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Sample records for distal sigmoid colon

  1. Colon cancer presented with sigmoid volvulus: A case report

    PubMed Central

    Aras, Abbas; K?z?ltan, Remzi; Batur, Abdussamet; elik, Sebahattin; Y?lmaz, zkan; Kotan, etin

    2015-01-01

    Introduction Sigmoid volvulus is the most prevalent type of colonic volvulus. Colon cancer is seen less where sigmoid volvulus is common, so it is rare to see that colon cancer is synchronous with sigmoid volvulus. Presentation of case We would like to present a case of sigmoid volvulus caused by colon cancer in a male patient aged 80 who was referred to the hospital with toxaemic shock presentation. Discussion Sigmoid cancer can be presented as sigmoid volvulus to the emergency department. In intestinal obstruction early diagnosis is of crucial importance. Computarized tomography is a diagnosis tool that should be preferred both in the diagnosis of obstruction and in detecting its cause, localisation, degree and complications. Conclusion When surgery is performed due to the urgent colonic obstruction in colonic volvulus diagnosed patients, a colon tumour should be considered in the same column loops or in the distal colon. We believe that CT is the method that should be preferred in large-bowel obstruction suspected patients. PMID:26519810

  2. Small intestinal complications of diverticulitis of the sigmoid colon

    SciTech Connect

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

    1986-12-19

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

  3. Robotic adrenalectomy for sigmoid colon cancer oligometastasis

    PubMed Central

    Pai, Vishwas D.; Bhandare, Manish; Deodhar, Kedar; Yuvaraja, Thyavihally Boregowda

    2015-01-01

    Solitary adrenal metastasis from colorectal cancer is rare with reported incidence from 3.1% to 14.4% in the literature. Conventionally, adrenal metastasis is considered as indicative of widespread systemic disease and hence treated with palliative intent. Surgical resection remains controversial although a median survival of 32 months was found in the largest reported case series. It has been postulated that surgical resection should be offered when the adrenal metastasis develops more than 6 months after the treatment of the primary tumor. For the metastatic lesions and potentially malignant lesions, role of minimally invasive surgery is still considered controversial. We are presenting a case of metachronous, solitary adrenal metastasis from sigmoid colon carcinoma treated surgically with curative intent. PMID:26807417

  4. [Bladder replacement with sigmoid colon for bladder cancer].

    PubMed

    Nishimura, N; Suzu, H; Yushita, Y; Yamashita, S; Kanetake, H; Saito, Y; Sakuragi, T

    1991-01-01

    From 1972 to 1989, 21 patients underwent bladder replacement with sigmoid colon after cystectomy for bladder cancer. A portion of sigmoid colon (about 15 to 20 cm) was isolated and anastomosed to the urethral stump. Then the ureters were implanted in the sigmoid colon via submucosal tunnels. There were 20 men and 1 woman, ranging in age from 24 to 71 years (average 51 years). Preoperative investigations showed that all the cases were free of metastasis. Five years survival rate was 60.7% and there was no operative mortality. There was urethral recurrence in one case and in that case postoperative histopathology revealed carcinoma in situ with tumor. All patients were able to void by themselves without any difficulty. Five patients complained mild incontinence at daytime and all patients had mild incontinence during deep sleep at night, but all of them could maintain their normal daily life like before. The major postoperative complications were: leak at the site of anastomosis (between sigmoid colon and urethra) in 6 cases, hydronephrosis in 2 cases, VUR in 2 cases and bladder stone in 1 case. The patients who underwent bladder replacement with sigmoid colon were well satisfied, because there were no external stoma and the patients could void by themselves. From now, we want to improve our operative method in order to avoid postoperative incontinence. PMID:2046199

  5. Role of the Enteric Nervous System in the Elongated Sigmoid Colon of Patients With Sigmoid Volvulus

    PubMed Central

    Tomita, Ryouichi; Sugitou, Kiminobu; Sakurai, Kenichi; Fujisaki, Shigeru; Ikeda, Taro; Koshinaga, Tsugumichi

    2014-01-01

    To clarify the physiologic function of the enteric nervous system (ENS) in the elongated sigmoid colon (ESC) of patients with sigmoid volvulus (SV), we examined the enteric nerve responses in lesional and normal longitudinal muscle strips (LMS) derived from patients with ESC and patients who underwent colon resection for colonic cancers. Thirty preparations of LMS were taken from the lesional sigmoid colons of 10 ESC patients with SV (8 men and 2 women, aged 53 to 80 years, mean 66.2 years). Forty preparations of LMS were taken from the normal sigmoid colons (NSC) of 20 patients with colonic cancer (12 men and 8 women, aged 55 to 76 years, mean 62.3 years). A mechanographic technique was used to evaluate in vitro muscle responses to electrical field stimulation (EFS) before and after treatment with various autonomic nerve blockers. Response to EFS before blockade of the adrenergic and cholinergic nerves was as follows: NSC and ESC significantly demonstrated relaxation reaction rather than contraction reaction (P = 0.0253, P < 0.0001, respectively). ESC showed relaxation reaction more than NSC (P = 0.1138). Response to EFS after blockade of the adrenergic and cholinergic nerves was as follows: NSC and ESC significantly demonstrated relaxation reaction via nonadrenergic noncholinergic (NANC) inhibitory nerves rather than contraction reaction via NANC excitatory nerves (P < 0.0001, P < 0.0001, respectively). ESC with SV significantly showed relaxation reaction more than NSC (P = 0.0092). An increased response of relaxation mediated NANC inhibitory nerves may play a role in impaired motility in the ESC of patients with SV. PMID:25437573

  6. Basaloid Squamous Cell Carcinoma of the Sigmoid Colon

    PubMed Central

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

    2015-01-01

    Basaloid squamous cell carcinoma (BSCC) of the colon is rarely found proximal to the anal canal. We report a case of an 81-year-old woman who was diagnosed with squamous cell carcinoma (SCC) of the lung without metastasis and BSCC of the sigmoid with differing histologic findings suggesting that these tumors were separate primary neoplasms. SCC of the colon has a dismal prognosis. Surgery is the primary method of treatment when feasible, in addition to chemotherapeutic agents. PMID:26157950

  7. Basaloid Squamous Cell Carcinoma of the Sigmoid Colon.

    PubMed

    Samo, Salih; Sherid, Muhammed; Liu, Kevin; Kia, Leila; Elliott, Glynn J

    2015-04-01

    Basaloid squamous cell carcinoma (BSCC) of the colon is rarely found proximal to the anal canal. We report a case of an 81-year-old woman who was diagnosed with squamous cell carcinoma (SCC) of the lung without metastasis and BSCC of the sigmoid with differing histologic findings suggesting that these tumors were separate primary neoplasms. SCC of the colon has a dismal prognosis. Surgery is the primary method of treatment when feasible, in addition to chemotherapeutic agents. PMID:26157950

  8. Rupture of sigmoid colon caused by compressed air.

    PubMed

    Yin, Wan-Bin; Hu, Ji-Lin; Gao, Yuan; Zhang, Xian-Xiang; Zhang, Mao-Shen; Liu, Guang-Wei; Zheng, Xue-Feng; Lu, Yun

    2016-03-14

    Compressed air has been generally used since the beginning of the 20(th) century for various applications. However, rupture of the colon caused by compressed air is uncommon. We report a case of pneumatic rupture of the sigmoid colon. The patient was admitted to the emergency room complaining of abdominal pain and distention. His colleague triggered a compressed air nozzle against his anus as a practical joke 2 h previously. On arrival, his pulse rate was 126 beats/min, respiratory rate was 42 breaths/min and blood pressure was 86/54 mmHg. Physical examination revealed peritoneal irritation and the abdomen was markedly distended. Computed tomography of the abdomen showed a large volume of air in the abdominal cavity. Peritoneocentesis was performed to relieve the tension pneumoperitoneum. Emergency laparotomy was done after controlling shock. Laparotomy revealed a 2-cm perforation in the sigmoid colon. The perforation was sutured and temporary ileostomy was performed as well as thorough drainage and irrigation of the abdominopelvic cavity. Reversal of ileostomy was performed successfully after 3 mo. Follow-up was uneventful. We also present a brief literature review. PMID:26973403

  9. Rupture of sigmoid colon caused by compressed air

    PubMed Central

    Yin, Wan-Bin; Hu, Ji-Lin; Gao, Yuan; Zhang, Xian-Xiang; Zhang, Mao-Shen; Liu, Guang-Wei; Zheng, Xue-Feng; Lu, Yun

    2016-01-01

    Compressed air has been generally used since the beginning of the 20th century for various applications. However, rupture of the colon caused by compressed air is uncommon. We report a case of pneumatic rupture of the sigmoid colon. The patient was admitted to the emergency room complaining of abdominal pain and distention. His colleague triggered a compressed air nozzle against his anus as a practical joke 2 h previously. On arrival, his pulse rate was 126 beats/min, respiratory rate was 42 breaths/min and blood pressure was 86/54 mmHg. Physical examination revealed peritoneal irritation and the abdomen was markedly distended. Computed tomography of the abdomen showed a large volume of air in the abdominal cavity. Peritoneocentesis was performed to relieve the tension pneumoperitoneum. Emergency laparotomy was done after controlling shock. Laparotomy revealed a 2-cm perforation in the sigmoid colon. The perforation was sutured and temporary ileostomy was performed as well as thorough drainage and irrigation of the abdominopelvic cavity. Reversal of ileostomy was performed successfully after 3 mo. Follow-up was uneventful. We also present a brief literature review. PMID:26973403

  10. Spontaneous aortic pseudoaneurysm rupture into the sigmoid colon in Behçet’s disease patient

    PubMed Central

    Lee, Su Lim; Ku, Young Mi; Won, Yoodong

    2015-01-01

    Behçet’s disease (BD) is a multisystem autoimmune disorder characterized by recurrent orogenital ulcers, uveitis, and skin lesions. The vascular manifestations include thrombophlebitis, stenosis, occlusion, and pseudoaneurysm. BD infrequently precipitates aortic pseudoaneurysm rupture into the sigmoid mesocolon and lumen of the adjacent colon. Here we report an extremely rare case of spontaneous abdominal aortic pseudoaneurysm rupture via the sigmoid mesocolon into the lumen of the sigmoid colon in a 37-year-old patient with BD. PMID:26675745

  11. Endometriosis within the sigmoid colon/extragenital endometriosis.

    PubMed

    Acar, Turan; Acar, Nihan; Çelik, Salih Can; Ekinci, Neşe; Tarcan, Ercüment; Çapkınoğlu, Emir

    2015-01-01

    Endometriosis is the presence of endometrial glands and stroma outside the uterine cavity. Although it is common in women in the reproductive age, intestinal endometriosis is extremely rare and may lead to serious clinical problems. In this article, we present two rare cases of endometriosis localized in the sigmoid colon lumen. The first case is a 45 year-old female complaining of rectal bleeding for 6 months. A polypoid lesion with suspicion of malignancy, 3-4 cm in size was identified at colonoscopy. Laparoscopic anterior resection was performed since it was not suitable for colonoscopic polypectomy. The pathology examination revealed extragenital endometriosis. The second case is a 36 year-old female admitted for lower abdominal pain and rectal bleeding for the last 3 months. She was diagnosed with sigmoid diverticulitis. The patient's symptoms regressed with medical treatment, but due to early and multiple recurrent episodes it was decided to perform an elective laparoscopic anterior resection. The pathology report stated diverticulosis coli and intraluminal endometriosis. Intestinal endometriosis should be considered as part of the differential diagnosis in female patients of the reproductive age who present with constipation, gastrointestinal bleeding, nausea, vomiting, cramp-like abdominal pain, diarrhea and pelvic pain. In these patients, resection and anastomosis of the effected bowel segment is accepted as the choice of treatment. PMID:26668537

  12. Endometriosis within the sigmoid colon/extragenital endometriosis

    PubMed Central

    Acar, Turan; Acar, Nihan; Çelik, Salih Can; Ekinci, Neşe; Tarcan, Ercüment; Çapkınoğlu, Emir

    2015-01-01

    Endometriosis is the presence of endometrial glands and stroma outside the uterine cavity. Although it is common in women in the reproductive age, intestinal endometriosis is extremely rare and may lead to serious clinical problems. In this article, we present two rare cases of endometriosis localized in the sigmoid colon lumen. The first case is a 45 year-old female complaining of rectal bleeding for 6 months. A polypoid lesion with suspicion of malignancy, 3–4 cm in size was identified at colonoscopy. Laparoscopic anterior resection was performed since it was not suitable for colonoscopic polypectomy. The pathology examination revealed extragenital endometriosis. The second case is a 36 year-old female admitted for lower abdominal pain and rectal bleeding for the last 3 months. She was diagnosed with sigmoid diverticulitis. The patient’s symptoms regressed with medical treatment, but due to early and multiple recurrent episodes it was decided to perform an elective laparoscopic anterior resection. The pathology report stated diverticulosis coli and intraluminal endometriosis. Intestinal endometriosis should be considered as part of the differential diagnosis in female patients of the reproductive age who present with constipation, gastrointestinal bleeding, nausea, vomiting, cramp-like abdominal pain, diarrhea and pelvic pain. In these patients, resection and anastomosis of the effected bowel segment is accepted as the choice of treatment. PMID:26668537

  13. Huge Congenital Segmental Dilatation of the Sigmoid Colon in a Neonate: A “Rarity to Meet” and a “Challenge to Treat”

    PubMed Central

    Kaiser, Margarita; Ratschek, Manfred; Till, Holger

    2016-01-01

    Only ten cases of neonatal congenital segmental dilatation (CSD) of the colon have been described so far. We present a full-term female newborn with trisomy 21, ventricular septal defect, and gross abdominal distension. Plain abdominal radiographs revealed a huge cystic lesion occupying the left hemiabdomen. Upon laparotomy on day 4 a CSD of the distal sigmoid and proximal rectum was confirmed and resected. The proximal colon was exteriorized and the distal part closed as a Hartmann pouch. Histology confirmed a huge segmental dilatation of the sigmoid without dysganglionosis or pseudodiverticula, but normal intestinal architecture. After correction of the ventricular septal defect a low rectal end-to-end anastomosis could be performed at an age of 5 months. The postoperative course was uneventful. CSD of the sigmoid colon is extremely “rare to meet” and a “challenge to treat” in the newborn period, but clinical awareness of this entity prompts pediatric surgical success.

  14. Delayed presentation of a sigmoid colon injury following blunt abdominal trauma: a case report

    PubMed Central

    2012-01-01

    Introduction The low incidence of colon injury due to blunt abdominal trauma and the lack of a definitive diagnostic method for the same can lead to delays in diagnosis and treatment, subsequently resulting in high morbidity and mortality. Case presentation A 66-year-old woman with sigmoid colon injury was admitted to our emergency department after sustaining blunt abdominal trauma. Her physical examination findings and laboratory results led to a decision to perform a laparotomy; exploration revealed a sigmoid colon injury that was treated by sigmoid loop colostomy. Conclusions Surgical abdominal exploration revealed gross fecal contamination and a perforation site. Intra-abdominal irrigation and a sigmoid loop colostomy were performed. Our patient was discharged on post-operative day six without any problems. Closure of the sigmoid loop colostomy was performed three months after the initial surgery. PMID:22905731

  15. Actinomycosis of the sigmoid colon: A case report

    PubMed Central

    Privitera, Antonio; Milkhu, Charanjit Singh; Datta, Vivek; Rodriguez-Justo, Manuel; Windsor, Alastair; Cohen, Charles Richard

    2009-01-01

    Abdominal actinomycosis is a chronic suppurative infection caused by Actinomyces species. The ileo-cecal region is most commonly affected, while the left side of the colon is more rarely involved. The infection has a tendency to infiltrate adjacent tissues and is therefore rarely confined to a single organ. Presentation may vary from non specific symptoms and signs to an acute abdomen. A computed tomography scan is helpful in identifying the inflammatory process and the organs involved. It also allows visual guidance for percutaneous drainage of abscesses, thus aiding diagnosis. Culture is difficult because of the anaerobic character and slow growth of actinomycetes. Colonoscopy is usually normal, but may shows signs of external compression. Preoperative diagnosis is rare and is established only in less than 10% of cases. In uncomplicated disease, high dose antibiotic therapy is the mainstay of treatment. Surgery is often performed because of a difficulty in diagnosis. Surgery and antibiotics are required in the case of complicated disease. Combined medical and surgical treatment achieves a cure in about 90% of cases. The authors report a case of sigmoid actinomycosis where diagnosis was made from the histology, and a review of the literature is presented. PMID:21160798

  16. Rett syndrome with colon cancer presented with sigmoid volvulus: Report of a case

    PubMed Central

    Yilmaz, Tonguç Utku; Güneş, Abdullah; Pösteki, Gökhan; Okay, Erdem

    2014-01-01

    INTRODUCTION Rett syndrome is a progressive neurodevelopment disorder in which MECP gene mutations are responsible and might be related to cancer. PRESENTATION OF CASE A 22 year-old girl with Rett syndrome was hospitalized for abdominal distention and shock. Abdominal tenderness and distention were revealed in physical examination. Radiological investigations revealed sigmoid volvulus and colonic obstruction. Sigmoid volvulus, sigmoid colon perforation due to sigmoid cancer with liver metastasis were observed at laparotomy. Hartman procedure performed. The patient died on the second postoperative day. DISCUSSION Rett syndrome has several gastrointestinal pathologies related with inadequate parasympathetic control. Genetic mutations in methyl-CpG-binding protein 2 (MECP2) which has role in several cancer mechanisms is the reason of Rett syndrome. Colon cancer with the underlying gastrointestinal pathologies complicated our case. CONCLUSION Rett syndrome patients need a high level of concern for gastrointestinal emergencies with cancer risk. PMID:25108072

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

    PubMed Central

    Lee, In Kyu; Sohn, Dong Wan

    2015-01-01

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

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

    PubMed

    Lee, In Kyu; Sohn, Dong Wan

    2015-01-01

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

  19. Radiography of the distal colon and rectum after irradiation of carcinoma of the cervix

    SciTech Connect

    Meyer, J.E.

    1981-04-01

    High dose therapeutic irradiation for carcinoma of the cervix, usually delivered using a combination of external and intracavitary sources, may damage the rectum, sigmoid, distal small bowel, vagina, and urinary bladder. A pretreatment barium enema is valuable for baseline comparison should symptoms developing after treatment necessitate radiographic evaluation of the colon and rectum. Included in this review are a summary of radiation therapy techniques for carcinoma of the cervix, the radiation tolerance of normal pelvic structures, and the histopathology of changes in the bowel following irradiation. The spectrum of radiographic manifestations of radiation effect on the rectum and sigmoid is presented and contrasted with changes secondary to recurrent of persistent tumor. Gradations of symmetrical volume loss characterize radiation change, whereas mass effect, asymmetrical narrowing of the colon lumen, or fixation are more typical of tumor recurrence.

  20. Evisceration of the small bowel through a perforated and prolapsed sigmoid colon: an unusual presentation of rectal prolapse.

    PubMed

    Ahmad, Arshad; Kumar, Suresh; Sonkar, Abhinav Arun; Kumar, Sanjeev

    2016-01-01

    Spontaneous prolapse of the sigmoid colon and evisceration of the small bowel through a rupture in the rectosigmoid is a rare presentation. We report a case of a 60-year-old man presenting with massive small bowel evisceration through a perforation in a prolapsed sigmoid colon. The patient had a 2-year history of rectal prolapse. He was also incontinent for flatus and liquid stool. There was no other significant medical history. After reduction of the small intestine, a large perforation was seen in the prolapsed sigmoid colon. The sigmoid colon was identified by presence of appendices epiploicae and taeniae coli. After initial resuscitation, an emergency laparotomy was performed. The perforated sigmoid colon was resected and a Hartmann's colostomy was created. This resulted in complete recovery. Reversal of the Hartmann's colostomy was performed after 6 weeks. PMID:27084900

  1. Immune reconstitution in the sigmoid colon after long-term HIV therapy.

    PubMed

    Sheth, P M; Chege, D; Shin, L Y Y; Huibner, S; Yue, F-Y; Loutfy, M; Halpenny, R; Persad, D; Kovacs, C; Chun, T-W; Kandel, G; Ostrowski, M; Kaul, R

    2008-09-01

    Early and profound CD4+ T-cell depletion in gut-associated lymphoid tissue (GALT) may drive Human Immunodeficiency Virus (HIV) immunopathogenesis, and GALT immune reconstitution on highly active antiretroviral therapy (HAART) may be suboptimal. Blood and sigmoid colon biopsies were collected from HAART-treated individuals with undetectable blood HIV RNA for > or =4 years and from uninfected controls. HIV proviral levels and T-cell phenotype/function were examined in both compartments. CD4+ T-cell reconstitution in the sigmoid, including CD4+ T cells expressing CCR5, exceeded that in blood and did not differ from uninfected controls. Sigmoid HIV proviral load was not correlated with CD4+ reconsitution, but was correlated with the degree of mucosal CD8+ T-cell immune activation. Colonic Gag-specific T-cell responses were common, but were not associated with proviral load or immune activation. In this select study population, long-term HAART was associated with complete CD4+ T-cell reconstitution in sigmoid colon. However, colonic immune activation may drive ongoing HIV replication. PMID:19079202

  2. Right Sided Sigmoid Colon and Redundant Loop of Descending Colon with Its Embryological Correlation and Clinical Significance

    PubMed Central

    Bahksh, Shahid; Agarwal, Shilpi; Pangtey, Babita; Kakar, Smita

    2016-01-01

    Anatomical variations of colon are mostly developmental and can lead to variety of acute and chronic pathological conditions. So it becomes important to recognize and understand the importance of clinical implications of such anomalies to benefit surgeons, clinical geneticists and research community. We describe two cases of right sided sigmoid colon and long descending colon which had two segments: vertical and horizontal. The mesentery of ascending and descending colon was retained. This mesentery along with the mesentery of transverse colon was continuous with the mesentery of small intestine. There were variations in blood vessels supplying these anomalous colons. The findings of this study may be helpful to make surgeons and radiologists aware about different varieties of presentations while undertaking an investigative or surgical procedure in this area like sigmoidoscopy, percutaneous cecostomy and anterior transperitoneal aproach of kidney to avoid colon puncture. PMID:27134852

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

    PubMed Central

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

    2013-01-01

    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. PMID:24163654

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

    PubMed

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

    2014-11-01

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

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

    PubMed

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

    2007-02-01

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

  6. Intussusception complicated by distal perforation of the colon.

    PubMed

    Armstrong, E A; Dunbar, J S; Graviss, E R; Martin, L; Rosenkrantz, J

    1980-07-01

    Three cases of perforation of the colon distal to an ileocolic intussusception are presented. Two cases were associated with attempted hydrostatic reduction of the intussusception, while the other was discovered at operation. The mechanism of this complication is not clear. When performing a contrast enhanced examination of the colon and there is a risk of perforation: (a) dilute water-soluble contrast medium should be used; (b) special attention should be paid to the colon distal to the intussusception; and (c) should contrast material be observed in the peritoneal cavity, the enema reservoir should immediately be lowered to the floor to siphon off the liquid from the colon. PMID:7384527

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

    PubMed Central

    2013-01-01

    A 58-year-old woman presented with a solitary myofibroma that arose in the sigmoid colon. Computed tomography revealed a highly enhanced intramural mass (1.3-cm maximum diameter) in the proximal sigmoid colon. Histologically, the tumor exhibited a biphasic growth pattern, which comprised haphazardly arranged, interwoven fascicles of plump, myoid-appearing spindle cells with elongated nuclei and abundant eosinophilic cytoplasm, and more cellular areas of primitive-appearing polygonal cells that were arranged in a hemangiopericytomatous pattern. The tumor cells were positive for smooth muscle actin (SMA), and negative for desmin, h-caldesmon, CD34, cytokeratin, S100 protein, and CD117. The Ki-67 labeling index was not high (up to 7%). Based on these histologic and immunohistochemical features, our patient was diagnosed with a myofibroma of the sigmoid colon. The presence of solitary myofibroma in the intestine of an adult requires attention to avoid misdiagnosis as a more aggressive mesenchymal tumor. Virtual Slides The virtual silde(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2096403796957687 PMID:23742153

  8. Transmural penetration of sigmoid colon and rectum by retained surgical sponge after hysterectomy.

    PubMed

    Shin, Woo Young; Im, Chan Hyuk; Choi, Sun Keun; Choe, Yun-Mee; Kim, Kyung Rae

    2016-03-14

    Gossypiboma is a surgical sponge that is retained in the body after the operation. A 39-year-old female presented with vague lower abdominal pain, fever, and rectal discharge 15 mo after hysterectomy. The sponge remaining in the abdomen had no radiopaque marker. Therefore a series of radiographic evaluations was fruitless. The surgical sponge was found in the rectosigmoid colon on colonoscopy. The sponge penetrated the sigmoid colon and rectum transmurally, forming an opening on both sides. The patient underwent low anterior resection and was discharged without postoperative complications. PMID:26973401

  9. Transmural penetration of sigmoid colon and rectum by retained surgical sponge after hysterectomy

    PubMed Central

    Shin, Woo Young; Im, Chan Hyuk; Choi, Sun Keun; Choe, Yun-Mee; Kim, Kyung Rae

    2016-01-01

    Gossypiboma is a surgical sponge that is retained in the body after the operation. A 39-year-old female presented with vague lower abdominal pain, fever, and rectal discharge 15 mo after hysterectomy. The sponge remaining in the abdomen had no radiopaque marker. Therefore a series of radiographic evaluations was fruitless. The surgical sponge was found in the rectosigmoid colon on colonoscopy. The sponge penetrated the sigmoid colon and rectum transmurally, forming an opening on both sides. The patient underwent low anterior resection and was discharged without postoperative complications. PMID:26973401

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

    SciTech Connect

    Burton, Sarah; Brown, Gina . E-mail: gina.brown@rmh.nhs.uk; Daniels, Ian; Norman, Andy; Swift, Ian; Abulafi, Muti; Wotherspoon, Andy; Tait, Diana

    2006-06-01

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

  11. Invading of intrauterine contraceptive device into the sigmoid colon through uterine perforation caused by a blunt trauma.

    PubMed

    Davoodabadi, Abdoulhossein; Mohammadzadeh, Mahdi; Amirbeigi, Mahdieh; Jazayeri, Hoda

    2015-08-01

    Intrauterine contraceptive device (IUCD) is relatively safe but still with some serious risks. Uterus perforation is rare and would be fatal. A case of Cu-7 IUCD invading into the sigmoid colon through uterine perforation caused by a pelvic blunt trauma was presented. Our case showed that uterus perforation by an IUCD could induce utero-sigmoid fistula which is likely to be missed. Imaging is required when the patients with IUCD present abdominal pain, particularly with a history of trauma. PMID:26764547

  12. Ammonia inhibits sodium and chloride absorption in rat distal colon.

    PubMed

    Cermak, R; Minck, K; Lawnitzak, C; Scharrer, E

    2002-05-01

    It was recently demonstrated that ammonia inhibits sodium absorption in the proximal colon of rats. In order to investigate the effect of luminal ammonia in the distal colon, sodium and chloride transport were measured in Ussing chambers. Under short-circuit conditions, distal colon absorbed sodium and chloride. When luminal ammonia (30 mmol l(-1)) was present, sodium and chloride absorption was diminished. Inhibition of the two Na(+)-H(+) exchanger isoforms NHE2 and NHE3, which are known to be located in the apical membrane of the distal colon epithelium, failed to influence the effect of ammonia on transepithelial sodium and chloride fluxes. The inhibitory effect of ammonia was eliminated under the following conditions: after block of carbonic anhydrases with acetazolamide, in the presence of an unspecific blocker of Na(+)-H(+) exchangers, and under chloride-free conditions. Ammonia did not alter electrogenic sodium absorption. These results demonstrate that luminal ammonia inhibits sodium and chloride absorption in rat distal colon. We suggest that ammonia inhibits NaCl absorption by interfering with a Na(+)-H(+) exchanger that is not NHE2 or NHE3 PMID:12089598

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

    PubMed Central

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

    2015-01-01

    Plasmablastic lymphoma (PBL) is a rare form of non-Hodgkins lymphoma that is associated with human immunodeficiency virus (HIV) infection. Although PBL is most commonly observed in the oral cavity of HIV-positive patients, it can also be observed at extra-oral sites in HIV-negative patients. This report represents an unusual case of HIV-negative PBL that occurred in the sigmoid colon. This patient had a history of systemic lupus erythematosus and an underlying immunosuppressive state from long term steroid therapy. The lymphoma cells were positive for CD138, kappa light chain restriction and Epstein-Barr virus and negative for CD20/L26, CD3, CD79a, UCHL1 (CD45RO) and cytokeratin (AE1/AE3). The patient died approximately 2 mo after the operation. In the present paper, we review cases of PBL of the colon in HIV-negative patients. PMID:26140010

  14. Lower Extremity Radicular Pain Caused by Entrapped Sigmoid Colon Between L5 and S1 Vertebrae

    PubMed Central

    Ko, Sanghyung; Park, Noh Kyoung; Cho, Kyoung Jin; Baek, Jung Hyun; Lim, Jeong-Wook; Choi, Dongjin

    2015-01-01

    Intestinal entrapment between two vertebral bodies is very rare. In all previous cases, it occurred by major trauma. However, the bowel entrapment between two vertebral bodies without trauma has never been reported, not to mention as the cause of lower extremity radicular pain. We describe the case of an 82-year-old female patient with right lower extremity radicular pain without recent trauma history. The patient was diagnosed sigmoid colon entrapment between the L5 and S1 vertebrae by lumbar spinal computerized tomography and magnetic resonance imaging, and showed improvement in radicular pain after manual reduction of interpositioned colon during surgery. Intestinal entrapment between two vertebrae without trauma is caused by degenerative and vacuum changes of the intervertebral disc combined with the anterior longitudinal ligament injury. PMID:26619145

  15. Lower Extremity Radicular Pain Caused by Entrapped Sigmoid Colon Between L5 and S1 Vertebrae.

    PubMed

    Ko, Sanghyung; Park, Noh Kyoung; Cho, Kyoung Jin; Baek, Jung Hyun; Lim, Jeong-Wook; Choi, Dongjin; Kang, Sangkuk

    2015-10-01

    Intestinal entrapment between two vertebral bodies is very rare. In all previous cases, it occurred by major trauma. However, the bowel entrapment between two vertebral bodies without trauma has never been reported, not to mention as the cause of lower extremity radicular pain. We describe the case of an 82-year-old female patient with right lower extremity radicular pain without recent trauma history. The patient was diagnosed sigmoid colon entrapment between the L5 and S1 vertebrae by lumbar spinal computerized tomography and magnetic resonance imaging, and showed improvement in radicular pain after manual reduction of interpositioned colon during surgery. Intestinal entrapment between two vertebrae without trauma is caused by degenerative and vacuum changes of the intervertebral disc combined with the anterior longitudinal ligament injury. PMID:26619145

  16. Wandering intrauterine contraceptive device: An unusual travel to the sigmoid colon.

    PubMed

    Kumarappan, A L; Karthikeyan, M; Gunaseelan, D; Ros'aini, P

    2015-10-01

    Intrauterine contraceptive device (IUCD) is common choice for contraception. Migration of IUCD is one of the complications that are encountered. Here we report a case of IUCD migration to the sigmoid colon. A 39-year-old Malay lady carrying a copper T type of IUCD presented with missing thread then underwent examination under anaesthesia, proceeded to hysteroscopy but failed removal. Abdominal ultrasound detected it in the left lower quadrant of abdomen. She then underwent diagnostic laparoscopy where the device was found to be embedded in the sigmoid colon. Technical difficulty necessitated conversion to mini laparotomy and sigmoidotomy to remove the IUCD and the bowel closed primarily. IUCD is a relatively simple and safe contraceptive procedure but possible complications are bleeding and pain that usually co-exist, pelvic infection, expulsion and perforation. Investigations should be based on clinical suspicion and migrated IUCD in symptomatic patients should be surgically removed whereas, asymptomatic patients can be managed conservatively under certain circumstances. However in the presence of a concurrent pathology that requires exploration then retrieval of the migrated IUCD should be undertaken. PMID:26556122

  17. [A Case of Sigmoid Colon Cancer with Metastasis to the Uterus].

    PubMed

    Tokoro, Yukinari; Tonooka, Toru; Souda, Hiroaki; Takiguchi, Nobuhiro; Chibana, Tomofumi; Kobayashi, Ryosuke; Arimitsu, Hidehito; Yanagibashi, Hiroo; Chou, Akihiro; Ikeda, Atsushi; Nabeya, Nobuhiro; Kainuma, Osamu; Yamamoto, Hiroshi; Nagata, Matsuo

    2015-11-01

    A 65-year-old woman complaining of fetor ex vagina was diagnosed with endometrial adenocarcinoma of the uterus based on the pathological findings of an endometrial biopsy. Sigmoid colon cancer was found on a pre-operative CT scan. Diagnosis of double cancer was made and we performed sigmoidectomy and panhysterectomy with associated resection of both adnexa. Histopathological examination found that the tumor accounted for almost all of the uterine mucosa and over half of the muscular layer. Immunostaining showed CK7 (-), CK20 (+), CDX2 (+), ER (-), and PgR (-), and we diagnosed it as a metastasis to the uterus of the sigmoid colon cancer. The pathological diagnosis was a moderately differentiated adenocarcinoma, pT4b (SI: urinary bladder), pN0 (0/12), H0, P1,M1a (uterus), pStage Ⅳ. As adjuvant chemotherapy, she was administered XELOX for 6 months. Although colorectal cancer rarely metastasizes to the uterus, due to the increase in the prevalence of colorectal cancer, it may be also increase. To choose the best treatment course, it is necessary to diagnose whether it is a primary uterine cancer or a metastatic uterine cancer. PMID:26805130

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

    PubMed Central

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

    2005-01-01

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

  19. The peptide transporter PEPT1 is expressed in distal colon in rodents and humans and contributes to water absorption.

    PubMed

    Wuensch, Tilo; Schulz, Stephan; Ullrich, Sina; Lill, Nicole; Stelzl, Tamara; Rubio-Aliaga, Isabel; Loh, Gunnar; Chamaillard, Mathias; Haller, Dirk; Daniel, Hannelore

    2013-07-01

    The peptide transporter PEPT1, expressed in the brush border membrane of enterocytes, mediates the uptake of di- and tripeptides from luminal protein digestion in the small intestine. PEPT1 was proposed not to be expressed in normal colonic mucosa but may become detectable in inflammatory states such as Crohn's disease or ulcerative colitis. We reassessed colonic expression of PEPT1 by performing a systematic analysis of PEPT1 mRNA and protein levels in healthy colonic tissues in mice, rats, and humans. Immunofluorescence analysis of different mouse strains (C57BL/6N, 129/Sv, BALB/c) demonstrated the presence of PEPT1 in the distal part of the colon but not in proximal colon. Rat and human intestines display a similar distribution of PEPT1 as found in mice. However, localization in human sigmoid colon revealed immunoreactivity present at low levels in apical membranes but substantial staining in distinct intracellular compartments. Functional activity of PEPT1 in colonic tissues from mice was assessed in everted sac preparations using [¹⁴C]Gly-Sar and found to be 5.7-fold higher in distal compared with proximal colon. In intestinal tissues from Pept1-/- mice, no [¹⁴C]Gly-Sar transport was detectable but feces samples revealed significantly higher water content than in wild-type mice, suggesting that PEPT1 contributes to colonic water absorption. In conclusion, our studies unequivocally demonstrate the presence of PEPT1 protein in healthy distal colonic epithelium in mice, rats, and humans and proved that the protein is functional and contributes to electrolyte and water handling in mice. PMID:23660505

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

    PubMed Central

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

    2015-01-01

    Fournier gangrene (FG) is an infectious condition with fulminant evolution and is sometimes life-threatening. Here, we present the case of an immunocompromised 59-year-old male with surgical history of a pancreatic pseudocyst stented endoscopically. After unrecognized stent migration in the sigmoid without colonic perforation, he developed severe necrosis of the scrotum and perineum, which spontaneously perforated, presenting a smell suggesting moist gangrene. FG that has spread to the male genital organs presents therapeutic challenges. The purpose of our study is to present this case, typical for FG, with an educational aim both for the internal and surgical specialties, and the goal of further multidisciplinary collaboration for the optimal management of the patient with personalized treatment. PMID:25878494

  1. The immediate effects of sigmoid colon manipulation on pressure pain thresholds in the lumbar spine.

    PubMed

    McSweeney, Terence P; Thomson, Oliver P; Johnston, Ross

    2012-10-01

    Visceral manual therapy is increasingly used by UK osteopaths and manual therapists, but there is a paucity of research investigating its underlying mechanisms, and in particular in relation to hypoalgesia. The aim of this study was to investigate the immediate effects of osteopathic visceral mobilisation on pressure pain thresholds. A single-blinded, randomised, within subjects, repeated measures design was conducted on 15 asymptomatic subjects. Pressure pain thresholds were measured at the L1 paraspinal musculature and 1st dorsal interossei before and after osteopathic visceral mobilisation of the sigmoid colon. The results demonstrated a statistically significant improvement in pressure pain thresholds immediately after the intervention (P<0.001). This effect was not observed to be systemic, affecting only the L1 paraspinal musculature. This novel study provides new experimental evidence that visceral manual therapy can produce immediate hypoalgesia in somatic structures segmentally related to the organ being mobilised, in asymptomatic subjects. PMID:23036875

  2. Intra-articular Fractures of the Sigmoid Notch of the Distal Radius: Analysis of Progression to Distal Radial Ulnar Joint Arthritis and Impact on Upper Extremity Function in Surgically Treated Fractures.

    PubMed

    Vitale, Mark A; Brogan, David M; Shin, Alexander Y; Berger, Richard A

    2016-03-01

    Background Studies have established an increased risk of radiocarpal joint posttraumatic arthritis in patients with displaced intra-articular fractures of the distal radius, although this phenomenon has yet to be evaluated in the distal radioulnar joint (DRUJ). Purpose We hypothesized that patients with displaced intra-articular fractures of the sigmoid notch would have a higher prevalence of DRUJ arthritis and greater upper extremity dysfunction after operative treatment of distal radius fractures compared with fractures without sigmoid notch involvement. We also hypothesized that the degree of sigmoid notch incongruity would be correlated with the grade of DRUJ arthritis and the severity of upper extremity dysfunction. Patients and Methods A retrospective review was conducted on surgically treated patients with distal radius fractures with pre- and/or postoperative computed tomography (CT) scans. Patients were divided into groups based on presence or absence of fracture extension into the sigmoid notch. Within the sigmoid notch group, postoperative CT scans were used to measure sigmoid notch fracture step-off and diastasis (mm), as well as volar or dorsal DRUJ subluxation (%). Patients were administered Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaires and radiographs were obtained to grade DRUJ arthritis using the Kellgren-Lawrence (KL) radiographic criteria. Results Thirty-three patients were included (19 with sigmoid notch involvement and 14 without) with an average radiographic follow-up of 6.3 years (range: 3.5-10.1 years). DASH scores were available for all patients, and radiographic follow-up was available in 24 patients (73%). A trend toward higher grade of DRUJ arthritis and poorer average DASH was found in those with sigmoid notch involvement, but was not statistically different. In the sigmoid notch group there were poorer DASH scores in patients with coronal step-off > 1.0-mm (p < 0.05). There were no significant correlations between sigmoid notch step-off, diastasis or DRUJ subluxation and either KL grade of arthritis or DASH scores. Conclusion Fractures involving the sigmoid notch did not appear to have a greater prevalence of DRUJ posttraumatic arthritis in operatively treated patients at greater than 6 years of follow-up. Postoperative sigmoid notch step-off, diastasis or DRUJ subluxation had a minimal effect on upper extremity function, but fractures with a coronal step-off of > 1.0-mm exhibited higher levels of upper extremity dysfunction. Level of Evidence Prognostic, Level III-Case control. PMID:26855837

  3. Giant sigmoid diverticulum: A case report.

    PubMed

    Durgakeri, Pramod; Strauss, Paul

    2015-01-01

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

  4. Gallstone ileus of the sigmoid colon: an extremely rare cause of large bowel obstruction detected by multiplanar CT.

    PubMed

    Carlsson, Tarryn; Gandhi, Sanjay

    2015-01-01

    Gallstone ileus of the sigmoid colon is an important, though extremely rare, cause of large bowel obstruction. The gallstone often enters the large bowel through a fistula formation between the gallbladder and colon, and impacts at a point of narrowing, causing large bowel obstruction. We describe the case of an 80-year-old woman who presented with features of bowel obstruction. Multiplanar abdominal CT demonstrated a cholecystocolonic fistula in exquisite detail. The scan also showed obstruction of the colon due to a large gallstone impacted just proximal to a stricture in the sigmoid. Owing to inflammatory adhesions and a stricture from extensive diverticular disease, the gallstone could not be retrieved. This frail and elderly woman was treated with a loop colostomy to relieve bowel obstruction. The patient made an uneventful recovery. PMID:26682834

  5. [A Case of Complete Pathological Response in a Patient with Locally Advanced Sigmoid Colon Cancer after FOLFOX IRI Chemotherapy].

    PubMed

    Goto, Masakazu; Okitsu, Hiroshi; Yuasa, Yasuhiro; Matsuo, Yuta; Edagawa, Hiroshi; Tani, Ryotaro; Mori, Osamu; Kuramoto, Shunsuke; Tomibayashi, Atsushi; Yamashita, Michiko; Fujii, Yoshiyuki

    2015-11-01

    A 61-year-old man with advanced sigmoid colon cancer was admitted to our hospital. Abdominal computed tomography (CT) revealed locally advanced sigmoid colon cancer, with suspected invasion of the bladder and small intestine. The clinical stage of the disease was T4b, N1, M0, and Stage III a, with wild-type KRAS expression. A transverse colostomy was performed because of the presence of a bowel obstruction. The patient received 4 courses of Leucovorin, 5-fluorouracil, oxaliplatin, and irinotecan (FOLFOXIRI). The size of the tumor and lymph nodes decreased noticeably after chemotherapy and laparoscopic high anterior resection with lymph node dissection. During this phase, the pathological stage of the disease was ypT0, N0, and Stage 0(no viable carcinoma cells, Grade 3). This result suggested that preoperative FOLFOXIRI chemotherapy is a useful regimen for the treatment of locally advanced colon cancer. PMID:26602406

  6. Sigmoid colonic metastasis by lymphatic spread occurring with unilateral Krukenberg tumor considered to be caused by stage IA early gastric cancer: A case report

    PubMed Central

    FUJIMOTO, DAISUKE; HIRONO, YASUO; GOI, TAKANAORI; YAMAGUCHI, AKIO

    2016-01-01

    Gastric cancer is one of the most common malignancies in Asia, and the second most common cause of cancer-associated mortality in Japan. Colorectal metastases originating from gastric adenocarcinoma are extremely rare. The present study reports an unusual case of lymphogenous sigmoid metastasis of gastric adenocarcinoma occurring in a 58-year-old female patient. Endoscopic and radiological findings were indicative of 0-IIc+IIa early gastric cancer, and radical distal gastrectomy with D2 lymph node dissection was performed. The pathological diagnosis was stage IA gastric adenocarcinoma (T1bN0M0), according to the Japanese classification of gastric cancer. A follow-up examination at 18 months post surgery revealed a recurrence of paraaortic lymph node metastasis, detected by abdominal computed tomography (CT) and positron emission tomography (PET)/CT. The patient received chemotherapy with S-1 and cisplatin. Subsequently, radiotherapy was administered to the paraaortic lymph nodes at levels Th11-L3. Follow-up abdominal CT and PET/CT revealed an enlarged left ovary, and abnormal uptake in the left ovary and sigmoid colon. An oophorectomy and sigmoidectomy with D3 lymph node dissection were performed. The pathological diagnosis was metastatic adenocarcinoma; this was identical to the gastric pathology in the previous pathological report. The patient continued treatment with chemotherapy. Although sigmoid colonic metastasis from gastric cancer is extremely rare, metastasis from gastric cancer must be considered during the differential diagnosis of cases involving a colorectal mass and a previous history of gastric cancer. PMID:26870264

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

    PubMed

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

    2011-11-01

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

  8. Subserous lymphangioma of the sigmoid colon: an uncommon cause of acute abdomen in pediatric patients.

    PubMed

    Fernandes, Bianca Furlan; Moraes, Érika Neves de Souza; de Oliveira, Francini Rossetto; Benevides, Gabriel Núncio; Felipe-Silva, Aloísio; Ferreira, Cristiane Rúbia; de Alcântara, Paulo Sérgio Martins; Tokeshi, Flavio; Martinês, João Augusto Dos Santos; Ferronato, Ângela Espósito

    2015-01-01

    Lymphangioma is a rare, benign lesion derived from a malformation of the lymphatic system, which is more frequently found in the head, neck, and axilla. However, it may be present anywhere in the body, and the diagnosis involves adults as children with some distinct clinical features among them. In pediatric patients, abdominal cystic lymphangioma occurs mostly in the mesentery presenting abdominal pain, intestinal obstruction, or, more rarely, hemorrhage. The authors report the case of a child with a short-course history of fever, abdominal pain, and constipation. The physical examination disclosed the presence of an abdominal mass and signs of peritoneal irritation. Imaging was consistent with a cystic lesion compressing the sigmoid colon and laterally displacing the remaining loops. Exploratory laparotomy was undertaken, and a sigmoidectomy, followed by Hartman's colostomy, was performed. Histological examination revealed the nature of the lesion as a cystic lymphangioma. The authors highlight the clinical features of this entity and call attention to this disease in the differential diagnosis of acute abdomen or abdominal pain, mainly in pediatric patients. PMID:26894047

  9. Subserous lymphangioma of the sigmoid colon: an uncommon cause of acute abdomen in pediatric patients

    PubMed Central

    Fernandes, Bianca Furlan; Moraes, Érika Neves de Souza; de Oliveira, Francini Rossetto; Felipe-Silva, Aloísio; Ferreira, Cristiane Rúbia; de Alcântara, Paulo Sérgio Martins; Tokeshi, Flavio; Martinês, João Augusto dos Santos; Ferronato, Ângela Espósito

    2015-01-01

    Lymphangioma is a rare, benign lesion derived from a malformation of the lymphatic system, which is more frequently found in the head, neck, and axilla. However, it may be present anywhere in the body, and the diagnosis involves adults as children with some distinct clinical features among them. In pediatric patients, abdominal cystic lymphangioma occurs mostly in the mesentery presenting abdominal pain, intestinal obstruction, or, more rarely, hemorrhage. The authors report the case of a child with a short-course history of fever, abdominal pain, and constipation. The physical examination disclosed the presence of an abdominal mass and signs of peritoneal irritation. Imaging was consistent with a cystic lesion compressing the sigmoid colon and laterally displacing the remaining loops. Exploratory laparotomy was undertaken, and a sigmoidectomy, followed by Hartman’s colostomy, was performed. Histological examination revealed the nature of the lesion as a cystic lymphangioma. The authors highlight the clinical features of this entity and call attention to this disease in the differential diagnosis of acute abdomen or abdominal pain, mainly in pediatric patients. PMID:26894047

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

    PubMed

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

    2013-03-01

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

  11. Metastatic Malignant Fibrous Histiocytoma Infiltrating Sigmoid Colon: A Case Diagnosed With the Help of 18F-FDG PET/CT.

    PubMed

    Wei, Wei-Jun; Shen, Chen-Tian; Song, Hong-Jun; Qiu, Zhong-Ling; Luo, Quan-Yong

    2016-04-01

    Metastatic malignant fibrous histiocytoma (MFH) in the colon is extremely rare, although MFH is one of the most common soft tissue sarcomas in adults. We report the case of a 45-year-old woman with metastatic MFH in the sigmoid colon, descending colon, and right lung with FDG PET/CT findings. PMID:26673233

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

    PubMed Central

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

    2009-01-01

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

  13. Propionate alters ion transport by rabbit distal colon

    SciTech Connect

    Horvath, P.J.; Weiser, M.M.; Duffey, M.E.

    1986-03-01

    The primary anions of the colon are short-chain fatty acids (SCFA) produced by intestinal microorganisms from endogenous secretions and dietary fiber. The effects of the SCFA propionate on ion transport by the epithelium of rabbit distal colon were studied on tissues stripped of underlying musculature and mounted in Ussing chambers. When tissues were bathed with NaCl Ringer's solutions at 37/sup 0/C (5% CO/sub 2/-21mM HCO/sub 3/, pH 7.4) replacement of 33mM Cl/sup -/ in both tissue baths by propionate reduced short-circuit current (Isc) from 86 to 35 ..mu..A/cm/sup 2/ and increased transepithelial conductance (G/sub t/) from 3.6 to 5.6mS/cm/sup 2/. Unidirectional /sup 14/C-propionate flux measurements revealed that this ion was secreted at a rate of 0.5..mu..Eq/cm/sup 2/hr. Intracellular measurements with potential and pH sensitive microelectrodes showed that propionate reduced intracellular pH (PH/sub i/) from 6.84 to 6.68 (P < 0.02), depolarized the apical membrane potential (phi/sub a/) by 4mV (P < 0.02) and decreased the membrane fractional resistance (f/sub R/) from .78 to .71 (P < 0.001). Addition of 0.1mM amiloride to the mucosal bath reversed Isc to -18..mu..A/cm/sup 2/, decreased G/sub t/ to 5.3mS/cm/sup 2/, hyperpolarized phi/sub a/ by 5mV (P < 0.05) and increased f/sub R/ to 0.85 (P < 0.001). Amiloride had no effect on pH/sub i/. These results show that propionate can be secreted by rabbit distal colon and that exposure to this SCFA causes cell acidification and electrophysiological changes consistent with H/sup +/ secretion.

  14. Modulation of Ion Transport Across Rat Distal Colon by Cysteine

    PubMed Central

    Pouokam, Ervice; Diener, Martin

    2012-01-01

    The aim of this study was to identify the actions of stimulation of endogenous production of H2S by cysteine, the substrate for the two H2S-producing enzymes, cystathionine-β-synthase and cystathionine-γ-lyase, on ion transport across rat distal colon. Changes in short-circuit current (Isc) induced by cysteine were measured in Ussing chambers. Free cysteine caused a concentration-dependent, transient fall in Isc, which was sensitive to amino-oxyacetate and β-cyano-L-alanine, i.e., inhibitors of H2S-producing enzymes. In contrast, Na cysteinate evoked a biphasic change in Isc, i.e., an initial fall followed by a secondary increase, which was also reduced by these enzyme inhibitors. All responses were dependent on the presence of Cl− and inhibited by bumetanide, suggesting that free cysteine induces an inhibition of transcellular Cl− secretion, whereas Na cysteinate – after a transient inhibitory phase – activates anion secretion. The assumed reason for this discrepancy is a fall in the cytosolic pH induced by free cysteine, but not by Na cysteinate, as observed in isolated colonic crypts loaded with the pH-sensitive dye, BCECF. Intracellular acidification is known to inhibit epithelial K+ channels. Indeed, after preinhibition of basolateral K+ channels with tetrapentylammonium or Ba2+, the negative Isc induced by free cysteine was reduced significantly. In consequence, stimulation of endogenous H2S production by Na cysteinate causes, after a short inhibitory response, a delayed activation of anion secretion, which is missing in the case of free cysteine, probably due to the cytosolic acidification. In contrast, diallyl trisulfide, which is intracellularly converted to H2S, only evoked a monophasic increase in Isc without the initial fall observed with Na cysteinate. Consequently, time course and amount of produced H2S seem to strongly influence the functional response of the colonic epithelium evoked by this gasotransmitter. PMID:22403551

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

    PubMed Central

    Vidyasagar, S; Ramakrishna, B S

    2002-01-01

    Short chain fatty acids, particularly butyrate, stimulate electroneutral NaCl absorption from the colon. Their effect in colonic epithelia lacking basal electroneutral NaCl absorption is unknown. Butyrate is also reported to inhibit active Cl− secretion in the colon. The present studies were undertaken to investigate the inter-relationships between the effects of butyrate on active Na+ and Cl− transport in the colon. Studies were carried out in rabbit distal colon (known to have predominant electrogenic Na+ absorption), rat distal colon (characterised by electroneutral Na+ absorption), and hyperaldosteronaemic rat distal colon (characterised by electrogenic Na+ absorption). The effect of cholera toxin (CT) was also noted. Potential difference, short-circuit current (ISC) and fluxes of Na+ and Cl− were measured in stripped mucosa under voltage-clamp conditions. Butyrate stimulated electroneutral Na+ and Cl− absorption in distal colon of normal and salt-depleted rats, and stimulated Na+ absorption in rabbit distal colon. Amiloride (10−4m) or CT did not inhibit this process. In rabbit distal colon, stimulation of Na+ absorption by butyrate was not dependent on the presence of Cl− in the medium. Butyrate significantly decreased conductance, decreased flux of sodium from serosa to mucosa (particularly in rabbit distal colon), and decreased ISC. Net Cl− secretion, induced by CT, was completely inhibited by butyrate. Stimulation of Na+ absorption was independent of exposure to CT. Bumetanide reversed net Cl− secretion to net absorption, but did not alter Na+ or Cl− fluxes in tissues exposed to butyrate. Thus butyrate stimulates active Na+ absorption in colonic epithelia, with or without expression of basal Na+-H+ exchange. Independently, butyrate inhibits active Cl− secretion induced by cAMP in these epithelia. PMID:11850510

  16. An unusual colon atresia in a calf: at the junction of the distal loop and transverse colon. A brief overview

    PubMed Central

    Lombardero, Matilde; Yllera, Mara del Mar

    2014-01-01

    Congenital defects are those abnormalities present at birth. During embryogenesis, many anomalies can occur. The primitive gut tube lengthens quickly and rotates, allowing the gastrointestinal tract acquire its final position and orientation. Because the colon of large animals is complex, most changes occur in this segment. Thus, in ruminants, colon atresia is the most frequent malformation, affecting mainly ascending colon, at the level of the spiral loop. There are no previous references about a very atypical colon atresia at the junction of distal loop and transverse colon, such we have described in a 5-day-old calf, after a history of abdominal distention and absence of feces at birth, even with a patent anal opening. Atresia coli was detected at distal position of the typical colon atresia, at the junction of distal loop and transverse colon. In addition, the distal blind end was bent into a U-shape supported by the mesocolon. Besides the anatomical findings of this worthwhile atresia coli we discuss its possible etiology, in which local factors, such as a compromised blood supply during embryogenesis, are more consistent than genetic factors. Finding out the causes of atresia coli would help to reduce its incidence, lessen animal suffering and economic loss. PMID:25495264

  17. Diagnosis of a submucosal mass at the staple line after sigmoid colon cancer resection by endoscopic cutting-mucosa biopsy

    PubMed Central

    Morimoto, Mitsuaki; Koinuma, Koji; Lefor, Alan K; Horie, Hisanaga; Ito, Homare; Sata, Naohiro; Hayashi, Yoshikazu; Sunada, Keijiro; Yamamoto, Hironori

    2016-01-01

    A 48-year-old man underwent laparoscopic sigmoid colon resection for cancer and surveillance colonoscopy was performed annually thereafter. Five years after the resection, a submucosal mass was found at the anastomotic staple line, 15 cm from the anal verge. Computed tomography scan and endoscopic ultrasound were not consistent with tumor recurrence. Endoscopic mucosa biopsy was performed to obtain a definitive diagnosis. Mucosal incision over the lesion with the cutting needle knife technique revealed a creamy white material, which was completely removed. Histologic examination showed fibrotic tissue without caseous necrosis or tumor cells. No bacteria, including mycobacterium, were found on culture. The patient remains free of recurrence at five years since the resection. Endoscopic biopsy with a cutting mucosal incision is an important technique for evaluation of submucosal lesions after rectal resection. PMID:27114752

  18. The Effects of Amiloride and Age on Oxygen Consumption Coupled to Electrogenic Sodium Transport in the Human Sigmoid Colon

    PubMed Central

    Carra, Graciela E.; Matus, Daniel; Ibáñez, Jorge E.; Saraví, Fernando D.

    2015-01-01

    Background/Aim: Aerobic metabolism is necessary for ion transport in many transporting epithelia, including the human colonic epithelium. We assessed the effects of the epithelial sodium channel blocker, amiloride, on oxygen consumption and short-circuit current of the human sigmoid epithelium to determine whether these effects were influenced by the age of the subject. Materials and Methods: Segments of the sigmoid colon were obtained from the safety margin of resections performed in patients of 62–77 years of age. Isolated mucosa preparations were obtained and mounted in airtight Ussing chambers, fit for simultaneous measurement of short-circuit current and oxygen concentration, before and after blocking epithelial sodium channels with amiloride (0.1 mmol/L). Regression analyses were performed to assess the associations between short-circuit current, oxygen consumption, and age of the subject as well as to define the relationship between the decreases in short-circuit current and oxygen consumption after blockade. Results: Epithelial sodium channel blockade caused an 80% reduction in short-circuit current and a 26% reduction in oxygen consumption. Regression analysis indicated that both changes were significantly related (r = 0.884; P = 0.0007). Oxygen consumption decreased by 1 μmol/h/cm2 for each 25 μA/cm2 decrease in short-circuit current. Neither short-circuit current nor oxygen consumption had any significant relationship with the age of the subjects. Conclusion: The decrease in epithelial oxygen consumption caused by amiloride is proportional to the decrease in short-circuit current and independent of the age of the subject. PMID:26458855

  19. Stercoral perforation of the sigmoid colon. A case report and brief review of the literature.

    PubMed

    Falidas, E; Mathioulakis, S; Vlachos, K; Archontovasilis, F; Villias, C

    2011-01-01

    Stercoral perforation of the colon due to fecaloma is a rare disease and less than 100 cases have been described in the literature. The disease mainly involves the rectosigmoid colon. The condition is correlated with longstanding decubitus, chronic constipation, abuse of laxatives and/or constipating agents (anticholinergics, neuroleptics, etc). We report a case of 82-year old woman who presented a covered colonic perforation due to fecaloma, related with a history of longstanding decubitus because of senile dementia, chronic constipation and use of anticholinergic drugs. PMID:22018258

  20. [Experience of the Pharmacotherapy against Appendix and Sigmoid Colon Signet Ring Cell Carcinoma with the Peritoneal Dissemination].

    PubMed

    Harada, Shingo; Tsuchida, Kazuhito; Shibuya, Taisuke; Doi, Yuki; Kikuchi, Akitomo; Mori, Koichi; Yabushita, Yasuhiro; Watanabe, Takuo; Murakami, Hitoshi; Hasegawa, Seiji; Fukushima, Tadao; Ike, Hideyuki; Nakayama, Takashi

    2015-10-01

    We report 2 cases of signet ring cell carcinoma of the appendix and colon. Case 1: A 61-year-old man was admitted for lower abdominal pain. Colonoscopy revealed an elevated lesion in the orifice of the appendix. Signet ring cell carcinoma was diagnosed on biopsy. The surgical findings showed multiple peritoneal dissemination nodules, while the primary tumor was unresectable owing to extensive invasion into the retroperitoneum. The histopathological findings were signet ring cell carcinoma, T4b (retroperitoneum), NX, P3, Stage Ⅳ. Although the patient received 14 courses of treatment with S-1 as postoperative chemotherapy, he died of his illness at 32 postoperative months. Case 2: A 76-year-old man was admitted for abdominal pain. Perforation of the lower gastrointestinal tract was diagnosed on abdominal CT, and an emergency operation was performed. The surgical findings demonstrated a large number of peritoneal dissemination nodules, cecal invasion of a sigmoid tumor, and perforation of the ascending colon. The primary tumor was thought to be unresectable, and the perforated segment was resected. The histopathological findings were signet ring cell carcinoma, T4b (cecum), NX, P3, Stage Ⅳ. Although 11 courses of treatment using FOLFIRI+Bev were administered as postoperative chemotherapy, the patient died of his illness at 26 postoperative months. PMID:26489568

  1. A case of a colocutaneous fistula: A rare complication of mesh migration into the sigmoid colon after open tension-free hernia repair

    PubMed Central

    Al-Subaie, Saud; Al-Haddad, Mohanned; Al-Yaqout, Wadha; Al-Hajeri, Mufarrej; Claus, Christiano

    2015-01-01

    Introduction The Lichtenstein technique is commonly used in inguinal hernia repair and a polypropylene mesh is the most frequently used mesh. Mesh migration into the colon has been rarely reported in the literature. Here we report a case of a colocutaneous fistula that developed following delayed mesh migration into the sigmoid colon. Presentation of case A 52-year-old man undergone Lichtenstein repair for left direct inguinal herniain 2008. Three years later, he presented complaining of rectal bleeding and concurrent bloody discharge from the hernia repair scar. Colonoscopy identified an internal fistulous orifice with intraluminal extrusion of the polypropylene mesh. Furthermore, abdominal ultrasound revealed a fistulous tract extending from the sigmoid colon to the anterior abdominal wall, and a fistulogram confirmed the findings. Open sigmoidectomy and resection of the abdominal wall with the fistula tract was performed, and BIO-A® tissue reinforcement meshwas placed. His postoperative course was unremarkable and was discharged on postoperative day 3. Discussion Mesh migration after mesh inguinal hernia repair is unpredictable. A previous report has presented complications related to prosthetics in hernia repair, such as infection, contraction, rejection, and, rarely, mesh migration.Mesh migration may occur as an early or late complication after hernioplasty. Conclusion During hernia repair, the surgeon should carefully check for a sliding hernia, which may contain the sigmoid colon within the sac, because failure to identify this hernia may lead to direct contact between the mesh and the colon, which may cause pressure necrosis and fistula formation followed by mesh migration. PMID:26209758

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

    PubMed

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

    2013-01-01

    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

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

    SciTech Connect

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

    2009-05-22

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

  4. Gut commensal bacteria and regional Wnt gene expression in the proximal versus distal colon.

    PubMed

    Neumann, Philipp-Alexander; Koch, Stefan; Hilgarth, Roland S; Perez-Chanona, Ernesto; Denning, Patricia; Jobin, Christian; Nusrat, Asma

    2014-03-01

    Regional expression of Wingless/Int (Wnt) genes plays a central role in regulating intestinal development and homeostasis. However, our knowledge of such regional Wnt proteins in the colon remains limited. To understand further the effect of Wnt signaling components in controlling intestinal epithelial homeostasis, we investigated whether the physiological heterogeneity of the proximal and distal colon can be explained by differential Wnt signaling. With the use of a Wnt signaling-specific PCR array, expression of 84 Wnt-mediated signal transduction genes was analyzed, and a differential signature of Wnt-related genes in the proximal versus distal murine colon was identified. Several Wnt agonists (Wnt5a, Wnt8b, and Wnt11), the Wnt receptor frizzled family receptor 3, and the Wnt inhibitory factor 1 were differentially expressed along the colon length. These Wnt signatures were associated with differential epithelial cell proliferation and migration in the proximal versus distal colon. Furthermore, reduced Wnt/β-catenin activity and decreased Wnt5a and Wnt11 expression were observed in mice lacking commensal bacteria, an effect that was reversed by conventionalization of germ-free mice. Interestingly, myeloid differentiation primary response gene 88 knockout mice showed decreased Wnt5a levels, indicating a role for Toll-like receptor signaling in regulating Wnt5a expression. Our results suggest that the morphological and physiological heterogeneity within the colon is in part facilitated by the differential expression of Wnt signaling components and influenced by colonization with bacteria. PMID:24418259

  5. Gut Commensal Bacteria and Regional Wnt Gene Expression in the Proximal Versus Distal Colon

    PubMed Central

    Neumann, Philipp-Alexander; Koch, Stefan; Hilgarth, Roland S.; Perez-Chanona, Ernesto; Denning, Patricia; Jobin, Christian; Nusrat, Asma

    2015-01-01

    Regional expression of Wingless/Int (Wnt) genes plays a central role in regulating intestinal development and homeostasis. However, our knowledge of such regional Wnt proteins in the colon remains limited. To understand further the effect of Wnt signaling components in controlling intestinal epithelial homeostasis, we investigated whether the physiological heterogeneity of the proximal and distal colon can be explained by differential Wnt signaling. With the use of a Wnt signaling-specific PCR array, expression of 84 Wnt-mediated signal transduction genes was analyzed, and a differential signature of Wnt-related genes in the proximal versus distal murine colon was identified. Several Wnt agonists (Wnt5a, Wnt8b, and Wnt11), the Wnt receptor frizzled family receptor 3, and the Wnt inhibitory factor 1 were differentially expressed along the colon length. These Wnt signatures were associated with differential epithelial cell proliferation and migration in the proximal versus distal colon. Furthermore, reduced Wnt/β-catenin activity and decreased Wnt5a and Wnt11 expression were observed in mice lacking commensal bacteria, an effect that was reversed by conventionalization of germ-free mice. Interestingly, myeloid differentiation primary response gene 88 knockout mice showed decreased Wnt5a levels, indicating a role for Toll-like receptor signaling in regulating Wnt5a expression. Our results suggest that the morphological and physiological heterogeneity within the colon is in part facilitated by the differential expression of Wnt signaling components and influenced by colonization with bacteria. PMID:24418259

  6. [A case of multiple lung metastases of sigmoid colon cancer responding well to oral UFT+leucovorin therapy].

    PubMed

    Fukasawa, Motoji; Kitahama, Seiichi; Watanabe, Yukihiro; Kitagawa, Michiko; Yamamoto, Satoshi; Koneri, Kenji; Kusanagi, Hiroshi; Kuroki, Motoo; Takeshi, Akihiko; Kano, Nobuyasu

    2005-11-01

    Chemotherapy combining 5-fluorouracil (5-FU) with leucovorin is now used as a standard regimen for chemotherapy of inoperative, recurrent or distantly-metastasized colorectal carcinoma. We recently treated a patient with multiple metastases of sigmoid colon cancer by sigmoidectomy and oral drug therapy using a combination of Uzel (dl-leucovorin) and UFT (uracil and tegafur). Three courses of this therapy were administered, with each course consisting of treatment for 4 consecutive week (UFT 400 mg/day, Uzel 75 mg/day) and a one week interval between successive courses. The therapy resulted in marked reduction of tumor and this response was rated as PR (partial response). The lower lobe of the right lung, which showed the largest tumor (34.5 x 35.7 mm), was resected, and the upper lobe of the same lung, showing a small metastastic tumor (4.4 x 4.6 mm), was partially resected. Oral chemotherapy, which had begun before surgery, was continued after lobectomy and partial pneumonectomy. To date (January 15, 2005), the patient has received 5 courses of this therapy and has shown no signs of tumor exacerbation. Because this therapy has allowed satisfactory control of metastatic tumor for about one year since surgery without causing any adverse reaction or requiring re-hospitalization, it is fair to say that the therapy has successfully maintained the quality of life (QOL) of this patient. PMID:16282737

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

    PubMed

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

    2010-03-01

    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

  8. Lower gastrointestinal bleeding as a result of fistula between the iliac artery and sigmoid colon in patient with advanced testicular cancer.

    PubMed

    Santos, Vanessa Prado dos; Razuk, Álvaro Filho; Júnior, Valter Castelli; Caffaro, Roberto Augusto

    2013-01-01

    Fistula between arteries and the gastrointestinal tract are a rare cause of gastrointestinal bleeding, but potentially fatal. The recognition and early treatment can modify the patient prognosis. We report a case of a patient with previous surgery for seminoma of cryptorchidic testicle, with massive lower gastrointestinal bleeding. We performed the diagnosis and surgical treatment of the fistula between left external iliac artery and sigmoid colon. The patient was successfully treated by external iliac artery ligation and left colectomy. PMID:24267117

  9. Transcriptional Profiling of mRNA Expression in the Mouse Distal Colon

    PubMed Central

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

    2009-01-01

    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. PMID:18848557

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

    PubMed Central

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

    1988-01-01

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

  11. [A Case of Double Cancer of Initially Unresectable Sigmoid Colon Cancer and Advanced Gastric Cancer Treated with Curative Resection after mFOLFOX6 Therapy].

    PubMed

    Yoshikawa, Toru; Aoki, Kazunori; Mitsuhashi, Yuto; Tomiura, Satoko; Suto, Akiko; Miura, Takuya; Ikenaga, Shojirokazunori; Shibasaki, Itaru; Endo, Masaaki

    2016-03-01

    A 61-year-old man was admitted to our hospital because of a complaint of blood in stool. He was diagnosed with advanced colon and gastric cancers. Computed tomography (CT) revealed a sigmoid tumor with invasion to the bladder, a metastatic tumor in the lateral segmental branch of the left hepatic lobe, and ascites. He was diagnosed with initially unresectable double cancer. Ileostomy was performed immediately, and he was treated with modified (m) FOLFOX6 regimen (oxaliplatin in combination with infusional 5-fluorouracil/Leucovorin). After 6 courses of the mFOLFOX6 regimen, CT revealed that the primary lesion of the sigmoid colon and liver metastasis had reduced in size, and the ascites had disappeared. Gastroscopy revealed that the gastric cancer had disappeared. Biopsy results were negative. Accordingly, his gastric cancer was diagnosed as treatment effect Grade 3. After 8 courses of mFOLFOX6 therapy, sigmoidectomy, partial resection of the bladder, and partial resection of the liver were performed. Gastric cancer was not resected in accordance with his will. Although 40 months has passed after the radical resection, neither the sigmoid colon cancer nor the gastric cancer recurred. PMID:27067857

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

    PubMed

    Dhaese, Ingeborg; Van Colen, Inge; Lefebvre, Romain A

    2010-02-25

    Hydrogen sulfide (H(2)S) has been suggested as a gaseous neuromodulator in mammals. The aim of this study was to examine the influence of H(2)S on contractility in mouse distal colon. The effect of sodium hydrogen sulfide (NaHS; H(2)S donor) on prostaglandin F(2alpha) (PGF(2alpha))-contracted circular muscle strips of mouse distal colon was investigated. In addition, tension and cytosolic calcium concentration ([Ca(2+)](cyt)) in the mouse distal colon strips were measured simultaneously in the presence of NaHS. NaHS caused concentration-dependent relaxation of the pre-contracted mouse distal colon strips. The NaHS-induced relaxation was not influenced by the K(+) channels blockers glibenclamide, apamin, charybdotoxin, barium chloride and 4-aminopyridine. The relaxation by NaHS was also not influenced by the nitric oxide inhibitor L-NAME, by the soluble guanylate cyclase respectively adenylate cyclase inhibitors ODQ and SQ 22536, by the nerve blockers capsazepine, omega-conotoxin and tetrodotoxin or by several channel and receptor blockers (ouabain, nifedipine, 2-aminoethyl diphenylborinate, ryanodine and thapsigargin). The initiation of the NaHS-induced relaxation was accompanied by an increase in [Ca(2+)](cyt), but once the relaxation was maximal and sustained, no change in [Ca(2+)](cyt) was measured. This calcium desensitization is not related to the best known calcium desensitizing mechanism as the myosin light chain phosphatase (MLCP) inhibitor calyculin-A and the Rho-kinase inhibitor Y-27632 had no influence. We conclude that NaHS caused concentration-dependent relaxations in mouse distal colon not involving the major known K(+) channels and without a change in [Ca(2+)](cyt). This calcium desensitization is not related to inhibition of Rho-kinase or activation of MLCP. PMID:19919833

  13. Dopamine stimulates Cl(-) absorption coupled with HCO(3)(-) secretion in rat late distal colon.

    PubMed

    Zhang, Gui Hong; Zhu, Jin Xia; Xue, Hong; Fan, Jing; Chen, Xin; Tsang, Lai Ling; Chung, Yiu Wa; Xing, Ying; Chan, Hsiao Chang

    2007-09-10

    Freshly isolated rat colonic mucosa close to anus (the late distal colonic mucosa) was used to investigate the effect of dopamine on the rat late distal colonic ion transport by means of short-circuit current (I(SC)) recording and reverse transcription PCR (RT-PCR) analysis. The results showed that the basolateral addition of dopamine (0.1-1000 micromol/l) produced a concentration-dependent downward deflection in I(SC) with an apparent EC(50) of 20.06 micromol/l in the late distal colon. The dopamine-induced I(SC) decrease was abolished by bilateral removal of Cl(-) or HCO(3)(-), apical Cl(-) replacement and apical pretreatment with non-specific Cl(-) channel blocker/transporter inhibitor, DPC (1 mmol/l) or glibenclamide (1 mmol/l), and reversed by subsequent addition of glibenclamide. Removal of basolateral Na(+) or reducing basolateral HCO(3)(-) (3 mmol/l) as well as basolateral pretreatment with DIDS (4,4'-didsothio- cyanostilbene-2, 2'-disulfonic acid) (250 micromol/l), an inhibitor of NBC or AE, could also inhibit the dopamine-induced I(SC) response. However, apical pretreatment with epithelial Na(+) channel blocker, amiloride (10 micromol/l), Ca(2+)-dependent Cl(-) channel blocker/anion exchanger, DIDS (100 micromol/l), or putative K(+) blockers such as Ba(2+) (5 mmol/l), TEA (tetraethylammonium) (5 mmol/l) or 293B (trans-6-cyano-4- (N-ethylsulfonyl-N-methylamino)-3-hydroxy-2,2-dimethyl-chromane) (10 micromol/l) did not significantly affect the dopamine-induced I(SC) response. RT-PCR results showed the expression of anion exchanger, SLC26A3, but not SLC26A6, in rat late distal colon. In conclusion, the present results suggest that dopamine may promote rat late distal colonic epithelial Cl(-) absorption coupled with HCO(3)(-) secretion, which may be mediated by apical electrogenic anion exchanger, SLC26A3, and require basolateral entry of HCO(3)(-) through Na(+)-HCO(3)(-) cotransporter. The present findings reveal a previously unreported dopamine-regulated anion transport process in rat late distal colon, which may have implication in Parkinson's disease. PMID:17597606

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

    PubMed Central

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

    2014-01-01

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

  15. Feasibility of Hand-Assisted Laparoscopic Surgery as Compared to Open Surgery for Sigmoid Colon Cancer: A Case-Controlled Study

    PubMed Central

    Nam, Sang Eun; Jung, Eun-Joo; Ryu, Chun-Geun; Paik, Jin Hee

    2013-01-01

    Purpose The aim of this study was to evaluate short-term clinical outcomes by comparing hand-assisted laparoscopic surgery (HALS) with open surgery for sigmoid colon cancer. Methods Twenty-six patients who underwent a hand-assisted laparoscopic anterior resection (HAL-AR group) and 52 patients who underwent a conventional open anterior resection during the same period were enrolled (open group) in this study with a case-controlled design. Results Pathologic parameters were similar between the two groups. The incidences of immediate postoperative leukocytosis were 38.5% in the HAL-AR group and 69.2% in the open group (P = 0.009). There were no significant differences between the two groups as to leukocyte count, hemoglobin, and hematocrits (P = 0.758, P = 0.383, and P = 0.285, respectively). Of the postoperative recovery indicators, first flatus, sips of water and soft diet started on postoperative days 3, 5, 7 in the HALS group and on days 4, 5, 6 in the open group showed statistical significance (P = 0.021, P = 0.259, and P = 0.174, respectively). Administration of additional pain killers was needed for 1.2 days in the HAL-AR group and 2.4 days in the open group (P = 0.002). No significant differences in the durations of hospital stay and the rates of postoperative complications were noted, and no postoperative mortality was encountered in either group. Conclusion The patients with sigmoid colon cancer who underwent a HAL-AR had a lower incidence of postoperative leukocytosis, less administration of pain killers, and faster first flatus than those who underwent open surgery. Clinical outcomes for patients' recovery and pathology status were similar between the two groups. Therefore, a HAL-AR for sigmoid colon cancer is feasible and has the same benefit as minimally invasive surgery. PMID:23586010

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

    PubMed

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

    2014-07-01

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

  17. [Surgical Simulation-CT Colonography for Laparoscopic Assisted Sigmoid Colectomy Preserving the Inferior Mesenteric Artery and Vein].

    PubMed

    Narushima, Kazuo; Miyauchi, Hideaki; Ohira, Gaku; Gunji, Hisashi; Hayano, Kouichi; Aoyagi, Tomoyoshi; Kagaya, Akiko; Muto, Yorihiko; Ota, Takumi; Saito, Hiroshige; Ishii, Sayaka; Isozaki, Tetsuro; Kurata, Yoshihiro; Takahashi, Yumiko; Matsubara, Hisahiro

    2015-11-01

    D2 lymph node dissection in laparoscopic surgery for early colon cancer requires selective vessel dissection, making it technically very difficult. Using surgical simulation-CT colonography (simulation-CTC), we could perform laparoscopic assisted sigmoid colectomy preserving the inferior mesenteric artery (IMA) and vein (IMV) more accurately and safely. The case described here was a type 0-Ip sigmoid colon cancer with a tumor size of 13 mm. Endoscopic mucosal resection was performed to confirm a pathological diagnosis of pT1b (4,000 mm) and v1. Sigmoid colectomy was planned, and simulation-CTC was performed, which demonstrated that the cancer was located in the proximal sigmoid colon and supplied by the first sigmoid colon artery (S1). To maintain the blood flow to the distal sigmoid colon, selective S1 resection preserving the IMA and IMV was planned. At the operation, S1, which branches off from the IMA near the bifurcation of the abdominal aorta, was dissected, and the vein accompanying S1, which branches from the IMV in the same area as S1, was dissected. The operation was performed accurately according to the plan, showing that simulation-CTC can be very useful. PMID:26805289

  18. Differential DNA methylation patterns of homeobox genes in proximal and distal colon epithelial cells.

    PubMed

    Barnicle, Alan; Seoighe, Cathal; Golden, Aaron; Greally, John M; Egan, Laurence J

    2016-04-01

    Region and cell-type specific differences in the molecular make up of colon epithelial cells have been reported. Those differences may underlie the region-specific characteristics of common colon epithelial diseases such as colorectal cancer and inflammatory bowel disease. DNA methylation is a cell-type specific epigenetic mark, essential for transcriptional regulation, silencing of repetitive DNA and genomic imprinting. Little is known about any region-specific variations in methylation patterns in human colon epithelial cells. Using purified epithelial cells and whole biopsies (n= 19) from human subjects, we generated epigenome-wide DNA methylation data (using the HELP-tagging assay), comparing the methylation signatures of the proximal and distal colon. We identified a total of 125 differentially methylated sites (DMS) mapping to transcription start sites of protein-coding genes, most notably several members of the homeobox (HOX) family of genes. Patterns of differential methylation were validated with MassArray EpiTYPER. We also examined DNA methylation in whole biopsies, applying a computational technique to deconvolve variation in methylation within cell types and variation in cell-type composition across biopsies. Including inferred epithelial proportions as a covariate in differential methylation analysis applied to the whole biopsies resulted in greater overlap with the results obtained from purified epithelial cells compared with when the covariate was not included. Results obtained from both approaches highlight region-specific methylation patterns ofHOXgenes in colonic epithelium. Regional variation in methylation patterns has implications for the study of diseases that exhibit regional expression patterns in the human colon, such as inflammatory bowel disease and colorectal cancer. PMID:26812987

  19. Distinct subclassification of DRG neurons innervating the distal colon and glans penis/distal urethra based on the electrophysiological current signature

    PubMed Central

    Petruska, Jeffrey C.; Cooper, Brian Y.; Johnson, Richard D.

    2014-01-01

    Spinal sensory neurons innervating visceral and mucocutaneous tissues have unique microanatomic distribution, peripheral modality, and physiological, pharmacological, and biophysical characteristics compared with those neurons that innervate muscle and cutaneous tissues. In previous patch-clamp electrophysiological studies, we have demonstrated that small- and medium-diameter dorsal root ganglion (DRG) neurons can be subclassified on the basis of their patterns of voltage-activated currents (VAC). These VAC-based subclasses were highly consistent in their action potential characteristics, responses to algesic compounds, immunocytochemical expression patterns, and responses to thermal stimuli. For this study, we examined the VAC of neurons retrogradely traced from the distal colon and the glans penis/distal urethra in the adult male rat. The afferent population from the distal colon contained at least two previously characterized cell types observed in somatic tissues (types 5 and 8), as well as four novel cell types (types 15, 16, 17, and 18). In the glans penis/distal urethra, two previously described cell types (types 6 and 8) and three novel cell types (types 7, 14, and 15) were identified. Other characteristics, including action potential profiles, responses to algesic compounds (acetylcholine, capsaicin, ATP, and pH 5.0 solution), and neurochemistry (expression of substance P, CGRP, neurofilament, TRPV1, TRPV2, and isolectin B4 binding) were consistent for each VAC-defined subgroup. With identification of distinct DRG cell types that innervate the distal colon and glans penis/distal urethra, future in vitro studies related to the gastrointestinal and urogenital sensory function in normal as well as abnormal/pathological conditions may be benefitted. PMID:24872531

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-07-01

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

  2. [A case of an ulcer of the sigmoid colon during chemotherapy with FOLFOX4 and bevacizumab for recurrence of rectal carcinoma].

    PubMed

    Okuya, Koichi; Mizushima, Yasuhiro; Hirata, Koichi

    2013-01-01

    The patient was a 73-year-old female. After curative resection for rectal cancer with uterus invasion, UFT/Leucovorin was administered orally for 16 months. Three years and six months after the initial surgery, en bloc cystourethrectomy was performed to control the bleeding caused by a local recurrence invading the bladder and ureter. Although postoperative FOL- FOX4/bevacizumab therapy was started, bevacizumab was discontinued after 4 courses of treatment because an ulcer was confirmed at the sigmoid colon with stoma. The ulcer was relieved by conservative medical treatment. In this case, we attempted to make a quick response because the site of the ulcer could be easily observed. During chemotherapy. Therefore, it is necessary to carefully observe the patient's conditions. PMID:23306930

  3. [Para-Aortic Lymphadenectomy and Subsequent Chemotherapy after Resection of the Primary Lesion for Poorly Differentiated Adenocarcinoma of the Sigmoid Colon - A Case Report].

    PubMed

    Kuribara, Tadao; Ichikawa, Tatsuo; Kaneko, Shiori; Osa, Kiyoshi; Ueda, Mamoru; Inoue, Takeshi; Asanuma, Kouzou; Sano, Takayuki; Kishimoto, Yutaka; Ishizu, Hideki; Iai, Akira

    2015-11-01

    The patient was a 68-year-old male who had bloody stools. A colonoscopy revealed a sigmoid colon stricture, and a histological examination confirmed the presence of a poorly differentiated adenocarcinoma.Computed tomography revealed the involvement of a para-aortic lymph nodes, without other metastatic lesions. The patient underwent a sigmoidectomy (with regional lymph node dissection) and a para-aortic lymph node biopsy to prove the histological conformation. Subsequently, he was provided with 6 courses of modified FOLFOX6(mFOLFOX6) chemotherapy, resulting in a marked decrease in para-aortic lymph node involvement. He subsequently underwent a para-aortic lymphadenectomy. The resected specimen was mostly composed of fibrous degenerative tissue; viable cancer cells were observed only in a 2-mm area. The patient was provided with 6 more courses of mFOLFOX6 chemotherapy, and has since been free of recurrence (for 6 years and 1 month after the second surgery). PMID:26602407

  4. 17β-Oestradiol acutely regulates Cl− secretion in rat distal colonic epithelium

    PubMed Central

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

    2001-01-01

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

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

    PubMed

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

    1992-07-01

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

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

    PubMed

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

    2012-01-01

    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

  7. Undiagnosed hypothyroidism presenting with sigmoid volvulus

    PubMed Central

    Meytes, Vadim; Schulberg, Steven P.; Morin, Nicholas; Glinik, Galina

    2016-01-01

    The incidence of hypothyroidism presenting with sigmoid volvulus, a phenomenon known as myxedema pseudovolvulus, is exceedingly rare. A male in his late thirties presented to our institution with a chief complaint of abdominal pain. The patient underwent CT scan, which was consistent with massive colonic dilatation with sigmoid volvulus. He was taken to the operating room for exploration and was found to have sigmoid volvulus and underwent a segmental resection. Postoperatively, the patient was newly diagnosed with severe hypothyroidism. PMID:27106615

  8. Undiagnosed hypothyroidism presenting with sigmoid volvulus.

    PubMed

    Meytes, Vadim; Schulberg, Steven P; Morin, Nicholas; Glinik, Galina

    2016-01-01

    The incidence of hypothyroidism presenting with sigmoid volvulus, a phenomenon known as myxedema pseudovolvulus, is exceedingly rare. A male in his late thirties presented to our institution with a chief complaint of abdominal pain. The patient underwent CT scan, which was consistent with massive colonic dilatation with sigmoid volvulus. He was taken to the operating room for exploration and was found to have sigmoid volvulus and underwent a segmental resection. Postoperatively, the patient was newly diagnosed with severe hypothyroidism. PMID:27106615

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

    PubMed Central

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

    2014-01-01

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

  10. Characterization of butyrate-dependent electroneutral Na-Cl absorption in the rat distal colon.

    TOXLINE Toxicology Bibliographic Information

    Binder HJ; Mehta P

    1990-12-01

    Recent studies have established that mucosal butyrate stimulates electroneutral sodium-chloride (Na-Cl) absorption in the distal colon of the rat and a model in which Na-hydrogen (H) and Cl-butyrate exchanges are coupled has been proposed as the mechanism of butyrate-dependent electroneutral Na-Cl absorption. These studies were designed to examine butyrate-dependent electroneutral Na-Cl absorption in experimental conditions in which HCO3-dependent electroneutral Na-Cl absorption is inhibited: in Na-depleted (aldosterone-treated) animals and in the presence of increased mucosal cyclic adenosine monophosphate (AMP). Butyrate-dependent electroneutral Na-Cl absorption was markedly reduced in Na-depleted rats. In contrast, the inhibition of both net Na and net Cl absorption by 5 mM serosal theophylline was significantly less in butyrate-containing, HCO3-free Ringer solution than in butyrate-free- HCO3-containing Ringer solution. These studies indicate that cyclic AMP does not inhibit butyrate-dependent electroneutral Na-Cl absorption and we propose that the mechanism of cyclic AMP inhibition of HCO3-dependent electroneutral Na-Cl absorption may be a result of its inhibition of Cl-HCO3, not Na-H exchange.

  11. Characterization of butyrate-dependent electroneutral Na-Cl absorption in the rat distal colon.

    PubMed

    Binder, H J; Mehta, P

    1990-12-01

    Recent studies have established that mucosal butyrate stimulates electroneutral sodium-chloride (Na-Cl) absorption in the distal colon of the rat and a model in which Na-hydrogen (H) and Cl-butyrate exchanges are coupled has been proposed as the mechanism of butyrate-dependent electroneutral Na-Cl absorption. These studies were designed to examine butyrate-dependent electroneutral Na-Cl absorption in experimental conditions in which HCO3-dependent electroneutral Na-Cl absorption is inhibited: in Na-depleted (aldosterone-treated) animals and in the presence of increased mucosal cyclic adenosine monophosphate (AMP). Butyrate-dependent electroneutral Na-Cl absorption was markedly reduced in Na-depleted rats. In contrast, the inhibition of both net Na and net Cl absorption by 5 mM serosal theophylline was significantly less in butyrate-containing, HCO3-free Ringer solution than in butyrate-free- HCO3-containing Ringer solution. These studies indicate that cyclic AMP does not inhibit butyrate-dependent electroneutral Na-Cl absorption and we propose that the mechanism of cyclic AMP inhibition of HCO3-dependent electroneutral Na-Cl absorption may be a result of its inhibition of Cl-HCO3, not Na-H exchange. PMID:2080102

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

    PubMed

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

    1994-01-01

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

  13. Extended right hemicolectomy and left hemicolectomy for colorectal cancers between the distal transverse and proximal descending colon.

    PubMed

    Gravante, G; Elshaer, M; Parker, R; Mogekwu, A C; Drake, B; Aboelkassem, A; Rahman, E U; Sorge, R; Alhammali, T; Gardiner, K; Al-Hamali, S; Rashed, M; Kelkar, A; Agarwal, R; El-Rabaa, S

    2016-05-01

    Introduction We report our experience with extended right hemicolectomy (ERH) and left hemicolectomy (LH) for the treatment of cancers located between the distal transverse and the proximal descending colon, and compare postoperative morbidity, mortality, pathological results and survival for the two techniques. Methods A retrospective review was performed of a single institution series over ten years. Patients who underwent different operations, had benign disease or received palliative resections were excluded. Data collected were patient demographics, type and duration of surgery, tumour site, postoperative complications and histology results. Results Ninety-eight patients were analysed (64 ERHs, 34 LHs). ERH was conducted using an open approach in 93.8% of cases compared with 73.5% for LH. The anastomotic leak rate was similar for both groups (ERH: 6.3%, LH: 5.9%). This was also the case for other postoperative complications, mortality (ERH: 1.6%, LH: 2.9%) and overall survival (ERH: 50.4 months, LH: 51.8 months). All but one patient in the ERH cohort had clear surgical margins. Nodal evaluation for staging was adequate in 78.1% of ERH cases and 58.8% of LH cases. Conclusions In our experience, both ERH and LH are adequate for tumours located between the distal transverse and the proximal descending colon. PMID:27023638

  14. Fibromatosis of the Sigmoid Colon With CTNNB1 (β-Catenin) Gene Mutation, Arising at the Site of Ileocolic Anastomosis for Resection of Gastrointestinal Stromal Tumor.

    PubMed

    Thway, Khin; Abou Sherif, Sara; Riddell, Angela M; Mudan, Satvinder

    2016-05-01

    We describe a case of intra-abdominal fibromatosis, which occurred in a 44-year-old woman who had a previous history of gastrointestinal stromal tumor (GIST) of the sigmoid mesocolon, which was treated with imatinib and resection. A mass was detected at the site of ileocolic anastomosis of the previous small bowel resection and sigmoid colectomy, nearly 3 years later. Clinically, this was suspected to represent recurrent GIST and was excised, but histology and mutational analysis showed desmoid-type fibromatosis with a mutation in codon 41 of exon 3 of the CTNNB1 (β-catenin) gene. The occurrence of fibromatosis at the site of excision of GIST is very rare, but its recognition is important as the treatment of the two neoplasms differs significantly. As imaging cannot reliably distinguish between these 2 entities, histological diagnosis is crucial for correct clinical management. PMID:26721303

  15. Reproductive factors and colon cancers.

    PubMed Central

    Peters, R. K.; Pike, M. C.; Chang, W. W.; Mack, T. M.

    1990-01-01

    In Los Angeles County, the age-adjusted incidence rate of colon cancer in men is almost 30% higher than that in women; however, in the descending and sigmoid colon, age-specific incidence rates for women are higher than those for men before age 55. Since menstrual and/or reproductive factors may be involved in producing this crossover in age-specific rates, they were examined in a population-based case-control study involving 327 white women with adenocarcinoma of the colon and age-, race- and neighbourhood-matched controls. After adjustment for other factors associated with colon cancer in this study (family history of large bowel cancer, total fat intake, calcium, weight and activity level), ever having been pregnant was protective (RR = 0.56, 95% CI = 0.33-0.97). For one to two pregnancies, the RR was 0.76 (CI = 0.42-1.37); for three or more pregnancies, the RR was 0.45 (CI = 0.25-0.81). However, the relationship between the number of pregnancies and colon cancer risk was actually U-shaped, with risk decreasing with successive pregnancies up to four and then increasing with additional pregnancies. The U-shaped relationship was present for incomplete as well as for full-term pregnancies and was more striking for cancers occurring in the distal (descending and sigmoid) than proximal (caecum to splenic flexure) colon. Risk was not related to age at menarche or use of exogenous oestrogens, but delayed natural menopause was weakly protective in the proximal but not distal colon. The crossover in incidence rates in the distal colon can be completely accounted for by the pregnancy effect. The U-shape of the pregnancy curve suggests the possibility of competing factors, some protective, especially after one or several pregnancies, and others conferring increasing risk with successive pregnancies, regardless of the pregnancy outcome. PMID:2337511

  16. Increased oxygen consumption caused by cAMP- and Ca(2+)-mediated chloride secretion in rat distal colon.

    PubMed

    Saraví, Fernando D; Cincunegui, Liliana M; Saldeña, Teobaldo A; Carra, Graciela E; Ibáñez, Jorge E

    2005-01-01

    Epithelial ion transport is dependent on ATP supply provided by aerobic metabolism. In the rat distal colon chloride secretion accounts for the largest portion of electrogenic transport measured as the short-circuit current (I(SC)). Inhibition of basal chloride secretion decreases epithelial oxygen consumption (QO2) in this tissue, while serotonin (5-hydroxytryptamine) proportionally increases both Isc and QO2. The effect of serotonin in this tissue is mainly mediated by 5HT4 receptors linked to adenylate cyclase through a stimulant G protein (GS). This work assessed whether the chloride secretion-induced increase in QO2 is a common characteristic of secretagogues, which act through either cAMP-dependent or Ca(2+)-dependent mechanisms. The effects of phosphodiesterase inhibitor 3-isobutyl-1-methylxantine (IBMX) and muscarinic agonist carbachol (both 0.1 mmol/L) were studied in rat distal colon isolated mucosa mounted in an Ussing chamber adapted for continuous measurement of oxygen concentration, allowing determination of QO2. Baseline I(SC) and QO2 were compared with I(SC) and QO2 after addition of either serotonin as an active control, IBMX, carbachol or IBMX plus carbachol. Each drug increased proportionally Isc and QO2. Although the effect of IBMX alone was modest and that of carbachol was short-lived, a synergic effect on Isc and QO2 was seen when both drugs were simultaneously added. Linear regression analysis showed a significant correlation between increases in I(SC) and QO2 (r2 = 0.746; P < 0.0001). Thus, stimulation of chloride secretion increases QO2 regardless of the intracellular pathway involved. These results extend previous findings, corroborating the close coupling between chloride secretion and QO2 in this epithelium. PMID:15954731

  17. Arecoline excites the contraction of distal colonic smooth muscle strips in rats via the M3 receptor-extracellular Ca2+ influx - Ca2+ store release pathway.

    PubMed

    Li, Chuan-Bao; Yang, Xiao; Tang, Wen-Bo; Liu, Chuan-Yong; Xie, Dong-Ping

    2010-04-01

    Areca is a Chinese herbal medicine that is widely used for constipation. However the mechanisms of its action are not clear. We investigated the effects of arecoline, the most active component of areca, on the motility of rat distal colonic smooth muscle strips. In longitudinal muscle of distal colon (LMDC) and circular muscle of distal colon (CMDC), arecoline increased the contraction in a dose-dependent manner. Tetrodotoxin (TTX) did not inhibit the effects of arecoline. The contractile response to arecoline was completely antagonized by atropine. 4-Diphenylacetoxy-N-methylpiperidine methiodide (4-DAMP) strongly depressed the response to arecoline, but gallamine and methoctramine did not. Nifedipine, 2-aminoethoxydiphenyl borate (2-APB), and Ca2+-free Krebs solution with EGTA partly inhibited the effects of arecoline. The sum of Ca2+-free Krebs solution, EGTA, and 2-APB completely inhibited the effects of arecoline. The results show that arecoline stimulates distal colonic contraction in rats via the muscarinic (M3) receptor - extracellular Ca2+ influx - Ca2+ store release pathway. It is likely that the action of areca in relieving constipation is due to its stimulation of muscle contraction. PMID:20555412

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

    SciTech Connect

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

    2013-12-04

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2011-01-01

    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. PMID:21410601

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

    PubMed Central

    Edmonds, C J

    1981-01-01

    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

  2. Routine Evaluation of the Distal Colon Remnant Before Hartmann’s Reversal is Not Necessary in Asymptomatic Patients

    PubMed Central

    Ballian, Nikiforos; Zarebczan, Barbara; Munoz, Alejandro; Harms, Bruce; Heise, Charles P.; Foley, Eugene F.

    2016-01-01

    Background Reversal of Hartmann’s is a common surgical procedure. Routine preoperative evaluation of the distal colonic/rectal remnant (DCRR) with contrast and/or endoscopic studies is frequently performed despite lack of evidence to support this practice. We hypothesize that asymptomatic patients can safely undergo Hartmann’s reversal without preoperative DCRR evaluation. Methods Adult patients undergoing reversal of Hartmann’s at a single institution were retrospectively identified. Operative characteristics and outcomes in patients with and without preoperative DCRR evaluation were compared. Results Between 1993 and 2008, 203 patients underwent reversal of Hartmann’s at a tertiary referral center. Sixty-eight patients (33%) did not undergo preoperative DCRR evaluation and had comparable demographic characteristics, comorbidities, DCRR length, and perioperative outcomes to 135 patients who underwent preoperative contrast and/or endoscopic studies. After evaluation, 125 (93%) patients had normal findings, seven (5%) patients had abnormal studies that did not impact their management, and three (2%) patients underwent additional procedures. Conclusion Hartmann’s reversal without previous DCRR evaluation is acceptable in selected asymptomatic patients, without increased risk of complications. PMID:19727977

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

    Wiener, H; Turnheim, K; van Os, C H

    1989-09-01

    A method has been developed for the simultaneous isolation of basolateral plasma membrane vesicles from surface and crypt cells of rabbit distal colon epithelium by sequential use of differential sedimentation, isopycnic centrifugation and Ficoll 400 barrier centrifugation. The protein yield was high (total 0.81 mg/g mucosa) and surface and crypt cell-derived basolateral membrane fractions have been purified 34- and 9-fold with respect to the homogenate. The pattern of marker enzyme enrichments revealed only minor contamination by subcellular organelles. Latency of ouabain-sensitive (Na+,K+)-ATPase activity prior and after trypsin treatment of membranes indicated a vesicle configuration of sealed right side-out: sealed inside-out: leaky of approximately 2:1:1. The presence of sealed vesicles was also evident from the osmotic sensitivity of the D-[1-14C] mannitol equilibrium space determined with either fraction. Although considerably different in protein profile, surface and crypt basolateral membranes were similar in cholesterol to phospholipid molar ratio and membrane fluidity as determined by steady-state fluorescence polarization. Stopped-flow light scattering experiments revealed a rather low water permeability of the membranes with a permeability coefficient of 6 microns/sec at 35 degrees C, which is one order of magnitude lower than reported for small intestinal plasma membranes. Both membrane fractions have been shown to effectively generate outward uphill potassium ion gradients, a process that is energized by ATP and inhibited by the membrane-permeant cardiac-glycoside digitoxin. These characteristics are consistent with the activity of a (Na+,K+) pump operating in inside-out vesicles. PMID:2553975

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

    PubMed

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

    2014-05-01

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

  6. Wheat bran diet reduces tumor incidence in a rat model of colon cancer independent of effects on distal luminal butyrate concentrations.

    PubMed

    Zoran, D L; Turner, N D; Taddeo, S S; Chapkin, R S; Lupton, J R

    1997-11-01

    To investigate the effects of dietary fibers in colonic luminal physiology and their role in the prevention of colon cancer, a study was conducted using two diet groups and two treatment groups in a 2 x 2 factorial design. The two diets differed only in the type of dietary fiber, wheat bran and oat bran, and the two treatments were injection with the colon-specific carcinogen azoxymethane, or saline, as a control. There were 34 rats in the carcinogen-injected groups and 11 saline-injected rats per diet group. The goal of the study was to determine if a moderate consumption (6 g/100 g diet) of wheat bran or oat bran would alter the development of colonic tumors in this rat model of colon cancer, and if the differences in tumor incidence were correlated to luminal butyrate concentrations, luminal pH or fecal bulk. Short-chain fatty acid concentrations (SCFA) were measured in feces during the first half of the study (the promotion phase of tumor development) and again at the end of the study. Rats consuming oat bran had greater body weights (P < 0. 002), produced much larger concentrations of all SCFA, including butyrate, in both the proximal and distal colon (P < 0.0001), had more acidic luminal pH values (P < 0.0001), but also had significantly more development of colon tumors (P < 0.03). Alternatively, rats consuming wheat bran produced more typical molar ratios of the SCFA (65:10:20), had a relatively greater concentration of butyrate than propionate, and produced a larger volume (P < 0.05) and more bulky stool than the rats fed oat bran. The results of this study support other evidence that an acidic luminal pH is not protective in and of itself, and that diets containing wheat bran are protective against colon cancer development. In addition, these data show that large luminal butyrate concentrations in the distal colon alone, as were present in the rats consuming oat bran diets, are not protective of tumor development. PMID:9349850

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

    PubMed Central

    Spencer, Nick J; Smith, Terence K

    2001-01-01

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

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

    PubMed Central

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

    1993-01-01

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

  9. Effects of selective antagonism of beta-adrenoceptor sub-types on responses to isoprenaline in rat distal colon in vitro.

    PubMed Central

    MacDonald, A.; Lamont, M.

    1993-01-01

    1. The effects of the beta 1- and beta 2-adrenoceptor selective antagonists, CGP 20712A and ICI 118551 respectively, on responses to isoprenaline-induced relaxation of rat distal colon were investigated in order to determine the contributions of these subtypes to relaxation. In addition, the properties of ICI D7114, a novel putative stimulant of atypical beta-adrenoceptors, were investigated. Our preliminary experiments with ICI D7114 showed that this compound lacked agonist activity in rat distal colon and in fact antagonized responses to isoprenaline. We therefore studied the antagonism of isoprenaline by ICI D7114 in more detail. 2. Longitudinal segments of rat distal colon were suspended in Krebs solution at 37 degrees C for isometric recording. The Krebs solution contained EDTA (23 microM) and prazosin (0.1 microM) and was gassed with 95/5% O2/CO2. After an initial equilibration period, reproducible contractions to a submaximal concentration of methacholine (1 microM) were obtained before carrying out a concentration-response curve (CRC) to isoprenaline in a non-cumulative manner. Four consecutive CRCs to isoprenaline were carried out in each tissue with a 1 h interval between each curve. Antagonists were present in increasing concentrations during the intervals between CRCs. Control tissues received no antagonists to allow estimation of the magnitude of time-dependent changes. 3. Isoprenaline produced a concentration-dependent inhibition of methacholine-induced contractions. CRCs to isoprenaline were reproducible with no significant time-dependent changes. Propranolol produced no shift of the isoprenaline CRC at 0.01 microM and a 5 fold shift at 0.1 microM. No further shift was observed with 1 microM.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8306100

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

    PubMed

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

    2011-01-01

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

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

    PubMed Central

    2011-01-01

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

  12. Effect of vasopressin on Na(+)-K(+)-2Cl(-) cotransporter (NKCC) and the signaling mechanisms on the murine late distal colon.

    PubMed

    Xue, Hong; Tang, Xudong

    2016-01-15

    It has been demonstrated that the antidiuretic hormone vasopressin is able to regulate the expression of Na-K-Cl cotransporters (NKCC1 and NKCC2) in the kidney. The present study investigated the effects of long- and short-term administration of vasopressin on NKCC and the possible signaling mechanism of vasopressin in the mouse distal colon using the siRNA, real-time PCR, western blotting and Ussing chambers method. The results showed the presence of NKCC2 expression in the colon, which was verified with a siRNA technique. The mRNA and protein expression level of NKCC2 significantly increased by about 40% and 90% respectively in response to restricting water intake to 1ml/day/20g for 7 days. In contrast, the NKCC1 expression level was unchanged in the colon. To determine the short-term activation of NKCC2 by vasopressin in vitro, we found that the administration of vasopressin caused a 3-fold increase in mouse colon NKCC2 phosphorylation, which was detected with phosphospecific antibody R5. In addition, the Ussing chamber results showed that NKCC2, cAMP and Ca(2+) signaling pathway may be involved in the vasopressin-induced response. Further, adenylate cyclase inhibitor MDL-12330A and PKA inhibitor H89 and Ca(2+) chelator BAPTA-AM reversed the vasopressin induced NKCC2 phosphorylation level increase by about 35%, 28% and 42% respectively suggesting vasopressin stimulate NKCC2 phosphorylation increase mediated by cAMP-PKA and Ca(2+) signaling in the colon. Collectively, these data suggest that the expression and phosphorylation of NKCC2 are increased in the colon by vasopressin stimulation, in association with enhanced activity of the vasopressin/cAMP and Ca(2+) pathways. PMID:26656758

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

    PubMed Central

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

    2009-01-01

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

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

    PubMed

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

    2009-01-01

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

  15. Sigmoid volvulus: an uncommon complication of Hirschsprung's disease.

    PubMed

    Ranjan, Abhishek; Jain, Vishesh; Sharma, Shilpa; Gupta, Devendra Kumar

    2016-01-01

    Sigmoid volvulus is a rare and potentially life-threatening condition that is usually seen in adults, however, when diagnosed in children, it is often associated with Hirschsprung's disease (HD). We report a case of an 11-year-old boy who presented with a history of constipation since 1.5 months of age, with acute onset of severe abdominal pain and marked distention of the abdomen. Sigmoid volvulus was suspected, detected and successfully managed with resection of the sigmoid colon and primary Scott Boley's pull-through. This report underscores the importance of suspecting sigmoid volvulus in the pertinent clinical setting; also, a primary definitive procedure can be performed in select cases. PMID:27229747

  16. Sigmoid volvulus in an adolescent girl: staged management with emergency colonoscopic reduction and decompression followed by elective sigmoid colectomy.

    PubMed

    Patel, Ramnik V; Njere, Ike; Campbell, Alison; Daniel, Rejoo; Azaz, Amer; Fleet, Mahmud

    2014-01-01

    A case of acute sigmoid volvulus in a 14-year-old adolescent girl presenting with acute low large bowel obstruction with a background of chronic constipation has been presented. Abdominal radiograph and CT scan helped in diagnosis. She underwent emergency colonoscopic detorsion and decompression uneventfully. Lower gastrointestinal contrast study showed very redundant sigmoid colonic loop without any transition zone and she subsequently underwent elective sigmoid colectomy with good outcome. The sigmoid volvulus should be considered in the differential diagnosis of paediatric acute abdomen presenting with marked abdominal distention, absolute constipation and pain but without vomiting. Plain abdominal radiograph and the CT scan are helpful to confirm the diagnosis. Early colonoscopic detorsion and decompression allows direct visualisation of the vascular compromise, assessment of band width of the volvulus and can reduce complications and mortality. Associated Hirschsprung's disease should be suspected if clinical and radiological features are suggestive in which case a rectal biopsy before definitive surgery should be considered. PMID:25143313

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  19. A simplified technique for a totally diverting transverse loop colostomy and distal irrigation.

    PubMed

    Rose, D; Koniges, F; Frazier, T G

    1985-12-01

    This technique of totally diverting loop colostomy may be performed as an independent procedure or with exploratory laparotomy and surgical treatment on the distal part of the colon. Either a transverse or sigmoid loop colostomy can be used for diversion without the risk of fecal contamination of the peritoneal cavity, particularly when working with unprepared intestine. When distal irrigation is desired to purge the intestine of fecal material, either intraoperatively or as part of a subsequent intestinal preparation, it can easily be accomplished by placing an irrigating catheter distal to the staple line. In addition, the use of a small rubber suspension bar facilitates application of standard colostomy appliances for the stoma. PMID:4071376

  20. Natural history of uncomplicated sigmoid diverticulitis.

    PubMed

    Buchs, Nicolas C; Mortensen, Neil J; Ris, Frederic; Morel, Philippe; Gervaz, Pascal

    2015-11-27

    While diverticular disease is extremely common, the natural history (NH) of its most frequent presentation (i.e., sigmoid diverticulitis) is poorly investigated. Relevant information is mostly restricted to population-based or retrospective studies. This comprehensive review aimed to evaluate the NH of simple sigmoid diverticulitis. While there is a clear lack of uniformity in terminology, which results in difficulties interpreting and comparing findings between studies, this review demonstrates the benign nature of simple sigmoid diverticulitis. The overall recurrence rate is relatively low, ranging from 13% to 47%, depending on the definition used by the authors. Among different risk factors for recurrence, patients with C-reactive protein > 240 mg/L are three times more likely to recur. Other risk factors include: Young age, a history of several episodes of acute diverticulitis, medical vs surgical management, male patients, radiological signs of complicated first episode, higher comorbidity index, family history of diverticulitis, and length of involved colon > 5 cm. The risk of developing a complicated second episode (and its corollary to require an emergency operation) is less than 2%-5%. In fact, the old rationale for elective surgery as a preventive treatment, based mainly on concerns that recurrence would result in a progressively increased risk of sepsis or the need for a colostomy, is not upheld by the current evidence. PMID:26649154

  1. Natural history of uncomplicated sigmoid diverticulitis

    PubMed Central

    Buchs, Nicolas C; Mortensen, Neil J; Ris, Frederic; Morel, Philippe; Gervaz, Pascal

    2015-01-01

    While diverticular disease is extremely common, the natural history (NH) of its most frequent presentation (i.e., sigmoid diverticulitis) is poorly investigated. Relevant information is mostly restricted to population-based or retrospective studies. This comprehensive review aimed to evaluate the NH of simple sigmoid diverticulitis. While there is a clear lack of uniformity in terminology, which results in difficulties interpreting and comparing findings between studies, this review demonstrates the benign nature of simple sigmoid diverticulitis. The overall recurrence rate is relatively low, ranging from 13% to 47%, depending on the definition used by the authors. Among different risk factors for recurrence, patients with C-reactive protein > 240 mg/L are three times more likely to recur. Other risk factors include: Young age, a history of several episodes of acute diverticulitis, medical vs surgical management, male patients, radiological signs of complicated first episode, higher comorbidity index, family history of diverticulitis, and length of involved colon > 5 cm. The risk of developing a complicated second episode (and its corollary to require an emergency operation) is less than 2%-5%. In fact, the old rationale for elective surgery as a preventive treatment, based mainly on concerns that recurrence would result in a progressively increased risk of sepsis or the need for a colostomy, is not upheld by the current evidence. PMID:26649154

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

    PubMed Central

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

    2013-01-01

    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

  3. Effects of selective antagonism of beta-adrenoceptor sub-types on responses to isoprenaline in rat distal colon in vitro.

    PubMed

    MacDonald, A; Lamont, M

    1993-12-01

    1. The effects of the beta 1- and beta 2-adrenoceptor selective antagonists, CGP 20712A and ICI 118551 respectively, on responses to isoprenaline-induced relaxation of rat distal colon were investigated in order to determine the contributions of these subtypes to relaxation. In addition, the properties of ICI D7114, a novel putative stimulant of atypical beta-adrenoceptors, were investigated. Our preliminary experiments with ICI D7114 showed that this compound lacked agonist activity in rat distal colon and in fact antagonized responses to isoprenaline. We therefore studied the antagonism of isoprenaline by ICI D7114 in more detail. 2. Longitudinal segments of rat distal colon were suspended in Krebs solution at 37 degrees C for isometric recording. The Krebs solution contained EDTA (23 microM) and prazosin (0.1 microM) and was gassed with 95/5% O2/CO2. After an initial equilibration period, reproducible contractions to a submaximal concentration of methacholine (1 microM) were obtained before carrying out a concentration-response curve (CRC) to isoprenaline in a non-cumulative manner. Four consecutive CRCs to isoprenaline were carried out in each tissue with a 1 h interval between each curve. Antagonists were present in increasing concentrations during the intervals between CRCs. Control tissues received no antagonists to allow estimation of the magnitude of time-dependent changes. 3. Isoprenaline produced a concentration-dependent inhibition of methacholine-induced contractions. CRCs to isoprenaline were reproducible with no significant time-dependent changes. Propranolol produced no shift of the isoprenaline CRC at 0.01 microM and a 5 fold shift at 0.1 microM. No further shift was observed with 1 microM. CGP 20712A had no effect on the CRC to isoprenaline at 0.1, 1 and 3 microM. ICI118551 produced little or no shift at 0.1 microM and a six fold shift with 1 microM. No further shift was observed with 3 microM. ICI D7114 produced a concentration-dependent parallel rightward shift of the CRC to isoprenaline. Schild analysis gave a slope close to unity and a mean pA2 value of 7.29 for ICI D7114.4. The results with propranolol and ,l- and 132-adrenoceptor antagonists confirm the mainly atypical nature of beta-adrenoceptors in rat distal colon. There may also be a small contribution from beta2-adrenoceptors in the response to isoprenaline but beta1-adrenoceptors are absent. ICI D7114 has no agonist activity and behaves as a relatively high affinity reversible competitive antagonist of atypical beta-adrenoceptors in this preparation. PMID:8306100

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

    PubMed Central

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

    2015-01-01

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

  5. Magnetic Field Topology of Sigmoids

    NASA Astrophysics Data System (ADS)

    Son, J. H.; Canfield, R. C.; Acton, L. W.

    2004-12-01

    Sigmoids are studied due to their eruptive nature, which affects the Earth and the space atmosphere. The shape of the sigmoid (S-shaped or inverse S-shaped) is an indicator of eruption. The origin of this shape has been the topic of many research papers. One such paper by Fan and Gibson, The Emergence of a Twisted Magnetic Flux Tube Into a Preexisting Coronal Arcade, appeared in 2003. Fan and Gibson argue that a sigmoid with left-handed twist has left-handed writhe, which gives the sigmoid its S-shape and right-handed twist the inverse S-shape. Our study determined that there is no correlation between a sigmoid's handedness and shape as claimed in the paper by Fan and Gibson. Doing a statistical study observing the topology of the sigmoid using the data from Yohkoh Soft X-ray Telescope, we classified each sigmoid by its shape, twist, and magnetic field lines. We found that 23% of our data was right-handed and S-shaped, 33% was left-handed and S-shaped, 22% was right-handed and inverse S-shaped, and 22% was left-handed and inverse-S shaped. Thus, we found no systematic relationship between the handedness and shape of the sigmoid -- in disagreement with Fan and Gibson.

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

    PubMed Central

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

    2000-01-01

    In this study, the effect of 17β-oestradiol on adenosine 3′ : 5′-cyclic monophosphate (cyclic AMP)-dependent protein kinase (PKA) activity was investigated. Rapid (within 15 min) activation of basal PKA activity was observed in cytosolic fractions by 17β-oestradiol but not by 17α-oestradiol, progesterone or testosterone. This stimulation was abolished by the specific PKA inhibitor PKI but not by the classical oestrogen receptor antagonist tamoxifen. 17β-Oestradiol did not stimulate basal PKA activity in membrane fractions or in cytosolic fractions from male rats. The increase in cytosolic PKA activity was indirect as (i) it was inhibited by the adenylyl cyclase inhibitor SQ22536, (ii) it was mimicked by forskolin and (iii) 17β-oestradiol did not cause a stimulation of basal PKA activity in either type I or type II commercially available PKA holoenzymes. Protein kinase Cδ (PKCδ) was directly activated by 17β-oestradiol. The specific PKC inhibitor, bisindolylmaleimide I (GF 109203X), abolished the 17β-oestradiol-induced PKA activation. 17β-Oestradiol stimulated an increase in free intracellular calcium ion concentration ([Ca2+]i) in isolated female but not male rat colonic crypts. This was inhibited by verapamil, nifedipine and zero extracellular [Ca2+] but unaffected by tamoxifen. 17α-Oestradiol, testosterone and progesterone failed to increase [Ca2+]i. PKC and PKA inhibitors abolished the 17β-oestradiol-induced increase in [Ca2+]i. These results demonstrate the existence of a novel 17β-oestradiol-specific PKA and Ca2+ signalling pathway, which is both sex steroid- and gender-specific, in rat distal colonic epithelium. PMID:10742293

  7. Factors Associated With Complications of Open Versus Laparoscopic Sigmoid Resection for Diverticulitis

    PubMed Central

    Simon, T.; Ambroze, W. L.; Armstrong, D. N.; Schertzer, M. E.; Choat, D.; Pennington, E. E.

    2005-01-01

    Background: This study critically reviews sigmoid colon resection for diverticulitis comparing open and laparoscopic techniques. Methods: We conducted a retrospective review of all open and laparoscopic cases of diverticulitis between 1992 and 2001. Data analyzed included the following: indications for operation, postoperative complications, and incidence of laparoscopic conversion to laparotomy. Major and minor complications were analyzed in relation to patients' preoperative diagnosis, age, presence or absence of splenic flexure mobilization, length of stay, and laparoscopic sigmoid resection versus open sigmoid resection. Results: Over a 10-year period, 166 resections for diverticulitis were performed including 126 open cases and 40 laparoscopic cases. No significant differences existed in patient characteristics between the groups. Major complications occurred in 14% of patients, and the laparoscopic conversion rate was 20%. The presence of abscess, fistula, or stricture preoperatively was associated with a higher complication rate only in patients ?50 years old undergoing open sigmoid resection. The length of stay between patients undergoing laparoscopic resection was significantly less than in patients having open resection. Conclusion: Advanced laparoscopic sigmoid resection is an alternative to open sigmoid resection in patients with diverticulitis and its complications. Open sigmoid resection in patients >50 years may have a higher complication rate in complicated diverticulitis when compared with laparoscopic sigmoid resection (all patient ages) and open sigmoid resection (patients <50 years old). Regarding complications, no difference existed between the length of stay in patients with open vs. laparoscopic resection. PMID:15791973

  8. Colonic motility in proctalgia fugax.

    PubMed

    Harvey, R F

    1979-10-01

    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

  9. Sigmoid diverticulitis: US findings

    PubMed Central

    2013-01-01

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

  10. Sigmoid diverticulitis: US findings.

    PubMed

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

    2013-07-15

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

  11. Sigmoid carcinoma localized in the sac of a right inguinoscrotal hernia

    PubMed Central

    Falidas, Evangelos; Gourgiotis, Stavros; Papachrysostomou, Marios; Oikonomou, Christiana; Villias, Constantinos

    2015-01-01

    The inguinoscrotal hernia with colonic malignancy in the sac presents rare but severe consequence. The most common side of this type of hernia is the left one while the most common part of the large bowel is the sigmoid colon. The clinical picture can be easily confused with simple inguinoscrotal hernia unless the clinician is alert to the presence of certain sinister symptoms and signs. We report an extremely rare case of a 91-year-old man presented with anemia who had a right inguinoscrotal hernia containing a sigmoid colon carcinoma. PMID:26604606

  12. [Actinomycosis of the sigmoid as obstructive space-occupying lesion of the pelvis. A case report].

    PubMed

    Hohenbleicher, F; Hohenbleicher, R; Hallfeldt, K H

    2002-07-01

    Abdominal actinomycosis is a rare chronic infectious disease, which may mimic abdominal cancer, inflammatory bowel disease or diverticulitis. We report the case of a 46-year-old women with a large bowel obstruction caused by extensive abdominal actinomycosis. Colon contrast examination revealed a stenosis in the sigmoid colon, while abdominal ultrasound showed a stenosis of the left ureter with left hydronephrosis. Preoperative presumptive diagnosis was a carcinoma of the sigmoid colon. She required emergency surgery, which involved both resection and colostomy. As in most cases reported in the literature, diagnosis was made postoperatively. Pathological examination following the sigmoid colon resection surprisingly revealed an actinomycosis. This case illustrates that consideration of actinomycosis in women with bowel obstruction and prolonged use of an intrauterine device could help to improve the preoperative diagnosis of this rare disease. PMID:12242985

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

    PubMed Central

    Halm, Susan T.; Zhang, Jin

    2010-01-01

    Adrenergic stimulation of isolated guinea pig distal colonic mucosa produced transient Cl− and sustained K+ secretion. Transient short-circuit current (Isc) depended on β2-adrenergic receptors (β2-AdrR), and sustained Isc relies on a β1-AdrR/β2-AdrR complex. Epinephrine (epi) increased cAMP content with a biphasic time course similar to changes in epi-activated Isc (epiIsc). Inhibition of transmembrane adenylyl cyclases (tmACs) reduced peak epiIsc and cAMP to near zero without decreasing sustained epiIsc, consistent with cAMP from tmAC signaling for only Cl− secretion. Inhibition of soluble adenylyl cyclase (sAC) reduced sustained epiIsc and cAMP to near zero without decreasing peak epiIsc 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 epiIsc but not sustained epiIsc, consistent with these PDEs as part of the β2-AdrR signaling domain. PYY suppressed peak epiIsc in a pertussis toxin (PTx)-sensitive manner, supporting Gαi-dependent inhibition of tmACs producing cAMP for Cl− secretion. Since PYY or PTx did not alter sustained epiIsc, signaling for K+ secretion occurred via a Gαi-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 epiIsc, but the cAMP-dependent guanine nucleotide exchange factor, Epac, may contribute. Thus β-adrenergic activation of electrogenic Cl− and K+ secretion, respectively, required tmAC- and sAC-dependent signaling pathways. PMID:20413718

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

    PubMed Central

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

    2013-01-01

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

  15. Chemokine (C-C Motif) Receptor 2 Mediates Dendritic Cell Recruitment to the Human Colon but Is Not Responsible for Differences Observed in Dendritic Cell Subsets, Phenotype, and Function Between the Proximal and Distal Colon

    PubMed Central

    Bernardo, David; Durant, Lydia; Mann, Elizabeth R.; Bassity, Elizabeth; Montalvillo, Enrique; Man, Ripple; Vora, Rakesh; Reddi, Durga; Bayiroglu, Fahri; Fernández-Salazar, Luis; English, Nick R.; Peake, Simon T.C.; Landy, Jon; Lee, Gui H.; Malietzis, George; Siaw, Yi Harn; Murugananthan, Aravinth U.; Hendy, Phil; Sánchez-Recio, Eva; Phillips, Robin K.S.; Garrote, Jose A.; Scott, Paul; Parkhill, Julian; Paulsen, Malte; Hart, Ailsa L.; Al-Hassi, Hafid O.; Arranz, Eduardo; Walker, Alan W.; Carding, Simon R.; Knight, Stella C.

    2015-01-01

    Background & Aims Most knowledge about gastrointestinal (GI)-tract dendritic cells (DC) relies on murine studies where CD103+ DC specialize in generating immune tolerance with the functionality of CD11b+/− subsets being unclear. Information about human GI-DC is scarce, especially regarding regional specifications. Here, we characterized human DC properties throughout the human colon. Methods Paired proximal (right/ascending) and distal (left/descending) human colonic biopsies from 95 healthy subjects were taken; DC were assessed by flow cytometry and microbiota composition assessed by 16S rRNA gene sequencing. Results Colonic DC identified were myeloid (mDC, CD11c+CD123−) and further divided based on CD103 and SIRPα (human analog of murine CD11b) expression. CD103-SIRPα+ DC were the major population and with CD103+SIRPα+ DC were CD1c+ILT3+CCR2+ (although CCR2 was not expressed on all CD103+SIRPα+ DC). CD103+SIRPα- DC constituted a minor subset that were CD141+ILT3−CCR2−. Proximal colon samples had higher total DC counts and fewer CD103+SIRPα+ cells. Proximal colon DC were more mature than distal DC with higher stimulatory capacity for CD4+CD45RA+ T-cells. However, DC and DC-invoked T-cell expression of mucosal homing markers (β7, CCR9) was lower for proximal DC. CCR2 was expressed on circulating CD1c+, but not CD141+ mDC, and mediated DC recruitment by colonic culture supernatants in transwell assays. Proximal colon DC produced higher levels of cytokines. Mucosal microbiota profiling showed a lower microbiota load in the proximal colon, but with no differences in microbiota composition between compartments. Conclusions Proximal colonic DC subsets differ from those in distal colon and are more mature. Targeted immunotherapy using DC in T-cell mediated GI tract inflammation may therefore need to reflect this immune compartmentalization. PMID:26866054

  16. DISTAL MYOPATHIES

    PubMed Central

    Dimachkie, Mazen M.; Barohn, Richard J.

    2014-01-01

    Over a century ago, Gowers described two young patients in whom distal muscles weakness involved the hand, foot, sternocleidomastoid, and facial muscles in the other case the shoulder and distal leg musculature. Soon after, , similar distal myopathy cases were reported whereby the absence of sensory symptoms and of pathologic changes in the peripheral nerves and spinal cord at postmortem examination allowed differentiation from Charcot-Marie-Tooth disease. In 1951, Welander described autosomal dominant (AD) distal arm myopathy in a large Scandanavian cohort. Since then the number of well-characterized distal myopathies has continued to grow such that the distal myopathies have formed a clinically and genetically heterogeneous group of disorders. Affected kindred commonly manifest weakness that is limited to foot and toe muscles even in advanced stages of the disease, with variable mild proximal leg, distal arm, neck and laryngeal muscle involvement in selected individuals. An interesting consequence of the molecular characterization of the distal myopathies has been the recognition that mutation in a single gene can lead to more than one clinical disorder. For example, Myoshi myopathy (MM) and limb girdle muscular dystrophy (LGMD) type 2B are allelic disorders due to defects in the gene that encodes dysferlin. The six well described distal myopathy syndromes are shown in Table 1. Table 2 lists advances in our understanding of the myofibrillar myopathy group and Table 3 includes more recently delineated and less common distal myopathies. In the same manner, the first section of this review pertains to the more traditional six distal myopathies followed by discussion of the myofibrillar myopathies. In the third section, we review other clinically and genetically distinctive distal myopathy syndromes usually based upon single or smaller family cohorts. The fourth section considers other neuromuscular disorders that are important to recognize as they display prominent distal limb weakness. PMID:25037092

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

    PubMed Central

    Bränning, Camilla E.; Nyman, Margareta E.

    2011-01-01

    Several substances, including glutamine and propionic acid but in particular butyric acid, have been proposed to be important for colonic health. β-Glucans lead to the formation of comparatively high amounts of butyric acid, and germinated barley foodstuff obtained from brewer’s spent grain (BSG), containing high amounts of β-glucans and glutamine, has been reported to reduce the inflammatory response in the colon of patients with ulcerative colitis. The present study examines how 3 barley products, whole grain barley, malt, and BSG, affect SCFA in the hindgut and serum of rats and whether the addition of Lactobacillus rhamnosus 271 to each of these diets would have further effects. Amino acids in plasma and the cecal composition of the microbiota were also analyzed. The butyric acid concentration in the distal colon and serum was higher in the malt groups than in the other groups as was the serum concentration of propionic acid. The concentrations of propionic and butyric acids were higher in the cecum and serum of rats given L. rhamnosus than in those not given this strain. The proportion of plasma glutamine and the cecal number of bifidobacteria were lower in the malt groups than in the other groups. L. rhamnosus decreased the number of cecal bifidobacteria, whereas plasma glutamine was unaffected. We conclude that malt together with L. rhamnosus 271 had greater effects on propionic and butyric acid concentrations in rats than the other barley products. This is interesting when developing food with effects on colonic health. PMID:21106924

  18. [Successful Removal of Hard Sigmoid Fecaloma Using Endoscopic Cola Injection].

    PubMed

    Lee, Jong Jin; Kim, Jeong Wook

    2015-07-01

    Colorectal fecaloma is hardening of feces into lumps of varying size that is much harder in consistency than a fecal impaction. Complications of colorectal fecaloma include ulceration, bleeding, perforation and obstruction of the colon. Most fecalomas are successfully removed by conservative treatment with laxatives, enemas and rectal evacuation to relieve fecal impaction. When conservative treatments have failed, a surgical intervention may be needed. Herein, we report a case of 4.7 cm sized sigmoid fecaloma showing no response to conservative treatments that was successfully removed by endoscopic fragmentation with Coca-Cola injection instead of surgery. PMID:26194129

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

    PubMed Central

    2014-01-01

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

  20. A Rare Case of Splenic Torsion with Sigmoid Volvulus in a 14-Year-Old Girl.

    PubMed

    Ahmadi, Hamid; Mohammad Khan Tehrani, Mahdieh

    2016-01-01

    Wandering spleen is an uncommon entity in adults and has been described only rarely with sigmoid volvulus, that rarely affects children and adolescents. It is usually described in adults.Wandering spleen characterized by the abnormal location of the spleen, caused by incomplete fusion of the four primary splenic ligaments, allowing the spleen to be mobile within the abdomen.The wandering spleen can lead to torsion and subsequent splenic infarction or rupture. Clinical suspicion plus urgent investigation and intervention are important. We present a rare clinical case of acute abdomen due to torsion of wandering spleen and volvulus of sigmoid in a 14-year-old girl presented with painful periumbilical mass. Detorsion of sigmoid occurred while undergoing exploratory laparotomy and splenectomy was performed. The possibility of torsion and its complication like gastric, pancreas tail and colon volvulus should be kept in mind in the differential diagnosis of the acute abdomen to avoid serious complications. PMID:26853294

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

    PubMed

    da Fonseca, Leonardo Maciel; Caldeira, Daniel Adonai Machado

    2013-04-01

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

  2. Colonic abscess induced by India ink tattooing.

    PubMed

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

    2014-07-01

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

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed

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

    2008-09-01

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

  5. Synchronous primary oesophageal malignant melanoma and sigmoid adenocarcinoma

    PubMed Central

    Malik, Ahsan; Bansil, Sandeep; Junglee, Naushad; Sutton, Jonathon; Gasem, Jaber; Ahmed, Waqar

    2011-01-01

    The authors present a case of a gentleman in his 70s who was referred to the gastroenterology outpatient clinic with dysphagia. An oesophagogastroduodenoscopy was performed which showed a polypoidal black coloured mass in the oesophagus. Endoscopic biopsies confirmed malignant melanoma. Further staging investigations were organised to assess suitability for surgery which revealed a mass in the sigmoid colon. Subsequent colonoscopy and biopsy confirmed adenocarcinoma. As this was an unusual case to associate these two malignancies at the same time, there was no ideal or recognised management plan available. Different treatment options were considered and a consensus was developed regarding best surgical approach but due to the lapse in time a repeat staging CT scan was organised which unfortunately now demonstrated lymph node metastasis. Patient was managed conservatively from this point onwards and he died 12 months later. PMID:22689833

  6. Laparoscopic Surgery for Inflammatory Complications of Acute Sigmoid Diverticulitis

    PubMed Central

    2001-01-01

    From March 1995 through March 2000, we treated patients with the laparoscopic approach who had emergent and urgent indications for surgery. We report a series of 17 procedures in 16 patients in the acute category excluding those with active bleeding. One case of morbidity (DVT) but no moralities occurred, with 3 of 17 patients converted to an open approach. The postoperative course and subsequent recoveries compare favorably with the open approach to this disease process. Three other series are discussed for comparison, all showing similar favorable results. We concluded that given sufficient experience in minimally invasive colon surgery, surgeons can manage acute inflammatory complications of sigmoid diverticulitis laparoscopically with potential benefit to the patient. PMID:11548828

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

    PubMed Central

    Goligher, J. C.

    1983-01-01

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

  8. Tether Cutting Action in Two Sigmoidal Filaments

    NASA Astrophysics Data System (ADS)

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

    2002-01-01

    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 α 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 α 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.

  9. Acute sigmoid diverticulitis within a nonincarcerated hernia.

    PubMed

    Arnold, Nicholas; Ernst, Amy A

    2015-07-01

    Separately, diverticulitis and inguinal hernias are both common findings in emergency medicine. However, diverticulitis within a reducible hernia has not been previously reported.We present a case of sigmoid diverticulitis within a non incarcerated easily reducible hernia treated with conservative management. Our review of literature did not reveal any previously documented cases of this type of presentation. PMID:25656328

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

    PubMed

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

    1989-01-01

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

  11. Robotic versus laparoscopic resection for sigmoid diverticulitis with fistula.

    PubMed

    Elliott, Peter A; McLemore, Elisabeth C; Abbass, Mohammad A; Abbas, Maher A

    2015-06-01

    Robotic abdominal surgery is growing despite a paucity of clinical reports to evaluate its impact on patient outcomes. In this retrospective case series, we aim to analyze our early experience with robotic resection in 11 consecutive patients with chronic colonic diverticulitis complicated by fistula to bladder, vagina, or skin and to compare the results of the robotic approach to 20 patients undergoing laparoscopic resection for the same indication. Our main outcome measures include operative time, blood loss, conversion rate, transfusion rate, hospital length of stay, complications, readmission, and fistula healing rate. In our study, we found robotic resection for colonic diverticulitis with fistula was technically feasible and yielded 100% fistula healing rate. The operative time, complication and readmission rates were similar to laparoscopy. A higher conversion rate, diverting stoma need, and longer hospital length of stay were noted in the robotic group; however, these findings could have been attributed to a higher number of cases involving rectal excision in the robotic group. Larger studies are needed to further examine the impact of robotic surgery on the outcome of patients with complicated chronic sigmoid diverticulitis. PMID:26531114

  12. Colonic endoscopy in perspective.

    PubMed

    Talbott, T M; MacKeigan, J M

    1978-06-01

    Sigmoidoscopy is an easy procedure and should be utilized more frequently. Barium enema examination is incomplete without sigmoidoscopy. Flexible fiberoptic sigmoidoscopy may have a role in the detection of disease of the descending, sigmoid, and rectosigmoid colon. The necessity for its routine usage remains to be determined. The control of colonic polyps by colonoscopy has been the greatest contribution to date by the fiberoptic instrument. Colonoscopy has improved the accuracy of diagnosis of colonic disease and, in certain instances, is helpful in the early detection of cancer of the colon. Colonoscopy complements the use of barium enema examination. Colonoscopy only for the purpose of confirmation of clinical or radiological diagnosis is often unnecessary. While the benefits of endoscopy are obvious, there are definite practical and technological limitations to its use. Complications, although infrequent, are major. Indications for colonoscopy must be clear and findings interpreted with knowledge of the limitations. PMID:675461

  13. The Diagnosis of Sigmoid Liposarcoma in a Young Male with Metabolic Syndrome

    PubMed Central

    Romanowski, Marek; Mędrek-Socha, Marta; Stec-Michalska, Krystyna

    2015-01-01

    The clinical picture and risk factors are decisive in differential diagnosis. It was proved that patients with metabolic syndrome have increased incidence of malignant tumours. The visceral adipose tissue releases active proteins that promote oncogenesis. We are presenting a case of 34-year-old male with metabolic syndrome suffering from pain in left iliac fossa with accompanying variable stool pattern. At first, the sigmoid diverticulosis was suspected. Patient’s condition after the treatment has improved. The ambulatory, partial colonoscopy revealed a cauliflower-like, balloting, wide-base growth in the sigmoid that narrowed its lumen. The biopsy did not reveal atypical growth characteristics. Because of tumour type and enlarged regional lymph nodes seen in abdomen CT scan, the segmental colon resection and end-to-end anastomosis was performed in the area of sigmoid-rectal junction. Macroscopically, there were no visible metastases in the operation field. The surgery and postoperative period ran without any complications. On histopathological examination, the removed tumour was a well differentiated liposarcoma (WDL) stemming unusually from adipose tissue of colonic submucosa in an obese male. WDL is a hard to diagnose tumour, especially in early stages of its growth. In the presented case, the tumour was completely resected. PMID:26816934

  14. Online Catalog for Filament-Sigmoid Correlation

    NASA Astrophysics Data System (ADS)

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

    2007-05-01

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

  15. Distal renal tubular acidosis

    MedlinePlus

    Renal tubular acidosis - distal; Renal tubular acidosis type I; Type I RTA; RTA - distal; Classical RTA ... excreting it into the urine. Distal renal tubular acidosis (Type I RTA) is caused by a defect ...

  16. Laparoscopic rectosigmoid resection for acute sigmoid diverticulitis.

    PubMed

    Zdichavsky, Marty; Knigsrainer, Alfred; Granderath, Frank A

    2009-04-01

    Laparoscopic sigmoid colectomy has been widely accepted as elective approach but is, however, still discussed controversially for acute cases. Patients receiving a laparoscopic early single-stage procedure benefit from an early postoperative convalescence with a minimum of disability. As more surgeons gain expertise in minimally invasive surgery of the rectosigmoid, this video highlights the main steps of a rectosigmoid resection for acute complicated diverticulitis. PMID:18795376

  17. The role of sigmoidoscopy in thediagnosis and treatment of sigmoid volvulus

    PubMed Central

    Atamanalp, Sabri Selcuk; Atamanalp, Refik Selim

    2016-01-01

    Sigmoid volvulus (SV) is a rare form of acute intestinal obstruction in which the sigmoid colon wraps around itself. The disease generally presents as a mechanical bowel obstruction with clinical features that are not pathognomonic. Similarly, X-ray films are not diagnostic in most cases. It is difficult to establish the correct preoperative diagnosis when CT and MRI are not used. The principal strategy in the treatment of SV in uncomplicated patients is emergency endoscopic detorsion followed by elective surgery; emergent surgery is required in patients with bowel gangrene, bowel perforation, peritonitis, or unsuccessful endoscopic treatment. In this review, we have discussed the role of sigmoidoscopy in the diagnosis and treatment of SV. Additionally, we have retrospectively and prospectively evaluated our 49-year, 987-patient clinical experience, the largest single-center SV series ever reported. PMID:27022384

  18. Stercoral Perforation of the Colon during Pregnancy: A Case Report and Review of the Literature

    PubMed Central

    Costales, Anthony B.; Agarwal, Amit K.; Chauhan, Suneet P.; Refuerzo, Jerrie S.; Taub, Ethan A.

    2015-01-01

    Stercoral perforation of the colon, though rare, is associated with high mortality. Review of the literature identified only three prior cases reported during pregnancy. We report a case on a multiparous female presenting at 31 weeks of gestation with acute abdominal pain. Computed tomography suggested a sigmoid colon perforation. An urgent exploratory laparotomy was performed where feculent peritonitis and a stercoral perforation of the sigmoid colon was confirmed. A cesarean delivery and sigmoid colectomy with descending end colostomy was performed. While the newborn had an uncomplicated course, the mother developed an intra-abdominal abscess requiring operative management. PMID:26199793

  19. Sigmoid volvulus during pregnancy: A rare non-obstetric complication. Report of a case and review of the literature

    PubMed Central

    Al Maksoud, Ahmed M.; Barsoum, Adel K.; Moneer, Mohamed M.

    2015-01-01

    Introduction Sigmoid volvulus is a rare cause of intestinal obstruction during pregnancy associated with high maternal and foetal mortality. Effective management represents a challenge due to delayed presentation, obstructive symptoms regarded as pregnancy-related and hesitation in using radiological evaluation. Presentation of case We report a case of a lady, pregnant for 26 weeks and with a 5 day history of abdominal pain and constipation. She underwent concomitant caesarean section and laparotomy for intestinal obstruction. Intra-operatively, the sigmoid colon was extensively dilated and gangrenous. The ischemic colon was resected and a Hartmanns procedure was performed. A preterm male child was delivered and admitted to neonatal intensive care. The post operative course was uneventful and the patient was discharged home on the 9th post-operative day. Six months later she underwent an uneventful reversal of the Hartmanns procedure. Discussion Sigmoid volvulus is the most common cause of bowel obstruction during pregnancy, accounting for up to 44% of reported cases. We have reviewed the available literature on this topic and present another case managed at our institution. Conclusion Diagnosis of sigmoid volvulus in pregnancy is a challenge, but a delay in diagnosis increases the rates of feto-maternal mortality. A high incidence of clinical suspicion and timely surgical intervention are the key to a favourable outcome. PMID:26551555

  20. Colonic and anal metastases from pancreato-biliary malignancies.

    PubMed

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

    2014-04-01

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

  1. Position paper: management of perforated sigmoid diverticulitis

    PubMed Central

    2013-01-01

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

  2. Ten Cases of Colovesical Fistula due to Sigmoid Diverticulitis.

    PubMed

    Miyaso, Hideaki; Iwakawa, Kazuhide; Hamada, Yuki; Yasui, Nanako; Nishii, Gou; Akai, Masaaki; Kawada, Kengo; Nonoshita, Takashi; Kajioka, Hiroki; Isoda, Kenta; Kitada, Kouji; Nishie, Manabu; Hamano, Ryosuke; Tokunaga, Naoyuki; Tsunemitsu, Yosuke; Otsuka, Shinya; Inagaki, Masaru; Iwagaki, Hiromi

    2015-06-01

    Colovesical fistula (CVF) resulting from colon diverticulosis is a comparatively rare disease, and neither the diagnosis nor treatment has been established. Our experience with CVF due to sigmoid diverticulitis over a 9-year period was reviewed to clarify the clinical presentation and diagnostic confirmation. Ten patients with CVF were identified in this period, and chief complaints, laboratory findings, presenting symptoms, diagnostic investigations, and subsequent treatments were reviewed. Preoperative urinalysis showing bacteriuria (100%) was the most common presentation, followed by fecaluria (40%), abdominal pain (40%), pneumaturia (30%), hematuria (30%), pain on urination (30%), pollakiuria (10%), and dysuria (10%). The abilities of various preoperative investigations to identify CVF were: computed tomography (CT), 88.9%; magnetic resonance imaging, 40%; cystoscopy, 30%, and gastrografin irrigoscopy, 22.2%. Colonoscopy (0%) was not diagnostic. Bowel resection was performed in nine of ten patients. When inflammation was intense, covering ileostomy was performed, and an omental plasty was placed between the bowel anastomosis and bladder. When CVF is suspected, we recommend CT followed by colonoscopy and cystoscopy as a first-line investigation to rule out malignancy as a cause. Other modalities should only be used if the diagnosis is in doubt or additional information is needed to plan operative management. Primary colic anastomosis appears to be safely performed by applying omental plasty and covering ileostomy. PMID:26211219

  3. Colonic High-grade Tubular Adenomas Associated with Schistosoma japonicum.

    PubMed

    Imai, Jin; Ichikawa, Hitoshi; Mizukami, Hajime; Suzuki, Takayoshi; Watanabe, Norihito; Mine, Tetsuya

    2016-01-01

    We reported a case of sigmoid colonic high grade tubular adenomas associated with deposited ova of Schistosoma japonicum. A 76-year-old Japanese man was referred to our colonoscopy due to a positive fecal occult blood test. He had a medical history of schistosomiasis japonica. The colonoscopy revealed that there were two sigmoid colon polyps, approximately 8 mm in diameter. These were removed by endoscopic mucosal resection (EMR). Pathological examination revealed high grade tubular adenomas and deposited some ova of Schistosoma japonicum with severe fibrotic change and granuloma formation in the submucosal layer. Colonic schistosomiasis is a probable independent risk factor for the development of colorectal carcinogenesis. PMID:27050891

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

    PubMed

    Saravia Burgos, Jaime; Acosta Canedo, Abel

    2015-01-01

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

  5. Detection of synchronous carcinomas of the colon with F-18 fluorodeoxyglucose: a case report.

    PubMed

    Pin, C A; Grigolon, M V; Etchebehere, E C; Santos, A O; Lima, M C; Ramos, C D; Camargo, E E

    2000-05-01

    Colon and rectal carcinomas are common in North America and Northwestern Europe. In South America, the risk of this disease is not as great. Adenocarcinomas are the most common types of tumors, and they occur mainly in the descending colon, sigmoid, and rectum. A patient with a possible right colon carcinoma was examined using F-18 FDG. PMID:10795698

  6. Distal Convoluted Tubule

    PubMed Central

    Ellison, David H.

    2014-01-01

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

  7. FIP bias in a sigmoidal active region

    NASA Astrophysics Data System (ADS)

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

    2014-01-01

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

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

    PubMed Central

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

    2013-01-01

    Introduction. This study aimed to evaluate symptoms and signs, inflammation markers, electrolytes, and ECG signs of increased vagal tone as markers of colon perforation in sigmoid diverticulitis or appendicitis. Methods. The records of all patients older than fifty years (only these had routine ECG done) admitted to our emergency station between January 2008 and December 2010 with sigmoid diverticulitis (n = 198, diagnosed by computer tomography) or appendicitis (n = 84, diagnosed intraoperatively) were retrospectively evaluated. Pain score, heart rate, blood pressure, and body temperature were assessed at presentation. Before starting infusion therapy, blood was taken to do a blood count and to analyze CRP, the electrolytes, and creatinine levels. Then an ECG was done. Results. The perforation rate was 37% (n = 103). Body temperature, heart rate, sodium, CRP, and leukocytes correlated significantly with infectious colon perforation. However, only body temperature, CRP, and sodium correlated significantly with infectious colon perforation if compared by logistic regression analysis. The prevalence of hyponatremia (sodium level <136 mmol/L) was 29% in the group with infectious colon perforation and 16% in the group without (P = 0.013). Conclusion. Hyponatremia is a specific marker of infectious colon perforation in patients older than fifty years. PMID:23476637

  9. Role of Damage Control Surgery in the Treatment of Hinchey III and IV Sigmoid Diverticulitis

    PubMed Central

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

    2014-01-01

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

  10. Ulnar Shortening Osteotomy for Distal Radius Malunion

    PubMed Central

    Kamal, Robin N.; Leversedge, Fraser J.

    2014-01-01

    Background Malunion is a common complication of distal radius fractures. Ulnar shortening osteotomy (USO) may be an effective treatment for distal radius malunion when appropriate indications are observed. Methods The use of USO for treatment of distal radius fracture malunion is described for older patients (typically patients >50 years) with dorsal or volar tilt less than 20 degrees and no carpal malalignment or intercarpal or distal radioulnar joint (DRUJ) arthritis. Description of Technique Preoperative radiographs are examined to ensure there are no contraindications to ulnar shortening osteotomy. The neutral posteroanterior (PA) radiograph is used to measure ulnar variance and to estimate the amount of ulnar shortening required. An ulnar, mid-sagittal incision is used and the dorsal sensory branch of the ulnar nerve is preserved. An USO-specific plating system with cutting jig is used to create parallel oblique osteotomies to facilitate shortening. Intraoperative fluoroscopy and clinical range of motion are checked to ensure adequate shortening and congruous reduction of the ulnar head within the sigmoid notch. Results Previous outcomes evaluation of USO has demonstrated improvement in functional activities, including average flexion-extension and pronosupination motions, and patient reported outcomes. Conclusion The concept and technique of USO are reviewed for the treatment of distal radius malunion when specific indications are observed. Careful attention to detail related to surgical indications and to surgical technique typically will improve range of motion, pain scores, and patient-reported outcomes and will reduce the inherent risks of the procedure, such as ulnar nonunion or the symptoms related to unrecognized joint arthritis. Level of Evidence: Level IV PMID:25097811

  11. Transient Coronal Sigmoids and Rotating Erupting Flux Ropes

    NASA Astrophysics Data System (ADS)

    Green, L. M.; Kliem, B.; Török, T.; van Driel-Gesztelyi, L.; Attrill, G. D. R.

    2007-12-01

    To determine the relationship between transient coronal (soft X-ray or EUV) sigmoids and erupting flux ropes, we analyse four events in which a transient sigmoid could be associated with a filament whose apex rotates upon eruption and two further events in which the two phenomena were spatially but not temporally coincident. We find the helicity sign of the erupting field and the direction of filament rotation to be consistent with the conversion of twist into writhe under the ideal MHD constraint of helicity conservation, thus supporting our assumption of flux rope topology for the rising filament. For positive (negative) helicity the filament apex rotates clockwise (counterclockwise), consistent with the flux rope taking on a reverse (forward) S shape, which is opposite to that observed for the sigmoid. This result is incompatible with two models for sigmoid formation: one identifying sigmoids with upward arching kink-unstable flux ropes and one identifying sigmoids with a current layer between two oppositely sheared arcades. We find instead that the observations agree well with the model by Titov and Démoulin ( Astron. Astrophys. 351, 707, 1999), which identifies transient sigmoids with steepened current layers below rising flux ropes.

  12. Sigmoid sinus thrombosis after closed head injury in children.

    PubMed

    Taha, J M; Crone, K R; Berger, T S; Becket, W W; Prenger, E C

    1993-04-01

    In the literature, clinical descriptions of sigmoid sinus thrombosis occurring after closed head injury in children are rare. One to 5 days after trauma to the back of the head, five children (aged 1 to 7 yr) presented with gait ataxia, vomiting, and headache. Trauma was mild in four children. Computed tomography of all the children, performed within 5 days after the injury, showed focal hyperdensity in the region of the left sigmoid sinus. Four children had extra-axial hyperdense collections along the left transverse sinus, and three had skull fractures adjacent to the left sigmoid sinus. Magnetic resonance imaging (MRI) of all the children, performed 2 to 6 days after injury, showed left sigmoid-sinus thrombosis and decreased flow or thrombosis within the lateral third of the left transverse sinus. All the children had MRI scans 4 to 6 weeks after their diagnosis and were followed up for 1 to 12 months. In four children whose symptoms subsided completely within 2 to 10 weeks, MRI showed recanalization of the sigmoid sinus within 4 to 6 weeks after injury. In one child whose symptoms resolved after 6 months, sigmoid-sinus thrombosis persisted with the formation of collateral flow. We conclude that traumatic sigmoid-sinus thrombosis should be suspected when a child has persistent or delayed gait ataxia and vomiting after injury to the back of the head. Computed tomography characteristically demonstrated focal hyperdensity within the sigmoid sinus that we term the dense sigmoid-sinus sign. Because the sinus recanalized and the symptoms subsided in most children within 6 weeks, we conclude that prophylactic medical or surgical intervention is not indicated. PMID:8474644

  13. Actinomycosis complicating sigmoid diverticular disease: a case report.

    PubMed

    Vodovnik, Aleksandar; Logishetty, Kartik

    2009-01-01

    A 63-year-old Caucasian woman was admitted to hospital as hypotensive with abdominal tenderness and vaginal discharge. Laboratory investigations showed microcytic anaemia, low albumin and high white cell count. Computerised tomography scans revealed small bowel dilatation, sigmoid diverticula, ascites and pelvic fluid. The endometrial pipelle was positive and vaginal swab was negative for actinomyces. Post mortem examination revealed widespread sigmoid diverticular disease and bowel perforation with an intense inflammation. Actinomycotic granules were noted in the diverticular inflammatory debris, pelvic abscess and lung sections. Clinical course and histomorphological findings favour the perforating sigmoid diverticular actinomycosis as an origin of the systemic infection. PMID:20181157

  14. Giant ascending colonic diverticulum presenting with intussusception.

    PubMed

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

    2013-10-01

    Diverticular disease of the colon is a common disease, and its incidence is increasing gradually. A giant colonic diverticulum (GCD) is a rare entity and is defined as a diverticulum greater than 4 cm in size. It mainly arises from the sigmoid colon, and possible etiology is a ball-valve mechanism permitting progressive enlargement. A plain abdominal X-ray can be helpful to make a diagnosis initially, and a barium enema and abdominal computed tomography may confirm the diagnosis. Surgical intervention is a definite treatment for a GCD. We report a case of an ascending GCD presenting with intussusception in a young adult. PMID:24278860

  15. [Individualized therapy of synchronous ovarian and colon cancers with lymph].

    PubMed

    Deme, Dániel; Bishr, Abdulfatah M; Nizar, Jamool; Telekes, András

    2015-06-01

    A 71-year-old female patient underwent urgent laparotomy due to severe right lower quadrant abdominal pain and fever. Macroscopically duplex coecal and transverse colon cancer as well as a sigmoid or left ovarian cancer were suspected. Pathological findings revealed synchronous left ovarian and transverse colonic neoplasms. Both primaries metastatized to their regional lymph nodes. Furthermore, the ovarian cancer infiltrating the sigmoid colon gave distant metastasis in the coecum, too. Ovarian cancer histology showed papillary adenocarcinoma, and transverse colon cancer was a tubular adenocarcinoma. The affected lymph nodes were clearly distinguished by immunohistochemistry staining: ovarian metastases were CK7 positive, and colonic metastases were CK20 and CEA positive. The patient was treated with combinated chemotherapy: FOLFOX-4 two weekly and paclitaxel monotherapy every other week. The patient tolerated this combined treatment well. The authors conclude that multiple synchronous neoplasms can be treated with individualized chemotherapeutic protocol with good efficacy and few adverse reactions. PMID:26027602

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

    PubMed Central

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

    2013-01-01

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

  17. Distal radius triplane fracture

    PubMed Central

    Marya, S; Auplish, S

    2014-01-01

    A triplane fracture is so named because of the three planes traversed by the fracture line. These are physeal fractures that result from injury during the final phase of maturation and cessation of growth. This fracture pattern typically involves the distal tibia. We present a rare case of a triplane fracture involving the distal radius. PMID:25350166

  18. Sigmoid volvulus in a patient with mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS): a rare occurrence.

    PubMed

    Hallac, Alexander; Keshava, Hari B; Morris-Stiff, Gareth; Ibrahim, Samuel

    2016-01-01

    Mitochondrial diseases are rare and devastating, with a wide spectrum of clinical presentations and systemic symptoms. The majority of the published literature focuses on the neuromuscular manifestations and genetic components of this mitochondrial cytopathy, however, cardiac, renal, endocrine and gastrointestinal manifestations may also be present. The authors report a case detailing a 56-year-old woman's final hospitalisation from the gastrointestinal sequelae of mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) (Co Q10 deficiency variant). She presented with abdominal pain and distension associated with lactic acidosis, and was shown on imaging to have a colon perforation. This resulted in emergent surgery at which a necrotic colon secondary to a sigmoid colon was identified. Following four subsequent operations, and the development of multiorgan failure, care was eventually withdrawn. Practitioners of patients with MELAS should be cognisant of the rare but devastating gastrointestinal consequences of mitochondrial diseases. PMID:26935953

  19. Distal Oblique Bundle Reinforcement for Treatment of DRUJ Instability.

    PubMed

    Brink, Peter R G; Hannemann, Pascal F W

    2015-08-01

    Background Chronic, dynamic bidirectional instability in the distal radioulnar joint (DRUJ) is diagnosed clinically, based on the patient's complaints and the finding of abnormal laxity in the vicinity of the distal ulna. In cases where malunion is ruled out or treated and there are no signs of osteoarthritis, stabilization of the DRUJ may offer relief. To this end, several different techniques have been investigated over the past 90 years. Materials and Methods In this article we outline the procedure for a new technique using a tendon graft to reinforce the distal edge of the interosseous membrane. Description of Technique A percutaneous technique is used to harvest the palmaris longus tendon and to create a tunnel, just proximal to the sigmoid notch, through the ulna and radius in an oblique direction. By overdrilling the radial cortex, the knotted tendon can be pulled through the radius and ulna and the knot blocked at the second radial cortex, creating a strong connection between the radius and ulna at the site of the distal oblique bundle (DOB). The tendon is fixed in the ulna with a small interference screw in full supination, preventing subluxation of the ulna out of the sigmoid notch during rotation. Results Fourteen patients were treated with this novel technique between 2011 and October 2013. The QuickDASH score at 25 months postoperatively (range 16-38 months) showed an improvement of 32 points. Similarly, an improvement of 33 points (67-34 months) was found on the PRWHE. Only one recurrence of chronic, dynamic bidirectional instability in the DRUJ was observed. Conclusion This simple percutaneous tenodesis technique between radius and ulna at the position of the distal edge of the interosseous membrane shows promise in terms of both restoring stability and relieving complaints related to chronic subluxation in the DRUJ. PMID:26261750

  20. Quiet-Sun Network Bright Point Phenomena with Sigmoidal Signatures

    NASA Astrophysics Data System (ADS)

    Chesny, D. L.; Oluseyi, H. M.; Orange, N. B.; Champey, P. R.

    2015-12-01

    Ubiquitous solar atmospheric coronal and transition region bright points (BPs) are compact features overlying strong concentrations of magnetic flux. Here, we utilize high-cadence observations from the Atmospheric Imaging Assembly on board the Solar Dynamics Observatory to provide the first observations of extreme ultraviolet quiet-Sun (QS) network BP activity associated with sigmoidal structuring. To our knowledge, this previously unresolved fine structure has never been associated with such small-scale QS events. This QS event precedes a bi-directional jet in a compact, low-energy, and low-temperature environment, where evidence is found in support of the typical fan-spine magnetic field topology. As in active regions and micro-sigmoids, the sigmoidal arcade is likely formed via tether-cutting reconnection and precedes peak intensity enhancements and eruptive activity. Our QS BP sigmoid provides a new class of small-scale structuring exhibiting self-organized criticality that highlights a multi-scaled self-similarity between large-scale, high-temperature coronal fields and the small-scale, lower-temperature QS network. Finally, our QS BP sigmoid elevates arguments for coronal heating contributions from cooler atmospheric layers, as this class of structure may provide evidence favoring mass, energy, and helicity injections into the heliosphere.

  1. Estimation and classification by sigmoids based on mutual information

    NASA Technical Reports Server (NTRS)

    Baram, Yoram

    1994-01-01

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

  2. Hinode Observations of an Eruption from a Sigmoidal Active Region

    NASA Astrophysics Data System (ADS)

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

    2012-08-01

    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.

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

    PubMed Central

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

    2013-01-01

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

  4. Colon cancer

    MedlinePlus

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

  5. Distal Ulna Reconstruction using the Second Metatarsal: Anatomical Study.

    PubMed

    Cavadas, Pedro C; Thione, Alessandro; Martinez, Isabel Elía

    2016-05-01

    Background The ulnar head is a key stabilizer of the wrist and forearm. The authors investigated the possibility of using the second metatarsal bone to replace the distal ulna in an anatomical study. Methods The morphology of the distal ulna and the head of the second metatarsal (MT2) were studied using three-dimensional computerized tomographic (CT) scans of the wrist and foot in 52 patients without pathology related to these two areas, and 11 cadaveric specimens. The radius and height of the best-fit cylinder for both epiphyses were measured in the CT scans and compared. In the cadaveric specimens an osteotomy of the metatarsal neck was performed to rotate 90 degrees the head of the MT2 to match the shape of the distal ulna. Results The osseous morphology of the distal ulna and the head of the MT2 are roughly cylindrical, but differently oriented relative to the diaphyseal axes. In the osteotomized cadaveric MT2specimens, the overall morphology was relatively similar that of the distal ulna. The mean length of the MT2 after the osteotomy was 65 mm. Conclusion The head of the MT2 was found to have a similar cylindrical morphology to that of the ulnar head, with a different orientation. The radius of the cylinder was similar, although the height was bigger for the MT2. After a rotation osteotomy of the neck of the MT2 the overall shape and orientation of the epiphysis was more similar to the distal ulna. A vascularized transfer of an osteotomized MT2 would be an option for autologous reconstruction of the distal ulna in selected patients, but further study is needed in terms of the vascular supply, ligamentous reconstruction, and reconstruction of the sigmoid notch. Level of Evidence Therapeutic, level IV. PMID:27104084

  6. Spontaneous haemoperitoneum due to a sigmoid diverticulum.

    PubMed

    George, Jayan; Ben-Sassi, Abozed; Dixon, Rebecca

    2014-01-01

    Spontaneous haemoperitoneum is rare. When it occurs it is a life-threatening condition. Common causes of this are gynaecological in nature and rarely due to colonic diverticular perforation. Diverticulitis is a common condition affecting people in western countries. This presentation of spontaneous haemoperitoneum highlights the disproportionate abdominal pain and opioid-induced constipation. Significant bloods on admission included haemoglobin of 148 g/L, C reactive protein (CRP) of 1.1 mg/L, white cell count (WCC) of 12.7×10(9)/L (neutrophils 10.9×10(9)/L). Bloods repeated 10 h later revealed the haemoglobin had dropped to 100 g/L, CRP had increased significantly to 120 mg/L, WCC: 7.4×10(9)/L (neutrophils 5.3×10(9)/L) and a reduced packed cell volume: 0.307 L/L. CT scan revealed free fluid and a possible mass. At laparoscopy, frank haemoperitoneum was seen and a decision was made to open and perform a Hartmann's procedure. The patient did very well postoperatively and was discharged on the ninth postoperative day. He is currently awaiting reversal of the ileostomy. PMID:25480140

  7. Outcome after rectum or sigmoid resection: a review for gynecologists.

    PubMed

    Ret Dávalos, María Lorena; De Cicco, Carlo; D'Hoore, Andre; De Decker, Bert; Koninckx, Philippe Robert

    2007-01-01

    It remains unclear when to perform a discoid or segmental bowel resection for large endometriotic nodules with intestinal invasion. Moreover, endometriosis series are rather small to fully evaluate functional consequences of bowel resection. We therefore reviewed the incidence of leakage and functional problems after anterior and sigmoid resection as reported in the surgical literature albeit for other indications. Endoscopic resection clearly is feasible but requires an experienced surgeon. The incidence of leakage is not different after hand-sewn or stapled anastomosis, but is higher after a low rectum resection than after a sigmoid resection. Similarly, functional bowel problems are higher after a low rectum resection than after sigmoid resection. Low rectum resection in addition can be associated with functional bladder problems and sexual disturbances as anorgasmia. In conclusion, short- and long-term complications are much higher after a low rectum than after a sigmoid resection. This seems to be important in making the decision to perform a discoid or a segmental bowel resection for severe endometriosis. PMID:17218226

  8. Large tubular colonic duplication in an adult treated with a small midline incision

    PubMed Central

    Yong, Yuen Geng; Jung, Kyung Uk; Cho, Yong Beom; Yun, Seong Hyeon; Kim, Hee Cheol; Lee, Woo Yong

    2012-01-01

    Tubular colonic duplication presenting in adults is rare and difficult to diagnose preoperatively. Only a few cases have been reported in the literature. We report a case of a 29-year-old lady presenting with a long history of chronic constipation, abdominal mass and repeated episodes of abdominal pain. The abdominal-pelvic computed tomography scan showed segmental bowel wall thickening thought to be small bowel, and dilatation with stasis of intraluminal content. The provisional diagnosis was small bowel duplication. She was scheduled for single port laparoscopic resection. However, a T-shaped tubular colonic duplication at sigmoid colon was found intraoperatively. Resection of the large T-shaped tubular colonic duplication containing multiple impacted large fecaloma and primary anastomosis was performed. There was no perioperative complication. We report, herein, the case of a T-shaped tubular colonic duplication at sigmoid colon in an adult who was successfully treated through mini-laparotomy assisted by single port laparoscopic surgery. PMID:22403754

  9. Role of damage control surgery in the treatment of Hinchey III and IV sigmoid diverticulitis: a tailored strategy.

    PubMed

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

    2014-11-01

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

  10. Pyogenic liver abscess secondary to disseminated streptococcus anginosus from sigmoid diverticulitis.

    PubMed

    Murarka, Shishir; Pranav, Fnu; Dandavate, Varsha

    2011-01-01

    Pyogenic liver abscess secondary to dissemination from Sigmoid Diverticulitis is rare. Streptococcus Anginosus has been linked to abscesses but has been rarely reported from a Sigmoid Diverticulitis source. We report a case of liver abscess in which the source was confounding but eventually was traced to Sigmoid Diverticulitis on laparotomy. PMID:21572613

  11. The distal interosseous membrane: current concepts in wrist anatomy and biomechanics.

    PubMed

    Moritomo, Hisao

    2012-07-01

    The distal interosseous membrane (DIOM) of the forearm acts as a secondary stabilizer of the distal radioulnar joint (DRUJ) when the dorsal and palmar radioulnar ligaments of the triangular fibrocartilage complex are cut. Recent anatomical studies revealed that thickness of the DIOM varies widely among specimens and the distal oblique bundle (DOB) exists within the DIOM in 40% of specimens. The DOB originates from the distal one-sixth of the ulnar shaft and runs distally to insert on the inferior rim of the sigmoid notch of the radius. The mean thickness of the DIOM without a DOB was 0.4 mm, which was significantly thinner than 1.2 mm with a DOB. Biomechanical studies have shown that the DOB is an isometric stabilizer of the forearm during pronosupination. The presence of a DOB was shown to have a significant impact on DRUJ stability. Innate DRUJ laxity in the neutral forearm position was greater in the group without a DOB than in the group with a DOB. Ulnar shortening with the osteotomy performed proximal to the attachment of the DIOM had a more favorable effect on stability of the DRUJ compared with the effect of distal osteotomy, especially in the presence of a DOB. The longitudinal resistance to ulnar shortening was significantly greater in proximal shortening than in distal shortening. It also suggested that the DIOM is of great importance in the management of concomitant ulnar-side injuries in distal radius fracture. PMID:22721462

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

    SciTech Connect

    Jiang Chaowei; Feng Xueshang; Wu, S. T.; Hu Qiang E-mail: fengx@spaceweather.ac.cn E-mail: qh0001@uah.edu

    2013-07-10

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

  13. Distal radioulnar joint injuries

    PubMed Central

    Thomas, Binu P; Sreekanth, Raveendran

    2012-01-01

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

  14. Adaptive sigmoid function bihistogram equalization for image contrast enhancement

    NASA Astrophysics Data System (ADS)

    Arriaga-Garcia, Edgar F.; Sanchez-Yanez, Raul E.; Ruiz-Pinales, Jose; Garcia-Hernandez, Ma. de Guadalupe

    2015-09-01

    Contrast enhancement plays a key role in a wide range of applications including consumer electronic applications, such as video surveillance, digital cameras, and televisions. The main goal of contrast enhancement is to increase the quality of images. However, most state-of-the-art methods induce different types of distortion such as intensity shift, wash-out, noise, intensity burn-out, and intensity saturation. In addition, in consumer electronics, simple and fast methods are required in order to be implemented in real time. A bihistogram equalization method based on adaptive sigmoid functions is proposed. It consists of splitting the image histogram into two parts that are equalized independently by using adaptive sigmoid functions. In order to preserve the mean brightness of the input image, the parameter of the sigmoid functions is chosen to minimize the absolute mean brightness metric. Experiments on the Berkeley database have shown that the proposed method improves the quality of images and preserves their mean brightness. An application to improve the colorfulness of images is also presented.

  15. Synchronous adenocarcinoma and neuroendocrine carcinoma of the colon: a case report

    PubMed Central

    Mohapatra, Sonmoon; Ibrarullah, Mohammad; Mohapatra, Ashutosh; Baisakh, Manas Ranjan

    2016-01-01

    Neuroendocrine tumors (NETs) originating from the gastrointestinal tract are considered to be relatively rare tumors with a poor prognosis. We describe a case of an 83-year-old male who presented with complains of bleeding per rectum. Colonoscopy revealed two ulceroproliferative tumors, one in the sigmoid colon and another in the descending colon. The patient underwent left hemicolectomy. Based on the immunohistochemistry, the sigmoid colon tumor was diagnosed as well-differentiated adenocarcinoma, whereas the descending colon tumor was diagnosed as NET. NET coexisted with adenocarcinoma occurring separately in the same segment of colon, as in the present case, is distinctly rare and has not been reported earlier. The coexistence of the NETs with other primary malignancies has been increasingly recognized. Therefore, we recommend that the patients with the diagnosis of NETs should undergo further screening for the associated primary malignancies to prevent late-stage diagnosis of synchronous malignancies. PMID:27009325

  16. Focal stenosis of the sigmoid sinus causing intracranial venous hypertension: Case report, endovascular management, and review of the literature.

    PubMed

    Honarmand, Amir R; Hurley, Michael C; Ansari, Sameer A; Alden, Tord D; Kuhn, Ryan; Shaibani, Ali

    2016-04-01

    Regardless of the underlying pathology, elevated intracranial pressure is the endpoint of any impairment in either cerebrospinal fluid (CSF) absorption (including arachnoid villi) or intracranial venous drainage. In all age groups, the predominant final common pathway for CSF drainage is the dural venous sinus system. Intracranial venous hypertension (ICVH) is an important vascular cause of intracranial hypertension (and its subsequent sequelae), which has often been ignored due to excessive attention to the arterial system and, specifically, arteriovenous shunts. Various anatomical and pathological entities have been described to cause ICVH. For the second time, we present a unique case of severe focal stenosis in the distal sigmoid sinus associated with concurrent hypoplasia of the contralateral transverse sinus causing a significant pressure gradient and intracranial hypertension, which was treated with endovascular stent placement and angioplasty. PMID:26769738

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

    PubMed Central

    Bergheim, Ina; Bode, Christiane; Parlesak, Alexandr

    2005-01-01

    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. PMID:16253141

  18. Segmentation algorithm of colon based on multi-slice CT colonography

    NASA Astrophysics Data System (ADS)

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

    2012-02-01

    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.

  19. Recent advances in the management of distal ulcerative colitis.

    PubMed

    Koutroubakis, Ioannis E

    2010-04-01

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

  20. Squamous cell carcinoma arising in a mature cystic teratoma invading the sigmoid colon: a rare presentation.

    PubMed

    Gooneratne, Alena Talia; James, Alexander Owen; Gupta, Jyoti; Abdulaal, Yasser

    2015-01-01

    We discuss a rare presentation of malignant teratoma in a 63-year-old woman who was admitted to accident and emergency with abdominal distension, bloody diarrhoea and peritonitis. CT of the abdomen and pelvis showed free air in the abdomen and a gas-fluid filled cavity measuring 12×6 cm in the mid-pelvis with possible fistulation that was suspicious for malignancy. A 10×12 cm ruptured dermoid cyst was found intraoperatively, which was adherent to the bowel wall. Bulky lymph nodes were also appreciated. The surgeon suspected a metastatic malignant teratoma, and a Hartmann's procedure, total abdominal hysterectomy and bilateral salpingoopherectomy were performed with clearance of the para-aortic lymph nodes. Subsequent histological analysis revealed a squamous cell carcinoma arising from an ovarian malignant teratoma. The patient went on to have carboplatin and paclitaxel chemotherapy and is alive at 6 months follow-up. PMID:25935913

  1. Tensile properties of the rectal and sigmoid colon: a comparative analysis of human and porcine tissue.

    PubMed

    Christensen, Michael B; Oberg, Kevin; Wolchok, Jeffrey C

    2015-01-01

    For many patients, rectal catheters are an effective means to manage bowel incontinence. Unfortunately, the incidence of catheter leakage in these patients remains troublingly high. Matching the mechanical properties of the catheter and the surrounding tissue may improve the catheter seal and reduce leakage. However, little data is available on the mechanical properties of colorectal tissue. Therefore, our group examined the mechanical properties of colorectal tissue obtained from both a common animal model and humans. Uniaxial tension tests were performed to determine the effects of location, orientation, and species (porcine and human) on bowel tissue tensile mechanical properties. Bowel tissue ultimate strength, elongation at failure, and elastic modulus were derived from these tests and statistically analyzed. Ultimate tensile strength (0.58 MPa, 0.87 MPa), elongation at failure (113.19%, 62.81%), and elastic modulus (1.83 MPa, 5.18 MPa) for porcine and human samples respectively exhibited significant differences based on species. Generally, human tissues were stronger and less compliant than their porcine counterparts. Furthermore, harvest site location and testing orientation significantly affected several mechanical properties in porcine derived tissues, but very few in human tissues. The data suggests that porcine colorectal tissue does not accurately model human colorectal tissue mechanical properties. Ultimately, the tensile properties reported herein may be used to help guide the design of next generation rectal catheters with tissue mimetic properties, as well as aid in the development of physical and computer based bowel models. PMID:25977885

  2. Contracting and Erupting Components of Sigmoidal Active Regions

    NASA Astrophysics Data System (ADS)

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

    2012-10-01

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

  3. CONTRACTING AND ERUPTING COMPONENTS OF SIGMOIDAL ACTIVE REGIONS

    SciTech Connect

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

    2012-10-01

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

  4. Field Topology Analysis of a Long-lasting Coronal Sigmoid

    NASA Astrophysics Data System (ADS)

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

    2012-01-01

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

  5. Controversies in the Surgical Management of Sigmoid Diverticulitis

    PubMed Central

    Bordeianou, Liliana

    2007-01-01

    The timing and appropriateness of surgical treatment of sigmoid diverticular disease remain a topic of controversy. We have reviewed the current literature on this topic, focusing on issues related to the indications and types of surgery. Current evidence would suggest that elective surgery for diverticulitis can be avoided in patients with uncomplicated disease, regardless of the number of recurrent episodes. Furthermore, the need for elective surgey should not be influenced by the age of the patient. Operation should be undertaken in patients with severe attacks, as determined by their clinical and radiological evaluation. PMID:17436142

  6. Atomic bomb survivors and the sigmoidal response model

    SciTech Connect

    Kondo, S.

    1994-12-31

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

  7. Tubular Colonic Duplication Presenting as Rectovestibular Fistula

    PubMed Central

    Bendre, Pradnya; D'souza, Flavia; Ramchandra, Mukunda; Nage, Amol; Palse, Nitin

    2015-01-01

    Complete colonic duplication is a very rare congenital anomaly that may have different presentations according to its location and size. Complete colonic duplication can occur in about 15% of all gastrointestinal duplications. Double termination of tubular colonic duplication in the perineum is even more uncommon. We present a case of a Y-shaped tubular colonic duplication which presented with a rectovestibular fistula and a normal anus. Radiological evaluation and initial exploration for sigmoidostomy revealed duplicated colons with a common vascular supply. Endorectal mucosal resection of theduplicated distal segment till the colostomy site with division of the septum of the proximal segment and colostomy closure proved curative without compromise of the continence mechanism. Tubular colonic duplication should always be ruled out when a diagnosis of perineal canal is considered in cases of vestibular fistula alongwith a normal anus. PMID:26473141

  8. Tubular Colonic Duplication Presenting as Rectovestibular Fistula.

    PubMed

    Karkera, Parag J; Bendre, Pradnya; D'souza, Flavia; Ramchandra, Mukunda; Nage, Amol; Palse, Nitin

    2015-09-01

    Complete colonic duplication is a very rare congenital anomaly that may have different presentations according to its location and size. Complete colonic duplication can occur in about 15% of all gastrointestinal duplications. Double termination of tubular colonic duplication in the perineum is even more uncommon. We present a case of a Y-shaped tubular colonic duplication which presented with a rectovestibular fistula and a normal anus. Radiological evaluation and initial exploration for sigmoidostomy revealed duplicated colons with a common vascular supply. Endorectal mucosal resection of theduplicated distal segment till the colostomy site with division of the septum of the proximal segment and colostomy closure proved curative without compromise of the continence mechanism. Tubular colonic duplication should always be ruled out when a diagnosis of perineal canal is considered in cases of vestibular fistula alongwith a normal anus. PMID:26473141

  9. [Distal femoral fractures].

    PubMed

    Neubauer, T

    2012-05-01

    Fractures of the distal femur still represent injuries that are difficult to treat as they either affect younger patients after a high-energy trauma with soft tissue damage and osseous comminution or elderly people with impaired local vascularity and a poor bone stock. However, exactly these fractures profit from new, biological principles of treatment, which help to diminish additional surgical trauma by indirect fracture reduction and insertion of stabilizing implants via mini-incisions. Basically, these techniques are represented by retrograde intramedullary nails and submuscularilly inserted plates/internal fixateurs. While intramedullary nails are well suited to fix extramedullary and simple articular fractures (C1), plates can also be used to treat complex articular fractures. Nevertheless, any displaced articular fracture component must still be anatomically reduced by an open approach and fixed with absolute stability. Technical advances as well as demographic changes will continue to represent challenges in the treatment of these fractures. PMID:22538345

  10. Distal biceps tendon injuries.

    PubMed

    Miyamoto, Ryan G; Elser, Florian; Millett, Peter J

    2010-09-01

    Distal biceps tendon ruptures present with an initial tearing sensation accompanied by acute pain; weakness may follow. The hook test is very reliable for diagnosing ruptures, and magnetic resonance imaging can provide information about the integrity and any intrasubstance degeneration of the tendon. There are subtle differences between the outcomes of single and modified two-incision operative repairs. With regard to complications, there is a higher prevalence of nerve injuries in association with single-incision techniques and a higher prevalence of heterotopic ossification in association with two-incision techniques. Fixation techniques include the use of bone tunnels, suture anchors, interference screws, and cortical fixation buttons. There is no clinical evidence supporting the use of one fixation method over another, although cortical button fixation has been shown to provide the highest load tolerance and stiffness. Postoperative rehabilitation has become more aggressive as fixation methods have improved. PMID:20810864

  11. Case report: Sigmoid strangulation from evisceration through a perforated rectal prolapse ulcer – An unusual complication of rectal prolapse

    PubMed Central

    Li, Jennifer Z.; Kittmer, Tiffaney; Forbes, Shawn; Ruo, Leyo

    2015-01-01

    Introduction Rectal prolapse occurs particularly in elder females and presentation can sometimes lead to complications such as strangulation and evisceration of other organs through the necrotic mucosa. Presentation of case This is a case of a 61 year-old female with rectal prolapse complicated by rectal perforation through which a segment of sigmoid colon eviscerated and became strangulated. This patient initially presented with sepsis requiring ICU admission, but fully recovered following a Hartmann’s procedure with a sacral rectopexy. Discussion Complications of rectal prolapse include incarceration, strangulation, and rarely, perforation with evisceration of other viscera requiring urgent operation. This report provides a brief overview of complications associated with rectal prolapse, reviews similar cases of transrectal evisceration, and discusses the management of chronic rectal prolapse. Conclusion Prompt surgical consult is warranted if any signs or symptoms suggestive of complications from prolapse are present. PMID:25680532

  12. Plasma composition in a sigmoidal anemone active region

    SciTech Connect

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

    2013-11-20

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

  13. Plasma Composition in a Sigmoidal Anemone Active Region

    NASA Astrophysics Data System (ADS)

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

    2013-11-01

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

  14. [Colonic balantidiasis].

    PubMed

    González de Canales Simón, P; del Olmo Martínez, L; Cortejoso Hernández, A; Arranz Santos, T

    2000-03-01

    Balantidium coli is a Protozoa that is not usually pathogenic in man, although epidemics have been described in tropical areas. It mainly affects the colon and clinical presentation varies from asymptomatic forms to severe dysenteric syndromes. We present a case of endoscopically diagnosed colonic balantidiasis and review the most important characteristics of this parasite-induced disease. PMID:10804691

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

    PubMed

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

    2014-05-01

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

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

    PubMed

    Chauhan, Narvir Singh; Sood, Dinesh

    2011-01-01

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

  17. Colon interposition for oesophageal replacement.

    PubMed

    Thomas, Pascal A; Gilardoni, Adrian; Trousse, Delphine; D'Journo, Xavier B; Avaro, Jean-Philippe; Doddoli, Christophe; Giudicelli, Roger; Fuentes, Pierre

    2009-01-01

    The choice of the colon as an oesophageal substitute results primarily from the unavailability of the stomach. However, given its durability and function, colon interposition keeps elective indications in patients with benign or malignant oesophageal disease who are potential candidates for long survival. The choice of the colonic portion used for oesophageal reconstruction depends on the required length of the graft, and the encountered colonic vascular anatomy, the last being characterised by the near-invariability of the left colonic vessels, in contrast to the vascular pattern of the right side of the colon. Accordingly, the transverse colon with all or part of the ascending colon is the substitute of choice, positioned in the isoperistaltic direction, and supplied either from the left colic vessels for long grafts or middle colic vessels for shorter grafts. Technical key points are: full mobilisation of the entire colon, identification of the main colonic vessels and collaterals, and a prolonged clamping test to ensure the permeability of the chosen nourishing pedicle. Transposition through the posterior mediastinum in the oesophageal bed is the shortest one and thereby offers the best functional results. When the oesophageal bed is not available, the retrosternal route is the preferred alternative option. The food bolus travelling mainly by gravity makes straightness of the conduit of paramount importance. The proximal anastomosis is a single-layer hand-fashioned end-to-end anastomosis to prevent narrowing. When the stomach is available, the distal anastomosis is best performed at the posterior part of the antrum for the reasons of pedicle positioning and reflux prevention, and a gastric drainage procedure is added when the oesophagus and vagus nerves have been removed. In the other cases, a Roux-en-Y jejunal loop is preferable to prevent bile reflux into the colon. Additional procedures include re-establishment of the colonic continuity, a careful closure of the mesentery to avoid a further internal hernia, and routine appendectomy. When applying these technical aids, the chances of achieving a viable and well-functioning colon graft are excellent. PMID:24413178

  18. Snapshot in surgery: brain abscess as a complication of a recurrent sigmoid diverticular abscess.

    PubMed

    Zhou, Zhaowei; Wuppalapati, Siddhartha; Scott, Nigel

    2015-06-01

    A 35-year-old man was found to have a cerebral abscess secondary to a recurrent sigmoid diverticular abscess. Both cultures grew Streptococcus anginosus. Brain abscess is a rare but potential complication of sigmoid diverticulitis. Streptococcus anginosus, which is found in human gut flora, is a common cause of brain abscess. PMID:26185659

  19. Unusual Morphological Alteration in Sigmoid Notch: An Insight Through CBCT.

    PubMed

    Gupta, Anjali; Kant, Sanchita; Phulambrikar, Tushar; Kode, Manasi; Singh, Siddharth Kumar

    2015-12-01

    The Temporomandibular Joint (TMJ) is a ginglymo-diarthrodial joint known to be the most complex joint in human body. Growth disturbances, owing to genetic influences or trauma during the intrauterine life or during early developmental age may lead to morphological and functional variations in the mandible resulting in developmental anomaly. We report a rare case of altered sigmoid notch morphology on the right side and condylar hypoplasia on the left side, not related to any clear pathological disorder. Cone Beam Computed Tomography (CBCT) was helpful in evaluating this case. This case of unknown aetiology was thoroughly examined; based on clinical and radiographic findings, we suggest that this case is of congenital origin. PMID:26816996

  20. Unusual Morphological Alteration in Sigmoid Notch: An Insight Through CBCT

    PubMed Central

    Gupta, Anjali; Phulambrikar, Tushar; Kode, Manasi; Singh, Siddharth Kumar

    2015-01-01

    The Temporomandibular Joint (TMJ) is a ginglymo-diarthrodial joint known to be the most complex joint in human body. Growth disturbances, owing to genetic influences or trauma during the intrauterine life or during early developmental age may lead to morphological and functional variations in the mandible resulting in developmental anomaly. We report a rare case of altered sigmoid notch morphology on the right side and condylar hypoplasia on the left side, not related to any clear pathological disorder. Cone Beam Computed Tomography (CBCT) was helpful in evaluating this case. This case of unknown aetiology was thoroughly examined; based on clinical and radiographic findings, we suggest that this case is of congenital origin. PMID:26816996

  1. Function estimation by feedforward sigmoidal networks with bounded weights

    SciTech Connect

    Rao, N.S.V.; Protopoescu, V.; Qiao, H.

    1996-05-01

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

  2. Complications of Distal Biceps Repair.

    PubMed

    Garon, Mark Tyson; Greenberg, Jeffrey A

    2016-04-01

    Modern techniques to repair the distal biceps tendon include one-incision and 2-incision techniques that use transosseous sutures, suture anchors, interference screws, and/or cortical buttons to achieve a strong repair of the distal biceps brachii. Repair using these techniques has led to improved functional outcomes when compared with nonoperative treatment. Most complications consist of neuropraxic injuries to the lateral antebrachial cutaneous nerve, posterior interosseous nerve, stiffness and weakness with forearm rotation, heterotopic ossification, and wound infections. Although complications certainly affect outcomes, patients with distal biceps repairs report a high satisfaction rate after repair. PMID:26772952

  3. Distal DVT: worth diagnosing? Yes.

    PubMed

    Schellong, S M

    2007-07-01

    Much of the argument for or against diagnosis of distal deep vain thrombosis (DVT) depends on the extra effort that has to be spent on it. This review presents the data on ultrasound of paired calf veins and calf muscle veins (distal ultrasound) in terms of protocols, feasibility, reliability and expected findings. In summary, provided there is adequate and anatomically sound training of sonographers, distal ultrasound is a valid, 4-minute procedure, which can easily be added to the examination of proximal veins. The second part of the review refers to the pathophysiology of ascending DVT, which is the most common type. Adequate patient care in terms of benefit, harm and cost includes a single non-invasive examination followed by risk adopted treatment allocation. This concept ideally should be valid for any type of DVT. The data extending this concept to distal DVT can only be derived from studies that look closely at this entity (i.e. in fact diagnose distal DVT). Even before these data are available, diagnosing distal DVT at least doubles the number of symptomatic patients in which signs and symptoms can be ascribed to a definitive diagnosis, which in itself is a benefit for patient care. PMID:17635708

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

    PubMed

    Shetty, Prakashchandra; Nayak, Satheesha B

    2014-12-01

    Congenital anomalies such as positional anomalies of the right half of the colon are more common when compared to its left half. We report a rare case of congenital anomaly where the transverse colon was totally absent. Ascending colon continued as descending colon at the right colic flexure. Ascending and descending colons formed an inverted U shaped loop which was situated in the right half of the abdomen. The sigmoid colon began from the descending colon, on the right side of the midline and coursed to the left iliac fossa. The terminal part of ascending colon and entire descending colon had a persistent mesocolon. The jejunum and ileum were situated in the upper left part of the abdominal cavity. This anomaly can cause volvulus of the colon at any stage of life. Furthermore, the knowledge of this anomaly is very useful for radiologists, gastroenterologists and surgeons. PMID:25548728

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

    PubMed Central

    Shetty, Prakashchandra

    2014-01-01

    Congenital anomalies such as positional anomalies of the right half of the colon are more common when compared to its left half. We report a rare case of congenital anomaly where the transverse colon was totally absent. Ascending colon continued as descending colon at the right colic flexure. Ascending and descending colons formed an inverted U shaped loop which was situated in the right half of the abdomen. The sigmoid colon began from the descending colon, on the right side of the midline and coursed to the left iliac fossa. The terminal part of ascending colon and entire descending colon had a persistent mesocolon. The jejunum and ileum were situated in the upper left part of the abdominal cavity. This anomaly can cause volvulus of the colon at any stage of life. Furthermore, the knowledge of this anomaly is very useful for radiologists, gastroenterologists and surgeons. PMID:25548728

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

    PubMed Central

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

    2008-01-01

    BACKGROUND & AIMS Irritable bowel syndrome (IBS) has been associated with mucosal dysfunction,, mild inflammation, and altered colonic bacteria. We used microarray expression profiling of sigmoid colon mucosa to assess whether there are stably expressed sets of genes that suggest there are objective molecular biomarkers associated with IBS. METHODS Gene expression profiling was performed using Affymetrix GeneChips with RNA from sigmoid colon mucosal biopsies from 36 IBS patients and 25 healthy control subjects. RTQ-PCR was used to confirm the data in 12 genes of interest. Statistical methods for microarray data were applied to search for differentially expressed genes, and to assess the stability of molecular signatures in IBS patients. RESULTS Mucosal gene expression profiles were consistent across different sites within the sigmoid colon and were stable on repeat biopsy over ~3 months. Differentially expressed genes suggest functional alterations of several components of the host mucosal immune response to microbial pathogens. The most strikingly increased expression involved a yet uncharacterized gene, DKFZP564O0823. Identified specific genes suggest the hypothesis that molecular signatures may enable distinction of a subset of IBS patients from healthy controls. Using 75% of the biopsies as a validation set to develop a gene profile, the test set (25%) was correctly predicted with ~70% accuracy. CONCLUSIONS Mucosal gene expression analysis shows there are relatively stable alterations in colonic mucosal immunity in IBS. These molecular alterations provide the basis to test the hypothesis that objective biomarkers may be identified in IBS and enhance understanding of the disease. PMID:18237869

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

    PubMed Central

    Shavers, Vickie L.

    2007-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2011-05-01

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

  9. Regional variation in the sensitivity of longitudinal smooth muscle to histamine at H1-receptors in guinea-pig ileum and colon.

    PubMed Central

    Barker, L. A.

    1985-01-01

    The sensitivity of the distal ileum, proximal colon, medial colon, and distal colon of the guinea-pig to histamine has been evaluated. The rank order of sensitivity was ileum greater than medial colon greater than proximal colon approximately equal to distal colon. The mean -logEC50 values at receptors in the ileum, medial, proximal, and distal colon were 6.74, 6.18, 5.79, and 5.72, respectively. The apparent dissociation constant for the interaction of histamine with receptors in the various regions was determined. The -log Kd values at receptors in the ileum, proximal colon, medial colon, and distal colon were 4.68, 4.65, 4.62, and 4.44, respectively. The mean apparent -log Kd values for the antagonism of histamine by mepyramine were 9.0, 9.0, 9.1, and 8.9 for receptors on the ileum, proximal, medial, and distal colon, respectively. The results of these experiments provide no evidence that histamine receptors in the colon are distinguishable from H1-receptors as characterized on the ileum. The differences in sensitivity to histamine in the various regions of the intestine may be due to differences in the density of H1-receptors. PMID:4027476

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

    PubMed

    Walker, Marjorie M; Talley, Nicholas J; Ingans, Linn; Engstrand, Lars; Jones, Michael P; Nyhlin, Henry; Agrus, Lars; Kjellstrom, Lars; st, ke; Andreasson, Anna

    2015-02-01

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

  11. Nutrients and Risk of Colon Cancer

    PubMed Central

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

    2010-01-01

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

  12. Sigmoid, Type II Precursor, and Coronal Mass Ejection

    NASA Astrophysics Data System (ADS)

    Lee, Jeongwoo; Liu, C.; Cho, K.; Gary, D. E.; Yurchyshyn, V.; Deng, N.; Wang, H.

    2006-06-01

    The 2005 May 13 flare occurred in the sigmoidal active region, NOAA 10759, and its time dependent change on the TRACE, EIT, and SXI images suggests an eruption process as envisioned by the runaway tether-cutting model. However, the onset of the eruption in the low corona and the final explosion of the magnetic field in the high corona are not directly observable at these wavelengths and we infer them indirectly from the radio data obtained with the Owens Valley Solar Array (OVSA), Green Bank Solar Radio Burst Spectrometer (GBSRBS), PHOENIX-spectrograph of ETH Zurich, and the Potsdam-Tremsdorf Spectrograph. The Potsdam spectrograph shows a so-called Type II Precursor in the early phase of loop expansion, indicating a coronal shock formed near the flare site. The GBSRBS spectra show a type III burst followed by type II bursts in the maximum phase, which implies opening of field lines and strong shock formation in the high corona. Finally, the radio pulsations are detected on the OVSA and PHOENIX spectrographs, which we interpret as due to the magnetic loop oscillation as a dynamic response to the mass ejection. These radio data along with the EUV and X-ray images are used to infer the runaway tether-cutting process during this event in all coronal heights.This work is supported by NSF/SHINE grant ATM-0548952 and NSF grant AST-0307670 to NJIT.

  13. [Unilateral decompressive craniectomy in left transverse and sigmoid sinus thrombosis].

    PubMed

    Weber, J; Spring, A

    2004-01-01

    Cerebral venous and dural sinus thrombosis is a rare cause of stroke. We explore the controversial issue of anticoagulation therapy and indication for decompressive craniectomy in association with severe sinus thrombosis. The 62-year-old female patient was admitted to hospital, because of first generalized seizure. A computed tomographic (CT) scan of the brain revealed a left occipital hemorrhage. Digital subtraction angiogram showing thrombosis of the left transverse and sigmoid sinus. An intravenously administered regimen of heparin was begun, because of a protein S deficiency. On the 6th day the patients level of consciousness deteriorated, necessitating intubation, hyperventilation, and mannitol. Repeat CT scan revealed increasing edema with midline shift and obliteration of the basal cisterns, although the hemorrhagic lesion was unchanged. The patient developed signs of diencephalic dysfunction. A large left temporoparietooccipital craniectomy was performed and the dura was opened. The multiloculated intraparenchymatous hemorrhage portion of the brain was not removed. In addition, the patient was treated postoperatively with heparin therapy for three months, than a regimen of phenprocoumon was begun. Twelve months later the hemianopsia had not improved and she had an incomplete Wernicke's dysphasia. When, despite adequate anticoagulation therapy and intensive care, neurological deterioration occurs in sigmoideus and/or transversus dural sinus thrombosis with unilateral edema, a decompressive craniectomy should be considered especially in young patients. PMID:15306978

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

    PubMed Central

    Lam, Lilian H.; Monack, Denise M.

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2009-02-01

    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 Ω-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.

  16. Space colonization.

    PubMed

    2002-12-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2010-05-01

    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.

  18. Colonoscopy in the emergency treatment of colonic volvulus in Nigeria.

    PubMed

    Arigbabu, A O; Badejo, O A; Akinola, D O

    1985-11-01

    The commonest cause of large-bowel obstruction in Nigeria is sigmoid volvulus. Patients usually present late, dehydrated, and in very poor condition. The mortality of emergency colonic surgery is undoubtedly high, more so in developing countries poorly equipped to cope with such a condition. To reduce the mortality rate and improve management of the patients, a four-year prospective study of detorsion followed by elective surgery after adequate resuscitation and bowel preparation was carried out between January 1979 and December 1982. Volvulus is classified into three groups: torsion, obstruction, and strangulation. Criteria for short colonoscopic detorsion of torsion and obstruction types are discussed, and the contraindication in the case of strangulation type mentioned. This article describes the management of 92 cases of sigmoid volvulus between 1979 and 1982. PMID:4053889

  19. Elective Surgery for Sigmoid Diverticulitis - Indications, Techniques, and Results.

    PubMed

    Jurowich, Christian F; Germer, Christoph T

    2015-04-01

    Diverticulitis is one of the leading indications for elective colonic resections although there is an ongoing controversial discussion about classification, stage-dependent therapeutic options, and therapy settings. As there is a rising trend towards conservative therapy for diverticular disease even in patients with a complicated form of diverticulitis, we provide a compact overview of current surgical therapy principles and the remaining questions to be answered. PMID:26989381

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

  1. [Acute sigmoid diverticulitis: toward a more and more conservative treatment].

    PubMed

    Joliat, G-R; Pittet, O; Demartines, N; Hahnloser, D

    2015-09-16

    Acute diverticulitis of the colon is a frequent pathology especially among elderly people and people of Caucasian origin. The prevalence is higher among sedentary people and in people with low-fiber diet. Its diagnosis is mainly based on computed tomography (CT) that allows guiding the therapeutic management. Over the last few years the treatment of acute diverticulitis has passably changed with in particular an evolution toward a restriction of the elective and emergency surgery indications and a reduction of the antiobiotherapy and hospitalization number. This article reviews the epidemiology, the diagnostic tools, and the management of this frequent digestive pathology. PMID:26591083

  2. Distal oblique bundle reconstruction and distal radioulnar joint instability.

    PubMed

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

    2013-11-01

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

  3. Regional differences in colonic mucosa-associated microbiota determine the physiological expression of host heat shock proteins

    PubMed Central

    Hu, Shien; Wang, Yunwei; Lichtenstein, Lev; Tao, Yun; Musch, Mark W.; Jabri, Bana; Antonopoulos, Dionysios; Claud, Erika C.

    2010-01-01

    Cytoprotective heat shock proteins (Hsps) are critical for intestinal homeostasis and are known to be decreased in inflammatory bowel diseases. Signals responsible for maintenance of Hsp expression are incompletely understood. In this study, we find that Hsp25/27 and Hsp70 protein expressions are differentially regulated along the longitudinal length of the large intestine, being highest in the proximal colon and decreasing to the distal colon. This longitudinal gradient was similar in both conventionally colonized mouse colon as well as biopsies of human proximal and distal colon but was abolished in the colon of germ-free mice, suggesting a role of intestinal microbiota in the Hsp regional expression. Correspondingly, analysis of 16S ribosomal RNA genes of bacteria from each colonic segment indicated increased bacterial richness and diversity in the proximal colon. The mechanism of regulation is transcriptional, as Hsp70 mRNA followed a similar pattern to Hsp70 protein expression. Lysates of mucosa-associated bacteria from the proximal colon stimulated greater Hsp25 and Hsp70 mRNA transcription and subsequent protein expression in intestinal epithelial cells than did lysates from distal colon. In addition, transrectal administration of cecal contents stimulated Hsp25 and Hsp70 expression in the distal colon. Thus host-microbial interactions resulting in differential Hsp expression may have significant implications for the maintenance of intestinal homeostasis and possibly for development of inflammatory diseases of the bowel. PMID:20864653

  4. Genetics Home Reference: Laing distal myopathy

    MedlinePlus

    ... Gene Review: Gene Review: Laing Distal Myopathy Laing NG, Laing BA, Meredith C, Wilton SD, Robbins P, ... T, Bridges LR, Fabian V, Rozemuller A, Laing NG. Laing early onset distal myopathy: slow myosin defect ...

  5. Epigenomic enhancer profiling defines a signature of colon cancer.

    PubMed

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

    2012-05-11

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

  6. Epigenomic enhancer profiling defines a signature of colon cancer

    PubMed Central

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

    2013-01-01

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

  7. Sarcomas of the distal extremities

    SciTech Connect

    Jenkin, R.D.T.

    1983-08-01

    This editorial focuses on sarcomas of bone or soft tissue at sites distal to the elbow or knee. These tumors are rare, so that it is not surprising that the best treatment is not clearly established. Whether or not systemic treatment is given to the patient with no evidence of metastatic disease, which is the common situation for sarcomas of the distal extremities, will be determined by results of adjuvant chemotherapy at the proximal limb and axial sites for the tumor entity in question. Necessarily the local treatment must be resection or irradiation or a combination of these treatments. The choice is determined by the relative effectiveness and morbidity of these treatments and is site-dependent.

  8. Distal clavicle fractures in children☆

    PubMed Central

    Labronici, Pedro José; da Silva, Ricardo Rodrigues; Franco, Marcos Vinícius Viana; Labronici, Gustavo José; Pires, Robinson Esteves Santos; Franco, José Sergio

    2015-01-01

    Objective To analyze fractures of the distal clavicle region in pediatric patients. Methods Ten patients between the ages of five to eleven years (mean of 7.3 years) were observed. Nine patients were treated conservatively and one surgically. All the fractures were classified using the Nenopoulos classification system. Results All the fractures consolidated without complications. Conservative treatment was used for nine patients, of whom three were in group IIIB, three IIb, two IIa and one IV. The only patient who was treated surgically was a female patient of eleven years of age with a group IV fracture. Conclusion The treatment indication for distal fractures of the clavicle in children should be based on the patient's age and the displacement of the fragments. PMID:26962489

  9. AN EXTREME ULTRAVIOLET WAVE ASSOCIATED WITH A MICRO-SIGMOID ERUPTION

    SciTech Connect

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

    2012-07-10

    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.

  10. Chondroblastoma of the distal phalanx.

    PubMed

    Gregory, James R; Lehman, Thomas P; White, Jeremy R; Fung, Kar-Ming

    2014-05-01

    Chondroblastoma is a rare, benign primary bone tumor that usually occurs at the epiphysis of long bones. The authors present an example of the diagnosis and successful treatment of this neoplasm in an exceedingly rare location in the distal phalanx. Clinical and radiographic outcomes after 68 months of follow-up are presented. A 15-year-old, right hand-dominant, boy developed painful swelling of the right ring finger. Radiographs revealed a radiolucent lesion of the distal phalanx with expansile remodeling of the bone. An excisional biopsy was performed with curettage and bone grafting of the lesion. The diagnosis of chondroblastoma was made based on pathologic evaluation of the biopsy specimen. Sixty-six months after surgical treatment, the patient was free of recurrence and metastatic disease with excellent clinical and functional outcomes. To the authors' knowledge, this represents only the second reported case of chondroblastoma of the distal phalanx. The diagnosis of chondroblastoma in this rare location was made by pathologic review of the resection specimen. It is imperative to confirm the diagnosis of any resected bone specimen even when the concern for an aggressive or malignant lesion is low. A tumor presenting in an unusual location may require a change in treatment or surveillance. PMID:24810830

  11. Mass peristalsis in the human colon after contact with oxyphenisatin

    PubMed Central

    Ritchie, James

    1972-01-01

    Colonic motility studies using time-lapse cinefluorography and intraluminal pressure recording before and after the introduction per rectum of a mixture of barium sulphate and oxyphenisatin solution show the different forms of movement of the colonic contents. Oxyphenisatin was found to be a selective actuator of a form of progressive mass propulsion indistinguishable from spontaneous mass peristalsis. Less than 0·5 mg distributed through the pelvic and distal descending colon was enough to produce a peristaltic response; larger quantities tended to increase the number of resulting movements. A standard dose of 4 mg of the drug was followed by mass peristalsis in 82% of the subjects in whom it came into adequate contact with colonic mucosa. The response usually took place within 20 minutes. The more sensitive the subject, the greater was the number of peristaltic responses and the shorter the interval before the response began. In 73% of the subjects who responded, the mass peristalsis came to a halt between 40 and 25 cm from the anal margin, and many of those in whom it extended farther appeared to have shortened distal colons. The likelihood of the drug giving rise to peristalsis diminished abruptly distal to about 45 cm from the anus; its effectiveness was greatest in the proximal descending colon. ImagesFig. 1Fig. 2Fig. 3 PMID:5024726

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

    PubMed Central

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

    2008-01-01

    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. PMID:18955806

  13. Pathological complete response following neoadjuvant radiotherapy and intraperitoneal perfusion chemotherapy for recurrent colon carcinoma: A case report and literature review

    PubMed Central

    BIAN, XINYU; LIU, BAORUI; YANG, YANG

    2016-01-01

    The present study reports the case of a 28-year-old male who was diagnosed with sigmoid colon carcinoma and exhibited local recurrence following radical surgery and 6 cycles of adjuvant chemotherapy. The primary surgery consisted of a partial sigmoidectomy and bladder repair. At 8 months post-chemotherapy, the patient was referred to Nanjing Drum Tower Hospital (Nanjing, China) due to local recurrence at the anastomotic site, which was confirmed by colonoscopy and total abdominal computed tomography. Synchronous intensity modulation radiation therapy and intraperitoneal (IP) perfusion chemotherapy with irinotecan (100 mg/m2) was administered. Following treatment, the object efficacy evaluation revealed a complete response and a second resection of the remaining sigmoid colon was performed. The post-operative results showed a pathological complete response. This case indicated that a combination of therapies, including radiotherapy, IP perfusion chemotherapy and surgery, may be beneficial and effective in patients with recurrent colon cancer. PMID:27073546

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2009-12-01

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

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

    PubMed

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

    2015-05-01

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

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

    SciTech Connect

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

    2012-03-01

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

  18. Colon cancer - resources

    MedlinePlus

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

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

    PubMed

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

    2015-07-01

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

  20. Autonomic Nerve Regulation of Colonic Peristalsis in Guinea Pigs

    PubMed Central

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

    2014-01-01

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

  1. [A case of early gastric cancer responding to adjuvant chemotherapy for treatment of colon cancer].

    PubMed

    Saito, Akira; Murakami, Masahiko; Suzuki, Satoshi; Sagane, Masahiro; Hayashi, Takahiro; Enosawa, Tetsuji; Murai, Noriyuki; Yoshizawa, Hiroto; Mochizuki, Kou; Fukushima, Motohiko; Yokokawa, Hideo

    2013-11-01

    A 63-year-old man underwent colonoscopy owing to a positive fecal occult blood test, and he was diagnosed as having advanced sigmoid colon cancer. Esophagogastroduodenoscopy( EGD), performed as a preoperative examination, revealed an 8 mm early gastric cancer in the lower body of his stomach. We performed laparoscopic sigmoid colon resection and D3 lymphadenectomy first because the patient had advanced sigmoid colon cancer. The histopathological diagnosis was Stage II; however, vascular invasion was apparent. Some authors have reported that chemotherapy with 5-fluorouracil (FU) is effective against early gastric cancer; therefore, we administered postoperative adjuvant chemotherapy comprising uracil and tegafur( UFT)+Leucovorin( LV) tablets before ESD for early gastric cancer. Two months later, follow-up EGD showed that the gastric cancer had become flat and small. Five months later, it resembled a scar, and examination of a biopsy showed no malignant finding. We continued to administer chemotherapy to the patient for 6 months. Nine months after the discontinuation of chemotherapy, EGD showed only a scar and biopsy revealed no malignant finding. PMID:24394082

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

    PubMed Central

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

    2015-01-01

    Introduction Adult intussusception is rare. Lipoma is the second most common benign tumor of the colon and most common to cause colonic intussusception in adults, but rare. Presentation of case A 35-years-old male presented with a history of intermittent abdominal pain and bright red rectal bleeding, with symptoms waxing and waning for one month. On physical examination, the abdomen was distended with tenderness over the periumbilical, suprapubic, and left lower quadrant regions with guarding. CT demonstrated colo-colonic intussusception of the sigmoid colon with a 2.3cmנ2.6cm intra-mural lipoma of the rectosigmoid region. The patient underwent an exploratory laparotomy with partial reduction of the intussusception, sigmoid colon resection and end colostomy. Histopathology confirmed a 2.5cm sub-mucosal lipoma without evidence of malignancy. Discussion Sixtysixty five percent of cases with intussusception of the large bowel in adults are related to a malignant etiology and most cases of sigmoidorectal intussusception reported in the literature are secondary to underlying malignancy. Colo-colic intussusception is the most common type of intussusception in adults. The incidence of lipomas of the large intestine is reported to range from 0.035% to 4.4%. Ninety percent of colonic lipomas are submuscosal and are mostly located in the right hemicolon. Only 25% of patients with colonic lipoma develop symptoms. Colonic lipomas of the rectosigmoid region represent a very rare occurrence and subsequent etiology for sigmoidorectal intussusceptions in adults. Conclusion Colonic lipoma should be considered in the differential diagnosis of adults with intussusception, with reduction and resection leading to excellent results. PMID:25839433

  3. Analysis of Surface Plasmon Resonance Curves with a Novel Sigmoid-Asymmetric Fitting Algorithm

    PubMed Central

    Jang, Daeho; Chae, Geunhyoung; Shin, Sehyun

    2015-01-01

    The present study introduces a novel curve-fitting algorithm for surface plasmon resonance (SPR) curves using a self-constructed, wedge-shaped beam type angular interrogation SPR spectroscopy technique. Previous fitting approaches such as asymmetric and polynomial equations are still unsatisfactory for analyzing full SPR curves and their use is limited to determining the resonance angle. In the present study, we developed a sigmoid-asymmetric equation that provides excellent curve-fitting for the whole SPR curve over a range of incident angles, including regions of the critical angle and resonance angle. Regardless of the bulk fluid type (i.e., water and air), the present sigmoid-asymmetric fitting exhibited nearly perfect matching with a full SPR curve, whereas the asymmetric and polynomial curve fitting methods did not. Because the present curve-fitting sigmoid-asymmetric equation can determine the critical angle as well as the resonance angle, the undesired effect caused by the bulk fluid refractive index was excluded by subtracting the critical angle from the resonance angle in real time. In conclusion, the proposed sigmoid-asymmetric curve-fitting algorithm for SPR curves is widely applicable to various SPR measurements, while excluding the effect of bulk fluids on the sensing layer. PMID:26437414

  4. Current indications and role of surgery in the management of sigmoid diverticulitis

    PubMed Central

    Stocchi, Luca

    2010-01-01

    Sigmoid diverticulitis is a common disease which carries both a significant morbidity and a societal economic burden. This review article analyzes the current data regarding management of sigmoid diverticulitis in its variable clinical presentations. Wide-spectrum antibiotics are the standard of care for uncomplicated diverticulitis. Recently published data indicate that sigmoid diverticulitis does not mandate surgical management after the second episode of uncomplicated disease as previously recommended. Rather, a more individualized approach, taking into account frequency, severity of the attacks and their impact on quality of life, should guide the indication for surgery. On the other hand, complicated diverticular disease still requires surgical treatment in patients with acceptable comorbidity risk and remains a life-threatening condition in the case of free peritoneal perforation. Laparoscopic surgery is increasingly accepted as the surgical approach of choice for most presentations of the disease and has also been proposed in the treatment of generalized peritonitis. There is not sufficient evidence supporting any changes in the approach to management in younger patients. Conversely, the available evidence suggests that surgery should be indicated after one attack of uncomplicated disease in immunocompromised individuals. Uncommon clinical presentations of sigmoid diverticulitis and their possible association with inflammatory bowel disease are also discussed. PMID:20143459

  5. Analysis of Surface Plasmon Resonance Curves with a Novel Sigmoid-Asymmetric Fitting Algorithm.

    PubMed

    Jang, Daeho; Chae, Geunhyoung; Shin, Sehyun

    2015-01-01

    The present study introduces a novel curve-fitting algorithm for surface plasmon resonance (SPR) curves using a self-constructed, wedge-shaped beam type angular interrogation SPR spectroscopy technique. Previous fitting approaches such as asymmetric and polynomial equations are still unsatisfactory for analyzing full SPR curves and their use is limited to determining the resonance angle. In the present study, we developed a sigmoid-asymmetric equation that provides excellent curve-fitting for the whole SPR curve over a range of incident angles, including regions of the critical angle and resonance angle. Regardless of the bulk fluid type (i.e., water and air), the present sigmoid-asymmetric fitting exhibited nearly perfect matching with a full SPR curve, whereas the asymmetric and polynomial curve fitting methods did not. Because the present curve-fitting sigmoid-asymmetric equation can determine the critical angle as well as the resonance angle, the undesired effect caused by the bulk fluid refractive index was excluded by subtracting the critical angle from the resonance angle in real time. In conclusion, the proposed sigmoid-asymmetric curve-fitting algorithm for SPR curves is widely applicable to various SPR measurements, while excluding the effect of bulk fluids on the sensing layer. PMID:26437414

  6. Distal limb and paw injuries.

    PubMed

    Fowler, David

    2006-07-01

    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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    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

    2011-01-01

    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. PMID:21814596

  9. Endoscopic removal of a toothpick perforating the sigmoid colon and causing chronic abdominal pain: a case report

    PubMed Central

    Oikonomou, Anastasia; Souftas, Vasilios; Gkotsis, Dimitrios; Pitiakoudis, Michail; Kouklakis, Georgios

    2009-01-01

    Toothpick ingestion is implicated in gut injuries which may cause severe complications, mimicking diseases causing acute abdomen. However, toothpick ingestion-related perforation may also cause mild, non-specific gastrointestinal symptoms without significant findings or major complications. We describe a young male with chronic postprandial lower abdominal pain caused by a toothpick impaction at the rectosigmoid junction after inadvertent ingestion. The foreign body was detected and successfully removed during flexible sigmoidoscopy. Perforation due to foreign body ingestion must be considered in the differential diagnosis in patients presenting with unexplained symptoms and findings, even when they do not recall any foreign body ingestion. PMID:19918434

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2015-03-01

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

  12. The Role of Erupting Sigmoid in Triggering a Flare with Parallel and Large-scale Quasi-circular Ribbons

    NASA Astrophysics Data System (ADS)

    Joshi, Navin Chandra; Liu, Chang; Sun, Xudong; Wang, Haimin; Magara, Tetsuya; Moon, Y.-J.

    2015-10-01

    In this paper, we present observations and analysis of an interesting sigmoid formation, eruption, and the associated flare that occurred on 2014 April 18 using multi-wavelength data sets. We discuss the possible role of the sigmoid eruption in triggering the flare, which consists of two different sets of ribbons: parallel ribbons and a large-scale quasi-circular ribbon. Several observational evidence and nonlinear force-free field extrapolation results show the existence of a large-scale fan-spine type magnetic configuration with a sigmoid lying under a section of the fan dome. The event can be explained with the following two phases. During the preflare phase, we observed the formation and appearance of the sigmoid via tether-cutting reconnection between the two sets of sheared fields under the fan dome. The second, main flare phase features the eruption of the sigmoid, the subsequent flare with parallel ribbons, and a quasi-circular ribbon. We propose the following multi-stage successive reconnection scenario for the main flare. First, tether-cutting reconnection is responsible for the formation and the eruption of the sigmoid structure. Second, the reconnection occurring in the wake of the erupting sigmoid produces the parallel flare ribbons on the both sides of the circular polarity inversion line. Third, the null-type reconnection higher in the corona, possibly triggered by the erupting sigmoid, leads to the formation of a large quasi-circular ribbon. For the first time, we suggest a mechanism for this type of flare consisting of a double set of ribbons triggered by an erupting sigmoid in a large-scale fan-spine-type magnetic configuration.

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

    PubMed Central

    Koçak, Erdem; Akbal, Erdem; Taş, Adnan; Köklü, Seyfettin; Karaca, Gökhan; Can, Murat; Kösem, Bahadır; Üstün, Hüseyin

    2013-01-01

    Background/Aim: Ankaferd blood stopper (ABS) is a herbal extract that enhances mucosal healing. In this study, we aimed to investigate the efficiency of ABS in the treatment of experimental distal colitis. Materials and Methods: Twenty one male albino rats were divided into three groups: Sham control (Group 1), colitis induced by acetic acid and treated with saline (Group 2), colitis induced by acetic acid and treated with ABS (Group 3). At end of the 7th day of induction, all the rats were lightly anesthetized with intramuscular ketamine (8 mg/kg) and thereafter laparotomy and total colectomy were performed. The distal colon segment was assessed macroscopically and microscopically. In addition malondialdehyde (MDA), superoxide dismutase (SOD) and nitric oxide (NO) levels of the colonic tissue and changes in body weight were measured. Results: The MDA and NO levels of the colonic tissues and weight loss were significantly higher in Group 2 compared to Group 1 and Group 3. Microscopic and macroscopic damage scores were significantly higher in Group 2 and Group 3 than Group 1 (P: 0.001, P: 0.004, respectively). Although the microscopic and macroscopic damage scores in Group 3 were slightly lower than Group 2, the difference was not statistically significant. The SOD levels of the colonic tissues were not different between the three groups. Conclusion: Weight alterations and high-levels of the colonic tissue MDA and NO suggested that ABS might have anti-inflammatory effects on experimental distal colitis. However, this suggestion was not supported by histopathological findings. PMID:23680710

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

    PubMed Central

    Du, C; Ferr, J P; Ruckebusch, Y

    1987-01-01

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

  15. Distal symphalangism: a report of two families.

    PubMed

    Poush, J R

    1991-01-01

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

  16. Robotic distal pancreatectomy: a valid option?

    PubMed

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

    2013-10-01

    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

  17. Liver Colonization Competence Governs Colon Cancer Metastasis

    NASA Astrophysics Data System (ADS)

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

    1995-12-01

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

  18. Cephalic phase of colonic pressure response to food.

    PubMed

    Rogers, J; Raimundo, A H; Misiewicz, J J

    1993-04-01

    A cephalic phase of colonic pressure response to food was sought in five normal subjects (mean age (22.6) years, 22-24), studied on six separate occasions by recording intraluminal pressures in the unprepared sigmoid colon. Gastric acid secretion was measured simultaneously by continuous aspiration through a nasogastric tube. After a 60 minute basal period, one of five 30 minute food related cephalic stimuli, or a control stimulus was given in random order; records were continued for a further 120 minutes. The cephalic stimuli were: food discussion, sight and smell of food without taste, smell of food without sight or taste, sight of food without smell or taste, and modified sham feeding; the control stimulus was a discussion of neutral topics. Colonic pressures were expressed as study segment activity index (area under curve, mm Hg.min) derived by fully automated computer analysis. Gastric acid output was expressed as mmol/30 min. Food discussion significantly (p < 0.02, Wilcoxon's rank sum test) increased colonic pressure activity compared with control or basal activity. Smell of food without sight or taste also significantly (p < 0.03) increased the colonic pressure activity compared with control and basal periods. Sham feeding and sight and smell of food without taste significantly (p < 0.02 and p < 0.03) increased colonic pressures compared with control but not basal activity. The increase in colonic activity after sight of food without smell or taste was not significantly different from control or basal activity (p = 0.44 and p = 0.34). Food discussion was the strongest colonic stimulus tested. Food discussion and sham feeding significantly (p<0.02) stimulated gastric acid output above control and basal values. Sight and smell of food without taste significantly (p<0.02) increased acid output above basal. Smell of food without sight or taste and sight of food without smell or taste did not significantly (p=0.06, p=0.34) increase acid output. In contrast with the effect on colonic pressures, sham feeding was the best stimulus of acid output. Increased colonic pressure activity after food discussion correlated significantly (r=0.45, p<0.02) with gastric acid output. There was no correlation (r=-0.1, p>0.5) between colonic pressure activity and gastric acid output in the control study. These data show that there is a cephalic phase of the colonic response to food. PMID:8491403

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

    PubMed Central

    Baykul, Timuçin

    2015-01-01

    Purpose: To evaluate the etiopathogenesis, clinical features and surgical approaches for removal of ectopic third molars in the mandible. Methods: We report a case of an impacted mandibular third molar dislocated on mandibular sigmoid notch. 20 cases of ectopic mandibular third molars reported in the English-language literature, identified from Pubmed and Medline databases are also reviewed. Results: Among the 20 article reported in the presented study, ectopic third molars were generally located in the condylar region. The common symptoms of the clinical examination were pain, trismus, swelling, temporomandibular joint syndroms or no symptoms. Conclusions: Ectopic third molar may be asymptomatic initially with clinical manifestations, later on as adjacent structures are affected. The surgical approach must be carefully planned for the aim of choosing the more conservative technique that produces the minimum trauma to patients. Key words:Ectopic third molar, sigmoid notch, cyst. PMID:25810825

  20. Image enhancement and space-variant color reproduction method for endoscopic images using adaptive sigmoid function.

    PubMed

    Imtiaz, Mohammad Shamim; Wahid, Khan A

    2014-01-01

    This paper presents an image enhancement and space-variant color reproduction method based on adaptive sigmoid function for endoscopic image. At first, using YCBCR conversion matrix, the color image is separated into luminance and chrominance components. The adaptive sigmoid function with two controlling parameters is applied on the uniformly distributed luminance pixels. The space-variant color reproduction generates new chrominance components by transferring and modifying old chrominance based on texture information. Finally, new luminance and chrominance components are converted into RGB color image. The proposed method highlights some of the tissue and vascular characteristics as well as pit patterns in lesion and polyp. The performance of the proposed scheme is compared with other related methods in terms of image quality, focus value, efficiency of color reproduction and statistic of visual representation. PMID:25570845

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

    NASA Astrophysics Data System (ADS)

    Pratap, Rana; Subadra, M.

    2011-10-01

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

  2. Chondromyxoid fibroma invasion of the transverse-sigmoid sinus junction causing posterior fossa hemorrhage.

    PubMed

    Hersh, David S; Firempong, Alexander O; Chesler, David; Castellani, Rudolph J; Woodworth, Graeme F

    2016-02-01

    We report a 50-year-old woman with a chondromyxoid fibroma of the occipital bone, who presented with a cerebellar hemorrhage due to invasion of the adjacent sinus. Chondromyxoid fibromas are benign cartilaginous tumors. However, this case represents the first example, to our knowledge, of a chondromyxoid fibroma invading the transverse-sigmoid junction, resulting in intracranial hemorrhage. Our report highlights that the location of an intracranial chondromyxoid fibroma is an important factor in guiding surgical management. PMID:26481053

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

    PubMed Central

    Roseau, Gilles

    2014-01-01

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

  4. [Microinjection of L-NAME into dorsal raphe nucleus inhibits nociceptive response in sigmoid pain model of rats].

    PubMed

    Yang, Bin; Zhang, Li-Cai; Zeng, Yin-Ming

    2003-10-25

    By means of Fos immunocytochemistry, nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) histochemistry and microinjection methods, the role of nitric oxide synthase (NOS) of dorsal raphe (DR) neurons in the modulation of rats sigmoid pain was studied. The results showed: (1) Rats exhibited aversive behavioral responses related to visceral pain after injecting formalin into the sigmoid wall. NOS neurons in DR were up-regulated, in addition, about 8% of NOS-labeled neurons were Fos positive. By contrast, there were no Fos/NOS double-labeled neurons in the control group. (2) Formalin-induced sigmoid pain scores and the expression of Fos in the spinal cord at S1 segment were decreased after microinjecting L-NAME into the DR. These findings suggest that NOS neurons are involved in the modulation of formalin-induced sigmoid pain and that NO may play an important role in the transmission of visceral nociceptive message in the midbrain. PMID:14566407

  5. Multiple Congenital Colonic Stenosis: A Rare Gastrointestinal Malformation.

    PubMed

    Elisa, Zambaiti; Cinzia, Chiaramonte; Sergio, Salerno; Giuseppe, Li Voti; Fortunato, Siracusa

    2016-01-01

    Congenital colonic stenosis is a rare pediatric condition. Since 1968, only 16 cases have been reported in the literature. To the authors' knowledge, multiple congenital colonic stenosis has not been previously reported in the literature. We report the case of a 2-month-old male, presented at our Neonatal Intensive Care Unit with a suspicion of intestinal malrotation. Clinical examination revealed persistent abdominal distension. During the enema examination, the contrast medium appeared to fill the lumen of the colon up to three stenotic segments and could not proceed further. Intraoperatively we confirmed the presence of four types of colonic atresia, located in the ascending, transverse, and descending colon, respectively, plus appendix atresia. First surgical steps consisted in resection of proximal stenotic segment, appendix removal, proximal cecostomy, and distal colostomy on ascending colon in order to preserve colonic length. Histopathological examination confirmed the diagnosis of colonic stenosis. Final surgical step consisted in multiple colocolostomy and enteroplasty. A planned two-stage procedure, consisting of resection with colostomy for decompression as the first step and a later anastomosis, is recommended in order to allow bowel length preservation. PMID:27066287

  6. Multiple Congenital Colonic Stenosis: A Rare Gastrointestinal Malformation

    PubMed Central

    Elisa, Zambaiti; Cinzia, Chiaramonte; Sergio, Salerno; Giuseppe, Li Voti; Fortunato, Siracusa

    2016-01-01

    Congenital colonic stenosis is a rare pediatric condition. Since 1968, only 16 cases have been reported in the literature. To the authors' knowledge, multiple congenital colonic stenosis has not been previously reported in the literature. We report the case of a 2-month-old male, presented at our Neonatal Intensive Care Unit with a suspicion of intestinal malrotation. Clinical examination revealed persistent abdominal distension. During the enema examination, the contrast medium appeared to fill the lumen of the colon up to three stenotic segments and could not proceed further. Intraoperatively we confirmed the presence of four types of colonic atresia, located in the ascending, transverse, and descending colon, respectively, plus appendix atresia. First surgical steps consisted in resection of proximal stenotic segment, appendix removal, proximal cecostomy, and distal colostomy on ascending colon in order to preserve colonic length. Histopathological examination confirmed the diagnosis of colonic stenosis. Final surgical step consisted in multiple colocolostomy and enteroplasty. A planned two-stage procedure, consisting of resection with colostomy for decompression as the first step and a later anastomosis, is recommended in order to allow bowel length preservation. PMID:27066287

  7. Anatomic Landmarks of the Distal Radioulnar Joint

    PubMed Central

    Augenstein, A.; Nadar, M.; Afflick, E.; Kasdan, M.; Wilhelmi, B.

    2015-01-01

    Hypothesis: Using Lister's tubercle and the ulnar styloid as landmarks, accurate localization of the distal radioulnar joint can be achieved without the need for an image-guided approach. Methods: Cadaveric dissection of 16 upper extremities was performed to measure the relationships between the ulnar styloid, Lister's tubercle, and the distal radioulnar joint. In each specimen, the location of the distal radioulnar joint (point A) in relation to Lister's tubercle and the ulnar styloid was determined as follows: (1) the perpendicular distance between the distal radioulnar joint and ulnar styloid–Lister's tubercle was measured; (2) with A' marking the intersection of this distance and the ulnar styloid–Lister's tubercle line, the location of the distal radioulnar joint along the ulnar styloid–Lister's tubercle axis was determined by comparing ulnar styloid–A' and A'–Lister's tubercle with ulnar styloid–Lister's tubercle. Results: The mean distance between ulnar styloid–Lister's tubercle was 4.3 ± 0.4 cm. The mean perpendicular distance between the distal radioulnar joint and the ulnar styloid–Lister's tubercle line was 0.2 ± 0.1 cm proximal to the ulnar styloid–Lister's tubercle line. The ratio of ulnar styloid–A' and A'–Lister's tubercle to ulnar styloid–Lister's tubercle was 0.5 ± 0.03 and 0.5 ± 0.03, respectively. Conclusions: Simple relationships between the ulnar styloid and Lister's tubercle serve as reliable landmarks for locating the distal radioulnar joint. The distal radioulnar joint is centered about the midpoint of the ulnar styloid–Lister's tubercle axis and slightly proximal to it. This may improve the accuracy and efficacy of corticosteroid injections in the treatment of distal radioulnar joint arthritis without the need for image guidance. PMID:26301001

  8. Perioperative management of distal pancreatectomy

    PubMed Central

    Fujino, Yasuhiro

    2015-01-01

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

  9. Unilateral Molar Distalization: A Nonextraction Therapy

    PubMed Central

    Prasad, M. Bhanu; Sreevalli, S.

    2012-01-01

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

  10. Unilateral molar distalization: a nonextraction therapy.

    PubMed

    Prasad, M Bhanu; Sreevalli, S

    2012-01-01

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

  11. Management of Complications of Distal Radius Fractures

    PubMed Central

    Chung, Kevin C.; Mathews, Alexandra L.

    2015-01-01

    Synopsis Treating a fracture of the distal radius may require the surgeon to make a difficult decision between surgical treatment and nonsurgical management. The use of surgical fixation has recently increased owing to complications associated with conservative treatment. However, conservative action may be necessary depending on certain patient factors. The treating surgeon must be aware of the possible complications associated with distal radius fracture treatments to prevent their occurrence. Prevention can be achieved with a proper understanding of the mechanism of these complications. This article discusses the most recent evidence on how to manage and prevent complications following a fracture of the distal radius. PMID:25934197

  12. Surgical Treatment of Distal Biceps Ruptures.

    PubMed

    Stoll, Laura E; Huang, Jerry I

    2016-01-01

    Distal biceps ruptures occur from eccentric loading of a flexed elbow. Patients treated nonoperatively have substantial loss of strength in elbow flexion and forearm supination. Surgical approaches include 1-incision and 2-incision techniques. Advances in surgical technology have facilitated the popularity of single-incision techniques through a small anterior incision. Recently, there is increased focus on the detailed anatomy of the distal biceps insertion and the importance of anatomic repair in restoring forearm supination strength. Excellent outcomes are expected with early repair of the distal biceps, with restoration of strength and endurance to near-normal levels with minimal to no loss of motion. PMID:26614933

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

    PubMed

    Bogomil'skiĭ, M R; Polunin, M M; Ivanenko, A M; Poliakov, A A

    2014-01-01

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

  14. Colon cancer - Series (image)

    MedlinePlus

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

  15. Pan-colonic pharmacokinetics of catechins and procyanidins in male Sprague-Dawley rats.

    PubMed

    Goodrich, Katheryn M; Smithson, Andrew T; Ickes, Anne K; Neilson, Andrew P

    2015-10-01

    Poor absorption and bioavailability of procyanidins from the upper gastrointestinal tract result in the majority of the dose reaching the colon. During colonic transit, progressive microbial metabolism likely produces gradients of procyanidins and microbial metabolites along the length of the colon, suggesting that proximal and distal regions are exposed to different profiles of procyanidins and metabolites. However, previous studies have largely treated the colon as a single organ or looked at fecal profiles, and differences in the profiles of native and metabolite compounds between regions have not been observed. The metabolism kinetics of procyanidins larger than trimers and formation of metabolites in the colon have not been well characterized. Therefore, the objective of this study was to determine the kinetics of delivery and microbial metabolism of monomeric, dimeric and oligomeric procyanidins in the cecum and proximal, mid and distal colon. Sprague-Dawley rats were gavaged grape seed extract and sacrificed over 18 h. Analysis of luminal contents showed distinct native and metabolite profiles for each region. Procyanidins had maximum concentrations at approximately 3h postgavage for all sections. Metabolites reached maximum concentrations from 3 to 18 h postgavage. The appearance of metabolites was highly dependent on species: larger metabolites were found at earlier times in the more proximal segments, and smaller metabolites were found at later times in more distal regions. This study allowed for the observation of regions in the lower gastrointestinal tract, giving insight into the distribution and delivery of procyanidins and their microbial metabolites throughout the colon. PMID:26026837

  16. Normal distal pulmonary vein anatomy

    PubMed Central

    Klimek-Piotrowska, Wies?awa; Pi?tek, Katarzyna; Koziej, Mateusz; Ho?da, Jakub

    2016-01-01

    Background. It is well known that the pulmonary veins (PVs), especially their myocardial sleeves play a critical role in the initiation and maintenance of atrial fibrillation. Understanding the PV anatomy is crucial for the safety and efficacy of all procedures performed on PVs. The aim of this study was to present normal distal PV anatomy and to create a juxtaposition of all PV ostium variants. Methods. A total of 130 randomly selected autopsied adult human hearts (Caucasian) were examined. The number of PVs ostia was evaluated and their diameter was measured. The ostium-to-last-tributary distance and macroscopic presence of myocardial sleeves were also evaluated. Results. Five hundred forty-one PV ostia were identified. Four classical PV ostia patterns (two left and two right PVs) were observed in 70.8% of all cases. The most common variant was the classical pattern with additional middle right PV (19.2%), followed by the common ostium for the left superior and the inferior PVs (4.44%). Mean diameters of PV ostia (for the classical pattern) were: left superior = 13.8 2.9 mm; left inferior = 13.3 3.4 mm; right superior = 14.3 2.9 mm; right inferior = 13.7 3.3 mm. When present, the additional middle right PV ostium had the smallest PV ostium diameter in the heart (8.2 4.1 mm). The mean ostium-to-last-tributary (closest to the atrium) distances were: left superior = 15.1 4.6 mm; left inferior = 13.5 4.0 mm; right superior = 11.8 4.0 mm; right inferior = 11.0 3.7 mm. There were no statistically significant differences between sexes in ostia diameters and ostium-to-last-tributary distances. Conclusion. Only 71% of the cases have four standard pulmonary veins. The middle right pulmonary vein is present in almost 20% of patients. Presented data can provide useful information for the clinicians during interventional procedures or radiologic examinations of PVs. PMID:26793429

  17. Normal distal pulmonary vein anatomy.

    PubMed

    Klimek-Piotrowska, Wies?awa; Ho?da, Mateusz K; Pi?tek, Katarzyna; Koziej, Mateusz; Ho?da, Jakub

    2016-01-01

    Background. It is well known that the pulmonary veins (PVs), especially their myocardial sleeves play a critical role in the initiation and maintenance of atrial fibrillation. Understanding the PV anatomy is crucial for the safety and efficacy of all procedures performed on PVs. The aim of this study was to present normal distal PV anatomy and to create a juxtaposition of all PV ostium variants. Methods. A total of 130 randomly selected autopsied adult human hearts (Caucasian) were examined. The number of PVs ostia was evaluated and their diameter was measured. The ostium-to-last-tributary distance and macroscopic presence of myocardial sleeves were also evaluated. Results. Five hundred forty-one PV ostia were identified. Four classical PV ostia patterns (two left and two right PVs) were observed in 70.8% of all cases. The most common variant was the classical pattern with additional middle right PV (19.2%), followed by the common ostium for the left superior and the inferior PVs (4.44%). Mean diameters of PV ostia (for the classical pattern) were: left superior = 13.8 2.9 mm; left inferior = 13.3 3.4 mm; right superior = 14.3 2.9 mm; right inferior = 13.7 3.3 mm. When present, the additional middle right PV ostium had the smallest PV ostium diameter in the heart (8.2 4.1 mm). The mean ostium-to-last-tributary (closest to the atrium) distances were: left superior = 15.1 4.6 mm; left inferior = 13.5 4.0 mm; right superior = 11.8 4.0 mm; right inferior = 11.0 3.7 mm. There were no statistically significant differences between sexes in ostia diameters and ostium-to-last-tributary distances. Conclusion. Only 71% of the cases have four standard pulmonary veins. The middle right pulmonary vein is present in almost 20% of patients. Presented data can provide useful information for the clinicians during interventional procedures or radiologic examinations of PVs. PMID:26793429

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

    PubMed

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

    2002-10-01

    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

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

    PubMed

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

    2014-04-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    Peters, Winfried S; Baskin, Tobias I

    2006-01-01

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

  2. Management of distal humeral coronal shear fractures

    PubMed Central

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

    2015-01-01

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

  3. Archaic and modern human distal humeral morphology.

    PubMed

    Yokley, Todd R; Churchill, Steven E

    2006-12-01

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

  4. Management of distal humeral coronal shear fractures.

    PubMed

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

    2015-05-16

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

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

    NASA Astrophysics Data System (ADS)

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

    2010-01-01

    We analyze the physical mechanisms that form a three-dimensional coronal flux rope and later cause its eruption. This is achieved by a zero-β 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.

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

    SciTech Connect

    Aulanier, G.; Toeroek, T.; Demoulin, P.; DeLuca, E. E.

    2010-01-01

    We analyze the physical mechanisms that form a three-dimensional coronal flux rope and later cause its eruption. This is achieved by a zero-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.

  7. Spontaneous aortoenteric fistula involving the sigmoid: A case report and review of literature

    PubMed Central

    Karthaus, Eleonora G.; Post, Ivo C.J.H.; Akkersdijk, George J.M.

    2015-01-01

    Introduction Primary aortoenteric fistula (PAEF) is a pathological communication between the aorta and any portion of the gastrointestinal tract. The pathology is very rare and easily overlooked during the diagnostic process. Presentation of Case We report the exceptional case of an 86-year-old man with episodes of abdominal pain and rectal bleeding of unknown cause over a period of 1,5 months due to a PAEF to the sigmoid. A sigmoidectomy was performed and a rifampicin-soaked aortic graft was placed. The patient had an uneventful post-operative recovery. The duration of symptoms, the anatomic location of the fistula and the outcome after surgery makes this case unique. Discussion With an incidence of 0.04–0.07% in all patients with aortic aneurysms a PAEF is very rare. Only 2% of PAEF's involves the sigmoid. The most common cause is an atherosclerotic aortic aneurysm. Patients with PAEF can present with a triad of symptoms including gastrointestinal bleeding, abdominal pain and a pulsating mass. A contrast-enhanced computer-tomography scan (CTa) is the most accurate tool to demonstrate a PAEF. Without a strong clinical suspicion, diagnosing a PAEF is hard and frequently delayed. The overall PAEF-related mortality is high (61–100%) and decreases after surgery (30–40%). Conclusion A primary aortoenteric fistula involving the sigmoid is very rare. Clinical presentation can vary, diagnosis can be difficult and surgical options may differ. Even with low suspicion of PAEF, we recommend performing a CTa. With a high overall mortality of more than 60% due to exsanguinating, surgical treatment is always indicated. PMID:26741274

  8. Long-term vestibulocochlear functional outcome following retro-sigmoid approach to resection of vestibular schwannoma.

    PubMed

    Abboud, Tammam; Regelsberger, Jan; Matschke, Jakob; Jowett, Nathan; Westphal, Manfred; Dalchow, Carsten

    2016-03-01

    The objective of this study was to evaluate long-term vestibulocochlear functional outcomes of patients operated for unilateral vestibular schwannoma via the retro-sigmoid approach. Patients who underwent vestibular schwannoma resection via retro-sigmoid approach between 2004 and 2008 at our institution, without prior surgical or radio-surgical therapy were considered to be eligible for this study. Preoperative auditory and vestibular symptoms were assessed retrospectively. Postoperative symptoms were prospectively assessed using a standardised questionnaire, pure tone audiometry, video-oculography, and rotary chair testing. Out of a total of 203 patients, 120 were eligible for this study, of whom 64 responded to follow-up requests and could be enrolled. Serviceable hearing was reported in 42 patients (66 %) preoperatively and was maintained in 18 (43 %) postoperatively. While no significant change in rate of tinnitus and balance impairment between pre- and postoperative periods was detected, vertigo decreased significantly (40 to 28 %, p < 0.001). Postoperative video-oculography demonstrated vestibular paresis in 80 %. Rotary chair testing demonstrated normal or central compensation in 84 %. Absence of central compensation was associated with postoperative balance disturbance (p = 0.035). Increasing tumour size and patient age, also decreasing quality of preoperative hearing were independent factors predictive of a postoperative non-serviceable hearing (p = 0.020, p = 0.039 and p = 0.002, respectively). Resection of vestibular schwannoma via the retro-sigmoid approach is associated with improvement in postoperative vertiginous symptoms. Absence of central compensation leads to increased postoperative balance disturbances. Preservation of serviceable postoperative hearing is associated with good preoperative hearing status, younger age, and smaller tumours. PMID:25700833

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

    NASA Astrophysics Data System (ADS)

    Savcheva, Antonia; van Ballegooijen, Adriaan

    2009-10-01

    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 α 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 Φ of the magnetic field increases with time to about 2π just prior to the eruption, but never reaches the value necessary for the kink instability.

  10. NONLINEAR FORCE-FREE MODELING OF A LONG-LASTING CORONAL SIGMOID

    SciTech Connect

    Savcheva, Antonia; Van Ballegooijen, Adriaan

    2009-10-01

    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.

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

    PubMed

    Diaz, Diana N; Eftekhari, Kambiz

    2015-05-01

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

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

    PubMed

    Punys, Vytenis; Maknickas, Ramunas

    2011-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

  14. Complications After Open Distal Clavicle Excision

    PubMed Central

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

    2008-01-01

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

  15. Laparoscopic treatment of complicated colonic diverticular disease: A review

    PubMed Central

    Daher, Ronald; Barouki, Elie; Chouillard, Elie

    2016-01-01

    Up to 10% of acute colonic diverticulitis may necessitate a surgical intervention. Although associated with high morbidity and mortality rates, Hartmann’s procedure (HP) has been considered for many years to be the gold standard for the treatment of generalized peritonitis. To reduce the burden of surgery in these situations and as driven by the accumulated experience in colorectal and minimally-invasive surgery, laparoscopy has been increasingly adopted in the management of abdominal emergencies. Multiple case series and retrospective comparative studies confirmed that with experienced hands, the laparoscopic approach provided better outcomes than the open surgery. This technique applies to all interventions related to complicated diverticular disease, such as HP, sigmoid resection with primary anastomosis (RPA) and reversal of HP. The laparoscopic approach also provided new therapeutic possibilities with the emergence of the laparoscopic lavage drainage (LLD), particularly interesting in the context of purulent peritonitis of diverticular origin. At this stage, however, most of our knowledge in these fields relies on studies of low-level evidence. More than ever, well-built large randomized controlled trials are necessary to answer present interrogations such as the exact place of LLD or the most appropriate sigmoid resection procedure (laparoscopic HP or RPA), as well as to confirm the advantages of laparoscopy in chronic complications of diverticulitis or HP reversal. PMID:26981187

  16. Laparoscopic treatment of complicated colonic diverticular disease: A review.

    PubMed

    Daher, Ronald; Barouki, Elie; Chouillard, Elie

    2016-02-27

    Up to 10% of acute colonic diverticulitis may necessitate a surgical intervention. Although associated with high morbidity and mortality rates, Hartmann's procedure (HP) has been considered for many years to be the gold standard for the treatment of generalized peritonitis. To reduce the burden of surgery in these situations and as driven by the accumulated experience in colorectal and minimally-invasive surgery, laparoscopy has been increasingly adopted in the management of abdominal emergencies. Multiple case series and retrospective comparative studies confirmed that with experienced hands, the laparoscopic approach provided better outcomes than the open surgery. This technique applies to all interventions related to complicated diverticular disease, such as HP, sigmoid resection with primary anastomosis (RPA) and reversal of HP. The laparoscopic approach also provided new therapeutic possibilities with the emergence of the laparoscopic lavage drainage (LLD), particularly interesting in the context of purulent peritonitis of diverticular origin. At this stage, however, most of our knowledge in these fields relies on studies of low-level evidence. More than ever, well-built large randomized controlled trials are necessary to answer present interrogations such as the exact place of LLD or the most appropriate sigmoid resection procedure (laparoscopic HP or RPA), as well as to confirm the advantages of laparoscopy in chronic complications of diverticulitis or HP reversal. PMID:26981187

  17. Acquired distal renal tubular acidosis in man.

    PubMed

    Better, O S

    1982-10-01

    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 blood may abolish distal tubular ability to maintain urine to blood proton gradients. In patients with obstructive uropathy the spectrum of tubular acidosis is widened by the occurrence of additional defects in tubular secretion of potassium and impairment of hydrogen ion secretion secondary to hypoaldosteronism. Hyperkalemia is also seen in "voltage dependent" states such as following the administration of lithium and amiloride. Hyperkalemia per se is conducive to acidosis by a combination of extrarenal and several intrarenal mechanisms. PMID:6755051

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

    PubMed Central

    Zamani, Farhad; Sohrabi, Masoudreza

    2015-01-01

    Actinomycosis is a rare and chronic infectious disease caused by a non-spore gram- positive, anaerobic bacterium that rarely infects the colon, in particular the left colon. A 53-year-old woman was referred to us due to chronic abdominal pain, bloating, a few episodes of bloody-mucous rectal discharge, and change of bowel habits. Her medical history and physical examination were unremarkable. Colonoscopy revealed a polypoid mass like lesion located 20 cm proximal to the anal verge above the rectosigmoid junction. Several biopsy samples were taken. Histopathological evaluation showed actinomycosis infection. Consequently the patient was treated with intravenous and then six months oral penicillin. Her complaints and colonic mass resolved totally. Diagnosis of colonic actinomycosis is not an easy task. It is advisable to keep this infection in mind among the differential diagnoses of unusual abdominal masses. Colonoscopy and histopathological examination can be the preferred modality for diagnosis of colonic actinomycosis infection. PMID:25628853

  19. Ovarian Dermoid Cyst Causing Distal Ureteral Obstruction.

    PubMed

    Aiken, W D; Mayhew, R G; Mitchell, S; Stennett, M; Johnson, P

    2015-03-01

    A case of a 45-year old woman with an ovarian dermoid cyst causing ureteric colic secondary to distal ureteral obstruction is reported. The dermoid cyst was observed on computed tomography to be adjacent to and compressing the distal left ureter and this was confirmed at surgical exploration. Following oophorectomy, the patient's symptoms completely resolved and the excised ovarian cyst was confirmed on pathological evaluation to be a dermoid cyst. This appears to be the first reported case of ureteral obstruction caused by an ovarian dermoid cyst in the English medical literature. PMID:26360692

  20. Distal Humerus Fractures: Open Reduction Internal Fixation.

    PubMed

    Mighell, Mark A; Stephens, Brent; Stone, Geoffrey P; Cottrell, Benjamin J

    2015-11-01

    Distal humerus fractures are challenging injuries for the upper extremity surgeon. However, recent techniques in open reduction internal fixation have been powerful tools in getting positive outcomes. To get such results, the surgeon must be aware of how to properly use these techniques in their respective practices. The method of fixation depends on the fracture, taking the degree of comminution and the restoration of the columns and articular surface into account. This article helps surgeons understand the concepts behind open reduction internal fixation of the distal humerus and makes them aware of pitfalls that may lead to negative results. PMID:26498548

  1. Ovarian Dermoid Cyst Causing Distal Ureteral Obstruction

    PubMed Central

    Aiken, WD; Mayhew, RG; Mitchell, S; Stennett, M; Johnson, P

    2015-01-01

    ABSTRACT A case of a 45-year old woman with an ovarian dermoid cyst causing ureteric colic secondary to distal ureteral obstruction is reported. The dermoid cyst was observed on computed tomography to be adjacent to and compressing the distal left ureter and this was confirmed at surgical exploration. Following oophorectomy, the patient's symptoms completely resolved and the excised ovarian cyst was confirmed on pathological evaluation to be a dermoid cyst. This appears to be the first reported case of ureteral obstruction caused by an ovarian dermoid cyst in the English medical literature. PMID:26360692

  2. [Dural arteriovenous fistula of the transverse-sigmoid sinus with intraventricular hemorrhage: a case report].

    PubMed

    Kawaguchi, T; Kawano, T; Kaneko, Y; Tsutsumi, M; Ooigawa, H; Kazekawa, K

    1999-12-01

    We report a case of dural arteriovenous fistula of the transverse-sigmoid sinus (TS-DAVF) with intraventricular hemorrhage. An 83-year-old woman presented with headache and vomiting. Neurological examination showed no defects. CT scans demonstrated intraventricular hemorrhage. Left external carotid angiograms showed a dural arteriovenous fistula of the isolated transverse-sigmoid sinus fed by the occipital and middle meningeal arteries. The draining vein was the leptomeningeal vein. Left internal carotid angiograms demonstrated venous congestion in the left temporal and occipital lobes. This case was grade 4 according to Lalwani's classification. 123I-IMP SPECT revealed a low perfusion are in the left temporal and occipital regions. Dynamic CT scans revealed venous congestion in the left temporal and occipital regions. We considered that the venous congestion was the cause of intraventricular hemorrhage. Initially, we embolized the DAVF using a transarterial approach with liquid material. However, the embolization of the DAVF was not complete. Therefore, we treated the DAVF by sinus packing with coils using a small craniotomy. Angiographic cure was obtained and the postoperative course was uneventful. We discuss the clinical features, the hemodynamic findings and the management of this case. PMID:10629895

  3. Temperature Tomography of a Coronal Sigmoid Supporting the Gradual Formation of a Flux Rope

    NASA Astrophysics Data System (ADS)

    Tripathi, Durgesh; Kliem, Bernhard; Mason, Helen E.; Young, Peter R.; Green, Lucie M.

    2009-06-01

    Multiwavelength observations of a sigmoidal (S-shaped) solar coronal source by the EUV Imaging Spectrometer and the X-Ray Telescope aboard the Hinode spacecraft and by the EUV Imager aboard STEREO are reported. The data reveal the coexistence of a pair of J-shaped hot arcs at temperatures T>2 MK with an S-shaped structure at somewhat lower temperatures (T ≈ 1-1.3 MK). The middle section of the S-shaped structure runs along the polarity inversion line of the photospheric field, bridging the gap between the arcs. Flux cancellation occurs at the same location in the photosphere. The sigmoid forms in the gradual decay phase of the active region, which does not experience an eruption. These findings correspond to the expected signatures of a flux rope forming, or being augmented, gradually by a topology transformation inside a magnetic arcade. In such a transformation, the plasma on newly formed helical field lines in the outer flux shell of the rope (S-shaped in projection) is expected to enter a cooling phase once the reconnection of their parent field line pairs (double-J shaped in projection) is complete. Thus, the data support the conjecture that flux ropes can exist in the corona prior to eruptive activity.

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

    PubMed Central

    Imtiaz, Mohammad S.; Wahid, Khan A.

    2015-01-01

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

  5. Application of Sigmoidal Transformation Functions in Optimization of Micellar Liquid Chromatographic Separation of Six Quinolone Antibiotics.

    PubMed

    Hadjmohammadi, Mohammadreza; Salary, Mina

    2016-03-01

    A chemometrics approach has been used to optimize the separation of six quinolone compounds by micellar liquid chromatography (MLC). A Derringer's desirability function, a multicriteria decision-making (MCDM) method, was tested for evaluation of two different measures of chromatographic performance (resolution and analysis time). The effect of three experimental parameters on a chromatographic response function (CRF) expressed as a product of two sigmoidal desirability functions was investigated. The sigmoidal functions were used to transform the optimization criteria, resolution and analysis time into the desirability values. The factors studied were the concentration of sodium dodecyl sulfate, butanol content and pH of the mobile phase. The experiments were done according to the face-centered cube central composite design, and the calculated CRF values were fitted to a polynomial model to correlate the CRF values with the variables and their interactions. The developed regression model showed good descriptive and predictive ability (R(2) = 0.815, F = 6.919, SE = 0.038, [Formula: see text]) and used, by a grid search algorithm, to optimize the chromatographic conditions for the separation of the mixture. The efficiency of prediction of polynomial model was confirmed by performing the experiment under the optimal conditions. PMID:26590234

  6. Beneficial effect of cibenzoline on left ventricular pressure gradient with sigmoid septum.

    PubMed

    Konishi, Chika; Shiraishi, Jun; Muraguchi, Naoko; Ohtsuki, Katsuichi; Inoue, Miho; Tatsumi, Tetsuya; Azuma, Akihiro; Matsubara, Hiroaki

    2004-10-01

    An 83-year-old woman with hypertension was admitted to hospital with episodes of dyspnea on effort after having breakfast. Physical examination revealed a systolic murmur at the left sternal border in the third to fourth intercostal space. Cross-sectional echocardiography showed a sigmoid-shaped interventricular septum markedly protruding into the left ventricle, concentric left ventricular hypertrophy, systolic anterior motion of the mitral valve, and a resultant left ventricular outflow tract obstruction with a pressure gradient of 121.8 mmHg. She began daily treatment with 60 mg metoprolol. However, the chest symptoms were not relieved and the left ventricular outflow tract obstruction was still visible on echocardiography. She was then given 200 mg daily of cibenzoline, in addition to 40 mg metoprolol, and the left ventricular pressure gradient significantly decreased and she was free of symptoms without any complications. This case shows that cibenzoline may be useful in the treatment of left ventricular outflow tract obstruction caused by sigmoid septum. PMID:15459474

  7. Laparoscopic Repair of Internal Transmesocolic Hernia of Transverse Colon

    PubMed Central

    Kishiki, Tomokazu; Mori, Toshiyuki; Hashimoto, Yoshikazu; Matsuoka, Hiroyoshi; Abe, Nobutsugu; Masaki, Tadahiko; Sugiyama, Masanori

    2015-01-01

    Introduction. Internal hernias are often misdiagnosed because of their rarity, with subsequent significant morbidity. Case Presentation. A 61-year-old Japanese man with no history of surgery was referred for intermittent abdominal pain. CT suggested the presence of a transmesocolic internal hernia. The patient underwent a surgical procedure and was diagnosed with transmesocolic internal hernia. We found internal herniation of the small intestine loop through a defect in the transverse mesocolon, without any strangulation of the small intestine. We were able to complete the operation laparoscopically. The patient's postoperative course was uneventful and the patient was discharged on postoperative day 6. Discussion. Transmesocolic hernia of the transverse colon is very rare. Transmesocolic hernia of the sigmoid colon accounts for 60% of all other mesocolic hernias. Paraduodenal hernias are difficult to distinguish from internal mesocolic transverse hernias. We can rule out paraduodenal hernias with CT. Conclusion. The patient underwent a surgical procedure and was diagnosed with transmesocolic internal hernia. We report a case of a transmesocolic hernia of the transverse colon with intestinal obstruction that was diagnosed preoperatively and for which laparoscopic surgery was performed. PMID:26246930

  8. RECURRENT EXPLOSIVE ERUPTIONS AND THE ''SIGMOID-TO-ARCADE'' TRANSFORMATION IN THE SUN DRIVEN BY DYNAMICAL MAGNETIC FLUX EMERGENCE

    SciTech Connect

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

    2014-05-10

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

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

    PubMed

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

    2014-02-15

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

  10. Spatial Modeling of Colonic Lesions With Geographic Information Systems

    PubMed Central

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

    2014-01-01

    Background: Geographic information system (GIS) software has been used in health care systems to display and analyze spatial pattern of diseases and health services. Objectives: This study was performed to assess spatial patterns of colon’s pathologic lesions based on the pathologic reports and assess whether it is possible to use GIS software in health services. Patients and Methods: Archives of pathology of Namazi and Faghihi hospitals, two main referral centers of south-west of Iran, were obtained and reviewed between January 2009 and September 2011 for biopsy reports of patients who underwent colonoscopy. Abnormal biopsies were categorized into five different subgroups according to the type of pathologic specimens. By GIS, spatial patterns of colon biopsies were plotted in different maps and spatial auto-correlation of colon biopsies was calculated using the Moran’s Index. Results: A total of 4815 biopsies from 2663 different patients were reviewed, 53.8% of which were men. Abnormal biopsies were 2781 of all specimens (57.8%). Neoplastic lesions, inflammatory bowel diseases and polyps were 9.3%, 19.3% and 29.2% of total biopsies, respectively. Pathologic biopsies were more common in the distal colon. Maps of all biopsies and maps of specific pathologies were manifested in GIS. Conclusions: Our study showed that left-sided lesions are still more common in the Iranian population. On the other hand, surveying the right side of colon is as important as the distal part, which necessitates total colonoscopy. PMID:25763265

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

    PubMed Central

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

    2014-01-01

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

  12. Bacteria, colonic fermentation, and gastrointestinal health.

    PubMed

    Macfarlane, George T; Macfarlane, Sandra

    2012-01-01

    The colonic microbiota plays an important role in human digestive physiology and makes a significant contribution to homeostasis in the large bowel. The microbiome probably comprises thousands of different bacterial species. The principal metabolic activities of colonic microorganisms are associated with carbohydrate and protein digestion. Nutrients of dietary and host origin support the growth of intestinal organisms. Short-chain fatty acids (SCFAs), predominantly acetate, propionate, and butyrate, are the principal metabolites generated during the catabolism of carbohydrates and proteins. In contrast, protein digestion yields a greater diversity of end products, including SCFAs, amines, phenols, indoles, thiols, CO2, H2, and H2S, many of which have toxic properties. The majority of SCFAs are absorbed from the gut and metabolized in various body tissues, making a relatively small but significant contribution to the body's daily energy requirements. Carbohydrate fermentation is, for the most part, a beneficial process in the large gut, because the growth of saccharolytic bacteria stimulates their requirements for toxic products associated with putrefaction, for incorporation into cellular proteins, thereby protecting the host. However, as digestive materials move along the gut, carbohydrates become depleted, which may be linked to the increased prevalence of colonic disease in the distal bowel. PMID:22468341

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

    SciTech Connect

    Yeoh, Eric K.; Bartholomeusz, Dylan L.; Holloway, Richard H.; Fraser, Robert J.; Botten, Rochelle; Di Matteo, Addolorata; Moore, James W.; Schoeman, Mark N.

    2010-11-01

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

  14. Colonic inflammation and secondary bile acids in alcoholic cirrhosis.

    PubMed

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

    2014-06-01

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

  15. Colonic inflammation and secondary bile acids in alcoholic cirrhosis

    PubMed Central

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

    2014-01-01

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

  16. Comparative evaluation of molar distalization therapy using pendulum and distal screw appliances

    PubMed Central

    Cafagna, Alessandra; Fontana, Mattia; Cozzani, Mauro

    2015-01-01

    Objective To compare dentoalveolar and skeletal changes produced by the pendulum appliance (PA) and the distal screw appliance (DS) in Class II patients. Methods Forty-three patients (19 men, 24 women) with Class II malocclusion were retrospectively selected for the study. Twenty-four patients (mean age, 12.2 ± 1.5 years) were treated with the PA, and 19 patients (mean age, 11.3 ± 1.9 years) were treated with the DS. The mean distalization time was 7 months for the PA group and 9 months for the DS group. Lateral cephalograms were obtained at T1, before treatment, and at T2, the end of distalization. A Mann-Whitney U test was used for statistical comparisons of the two groups between T1 and T2. Results PA and DS were equally effective in distalizing maxillary molars (4.7 mm and 4.2 mm, respectively) between T1 and T2; however, the maxillary first molars showed less distal tipping in the DS group than in the PA group (3.2° vs. 9.0°, respectively). Moreover, significant premolar anchorage loss (2.7 mm) and incisor proclination (5.0°) were noted in the PA group, whereas premolar distal movement (1.9 mm) and no significant changes at the incisor (0.1°) were observed in the DS group. No significant sagittal or vertical skeletal changes were detected between the two groups during the distalization phase. Conclusions PA and DS seem to be equally effective in distalizing maxillary molars; however, greater distal molar tipping and premolar anchorage loss can be expected using PA. PMID:26258063

  17. [Two cases of curative resection by laparoscopic surgery following preoperative chemotherapy with bevacizumab for locally advanced colon cancer].

    PubMed

    Sakaguchi, Masazumi; Kan, Takatsugu; Tsubono, Michihiko; Kii, Eiji

    2014-04-01

    Here we report 2 cases of curative resection following preoperative chemotherapy with bevacizumab for locally advanced colon cancer. Case 1 was a 62-year-old man admitted with constipation, abdominal distention, and abdominal pain. An abdominal computed tomography(CT)scan revealed an obstructive tumor of the sigmoid colon with invasion into the bladder. A diverting colostomy was performed, and chemotherapy with mFOLFOX6(infusional 5-fluorouracil/Leucovorin+ oxaliplatin) plus bevacizumab was initiated. The tumor shrunk markedly after 6 courses of this treatment. Thereafter, laparoscopy- assisted sigmoidectomy was successfully performed. Case 2 was a 61-year-old woman admitted with diarrhea, abdominal pain, and fever. An abdominal CT scan revealed an obstructive tumor of the sigmoid colon with invasion into the ileum, uterus and retroperitoneum. A diverting colostomy was performed, and chemotherapy with XELOX(capecitabine+ oxaliplatin)plus bevacizumab was initiated. The tumor shrunk markedly after 6 courses of this treatment. Thereafter, laparoscopy- assisted sigmoidectomy was successfully performed. Both cases demonstrated partial clinical responses to chemotherapy; thus, curative resection surgeries were performed. There were no perioperative complications. Therefore, we conclude that oxaliplatin-based chemotherapy plus bevacizumab and laparoscopic resection could be very effective for locally advanced colon cancer. PMID:24743370

  18. Scintigraphic evaluation of the distal tarsal region in horses with distal tarsal pain.

    PubMed

    Murray, Rachel C; Dyson, Sue J; Weekes, Jo S; Short, Carly; Branch, Marion V

    2005-01-01

    Distal tarsal pain is a common reason for hind limb lameness, but diagnosis cannot always be made on radiographic examination. Scintigraphy may allow detection of subtle changes undetected by other diagnostic methods. We hypothesized that (1) distal tarsal pain would be associated with a loss of the expected pattern of radiopharmaceutical uptake (RU) detected in normal horses, (2) distal tarsal RU would be greater in limbs with tarsal pain than without pain, (3) RU in painful tarsi with radiographic evidence of osteoarthritis (OA) would be greater than in distal tarsal pain with no radiographic evidence of OA. The study aimed to describe radiopharmaceutical distribution in the distal tarsal region of horses with distal tarsal pain, and to compare this with the contralateral limb and results from horses without tarsal pain. Retrospective evaluation of scintigraphic images of the distal tarsal region was performed for 52 horses with distal tarsal pain: 15 with no radiographic evidence of OA (Group 1) and 37 with radiographic evidence (Group 2). The images were assessed using vertical and horizontal profile analysis across the distal tarsal region and regions of interest comparisons between the distal tarsal region and tibia within each horse (RU ratio). Painful limbs in unilaterally lame horses from Groups 1 and 2 had a significantly greater RU ratio than the respective contralateral limbs, and were significantly greater than the RU ratio in normal horses. On plantar images, mean region of interest counts were greater in the lame than the contralateral limb in Group 2 but not in Group 1. Although there was a positive correlation between lame and contralateral limb RU ratio in group 1, this was lost in group 2 horses. In lame limbs, the normal vertical activity profile was lost in 85% of group 1 and all of group 2, and the normal horizontal activity profile was lost in all of group 1 and 96% of group 2. There was a significant effect of lameness, but not of group on sites of peak activity on all profiles. The results of this study indicate that distal tarsal pain is associated with loss of the expected pattern of RU detected in normal horses. The findings also suggest that distal tarsal RU in lame limbs is greater than in limbs without pain, and that painful limbs with radiographic evidence of OA have a greater RU than painful limbs without radiographic evidence of OA. PMID:15869163

  19. Torsional properties of distal femoral cortical defects.

    PubMed

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

    2014-03-01

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

  20. Distal axonopathy in streptozotocin diabetes in rats.

    PubMed

    Chokroverty, S; Seiden, D; Navidad, P; Cody, R

    1988-05-15

    We noted the earliest morphological changes in the motor endplates 8 weeks after the induction of streptozotocin diabetes in rats. Morphometric measurements showed reduced axonal areas of the lateral plantar and the sciatic nerves in the diabetic rats 28 but not 2 and 8 weeks after the experiment. These findings suggested distal axonopathy. PMID:3371449

  1. Cecal volvulus in a dairy cow: partial resection of the proximal portion of the ascending colon.

    PubMed

    Pankowski, R L; Fubini, S L; Stehman, S

    1987-08-15

    Cecal volvulus in a dairy cow with vascular compromise of the proximal portion of the ascending colon was corrected surgically with preservation of the ileocecocolic junction. Partial cecectomy was combined with resection of the proximal portion of the ascending colon and anastomosis of the remaining cecum to the distal portion of the ascending colon. The procedure was done with the use of mechanical suturing devices while the cow was standing. Previously, general anesthesia and relocation of the ileocecocolic junction had been suggested. PMID:3654317

  2. Huqi San-Evoked Rat Colonic Anion Secretion through Increasing CFTR Expression

    PubMed Central

    Xue, Xiaowei; Shi, Zhengming; Wang, Wen; Yu, Xiaotong; Feng, Ping; Zhang, Min; Wang, Xuejiang; Xu, Jingdong

    2015-01-01

    Huqi San (HQS) is a Chinese herbal preparation of eight medicinal herbs that promote diuresis, detoxification, blood circulation, and cholestasis. Defects in transporter expression and function can cause cholestasis and jaundice. However, the mechanism of the cholestasis underlying HQS effects, especially on the gastrointestinal tract ion secretion, has not been elucidated. Real-time RT-PCR and Western blotting were used to study the expression and localization of cystic fibrosis transmembrane conductance regulator (CFTR) and α-ENaC in rat alimentary tract, and then the effect of HQS on the ion transport in rat distal colon mucosa was investigated using the short-circuit current (ISC) technique. The results showed that pretreatment with HQS significantly enhanced mRNA transcripts and protein content of CFTR in liver and distal colon but not α-ENaC in alimentary organs. HQS increases ISC and decreases the transepithelial resistance. Pretreatment with epithelial Na+ channel blocker did not affect the ISC responses elicited by HQS, but removal of extracellular Cl− or pretreatment with Cl− channel or Na+-K+-2Cl− cotransporter blocker inhibited HQS-elicited ISC responses. These findings demonstrated that HQS, RA, and RP can stimulate Cl− secretion in the distal colon by increasing the mRNA transcripts and protein content of CFTR in liver and distal colon. PMID:26290673

  3. Anatomical registration and three-dimensional visualization of low and high-resolution pan-colonic manometry recordings

    PubMed Central

    Davidson, JB; O’Grady, G; Arkwright, JW; Zarate, N; Scott, SM; Pullan, AJ; Dinning, PG

    2010-01-01

    Colonic propagating sequences (PS) are important for the movement of colonic content and defecation, and aberrant PS patterning has been associated with slow-transit constipation. However, because these motor patterns are typically recorded over long periods (24 hrs.+), the visualization of PS spatiotemporal patterning is difficult. Here we develop a novel method for displaying pan-colonic motility patterns. Methods A 3D mesh representing the geometry of the human colon was created as follows: i) Human colon images from the Visible Human Dataset were digitized to create a 3D data cloud; ii) A surface mesh was fitted to the cloud using a least-squares minimization technique. Colonic manometry catheters were placed in the ascending colon of healthy controls and patients with slow transit constipation (STC), with the aid of a colonoscope. The colonic manometry data were interpolated and mapped to the model according to the following anatomical landmarks: caecum, hepatic flexure, splenic flexure, sigmoid-descending junction, and anus. Key Results These 3D images clearly and intuitively communicate characteristics of normal and abnormal colonic motility. Specifically we have shown the reduced amplitude of the antegrade propagating pressure waves (PPW) throughout the colon and reduced frequency of PPWs at the mid-colon in patients with STC. Conclusion and inferences A novel method for the 3D visualization of colonic propagating sequences is presented, providing an intuitive method for representing a large volume of physiological data. These techniques can be used to display frequency, amplitude or velocity data, and will help to convey regions of abnormally in patient populations. PMID:21199536

  4. Locked volar distal radioulnar joint dislocation

    PubMed Central

    Bouri, Fadi; Fuad, Mazhar; Elsayed Abdolenour, Ayman

    2016-01-01

    Introduction Volar dislocation of the distal radioulnar joint is a rare injury which is commonly missed in the emergency departments. A thorough review of literature showed very few reported cases and the cause for irreducibility varied in different cases, Lack of suspicion and improper X-ray can delay the diagnosis. Case presentation Our article discusses a case 40 year old construction worker, who presented to the Emergency with work-related injury, complaining of left wrist pain, deformity and inability to rotate his forearm. X-rays revealed a volar dislocation of distal ulna which was reducible after manipulation under General Anesthesia (GA). The joint was stable after the reduction. Discussion Isolated dislocation of the distal radioulnar joint can be either volar or dorsal, although dorsal dislocation is more common. The distal radioulnar articulation plays an important role in the rotational movement of the forearm. It allows pronation and supination which are essential for the function of the upper limb. Pronator Quadratus muscle spasm is an important blockade to reduction and was preventing reduction in this case. Methods The work has been reported in line with the CARE criteria [9]. Conclusion Volar locked dislocation of Distal Radio ulnar joint is a rare injury. High degree of clinical suspicion and proper X-ray is required for prompt detection. The importance of this case is to raise the awareness among physicians in treating these kind of injuries by careful assessment of the patient and radiographs, and to consider pronator quadratus as an important cause for the blockade to reduction. PMID:27016647

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

    SciTech Connect

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

    1986-03-01

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

  6. Protective role of luteolin in 1,2-dimethylhydrazine induced experimental colon carcinogenesis.

    PubMed

    Manju, V; Nalini, N

    2007-01-01

    The aim of the present study was to unravel the chemopreventive effect of luteolin on bacterial enzymes such as beta-glucuronidase and mucinase in a colon carcinogenesis model induced by 1, 2-dimethyl hydrazine (DMH). Twenty mg/kg body weight of DMH were administered subcutaneously once a week for the first 15 weeks and then discontinued. Luteolin (0.1, 0.2, or 0.3 mg/kg body weight/everyday (p.o.) was administered in a dose dependent manner at the initiation and also at the post-initiation stages of carcinogenesis to DMH treated rats. The animals were sacrificed at the end of 30 weeks. Colon cancer incidence and the activities of bacterial enzymes beta-glucuronidase (in the proximal colon, distal colon, intestines, liver and colon contents) and mucinase (colon and fecal contents) were significantly increased in DMH -treated rats compared to the control rats. On luteolin administration, colon cancer incidence, number of tumors per rat and the activities of beta-glucuronidase and mucinase, were significantly decreased both in the initiation and post-initiation stages of colon carcinogenesis dependent on the three different doses given. The increase in beta-glucuronidase activity may augment the hydrolysis of glucuronide conjugates, liberating toxins, while the increase in the mucinase activity may enhance the hydrolysis of the protective mucins in the colon. Thus our results demonstrate for the first time that luteolin, a dietary flavonoid, exerts chemopreventive and anticarcinogenic effects against DMH induced colon cancer. PMID:16850523

  7. Bacterial translocation as a cause for septic complications in obstructive colonic ileus.

    PubMed

    Belyansky, L S; Sayenko, V F; Furmanov, J A; Churilova, T J

    2002-04-01

    Failure of intestinal barrier function and subsequent translocation of microorganisms and their degradation products play a decisive role in development of systemic septic complications for many systemic and intra-abdominal pathologies, for example, following obstructive colonic ileus (OCI). This study was aimed at the evaluation of the intestinal barrier state in OCI. Sixty albino Wistar rats weighting 250 to 300 g (mean 265 g) were divided into four groups (15 animals in each). Acute colonic ileus (ACI) was modeled as follows except a control group (Group 1). Our objective was to examine changes in bacterial flora in the abdomen, mesenteric lymphatic nodes (MLN), liver, spleen, and lungs during the model of OCI after 72 hours following the beginning of experiment. The composition of parietal mucus in normal and in OCI 48 hours following the beginning of experiment examined. Interleukin (IL-VI) levels were determined in both portal and peripheral blood. The right-hand half of colon was ligated at the level of ileocaecal junction in animals of Group 2 (n = 15), whereas in animals of Group 3 (n = 15) it was ligated at the level of sigmoid colon. With the same purpose, a portion of the suspended caecal content was administered into lumen of the jejunum at a concentration of 10(6) colony-forming units (CFU) in animals of Group 4 (n = 15). Experimentally--induced OCI causes significant bacterial translocation (BT) in rats. The process of colonization of the proximal small intestine with colonic flora takes place under the conditions of ileus. The conditions favorable for the development of BT are generated with colonization of 10(6) CFU in volume. As a result, intestinal flora penetrates into the abdominal organs and lungs. Its highest concentrations are noted in the lymph nodes, lungs and liver. The modeling of the small intestine colonization with colonic flora (Group 4) demonstrates critical parameters of microbial semination. PMID:12051094

  8. Butyrylated starch increases large bowel butyrate levels and lowers colonic smooth muscle contractility in rats.

    PubMed

    Bajka, Balazs H; Clarke, Julie M; Topping, David L; Cobiac, Lynne; Abeywardena, Mahinda Y; Patten, Glen S

    2010-06-01

    The short-chain fatty acids acetate, propionate, and butyrate are produced by colonic bacterial fermentation of carbohydrates. Butyrate is important in the regulation of the colonocyte cell cycle and gut motility and may also reduce the risk of large bowel cancer. We have shown that dietary butyrylated starch can deliver butyrate to the large bowel in a sustained manner. We hypothesized that ingestion of butyrylated starch increases large bowel butyrate levels and decreases colonic contractility. Groups of male Sprague-Dawley rats (n = 8) were fed AIN-93G-based diet containing a highly digestible low-amylose maize starch (LAMS) control or 5% or 10% butyrylated LAMS (LAMSB) for 10 days. We found that cecal but not colonic tissue weight as well as cecal and distal colonic digesta weights and fecal output were higher in LAMSB fed rats. Butyrylated LAMS lowered digesta pH throughout the large bowel. Cecal, proximal, and distal colonic butyrate pools and portal venous butyrate concentrations were higher in rats fed LAMSB. Electrically stimulated and receptor-dependent carbachol and prostaglandin E(2)-induced isotonic contractions were lower in isolated intact sections of proximal colon (P < .05) but not the terminal ileum after 10% LAMSB ingestion. These results demonstrated that elevation of butyrate levels in the large bowel of the rat correlated with reduction of contractile activity of the colonic musculature, which may assist in the reabsorption of water and minerals. PMID:20650351

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

    PubMed

    Tuscano, Carmelo; Russi, Elvio Grazioso; Al Sayyad, Said; Pergolizzi, Stefano

    2014-01-01

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

  10. Colon capsule endoscopy.

    PubMed

    Spada, Cristiano; Hassan, Cesare; Costamagna, Guido

    2015-04-01

    Colon capsule endoscopy (CCE) is a minimally invasive technique specifically designed to explore the colon without sedation and air insufflation. CCE may overcome some of the limitations of colonoscopy. Second-generation CCE (CCE-2) was proved accurate in detecting colonic neoplastic lesions when used in average-risk individuals. The evidence to date supports the use of CCE-2 in cases of colonoscopy failure, in patients unwilling to undergo colonoscopy, and when colonoscopy is contraindicated. Other potential applications, such as colorectal cancer screening or diagnostic surveillance of inflammatory bowel disease, require clarification. PMID:25839692

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

    PubMed Central

    Kim, Taeyun

    2013-01-01

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

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

    PubMed

    Kim, Taeyun; Choi, Jin-Young

    2013-04-01

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

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

    PubMed Central

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

    2014-01-01

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

  14. Anesthesia management of surgery for sigmoid perforation and acute peritonitis patient following heart transplantation: case report

    PubMed Central

    Yang, Xu-Li; Dai, Shu-Hong; Zhang, Juan; Zhang, Jing; Liu, Yan-Jun; Yang, Yan; Sun, Yu-E; Ma, Zheng-Liang; Gu, Xiao-Ping

    2015-01-01

    Here we described a case in which a patient underwent emergency laparotomy for acute peritonitis and sigmoid perforation under general anesthesia with a history of heart transplantation. A good knowledge in the physiology of the transplanted heart is critical for effective and safe general anesthesia. We chose etomidate that have a weaker impact on cardiovascular function plus propofol for induction, and propofol plus cisatracurium for maintenance with intermittently analgesics and vasoactive drugs to facilitate the anesthesia. In addition, fluid input, electrolyte and acid-base balance were well adjusted during the whole procedure. The patient was in good condition after the surgery. In this case report we are aiming to provide some guidance for those scheduled for non-cardiac surgery after heart transplant. PMID:26379997

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

    SciTech Connect

    Mao, D.; Kim, K.J.; Frank, A.J.

    1995-06-01

    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.

  16. Smoothing tautologies, hidden dynamics, and sigmoid asymptotics for piecewise smooth systems

    NASA Astrophysics Data System (ADS)

    Jeffrey, Mike R.

    2015-10-01

    Switches in real systems take many forms, such as impacts, electronic relays, mitosis, and the implementation of decisions or control strategies. To understand what is lost, and what can be retained, when we model a switch as an instantaneous event, requires a consideration of so-called hidden terms. These are asymptotically vanishing outside the switch, but can be encoded in the form of nonlinear switching terms. A general expression for the switch can be developed in the form of a series of sigmoid functions. We review the key steps in extending Filippov's method of sliding modes to such systems. We show how even slight nonlinear effects can hugely alter the behaviour of an electronic control circuit, and lead to "hidden" attractors inside the switching surface.

  17. SIGMOID-TO-FLUX-ROPE TRANSITION LEADING TO A LOOP-LIKE CORONAL MASS EJECTION

    SciTech Connect

    Liu Rui; Liu Chang; Wang Shuo; Deng Na; Wang Haimin

    2010-12-10

    Sigmoids are one of the most important precursor structures for solar eruptions. In this Letter, we study a sigmoid eruption on 2010 August 1 with EUV data obtained by the Atmospheric Imaging Assembly (AIA) on board the Solar Dynamic Observatory (SDO). In AIA 94 A (Fe XVIII; 6 MK), topological reconfiguration due to tether-cutting reconnection is unambiguously observed for the first time, i.e., two opposite J-shaped loops reconnect to form a continuous S-shaped loop, whose central portion is dipped and aligned along the magnetic polarity inversion line (PIL), and a compact loop crossing the PIL. A causal relationship between photospheric flows and coronal tether-cutting reconnections is evidenced by the detection of persistent converging flows toward the PIL using line-of-sight magnetograms obtained by the Helioseismic and Magnetic Imager on board SDO. The S-shaped loop remains in quasi-equilibrium in the lower corona for about 50 minutes, with the central dipped portion rising slowly at {approx}10 km s{sup -1}. The speed then increases to {approx}60 km s{sup -1} about 10 minutes prior to the onset of a GOES-class C3.2 flare, as the S-shaped loop speeds up its transformation into an arch-shaped loop, which eventually leads to a loop-like coronal mass ejection. The AIA observations combined with H{alpha} filtergrams as well as hard X-ray imaging and spectroscopy are consistent with most flare loops being formed by reconnection of the stretched legs of less-sheared J-shaped loops that envelopes the rising flux rope, in agreement with the standard tether-cutting scenario.

  18. Formation of a double-decker magnetic flux rope in the sigmoidal solar active region 11520

    SciTech Connect

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

    2014-07-10

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-07-01

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

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

    PubMed Central

    Ramírez-Alcántara, Verónica

    2014-01-01

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

  1. Genetics Home Reference: distal hereditary motor neuropathy, type II

    MedlinePlus

    ... hereditary motor neuropathy, type II distal hereditary motor neuropathy, type II Enable Javascript to view the expand/ ... Open All Close All Description Distal hereditary motor neuropathy, type II is a progressive disorder that affects ...

  2. INDICATIONS FOR DISTAL RADIOULNAR ARTHROPLASTY: REPORT ON THREE CLINICAL CASES

    PubMed Central

    Santos, Cláudia; Pereira, Alexandre; Sousa, Marco; Trigeuiros, Miguel; Silva, César

    2015-01-01

    Distal radioulnar arthroplasty is an attractive solution for treating various pathological conditions of the distal radioulnar joint because it allows restoration of stability, load transmission and function. The main indications are: radioulnar impingement after partial or complete resection of the distal ulna; and degenerative, inflammatory or post-traumatic arthritis of the distal radioulnar joint. The authors present three clinical cases of distal radioulnar pathological conditions: two patients with post-traumatic sequelae and one case of distal radioulnar impingement after a Sauvé-Kapandji operation. The three cases were treated surgically with a metallic prosthesis to replace the distal ulna (First Choice - Ascension®). The first two were treated with a resurfacing prosthesis and the last one with a modular prosthesis. All of the patients had achieved pain relief and increased movement of the distal radioulnar joint after one year of postoperative follow-up. PMID:27047827

  3. Effect of conjugated linoleic acid on the formation of spontaneous and PhIP-induced mutation in the colon and cecum of rats.

    PubMed

    Yang, Haiyan; Glickman, Barry W; de Boer, Johan G

    2002-03-20

    Conjugated linoleic acid (CLA), a mixture of positional and geometric isomers of linoleic acid, has been reported to inhibit chemically induced mammary and colon carcinogenesis in rodents. In a preliminary experiment, we found that CLA significantly reduced the induction of mutations by the dietary carcinogen 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) in the distal colon in male rats. Here, the chemopreventive properties of CLA were further evaluated by assessing its effect on PhIP-induced mutation and aberrant crypt foci (ACF) in both male and female rats. CLA (1%, w/w) was added to the diet (1) from weaning to 50-day-old, or (2) starting 1 week prior to exposure to PhIP. The 50-day-old Big Blue and F344 rats were then exposed to 100 ppm PhIP for 47 days. No sex differences were observed in mutagenic response to the various treatments in either the distal colon or cecum. The mutation frequency (MF) in the cecum and the distal colon from control animals is 4.3+/-1.3 and 5.3+/-1.4 x 10(-5), respectively showing no statistically significant difference. Administration of PhIP induced a four-fold increase in the MF in the cecum and a seven-fold increase in the distal colon compared to the corresponding controls. Supplementation of the diet with CLA lowered the PhIP-induced MF in the distal colon by 23% (P<0.03), but had no effect in the cecum. The PhIP-induced ACF, determined 9 weeks after the termination of treatment with PhIP, were 0.75 ACF/rat, with 1.7 aberrant crypts /ACF in the colon of male rats, all located in the distal colon. This induction was completely inhibited by the addition of CLA. PMID:11890945

  4. Colonic health: fermentation and short chain fatty acids.

    PubMed

    Wong, Julia M W; de Souza, Russell; Kendall, Cyril W C; Emam, Azadeh; Jenkins, David J A

    2006-03-01

    Interest has been recently rekindled in short chain fatty acids (SCFAs) with the emergence of prebiotics and probiotics aimed at improving colonic and systemic health. Dietary carbohydrates, specifically resistant starches and dietary fiber, are substrates for fermentation that produce SCFAs, primarily acetate, propionate, and butyrate, as end products. The rate and amount of SCFA production depends on the species and amounts of microflora present in the colon, the substrate source and gut transit time. SCFAs are readily absorbed. Butyrate is the major energy source for colonocytes. Propionate is largely taken up by the liver. Acetate enters the peripheral circulation to be metabolized by peripheral tissues. Specific SCFA may reduce the risk of developing gastrointestinal disorders, cancer, and cardiovascular disease. Acetate is the principal SCFA in the colon, and after absorption it has been shown to increase cholesterol synthesis. However, propionate, a gluconeogenerator, has been shown to inhibit cholesterol synthesis. Therefore, substrates that can decrease the acetate: propionate ratio may reduce serum lipids and possibly cardiovascular disease risk. Butyrate has been studied for its role in nourishing the colonic mucosa and in the prevention of cancer of the colon, by promoting cell differentiation, cell-cycle arrest and apoptosis of transformed colonocytes; inhibiting the enzyme histone deacetylase and decreasing the transformation of primary to secondary bile acids as a result of colonic acidification. Therefore, a greater increase in SCFA production and potentially a greater delivery of SCFA, specifically butyrate, to the distal colon may result in a protective effect. Butyrate irrigation (enema) has also been suggested in the treatment of colitis. More human studies are now needed, especially, given the diverse nature of carbohydrate substrates and the SCFA patterns resulting from their fermentation. Short-term and long-term human studies are particularly required on SCFAs in relation to markers of cancer risk. These studies will be key to the success of dietary recommendations to maximize colonic disease prevention. PMID:16633129

  5. [Colonic metabolism of fiber].

    PubMed

    García Peris, P; Bretón Lesmes, I; de la Cuerda Compes, C; Camblor Alvarez, M

    2002-01-01

    Over the last few years, the colon has come to be considered more and more as a central digestive organ. This is where bacterial fermentation takes place to eliminate the substrates, mostly carbohydrates, that have avoided digestion by human enzymes within the small intestine. Of these, fibre plays a prominent role. As a result of this colonic fermentation, short-chain fatty acids are created and these have an important function at the level of the colon (reduction in pH, trophic effect, energy production, etc.) and at the systemic level (lipid metabolism, glycaemic metabolism, etc.) No less important are the effects of this colonic metabolism of fibre on proliferation of bacteria, thus giving fibre probiotic effects. PMID:12141180

  6. Colon diverticula - series (image)

    MedlinePlus

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

  7. The Epidemiology of Distal Radius Fractures

    PubMed Central

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

    2012-01-01

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

  8. Fractures of Distal Radius: An Overview

    PubMed Central

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

    2014-01-01

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

  9. Fracture epiphyseal separation of the distal humerus.

    PubMed

    Sen, R K; Bedi, G S; Nagi, O N

    1998-08-01

    Seven patients seen with fracture separation of the distal humerus epiphysis have been analysed for the problems linked with the radiological diagnosis of this injury. Peculiar male predominance, exclusive left-side involvement, consistent postero-medial displacement of the epiphyseal fragment and ability to achieve near anatomic reduction by closed manipulation in fresh cases have been some of the other features observed. The literature has been briefly reviewed for this infrequent and usually misdiagnosed injury. PMID:9727266

  10. Intestinal colonization resistance

    PubMed Central

    Lawley, Trevor D; Walker, Alan W

    2013-01-01

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

  11. Aromatase in colon carcinoma.

    PubMed

    Sato, Ryuichiro; Suzuki, Takashi; Katayose, Yu; Miura, Koh; Shiiba, Kenichi; Miki, Yasuhiro; Kamogawa, Yukiko; Yamamoto, Kuniharu; Takayuki; Egawa, Shinichi; Unno, Michiaki; Sasano, Hironobu

    2012-08-01

    Aromatase is one of the key estrogen-producing enzymes and is regarded as one of the therapeutic targets in estrogen receptor-positive breast cancer patients. Human colon carcinoma has also been recently proposed as being an estrogen-responsive malignancy, but the detailed status of aromatase has not yet been reported. Therefore, in this study, we evaluated the aromatase expression in colon carcinoma using immunohistochemistry and real-time polymerase chain reaction. Aromatase mRNA was significantly higher (p=0.03) in colon carcinoma than in the corresponding non-neoplastic mucosa (n=31). Aromatase immunoreactivity tended to be positively associated with the intratumoral concentration of estrogens (n=53), and in particular, the concentration of estradiol was significantly higher (p=0.02) in aromatase-positive cases in men. Aromatase immunoreactivity was detected in the cytoplasm of the carcinoma cells in 217/328 (65%) examined colon carcinoma cases. Aromatase immunoreactivity was significantly positively correlated with tubular differentiation, and inversely correlated with Ki-67 labeling index, although not necessarily correlated with the clinical outcome of the patients. All these results demonstrate that colon carcinoma expresses functional aromatase, and that estrogens are locally synthesized in the tumor tissues. The findings reported here could contribute to a better understanding of the actions of estrogen in colon carcinoma. PMID:22843875

  12. ZASPopathy with childhood-onset distal myopathy.

    PubMed

    Strach, Katharina; Reimann, Jens; Thomas, Daniel; Naehle, Claas P; Kress, Wolfram; Kornblum, Cornelia

    2012-07-01

    We report on a German family presenting with a predominantly distal myopathy primarily affecting anterior compartments of lower legs in childhood. Proximal lower limb and hip girdle weakness developed later in early adulthood in the female index patient and likewise in her mother. Consecutive muscle biopsy findings were first attributed to a mild congenital myopathy and later on interpreted as neurogenic changes without clear signs of a myopathy. Molecular genetic analysis was performed because of the clinical impression of a distal myopathy combined with dominant inheritance. The heterozygous mutation c.349G>A (p.D117N) in the ZASP gene could be found. This mutation had been previously associated with an adult-onset, isolated, dilated left ventricular non-compaction cardiomyopathy (OMIM*605906.0007), which was not present in our patients. Our data show that this mutation can be associated with an isolated skeletal muscle phenotype. Second, mutation analysis of the ZASP gene is suggested for distal myopathies of any age, even in cases of uncharacteristic muscle biopsy findings on routine analysis. PMID:22619057

  13. Distal Embolic Protection for Renal Arterial Interventions

    SciTech Connect

    Dubel, Gregory J. Murphy, Timothy P.

    2008-01-15

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

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

    PubMed

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

    2007-10-01

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

  15. Fragment-Specific Fixation for Fractures of the Distal Radius.

    PubMed

    Geissler, William B; Clark, Sonja M

    2016-03-01

    This article summarizes the management of distal fractures utilizing Acumed fragment-specific family of plates. No single plate option can address every fracture pattern of the distal radius. These fragment-specific plates are usually adjuncts to allow the surgeon to expand the armamentarium in the management of complex volar and dorsal comminuted distal radius fracture patterns. PMID:26855832

  16. Withdrawing method of the stiffening tube incidentally inserted into the descending colon.

    PubMed

    Fukuda, Shinsaku; Mikami, Tatsuya; Shimoyama, Tadashi; Hanabata, Norihiro; Iwamura, Hideki; Munakata, Akihiro

    2005-09-14

    We experienced a very rare complication of colonoscopy, a migration of stiffening tube into the colorectum. We herein introduce a withdrawing method of migrating stiffening tube incidentally inserted into the colorectum. A 65-year-old Japanese woman underwent colonoscopy because of abdominal discomfort. We used stiffening tube to insert the scope to the proximal colon because of her redundant sigmoid colon. When withdrawing the scope, we realized that the tube was fully inside the colorectum. We could not remove the tube instantly, and it reached the splenic flexure, finally. We reinserted the scope through the migrating tube, straightened the scope, and withdrew it holding a slight angle of the scope over the proximal end of the tube. Then, we could safely remove the tube along with the scope through the anus. PMID:16149153

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

    SciTech Connect

    Stubbs, J.B.; Valenzuela, G.A.; Stubbs, C.C.; Croft, B.Y.; Teates, C.D.; Plankey, M.W.; McCallum, R.W. )

    1991-07-01

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

  18. [A Case of Idiopathic Thrombocytopenic Purpura during Adjuvant Chemotherapy for Colon Cancer].

    PubMed

    Takahara, Yoshihiro; Ozawa, Shinichi; Ogasawara, Takeshi; Shida, Takashi; Nomura, Satoru; Sato, Yoshiharu; Takahashi, Makoto

    2015-11-01

    A 76-year-old man underwent surgery for sigmoid colon cancer. The pathological finding was stage Ⅱ with a high-risk of recurrence (SI [bladder], l y0, v2, pN0, H0, P0, M0). He was treated with TS-1 as adjuvant chemotherapy. After the 1 course of chemotherapy, his platelet count was 4,000/mL. The high index of platelet associated IgG (PA-IgG) and bone marrow examination suggested that thrombocytopenia was caused by idiopathic thrombocytopenic purpura. The platelet count improved by prednisolone administration and Helicobacter pylori eradication treatment. After 6 months with no administration of adjuvant chemotherapy, the colon cancer recurred locally, and we performed a Hartmann's operation. PMID:26805292

  19. [Morphological and enzymatic studies of the supratumoral distended colonic loop in colorectal cancers (therapeutic aspects)].

    PubMed

    Stoica, T; Laky, D; Poenaru, D; Stadnicov, O; Voicu, F; Herescu, N; Stoica, D

    1975-01-01

    The authors carried out experimental and clinical studies in an attempt to explain the causes leading to anastomotic dehiscences, a major complication of exeresis surgery of the left colon and of the rectum. In this view they have performed in dogs incomplete stenoses at the level of the sigmoid and also made parallel studies of the morphological and histochemical changes occuring in the supra-stenosis colon wall, with those of the supra-tumoral colon wall found in human colo-rectal carcinomas, in the "sub-occlusion" stage. Histological alterations are presented, characterized by marked edema in all the layers of the wall, leading to evidently hampered colon vascularization. From the enzymological viewpoint there was noted an intensive phosphatasic and ATP-ase reaction in all the layers of the colon wall. These studies led to the conclusion that it is necessary to evaluate the degree and the duration of the supra-tumoral colic distension before a decision is taken to carry out primary colectomy or rectal resection (single-step procedure), and not to avoid the practice of a seriated intervention when necessary. The reversibility of the lesions noted by the authors allows for the possibility to perform a resection after the colic wall to be anastomosed has returned to an almost normal condition, thus avoiding the dehiscence of the sutures. PMID:175406

  20. Synbiotic effects of lactitol and Lactobacillus acidophilus NCFM™ in a semi-continuous colon fermentation model.

    PubMed

    Mäkivuokko, H; Forssten, S; Saarinen, M; Ouwehand, A; Rautonen, N

    2010-06-01

    The effects of Lactobacillus acidophilus NCFM™, lactitol, and the combination of lactitol and L. acidophilus NCFM™ were studied with a semi-continuous colon fermentation simulation; consisting of compartments mimicking, ascending, transverse, descending and sigmoid colon and their conditions with faecal inoculation. L. acidophilus NCFM™ was detected throughout the colon simulator. Lactitol was utilised early on by the microbes in the proximal part of the simulator. Lactitol increased the total numbers of microbes and bifidobacteria, and decreased clostridia cluster IV, while L. acidophilus NCFM™ alone decreased the numbers of clostridia cluster XIV. Combination treatment increased the numbers of bifidobacteria. Furthermore, concentrations of acetic acid, butyric acid and the sum of total short-chain fatty acids were increased by both lactitol-including treatments. The treatment with L. acidophilus NCFM™ alone increased the concentration of propionic acid and butyric acid. L. acidophilus NCFM™ tended to increase the total concentrations of biogenic amines, while lactitol suppressed production of biogenic amines also in the presence of L. acidophilus NCFM™. True synergistic effects are suggested in stimulation of the production of butyrate, an important microbial metabolite for colon health. In conclusion, lactitol as well as the combination of lactitol and L. acidophilus NCFM™ were found to exhibit complementary beneficial effects on the colon microbial composition and activity. PMID:21840801

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

    PubMed Central

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

    2015-01-01

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

  2. Cortagine, a CRF1 agonist, induces stresslike alterations of colonic function and visceral hypersensitivity in rodents primarily through peripheral pathways.

    PubMed

    Larauche, Muriel; Gourcerol, Guillaume; Wang, Lixin; Pambukchian, Karina; Brunnhuber, Stefan; Adelson, David W; Rivier, Jean; Million, Mulugeta; Taché, Yvette

    2009-07-01

    Corticotropin-releasing factor (CRF) 1 receptor (CRF(1)) 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 CRF(1) 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 microg/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 microg/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 mug/kg ip) abolished ip cortagine-induced hyperalgesia whereas injected icv it had no effect. In mice, cortagine (30 microg/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 CRF(1) receptors support a role for peripheral CRF(1) signaling as the local arm of the colonic response to stress. PMID:19407218

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

    PubMed

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

    2014-04-01

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

  4. Colon adenocarcinoma with dome-like phenotype: characteristic endoscopic ultrasonography (EUS) findings.

    PubMed

    Takagi, Wataru; Yamamoto, Katsumi; Amano, Takahiro; Sakamoto, Aisa; Otake, Yuriko; Saiki, Hirotsugu; Kondo, Hisashi; Urabe, Makiko; Takahashi, Kei; Yamamoto, Masashi; Hayashi, Shiro; Nakajima, Sachiko; Nishida, Tsutomu; Komori, Takamichi; Morita, Shunji; Adachi, Shiro; Inada, Masami

    2015-08-01

    An 80-year-old man underwent colonoscopy for proctorrhagia. Conventional white-light imaging showed a superficially flat and elevated lesion that appeared to be a submucosal tumor of the sigmoid colon. Chromoendoscopy with Indigo Carmine showed that the margin of the tumor was covered with normal epithelium but that there was a slight depression on its surface. Magnification endoscopy with Crystal Violet staining revealed the amorphous surface structure of the depressed lesion, but the surrounding mucosa showed a normal pit pattern. Endoscopic ultrasonography demonstrated that a hypoechoic mass was located in the submucosal layer, and a biopsy specimen obtained from the surface of the lesion showed evidence of adenocarcinoma. We then performed sigmoidectomy on the patient. Immunohistochemically, the tumor cells were positive for two mismatch repair proteins (MLH1 and MSH2), but in situ hybridization revealed that the specimen was negative for the Epstein - Barr virus. We finally diagnosed the lesion as adenocarcinoma with a dome-like phenotype of the sigmoid colon. PMID:26355327

  5. [Pneumocystis Pneumonia during Adjuvant Chemotherapy for Advanced Colon Cancer - A Case Report].

    PubMed

    Fujiwara, Yushi; Lee, Shigeru; Kishida, Satoru; Hashiba, Ryoya; Gyobu, Ken; Osugi, Harushi

    2015-11-01

    We report a case of pneumocystis pneumonia (PCP) during adjuvant chemotherapy for advanced sigmoid colon cancer. A 70-year-old Japanese man was referred to our hospital after complaining of bloody stools. He was diagnosed with advanced sigmoid colon cancer, T2N2aM1b, Stage IV B. After 3 cycles of mFOLFOX6 plus panitumumab as first-line chemotherapy, he received FOLFIRI plus bevacizumab as second-line chemotherapy because of progressive disease. Aprepitant and steroids were administered as antiemetic agents for a short period during each chemotherapy session. During the 2 cycle of FOLFIRI plus bevacizumab, he developed a high fever without respiratory symptoms. Chest CT revealed ground-glass opacities in both the lungs. We first treated him with antibiotics (PIPC/TAZ plus GRNX), suspecting bacterial pneumonia. However, based on the elevation of serum b -D-glucan (148 pg/mL), we diagnosed PCP and initiated SMX/TMP in addition to PIPC/TAZ. The inflammation promptly decreased, and follow-up chest CT revealed the disappearance of the ground-glass opacities. If a patient develops a fever or respiratory symptoms during a course of chemotherapy, we should consider the possibility of PCP and perform careful examinations. PMID:26602404

  6. The development of colon innervation in trisomy 16 mice and Hirschsprungs disease

    PubMed Central

    Li, Ji Cheng; Mi, Kai Hong; Zhou, Ji Lin; Busch, LC; Kuhnel, W

    2001-01-01

    AIM: To study the colon innervation of trisomy 16 mouse, an animal model for Down’s syndrome, and the expression of protein gene product 9.5 (PGP 9.5) in the stenosed segment of colon in Hirschsprungs disease (HD). METHODS: Trisomy 16 mouse breeding; cytogenetic analysis of trisomy 16 mice; and PGP 9.5 immunohistochemistry of colons of trisomy 16 mice and HD were carried out. RESULTS: Compared with their normal littermates, the nervous system of colon in trisomy 16 mice was abnormally developed. There existed developmental delay of muscular plexuses of colon, no submucosal plexus was found in the colon, and there was 5 mm aganglionic bowel aparting from the anus in trisomy 16 mice. The mesentery nerve fibers were as well developed as shown in their normal littermates. Abundant proliferation of PGP 9.5 positive nerve fibers was evealed in the stenosed segment of HD colon. CONCLUSION: Trisomy 16 mice could serve as an animal model for Hirschsprung’s disease for aganglionic bowel in the distal part of colon. Abundant proliferation of PGP 9.5 positive fibers resulted from extrinsic nerve compensation, since no ganglionic cells were observed in the stenosed segment of the colon in HD. HD has a genetic tendency. PMID:11819726

  7. Lower Neighborhood Socioeconomic Status Associated with Reduced Diversity of the Colonic Microbiota in Healthy Adults

    PubMed Central

    Miller, Gregory E.; Engen, Phillip A.; Gillevet, Patrick M.; Shaikh, Maliha; Sikaroodi, Masoumeh; Forsyth, Christopher B.; Mutlu, Ece; Keshavarzian, Ali

    2016-01-01

    In the United States, there are persistent and widening socioeconomic gaps in morbidity and mortality from chronic diseases. Although most disparities research focuses on person-level socioeconomic-status, mounting evidence suggest that chronic diseases also pattern by the demographic characteristics of neighborhoods. Yet the biological mechanisms underlying these associations are poorly understood. There is increasing recognition that chronic diseases share common pathogenic features, some of which involve alterations in the composition, diversity, and functioning of the gut microbiota. This study examined whether socioeconomic-status was associated with alpha-diversity of the colonic microbiota. Forty-four healthy adults underwent un-prepped sigmoidoscopy, during which mucosal biopsies and fecal samples were collected. Subjects’ zip codes were geocoded, and census data was used to form a composite indicator of neighborhood socioeconomic-status, reflecting household income, educational attainment, employment status, and home value. In unadjusted analyses, neighborhood socioeconomic-status explained 12–18 percent of the variability in alpha-diversity of colonic microbiota. The direction of these associations was positive, meaning that as neighborhood socioeconomic-status increased, so did alpha-diversity of both the colonic sigmoid mucosa and fecal microbiota. The strength of these associations persisted when models were expanded to include covariates reflecting potential demographic (age, gender, race/ethnicity) and lifestyle (adiposity, alcohol use, smoking) confounds. In these models neighborhood socioeconomic-status continued to explain 11–22 percent of the variability in diversity indicators. Further analyses suggested these patterns reflected socioeconomic variations in evenness, but not richness, of microbial communities residing in the sigmoid. We also found indications that residence in neighborhoods of higher socioeconomic-status was associated with a greater abundance of Bacteroides and a lower abundance of Prevotella, suggesting that diet potentially underlies differences in microbiota composition. These findings suggest the presence of socioeconomic variations in colonic microbiota diversity. Future research should explore whether these variations contribute to disparities in chronic disease outcomes. PMID:26859894

  8. Piroxicam decreases postirradiation colonic neoplasia in the rat

    SciTech Connect

    Northway, M.G.; Scobey, M.W.; Cassidy, K.T.; Geisinger, K.R. )

    1990-12-01

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

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

    PubMed Central

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

    2015-01-01

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

  10. Human colon cancer cells deficient in DCC produce abnormal transcripts in progression of carcinogenesis.

    PubMed

    Huerta, S; Srivatsan, E S; Venkatasan, N; Livingston, E H

    2001-09-01

    Expressive loss of the tumor suppressor deleted in colon cancer (DCC) may be superior to lymph node status in predicting patient survival for intermediate stage colon cancer. A polymerase chain reaction (PCR)-based method for detecting DCC would be ideal as a prognostic indicator. DCC is an alternatively spliced molecule; thus, reliability of a PCR test for DCC will depend on amplifying only those regions of the molecule that are lost in the progression of colon cancer. For this reason, we studied a colon cancer cell line model at different stages of tumor progression to determine the alternative splice pattern for DCC. A commercially available colon cancer cell line system at different stages of tumor progression was used to identify which DCC exons are lost by western blot analysis, PCR, and RT-PCR techniques. Colon cancers express abnormal DCC transcripts. The proximal and distal exons are present (exons 2 and 28-29). Exons located in the center of the molecule are absent (6-7 and 18-23). This correlated to DCC protein loss in the cell lines. For clinical utility as a disease marker, exons in the middle portion of the DCC molecule that are spliced out should be utilized. Amplification of the proximal and distal regions will result in falsely concluding that DCC is present when its protein product is not expressed. PMID:11575440

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

    PubMed

    Carson, C C; Noh, C H

    2002-04-01

    Subcutaneous extrusion of penile prosthesis cylinders beneath the glans penis is an unusual but difficult complication of penile prosthesis. Without surgical repair, extrusion, infection, and corporeal fibrosis may ensue. Twenty-eight patients with distal corporeal extrusion were reviewed to identify the optimum treatment outcome for these penile prosthesis complications. Records of 28 men with subcutaneous distal penile prosthesis cylinder extrusion were reviewed. Mean age was 56.2 y. Etiology of erectile dysfunction was diabetes mellitus in 11, vasculogenic in 10, Peyronie's disease in five, radical pelvic surgery in five. Duration of penile prosthesis was 8-72 months (mean 42.6). No patient had penile prosthesis infection or device exposure through the skin. Distal corporoplasty was treated on 18/28 men using cylinder repositioning and direct tunica albuginea repair. Ten men underwent repair using a Gortex windsock. 8/18 corporoplasty and 6/10 windsock patients required glans fixation for treatment of hypermobile glans following cylinder relocation. In two patients with windsock repair, extrusion recurrence occurred 6 and 18 months following surgery and 1/6 had post operative infection requiring prosthesis removal. Mean surgical time for corporoplasty was 52.8 minutes while windsock reconstruction was 89.6 minutes. Distal subcutaneous penile prosthesis cylinder extrusion produces coital pain and predisposes to cylinder exposure and infection. Early repair with or without additional prosthetic materials will return penile prostheses to a normal functioning state. Distal corporoplasty with cylinder repositioning appears to be a simple, low morbidity solution to this difficult dilemma. Outcomes with distal corporoplasty result in better function, less pain, and fewer recurrences than Gortex windsock repair. PMID:11979321

  12. Creation of distal canine limb lymphedema

    SciTech Connect

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

    1989-06-01

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

  13. Distal amputations for the diabetic foot

    PubMed Central

    Nather, Aziz; Wong, Keng Lin

    2013-01-01

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

  14. Reconstruction of foreskin in distal hypospadias repair.

    PubMed

    Frey, P; Cohen, S J

    1989-01-01

    In the period between 1980 and 1985 101 one-stage repairs for distal hypospadias were carried out. Fifty-five patients were operated on using the Magpi technique as originally described by Duckett (1981). The hypospadias of the remaining 46 patients were corrected using a modification of this technique incorporating reconstruction of the foreskin. The technique of the modified, prepuce-preserving operation is described. Despite complications such as moderate meatal stenosis, fistulae and glandular-meatal as well as foreskin dehiscence, the overall functional and cosmetic results were very good. PMID:2498999

  15. Distal Renal Tubular Acidosis and Calcium Nephrolithiasis

    NASA Astrophysics Data System (ADS)

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

    2008-09-01

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

  16. [Vascularized iliac crest and distal radius reconstruction].

    PubMed

    Pic Gomis, L; Gomis, R

    2010-12-01

    The authors relate their experience concerning the vascularized iliac crest flap. In the first chapter, they detail the anatomic vascularized osteocutaneous iliac crest. Blood supply arises from the deep and superficial circonflexe iliac artery. Many anastomoses connect the two systems. In the second chapter, they detail the operative technique of free and pedicule hone iliac crest flap. Composite cutaneous bone flaps are also detailed. In the third chapter, they detail informations about treatment of distal radius bone defects with associated skeen flap if necessary. PMID:21084210

  17. Total Elbow Arthroplasty for Distal Humerus Fractures.

    PubMed

    Harmer, Luke S; Sanchez-Sotelo, Joaquin

    2015-11-01

    Total elbow arthroplasty is a good treatment alternative for selected patients with distal humerus fractures. Its attractiveness is related to several factors, including the possibility of performing the procedure; leaving the extensor mechanism intact; faster, easier rehabilitation compared with internal fixation; and overall good outcomes reported in terms of both pain relief and function. Implant failure leading to revision surgery does happen, and patients must comply with certain limitations to extend the longevity of their implant. Development of high-performance implants may allow expanding the indications of elbow arthroplasty for fractures. PMID:26498549

  18. Colonic Crohn Disease

    PubMed Central

    Hedrick, Traci L.; Friel, Charles M.

    2013-01-01

    Colonic Crohn disease is a complicated disease entity that requires a multidisciplinary effort on the part of the surgeon, gastroenterologist, and pathologist. Crohn disease affects ?500,000 people in North America with nearly 300,000 people suffering from colonic manifestations. This represents a significant portion of the patient population in the typical colorectal surgeon's practice. As such, an intimate understanding of the disease process, presentation, and treatment options is imperative. In this article, the authors review the clinical manifestations, diagnosis, and medical and surgical treatment options with a focus on current strategies for surgical management. PMID:24436655

  19. Sigmoid endometriosis and a diagnostic dilemma – A case report and literature review

    PubMed Central

    Nasim, H.; Sikafi, D.; Nasr, A.

    2011-01-01

    Introduction Intestinal endometriosis is often an infrequently considered diagnosis in female of childbearing age by general surgeon. There is a delay in diagnosis because of constellation of symptoms and lack of specific diagnostic modalities. Patients suffer from intestinal endometriosis for many years before they are diagnosed. Often, such patients are labelled with irritable bowel syndrome. Intestinal endometriosis has a diagnostic time delay of 8–11 years due to its non-specific clinical features and multi-system involvement. Presentation of Case Our patient was a 32 years old Caucasian female who was referred to us with features of intestinal obstruction. Despite repeated clinical assessments and use of different diagnostic modalities the diagnosis was still inconclusive even after 21 days of her first presentation to primary care physician. She had an exploratory laparotomy, sigmoid colectomy, and Hartmann's procedure with a temporary colostomy with us. Histopathology confirmed endometriosis and also showed melanosis coli. She was referred to the gynaecological team for review and follow up. Discussion Intestinal endometriosis should be considered as a differential diagnosis in female patients of childbearing age group presenting with non-specific gastrointestinal signs and symptoms. Our patient manifested intestinal endometriosis and melanosis coli on histopathology suggesting symptoms of long duration. Conclusion Bowel endometriosis is a less considered and often ignored differential diagnosis in acute and chronic abdomen. This condition has considerable effect on patient's health both physically and psychologically. PMID:22096721

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

    PubMed

    Zhou, G D

    2006-06-01

    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 information independence model (MIIM). In addition, a support vector machine (SVM) plus sigmoid is proposed to resolve the data sparseness problem in the MIIM. In this way, the data sparseness problem in MIIM-based biomedical name recognition can be resolved effectively and a biomedical name recognition system with better performance and better portability can be achieved. Finally, we present two post-processing modules to deal with the nested entity name and abbreviation phenomena in the biomedical domain to further improve the performance. Evaluation shows that our system achieves F-measures of 69.1 and 71.2 on the 23 classes of GENIA V1.1 and V3.0, respectively. In particular, our system achieves an F-measure of 77.8 on the "protein" class of GENIA V3.0. It also shows that our system outperforms the best-reported system on GENIA V1.1 and V3.0. PMID:16112894

  1. Sigmoid curves, non-linear double-reciprocal plots and allosterism.

    PubMed Central

    Bardsley, W G; Childs, R E

    1975-01-01

    1. The theory of plane curves was applied to the graphical methods used in enzyme kinetics and a mathematical analysis of the possible graph shapes is given. 2. The belief that allosterism can be inferred from steady-state data alone is subjected to criticism and the mathematical significance of sigmoid curves and non-linear double-reciprocal plots is explored. 3. It is suggested that the usual methods of interpreting steady-state kinetic data are often based on over-restrictive assumptions which prevent maximum utilization of the available data. 4. Methods for obtaining the degree of the rate equation from graph shapes obtained directly from initial-rate measurements and from replots of asymptotic behaviour as chi approach the level 0 and chi approach the level infinity are discussed. 5. Detailed proofs of the theorems given in the text have been deposited as Supplementary Publication SUP 50049 (10 pages) at the British Library (Lending Division), Boston Spa, West Yorkshire LS23 7BQ, U.K., from whom copies can be obtained on the terms indicated in Biochem. J. (1975), 145, 5. PMID:1180901

  2. Metastable dynamical patterns and their stabilization in arrays of bidirectionally coupled sigmoidal neurons.

    PubMed

    Horikawa, Yo

    2013-12-01

    Transient patterns in a bistable ring of bidirectionally coupled sigmoidal neurons were studied. When the system had a pair of spatially uniform steady solutions, the instability of unstable spatially nonuniform steady solutions decreased exponentially with the number of neurons because of the symmetry of the system. As a result, transient spatially nonuniform patterns showed dynamical metastability: Their duration increased exponentially with the number of neurons and the duration of randomly generated patterns obeyed a power-law distribution. However, these metastable dynamical patterns were easily stabilized in the presence of small variations in coupling strength. Metastable rotating waves and their pinning in the presence of asymmetry in the direction of coupling and the disappearance of metastable dynamical patterns due to asymmetry in the output function of a neuron were also examined. Further, in a two-dimensional array of neurons with nearest-neighbor coupling, intrinsically one-dimensional patterns were dominant in transients, and self-excitation in these neurons affected the metastable dynamical patterns. PMID:24483526

  3. Sigmoid incision rescue nasoseptal flap technique for endoscopic endonasal skull base surgery.

    PubMed

    Ozawa, Hiroyuki; Tomita, Toshiki; Watanabe, Yoshihiro; Sekimizu, Mariko; Ito, Fumihiro; Ikari, Yuichi; Saito, Shin; Toda, Masahiro; Ogawa, Kaoru

    2016-06-01

    Conclusion The sigmoid-incision (S-I) rescue flap technique has the advantage of both reduced-invasiveness and providing a sufficient surgical corridor for endoscopic endonasal skull base surgery (EESBS). Objective Skull base reconstruction with nasoseptal flap (NSF) is critically important in managing post-operative cerebrospinal fluid (CSF) leakage after tumor removal by EESBS. The NSF needs to be elevated before sphenoidotomy and posterior septectomy to preserve the pedicle. However, most extradural surgery without CSF leakage does not require NSF and, therefore, NSF preparation is often futile. As a result, a rescue flap technique to overcome this problem has been developed, whereby a new S-I rescue flap method is used that enables wide exposure of the sphenoidal rostrum and smooth manipulation of surgical instruments to preserve the NSF pedicle. Materials and methods Starting in April 2014, 19 cases underwent EESBS with S-I rescue flap. Results All patients underwent tumor resection under an adequate operative field with smooth manipulation of surgical instruments. Two complications were experienced. One patient had CSF leak after removal of the nasal packing, but the leakage was successfully closed by conventional NSF. Another patient had epistaxis from the septal wall, but this was controlled by electrocautery. PMID:26901123

  4. Simulating the formation of a sigmoidal flux rope in AR10977 from SOHO/MDI magnetograms

    SciTech Connect

    Gibb, G. P. S.; Mackay, D. H.; Meyer, K. A.; Green, L. M.

    2014-02-20

    The modeling technique of Mackay et al. is applied to simulate the coronal magnetic field of NOAA active region AR10977 over a seven day period (2007 December 2-10). The simulation is driven with a sequence of line-of-sight component magnetograms from SOHO/MDI and evolves the coronal magnetic field though a continuous series of non-linear force-free states. Upon comparison with Hinode/XRT observations, results show that the simulation reproduces many features of the active region's evolution. In particular, it describes the formation of a flux rope across the polarity inversion line during flux cancellation. The flux rope forms at the same location as an observed X-ray sigmoid. After five days of evolution, the free magnetic energy contained within the flux rope was found to be 3.9 × 10{sup 30} erg. This value is more than sufficient to account for the B1.4 GOES flare observed from the active region on 2007 December 7. At the time of the observed eruption, the flux rope was found to contain 20% of the active region flux. We conclude that the modeling technique proposed in Mackay et al.—which directly uses observed magnetograms to energize the coronal field—is a viable method to simulate the evolution of the coronal magnetic field.

  5. Effectiveness of Elective Laparoscopic Treatment for Colonic Diverticulitis

    PubMed Central

    Grillone, Gianluca; Frattini, Paolo; De Luca, Antonio; Girardi, Valerio; Scandroglio, Ildo

    2015-01-01

    Background and Objectives: To analyze the short- and long-term outcomes of laparoscopic sigmoid colectomy for the elective treatment of diverticular disease. Methods: A consecutive unselected series of 94 patients undergoing elective laparoscopic sigmoid colectomy for diverticular disease from 2008 to 2012 was analyzed. We collected patients-, surgery- and hospital stay–related data, as well as the short- and long-term outcomes. Operative steps, instrumentation, and postoperative cares were standardized. Comorbidity was assessed by Charlson comorbidity index. Complications were classified using the Clavien-Dindo classification system. The qualitative long-term assessment was carried out by subjecting patients to the validated gastrointestinal quality of life index questionnaire before and after surgery. Results: The mean age of our cohort was 61.3 ± 11.0 years with a Charlson comorbidity index of 1.2 ± 1.5. Mean operative time was 213.5 ± 60.8 minutes and estimated blood loss was 67.2 ± 94.3 mL. We had 3 cases (3.2%) of conversion to open laparotomy. The rates of postoperative complications were 35.1%, 6.3%, 2.1%, and 1.06%, respectively, for grades 1, 2, 3b, and 5 according to the Clavien-Dindo system. Length of hospital stay was 8.1 ± 1.9 days, and we have not recorded readmissions in patients discharged within 60 days after surgery. Median follow-up was of 9.6 ± 2.7 months. We observed no recurrence of diverticular disease, but there was evidence of 3 cases of incisional hernia (3.19%). The difference between preoperative and late gastrointestinal quality of life index score was statistically significant (97.1 ± 5.8 vs 129.6 ± 8.0). Conclusions: Elective laparoscopic treatment of colonic diverticular disease represents an effective option that produces adequate postoperative results and ensures a satisfactory functional outcome. PMID:26005319

  6. Central neurotensin nerves modulate colo-colonic reflex activity in the guinea-pig inferior mesenteric ganglion.

    PubMed Central

    Stapelfeldt, W H; Szurszewski, J H

    1989-01-01

    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 PMID:2559196

  7. Maxillary molar distalization with first class appliance.

    PubMed

    Ramesh, Namitha; Palukunnu, Biswas; Ravindran, Nidhi; Nair, Preeti P

    2014-01-01

    Non-extraction treatment has gained popularity for corrections of mild-to-moderate class II malocclusion over the past few decades. The distalization of maxillary molars is of significant value for treatment of cases with minimal arch discrepancy and mild class II molar relation associated with a normal mandibular arch and acceptable profile. This paper describes our experience with a 16-year-old female patient who reported with irregularly placed upper front teeth and unpleasant smile. The patient was diagnosed to have angles class II malocclusion with moderate maxillary anterior crowding, deep bite of 4 mm on a skeletal class II base with an orthognathic maxilla and retrognathic mandible and normal growth pattern. She presented an ideal profile and so molar distalization was planned with the first-class appliance. Molars were distalised by 8 mm on the right and left quadrants and class I molar relation achieved within 4 months. The space gained was utilised effectively to align the arch and establish a class I molar and canine relation. PMID:24577171

  8. Prospective randomized trial comparing short-term antibiotic therapy versus standard therapy for acute uncomplicated sigmoid diverticulitis.

    TOXLINE Toxicology Bibliographic Information

    Schug-Pass C; Geers P; Hgel O; Lippert H; Kckerling F

    2010-06-01

    PURPOSE: To date, the standard therapy used for acute episodes of uncomplicated sigmoid diverticulitis has been a 7-10-day antibiotic treatment regimen. Thanks to the development of highly potent, broad-spectrum antibiotics such as ertapenem, the question arises as to whether the duration of treatment of acute uncomplicated sigmoid diverticulitis can be reduced by using highly effective antibiotics.METHODS: To compare the efficacy of short-term therapy (4 days) versus standard therapy (7 days) for uncomplicated sigmoid diverticulitis, a prospective randomized multicenter trial was conducted. Patients were randomized to treatment groups after 4 days. Both patient groups were monitored until discharge and were followed up after 4-6 weeks and 52 weeks. [corrected] The results were standardized and statistically evaluated.RESULTS: Between 16 December 2004 and 15 November 2007, 123 patients from 11 hospitals were enrolled in the study. Seventeen patients dropped out. In the remaining 106 cases, no significant differences were discerned between the two groups in terms of the basic data, apart from the mean number of diverticulitis episodes (short term 1.28 +/- 0.64 versus standard 1.64 +/- 1.07, p = 0.037). The mean hospital stay was 8.8 days, with significant differences seen between short-term and standard therapy (7.8 +/- 2.8 versus 9.7 +/- 3.2 days; p = 0.002). After 4 days, treatment was classified as having proved successful in 98.0% of cases and after 7 days in 98.2% of cases. An overall success rate of 95.1% (94.0% versus 96.2%, n.s.) was recorded after 1 month.CONCLUSION: The results obtained with short-term ertapenem therapy (4 days) showed that this was as effective as standard therapy (7 days) for treatment of uncomplicated sigmoid diverticulitis.

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

    PubMed Central

    Baş, Yılmaz; Güney, Güven; Uzbay, Pınar; Zobacı, Ethem; Ardalı, Selin; Özkan, Ayşegül Taylan

    2015-01-01

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

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

    PubMed

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

    2015-08-01

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

  11. Understanding your colon cancer risk

    MedlinePlus

    Colon cancer risk factors are things that increase the chance that you could get cancer. Some risk factors ... risk factors never get cancer. Other people get colon cancer but do not have any known risk factors. ...

  12. Colon-Cut-off-Sign in the CT-Scanogram – Evidence of Pancreatitis?

    PubMed Central

    Scheer, Fabian; Andresen, Reimer

    2015-01-01

    One of the less considered but radiologically characteristic signs in conventional radiographic imaging of the abdomen in acute pancreatitis is the so-called colon-cut-off-sign. This sign refers to the abrupt termination of gas filling of the colon at the level of the left flexure. The more distal part of the colon usually shows a markedly reduced or a lack of gas filling. This bowel gas distribution, which feigns a constriction of the colon at the left flexure, has been observed within the context of acute pancreatitis for over 50 years. The frequency and sensitivity of the Colon-cut-off-sign fluctuate considerably in different studies. It can also be demonstrated in computed tomography (CT) and in the retrograde contrast medium filling of the colon. We report on a patient who was admitted to the department of internal medicine with pronounced, progressive upper abdominal pain, combined with fever, elevated CRP, lipase and amylase, and leukocytosis, with suspected pancreatitis. Colonoscopy was interrupted due to stenosis in the area of the left flexure, a stenosing tumour being suspected. Over the course of further diagnostics, the scanogram of the abdominal CT already showed a colon-cut-off-sign. In addition, exudative pancreatitis with a stenosing process in the area of the left colonic flexure was found. A solid tumour could be ruled out in repeated endoscopy. PMID:26675990

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

    SciTech Connect

    Jiang, Chaowei; Feng, Xueshang; Wu, S. T.; Hu, Qiang E-mail: fengx@spaceweather.ac.cn E-mail: qh0001@uah.edu

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  16. Severe Colonic Bleeding

    PubMed Central

    Smith, W. Russell; Berne, Clarence J.

    1964-01-01

    Patients requiring emergency operation for severe acute colonic hemorrhage usually arrive in the operating room inadequately studied and the point of bleeding not known. A well planned procedure for making an operative diagnosis is lacking. The fact that diverticular disease is the most common cause of massive colonic bleeding, dominates the surgical management of this problem. A critical interpretation of the color and the consistency of the stools must be made by the surgeon. Since the bleeding lesion is usually otherwise clinically silent, the character of the stools may be the only indication of the level of bleeding and the rate and the amount of the blood loss. A proctoscopic examination, followed by an emergency barium enema study if possible, is always done before subjecting a patient to laparotomy. The indications for emergency operation include acute exsanguinating hemorrhage, less severe but persistent colonic bleeding and recurrent colonic bleeding. The steps for the operative diagnosis and the surgical procedure utilized for a specific situation are discussed. PMID:14201233

  17. [Colonic histoplasmosis as a diagnostic manifestation of AIDS].

    PubMed

    Alva, Edgar; Vásquez, Jorge; Frisancho, Oscar; Yoza, Max; Yábar, Alejandro

    2010-01-01

    We report the case of 48 year old female patient without a history of significance importance.(refuses blood transfusion). She complaint of diarrhea of four months of duration and weight loss of 8 kg. she added episodes of hematochezia and severe anemia requiring transfusion. An intrahemorrhagic colonoscopy was performed detecting three ulcerated lesions. First at 10 cm from the anus, one in transverse colon distal, another similar ulcer in the proximal transverse The biopsies showed ulcer granulation tissue, abundant macrophages with intracytoplasmic structures consistent with histoplasmosis. Tests showed no tuberculosis or intestinal parasitosis. HIV testing (ELISA and Western Blot) were positive. The CD4 (78 cells) and extrapulmonary histoplasmosis were the criteria defined stage AIDS. The extrapulmonary histoplasmosis defines stage IV in immunosuppressed patients with HIV. Lower gastrointestinal bleeding colonic ulcer secondary to Histoplasma is a rare form presentation as a diagnostic manifestation of AIDS. PMID:20644610

  18. [Case Report of a Splenic Abscess Due to Colon Cancer].

    PubMed

    Suzuki, Katsunori; Akai, Toshiya; Nakamura, Koichi; Higashi, Yukihiro; Shoji, Tsuyoshi; Yamazaki, Masanori; Taniguchi, Masami; Nishiyama, Raisuke; Maruo, Hirotoshi

    2015-11-01

    The patient was a 63-year-old man with a chief complaint of fever and abdominal pain. He was admitted with the diagnosis of splenic abscess on enhanced abdominal computed tomography. After improvement of general condition, we planned a colonoscopy. However, the symptoms were not relieved, so we decided to perform splenectomy. The operative findings included a bulky mass at the splenic flexure, which involved the spleen and the pancreatic tail. Therefore, partial colectomy, splenectomy, and distal pancreatectomy were performed. The pathological examination revealed that the splenic abscess had not developed as a direct extension of the colon cancer but the cancer spread to the splenic hilus. Surgical resection is the first choice in the therapy of splenic abscess developing from colon cancer. PMID:26805319

  19. Distal Communication by Chimpanzees (Pan troglodytes): Evidence for Common Ground?

    PubMed Central

    Leavens, David A.; Reamer, Lisa A.; Mareno, Mary Catherine; Russell, Jamie L.; Wilson, Daniel; Schapiro, Steven J.; Hopkins, William D.

    2015-01-01

    van der Goot et al. (2014) proposed that distal, deictic communication indexed the appreciation of the psychological state of a common ground between a signaler and a receiver. In their study, great apes did not signal distally, which they construed as evidence for the human uniqueness of a sense of common ground. This study exposed 166 chimpanzees to food and an experimenter, at an angular displacement, to ask, “Do chimpanzees display distal communication?” Apes were categorized as (a) proximal or (b) distal signalers on each of four trials. The number of chimpanzees who communicated proximally did not statistically differ from the number who signaled distally. Therefore, contrary to the claim by van der Goot et al., apes do communicate distally. PMID:26292996

  20. Distal Communication by Chimpanzees (Pan troglodytes): Evidence for Common Ground?

    PubMed

    Leavens, David A; Reamer, Lisa A; Mareno, Mary Catherine; Russell, Jamie L; Wilson, Daniel; Schapiro, Steven J; Hopkins, William D

    2015-01-01

    van der Goot et al. (2014) proposed that distal, deictic communication indexed the appreciation of the psychological state of a common ground between a signaler and a receiver. In their study, great apes did not signal distally, which they construed as evidence for the human uniqueness of a sense of common ground. This study exposed 166 chimpanzees to food and an experimenter, at an angular displacement, to ask, "Do chimpanzees display distal communication?" Apes were categorized as (a) proximal or (b) distal signalers on each of four trials. The number of chimpanzees who communicated proximally did not statistically differ from the number who signaled distally. Therefore, contrary to the claim by van der Goot et al., apes do communicate distally. PMID:26292996

  1. Streptococcus Adherence and Colonization

    PubMed Central

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

    2009-01-01

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

  2. Neutropenic enterocolitis affecting the transverse colon: an unusual complication of chemotherapy

    PubMed Central

    Ramsingh, Jason; Bolln, Carsten; Hodnett, Robert; Al-Ani, Ahmed

    2014-01-01

    A 66-year-old woman presented with a 1-day history of sudden onset of generalised abdominal pain associated with fever and vomiting. She was previously diagnosed with left breast cancer 2 months ago and completed a course of chemotherapy 1 week prior to presentation. She was clinically unwell with generalised tenderness in her abdomen. Blood investigations showed severe neutropenia. A CT scan was requested which reported a marked oedematous swelling of the transverse colon with features suggestive of a contained perforation. The decision was made to operate. Intraoperatively, the transverse colon was found to be thickened with omentum adherent focally around the distal third. A right hemicolectomy was performed with an end ileostomy and mucus fistula. The patient made a successful recovery and was discharged within 7 days of presenting. Pathology reported typical features of neutropenic enterocolitis affecting the transverse colon with a normal terminal ileum, caecum and ascending colon. PMID:24792023

  3. The effect of microbial colonization on the host proteome varies by gastrointestinal location.

    PubMed

    Lichtman, Joshua S; Alsentzer, Emily; Jaffe, Mia; Sprockett, Daniel; Masutani, Evan; Ikwa, Elvis; Fragiadakis, Gabriela K; Clifford, David; Huang, Bevan Emma; Sonnenburg, Justin L; Huang, Kerwyn Casey; Elias, Joshua E

    2016-05-01

    Endogenous intestinal microbiota have wide-ranging and largely uncharacterized effects on host physiology. Here, we used reverse-phase liquid chromatography-coupled tandem mass spectrometry to define the mouse intestinal proteome in the stomach, jejunum, ileum, cecum and proximal colon under three colonization states: germ-free (GF), monocolonized with Bacteroides thetaiotaomicron and conventionally raised (CR). Our analysis revealed distinct proteomic abundance profiles along the gastrointestinal (GI) tract. Unsupervised clustering showed that host protein abundance primarily depended on GI location rather than colonization state and specific proteins and functions that defined these locations were identified by random forest classifications. K-means clustering of protein abundance across locations revealed substantial differences in host protein production between CR mice relative to GF and monocolonized mice. Finally, comparison with fecal proteomic data sets suggested that the identities of stool proteins are not biased to any region of the GI tract, but are substantially impacted by the microbiota in the distal colon. PMID:26574685

  4. Distal Xq duplication and functional Xq disomy

    PubMed Central

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

    2009-01-01

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

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

    PubMed

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

    1988-01-01

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

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

    PubMed Central

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

    1993-01-01

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

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

    PubMed

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

    1993-07-01

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

  8. Lung Adenocarcinoma Distally Rewires Hepatic Circadian Homeostasis.

    PubMed

    Masri, Selma; Papagiannakopoulos, Thales; Kinouchi, Kenichiro; Liu, Yu; Cervantes, Marlene; Baldi, Pierre; Jacks, Tyler; Sassone-Corsi, Paolo

    2016-05-01

    The circadian clock controls metabolic and physiological processes through finely tuned molecular mechanisms. The clock is remarkably plastic and adapts to exogenous "zeitgebers," such as light and nutrition. How a pathological condition in a given tissue influences systemic circadian homeostasis in other tissues remains an unanswered question of conceptual and biomedical importance. Here, we show that lung adenocarcinoma operates as an endogenous reorganizer of circadian metabolism. High-throughput transcriptomics and metabolomics revealed unique signatures of transcripts and metabolites cycling exclusively in livers of tumor-bearing mice. Remarkably, lung cancer has no effect on the core clock but rather reprograms hepatic metabolism through altered pro-inflammatory response via the STAT3-Socs3 pathway. This results in disruption of AKT, AMPK, and SREBP signaling, leading to altered insulin, glucose, and lipid metabolism. Thus, lung adenocarcinoma functions as a potent endogenous circadian organizer (ECO), which rewires the pathophysiological dimension of a distal tissue such as the liver. PAPERCLIP. PMID:27153497

  9. Transphyseal Fracture of the Distal Humerus.

    PubMed

    Abzug, Joshua M; Ho, Christine A; Ritzman, Todd F; Brighton, Brian K

    2016-02-01

    Transphyseal fractures of the distal humerus typically occur in children younger than 3 years secondary to birth trauma, nonaccidental trauma, or a fall from a small height. Prompt and accurate diagnosis of the injury is crucial for a successful outcome. Recognizing that the forearm is not aligned with the humerus on plain radiography can aid in the diagnosis of the injury. Surgical management is most commonly performed with the aid of an arthrogram. Closed reduction and percutaneous pinning techniques similar to those used for supracondylar humerus fractures are employed. The most common complication is cubitus varus caused by a malunion, osteonecrosis of the medial condyle, or growth arrest. A corrective lateral closing wedge osteotomy can be performed to restore a nearly normal carrying angle. PMID:26808044

  10. Laparoscopic Nephroureterectomy: The Distal Ureteral Dilemma

    PubMed Central

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

    2009-01-01

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

  11. Ethylene diamine tetraacetic acid induced colonic crypt cell hyperproliferation in rats

    PubMed Central

    Ma, Qing-Yong; Williamson, Kate E; Rowlands, Brian J

    2004-01-01

    AIM: To investigate the effect of ethylene diamine tetraacetic acid (EDTA) on proliferation of rat colonic cells. METHODS: EDTA was administered into Wistar rats, carcinogenesis induced by 1,2-dimethylhydrazine (DMH) in rats was studied with immunohistochemistry. RESULTS: Marked regional differences in cell proliferation were found in all groups. In EDTA-treated animals, total labelling indexes in both proximal (10.00 ± 0.44 vs 7.20 ± 0.45) and distal (11.05 ± 0.45 vs 8.65 ± 0.34) colon and proliferative zone size (21.67 ± 1.13 vs 16.75 ± 1.45, 27.73 ± 1.46 vs 21.74 ± 1.07) were significantly higher than that in normal controls (P < 0.05) and lower than that in DMH group (10.00 ± 0.44 vs 11.54 ± 0.45, 11.05 ± 0.45 vs 13.13 ± 0.46, 21.67 ± 1.13 vs 35.52 ± 1.58, 27.73 ± 1.46 vs 39.61 ± 1.32, P < 0.05). Cumulative frequency distributions showed a shift of the EDTA distal curve to the right (P < 0.05) while the EDTA proximal curve did not change compared to normal controls. Despite the changes of proliferative parameters, tumours did not develop in EDTA treated animals. CONCLUSION: Hyperproliferation appears to be more easily induced by EDTA in distal colon than in proximal colon. Hyperproliferation may need to exceed a threshold to develop colonic tumours. EDTA may work as a co-factor in colonic tumorigenesis. PMID:14716826

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

    SciTech Connect

    Yan, X. L.; Qu, Z. Q.; Kong, D. F.

    2012-07-20

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

  13. Association of Dietary Quercetin with Reduced Risk of Proximal Colon Cancer

    PubMed Central

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

    2012-01-01

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

  14. ALDH as a marker for enriching tumorigenic human colonic stem cells.

    PubMed

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

    2012-01-01

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

  15. Automatic segmentation of the colon

    NASA Astrophysics Data System (ADS)

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

    1999-05-01

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

  16. Resurfacing the distal radioulnar joint with rib perichondrium-a novel method.

    PubMed

    Vedung, Torbjörn; Vinnars, Bertil

    2014-08-01

    Background Osteoarthritis in the distal radioulnar joint (DRUJ) is a challenging condition with few really reliable surgical options, particularly in young individuals. Traditional methods as hemiresection, the Darrach procedure, and the Sauvé-Kapandji procedure have less favorable results in the nonrheumatoid patient. The results after implant arthroplasty have improved, but long-term results are yet to be presented before implant arthroplasty can be recommended to young individuals with osteoarthritis in the DRUJ. An alternative method to treat osteoarthritic joints is surface replacement with free costal perichondrium. The technique has been used since the 1970s for other joints. Case Description We adapted the method and used it in two female patients (37 and 38 years old) with nontraumatic osteoarthritis in the DRUJ. Both patients had severe pain and were unable to work. The eroded joint surfaces were resected down to bleeding subchondral cortex. Perichondrium from the seventh rib was osteo-sutured and glued to the ulnar head and the sigmoid notch. Results The maximum follow-up-time in this retrospective review is 25 months. Our short-term results are encouraging in terms of pain relief, motion, grip strength, and return to work. The first patient had an excellent result and was completely normalized. The second patient has improved significantly and experiences only slight pain on heavy lifting and rotational load. Clinical Relevance Free costal perichondrium may be a useful alternative for treating osteoarthritis in the DRUJ, especially in young individuals. The option for a later implant arthroplasty is preserved because most of the anatomy of the joint and all the soft tissue stabilizers are intact. Level of Evidence Therapeutic IV, Case series. PMID:25097816

  17. Resurfacing the Distal Radioulnar Joint with Rib Perichondrium–A Novel Method

    PubMed Central

    Vedung, Torbjörn; Vinnars, Bertil

    2014-01-01

    Background Osteoarthritis in the distal radioulnar joint (DRUJ) is a challenging condition with few really reliable surgical options, particularly in young individuals. Traditional methods as hemiresection, the Darrach procedure, and the Sauvé-Kapandji procedure have less favorable results in the nonrheumatoid patient. The results after implant arthroplasty have improved, but long-term results are yet to be presented before implant arthroplasty can be recommended to young individuals with osteoarthritis in the DRUJ. An alternative method to treat osteoarthritic joints is surface replacement with free costal perichondrium. The technique has been used since the 1970s for other joints. Case Description We adapted the method and used it in two female patients (37 and 38 years old) with nontraumatic osteoarthritis in the DRUJ. Both patients had severe pain and were unable to work. The eroded joint surfaces were resected down to bleeding subchondral cortex. Perichondrium from the seventh rib was osteo-sutured and glued to the ulnar head and the sigmoid notch. Results The maximum follow-up-time in this retrospective review is 25 months. Our short-term results are encouraging in terms of pain relief, motion, grip strength, and return to work. The first patient had an excellent result and was completely normalized. The second patient has improved significantly and experiences only slight pain on heavy lifting and rotational load. Clinical Relevance Free costal perichondrium may be a useful alternative for treating osteoarthritis in the DRUJ, especially in young individuals. The option for a later implant arthroplasty is preserved because most of the anatomy of the joint and all the soft tissue stabilizers are intact. Level of Evidence Therapeutic IV, Case series PMID:25097816

  18. Difficult colon polypectomy

    PubMed Central

    Vormbrock, Klaus; Mnkemller, Klaus

    2012-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  20. Young Children's Sibling Relationship Quality: Distal and Proximal Correlates

    ERIC Educational Resources Information Center

    Kretschmer, Tina; Pike, Alison

    2009-01-01

    Background: Relationships within families are interdependent and related to distal environmental factors. Low socioeconomic status (SES) and high household chaos (distal factors) have been linked to less positive marital and parent-child relationships, but have not yet been examined with regard to young children's sibling relationships. The…

  1. Distal Prosodic Context Affects Word Segmentation and Lexical Processing

    ERIC Educational Resources Information Center

    Dilley, Laura C.; McAuley, J. Devin

    2008-01-01

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

  2. Proximal versus Distal Validity Coefficients for Teacher Observational Instruments

    ERIC Educational Resources Information Center

    Marzano, Robert J.

    2014-01-01

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

  3. Laparoscopic treatment of colovesical fistulas due to complicated colonic diverticular disease: a systematic review.

    PubMed

    Cirocchi, R; Cochetti, G; Randolph, J; Listorti, C; Castellani, E; Renzi, C; Mearini, E; Fingerhut, A

    2014-10-01

    Colovesical fistulas originating from complicated sigmoid diverticular disease are rare. The primary aim of this review was to evaluate the role of laparoscopic surgery in the treatment of this complication. The secondary aim was to determine the best surgical treatment for this disease. A systematic search was conducted for studies published between 1992 and 2012 in PubMed, the Cochrane Register of Controlled Clinical Trials, Scopus, and Publish or Perish. Studies enrolling adults undergoing fully laparoscopic, laparoscopic-assisted, or hand-assisted laparoscopic surgery for colovesical fistula secondary to complicated sigmoid diverticular disease were considered. Data extracted concerned the surgical technique, intraoperative outcomes, and postoperative outcomes based on the Cochrane Consumers and Communication Review Group's template. Descriptive statistics were reported according to the PRISMA statement. In all, 202 patients from 25 studies were included in this review. The standard treatment was laparoscopic colonic resection and primary anastomosis or temporary colostomy with or without resection of the bladder wall. Operative time ranged from 150 to 321 min. It was not possible to evaluate the conversion rate to open surgery because colovesical fistulas were not distinguished from other types of enteric fistulas in most of the studies. One anastomotic leak after bowel anastomosis was reported. There was zero mortality. Few studies conducted follow-up longer than 12 months. One patient required two reoperations. Laparoscopic treatment of colovesical fistulas secondary to sigmoid diverticular disease appears to be a feasible and safe approach. However, further studies are needed to establish whether laparoscopy is preferable to other surgical approaches. PMID:24848529

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

    PubMed

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

    2015-10-01

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

  5. Specialized junction in the distal convoluted tubule of rat kidney.

    PubMed

    Giacomelli, F; Wiener, J

    1976-06-01

    The ultrastructure and permeability of the apical junctions between epithelial cells of the distal nephron have been studied in rat kidney using a collidal lanthanum tracer and uranyl acetate staining en bloc. The apical intercellular junctions of the macula densa and juxtaglomerular segment of the early distal convoluted tubule measure up to 0.5 mu in length and about 50 A in width. Lanthanum permeates the occluding portion of these junctions in a discontinuous manner, defining a series of closely spaced and parallel lines of fusion that run in a direction perpendicular to the apical-basal axis of the tubular cells. The apical junctions of the remainder of the distal convoluted and cortical collecting tubules are impermeable bolanthanum. This distinctive apical tight junction can account for the greater permeability to ions of the early distal convoluted vs. late distal convoluted and cortical collecting tubules. PMID:58570

  6. Insights into the mechanics of en-échelon sigmoidal vein formation using ultra-high resolution photogrammetry and computed tomography

    NASA Astrophysics Data System (ADS)

    Thiele, Samuel T.; Micklethwaite, Steven; Bourke, Paul; Verrall, Michael; Kovesi, Peter

    2015-08-01

    Two novel techniques, photo based reconstruction (photogrammetry) and computed tomography (CT), are used to investigate the formation of an exceptional array of sigmoidal veins in a hand sample from Cape Liptrap, Southern Victoria, and to provide constraint on models for their development. The accuracies of the photogrammetric models were tested by comparison with a laser scan generated three dimensional (3D) model. The photogrammetric model was found to be accurate to at least 0.25 mm and substantially more detailed than the laser scan. A methodology was developed by which 3D structural measurements could be extracted from the photogrammetric model. This was augmented with the CT model which, through its capacity to elucidate internal structure, was used to constrain the geometry and linkage of structures within the rock volume. The photogrammetric and CT data were then combined with detailed photomicrographs to evaluate the evolution of the sigmoidal veins in the sample. The angle between the sigmoidal vein margins and an inferred shear zone, as well as the orientations of the crystal fibres, were found to imply a rotation of >27°. However coeval pressure solution seams and older veinlets in the rock bridges between the veins were only found to have rotated by ˜10°, an observation not easily explained using existing models for sigmoidal vein formation. A new model is proposed in which a significant component of sigmoidal vein geometry is due to localised dilation caused by slip on the pressure solution seams. The process involves strain partitioning onto pressure solution seams, which leads to exaggeration of sigmoidal vein geometries. If not accounted for, the apparent vein rotation due to slip partitioning introduces errors into calculations of simple shear and volume strain based on sigmoidal arrays of this type. Furthermore, the CT data demonstrated that in 3D the veins are continuous and channel-like, implying a far higher degree of connectivity and fluid transport than is suggested by their 2D form.

  7. Fulminant Pseudomembranous Colitis Presenting as Sigmoid Stricture and Severe Polyposis with Clinical Response to Intracolonic Vancomycin

    PubMed Central

    Li, Kin Kong

    2016-01-01

    Clostridium difficile infection (CDI) is the most common cause of antibiotic-associated diarrhea. Severe diseases carry significant morbidities such as septic shock, acute kidney injury, bowel perforation, and mortality. Immunocompromising conditions increase the risk of developing the disease but whether these individuals suffer a more fulminant course or warrant a more potent first-line treatment is still controversial issue. Hereby we report a case of a cirrhotic patient with life-threatening pseudomembranous colitis complicated by colonic stricture, initially refractory to standard treatment but with subsequent improvement on intracolonic vancomycin. PMID:27034681

  8. A 3-Dimensional Anatomic Study of the Distal Biceps Tendon

    PubMed Central

    Walton, Christine; Li, Zhi; Pennings, Amanda; Agur, Anne; Elmaraghy, Amr

    2015-01-01

    Background Complete rupture of the distal biceps tendon from its osseous attachment is most often treated with operative intervention. Knowledge of the overall tendon morphology as well as the orientation of the collagenous fibers throughout the musculotendinous junction are key to intraoperative decision making and surgical technique in both the acute and chronic setting. Unfortunately, there is little information available in the literature. Purpose To comprehensively describe the morphology of the distal biceps tendon. Study Design Descriptive laboratory study. Methods The distal biceps terminal musculature, musculotendinous junction, and tendon were digitized in 10 cadaveric specimens and data reconstructed using 3-dimensional modeling. Results The average length, width, and thickness of the external distal biceps tendon were found to be 63.0, 6.0, and 3.0 mm, respectively. A unique expansion of the tendon fibers within the distal muscle was characterized, creating a thick collagenous network along the central component between the long and short heads. Conclusion This study documents the morphologic parameters of the native distal biceps tendon. Reconstruction may be necessary, especially in chronic distal biceps tendon ruptures, if the remaining tendon morphology is significantly compromised compared with the native distal biceps tendon. Knowledge of normal anatomical distal biceps tendon parameters may also guide the selection of a substitute graft with similar morphological characteristics. Clinical Relevance A thorough description of distal biceps tendon morphology is important to guide intraoperative decision making between primary repair and reconstruction and to better select the most appropriate graft. The detailed description of the tendinous expansion into the muscle may provide insight into better graft-weaving and suture-grasping techniques to maximize proximal graft incorporation. PMID:26665092

  9. Clinical Features and Treatment of Distal Intracranial Aneurysms.

    PubMed

    Mou, Kejie; Zhou, Zheng; Yin, Jinbo; Yang, Hui; Liu, Jun

    2016-05-01

    To analyze the clinical characteristics, therapies, and outcomes of distal intracranial aneurysms, the authors retrospectively studied the clinical and imaging data of 18 patients with distal intracranial aneurysms. There were 10 males and 8 females, aged from 11 months to 59 years (mean, 40.4 ± 11.4 years). All patients were diagnosed by digital subtract angiography. Aneurysm locations were as follows: distal anterior cerebral artery (n = 5), distal middle cerebral artery (n = 2), distal posterior cerebral artery (n = 6), distal posterior inferior cerebellar artery (n = 3), distal anterior inferior cerebellar artery (n = 1), and distal superior cerebellar artery (n = 1). Endovascular embolization was performed on 16 patients, including coil embolization on 10 patients and embolization using Glubran 2 surgical glue on 6 patients, and 7 of the 16 patients also underwent parent artery occlusion. Aneurysms were all completely embolized at the first phase for these 16 patients. The other 2 patients underwent craniotomy with hematoma evacuation and complete aneurysm clipping. Postoperatively, 14 patients showed a good recovery, 2 patients had neurological deficits, 1 patient had seizures and was managed with drugs, 1 patient developed hydrocephalus, and a ventriculo-peritoneal shunt was performed. Follow-up angiographies showed no aneurysm recurrence. Clinical manifestations of distal intracranial aneurysms are varied. Their treatment should follow the principle of individual choice. Endovascular embolization is an effective way to treat distal intracranial aneurysms; and for those with intracranial hematoma, craniotomy with hematoma evacuation and aneurysm clipping may be a feasible treatment. PMID:26982109

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

    PubMed

    Estrella, Sora M; Masero, José A

    2007-11-01

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

  11. Intrapancreatic bile duct metastasis from colon cancer after resection of liver metastasis with intrabiliary growth: a case report.

    PubMed

    Kawakatsu, Shoji; Kaneoka, Yuji; Maeda, Atsuyuki; Takayama, Yuichi; Fukami, Yasuyuki; Onoe, Shunsuke

    2015-01-01

    An extremely rare case of intrapancreatic bile duct metastasis from sigmoid colon adenocarcinoma is herein presented. Sigmoid colon cancer (T3, N0, M0, stage IIA) had been diagnosed and treated by sigmoidectomy in October 1993. In December 2002, a liver metastasis with intrabiliary growth was found, and this was treated by extended right hepatic lobectomy and caudate lobectomy with extrahepatic bile duct resection. In February 2014, intrapancreatic bile duct metastasis was found, and this was treated by subtotal stomach-preserving pancreatoduodenectomy. The intrapancreatic metastasis was judged to have arisen from cancer cell implantation, either by spontaneous shedding of cancer cells or as a complication of percutaneous transhepatic biliary drainage. Twelve months have passed since the last surgical intervention, and there has been no sign of local recurrence or distant metastasis. Differential diagnosis between intrahepatic cholangiocarcinoma and intrabiliary growth of a liver metastasis originating from colorectal adenocarcinoma is difficult but very important for determining the therapeutic strategy. Careful examination is needed to diagnose intrahepatic biliary dilatation, especially for patients with a history of carcinoma in the digestive tract and even if years have passed since curative resection of the digestive tract cancer. Aggressive surgical management for localized recurrence of a hepatic metastasis from colorectal adenocarcinoma may improve patient survival. PMID:26293132

  12. Genome-wide association and fine mapping of genetic loci predisposing to colon carcinogenesis in mice.

    PubMed

    Liu, Pengyuan; Lu, Yan; Liu, Hongbo; Wen, Weidong; Jia, Dongmei; Wang, Yian; You, Ming

    2012-01-01

    To identify the genetic determinants of colon tumorigenesis, 268 male mice from 33 inbred strains derived from different genealogies were treated with azoxymethane (AOM; 10 mg/kg) once a week for six weeks to induce colon tumors. Tumors were localized exclusively within the distal colon in each of the strains examined. Inbred mouse strains exhibit a large variability in genetic susceptibility to AOM-induced colon tumorigenesis. The mean colon tumor multiplicity ranged from 0 to 38.6 (mean = 6.5 8.6) and tumor volume ranged from 0 to 706.5 mm(3) (mean = 87.4 181.9) at 24 weeks after the first dose of AOM. AOM-induced colon tumor phenotypes are highly heritable in inbred mice, and 68.8% and 71.3% of total phenotypic variation in colon tumor multiplicity and tumor volume, respectively, are attributable to strain-dependent genetic background. Using 97,854 single-nucleotide polymorphisms, we carried out a genome-wide association study (GWAS) of AOM-induced colon tumorigenesis and identified a novel susceptibility locus on chromosome 15 (rs32359607, P = 6.31 10(-6)). Subsequent fine mapping confirmed five (Scc3, Scc2, Scc12, Scc8, and Ccs1) of 16 linkage regions previously found to be associated with colon tumor susceptibility. These five loci were refined to less than 1 Mb genomic regions of interest. Major candidates in these loci are Sema5a, Fmn2, Grem2, Fap, Gsg1l, Xpo6, Rabep2, Eif3c, Unc5d, and Gpr65. In particular, the refined Scc3 locus shows high concordance with the human GWAS locus that underlies hereditary mixed polyposis syndrome. These findings increase our understanding of the complex genetics of colon tumorigenesis, and provide important insights into the pathways of colorectal cancer development and might ultimately lead to more effective individually targeted cancer prevention strategies. PMID:22127497

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  14. Mitotoxicity in distal symmetrical sensory peripheral neuropathies

    PubMed Central

    Bennett, Gary J.; Doyle, Timothy; Salvemini, Daniela

    2016-01-01

    Chronic distal symmetrical sensory peripheral neuropathy is a common neurological complication of cancer chemotherapy, HIV treatment and diabetes. Although aetiology-specific differences in presentation are evident, the clinical signs and symptoms of these neuropathies are clearly similar. Data from animal models of neuropathic pain suggest that the similarities have a common cause: mitochondrial dysfunction in primary afferent sensory neurons. Mitochondrial dysfunction is caused by mitotoxic effects of cancer chemotherapeutic drugs of several chemical classes, HIV-associated viral proteins, and nucleoside reverse transcriptase inhibitor treatment, as well as the (possibly both direct and indirect) effects of excess glucose. The mitochondrial injury results in a chronic neuronal energy deficit, which gives rise to spontaneous nerve impulses and a compartmental neuronal degeneration that is first apparent in the terminal receptor arbor—that is, intraepidermal nerve fibres—of cutaneous afferent neurons. Preliminary data suggest that drugs that prevent mitochondrial injury or improve mitochondrial function could be useful in the treatment of these conditions. PMID:24840972

  15. C6-Modifications on chitosan to develop chitosan-based glycopolymers and their lectin-affinities with sigmoidal binding profiles.

    PubMed

    Koshiji, Kazuhiro; Nonaka, Yuki; Iwamura, Maho; Dai, Fumiko; Matsuoka, Ryoji; Hasegawa, Teruaki

    2016-02-10

    Chitosan-based glycopolymers having multiple β-lactosides exclusively at their C6-positions were successfully synthesized from partially deacetylated chitin through perfect N-deacetylation/phthaloylation and C6-selective bromination/azidation to afford 6-azide-6-deoxy-N-phthaloyl-chitosan and the subsequent Cu(+)-catalyzed Huisgen cycloadditions using alkyne-terminated β-lactoside and/or quaternary ammonium modules followed by dephthaloylations. Lectin-affinities of the resultant chitosan-based glycopolymers were assessed through fluorescence titration assays to show their unique sigmoidal binding profiles with amplified binding constants. PMID:26686131

  16. A case of fatal sigmoid volvulus visualized on postmortem radiography: The importance of image optimization with multidetector computed tomography.

    PubMed

    Usui, Akihito; Kawasumi, Yusuke; Hosokai, Yoshiyuki; Ishizuka, Yuya; Ikeda, Tomoya; Saito, Haruo; Funayama, Masato

    2016-03-01

    This report describes the case of a man who developed fatal sigmoid volvulus that was identified on postmortem radiography before forensic autopsy. Postmortem radiography is useful for visualizing the body prior to autopsy. We discuss postmortem multidetector computed tomography that was tailored for optimum image quality to allow reconstruction of the fatal findings in multiple axes and in three dimensions, helping to pinpoint the anatomical sites of interest. This involves techniques such as manipulation of the scanning beam pitch and overlapping CT section acquisition. These techniques are best performed by personnel with CT technology training. PMID:26980251

  17. A sigmoid function is the best fit for the ascending limb of the Hoffmann reflex recruitment curve.

    PubMed

    Klimstra, Marc; Zehr, E Paul

    2008-03-01

    The Hoffmann (H)-reflex has been studied extensively as a measure of spinal excitability. Often, researchers compare the H-reflex between experimental conditions with values determined from a recruitment curve (RC). An RC is obtained experimentally by varying the stimulus intensity to a nerve and recording the peak-to-peak amplitudes of the evoked H-reflex and direct motor (M)-wave. The values taken from an RC may provide different information with respect to a change in reflex excitability. Therefore, it is important to obtain a number of RC parameters for comparison. RCs can be obtained with a measure of current (HCRC) or without current (HMRC). The ascending limb of the RC is then fit with a mathematical analysis technique in order to determine parameters of interest such as the threshold of activation and the slope of the function. The purpose of this study was to determine an unbiased estimate of the specific parameters of interest in an RC through mathematical analysis. We hypothesized that a standardized analysis technique could be used to ascertain important points on an RC, regardless of data presentation methodology (HCRC or HMRC). For both HCRC and HMRC produced using 40 randomly delivered stimuli, six different methods of mathematical analysis [linear regression, polynomial, smoothing spline, general least squares model with custom logistic (sigmoid) equation, power, and logarithmic] were compared using goodness of fit statistics (r-square, RMSE). Behaviour and robustness of selected curve fits were examined in various applications including RCs generated during movement and somatosensory conditioning from published data. Results show that a sigmoid function is the most reliable estimate of the ascending limb of an H-reflex recruitment curve for both HCRC and HMRC. Further, the parameters of interest change differentially with respect to the presentation methodology and the analysis technique. In conclusion, the sigmoid function is a reliable analysis technique which mimics the physiologically based prediction of the input/output relation of the ascending limb of the recruitment curve. Therefore, the sigmoid function should be considered an acceptable and preferable analytical tool for H-reflex recruitment curves obtained with reference to stimulation current or M-wave amplitude. PMID:18046545

  18. Excitation of rat colonic afferent fibres by 5-HT3 receptors

    PubMed Central

    Hicks, Gareth A; Coldwell, Jonathan R; Schindler, Marcus; Bland Ward, Philip A; Jenkins, David; Lynn, Penny A; Humphrey, Patrick P A; Blackshaw, L Ashley

    2002-01-01

    The gastrointestinal tract contains most of the body's 5-hydroxytryptamine (5-HT) and releases large amounts after meals or exposure to toxins. Increased 5-HT release occurs in patients with irritable bowel syndrome (IBS) and their peak plasma 5-HT levels correlate with pain episodes. 5-HT3 receptor antagonists reduce symptoms of IBS clinically, but their site of action is unclear and the potential for other therapeutic targets is unexplored. Here we investigated effects of 5-HT on sensory afferents from the colon and the expression of 5-HT3 receptors on their cell bodies in the dorsal root ganglia (DRG). Distal colon, inferior mesenteric ganglion and the lumbar splanchnic nerve bundle (LSN) were placed in a specialized organ bath. Eighty-six single fibres were recorded from the LSN. Three classes of primary afferents were found: 70 high-threshold serosal afferents, four low-threshold muscular afferents and 12 mucosal afferents. Afferent cell bodies were retrogradely labelled from the distal colon to the lumbar DRG, where they were processed for 5-HT3 receptor-like immunoreactivity. Fifty-six percent of colonic afferents responded to 5-HT (between 10?6 and 10?3 M) and 30 % responded to the selective 5-HT3 agonist, 2-methyl-5-HT (between 10?6 and 10?2 M). Responses to 2-methyl-5-HT were blocked by the 5-HT3 receptor antagonist alosetron (2 10?7 M), whereas responses to 5-HT were only partly inhibited. Twenty-six percent of L1 DRG cell bodies retrogradely labelled from the colon displayed 5-HT3 receptor-like immunoreactivity. We conclude that colonic sensory neurones expressing 5-HT3 receptors also functionally express the receptors at their peripheral endings. Our data reveal actions of 5-HT on colonic afferent endings via both 5-HT3 and non-5-HT3 receptors. PMID:12411529

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2008-01-01

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

  1. Fungal infection of the colon

    PubMed Central

    Praneenararat, Surat

    2014-01-01

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

  2. CARE—Pediatric Colon Adenocarcinoma

    PubMed Central

    Koh, King-Jun; Lin, Lung-Huang; Huang, Shih-Hung; Wong, Jia-Uei

    2015-01-01

    Abstract Colon carcinoma is a rare disease in the pediatric population. Here is a report on a 17-year-old male adolescent with colon adenocarcinoma who presented with recurrent epigastric colic pain for 1 month. Diagnostic laparoscopic surgery revealed a 3.2 × 3 cm tumor at the ascending colon, with serosal involvement and peritoneal metastasis. Clinical differences of colorectal carcinoma among children and adults are reviewed and summarized. PMID:25674743

  3. [Laparoscopic colon surgery].

    PubMed

    Waninger, Jrg

    2005-05-19

    Such a wealth of experience with the laparoscopic surgery has since been gained in specialized centers that laparoscopic colon surgery can now be recommended for the treatment of both benign and malignant diseases of the large bowel and rectum. Faster postoperative recovery, a shorter hospital stay and the presumably superior oncological results are not only patient-friendly, but also pass muster in terms of economics. In the future, there will be a greater concentration of such interventions in specialized centers, since only in such facilities can the required quality and further advances be expected. PMID:15957856

  4. [Effects of low anterior resection on colonic motor activity and defecation. An experimental study].

    PubMed

    Iikura, M

    1995-06-01

    The functional disorder of defecation after low anterior resection (LAR) was studied from the aspect of colonic motility in an experiment with dogs using a strain gage transducer, and the following results were obtained: 1) In early phase after LAR, the frequency of the colonic contractile waves increased at the proximal and distal sites of the anastomosis in both subgroups of dogs denervated and innervated of hypogastric and pelvic nerves. The increase was more remarkable at the distal site of the anastomosis. Also, the contractile waves were not propagated across the anastomosis. 2) After LAR, strong colonic contractions occurred during defecation only at the distal anastomosis. Various patterns of contraction time required for defecation were demonstrated as compared to a single pattern in control dogs. 3) The frequency of the occurrence of colonic contractile waves and the propagation of the contraction tended to be normalized with time after LAR both in denervated and innervated groups, though the recovery was faster in the latter subgroup. 4) The frequency of defecation increased after LAR both in denervated and innervated groups compared to be in the control dogs, though more remarkable in the denervated groups. Although tended to be gradually normalized with time after LAR, the colectomized dogs required a long time for normalization of the frequency of defecation. These results suggested the significant effect of reduction in reservoir space and disturbed continuity of intramural plexus caused by colectomy. Less severity, however, of functional disorder of defecation and earlier recovery from colonic motility disorder in the subgroup of the dogs innervated of autonomic nerves indicated usefulness of retaining autonomic nerves in colectomy. PMID:8563059

  5. Haustral boundary contractions in the proximal 3-taeniated rabbit colon.

    PubMed

    Chen, Ji-Hong; Yang, Zixian; Yu, Yuanjie; Huizinga, Jan D

    2016-02-01

    The rabbit proximal colon is similar in structure to the human colon. Our objective was to study interactions of different rhythmic motor patterns focusing on haustral boundary contractions, which create the haustra, using spatiotemporal mapping of video recordings. Haustral boundary contractions were seen as highly rhythmic circumferential ring contractions that propagated slowly across the proximal colon, preferentially but not exclusively in the anal direction, at ∼0.5 cycles per minute; they were abolished by nerve conduction blockers. When multiple haustral boundary contractions propagated in the opposite direction, they annihilated each other upon encounter. Ripples, myogenic propagating ring contractions at ∼9 cycles per min, induced folding and unfolding of haustral muscle folds, creating an anarchic appearance of contractile activity, with different patterns in the three intertaenial regions. Two features of ripple activity were prominent: frequent changes in propagation direction and the occurrence of dislocations showing a frequency gradient with the highest intrinsic frequency in the distal colon. The haustral boundary contractions showed an on/off/on/off pattern at the ripple frequency, and the contraction amplitude at any point of the colon showed waxing and waning. The haustral boundary contractions are therefore shaped by interaction of two pacemaker activities hypothesized to occur through phase-amplitude coupling of pacemaker activities from interstitial cells of Cajal of the myenteric plexus and of the submuscular plexus. Video evidence shows the unique role haustral folds play in shaping contractile activity within the haustra. Muscarinic agents not only enhance the force of contraction, they can eliminate one and at the same time induce another neurally dependent motor pattern. PMID:26635318

  6. Cellular mechanism of mechanotranscription in colonic smooth muscle cells

    PubMed Central

    Li, Feng; Lin, You-Min; Sarna, Sushil K.

    2012-01-01

    Mechanical stretch in obstruction induces expression of cyclooxygenase-2 (COX-2) in gut smooth muscle cells (SMCs). The stretch-induced COX-2 plays a critical role in motility dysfunction in obstructive bowel disorders (OBDs). The aims of the present study were to investigate the intracellular mechanism of mechanotranscription of COX-2 in colonic SMCs and to determine whether inhibition of mechanotranscription has therapeutic benefits in OBDs. Static stretch was mimicked in vitro in primary culture of rat colonic circular SMCs (RCCSMCs) and in colonic circular muscle strips. Partial obstruction was surgically induced with a silicon band in the distal colon of rats and COX-2-deficient mice. Static stretch of RCCSMCs significantly induced expression of COX-2 mRNA and protein and activated MAP kinases ERKs, p38, and JNKs. ERKs inhibitor PD98059, p38 inhibitor SB203580, and JNKs inhibitor SP600125 significantly blocked stretch-induced COX-2 expression. Pharmacological and molecular inhibition of stretch-activated ion channels (SACs) and integrins significantly suppressed stretch-induced expression of COX-2. SAC blockers inhibited stretch-activated ERKs, p38, and JNKs, but inhibition of integrins attenuated p38 activation only. In colonic circular muscle strips, stretch led to activation of MAPKs, induction of COX-2, and suppression of contractility. Inhibition of p38 with SB203580 blocked COX-2 expression and restored muscle contractility. Administration of SB203580 in vivo inhibited obstruction-induced COX-2 and improved motility function. Stretch-induced expression of COX-2 in RCCSMCs depends on mechanosensors, SACs, and integrins and an intracellular signaling mechanism involving MAPKs ERKs, p38, and JNKs. Inhibitors of the mechanotranscription pathway have therapeutic potentials for OBDs. PMID:22700825

  7. Long term outcome following surgical treatment for distal gastric cancer.

    PubMed

    Mocan, Lucian; Tomus, Claudiu; Bartos, Dana; Zaharie, Florin; Ioana, Ilie; Bartos, Adrian; Puia, Cosmin; Necula, Alexandru; Mocan, Teodora; Iancu, Cornel

    2013-03-01

    BACKGROUND. At the current time, the belief that total gastrectomy (TG) offers a better survival benefit compared with distal gastrectomy (DG) in distal gastric cancer still persists among many surgeons. The aim of the study was to determine whether TG in patients with distal stomach cancer offers a benefit in long term survival compared with DG. METHODS. Data on 180 consecutive patients with adenocarcinoma of the distal stomach that underwent surgery during the period 2000-2003 were analyzed. Distal gastrectomy was performed on 91 patients (50.5%), and 89 patients (49.5%) underwent TG. RESULTS. The postoperative morbidity (anastomotic leakage, intraperitoneal hemorrhage and pulmonary complications) was significantly higher in the TG group than in the DG group. The TG group had a significantly higher rate of 30-day postoperative mortality than DG group, and a longer mean postoperative hospital stay. The 5-year survival rate was significantly higher for the DG group than for the TG group. The number of lymph node metastases and TNM stages are significant predictors of poor survival. CONCLUSIONS. Compared with patients undergoing TG, a better long-term survival time, lower postoperative morbidity and mortality rates and a lower hospitalization stay was obtained in patients that underwent DG for distal gastric cancer. This observation justifies the use of this procedure for the surgical therapy of the cancer of distal stomach. PMID:23539391

  8. Resection Interposition Arthroplasty for Failed Distal Ulna Resections

    PubMed Central

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

    2013-01-01

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

  9. Distal Insertions of the Biceps Femoris

    PubMed Central

    Branch, Eric A.; Anz, Adam W.

    2015-01-01

    Background: Avulsion of the biceps femoris from the fibula and proximal tibia is encountered in clinical practice. While the anatomy of the primary posterolateral corner structures has been qualitatively and quantitatively described, a quantitative analysis regarding the insertions of the biceps femoris on the fibula and proximal tibia is lacking. Purpose: To quantitatively assess the insertions of the biceps femoris, fibular collateral ligament (FCL), and anterolateral ligament (ALL) on the fibula and proximal tibia as well as establish relationships among these structures and to pertinent surgical anatomy. Study Design: Descriptive laboratory study. Methods: Dissections were performed on 12 nonpaired, fresh-frozen cadaveric specimens identifying the biceps femoris, FCL, and ALL, and their insertions on the proximal tibia and fibula. The footprint areas, orientations, and distances from relevant osseous landmarks were measured using a 3-dimensional coordinate measurement device. Results: Dissection produced 6 easily identifiable and reproducible anatomic footprints. Tibial footprints included the insertion of the ALL and an insertion of the biceps femoris (TBF). Fibular footprints included the insertion of the FCL, a distal insertion of the biceps femoris (DBF), a medial footprint of the biceps femoris (MBF), and a proximal footprint of the biceps femoris (PBF). The mean area of these footprints (95% CI) was as follows: ALL, 53.0 mm2 (38.4-67.6); TBF, 93.9 mm2 (72.0-115.8); FCL, 86.8 mm2 (72.3-101.2); DBF, 119 mm2 (91.1-146.9); MBF, 46.8 mm2 (29.0-64.5); and PBF, 215 mm2 (192.4-237.5). The mean distance (95% CI) from the Gerdy tubercle to the center of the ALL footprint was 24.3 mm (21.6-27.0) and to the center of the TBF was 22.5 mm (21.0-24.0). The center of the DBF was 8.68 mm (7.0-10.3) from the anterior border of the fibula, the center of the FCL was 14.6 mm (12.5-16.7) from the anterior border of the fibula and 20.7 mm (19.0-22.4) from the tip of the fibular styloid, and the center of the PBF was 8.96 mm (8.2-9.7) from the tip of the fibular styloid. Conclusion: A tibial footprint, distal fibular footprint, medial fibular footprint, and proximal fibular footprint were all consistent components of the insertion of the biceps femoris. Consistent relationships existed between the biceps femoris and insertions of the ALL and FCL. Clinical Relevance: The size of these footprints and distances from pertinent surgical landmarks will guide repairs of biceps femoris avulsion injuries. PMID:26535398

  10. Computational Modeling of Distal Protection Filters

    PubMed Central

    Siewiorek, Gail M.; Finol, Ender A.

    2010-01-01

    Purpose: To quantify the relationship between velocity and pressure gradient in a distal protection filter (DPF) and to determine the feasibility of modeling a DPF as a permeable surface using computational fluid dynamics (CFD). Methods: Four DPFs (Spider RX, FilterWire EZ, RX Accunet, and Emboshield) were deployed in a single tube representing the internal carotid artery (ICA) in an in vitro flow apparatus. Steady flow of a blood-like solution was circulated with a peristaltic pump and compliance chamber. The flow rate through each DPF was measured at physiological pressure gradients, and permeability was calculated using Darcy's equation. Two computational models representing the RX Accunet were created: an actual representation of the filter geometry and a circular permeable surface. The permeability of RX Accunet was assigned to the surface, and CFD simulations were conducted with both models using experimentally derived boundary conditions. Results: Spider RX had the largest permeability while RX Accunet was the least permeable filter. CFD modeling of RX Accunet and the permeable surface resulted in excellent agreement with the experimental measurements of velocity and pressure gradient. However, the permeable surface model did not accurately reproduce local flow patterns near the DPF deployment site. Conclusion: CFD can be used to model DPFs, yielding global flow parameters measured with bench-top experiments. CFD models of the detailed DPF geometry could be used for “virtual testing” of device designs under simulated flow conditions, which would have potential benefits in decreasing the number of design iterations leading up to in vivo testing. PMID:21142490

  11. Quantitative shape measurements of distal volcanic ash

    NASA Astrophysics Data System (ADS)

    Riley, Colleen M.; Rose, William I.; Bluth, Gregg J. S.

    2003-10-01

    Large-scale volcanic eruptions produce fine ash (<200 μm) which has a long atmospheric residence time (1 hour or more) and can be transported great distances from the volcanic source, thus, becoming a hazard to aircraft and public health. Ash particles have irregular shapes, so data on particle shape, size, and terminal velocities are needed to understand how the irregular-shaped particles affect transport processes and radiative transfer measurements. In this study, a methodology was developed to characterize particle shapes, sizes, and terminal velocities for three ash samples of different compositions. The shape and size of 2500 particles from (1) distal fallout (˜100 km) of the 14 October 1974 Fuego eruption (basaltic), (2) the secondary maxima (˜250 km) of the 18 August 1992 Spurr eruption (andesitic), and (3) the Miocene Ash Hollow member, Nebraska (rhyolitic) were measured using image analysis techniques. Samples were sorted into 10 to 19 terminal velocity groups (0.6-59.0 cm/s) using an air elutriation device. Grain-size distributions for the samples were measured using laser diffraction. Aspect ratio, feret diameter, and perimeter measurements were found to be the most useful descriptors of how particle shape affects terminal velocity. These measurement values show particle shape differs greatly from a sphere (commonly used in models and algorithms). The diameters of ash particles were 10-120% larger than ideal spheres at the same terminal velocity, indicating that irregular particle shape greatly increases drag. Gas-adsorption derived surface areas are 1 to 2 orders of magnitude higher than calculated surface areas based on measured dimensions and simple geometry, indicating that particle shapes are highly irregular. Correction factors for surface area were derived from the ash sample measurements so that surface areas calculated by assuming spherical particle shapes can be corrected to reflect more realistic values.

  12. Pathways to Colonization

    NASA Technical Reports Server (NTRS)

    Smitherman, David V., Jr.

    2003-01-01

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

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

    PubMed Central

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

    1989-01-01

    An uncommon variety of non familial, juvenile onset, spinal muscular atrophy with asymmetric distal upper extremity affection is described. One hundred and two patients with a one to 14 year follow up are analysed. Spinal muscular atrophies with a distal distribution are rare. However, in the past three decades, previously unrecognised varieties of neurogenic muscular atrophy have been described in Asia (Japan, India, Sri Lanka and Singapore) under a variety of names. These provide interesting data for discussion of Asian neurogenic muscular atrophies with distal affection, in the context of diseases of the motor neuron. Images PMID:2926413

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

    NASA Astrophysics Data System (ADS)

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

    2015-07-01

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

  15. Primary nonunion of the distal radius fractures in healthy children.

    PubMed

    Song, Kwang Soon; Lee, Si Wook; Bae, Ki Cheor; Yeon, Chang Jin; Naik, Premal

    2016-03-01

    There are no published case series of nonunion of distal radius fractures in healthy children because of the rarity of its occurrence. We searched for all reported cases of this condition in Pubmed, Google scholar, and SCOPUS. We found three series, which included one previously reported by our group. The aim of the present study was to define the predisposing factors leading to nonunion after treatment of distal radius fractures in healthy children. We also aimed to emphasize that nonunion should be included in the list of complications of distal radius fractures in children and be mentioned in the textbook of pediatric trauma. PMID:26583931

  16. Inter-relationships between inflammatory mediators released from colonic mucosa in ulcerative colitis and their effects on colonic secretion.

    PubMed Central

    Wardle, T D; Hall, L; Turnberg, L A

    1993-01-01

    Metabolites of arachidonic acid have been implicated in the pathophysiology of ulcerative colitis-they can stimulate intestinal secretion, increase mucosal blood flow, and influence smooth muscle activity. The influence on the mucosal transport function of culture medium in which colonic mucosal biopsy specimens had been incubated was investigated using rat stripped distal colonic mucosa in vitro as the assay system. Colonic tissue from patients with colitis and from control subjects was cultured. Medium from inflamed tissue contained more prostaglandin E2 (PGE2) and leukotriene D4 (LTD4) and evoked a greater electrical (secretory) response in rat colonic mucosa than control tissue medium. In inflamed tissue, cyclo-oxygenase inhibition (indomethacin) attenuated PGE2 but increased LTD4 production; conversely lipoxygenase inhibition (ICI 207968) inhibited LTD4 production but enhanced PGE2 output. Each inhibitor alone enhanced the electrical response in the rat colon. Inhibition of both enzymes (indomethacin plus ICI 207968) caused a fall in both PGE2 (82%) and LTD4 (89%) production and in the electrical response (57%). Inflamed tissue treated with a phospholipase A2 inhibitor (mepacrine) produced less PGE2, LTD4, and electrical responses when compared with inflamed tissue, either untreated (91%, 92%, and 79% respectively) or treated with cyclo-oxygenase and lipoxygenase inhibition. Incubation with bradykinin stimulated eicosanoid release and electrical response, while a bradykinin antagonist caused a modest inhibition. Analysis of these observations suggests that a combination of arachidonic acid derivatives accounts for about half the secretory response. Other products of phospholipase A2 activity are probably responsible for much of the remainder, leaving up to 20% the result of types of mediator not determined in this study. PMID:8491398

  17. Retention mucocele of distal viable remnant tip of appendix: An unusually rare late surgical complication following incomplete appendectomy

    PubMed Central

    Johnson, Maria Antony; Jyotibasu, Damodaran; Ravichandran, Palaniappan; Jeswanth, Satyanesan; Kannan, Devy Gounder; Surendran, Rajagopal

    2006-01-01

    A 67-year old man was presented with a 6-mo history of recurrent right lower quadrant abdominal pain. On physical examination, a vague mass was palpable in the right lumbar region. His routine laboratory tests were normal. Ultrasonography showed a hypoechoic lesion in the right lumbar region anterior to the right kidney with internal echoes and fluid components. Abdominal contrast-enhanced computed tomography (CECT) showed a well-defined hypodense cystic mass lesion lateral to the ascending colon/caecum, not communicating with the lumen of colon/caecum. After complete open excision of the cystic mass lesion, gross pathologic examination revealed a turgid cystic dilatation of appendiceal remnant filled with the mucinous material. On histopathological examination, mucinous cyst adenoma of appendix was confirmed. We report this rare unusual late complication of mucocele formation in the distal viable appendiceal remnant, which was leftover following incomplete retrograde appendectomy. This unusual complication is not described in the literature and we report it in order to highlight the fact that a high index of clinical and radiological suspicion is essential for the diagnosis of mucocele arising from a distal viable appendiceal remnant in a patient who has already undergone appendectomy presenting with recurrent abdominal pain. PMID:16489657

  18. Perirenal hematoma in a patient treated with bevacizumab for metastatic colon cancer: A case report

    PubMed Central

    LEE, MIN SUNG; SHIN, IL SANG; KWUN, DO HYUNG; KIM, SE HYUNG; KIM, HYUN JUNG; KIM, CHAN KYU; PARK, SEONG KYU; HONG, DAE SIK; YUN, JINA

    2016-01-01

    The present study reports the case of a patient that developed spontaneous perirenal hematoma during treatment with bevacizumab-containing chemotherapy. A 44-year-old woman with metastatic sigmoid colon cancer, who was being treated with bevacizumab (5 mg/kg, intravenous, 90 min biweekly), was admitted to hospital following 3 cycles of chemotherapy, with a sudden onset of dyspnea and oliguria. An emergency hemodialysis was performed and a large right perirenal hematoma was diagnosed using computed tomography. The patient was immediately instructed to discontinue chemotherapy, including bevacizumab. However, the right perirenal hematoma increased in size and a left perirenal hematoma developed 3 weeks later. The two perirenal hematomas stabilized 7 weeks subsequent to the termination of bevacizumab treatment. Spontaneous perirenal hematoma due to bevacizumab treatment is an extremely rare occurrence. However, physicians should be aware of this potential complication associated with bevacizumab treatment. PMID:27123092

  19. A vaginal drain of a pelvic abscess due to colonic diverticulitis

    PubMed Central

    Milone, Marco; Sosa Fernandez, Miguel Emilio; Venetucci, Piero; Maietta, Paola; Sosa Fernandez, Loredana Maria; Taffuri, Caterina; Milone, Francesco

    2013-01-01

    Although well recognized for tubo-ovarian abscesses, we report, in our best knowledge, the first case of a vaginal drain of a pelvic abscess due to colonic diverticulitis. A 78-year-old patient presented with abdominal and pelvic pain, fever (39.3 °C) and an elevated white blood cell count (18500/mL). After abdominopelvic computed tomography the patient was presumed to have a pelvic abscess, which developed as a complication of the sigmoid diverticulitis. Due to the numerous intervening structures that create obstacles to safe percutaneous access, we planned a trans-vaginal drain. A rapid recovery was obtained within 2 d from the procedure and, at present, the follow-up was uneventful after 18 mo. We believe that transvaginal drain of pelvic abscess could be a useful alternative, when percutaneous approach is not feasible. PMID:24303472

  20. Structurally Well-Defined Sigmoidal Gold Clusters: Probing the Correlation between Metal Atom Arrangement and Chiroptical Response.

    PubMed

    He, Xin; Wang, Yuechao; Jiang, Hong; Zhao, Liang

    2016-05-01

    Asymmetric arrangement of metal atoms is crucial for understanding the chirality origin of chiral metal nanoclusters and facilitating the design and development of new chiral catalysts and chiroptical devices. Here, we describe the construction of four asymmetric gold and gold-silver clusters by chirality transfer from diimido ligands. The acquired metal clusters show strong circular dichroism (CD) response with large anisotropy factors of up to 6 × 10(-3), larger than the values of most reported chiral gold nanoclusters. Regardless of the same absolute configuration of the applied three diimido ligands, sigmoidal and reverse-sigmoidal arrangements of gold atoms both can be achieved, which resultantly produce an opposite Cotton effect within a specific absorption range. On the basis of the detailed structural characterization via X-ray crystallography and contrast experiments, the chirality contribution of the imido ligand, the asymmetrically arranged metal cluster, and the chiral arrangement of aromatic rings of phosphine ligands have been qualitatively evaluated. Time-dependent DFT calculations reveal that the chiroptical property of the acquired metal clusters is mainly influenced by the asymmetrically arranged metal atoms. Correlation of asymmetric arrangements of metal atoms in clusters with their chiroptical response provides a viable means of fabricating a designable chiral surface of metal nanoclusters and opens a broader prospect for chiral cluster application. PMID:27070415

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

    SciTech Connect

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

    2013-06-15

    We present an observation of overlying coronal loop contraction and rotating motion of the sigmoid filament during its eruption on 2012 May 22 observed by the Solar Dynamics Observatory (SDO). Our results show that the twist can be transported into the filament from the lower atmosphere to the higher atmosphere. The successive contraction of the coronal loops was due to a suddenly reduced magnetic pressure underneath the filament, which was caused by the rising of the filament. Before the sigmoid filament eruption, there was a counterclockwise flow in the photosphere at the right feet of the filament and the contraction loops and a convergence flow at the left foot of the filament. The hot and cool materials have inverse motion along the filament before the filament eruption. Moreover, two coronal loops overlying the filament first experienced brightening, expansion, and contraction successively. At the beginning of the rising and rotation of the left part of the filament, the second coronal loop exhibited rapid contraction. The top of the second coronal loop also showed counterclockwise rotation during the contraction process. After the contraction of the second loop, the left part of the filament rotated counterclockwise and expanded toward the right of NOAA AR 11485. During the filament expansion, the right part of the filament also exhibited counterclockwise rotation like a tornado.

  2. Albite porphyroblasts with sigmoidal inclusion trails and their kinematic implications: an example from the Taconic Allochthon, west-central Vermont

    NASA Astrophysics Data System (ADS)

    Chan, Yu-Chang; Crespi, Jean M.

    1999-10-01

    Microstructural analyses of albite porphyroblasts in phyllite of the Taconic Allochthon were conducted in order to determine the origin of the sigmoidal inclusion trails within the porphyroblasts and to evaluate if and when the porphyroblasts rotated during the deformation history. Three cleavages ( S2, S3, and S4) with similar strike are present in the phyllite. The albite porphyroblasts are characterized by inclusion-rich cores and inclusion-free rims, and the boundary between the cores and overgrowths is characterized by relatively straight and parallel zones of concentrated rutile. The sigmoidal inclusion trails within the cores are inferred to be trapped microfolds. The zones of concentrated rutile are interpreted to be truncation planes that formed during the development of S3. In contrast to the tight orientation distribution of S3, the truncation planes show a wide distribution pattern. The mean orientations of S3 and the truncation planes also differ. These orientation data indicate that the porphyroblasts have not only rotated with respect to S3 but also to the geographic reference frame. In addition, the growth of the porphyroblasts was influenced by differentiation associated with S3 crenulation cleavage formation; the porphyroblasts grew preferentially within microlithon domains where chlorite, a reactant mineral for the porphyroblasts, is abundant.

  3. Diagnostics and Therapy for Malignant (Degenerate) Colon Endometriosis – Three Case Reports

    PubMed Central

    Schutz, R.; Woziwodzki, J.; Schweppe, K.-W.

    2016-01-01

    Malignant degeneration of colon endometriosis is a very rare event. We report here on three cases. A 48-year-old woman with a 10-year history of endometriosis was treated for a rectal adenocarcinoma, a 61-year-old G1P1, who was operated at the age of 40 years for ovarian endometriosis and again at the age of 53 years for an endometriosis-associated endometroid ovarian carcinoma, presented for therapy for a lymph node recurrence of the ovarian cancer and, secondly, due to a malignantly degenerated rectum-sigmoid colon endometriosis; furthermore a 54-year old woman with a 21-year history of endometriosis was operated for malignant colon endometriosis. The tumour occurred during an adjuvant anti-oestrogen treatment with an aromatase inhibitor following surgical and radiotherapy for breast cancer. In all cases a radical cancer operation was followed by adjuvant chemotherapy and in one case with an additional radiotherapy. In the follow-up periods of 18 months, 2 and 5 years, respectively, all women remained free of recurrences. Although this is not a randomised controlled study due to the rare occurrence of such cases, a radical operation followed by individualised adjuvant therapy appears to be the treatment of choice. PMID:27134299

  4. Increased absorption of polyethylene glycol 600 deposited in the colon in active ulcerative colitis.

    PubMed

    Almer, S; Franzén, L; Olaison, G; Smedh, K; Ström, M

    1993-04-01

    A defect in the barrier function of the intestinal mucosa has been proposed as important in both the pathogenesis and systemic manifestations of inflammatory bowel disease. After colonoscopy, polymers of polyethylene glycol (PEG) with molecular weights of 414-810 (mean 600), were instilled in the descending colon of patients with ulcerative colitis (n = 17) and in controls without intestinal inflammation (n = 8). The patients with active ulcerative colitis (n = 6) had a significantly increased uptake of PEGs in the molecular weight range 458-810, measured as urinary excretion over the first 6 hours after instillation. The median values for their excretion were 2.85-3.80% of PEGs instilled compared with 0.32-0.94% for patients in remission (n = 11) (p < 0.05-0.01) and 0.17-0.60% for the controls (p < 0.05-0.01). The differences in absorption of PEG 414 did not reach the present level of statistical significance. There was a positive correlation between PEG absorption and the endoscopic and histological grading of inflammatory activity in the sigmoid colon (p < 0.01-0.001). These findings support a correlation between the presence of active inflammation and PEG absorption. There was little evidence to support the presence of a primary defect in the colonic barrier in patients with ulcerative colitis. PMID:8491399

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

    2014-01-01

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

  7. Human Colon-Derived Soluble Factors Modulate Gut Microbiota Composition

    PubMed Central

    Hevia, Arancha; Bernardo, David; Montalvillo, Enrique; Al-Hassi, Hafid O.; Fernández-Salazar, Luis; Garrote, Jose A.; Milani, Christian; Ventura, Marco; Arranz, Eduardo; Knight, Stella C.; Margolles, Abelardo; Sánchez, Borja

    2015-01-01

    The commensal microbiota modulates immunological and metabolic aspects of the intestinal mucosa contributing to development of human gut diseases including inflammatory bowel disease. The host/microbiota interaction often referred to as a crosstalk, mainly focuses on the effect of the microbiota on the host neglecting effects that the host could elicit on the commensals. Colonic microenvironments from three human healthy controls (obtained from the proximal and distal colon, both in resting conditions and after immune – IL-15- and microbiota – LPS-in vitro challenges) were used to condition a stable fecal population. Subsequent 16S rRNA gene-based analyses were performed to study the effect induced by the host on the microbiota composition and function. Non-supervised principal component analysis (PCA) showed that all microbiotas, which had been conditioned with colonic microenvironments clustered together in terms of relative microbial composition, suggesting that soluble factors were modulating a stable fecal population independently from the treatment or the origin. Our findings confirmed that the host intestinal microenvironment has the capacity to modulate the gut microbiota composition via yet unidentified soluble factors. These findings indicate that an appropriate understanding of the factors of the host mucosal microenvironment affecting microbiota composition and function could improve therapeutic manipulation of the microbiota composition. PMID:25918688

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

    PubMed Central

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

    2011-01-01

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

  9. Anatomically correct deformable colon phantom

    NASA Astrophysics Data System (ADS)

    Norris, James A.; Barton, Michael D.; Davis, Brynmor J.; Bieszczad, Jerry; Meunier, Norm L.; Brown, Nathan W.; Kynor, David B.

    2011-03-01

    We describe a technique to build a soft-walled colon phantom that provides realistic lumen anatomy in computed tomography (CT) images. The technique begins with the geometry of a human colon measured during CT colonography (CTC). The three-dimensional air-filled colonic lumen is segmented and then replicated using stereolithography (SLA). The rigid SLA model includes large-scale features (e.g., haustral folds and tenia coli bands) down to small-scale features (e.g., a small pedunculated polyp). Since the rigid model represents the internal air-filled volume, a highly-pliable silicone polymer is painted onto the rigid model. This thin layer of silicone, when removed, becomes the colon wall. Small 3 mm diameter glass beads are affixed to the outer wall. These glass beads show up with high intensity in CT scans and provide a ground truth for evaluating performance of algorithms designed to register prone and supine CTC data sets. After curing, the silicone colon wall is peeled off the rigid model. The resulting colon phantom is filled with air and submerged in a water bath. CT images and intraluminal fly-through reconstructions from CTC scans of the colon phantom are compared against patient data to demonstrate the ability of the phantom to simulate a human colon.

  10. Colonic cancer and Crohn's disease

    PubMed Central

    Jones, J. Hywel

    1969-01-01

    Four patients with both carcinoma and Crohn's disease of the colon are reported. Other cases in the world literature are summarized and the relationship between the two diseases is discussed. It is concluded that present evidence does not establish an increased risk of malignancy in colonic Crohn's disease. ImagesFIG. 1 PMID:5810976

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

    PubMed

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

    2015-01-01

    Physical activity is associated with a reduced risk of colorectal cancer. We examined the colon transit time (CTT) according to the total energy expenditure (TEE) in psychiatry unit patients. The study participants included 67 adults, with a mean age of 49.8 years. The participants used an accelerometer for 7 days to measure their 1-week TEE. They took a capsule containing 20 radio-opaque markers for 3 days. On the 4th day and 7th day, a supine abdominal radiography was performed. According to the TEE of all study participants, the upper 30%, middle 30%, and lower 40% were classified into groups according to high (H), moderate (M), and low (L) physical activity. The mean total CTT was 52.0 hours. The segmental CTT for the right, left, and recto-sigmoid colon were 15.3 hours, 19.2 hours, and 17.4 hours. Total CTT in the H group was significantly shorter than that in the L group (p = .010). A comparison of the segmental CTT between the L, M, and H groups showed that the right CTT (p = .010) of the H group was significantly shorter than that of the M group. The left CTT of the M group (p = .028) and H group (p = .004) was significantly shorter than that of the L group. The recto-sigmoid CTT (p = .016) of the M group was significantly shorter than that of the L group. The study showed that moderate and high TEE was assisted with reduced CTT. PMID:25181498

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

    PubMed Central

    Kim, Yeon Soo; Lee, On; Kwon, Hyun Jin

    2015-01-01

    Physical activity is associated with a reduced risk of colorectal cancer. We examined the colon transit time (CTT) according to the total energy expenditure (TEE) in psychiatry unit patients. The study participants included 67 adults, with a mean age of 49.8 years. The participants used an accelerometer for 7 days to measure their 1-week TEE. They took a capsule containing 20 radio-opaque markers for 3 days. On the 4th day and 7th day, a supine abdominal radiography was performed. According to the TEE of all study participants, the upper 30%, middle 30%, and lower 40% were classified into groups according to high (H), moderate (M), and low (L) physical activity. The mean total CTT was 52.0 hours. The segmental CTT for the right, left, and recto-sigmoid colon were 15.3 hours, 19.2 hours, and 17.4 hours. Total CTT in the H group was significantly shorter than that in the L group (p = .010). A comparison of the segmental CTT between the L, M, and H groups showed that the right CTT (p = .010) of the H group was significantly shorter than that of the M group. The left CTT of the M group (p = .028) and H group (p = .004) was significantly shorter than that of the L group. The recto-sigmoid CTT (p = .016) of the M group was significantly shorter than that of the L group. The study showed that moderate and high TEE was assisted with reduced CTT. PMID:25181498

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

    PubMed

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

    2009-07-01

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

  14. Reconstruction with distally based dorsalis pedis fasciocutaneous flap for the coverage of distal toe-plantar defects.

    PubMed

    Emsen, Ilteris Murat

    2012-01-01

    Reconstruction of small defects in the distal portion of the foot has always been a difficult problem. A case involving 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 fasciocutaneous flap, is presented. The donor site area of the dorsum of the foot was grafted, and deambulation was reassumed three weeks later. Advantages, limits and anatomical consideration regarding the viability of the flap are also discussed. PMID:23730161

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

    ERIC Educational Resources Information Center

    Rodriguez-Soriano, J.; And Others

    1975-01-01

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

  16. Distally based sural artery flap without sural nerve.

    PubMed

    Motamed, Sadrollah; Yavari, Masood; Mofrad, Hamid Reza Hallaj; Rafiee, Reza; Shahraki, Feaz Niazi

    2010-01-01

    The distal third of the tibia, ankle and heel area is difficult to reconstruct. For small to medium size defects, local flaps are often an easier alternative than free flap. In lower limb surgery, the sural flap is based on this principle and this flap is becoming increasingly popular. The distally based superficial sural artery flap, first described as a distally based neuro skin flap by masquelet et al., is a skin island flap supplied by the vascular axis of the sural nerve. The main disadvantage of distally based sural artery flap is sacrifice of the sural nerve because it is described the concept of neurocutaneus island flap. We describe one case of reverse sural flap without sural nerve .The aim of this paper is to establish the reliability of this flap even without sural nerve. PMID:21133008

  17. Hereditary and Familial Colon Cancer

    PubMed Central

    Jasperson, Kory W.; Tuohy, Thérèse M.; Neklason, Deborah W.; Burt, Randall W.

    2011-01-01

    Between 2% to 5% of all colon cancers arise in the setting of well defined inherited syndromes, including Lynch syndrome, familial adenomatous polyposis, MUTYH-associated polyposis, and certain hamartomatous polyposis conditions. Each is associated with a high risk of colon cancer. In addition to the syndromes, up to one-third of colon cancers exhibit increased familial risk, likely related to inheritance. A number of less penetrant, but possibly more frequent susceptibility genes have been identified for this level of inheritance. Clarification of predisposing genes allows for accurate risk assessment and more precise screening approaches. This review examines the colon cancer syndromes, their genetics and management, and also the common familial colon cancers with current genetic advances and screening guidelines. PMID:20420945

  18. The role of multidetector CT in local staging and evaluation of retroperitoneal surgical margin involvement in colon cancer

    PubMed Central

    Elibol, Funda Dinç; Obuz, Funda; Sökmen, Selman; Terzi, Cem; Canda, Aras Emre; Sağol, Özg