena and it is essential toward the goal of the space weather prediction. Especially, because the “Sigmoid”, which is highly sheared magnetic field, is observed by X - ray telescope before the solar flares, we have considered as a precursor of that. However, because we can find the only two-dimensional information from the observation, 3D structure is not fully understood. In this study, 3D coronal magnetic field was extrapolated based on the vercormagnetogram data on Dec.12,2006 from Hinode/SP data under the Nonlinear Force-Free (NLFF) approximation and the purpose of this study is to clarify the 3D Sigmoidal structure of the flare-producing solar active region. As a result, we clearly find that the sigmoidal structure is not composed of the single magnetic flux but also the multiple structures. This result indicates the Sigmoid has very complex structure. The height of magnetic loop, where the X-ray intensity is strongest region, is about 10000(km) and the curve region of “S” shaped structure is about 60000(km). Furthermore, from the Quasi-Separatrix Layers (QSL), we clearly find that the part of magnetic flux surrounded by QSL corresponds to the region where the X-ray intensity is strongest. We will also report about the comparison with the flux emergence simulation from Magara 2004 and 180-deg. ambiguity.

Inoue, S.; Magara, T.; Yamamoto, T. T.



The sigmoidal average - a powerful tool for predicting the thermal conductivity of composite ceramics  

NASA Astrophysics Data System (ADS)

The sigmoidal average between the upper and lower Hashin-Shtrikman bounds is shown to be the appropriate average relation for isotropic two-phase composites consisting of geometrically equivalent grains. This average ensures that the prediction is close the upper bound for low volume fractions of the low-conductivity phase (corresponding to low-conductivity inclusions in a high-conductivity matrix) and vice versa. In the intermediate concentration range the sigmoidal average reflects the fact that the microstructure is bicontinuous and can undergo a percolation-type transition. It is shown that the sigmoidal average of the Hashin-Shtrikman bounds lies automatically within the three-point bounds (Miller bounds) for a practically important class of microstructures (symmetric-cell materials with spherical cells) and that in the infinite-phase-contrast case (porous media) it is close to the exponential relation, which has been very successful in describing the porosity dependence of properties. Theoretical predictions are compared with experimentally measured values for alumina-zirconia composites in the whole range of volume fractions, from pure alumina to pure zirconia. Even after appropriate correction for porosity, essentially all experimental data are below the sigmoidal average. The fact that some values are even below the lower Hashin-Shtrikman bound is indicative of microcracking and / or grain size (interface) effects.

Pabst, W.; Gregorová, E.



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



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

Microsoft Academic Search

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

G. D. Zhou




Microsoft Academic Search

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

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



Laparoscopic Repair of Colonic Anastomotic Leak in an Elderly Patient  

PubMed Central

Background: Laparoscopy to repair iatrogenic colonoscopic perforation of the colon has proven to be a safe, effective, and reproducible means to treat these potentially devastating emergencies. The use of the laparoscope provides exceptional diagnostic yield, and under the hand of a trained surgeon, produces excellent therapeutic results while minimizing recovery time for the patient. Methods: We report the case of an 86-year-old man who underwent emergent laparoscopic repair of a postoperative anastomotic leak following sigmoid colectomy. Results: The patient underwent laparoscopic oversewing of a colonic anastomotic leak, omental patch, and diverting loop ileostomy. The patient recovered fully from his emergency procedure without any further complications. Conclusion: Laparoscopic surgery can be extended to a wider variety of colorectal emergencies in a carefully selected group of patients, including the elderly.

Shadis, Ryan; Zebley, D. Mark; Kim, Soo Y.; Hofmann, Mary T.



Clinical Outcome of Self-Expandable Metal Stent Placement in the Management of Malignant Proximal Colon Obstruction  

PubMed Central

Background/Aims There are limited data regarding the clinical outcomes of self-expandable metal stents in the treatment of proximal colon obstruction. We compared the clinical outcomes of stent placement in patients with malignant proximal to distal colon obstructions. Methods We reviewed medical records from 37 consecutive patients from three institutions (19 men; mean age, 72 years) who underwent endoscopic stent placement at a malignant obstruction of the proximal colon. We also examined the records from 99 patients (50 men; mean age, 65 years) who underwent endoscopic stent placement for a distal colon obstruction. Technical success, clinical improvements, complications and stent patency were compared between treatments. Results The technical success rate tended to be lower in stents inserted to treat proximal colon obstructions than in those used to treat distal colon obstructions (86% vs 97%, p=0.06). Clinical improvement was achieved in 78% of patients (29/37) with proximal colonic stenting and in 91% of patients (90/99) with distal colonic stenting (p=0.08). Complications (24% vs 27%), stent migration (8% vs 8%) and stent reocclusion rates (11% vs 17%) did not differ significantly between groups. Two cases of bowel perforation related to stenting (5%) occurred in patients with proximal colonic stenting. Conclusions The technical success and clinical improvement associated with self-expandable metal stents used to treat proximal colon obstruction tend to be lower than cases of distal colon obstruction. Technical failure is an important cause of poor clinical improvement in patients with proximal colon stenting. Complication rates and stent patency appear to be similar in both groups.

Cho, Yu Kyung; Lee, Bo-In; Lee, Kang Moon; Lim, Chul Hyun; Kim, Jin Su; Chang, Jae Hyuck; Park, Jae Myung; Lee, In Seok; Choi, Myung-Gyu; Choi, Kyu Yong; Chung, In-Sik



Posttreatment evaluation of the distal jet appliance  

Microsoft Academic Search

This study analyzed molar distalization with the distal jet appliance, its effect on the anchor teeth, and the outcome at the completion of orthodontic treatment. Pretreatment, after distalization, and posttreatment lateral cephalometric radiographs were evaluated for 21 adolescent girls and 12 adolescent boys. The mean age of the subjects at the time of the pretreatment radiograph was 12.8 ± 2.2

Vonny Ngantung; Ram S. Nanda; S. Jay Bowman



The sigmoid volvulus: surgical timing and mortality for different clinical types  

PubMed Central

Background In western countries intestinal obstruction caused by sigmoid volvulus is rare and its mortality remains significant in patients with late diagnosis. The aim of this work is to assess what is the correct surgical timing and how the prognosis changes for the different clinical types. Methods We realized a retrospective clinical study including all the patients treated for sigmoid volvulus in the Department of General Surgery, St Maria Hospital, Terni, from January 1996 till January 2009. We selected 23 patients and divided them in 2 groups on the basis of the clinical onset: patients with clear clinical signs of obstruction and patients with subocclusive symptoms. We focused on 30-day postoperative mortality in relation to the surgical timing and procedure performed for each group. Results In the obstruction group mortality rate was 44% and it concerned only the patients who had clinical signs and symptoms of peritonitis and that were treated with a sigmoid resection (57%). Conversely none of the patients treated with intestinal derotation and colopexy died. In the subocclusive group mortality was 35% and it increased up to 50% in those patients with a late diagnosis who underwent a sigmoid resection. Conclusions The mortality of patients affected by sigmoid volvulus is related to the disease stage, prompt surgical timing, functional status of the patient and his collaboration with the clinicians in the pre-operative decision making process. Mortality is higher in both obstructed patients with generalized peritonitis and patients affected by subocclusion with late diagnosis and surgical treatment; in both scenarios a Hartmann's procedure is the proper operation to be considered.



Noncompliance unilateral maxillary molar distalization:.  


The aim of this prospective study was the three-dimensional (3-D) analysis of tooth movements after unilateral upper molar distalization by means of a noncompliance intraoral appliance, the Keles slider. This appliance exerts a distalizing force of 150 g at approximately the level of the center of resistance of the upper first molar. Twelve patients (six girls and six boys with a mean age of 13.1 years) with a unilateral Class II molar relationship participated in the study. Dental casts were taken immediately before placement and after removal of the appliance. The casts were digitized using a 3-D surface laser scanner and superimposed on a predefined area of the palate. The average unilateral upper first molar distal movement was 3.1 mm (range: 2.4 to 5.3 mm). Anchorage loss was expressed by a 2.1 mm (range: 0.8 to 3.8 mm) proclination of the central incisors and a 6.1 degrees mesial inclination of the ipsilateral first premolar (range: 1.7 degrees to 12.3 degrees ). There was approximately 1 mm of midline deviation toward the contralateral side and a 1.6 mm (range: 0.8 to 2.3 mm) buccal displacement of the contralateral first premolar. A substantial variation was observed among patients. Noncompliance unilateral upper molar distalization was an efficient treatment approach. There was, however, a substantial anchorage loss. Case selection is strongly recommended because significant anterior crowding, ectopic canines, or spacing can lead to significant anchorage loss. PMID:16637715

Mavropoulos, Anestis; Sayinsu, Korkmaz; Allaf, Ferdi; Kiliaridis, Stavros; Papadopoulos, Moschos A; Keles, Ahmet Ozlem



Colonic epithelial lymphocytosis without a thickened subepithelial collagen table: a clinicopathologic study of 40 cases supporting a heterogeneous entity.  


Lymphocytic colitis (LC) is classically described as a triad of chronic nonbloody, watery diarrhea, normal or nearly normal endoscopy findings, and colonic epithelial lymphocytosis without a thickened subepithelial collagen table (SECT). It is unknown how often patients with colonic epithelial lymphocytosis without a thickened SECT actually present with this classic triad. Cases diagnosed histologically as lymphocytic or microscopic colitis were reviewed. Criteria for inclusion were the presence of at least 15 surface lymphocytes per 100 epithelial cells and the absence of a thickened SECT (<12 microm). Clinical features and course were recorded by chart review and telephone follow-up. Forty patients met the inclusion criteria, including 25 women and 15 men with a mean age of 63.2 years (range, 25-83 years). Twenty-eight patients had the classic triad and were designated as having classic LC. The other 12 patients fulfilled the histologic criteria but not the clinical or endoscopic criteria for classic LC and were classified as having atypical LC (constipation, five patients; macroscopic colitis at endoscopy, five patients; hematochezia, one patient; and incidental finding, one patient). Clinically, patients with classic LC were predominantly women and had a higher incidence of autoimmune disease (p = 0.03) than did those with atypical LC. Histologically, surface eosinophilia was significantly greater in patients with classic LC (p = 0.04). Twenty patients were using nonsteroidal antiinflammatory drugs at the time of their colonic biopsy. Surface epithelial lymphocyte counts were higher in these patients, particularly in the distal sigmoid colon (p = 0.02). Fourteen patients had associated autoimmune disease, including three patients with sprue diagnosed by small bowel biopsy, all of whom responded to gluten withdrawal. Diarrhea present in 25 patients, without documented evidence of celiac sprue, was self-limited in five, resolved with treatment in three, required intermittent treatment in eight, daily treatment in five, and was refractory to treatment in four. All eight patients who experienced spontaneous or treatment-related symptom resolution had classic LC. No histologic feature correlated with clinical course. In conclusion, our study shows that colonic epithelial lymphocytosis without a thickened SECT is a histologic finding seen in a heterogeneous group of patients. Within this heterogeneous group is a distinct subset of patients who have the classic clinicopathologic triad of LC. This subset of patients has striking similarities to patients with collagenous colitis, lending further support to a close relationship between these two entities. Atypical LC comprises a heterogeneous group and includes patients with idiopathic constipation, coexisting LC and inflammatory bowel disease, and possibly infectious colitides. Because of the clinical heterogeneity among our study population, the descriptive term colonic epithelial lymphocytosis may be a more prudent diagnosis than lymphocytic colitis in the absence of adequate clinical information. PMID:10478666

Wang, N; Dumot, J A; Achkar, E; Easley, K A; Petras, R E; Goldblum, J R



Distal upper extremity musculoskeletal risk factors associated with colonoscopy.  


Gastroenterologists are at increased risk for developing recurrent thumb, hand, and elbow pain due to colonoscopy procedures. We evaluated forearm muscle loads and wrist postures during routine colonoscopy (N=12 gastroenterologists) to understand distal upper extremity musculoskeletal risk factors associated with the 4 different subtasks of colonoscopy. Bilateral forearm extensor carpiradialis (ECR) and flexor digitorum superficialis (FDS) surface electromyography and bilateral wrist postures were recorded continuously. The mean duration of colonoscopy was 24.2 (± 12.1) minutes and was dominated by the withdrawal subtask [13.7 (± 8.8) min] followed by right colon insertion [5.8 (± 4.8) min], left colon insertion [3.5 (± 3.1) min], and retroflexion [1.2 (± 2.1) min]. Median (APDF50) and peak (APDF90) left forearm muscle activity was significantly greater than right forearm muscle activity across all subtasks. Median and peak ECR muscle activity was significantly greater during the left and right colon insertion subtasks compared to retroflexion. Both wrists were predominantly in wrist extension during all phases of colonoscopy. The left forearm muscle activity was higher than right forearm activity due to differences in wrist posture and grip force. The risk factors for the left hand may be reduced with alternative designs and support mechanisms for the colonoscope head. PMID:22317441

Rempel, David; Lee, David; Shergill, Amandeep



P 2 purinoceptor antagonists inhibit the non-adrenergic, non-cholinergic relaxation of the human colon in vitro  

Microsoft Academic Search

Neurotransmitters released by myenteric neurons regulate movements of intestinal smooth muscles. There has been little pharmacological evidence for a role of purinergic mechanisms in the non-adrenergic, non-cholinergic (NANC) relaxation of the human large intestine. We used P2 purinoceptor antagonists to assess whether such receptors are involved in the NANC relaxation of the circular muscle of the human sigmoid colon. It

R. Benkó; S. Undi; M. Wolf; A. Vereczkei; L. Illényi; M. Kassai; L. Cseke; D. Kelemen; Ö. P. Horváth; A. Antal; K. Magyar; L. Barthó



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

PubMed Central

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

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



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

PubMed Central

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

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



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



Calcium and Vitamin D Intakes in Relation to Risk of Distal Colorectal Adenoma in Women  

Microsoft Academic Search

The authors examined intakes of calcium and vitamin D, and interaction with retinol, in relation to risk of adenoma of the distal colon or rectum among 48,115 US women who were free of colorectal cancer or polyps, completed a food frequency questionnaire in 1980, and underwent endoscopy by 2002. They documented 2,747 cases of adenoma (1,064 large, 1,531 small, 2,085

Kyungwon Oh; Walter C. Willett; Kana Wu; Charles S. Fuchs; Edward L. Giovannucci


Morphology of the distal radius in extant hominoids and fossil hominins: implications for the evolution of bipedalism.  


One of the long-standing arguments about the evolution of bipedality centers on the locomotor pattern used by the last common ancestor (LCA) of apes and humans. In particular, knuckle-walking has been suggested as this locomotor pattern on the basis of shared morphology in the upper limb between African apes and humans and phylogenetic parsimony. Using three-dimensional geometric morphometrics, this study tests whether the distal radius of extant hominoids is sufficient for determining locomotor pattern and the affiliations of Plio-Pleistocene hominins to the extant taxa. Results indicate that while the entire radius differentiates the extant taxa very well by locomotor pattern, the distal radius fails to clearly differentiate the extant taxa. The sigmoid notch of the distal radius is the anatomical feature that differs most among the extant taxa, and its variability broadly correlates with necessary mobility at the wrist joint. Principal components and discriminant function analyses indicate that early hominins are affiliated with a variety of extant taxa with different locomotor patterns. Overall, the bony anatomy of the distal radius of early hominins points towards something adapted for a wide variety of locomotor postures. PMID:22262653

Tallman, Melissa



Distal Myopathy with Rimmed Vacuoles  

PubMed Central

Distal myopathy with rimmed vacuoles (DMRV), is an autosomal recessive disorder with early adult onset, displays distal dominant muscular involvement and is characterized by the presence of numerous rimmed vacuoles in the affected muscle fibers. The pathophysiology of DMRV has not been clarified yet, although the responsible gene was identified as that encoding UDP-N-acetylglucosamine 2-epimerase/N-acetylmannosamine kinase involved in the biosynthesis of sialic acids. To identify defective carbohydrate moieties of muscular glycoproteins from DMRV patients, frozen skeletal muscle sections from seven patients with DMRV, as well as normal and pathological controls, were treated with or without sialidase or N-glycosidase F followed by lectin staining and lectin blotting analysis. The sialic acid contents of the O-glycans in the skeletal muscle specimens from the DMRV patients were also measured. We found that Arachis hypogaea agglutinin (PNA) lectin reacted strongly with sarcolemmal glycoproteins in the DMRV patients but not with those in control subjects. ?-Dystroglycan from the DMRV patients strongly associated with PNA lectin, although that from controls did not. The sialic acid level of the O-glycans in the DMRV muscular glycoproteins with molecular weights of 30 to 200 kd was reduced to 60 to 80% of the control level. The results show that impaired sialyl O-glycan formation in muscular glycoproteins, including ?-dystroglycan, occurs in DMRV.

Tajima, Youichi; Uyama, Eiichiro; Go, Shinji; Sato, Chihiro; Tao, Nodoka; Kotani, Masaharu; Hino, Hirotake; Suzuki, Akemi; Sanai¶, Yutaka; Kitajima, Ken; Sakuraba, Hitoshi



Trans-Theta Logistics: A New Family of Population Growth Sigmoid Functions  

Microsoft Academic Search

Sigmoid functions have been applied in many areas to model self limited population growth. The most popular functions; General\\u000a Logistic (GL), General von Bertalanffy (GV), and Gompertz (G), comprise a family of functions called Theta Logistic ($$ \\\\Uptheta $$\\u000a L). Previously, we introduced a simple model of tumor cell population dynamics which provided a unifying foundation for these\\u000a functions. In

F. Kozusko; M. Bourdeau


Training a reciprocal-sigmoid classifier by feature scaling-space  

Microsoft Academic Search

This paper presents a reciprocal-sigmoid model for pattern classification. This proposed classifier can be considered as a\\u000a ?-machine since it preserves the theoretical advantage of linear machines where the weight parameters can be estimated in\\u000a a single step. The model can also be considered as an approximation to logistic regression under the framework of Generalized\\u000a Linear Models. While inheriting the

Kar-ann Toh



Sigmoid diverticulitis perforation in burns: case reports and review of the literature  

PubMed Central

Summary Burned patients are prone to develop severe intestinal complications because of decreased splanchnic circulation. We report three cases of sigmoid perforation in burn patients appearing late during hospitalization. The common aetiological factor was a state of septic shock treated with infusion of vasopressors. Two patients also received corticosteroids as treatment for acute respiratory distress syndrome. These cases underline the necessity to maintain adequate organ perfusion and to prevent intestinal ischaemia in severe burns.

Cirodde, A.; Jault, P.; Leclerc, T.; Donat, N.; Bargues, L.



Tuboovarian Abscess due to Colonic Diverticulitis in a Virgin Patient with Morbid Obesity: A Case Report.  


Since tuboovarian abscess is almost always a complication of pelvic inflammatory disease, it is rarely observed in virgins. A 30-year-old virgin patient presented with pelvic pain, fever, and vaginal spotting for the previous three weeks. Her abdominopelvic computed tomography scan revealed bilateral multiseptated cystic masses with prominent air-fluid levels suggesting tuboovarian abscesses. The sigmoid colon was lying between two tuboovarian masses, and its borders could not be distinguished from the ovaries. The patient was presumed to have bilateral tuboovarian abscesses which developed as a complication of the sigmoid diverticulitis. She was administered intravenous antibiotic therapy followed by percutaneous drainage under ultrasonographic guidance. She was discharged on the twenty second day with prominent clinical and radiological improvement. Diverticulitis may be a reason for development of tuboovarian abscess in a virgin patient. Early recognition of the condition with percutaneous drainage in addition to antibiotic therapy helps to have an uncomplicated recovery. PMID:22952477

Tuncer, Zafer Selçuk; Boyraz, Gokhan; Yücel, Senem Özge; Selçuk, Ilker; Yazicio?lu, Asl?han



Venous thrombosis in subclavian, axillary, brachial veins with extension to internal jugular vein, right sigmoid sinus and simultaneous pulmonary embolism  

PubMed Central

We present a rare case of Venous Thrombosis in Subclavian, Axillary, Brachial Veins with extension to Internal Jugular vein, right sigmoid sinus and simultaneous Pulmonary embolism during the treatment with low molecular weight heparin.

Tamizifar, Babak; Beigi, Arash; Rismankarzadeh, Maryam



Colonic mass movements in idiopathic chronic constipation.  

PubMed Central

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

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



Colon cancer - series (image)  


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; ...


Colon Cancer (PDQ): Treatment  


... bulging tissue ) in the colon or rectum. Enlarge Polyps in the colon. Some polyps have a stalk and others do not. Inset shows a photo of a polyp with a stalk. Signs of colon cancer include blood in the stool or a ...


Modeling the Length of Distal Radioulnar Ligaments  

Microsoft Academic Search

The distal radioulnar ligaments are essential contributors to wrist joint stability. We present a CT-based model for ligament displacement, in which ligaments are approximated by shortest paths in a 3D space with bone obstacles. This rst model allows for the study of distal ligaments biomechanics in vivo and non-invasively. We show that our simplied model gives surprising insight into distal

Liz Marai


Mandibular first molar with three distal canals  

PubMed Central

With the increasing number of reports of aberrant root canal morphology, the clinician needs to be aware of the variable anatomy. Various case reports have been published with the finding of middle mesial canal in mandibular first molar, however finding of middle distal canal in distal root of mandibular first molar is rare. This case report describes root canal treatment of two rooted mandibular first molar with five root canals (three in distal and two in mesial root), and Sert and Bayirli Type XVIII canal configuration in distal root.

Jain, Shweta



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

PubMed Central

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

Caballero, T; Nogueras, F; Medina, M T; Caracuel, M D; de Sola, C; Martinez-Salmeron, F J; Rodrigo, M; Garcia del Moral, R



Haemodynamics after distal splenorenal shunt.  


Haemodynamic studies were made both preoperatively and 7--62 months after the operation in 17 cirrhotic patients subjected to distal splenorenal shunt. Patent shunt was demonstrated in all patients. Preoperatively all patients had hepatopetal portal flow. Postoperatively portography through percutaneous transhepatic portal vein cannulation demonstrated hepatopetal flow in nine patients and reversed flow in eight patients. Portal pressure was significantly decreased in both groups after the shunt (p less than 0.01). However, no differences in pre- and post-operative portal pressure were observed in the two patient groups. In patients with hepatopetal flow, minimal new collaterals without clear connection to gastroesophageal region could be demonstrated. Collateral formation in patients with reversed flow was more abandoned but, even in these cases, no connection to gastroesophageal region could be demonstrated. The results indicate that a continuous increase in liver resistance due to the progression of the liver disease is the main cause of changes in portal circulation. PMID:6538372

Kallio, H; Suoranta, H; Lempinen, M



Distal limb and paw injuries.  


Distal limb reconstruction is complicated by the paucity of local tissues and the frequent association of orthopedic injury with cutaneous loss. Second-intention healing or skin stretching techniques are used for wounds involving less than a 30% circumference of the limb. Skin grafts are recommended for reconstruction of larger superficial wounds after establishing a bed of granulation tissue or for immediate reconstruction of clean wounds overlying healthy muscle. Wounds complicated by orthopedic injury benefit from early reconstruction using vascularized tis-sue. Weight-bearing surface reconstruction and management of partial amputation injuries are functionally difficult because of the environmental stress placed on the paw pads. Paw pad grafts, paw pad transposition techniques, centralization of digits, and microvascular free tissue trans-fer of paw pads can be considered for weight-bearing surface reconstruction. Definitive guidelines describing when each of these techniques should be used have not been established. PMID:16787789

Fowler, David



[Distal radio-ulnar prosthesis].  


Many procedures have been proposed for the treatment of traumatic painful instabilities of the Distal Radio-Ulnar Joint (DRUJ). Moore-Darrach, Milch, Baldwin, Bowers, Kapandji-Sauvé. Except for the Milch procedure, the risk of painful instability of the ulnar stump is real, but not very frequent if the technique is correctly applied. When this complication occurs, the best way to ensure the ulnar stump stabilization is mechanical, by mean of a DRUJ Prosthesis which we were the first to imagine and build. Used in two cases, with or without remnant ulnar head, these two types of prosthesis seem to have been favourable. Obviously, it is too early to know the final value of this prosthesis, based only on two cases, but it seemed important to make it known as an additional possibility in the treatment of the DRUJ problems. These two types of prosthesis are conceived on original principles: cementless fixation but with screws and nuts giving immediate and definitive stability and allowing a fast rehabilitation. The articular pieces are composite, metal on H.D. Polythylene. The articular surface is spherical permitting all the mobilities of this complex joint. The two articular surfaces are supported by two pieces: the proximal part, holding a hollow hemisphere, inserted in the ulna and the same for the two types of prosthesis, and a distal part, holding the sphere; this part is different according to the type of the prosthesis. We are well aware that in time and with clinical experience, some of its secondary characteristics will evolve, mainly its fixation system. At the present time this prosthesis is indicated in two "second look" situations: painful ulnar stump instability after a Kapandji-Sauvé procedure, and after a Moore-Darrach procedure. Perhaps it will be used in unstable stumps after a Bowers procedure? It is possible that this prosthesis will be used primarlly in the future when its reliability has been definitively established. We are working towards this objective. PMID:1280973

Kapandji, A I



A morphometric study of the canine colon: comparison of control dogs and cases of colonic disease.  

PubMed Central

The microstructure of the canine colon was described morphometrically. The artifacts induced by administration of enemas and biopsy technique were studied by comparing biopsy specimens to tissues obtained at necropsy from 15 normal dogs. Biopsies from control dogs and clinical cases of colonic disease were then evaluated quantitatively, and histological abnormalities which might clarify mechanisms underlying large bowel dysfunction in the dog were sought. In control dogs, gland length and diameter, epithelial, goblet cell and mucosal mast cell numbers, and intraepithelial lymphocyte and mitotic indices were remarkably uniform throughout the colon. Minor variations were found in the proximal and distal regions of the colon. An apparent shortening of glands, and a reduction in mucous goblets and intraepithelial lymphocytes in biopsies were attributed to suboptimal orientation and irritation caused by enemas. The only significant difference from controls identified by morphometric analysis of biopsies from clinical cases was fewer epithelial cells lining longitudinal sections of glands. It was concluded that failure to identify morphometric variations in the colonic mucosa of clinical cases might reflect either a biased, homogeneously mild clinical syndrome in this group, or the possibility that in many of the clinical cases, a functional rather than physical abnormality was involved. The proprial inflammatory cell population was not examined quantitatively; further investigation of this component is merited. Images Fig. 1. Fig. 2. Fig. 3.

Spinato, M T; Barker, I K; Houston, D M



Long pedunculated colonic polyp with diverticulosis: case report and review of the literature.  


Colonic muco-submucosal elongated polyp is a rare entity (0.39% in an endoscopic polypectomy series). It is an elongated drumstick-shaped lesion characterized by oedematous, loose connective tissue with a dense submucosal layer showing dilation of blood and lymphatic vessels. First described as a polypoid lesion associated with diverticular disease of the sigmoid colon, it was histologically characterized as a separate entity by Kelly in 1991. In that study, the author reported eight cases in which a red or brown mucosal protrusion or polyp were associated with diverticular disease, and described the syndrome as "polypoid prolapsing mucosal folds in diverticular disease". In 1994, Matake et al. described a new entity defined as colonic muco-submucosal elongated polyp. Herein, we describe another case in a 77-year-old woman with abdominal pain, followed by a review of the literature. PMID:21837918

Ambrosio, M R; Rocca, B J; Ginori, A; Barone, A; Onorati, M; Lazzi, S



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.



Three-dimensional bimetric maxillary distalization arches compared with a modifi ed Begg intraoral distalization system  

Microsoft Academic Search

SUMMARY The purpose of this study was to compare the dentofacial effects of two intraoral molar distalization techniques (three-dimensional bimetric maxillary distalization arches (3D-BMDA) and a modifi ed Begg intraoral distalization system (MBIDS)) in subjects requiring maxillary molar distalization. Twenty-one patients (12 females and 9 males, mean age pre-treatment: 14.7 ± 1.50 years) were treated with the 3D-BMDA and 17

Ayse Tuba Altug-Atac; Dilek Erdem; Züleyha Mirzen Arat


Distally based dorsalis pedis island flap for a distal lateral electric burn of the big toe  

Microsoft Academic Search

Reconstruction of the small defects in the distal portion of the foot has always represented a difficult problem. A case of a young man with a deep electric burn of the distal lateral side of the big toe successfully treated with a distally based dorsalis pedis island flap based on the first dorsal metatarsal artery (FDMA) is presented. The donor

M. Governa; D. Barisoni



Acquired distal renal tubular acidosis in man  

Microsoft Academic Search

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

O. S. Better



Laparoscopic Distal Pancreatectomy with Splenic Conservation: An Operation without Increased Morbidity  

PubMed Central

Objectives. The advent of minimally invasive techniques was marked by a paradigm shift towards the use of laparoscopy for benign distal pancreatic masses. Herein we describe one center's experience with laparoscopic distal pancreatectomy. Methods. A retrospective chart review was performed for all distal pancreatectomies completed laparoscopically from 1999 to 2009. Outcomes from those cases completed with a concurrent splenectomy were compared to the spleen-preserving procedures. Results. Twenty-four patients underwent laparoscopic distal pancreatectomy. Seven had spleen-conserving operations. There was no difference in the mean estimated blood loss (316 versus 285?mL, P = .5) or operative time (179 versus 170?minutes, P = .9). The mean tumor size was not significantly different (3.1 versus 2.2?cm, P = .9). There was no difference in the average hospital stay (7.1 versus 7.0 days, P = .7). Complications in the spleen-preserving group included one iatrogenic colon injury, two pancreatic fistulas, and two cases of iatrogenic diabetes. In the splenectomy group, two developed respiratory failure, three acquired iatrogenic diabetes, and two suffered pancreatic fistulas (71% versus 41%, P = .4). Conclusions. The laparoscopic distal pancreatectomy is a safe operation with a low morbidity. Splenic conservation does not significantly increase the morbidity of the procedure.

Nau, Peter; Melvin, W. Scott; Narula, Vimal K.; Bloomston, P. Mark; Ellison, E. Christopher; Muscarella, Peter



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

PubMed Central

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

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



[Effect of tiemonium iodide on colonic motility in dogs].  


Effects of tiemonium iodide (tiemonium, 20 micrograms/kg), mepenzolate bromide (mepenzolate, 20 micrograms/kg), butylscopolamine bromide (butylscopolamine, 50 micrograms/kg) and atropine sulfate (atropine, 10 micrograms/kg) on the colonic motility in dogs were evaluated using a balloon method. The frequency of the wave motion was analyzed by fast Fourier transform, and the power spectra were obtained. The value of the first term of the power spectrum is regarded as an indication of the colonic tonus. Inhibitory effects of tiemonium on both the normal proximal colonic motility and the accelerating motility induced by neostigmine metylsulfate (neostigmine, 50 micrograms/kg) were equal to those of butylscopolamine. In the case of distal colonic motility, tiemonium showed potent mepenzolate-like inhibition. When the drugs were injected into the veins after administration of PGF2 alpha (10 micrograms/kg), all of the drugs depressed the colonic constriction induced by PGF2 alpha. The colonic motility was not restored by the administration of tiemonium or mepenzolate before the injection of PGF2 alpha, but such an effect was not observed in the case of butylscopolamine and atropine. It is suggested that tiemonium shows an extensive inhibition on the colonic motility in the mode of mepenzolate-like action and by some additional mechanism. PMID:6962171

Okada, K; Imai, H; Togawa, Y; Nagaoka, S; Nozaki, M; Tsurumi, K; Fujimura, H



Robotic distal pancreatectomy: a valid option?  


Although reported in the literature, conventional laparoscopic approach for distal pancreatectomy is still lacking widespread acceptance. This might be due to two-dimensional vision and decreased range of motion to reach and safely dissect this highly vascularized retroperitoneal organ by laparoscopy. However, interest in minimally invasive access is growing ever since and the robotic system could certainly help overcome limitations of the laparoscopic approach in the challenging domain of pancreatic resection, notably in distal pancreatectomy. Robotic distal pancreatectomy with and without spleen preservation has been reported with encouraging outcomes for benign and borderline malignant disease. As a result of upgraded endowristed manipulation and three-dimensional visualization, improved outcome might be expected with the launch of the robotic system in the procedure of distal pancreatectomy. Our aim was thus to extensively review the current literature of robot-assisted surgery for distal pancreatectomy and to evaluate advantages and possible limitations of the robotic approach. PMID:24101006

Jung, M K; Buchs, N C; Azagury, D E; Hagen, M E; Morel, P



Localization and regulation by steroids of the ?, ? and ? subunits of the amiloride-sensitive Na + channel in colon, lung and kidney  

Microsoft Academic Search

Polyclonal antibodies have been raised against the a, ß and ? subunits of the amiloride-sensitive Na+ channel. The three subunits were detected by immunohistochemistry at the apical membrane of epithelial cells from the distal colon, the lung and the distal segments of the kidney tubules. No significant labelling was detected in lung alveoli, suggesting that it is not a major

Stéphane Renard; Nicolas Voilley; Frédéric Bassilana; Michel Lazdunski; Pascal Barbry



Unilateral distal molar movement with an implant-supported distal jet appliance.  


With the guidance of the basis of the distal jet appliance, we present a new implant-supported distal jet appliance. In this case, we used a modified distal jet appliance that was supported by a palatal implant placed at the anterior edge of the rugae region of the palate for molar distalization. The treatment results were evaluated from lateral cephalometric and panoramic radiographs and dental casts. We conclude that an implant-supported modified distal jet appliance is effective in the correction of a Class II molar relationship. PMID:11999940

Karaman, A I; Basciftci, F A; Polat, O



Periscope graft to extend distal landing zone in ruptured thoracoabdominal aneurysms with short distal necks.  


Endovascular aneurysm repair (EVAR) of ruptured thoracoabdominal aortic aneurysms may be compromised or even impossible due to short proximal and/or distal necks or landing zones, respectively. Supra-aortic branches may limit the proximal anchorage and visceral or renal arteries the distal anchorage of endografts. While solutions have been proposed to overcome the problem of a short proximal neck, no technique has been described that solves the problem of a short distal neck. We present the "periscope technique," which allows extension of the distal landing zone and complete endovascular treatment of ruptured thoracoabdominal aneurysms with short distal necks using devices already stocked in most centers performing EVAR procedures. PMID:20299176

Rancic, Zoran; Pfammatter, Thomas; Lachat, Mario; Hechelhammer, Lukas; Frauenfelder, Thomas; Veith, Frank J; Criado, Frank J; Mayer, Dieter



CB1 and TRPV1 receptors mediate protective effects on colonic electrophysiological properties in mice  

Microsoft Academic Search

CB1 and TRPV1 receptors modulate enteric neurotransmission and colonic inflammation. This study investigates early electrophysiological changes in distal colon of wild-type and receptor deficient mice after an inflammatory insult set by dinitrobenzene sulfonic acid (DNBS). Colitis was induced by DNBS in CB1?\\/? mice, TRPV1?\\/? mice, and their respective wild-type littermates. Electrophysiological properties consisting of membrane potentials and electrically induced inhibitory

A. Sibaev; F. Massa; B. Yüce; G. Marsicano; H. A. Lehr; B. Lutz; B. Göke; H. D. Allescher; M. Storr



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



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.




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)



Submucosal Invasive Micropapillary Carcinoma of the Colon with Massive Lymph Node Metastases: A Case Report  

PubMed Central

Micropapillary carcinoma was originally reported to be an aggressive variant of breast carcinoma, and it is associated with frequent lymphovascular invasion and a dismal clinical outcome. It has subsequently been found in other organs; however, at present, only a limited number of cases of colorectal micropapillary carcinoma have been reported. We present a case of early colon cancer with extensive nodal metastases in a Japanese patient. An 82-year-old man was found by colonoscopy to have a 20-mm pedunculated polyp in his sigmoid colon. Endoscopic resection of the sigmoid colon tumor was performed, and pathological examination of the resected specimen revealed a poorly differentiated adenocarcinoma component and a micropapillary component. Despite the tumor being confined within the submucosa, massive lymphatic invasion was noted. Thereafter, the patient underwent laparoscopic sigmoidectomy with lymph node dissection, and multiple lymph node metastases were observed. Our case suggests that when a micropapillary component is identified in a pre-operative biopsy specimen, even for early colorectal cancer, surgical resection with adequate lymph node dissection would be required because of the high potential for nodal metastases.

Mukai, Shoichiro; Takakura, Yuji; Egi, Hiroyuki; Hinoi, Takao; Saito, Yasufumi; Tanimine, Naoki; Miguchi, Masashi; Adachi, Tomohiro; Shimomura, Manabu; Ohdan, Hideki



Colonic insufflation with carbon monoxide gas inhibits the development of intestinal inflammation in rats  

PubMed Central

Background The pathogenesis of inflammatory bowel disease (IBD) is complex, and an effective therapeutic strategy has yet to be established. Recently, carbon monoxide (CO) has been reported to be capable of reducing inflammation by multiple mechanisms. In this study, we evaluated the role of colonic CO insufflation in acute colitis induced by trinitrobenzene sulfonic acid (TNBS) in rats. Methods Acute colitis was induced with TNBS in male Wistar rats. Following TNBS administration, the animals were treated daily with 200?ppm of intrarectal CO gas. The distal colon was removed to evaluate various parameters of inflammation, including thiobarbituric acid (TBA)-reactive substances, tissue-associated myeloperoxidase (MPO) activity, and the expression of cytokine-induced neutrophil chemoattractant (CINC)-1 in colonic mucosa 7?days after TNBS administration. Results The administration of TNBS induced ulceration with surrounding edematous swelling in the colon. In rats treated with CO gas, the colonic ulcer area was smaller than that of air-treated rats 7?days after TNBS administration. The wet colon weight was significantly increased in the TNBS-induced colitis group, which was markedly abrogated by colonic insufflation with CO gas. The increase of MPO activity, TBA-reactive substances, and CINC-1 expression in colonic mucosa were also significantly inhibited by colonic insufflation with CO gas. Conclusions Colonic insufflation with CO gas significantly ameliorated TNBS-induced colitis in rats. Clinical application of CO gas to improve colonic inflammatory conditions such as IBD might be useful.



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




SciTech Connect

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 x 10{sup 20} 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 alpha 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 Demoulin model. We find that the twist angle PHI of the magnetic field increases with time to about 2pi just prior to the eruption, but never reaches the value necessary for the kink instability.

Savcheva, Antonia; Van Ballegooijen, Adriaan, E-mail: asavcheva@cfa.harvard.ed [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States)



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



Traveling Wave Solutions for a Predator-Prey System With Sigmoidal Response Function  

NASA Astrophysics Data System (ADS)

We study the existence of traveling wave solutions for a diffusive predator-prey system. The system considered in this paper is governed by a Sigmoidal response function which is more general than those studied previously. Our method is an improvement to the original method introduced in the work of Dunbar \\cite{Dunbar1,Dunbar2}. A bounded Wazewski set is used in this work while unbounded Wazewski sets were used in \\cite{Dunbar1,Dunbar2}. The existence of traveling wave solutions connecting two equilibria is established by using the original Wazewski's theorem which is much simpler than the extended version in Dunbar's work.

Lin, Xiaobiao; Weng, Peixuan; Wu, Chufen



Fatal Septic Internal Jugular Vein-Sigmoid Sinus Thrombosis Associated with a Malpositioned Central Venous Catheter  

PubMed Central

Septic internal jugular vein-sigmoid sinus thrombosis (IJV-SST) associated with a malpositioned central venous catheter is a rare condition. It is potentially life-threatening and necessitates early diagnosis and rapid administration of appropriate medications. Unfortunately, it is difficult to diagnose due to vague clinical presentations. Several studies such as CT, MRI, and cerebral angiography should be performed and carefully examined to help make the diagnosis. We report a case of septic IJV-SST due to a malpositioned central venous catheter.

Seung, Won-Bae; Kim, Dae-Yong; Kim, Jin-Wook



[An unusual complication of perforated sigmoid diverticulitis: gas in the portal vein with miliary liver abscesses].  


A patient presented with gas in the portal vein and miliary liver abscesses due to perforation of a sigmoid diverticulitis abscess. The outcome was favorable after surgical treatment. Gas in the portal vein, a sign of extreme seriousness, is generally the result of intestinal necrosis from ileo-mesenteric artery infarction, responsible for more than 75% of deaths. Diagnosis of this exceptional complication, suggested from a straight abdominal film, was confirmed by hepatic ultrasound and scan imaging. Urgent surgical intervention can hopefully, as in the present case, result in the patient's survival. PMID:8345021

Burgard, G; Cuilleron, M; Cuilleret, J



The irritable colon  

PubMed Central

The irritable colon syndrome is a very common disorder with no serious sequelae. The cause is unknown but low dietary bulk and psychological factors are believed important. Sufferers may experience various combinations of diarrhea, constipation and abdominal pain. The mechanisms are obscure but abnormal colon motility has been amply demonstrated. Serious organic diseases such as colitis and carcinoma of the colon must be firmly excluded. Treatment consists of sympathetic explanation and reassurance, increased dietary bulk and occasional judicious use of antispasmodic agents.

Thompson, W. Grant




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


Primary peritoneal serous papillary carcinoma presenting as a single colonic mass without peritoneal dissemination.  


Peritoneal serous papillary carcinoma (PSPC), a rare primary malignancy arising from the abdominal and pelvic peritoneum, is characterized by peritoneal carcinomatosis with ascites and a histological pattern similar to that of papillary serous ovarian carcinoma. We herein describe a rare case of PSPC with unusual clinical presentations involving a single primary tumor originating from the peritoneal lining of the sigmoid colon with no evidence of intraperitoneal spread, pelvic lymph node involvement or distant metastasis. Awareness of such unusual presentations of PSPC should assist in the diagnosis of this disease, thereby improving the management of patients with this condition. PMID:23318853

Kim, Hyun-Soo; Sung, Ji-Youn; Park, Won Seo; Kim, Youn Wha



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.



[The incidence and clinical characteristics of proximal colonic polyps when the polyps are noted on rectosigmoid colon by colonoscopy].  


Background/Aims: Colorectal cancer is the third most common type of cancer and second leading cause of cancer death overall. Recently, there has been an emphasis on primary screening for colorectal cancer with colonoscopy. In this study, we aimed to address clinical characteristics and incidence of colonic polyps according to location. Methods: From January 2009 to December 2010, 6,417 total colonoscopic examinations were performed at Boramae Hospital in Seoul, Korea. We reviewed these patients retrospectively. The distal colon was defined as the rectosigmoid junction. Results: Overall, 1,972 patients (31.3%) had one of more colorectal polyps. Total of 4,445 patients were excluded from this study because of combined advanced colorectal cancer, inflammatory bowel disease, or familial adenomatous polyposis. Patients who had only proximal polyps were 633 (32.1%), 530 patients (26.9%) had both proximal and distal polyps, and 809 patients (41.0%) had polyps only in the rectosigmoid region. The prevalence of the proximal polyps in patients with rectosigmoid polyps was found to be significantly related to the male gender and elderly patients. However, the prevalence of the proximal colonic polyps was not related to the size and number of rectosigmoid polyps. In 530 patients with both rectosigmoid and proximal colonic polyps, the characteristics of proximal colonic polyps as size and number were similar to those of rectosigmoid polyps. Advanced proximal adenomas without distal polyps were found in 25 (29.4%) patients whom were associated with size and pathology. Conclusions: We recommend total colonoscopic examination in all patients regardless of the size and number, especially in elderly males. (Korean J Gastroenterol 2013;62:42-48). PMID:23954959

Joo, Sae Kyung; Kim, Ji Won; Lee, Kook Lae; Kim, Byeong Gwan; Jeong, Ji Bong; Lee, Jae Kyung; Koh, Seong Joon; Kim, Young Hoon



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

SciTech Connect

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

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



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: [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)



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



Robot-Assisted Laparoscopic Distal Ureteral Surgery  

PubMed Central

Background: The use of robotic assistance in adult genitourinary surgery has been successful in many operations, leading surgeons to test its use in other applications as well. Methods: Based on our use during prostatectomy, we have applied robotic surgery to complex distal ureteral surgeries since 2004 with successful outcomes. Results: A series of 11 patients who underwent robot-assisted laparoscopic distal ureteral surgery is presented. These surgeries include distal ureterectomy for ureteral cancer with reimplantation, as well as reimplantation with and without Boari flap or psoas hitch for benign conditions. Conclusions: Robot-assisted laparoscopic surgery can be successfully applied to patients requiring distal ureteral surgery. Maintenance of the principles of open surgery is paramount.

Wagner, Joseph R.



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



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



Colon cancer screening  


... This method checks your bowel movements for blood. Polyps in the colon and smaller cancers often cause small amounts of ... RISK PEOPLE People with certain risk factors for colon cancer may need ... This usually means first-degree relatives (parent, sibling, ...


The distal venous anatomy of the finger.  


An exhaustive anatomic dissection of all of the veins of the finger distal to the proximal interphalangeal joint was done. More than 3200 segments of veins were individually dissected out, measured, and recorded. From this survey new schematic diagrams have been drawn emphasizing the pertinent venous anatomy at the proximal, distal interphalangeal joints and eponychial levels. Suggestions are made for regions that are apt to have the largest vessels available for anastomosis. PMID:2022842

Smith, D O; Oura, C; Kimura, C; Toshimori, K



[Distal protection devices in carotid stent].  


Endovascular treatment of carotid stenoses is increasingly used. Frequently temporary occlusion balloons or filters are placed distal to the stenosis to gain additional protection against cerebral emboli. There is still a scientific debate about the usefulness of such distal protection devices. The following contribution reviews existing techniques and their clinical results and should allow for a critical discussion and selection of current techniques and materials. PMID:15549222

Berkefeld, J; du Mesnil de Rochemont, R; Sitzer, M; Zanella, F E



Nonunion of the scaphoid distal pole.  


This study was undertaken to determine the incidence of and assess factors affecting nonunion of scaphoid distal pole fractures. A total of 193 established scaphoid nonunions were treated in our clinics between the years 1999 and 2004; of which, eight cases involved the distal pole of the scaphoid. These were further analyzed to determine factors that may have contributed to the development of nonunion. This study reveals that distal pole nonunions account for 4.1% of all scaphoid nonunions. We found inadequate initial treatment to be the cause for nonunion in 63% of patients. Type IIC fracture pattern according to Posser's classification was seen in 100% of patients and a persistent Dorsal Intercalated Segmental Instability (DISI) pattern in 100% patients. In addition, 100% of fractures occurred at the watershed zone between the two vascular networks of the scaphoid. We believe the key features leading to the likelihood of nonunion at the distal pole include a Type IIC fracture pattern associated with a continued deforming force that eventually leads to a DISI deformity. The watershed area between the proximal vascular network supplying the waist and the distal one supplying the distal pole is especially vulnerable to poor healing. PMID:23413847

Oron, Amir; Gupta, Amitava; Thirkannad, Sunil



Posttreatment evaluation of the distal jet appliance.  


This study analyzed molar distalization with the distal jet appliance, its effect on the anchor teeth, and the outcome at the completion of orthodontic treatment. Pretreatment, after distalization, and posttreatment lateral cephalometric radiographs were evaluated for 21 adolescent girls and 12 adolescent boys. The mean age of the subjects at the time of the pretreatment radiograph was 12.8 +/- 2.2 years. The mean time for the correction of the Class II molar relationship was 6.7 +/- 1.7 months, and the mean total treatment time was 25.7 +/- 3.9 months. The results of this study showed that the distal jet appliance distalized the maxillary molars, but there was significant loss of anchorage. The distal jet also showed less tipping of the maxillary molars and better bodily movement of molars because the force was applied closer to the center of resistance. The observations of treatment outcome indicate that the 1.8-mm mean net anterior movement of the maxillary first molar was more than offset by the 4.8-mm mesial movement of the mandibular first molar. There was no significant increase in lower face height. Consequently the effect on the facial balance was negligible. PMID:11500660

Ngantung, V; Nanda, R S; Bowman, S J



Alterations of Colonic Contractility in Long-term Diabetic Rat Model  

PubMed Central

Background/Aims Dysfunction of the gastrointestinal tract occurs in about 76% of patients who are diabetic for more than 10 years. Although diabetes-related dysfunctions of the stomach such as gastroparesis have been extensively studied over the recent years, studies about the mechanism underlying colonic symptoms in long-term diabetes models are rare. Therefore, the goal of our study was to clarify the nature of colonic dysfunction in a long-term diabetic rat model. Methods The characteristics of colonic smooth muscle were investigated in Otsuka Long-Evans Tokushima Fatty (OLETF) rats, an animal model of type 2 diabetes. These results were compared to those obtained from Long-Evans Tokushima Otsuka (LETO) control rats. Results Spontaneous contractility of the proximal colon was significantly decreased in the diabetic rats compared to the controls, while the spontaneous contractility of the distal colon was not. The number of interstitial cells of Cajal networks in the proximal colon was greatly decreased in diabetic rats compared to the controls. Contractility of the proximal colon in response to carbachol, an acetylcholine receptor agonist, was significantly weaker in the diabetic rats. In addition, the degree of relaxation in response to nitric oxide in the proximal colon of diabetic rats also appeared to be attenuated. Conclusions The results from our study suggest that the decrease of interstitial cells of Cajal network, cholinergic receptors, and neuronal nitric oxide synthase in the proximal colon plays important roles in diabetes-related dysfunction of colon.

Kim, Sun Joo; Park, Jae Hyung; Song, Dae Kyu; Lee, Jeong Eun; Kim, Eun Soo; Cho, Kwang Bum; Jang, Byoung Kuk; Chung, Woo Jin; Hwang, Jae Seok; Kwon, Joong Goo; Kim, Tae Wan



Association of steroid use with complicated sigmoid diverticulitis: potential role of activated CD68+\\/CD163+ macrophages  

Microsoft Academic Search

Background  Immunosupression and, especially, intake of steroids have previously been identified as risk factors for complicated types\\u000a of sigmoid diverticulitis. However, little is known about the underlying molecular and cellular mechanisms. We aimed to elucidate\\u000a the potential role of activated macrophages in this respect.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A consecutive series of n?=?101 patients having undergone surgical resection for sigmoid diverticulitis at our institution was

Burkhard H. A. von Rahden; Stefan Kircher; Svenja Thiery; Denise Landmann; Christian F. Jurowich; Christoph-Thomas Germer; Martin Grimm


On the use of non-linear regression with the logistic equation for changes with time of percentage root length colonized by arbuscular mycorrhizal fungi  

Microsoft Academic Search

For the regression of sigmoid-shaped responses with time t of colonization C of roots by arbuscular mycorrhizal fungi, C=C\\u000a p\\/1+[e\\u000a ?k(t?ti)\\u000a ] is the most useful form of the logistic equation. At the time of inflection t\\u000a i the slope is maximal and directly proportional to the product of the colonization plateau C\\u000a p and the abruptness k of the

Terence P. McGonigle



Evaluation of maxillary molar distalization with the distal jet: a comparison with other contemporary methods.  


Maxillary molar distalization is an increasingly popular option for the resolution of Class II malocclusions. This communication describes the effects of one particular molar distalizing appliance, the distal jet, in a sample of 20 consecutively treated and growing subjects (11 females, nine males; mean starting age of 13) and compares these effects with those of similar devices. Pre- and postdistalization cephalometric radiographs and dental models were analyzed to determine the dental and skeletal effects. The distal jet appliances were constructed using a biomechanical couple to direct the distalizing force to the level of the maxillary first molar's center of resistance. The distal jet was the only appliance used during the distalization phase of treatment. Examination of the cephalometric tracings demonstrated that the crowns of the maxillary first molars were distalized an average of 3.2 mm into a Class I molar relationship. In the process, the first molars were tipped distally an average of 3.1 degrees, however, the amount of tipping in each case was influenced by the state of eruption of the second molar. In subjects whose second molars had erupted only to the level of the apical third of the first molar roots, distal tipping was almost twice that seen when the second molar had completed their eruption. Anchorage loss measured at the first premolars averaged 1.3 mm, but the crowns tipped 3.1 degrees distally because of the design of the appliance. The maxillary incisors were proclined an average of 0.6 degrees with minimal effect on the mandibular plane angle and lower facial height. This study suggests that the distal jet appliance effectively moves the maxillary molars distally into a Class I molar relationship with minimal distal tipping, however, some loss of anchorage is to be expected during this process. The distal jet appliance compares favorably with other intraoral distalization devices and with mechanics featuring mandibular protraction for the resolution of patients with Class II, despite the fact that these types of mechanics address different jaws. PMID:12401059

Bolla, Eugenio; Muratore, Filippo; Carano, Aldo; Bowman, S Jay



Deoxycholate is an important releaser of peptide YY and enteroglucagon from the human colon  

Microsoft Academic Search

Peptide YY (PYY) and enteroglucagon are hormonal peptides found in endocrine cells of the distal intestinal mucosa. Although it is known that plasma concentrations of both peptides increase in response to feeding, the mechanism by which ingested food causes release of colonic hormones is not understood. The release of PYY and enteroglucagon was measured in response to intraluminal stimuli in

T E Adrian; G H Ballantyne; W E Longo; A J Bilchik; S Graham; M D Basson; R P Tierney; I M Modlin



In situ characterization of O-linked glycans of Muc2 in mouse colon.  


The characterization of mucus O-linked glycans in the proximal and distal mouse colon was performed by conventional histochemical methods and by lectin histochemistry in combination with enzymatic treatment (PNGase, ?1,2 fucosidase, sialidase digestion), with and without prior desulfation. We demonstrated the presence of sialo- and sulfomucins in both the proximal and distal colon of the mouse. In the distal colon the sulfomucins were clearly prevalent, although there were always sialomucins with sialyl residues linked ?2,6 to the subterminal galactose. Sialic acid was poorly O-acetylated, especially in the distal colon. The lectin binding pattern indicates a massive presence of fucose ?1,2 linked to galactose in O-glycans and smaller quantities of fucose linked ?1,6 to N-acetylglucosamine in the core of N-linked glycans. Lectin histochemistry also demonstrated the presence of glycosidic residues of N-acetylglucosamine, N-acetylgalactosamine, and galactose in oligosaccharide chains of highly sulfated mucins. PMID:22261557

Liquori, Giuseppa Esterina; Mastrodonato, Maria; Mentino, Donatella; Scillitani, Giovanni; Desantis, Salvatore; Portincasa, Piero; Ferri, Domenico



Regulation of cation transport by low doses of glucocorticoids in in vivo adrenalectomized rat colon.  

PubMed Central

A dose response curve for glucocorticoid-induced proximal and distal colonic cation transport in vivo was established in adrenalectomized rats. All doses (0.5-50 nmol/100 g body wt) stimulated sodium absorption. Distal sodium absorption did not saturate at dexamethasone levels that saturate the glucocorticoid receptor but also bind to greater than 35% of aldosterone receptors. Saturation of the pure glucocorticoid response occurred in both segments with RU26988, a synthetic glucocorticoid that does not occupy aldosterone receptors. Maximum velocities for pure glucocorticoid-induced sodium absorption were 15 and 16 mu eq/min per g dry tissue, and Michaelis constants (Km) were 4.2 and 4.6 X 10(-9) mol/liter for proximal and distal colon. Kms are similar to the dissociation constant for the colonic glucocorticoid receptor and too low for significant aldosterone receptor occupancy. Dexamethasone increased sodium absorption significantly within 30 min of injection, suggesting the response is not dependent on new protein synthesis. Similar time and dose responses in proximal and distal colon suggest glucocorticoids stimulate the same pathway in both segments.

Bastl, C P



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


In the presence of a known colon carcinogen, 1,2-dimethyl hydrazine (DMH), the activity of beta-glucuronidase was found to be significantly increased in the distal colon, distal intestine, liver and colon contents and the activity of mucinase was increased in both the colon and fecal contents when compared to control rats. Chilli (Capsicum annum L., Solanaceae) administration also showed an increase when compared to control rats, whereas supplementation with cumin (Cuminum cyminum L., Apiaceae) and black pepper (Piper nigrum L., Piperaceae) in the presence of DMH, showed more or less similar values as that of the control rats. The increase in beta-glucuronidase activity may increase the hydrolysis of glucuronide conjugates, liberating the toxins, while the increase in mucinase activity may enhance the hydrolysis of the protective mucins in the colon. Thus cumin and black pepper may protect the colon by decreasing the activity of beta-glucuronidase and mucinase. Histopathological studies also showed lesser infiltration into the submucosa, fewer papillae and lesser changes in the cytoplasm of the cells in the colon in cumin and black pepper groups when compared to the DMH and chilli treated animals. PMID:9720607

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



tFPR: A fuzzy and structural pattern recognition system of multi-variate time-dependent pattern classes based on sigmoidal functions  

Microsoft Academic Search

tFPR is a hybrid fuzzy and structural pattern recognition system that uses fuzzy sets to represent multi-variate pattern classes that can be either static or dynamic depending on time or some other parameter space. The membership functions of the fuzzy sets that represent pattern classes are modeled by sigmoidal functions. The choice of sigmoidal functions was motivated by their ability

John A. Drakopoulos; Barbara Hayes-Roth



A new approach in maxillary molar distalization: intraoral bodily molar distalizer.  


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. Mean age for the study group was 13.53 years. Dentally, all the patients had Class II molar relationship on both sides. The patients were in permanent dentition, second molars were erupted, and the lower dental arch was well aligned. Patients showed normal or sagittally directed growth pattern. Lateral cephalograms and study models were taken and analyzed before and after molar distalization. In the present study, in order to achieve maxillary molar distalization, a new intraoral appliance was developed. The intraoral bodily molar distalizer (IBMB) was composed of 2 parts: the anchorage unit and the distalizing unit. The anchorage unit was a wide Nance button, and the active unit consisted of distalizing springs. The springs had 2 components: the distalizer section of the spring applied a crown tipping force, while the uprighting section of the spring applied a root uprighting force on the first molars. A total of 230 g of distalizing force was used on both sides. After the distal movement of the first molars, the cephalometric results of 15 patients showed the following. Maxillary first molars were moved distally by an average of 5.23 mm (P <.001) without tipping or extrusion. Maxillary first premolars were moved 4.33 mm mesially (P <.001), tipped 2.73 degrees distally (P <.05), and extruded by 3.33 mm (P <.001). Maxillary central incisors were proclined by an average of 4.7 mm (P <.001) and tipped 6.73 degrees labially (P <.01). Model analysis showed that maxillary first molars were not rotated, and intermolar distance did not change after distal movement of molars. In conclusion, unlike most of the other molar distalization mechanics, this newly developed device achieved (1) bodily distal movement of maxillary molars and (2) eliminated dependence on patient cooperation and did not require headgear wear for molar root uprighting. PMID:10629518

Keles, A; Sayinsu, K



Archaic and modern human distal humeral morphology.  


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

Yokley, Todd R; Churchill, Steven E



Topical agents for idiopathic distal colitis and proctitis.  


Rectally administered topical agents have demonstrated efficacy in the maintenance of distal colitis (DC) and proctitis and as they are rarely associated with significant blood drug levels, side effects are infrequent. The topical 5-aminosalicylic acid (5-ASA) suppositories and enemas target different regions of the distal colon and are effective for proctitis and DC, respectively. They demonstrate clinical results that are better than oral 5-ASAs and are preferred to topical steroids with better clinical, endoscopic and histological outcomes, without the risk of adrenal suppression. Disease resistant to topical agents, however, can be extremely difficult to manage. The addition of oral 5ASAs, steroids, immunosuppressants and the anti-tumor necrosis factor-? agents may be effective, but can result in significant side effects and not all patients will respond to the therapies. It is for these patients that new and novel therapies are required. Novel topical agents have been proposed for the management of resistant DC. These agents included butyrate, cyclosporine, and nicotine enemas, as well as tacrolimus suppositories, and tacrolimus, ecabet sodium, arsenic, lidocaine, bismuth, rebamipide and thromboxane enemas. While some of these agents appear to demonstrate impressive outcomes, the majority have only been examined in small open-labeled studies. There is thus a desperate need for more randomized double-blinded placebo controlled studies to investigate the clinical utility of these topical therapies. This review summarizes the efficacy of the established topical therapies, and explores the available data on the new and novel topical agents for the management of DC and proctitis. PMID:21175791

Lawrance, Ian Craig



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



Diminished nitroprusside-induced relaxation of inflamed colonic smooth muscle in mice.  

PubMed Central

The dextran sodium sulphate (DSS) induced colitis in mice was used as a experimental model to study the contractility of murine longitudinal colonic smooth muscle during inflammation. Smooth muscle segments of proximal, middle and distal colon were mounted in organ baths. Smooth muscle contraction was induced by carbachol showing an aboral increase in activity, whereas in the inflamed middle colonic segment a marked decrease in activity was observed. The dilatative effect of sodium-nitroprusside (SNP) as a nitric oxide donor was investigated after precontraction by carbachol. Both in normal and DSS segments administration of SNP to isolated mouse colonic smooth muscle preparations caused regional differences in relaxation, the highest relaxation seen in normal proximal colonic tissue. However, this relaxation was markedly reduced in inflamed proximal preparations, associated with a diminished cGMP contents.

van Bergeijk, J D; van Westreenen, H; Adhien, P; Zijlstra, F J



Perforation of the colon in a 15-year-old girl with Ehlers-Danlos syndrome type IV.  


A 15-year-old girl presented with severe fecal peritonitis due to a large spontaneous colonic perforation. The sigmoid colon was the site of a cluster of white serosal lesions with omental adhesions, of an appearance identical to that of the edges of the perforation. Her father had died at 30 years of age of spontaneous rupture of an iliac artery aneurysm, preceded by rupture of a splenic artery aneurysm and a spontaneous carotid-cavernous fistula. The clinical diagnosis of Ehlers-Danlos syndrome type IV was made, and confirmed by demonstrating that the patient's cultured fibroblasts are not producing or secreting type III collagen. Spontaneous perforation of the colon is a well-described complication of this syndrome, with a high incidence of recurrence. We recommend total abdominal colectomy to minimize the latter possibility. PMID:2273436

Soucy, P; Eidus, L; Keeley, F



Predictive Factors for Colonic Diverticular Rebleeding: A Retrospective Analysis of the Clinical and Colonoscopic Features of 111 Patients  

PubMed Central

Background/Aims Colonic diverticular bleeding can stop spontaneously or be stopped by endoscopic hemostasis. We analyzed the clinical and colonoscopic features of patients with colonic diverticular bleeding to establish the predictive factors for rebleeding. Methods A total of 111 patients (median age, 72 years) with colonic diverticular bleeding in Aso Iizuka Hospital between April 2007 and July 2010 were enrolled. Age, sex, body mass index (BMI), comorbidity, medication, location of bleeding, colonoscopic findings and hemostatic methods were analyzed retrospectively from the hospital records. Results The most common sites of bleeding were the ascending (39.6%) and sigmoid (29.7%) colon. Overt rebleeding occurred in 30 patients (27.0%). Spontaneous hemostasis was seen in 81 patients (73.0%), and endoscopic hemostatic treatment was performed in 30 patients. The BMI in the patients with colonic diverticular rebleeding was significantly higher than in patients without rebleeding. Colonoscopic findings of actively bleeding or nonbleeding visible vessels in the responsible diverticula were more frequent in the group with rebleeding. Conclusions A higher BMI and colonoscopic findings of actively bleeding or nonbleeding visible vessels can be used as predictive factors for colonic diverticular rebleeding. Patients with such findings should be carefully followed up after hemostasis of the initial colonic diverticular bleeding.

Motomura, Yasuaki; Akahoshi, Kazuya; Iwao, Risa; Komori, Keishi; Nakama, Naotaka; Osoegawa, Takashi; Itaba, Soichi; Kubokawa, Masaru; Hisano, Terumasa; Ihara, Eikichi; Nakamura, Kazuhiko; Takayanagi, Ryoichi



Use of a colonic pouch as a rectal substitute after rectal excision.  


Mid or distal rectal resection with straight coloanal anastomosis effectively treats distal rectal cancer and avoids a permanent stoma. However, the straight colonic segment is a poor reservoir for stools, and patients usually experience varying degrees of impaired rectal function after operation, including frequent bowel movements, incontinence, tenesmus, and soiling. In contrast, a J-shaped colonic pouch provides an adequate neorectal reservoir after operation. Patients with a colonic pouch-anal canal anastomosis have fewer bowel movements per day than patients with straight colorectal or coloanal anastomosis. Furthermore, the morbidity of the colonic pouch is not greater than that of the straight coloanal anastomosis. An important technical aspect of the colonic pouch procedure is that the limbs used to form the pouch must be no longer than 5 to 6 cm. Patients with larger pouches experience emptying difficulties. Also, the level of the anastomosis between the pouch and the anal canal must be no more than 4 cm from the anal verge, again to avoid problems with defecation. With these caveats, the operation should be considered in patients who require excision of the mid and distal rectum for cancer. PMID:10511890

Teixeira, F V; Pera, M; Kelly, K A


On the sigmoidal shape of current-voltage curves of photoelectrochemical solar cells  

SciTech Connect

Current-voltage (J-V) curves of n-GaAs/KOH(aq)-Se{sub 2}{sup 2{minus}}/Se{sup 2{minus}} and n-Si/acetone-LiClO{sub 4}-Fc{sup +/0} (ferrocenium ion/ferrocene) solar cells exhibit sigmoidal shapes near the open-circuit potential. J-V and flatband potential measurements indicate that the deviation of the J-V curves from the ideal square-like shape to S shape is due to the light-induced displacement of the bandedges. Analytical expression describing the dependence of light-induced bandedge shifts on the anodic photocurrent, the density of surface states, and the interfacial charge-transfer velocity are derived and verified experimentally. Application of the expressions to J-V data yields quantitative information on the kinetics of interfacial charge transfer.

Mao, D.; Kim, K.J.; Frank, A.J. [National Renewable Energy Lab., Golden, CO (United States)



Portal Vein Thrombosis after Restorative Proctocolectomy for Familial Adenomatous Polyposis and Sigmoid Cancer  

PubMed Central

Postoperative portal vein thrombosis (PVT) is rare, but has been described after various open as well as minimal access abdominal operations, especially splenectomy and colorectal surgical procedures. We report the case of a 39-year-old female who underwent restorative proctocolectomy and ileal pouch-anal anastomosis for familial adenomatous polyposis with sigmoid cancer. She presented 14 days later with vague upper abdominal pain, nausea, vomiting and high output stoma. Doppler ultrasonography confirmed PVT and therefore anticoagulant therapy was started. Her condition improved dramatically and she underwent closure of ileostomy after finishing adjuvant chemotherapy. She remained well at 3-year follow-up with good pouch function and no local or distant recurrence. A high index of suspicion is essential for early diagnosis and prompt treatment of postoperative PVT after restorative proctocolectomy. Early anticoagulation is essential to avoid subsequent complications.

Meshikhes, Abdul-Wahed Nasir; Al-Ghazal, Thabit



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



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.



[The colonosphincterometrogram (CSMG). An original method of simultaneous study of the motility of the left colon and of the anal sphincters].  


Colonsphinctorometrography (CSMG) is a new, original method for the simultaneous investigation of the motility of the descending colon, sigmoid colon, rectosigmoid junction, rectum, and internal and external anal sphincters. A 60 cm open-ended tip sound with an external diameter of 10 mm is used. Three 3 cm long stimulating balloons are located at points 15 cm, 30 cm, and 50 cm along its length. A basal recording is taken for about 15 min with the patient absolutely at rest. The balloons are then inflated to measure the kinetic responses of colon and anal sphincters to stimuli of different volume. In addition to offering a pressure recording for the left colon and internal sphincter, the method also provides an EMG for the external sphincter and a pneumogram. PMID:7366870

Reboa, G; Giusto, F; Secco, G B; Terrizzi, A; Berti Riboli, E



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))



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


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

Sudo, Yoshio; Enomoto, Yoshinori



Reconstructive treatment of dural arteriovenous fistulas of the transverse and sigmoid sinus: transvenous angioplasty and stent deployment  

Microsoft Academic Search

Various techniques for the endovascular treatment of dural arteriovenous fistulas (dAVFs) of the transverse and sigmoid sinus have recently evolved. Transvenous coil occlusion of the involved segment and transarterial embolization of the feeding arteries with liquid agents are the commonest treatments utilized. However, with respect to venous hypertension as the probable pathogenic cause of this disorder, a nonocclusive or remodeling

T. Liebig; H. Henkes; S. Brew; E. Miloslavski; M. Kirsch; D. Kühne



Gdnf is mitogenic, neurotrophic, and chemoattractive to enteric neural crest cells in the embryonic colon.  


Glial-derived neurotrophic factor (Gdnf) is required for morphogenesis of the enteric nervous system (ENS) and it has been shown to regulate proliferation, differentiation, and survival of cultured enteric neural crest-derived cells (ENCCs). The goal of this study was to investigate its in vivo role in the colon, the site most commonly affected by intestinal neuropathies such as Hirschsprung's disease. Gdnf activity was modulated in ovo in the distal gut of avian embryos using targeted retrovirus-mediated gene overexpression and retroviral vector-based gene silencing. We find that Gdnf has a pleiotropic effect on colonic ENCCs, promoting proliferation, inducing neuronal differentiation, and acting as a chemoattractant. Down-regulating Gdnf similarly induces premature neuronal differentiation, but also inhibits ENCC proliferation, leading to distal colorectal aganglionosis with severe proximal hypoganglionosis. These results indicate an important role for Gdnf signaling in colonic ENS formation and emphasize the critical balance between proliferation and differentiation in the developing ENS. PMID:21465624

Mwizerwa, Olive; Das, Pragnya; Nagy, Nandor; Akbareian, Sophia E; Mably, John D; Goldstein, Allan M



Gdnf is mitogenic, neurotrophic, and chemoattractive to enteric neural crest cells in the embryonic colon  

PubMed Central

Glial-derived neurotrophic factor (Gdnf) is required for morphogenesis of the enteric nervous system (ENS) and it has been shown to regulate proliferation, differentiation, and survival of cultured enteric neural crest-derived cells (ENCCs). The goal of this study was to investigate its in vivo role in the colon, the site most commonly affected by intestinal neuropathies such as Hirschsprung’s disease. Gdnf activity was modulated in ovo in the distal gut of avian embryos using targeted retrovirus-mediated gene overexpression and retroviral vector-based gene silencing. We find that Gdnf has a pleiotropic effect on colonic ENCCs, promoting proliferation, inducing neuronal differentiation, and acting as a chemoattractant. Downregulating Gdnf similarly induces premature neuronal differentiation, but also inhibits ENCC proliferation, leading to distal colorectal aganglionosis with severe proximal hypoganglionosis. These results indicate an important role for Gdnf signaling in colonic ENS formation and emphasize the critical balance between proliferation and differentiation in the developing ENS.

Mwizerwa, Olive; Das, Pragnya; Nagy, Nandor; Akbareian, Sophia E.; Mably, John D.; Goldstein, Allan M.



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



Antioxidant and DNA methylation-related nutrients and risk of distal colorectal cancer  

Microsoft Academic Search

Objective  To investigate the relationship between antioxidant nutrients (vitamins C and E, ?-carotene, selenium) and DNA methylation-related\\u000a nutrients (folate, vitamins B6 and B12) and distal colorectal cancer risk in whites and African Americans and to examine intakes\\u000a from food only versus total (food plus dietary supplements) intakes.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Data are from the North Carolina Colon Cancer Study-Phase II, a case–control study of

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



Colonic pseudo-obstruction.  


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

Durai, R



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.




About This Booklet 1 The Colon and Rectum 2 Understanding Cancer 3 Risk Factors 4 Screening 7 Symptoms 9 Diagnosis 9 Staging 11 Treatment 13 Nutrition and Physical Activity 25 Rehabilitation 26 Follow-up Care 26 Complementary Medicine 27 Sources of Support 28 The Promise of Cancer Research 29 Dictionary 32 National Cancer Institute Information Resources 42 National Cancer Institute Publications 43 About This Booklet This National Cancer Institute (NCI) booklet is about cancer of the colon and rectum.


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

PubMed Central

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

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



Three-dimensional bimetric maxillary distalization arches compared with a modified Begg intraoral distalization system.  


The purpose of this study was to compare the dentofacial effects of two intraoral molar distalization techniques [three-dimensional bimetric maxillary distalization arches (3D-BMDA) and a modified Begg intraoral distalization system (MBIDS)] in subjects requiring maxillary molar distalization. Twenty-one patients (12 females and 9 males, mean age pre-treatment: 14.7 +/- 1.50 years) were treated with the 3D-BMDA and 17 (14 females and 3 males, mean age pre-treatment: 14.4 +/- 1.43 years) with the MBIDS. Measurements were recorded from lateral cephalometric radiographs taken at two different points in time: at the start of treatment for the MBIDS group and prior to distalization for the 3D-BMDA group (T1) and post-distalization (T2). Student's t- and paired t-tests were used to determine differences between and within the groups. The total amount of distalization for the 3D-BMDA and MBIDS groups was similar (3.55 and 3.27 mm, respectively). However, there were statistically significant differences in the length of the distalization period (3.4 and 6.5 months, respectively) and the amount monthly of distalization (1.11 and 0.54 mm, respectively). The most significant differences were observed in the mandibular dental arches and vertical facial dimensions. Anchorage loss in the mandible was greater in the 3D-BMDA group, whereas increases in facial dimensions were greater in the MBIDS group. Both 3D-BMDA and MBIDS techniques were found to be effective to obtain distal movement of the maxillary molars. In order to achieve successful results, the side-effects of each treatment modality on dentofacial structures need to be taken into consideration. PMID:17947349

Altug-Atac, Ayse Tuba; Erdem, Dilek; Arat, Züleyha Mirzen



Distal tibiofibular ligaments. Analysis of function.  


The function of the anterior tibiofibular ligament, of the syndesmosis between the distal parts of the tibia and fibula, and of the posterior tibiofibular ligament was elucidated by tracing mobility patterns before and after successive ligament transection in varying sequence. Eighteen osteoligamentous preparations were studied. Mobility was only minimally influenced by isolated cutting of the anterior tibiofibular ligament, and even complete cutting of the distal tibiofibular ligaments involved only minor abnormality in motion. However, external rotation was greatly increased by further cutting of the anterior part of the deltoid ligament or of the posterior talofibular ligament. This indicates that isolated injury of the anterior tibiofibular ligament must be rare, and total rupture of the distal tibiofibular structures is presumably as a rule combined with lesions of the anterior part of the deltoid ligament and/or of the posterior talofibular ligament. PMID:7102288

Rasmussen, O; Tovborg-Jensen, I; Boe, S



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



Comparison of a Magnetohydrodynamical Simulation and a Non-Linear Force-Free Field Model of a Sigmoidal Active Region.  

NASA Astrophysics Data System (ADS)

Sigmoids are solar magnetic structures where highly non-potential fields (strong shear/twist) are believed to be present. Thanks to the high level of free magnetic energy, active regions with sigmoids possess a higher eruptivity. In the present study, we will present a comparive topological analysis between a Non-Linear Force Free Field (NLFFF) model of sigmoid region, and a three-dimensional (3D) magnetohydrodynamics numerical simulation of the formation and eruption of such a structure. The MHD simulation is based on an idealized magnetic field distribution and the sigmoidal flux rope is built by means of shearing motions and magnetic polarity diffusion. The NLFFF model is based on the flux rope insertion method which utilizes line of sight magnetograms and X-ray observations of the region to constrain the models. We compare the geometrical and topological properties of the 3D magnetic fields given by both methods in their pre-eruptive phases. We arrive at a consistent picture for the evolution and eruption of the sigmoid by using the idealized MHD simulation as a context for the more specific observationally-constrained NLFFF models and data. Although, the two models are very different in their setups, we identify strong similarities between the two models and understandable differences. By computing the squashing factor in different horizontal maps at various heights above the photosphere and in vertical cuts in the domains, we demonstrate the existence of key Quasi-Separatrix Layers (QSL) eventually involved in the dynamic of the structure. We also show that there are electric current concentrations coinciding with the main QSLs. Finally, we perform torus instability analysis and show that a combination between reconnection at the main QSL and the resulting expansion of the flux rope into the torus instability domain is the cause of the CME in both models. This study finally highlights the interest of the use of in-depth topological tools to study highly non-potential magnetic fields.

Pariat, Etienne; DeLuca, Edward; Van Ballegooijen, Adriaan; Aulanier, Guillaume; Savcheva, Antonia



Unilateral molar distalization with a modified slider.  


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



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



Management of malunions of the distal radius.  


Despite encouraging results from small case series, correction of distal radius malunion remains a challenging procedure with uncertain outcomes. The most appropriate treatment for a distal radius malunion is prevention. If a symptomatic malunion is discovered, correction should be undertaken as early as possible. It is recommended that action be taken within six months of the primary injury to decrease the negative impact of soft-tissue contracture on the eventual reconstruction. Although some patients complain about residual problems after malunion surgery, corrective surgery has been shown to improve both radiographic and functional outcomes, and may prevent future secondary problems. PMID:22554664

Haase, Steven C; Chung, Kevin C



Triplication of distal chromosome 10q  

PubMed Central

We describe a patient with a de novo chromosomal aberration with karyotype 46,XY,10q+, presenting clinical features of partial duplication of distal chromosome 10q. Further studies using microsatellites and FISH showed a triplication of distal chromosome 10q. The rearrangement involved both maternal homologues and the middle chromosomal 10q fragment of the triplication was inverted, similar to previously reported chromosomal triplications. Chromosomal triplications may be more frequent than assumed and may share a common molecular mechanism.???Keywords: chromosome 10q; triplication; FISH; cytogenetics

Devriendt, K.; Matthijs, G.; Holvoet, M.; Schoenmakers, E.; Fryns, J.



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



The effect of short-chain fatty acids on Cl ? and K + conductance in rat colonic crypts  

Microsoft Academic Search

The effect of butyrate on membrane potential and membrane currents of colonic enterocytes was studied with the whole-cell patch-clamp method. Superfusion of crypts from the rat distal colon with butyrate-containing solutions induced a membrane depolarization of 16.5±2.3 mV. This response was only observed in the upper third of the crypt. The depolarization was dependent on the presence of Cl- and

M. Diener; E. Scharrer



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

PubMed Central

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

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



The early days of diverticula of the colon.  


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



Colon Transit Time According to Physical Activity Level in Adults  

PubMed Central

Background/Aims Physical activity (PA) is associated with a reduced risk of colorectal cancer. Thus, we examined the colon transit time (CTT) according to the physical activity level (PAL) in Korean adults. Methods The study subjects were 49 adults: 24 males and 25 females. The subjects used an accelerometer for 7 consecutive days to measure the 1-week PAL. The subjects took a capsule containing 20 radio-opaque markers for 3 days. On the fourth day, a supine abdominal radiography was performed. According to the total activity count of all study subjects, the upper 25%, middle 50% and lower 25% were classified into the high (H), moderate (M) and low (L) physical activity (PA) groups, respectively. Results The total CTT was significantly longer in the female (25.8 hours) than in the male subjects (7.4 hours) (P = 0.002). In regard to difference on PAL, although there was no significant difference among the male subjects, the right CTT in the female subjects was significantly shorter in H group than in M group (P = 0.048), and the recto-sigmoid CTT was significantly shorter in H group than in L group (P = 0.023). Furthermore, there were significant differences in total CTT between L and M groups (P = 0.022), M and H groups (P = 0.026) and between L and H groups (P = 0.002). Conclusions The female, but not male, subjects showed that moderate and high PAL assisted colon transit.

Song, Bong Kil; Cho, Kang Ok; Jo, Yunju; Oh, Jung Woo



Inflammation and gastrointestinal Candida colonization  

PubMed Central

SUMMARY Candida organisms commonly colonize the human gastrointestinal tract as a component of the resident microbiota. Their presence is generally benign. Recent studies, however, show that high level Candida colonization is associated with several diseases of the gastrointestinal tract. Further, results from animal models argue that Candida colonization delays healing of inflammatory lesions and that inflammation promotes colonization. These effects may create a vicious cycle in which low-level inflammation promotes fungal colonization and fungal colonization promotes further inflammation. Both inflammatory bowel disease and gastrointestinal Candida colonization are associated with elevated levels of the pro-inflammatory cytokine IL-17. Therefore, effects on IL-17 levels may underlie the ability of Candida colonization to enhance inflammation. Because Candida is a frequent colonizer, these effects have the potential to impact many people.

Kumamoto, Carol A.



Neonatal Colon Insult Alters Growth Factor Expression and TRPA1 Responses in Adult Mice  

PubMed Central

Inflammation or pain during neonatal development can result in long-term structural and functional alterations of nociceptive pathways, ultimately altering pain perception in adulthood. We have developed a mouse model of neonatal colon irritation (NCI) to investigate the plasticity of pain processing within the viscerosensory system. Mouse pups received an intracolonic administration of 2% mustard oil (MO) on postnatal days 8 and 10. Distal colons were processed at subsequent timepoints for myeloperoxidase (MPO) activity and growth factor expression. Adult mice were assessed for visceral hypersensitivity by measuring the visceromotor response during colorectal distension. Dorsal root ganglion (DRG) neurons from adult mice were retrogradely labeled from the distal colon and calcium imaging was used to measure transient receptor potential vanilloid 1 (TRPV1) and ankyrin 1 (TRPA1) responses to acute application of capsaicin and MO, respectively. Despite the absence of inflammation (as indicated by MPO activity), neonatal exposure to intracolonic MO transiently maintained a higher expression level of growth factor messenger RNA (mRNA). Adult NCI mice displayed significant visceral hypersensitivity, as well as increased sensitivity to mechanical stimulation of the hindpaw, compared to control mice. The percentage of TRPA1-expressing colon afferents was significantly increased in NCI mice, however they displayed no increase in the percentage of TRPV1-immunopositive or capsaicin-sensitive colon DRG neurons. These results suggest that early neonatal colon injury results in a long-lasting visceral hypersensitivity, possibly driven by an early increase in growth factor expression and maintained by permanent changes in TRPA1 function.

Christianson, Julie A.; Bielefeldt, Klaus; Malin, Sacha A.; Davis, Brian M.



Distally based dorsalis pedis island flap for a distal lateral electric burn of the big toe.  


Reconstruction of the small defects in the distal portion of the foot has always represented a difficult problem. A case of a young man with a deep electric burn of the distal lateral side of the big toe successfully treated with a distally based dorsalis pedis island flap based on the first dorsal metatarsal artery (FDMA) is presented. The donor site area of the dorsum of the foot was grafted, and deambulation was reassumed 3 weeks later. Advantages; limits and anatomical consideration regarding the viability of the flap are also discussed. PMID:8982547

Governa, M; Barisoni, D



Partial rupture of the distal biceps tendon  

Microsoft Academic Search

We report on 7 cases of partial rupture of the distal biceps tendon. The mean patient age was 52 years (range, 38-58 years). There were 5 men and 2 women. The dominant arm was affected in all 7 patients. Pain was the chief complaint in all patients. Immobilization and physiotherapy were attempted in all patients, and 4 had at least

Dimitris G. Vardakas; Douglas S. Musgrave; Sokratis E. Varitimidis; Felix Goebel; Dean G. Sotereanos



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



Distal Xq duplication and functional Xq disomy  

Microsoft Academic Search

Distal Xq duplications refer to chromosomal disorders resulting from involvement of the long arm of the X chromosome (Xq). Clinical manifestations widely vary depending on the gender of the patient and on the gene content of the duplicated segment. Prevalence of Xq duplications remains unknown. About 40 cases of Xq28 functional disomy due to cytogenetically visible rearrangements, and about 50

Damien Sanlaville; Caroline Schluth-Bolard; Catherine Turleau



Triplane fracture of the distal tibia  

Microsoft Academic Search

A prospective study of 21 triplane fractures of the distal tibia is presented. Nineteen cases (90.5%) had lateral triplane fractures, while the other two (9.5%) had medial triplane fractures. Two fragment fractures were encountered in 12 cases (57%); three fragment fractures in six cases (29%), and four fragment fractures in the remaining three cases (14%). Fourteen cases (67%) were managed

E. El-Karef; H. I. Sadek; D. S. Nairn; C. H. Aldam; P. W. Allen



Distal Airway Impairment in Obese Normoreactive Women  

PubMed Central

Background. Asthma-like symptoms are frequent in overweight and obesity, but the mechanism is unclear when airway hyperresponsiveness (AHR) is lacking. In this study, we focused on obese women with a clinical suspicion of asthma but negative methacholine challenge and tested distal airway hyperreactivity, explored by Forced Vital Capacity dose-response slope (FVC DRS). Objective. To question AHR at the distal airway level in obese women. Methods. A total of 293 symptomatic obese and nonobese women free of treatment were investigated. Methacholine challenge tests were undertaken, and patients were divided according to their results to the test. In hyperreactive and nonhyperreactive patients and in our total population, correlations, regression analyses, and analyses of covariance were performed to compare distal airway hyperreactivity in three groups of body mass index (BMI). Results. After adjusting for age and baseline respiratory values, the relationship between FVC and FEV1 (forced expiratory volume in one second) DRS was influenced by BMI, with a lower slope in obese than overweight and normal patients in our total population (P = 0.008) and in our nonhyperreactive one (P = 0.028). Conclusion. Distal airway hyperresponsiveness was observed in symptomatic wheezing obese women negative to methacholine challenge.

Marin, Gregory; Gamez, Anne Sophie; Molinari, Nicolas; Kacimi, Djamila; Paganin, Fabrice; Chanez, Pascal; Bourdin, Arnaud



Ligamentous anatomy of the distal clavicle  

Microsoft Academic Search

We describe the insertional variations of supporting ligaments of the acromioclavicular joint, especially with respect to gender. We analyzed 41 cadaveric clavicles (22 female and 19 male) with attached ligaments. The distance between the insertion of the trapezoid ligament and the distal end of the clavicle was not significantly different between sexes, although that of the conoid ligament and the

Kevin J Renfree; Michael K Riley; Donna Wheeler; Joseph G Hentz; Thomas W Wright



Therapeutic transplantation of the distal gut microbiota  

Microsoft Academic Search

Although it is generally accepted that the distal gut microbiota are relatively stable in healthy adult individuals, a collapse of the microbial community structure resulting from antibiotic therapy or pathogen presence can lead to gut dysfunction. However, recent findings demonstrate that it is possible to engraft new microbiota from a donor source, resulting in the restoration of gut functionality and

A Khoruts; M J Sadowsky



Genetics Home Reference: Distal arthrogryposis type 1  


... proteins to help regulate the tensing of muscle fibers (muscle contraction). It is unclear how mutations in the TPM2 and MYBPC1 genes lead to the joint abnormalities characteristic of distal arthrogryposis type 1. However, researchers speculate that contractures may be ...


Ultrasound of colon diverticulitis.  


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

Puylaert, Julien B C M



Effects of the enterokinetic prucalopride (R093877) on colonic motility in fasted dogs.  


The novel enterokinetic drug prucalopride was tested at various intravenous and oral doses in fasted dogs to assess: (i) the effects on colonic contractile motility patterns; and (ii) the mediation of these effects by 5-hydroxytryptamine (5-HT4) receptors. Colonic motility patterns were assessed in conscious dogs with four chronically implanted strain-gauge force transducers that were sutured on the serosal side of the colon. Prucalopride altered colonic contractile motility patterns in a dose-dependent fashion by stimulating high-amplitude clustered contractions in the proximal colon and by inhibiting contractile activity in the distal colon. Prucalopride was equipotent after oral and intravenous administration, as reflected by the values for the effective dose that induced 50% of maximum effect (95% confidence limits): 0.04 mg kg(-1) p.o. (0.01-0.1 mg kg(-1)) and 0.01 mg kg(-1) i.v. (0.006-0.04 mg kg(-1)). Prucalopride also caused a dose-dependent decrease in the time to the first giant migrating contraction (GMC); at higher doses of prucalopride, the first GMC generally occurred within the first half-hour after treatment. Subcutaneous pretreatment with the 5-HT4 receptor antagonist GR125487 (40 microg kg(-1) bodyweight) completely prevented the effects of orally administered prucalopride (0.31 mg kg(-1) bodyweight). Prucalopride, given orally or intravenously, alters colonic motility in the fasted conscious dog in a dose-dependent fashion. It induces GMCs and causes proximal colon stimulation and distal colon inhibition of contractile motility patterns by stimulating 5-HT4 receptors. PMID:11696108

Briejer, M R; Prins, N H; Schuurkes, J A



Central neurotensin nerves modulate colo-colonic reflex activity in the guinea-pig inferior mesenteric ganglion.  

PubMed Central

1. The effects of neurotensin and of stimulation of preganglionic nerves on peripheral afferent synaptic input from segments of distal colon to neurones in the inferior mesenteric ganglia of guinea-pigs were studied using intracellular recording techniques in vitro. 2. Electrical stimulation of colonic afferent nerve fibres evoked fast, nicotinic synaptic responses (fast EPSPs or action potentials) followed by a slow depolarizing response (slow EPSP). 3. Neurotensin (1 microM) increased the amplitude and duration of slow EPSPs evoked by stimulation of colonic afferents. 4. Distention of a segment of distal colon left attached to an inferior mesenteric ganglion evoked a slow depolarization. Neurotensin (1 microM) increased the amplitude and duration of distention-induced depolarizations. 5. Electrical stimulation of central preganglionic nerve fibres present in the third and fourth lumbar ventral roots increased the amplitude and duration of slow EPSPs evoked by electrical stimulation of colonic afferent nerves. This facilitatory effect was abolished after desensitization to neurotensin. 6. Slow depolarizations evoked by neurotensin and by stimulation of central preganglionic nerves converted subthreshold fast EPSPs due to mechanosensory synaptic input from an attached segment of distal colon to action potentials. This increase in firing rate of sympathetic ganglion cells led to a decrease in colonic intraluminal pressure. 7. Taken together these data support the hypothesis that neurotensin or a closely related substance contained in central preganglionic nerves facilitated release of a non-cholinergic excitatory transmitter from colonic mechanosensory nerves. The slow depolarization evoked by the non-cholinergic transmitter converted on-going subthreshold fast EPSPs to action potentials thereby increasing sympathetic output to the colon. 8. It is suggested that under normal in vivo conditions, central preganglionic fibres containing neurotensin or a closely related peptide modulate peripheral reflex activity through prevertebral ganglia in guinea-pigs. Images Fig. 3 Fig. 5

Stapelfeldt, W H; Szurszewski, J H



[Complicated colonic diverticulitis at 34 weeks gestation].  


Peritonitis is a set of symptoms of varying etiology usually with an accompanying infection, systemic and local changes within the peritoneal cavity Colonic diseases, especially colon perforation, are one of the most common causes of peritonitis. The course of the disease may be turbulent due to sudden perforation. In case of limited peritonitis the disease is not as acute as the perforation hole is small and it can be sealed by the omentum and internal organs. Abdominal pain is usually located around the source of infection and is less severe. A 38-year-old patient at 34 weeks gestation was hospitalized in the obstetric-gynecological ward of the Health Care Center with a diagnosis of preterm delivery urinary infection and renal colic. Due to increasing peritoneal symptoms and deteriorating general condition of the patient, a decision to perform immediately exploratory laparotomy combined with the Cesarean section was made. The surgeon indicated a place in the left mesogastrium that could correspond with a drained interintestinal abscess and also found a large amount of fibrin in the lower floor of the peritoneal cavity The initial point of the abscess remained unknown and the patient received total parenteral nutrition for 10 days. On 5 postoperative day the drain was removed from the peritoneal cavity and since day 10 patient health was steadily improving. Bacteriological cultures revealed abundant growth of E. coli that showed sensitivity to the used antibiotics. On 22 postoperative day the patient and her child were discharged home in good condition. Five months later the patient was admitted to the surgical ward with acute abdominal pain with the diagnosis of an abscess in her left mesogastric and subgastric area, perforation of sigmoid diverticulum and fecal fistula. Our case illustrates great difficulties in diagnosing diseases of the abdominal cavity during pregnancy because causes and symptoms may be typical of this condition, as well as of unrelated diseases, including: kidney problems, appendicitis, cholecystitis and bowel disease. Examination of the pregnant patient presents a challenge and the symptoms are uncharacteristic. Tension of the abdominal wall, as well as the muscles of the digestive and urinary tract are reduced and the topography of the internal organs changes during pregnancy. The interpretation of laboratory tests becomes more difficult. In our case, the initial local peritonitis, caused by microperforation of the diverticulum, ran a latent course and was masked by both pregnancy and renal colic symptoms, consequently leading to diffuse peritonitis. The presented case demonstrates the importance of the problem and forces obstetricians to be more vigilant in determining the diagnosis and decision-making, because of its meaning for the health and even the life of the patient and her child. PMID:23488299

Milczarek-?ukowiak, Maria; Pyziak, Andrzej; Kocemba, Wojciech; P?usajska, Justyna



Proliferative and morphologic changes in rat colon following bypass surgery.  

PubMed Central

In this study the proliferative and morphologic changes that occur in the colon of normal and dimethylhydrazine-treated rats following surgical bypass of the middle third of the colon are reported. Proliferative changes were measured by estimating accumulated mitotic indexes following vinblastine treatment and morphologic changes were observed with the use of light microscopy and scanning electron microscopy. Data were collected on Days 0, 7, 14, 30, and 72 after surgery. The results show that surgical bypass produces contrasting effects in the segments proximal to and distal to the suture line. In the proximal segment there was morphologic evidence of hyperplasia, although proliferative activity was unchanged except for an increase at 7 days in normal rats. In the distal segment there was a long-lived increase in the mitotic index, although morphologic changes were not seen. The results for DMH-treated rats were similar to those in normal rats. Groups of isolated dysplastic epithelial cells were often seen in the submucosa adjacent to sutures up to 72 days after surgery. Increased lymphoid infiltration was seen in segments proximal to but not distal to the suture line. It is hypothesized that the different responses of the proximal and distal segments may be related to the different embryologic origins of those segments. It is also hypothesized that the seeding of the submucosa with epithelial cells during suturing may be a factor in tumor recurrence. Images Figure 19 Figure 20 Figure 21 Figure 22 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 Figure 14 Figure 15 Figure 16 Figure 17 Figure 18

Barkla, D. H.; Tutton, P. J.



Sigmoidal concentration dependence of antimicrobial peptide activities: a case study on alamethicin.  

PubMed Central

The transition of the state of alamethicin from its inactive state to its active state of pore formation was measured as a function of the peptide concentration in three different membrane conditions. In each case the fraction of the alamethicin molecules occupying the active state, phi, showed a sigmoidal concentration dependence that is typical of the activities of antimicrobial peptides. Such a concentration dependence is often interpreted as due to peptide aggregation. However, we will show that a simple effect of aggregation cannot explain the data. We will introduce a model based on the elasticity of membrane, taking into consideration the membrane-thinning effect due to protein inclusion. The elastic energy of membrane provides an additional driving force for aggregation. The model produces a relation that not only predicts the correct concentration dependence but also explains qualitatively how the dependence changes with membrane conditions. The result shows that the membrane-mediated interactions between monomers and aggregates are essential for the strong cooperativity shown in pore formation.

Chen, Fang-Yu; Lee, Ming-Tao; Huang, Huey W



[Metachronous primary cancers of the colon and stomach].  


We report herein a case of 69 years old woman who, in the course of 11 years, developed two cancers: carcinoma of the colon fistulization in duodenum and adenocarcinoma of the stomach. No polyposis has been found. This patient successfully underwent a right hemicolectomy with pancreaticoduodenectomy (Traverso-Longmire procedure). A decade later, she suffered a total gastrectomy with distal pancreatectomy for gastric adenocarcinoma. The patient made an uneventful postoperative recovery. Although patients with primary multiple cancers are not common, it is nonetheless important for clinicians to consider the possibility of metachronous cancers in patients who were treated for a primary malignant tumor. PMID:16610181

Pricop, C?t?lina; Lefter, L P; Scripcariu, V; Danciu, M; Buleu, Daniela; Dragomir, Cr


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

Microsoft Academic Search

Aim:The cerebral state index (CSI) was recently introduced as an electroencephalographic monitor for measuring the depth of anesthesia. We compared the performance of CSI to the bispectral index (BIS) as electroencephalographic measures of sevoflurane effect using two combined sigmoidal Emax models.Methods:Twenty adult patients scheduled for laparotomy were studied. After induction of general anesthesia, sevoflurane concentrations were progressively increased and then

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