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Endoscopy May 2024Adenoma detection rate (ADR) is an important indicator of colonoscopy quality and colorectal cancer incidence. Both linked-color imaging (LCI) with artificial... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Adenoma detection rate (ADR) is an important indicator of colonoscopy quality and colorectal cancer incidence. Both linked-color imaging (LCI) with artificial intelligence (LCA) and LCI alone increase adenoma detection during colonoscopy, although it remains unclear whether one modality is superior. This study compared ADR between LCA and LCI alone, including according to endoscopists' experience (experts and trainees) and polyp size.
METHODS
Patients undergoing colonoscopy for positive fecal immunochemical tests, follow-up of colon polyps, and abdominal symptoms at a single institution were randomly assigned to the LCA or LCI group. ADR, adenoma per colonoscopy (APC), cecal intubation time, withdrawal time, number of adenomas per location, and adenoma size were compared.
RESULTS
The LCA (n=400) and LCI (n=400) groups showed comparable cecal intubation and withdrawal times. The LCA group showed a significantly higher ADR (58.8% vs. 43.5%; P<0.001) and mean (95%CI) APC (1.31 [1.15 to 1.47] vs. 0.94 [0.80 to 1.07]; P<0.001), particularly in the ascending colon (0.30 [0.24 to 0.36] vs. 0.20 [0.15 to 0.25]; P=0.02). Total number of nonpolypoid-type adenomas was also significantly higher in the LCA group (0.15 [0.09 to 0.20] vs. 0.08 [0.05 to 0.10]; P=0.02). Small polyps (≤5, 6-9mm) were detected significantly more frequently in the LCA group (0.75 [0.64 to 0.86] vs. 0.48 [0.40 to 0.57], P<0.001 and 0.34 [0.26 to 0.41] vs. 0.24 [0.18 to 0.29], P=0.04, respectively). In both groups, ADR was not significantly different between experts and trainees.
CONCLUSIONS
LCA was significantly superior to LCI alone in terms of ADR.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Adenoma; Artificial Intelligence; Colonic Neoplasms; Colonic Polyps; Colonoscopy; Colorectal Neoplasms
PubMed: 38191000
DOI: 10.1055/a-2239-8145 -
PloS One 2024Recent magnetic resonance imaging (MRI) studies showed that colonic volumes in children are different between health and functional constipation. The length of the colon...
Recent magnetic resonance imaging (MRI) studies showed that colonic volumes in children are different between health and functional constipation. The length of the colon has however been rarely measured and principally using unphysiological colon preparations or cadaver studies. The main objective of this study was to measure the length of the undisturbed colon in children with functional constipation (FC) and healthy controls. Here, the colon of 19 healthy controls (10-18 years old) and 16 children with FC (7-18 years old) was imaged using MRI. Different regions of the colon (ascending, transverse, descending, and sigmoid-rectum) were first segmented manually on the MRI images. Three-dimensional skeletonization image analysis methods were then used to reduce the regions of interest to a central, measurable line. Total colon length (corrected for body surface area) in healthy controls was 56±2 cm/m2 (mean±SEM). Total colon length was significantly longer in children with FC 69±3 cm/m2 compared to controls (p = 0.0037). The colon regions showing the largest differences between groups were the ascending colon (p = 0.0479) and the sigmoid-rectum (p = 0.0003). In a linear regression model, there was a positive significant correlation between total colon length and age (R = 0.45, p = 0.0064), height (R = 0.49, p = 0.0031), weight (R = 0.46, p = 0.0059) and colon volume (R = 0.4543, p = 0.0061). Our findings showed significant differences in colon lengths between healthy controls and children with constipation. A new objective diagnostic imaging endpoint such as colon length may help to improve knowledge of colon morphology and function and, in turn, understanding of colon functional pathology.
Topics: Humans; Child; Adolescent; Colon; Constipation; Colon, Sigmoid; Rectum; Magnetic Resonance Imaging
PubMed: 38165858
DOI: 10.1371/journal.pone.0296311 -
International Journal of Molecular... Nov 2023This study aimed to determine the effects of Zn sources, used with potato fiber (PF) or lignocellulose (LC), on electrolyte concentration and the mucus layer in the...
Comparison between Organic and Inorganic Zinc Forms and Their Combinations with Various Dietary Fibers in Respect of the Effects on Electrolyte Concentrations and Mucosa in the Large Intestine of Pigs.
This study aimed to determine the effects of Zn sources, used with potato fiber (PF) or lignocellulose (LC), on electrolyte concentration and the mucus layer in the large intestine of pigs. The experiment involved 24 barrows with an initial body weight of 10.8 ± 0.82 kg, divided into four groups fed the following diets: LC and ZnSO, LC and Zn glycinate (ZnGly), PF and ZnSO, or PF and ZnGly. Fiber supplements provided 10 g crude fiber/kg diet, while Zn additives introduced 120 mg Zn/kg diet. After four weeks of feeding, the pigs were sacrificed and digesta and tissue samples were taken from the cecum and colon. PF increased the water content and decreased the phosphorus concentration in the large intestine in comparison with LC. PF also increased calcium, iron, and chloride concentrations in the descending colon. Mucus layer thickness and histological parameters of the large intestine were not affected. ZnGly diets increased expression in the cecum as compared to the LC-ZnSO group. In the ascending colon, the PF-ZnGly diet increased expression, while both PF groups had greater expression in comparison with the LC-ZnSO group. In the transverse colon, the LC-ZnGly group and both PF groups had higher expression in comparison with the LC-ZnSO group, and both ZnGly groups had higher expression than ZnSO groups. PF and ZnGly increased and expression in the descending colon. PF and ZnGly may exert a beneficial effect on colon health in pigs by upregulating the expression of the and genes and are more effective than LC and ZnSO.
Topics: Swine; Animals; Zinc; Zinc Sulfate; Dietary Fiber; Dietary Supplements; Diet; Intestine, Large; Electrolytes; Mucous Membrane; Animal Feed
PubMed: 38069066
DOI: 10.3390/ijms242316743 -
Revista Medica Del Instituto Mexicano... Sep 2023The colon has two different embryological origins, which is why it can be divided into right and left with different characteristics each one; therefore, neoplastic... (Observational Study)
Observational Study
BACKGROUND
The colon has two different embryological origins, which is why it can be divided into right and left with different characteristics each one; therefore, neoplastic lesions have a different clinical picture and are also associated with different pathologies.
OBJECTIVE
To describe the clinical and histopathological characteristics of malignant colon tumors acording to their location.
MATERIAL AND METHODS
Descriptive, retrospective study with 94 patients diagnosed with colon cancer. Descriptive statistics were performed with the calculation of frequencies and percentages, and chi-squared tests were calculated.
RESULTS
Mean age was 61.3 years, 49 (52.1%) were women; 53 (56.4%) were left-sided and 41 (43.6%) right-sided. The main symptom was hematochezia in 32 (60.4%), in patients with left cancer; and diarrhea in 20 (48.8%), in patients with right-sided colon cancer. The presentation of stage I tumors and polyps, p = 0.044 and p = 0.043, respectively, was more frequent on the right side compared to the left side; in the left, hematochezia (p = 0.001), narrow stools(p = 0.05), and a history of type 2 diabetes mellitus (T2DM) (p= 0.036) were more frequent compared to the opposite site.
CONCLUSIONS
Stage I and the presence of polyps were more frequent in right-sided cancer compared to left-sided cancer; T2DM, as well as hematochezia and narrow stools were more associated with the left side compared to the right side.
Topics: Humans; Female; Middle Aged; Male; Retrospective Studies; Diabetes Mellitus, Type 2; Colonic Neoplasms; Gastrointestinal Hemorrhage; Neoplasm Staging; Prognosis
PubMed: 37769029
DOI: 10.5281/zenodo.8316446 -
Radiology Case Reports May 2024A rare case of an ascending colon injury and ileal perforation in a 34-year-old male patient due to blunt abdominal trauma caused by a road traffic accident is reported...
A rare case of an ascending colon injury and ileal perforation in a 34-year-old male patient due to blunt abdominal trauma caused by a road traffic accident is reported in this study. This paper reports the clinical and imaging findings of seat belt syndrome. The seat belt syndrome primarily involves soft tissue injury; however, lacerations of the colon, small intestine, and mesentery have rarely been reported in the literature. However intestinal injuries, including bowel perforation and mesenteric injuries due to seat belt syndrome, must not be underestimated because they usually require emergency laparotomy because of accompanying peritonitis and hemorrhaging, and can be lethal if left untreated. Therefore, when an ascending mesocolon hematoma and free gas in the peritoneal cavity are present, gastrointestinal perforation due to seat belt syndrome should be suspected. In this case, gastrointestinal perforation was suspected based on the computed tomography findings, and emergency surgery was performed; the patient's course was uneventful without any postoperative complications. Early diagnosis and management are essential to prevent associated morbidity and mortality.
PubMed: 38390424
DOI: 10.1016/j.radcr.2024.01.090 -
Food & Function Dec 2023Herein, we studied the -simulated intestinal flora fermentation of polysaccharides (PHPs) with microwave, ultrasonic, ultra-high pressure-assisted extraction and the...
-simulated intestinal flora fermentation of polysaccharides obtained by different assisted extractions and their fermented products against HT-29 human colon cancer cells.
Herein, we studied the -simulated intestinal flora fermentation of polysaccharides (PHPs) with microwave, ultrasonic, ultra-high pressure-assisted extraction and the protective effect of their fermented products against HT-29 human colon cancer cells. The results showed that PHPs were largely degraded at the 18 h stage of ascending colon fermentation, further greatly increasing the contents of reducing sugars and short-chain fatty acids ( < 0.05). Particularly, the PHPs subjected to ultra-high pressure-assisted extraction (UHP-PHP) showed the highest reducing sugar content of 1.68 ± 0.01 mg mL and butyric acid content of 410.77 ± 7.99 mmol mL. Moreover, UHP-PHP showed a better effect in increasing the ratio of / and decreasing the abundance of and . PHPs could protect against HT-29 cells by increasing the ROS levels in a concentration-dependent manner, especially UHP-PHP fermented in a descending colon for 24 h. This was related to the up-regulated apoptosis-related genes (Bax and Bak), down-regulated protein expression of Bcl-2 and activation of the -AKT protein, thereby promoting the apoptosis of HT-29 cells. Our results can facilitate the modification of PHPs and their practical application in the development of intestinal health improving products.
Topics: Humans; Gastrointestinal Microbiome; HT29 Cells; Porphyra; Fermentation; Polysaccharides; Colonic Neoplasms; Butyric Acid
PubMed: 37975749
DOI: 10.1039/d3fo04421a -
Gan To Kagaku Ryoho. Cancer &... Oct 2023A 78-year-old male was diagnosed with a primary gastric B-cell malignant lymphoma and metastatic lung tumor 10 years ago. He underwent chemotherapy at another hospital,...
A 78-year-old male was diagnosed with a primary gastric B-cell malignant lymphoma and metastatic lung tumor 10 years ago. He underwent chemotherapy at another hospital, achieved complete remission, and was actively undergoing follow- up. He presented to our hospital with a 1-month history of a bulge in his right lower abdomen. CT revealed thickening of the ascending colon and dilatation of the oral intestine. He was diagnosed with ascending colon cancer and underwent right hemicolectomy. The subsequent pathological examination revealed a collision tumor involving diffuse, large B-cell lymphoma and well-differentiated adenocarcinoma. He was discharged from our hospital and received chemotherapy at another institution. Unfortunately, the patient died of interstitial pneumonia 31 months postoperatively. This report describes the resection of a collision tumor involving ascending colon cancer and malignant lymphoma. Surgical treatment combined with postoperative chemotherapy improved this patient's long-term survival.
Topics: Male; Humans; Aged; Colon, Ascending; Colonic Neoplasms; Lymphoma, Large B-Cell, Diffuse; Adenocarcinoma
PubMed: 38035839
DOI: No ID Found -
Life Sciences Nov 2023This study investigated the regenerative efficacy of leukocyte platelet-rich fibrin (L-PRF) on colon anastomotic healing in rabbits.
AIM
This study investigated the regenerative efficacy of leukocyte platelet-rich fibrin (L-PRF) on colon anastomotic healing in rabbits.
MAIN METHODS
Thirty-six healthy male white New Zealand rabbits were subjected to complete transactions of the ascending colon. The rabbits were equally divided into two groups: the control group, where the transected colon ends were anastomosed by a simple interrupted suture pattern, and the L-PRF-treated group, in which L-PRF was wrapped entirely around the anastomotic line. The postoperative acute pain scale was assessed using the Bristol Rabbit Pain Scale before surgery and at each four-hour interval post-operatively. After euthanizing the rabbits, the adhesion degree score, anastomotic bursting pressure, and stenosis degree of the anastomotic colon were assessed, and histopathological examination at the 7th, 14th, and 28th days postoperatively.
KEY FINDINGS
Rabbits in both groups showed a significant increase in pain scores compared to baseline. Postoperatively, the L-PRF group exhibited significantly lower pain scores, adhesion scores, and stenosis degrees than the control group. However, the anastomotic bursting pressure was significantly higher in the L-PRF group. Re-epithelialization, polymorphonuclear neutrophil infiltration, granulation tissue formation, and collagen deposition scores were improved considerably in the L-PRF group compared to the control group. Immunostaining of growth factor expression was significantly lower in the control than in the L-PRF group.
SIGNIFICANCE
The L-PRF can augment collagen deposition, re-epithelialize the mucosa, promote angiogenesis, reduce adhesions, and diminish the stenosis degree scores. Therefore, it can be considered a promising aid in healing bowel anastomoses.
Topics: Rabbits; Male; Animals; Platelet-Rich Fibrin; Constriction, Pathologic; Collagen; Anastomosis, Surgical; Pain, Postoperative; Leukocytes; Colon
PubMed: 37802197
DOI: 10.1016/j.lfs.2023.122146 -
European Journal of Surgical Oncology :... Jul 2023We aimed to investigate manual subtraction computed tomography angiography (MS-CTA) to further confirm the distribution and classification of LCA (left colic artery)...
Verification of blood flow path reconstruction mechanism in distal sigmoid colon and rectal cancer after high IMA ligation through preoperative and postoperative comparison by manual subtraction CTA.
INTRODUCTION
We aimed to investigate manual subtraction computed tomography angiography (MS-CTA) to further confirm the distribution and classification of LCA (left colic artery) ascending/descending branches, then observe the postoperative blood flow path to illustrate how the above branches evolved to postoperative blood path.
MATERIAL AND METHODS
89 patients with distal sigmoid and rectal cancer were referred in our observation and underwent MS-CTA between June 2020 and March 2022. We classified the distribution of LCA and confirmed whether there exists AMCA (accessory middle colic artery). Then we planned blood flow path based on the classification of LCA branches before operation. High ligation was applied in regular radical surgery. During operation, we carefully protect the bifurcation of ascending and descending LCA. Then we compared the planned blood flow path with the actual postoperative blood flow path to verify the mechanism we proposed previously.
RESULTS
Of 89 patients, 82 cases met our criteria, we summarized 6 distribution pattens of LCA ascending and descending branches. These preoperative pattens are consistent with the inspection during operation. The postoperative blood flow path of 6 pattens is evolved from the above adjacent anastomotic branches and is consistent with the planned blood flow path. We also found 2 cases with IMA stenosis and 1 case with SMA stenosis under pathological condition, and their compensatory blood flow path is in accordance with our theory. The rate of the anastomotic leakage in our study group is relatively low (7.3%).
CONCLUSION
MS-CTA could confirm the distribution of LCA and AMCA, display accurate postoperative blood reconstruction path after IMA high ligation, and it further verified the mechanism we proposed previously, which is the proximal anastomotic branches forming new blood flow path from high-pressure area to the low-pressure area. This mechanism might be helpful for performing accurate laparoscopic sigmoid and rectal cancer surgery.
Topics: Humans; Colon, Sigmoid; Constriction, Pathologic; Tranexamic Acid; Rectal Neoplasms; Rectum; Ligation; Mesenteric Artery, Inferior; Laparoscopy; Lymph Node Excision
PubMed: 36658053
DOI: 10.1016/j.ejso.2023.01.012 -
The American Journal of Surgical... Jul 2024Isolated hypoganglionosis (IHG) is histologically characterized by small numbers of myenteric ganglion cells and small myenteric ganglia; however, no numerical...
Isolated hypoganglionosis (IHG) is histologically characterized by small numbers of myenteric ganglion cells and small myenteric ganglia; however, no numerical diagnostic criteria for IHG have been established. Therefore, this study aimed to develop quantitative pathologic criteria for IHG. We evaluated 160 resected intestinal tissue specimens from 29 pediatric autopsies and 10 IHG cases. These specimens were obtained from the jejunum, ileum, ascending colon, transverse colon, and rectum. Morphologic features of the myenteric ganglion cells and myenteric ganglia were quantified and analyzed in digitized HuC/HuD-immunostained and CD56-immunostained sections, respectively. Quantitative criteria were developed with a scoring system that used parameters with the area under the receiver operating characteristic curve (AUC) values >0.7 and sensitivity and specificity exceeding 70%. The selected parameters were the number of myenteric ganglion cells per cm and the number of myenteric ganglia with an area >2500 µm 2 per cm. The score for each parameter ranged from -1 to 2, and the total score of the scoring system ranged from -2 to 4. With a cutoff value of ≥2 (AUC, 0.98; 95% CI: 0.96-1.00), the scoring system had a sensitivity of 96% (95% CI: 0.82-1.00) and a specificity of 99% (95% CI: 0.95-1.00). We devised a novel pathologic criterion based on the quantification of the number of myenteric ganglion cells and ganglia. Furthermore, this criterion showed high diagnostic accuracy and could lead to a definitive diagnosis of IHG in clinical practice.
Topics: Humans; Male; Female; Myenteric Plexus; Infant; Child, Preschool; Child; Predictive Value of Tests; Immunohistochemistry; Infant, Newborn; Autopsy; Biomarkers; ROC Curve; Adolescent; Cell Count; Area Under Curve
PubMed: 38726836
DOI: 10.1097/PAS.0000000000002243