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Surgical Endoscopy Jun 2024Preserving sufficient oxygen supply to the tissue is fundamental for maintaining organ function. However, our ability to identify those at risk and promptly recognize...
BACKGROUND
Preserving sufficient oxygen supply to the tissue is fundamental for maintaining organ function. However, our ability to identify those at risk and promptly recognize tissue hypoperfusion during abdominal surgery is limited. To address this problem, we aimed to develop a new method of perfusion monitoring that can be used during surgical procedures and aid surgeons' decision-making.
METHODS
In this experimental porcine study, thirteen subjects were randomly assigned one organ of interest [stomach (n = 3), ascending colon (n = 3), rectum (n = 3), and spleen (n = 3)]. After baseline perfusion recordings, using high-frequency, low-dose bolus injections with weight-adjusted (0.008 mg/kg) ICG, organ-supplying arteries were manually and completely occluded leading to hypoperfusion of the target organ. Continuous organ perfusion monitoring was performed throughout the experimental conditions.
RESULTS
After manual occlusion of pre-selected organ-supplying arteries, occlusion of the peripheral arterial supply translated in an immediate decrease in oscillation signal in most organs (3/3 ventricle, 3/3 ascending colon, 3/3 rectum, 2/3 spleen). Occlusion of the central arterial supply resulted in a further decrease or complete disappearance of the oscillation curves in the ventricle (3/3), ascending colon (3/3), rectum (3/3), and spleen (1/3).
CONCLUSION
Continuous organ-perfusion monitoring using a high-frequency, low-dose ICG bolus regimen can detect organ hypoperfusion in real-time.
PubMed: 38869642
DOI: 10.1007/s00464-024-10938-0 -
CNS Oncology Jun 2024This report describes a case of BRAF V600E-mutated colorectal cancer with CNS metastases in which treatment with encorafenib, binimetinib and cetuximab was effective....
This report describes a case of BRAF V600E-mutated colorectal cancer with CNS metastases in which treatment with encorafenib, binimetinib and cetuximab was effective. There is limited information on the ability of encorafenib, binimetinib and cetuximab to enter the CNS.The patient was a 53-year-old man was diagnosed with ascending colon cancer (cT3N3M1c stage IVc). BRAF V600E mutation was confirmed. FOLFOX was started, but CNS metastases soon appeared. Encorafenib, binimetinib and cetuximab were administered and had a favorable effect on the CNS lesions. The patient initially responded well, but his disease progressed 2 months later. Further research is needed to improve management strategies for BRAF V600E-mutated colorectal cancer with CNS metastases.
Topics: Humans; Cetuximab; Male; Middle Aged; Proto-Oncogene Proteins B-raf; Carbamates; Sulfonamides; Benzimidazoles; Antineoplastic Combined Chemotherapy Protocols; Colorectal Neoplasms; Mutation; Central Nervous System Neoplasms
PubMed: 38869444
DOI: 10.1080/20450907.2024.2347824 -
Journal of Agricultural and Food... Jun 2024Taste receptors are found in the gastrointestinal tract, where they are susceptible to dietary modulation, a key point that is crucial for diet-related responses....
Taste receptors are found in the gastrointestinal tract, where they are susceptible to dietary modulation, a key point that is crucial for diet-related responses. Insects are sustainable and good-quality protein sources. This study analyzed the impact of insect consumption on the modulation of taste receptor expression across various segments of the rat intestine under healthy or inflammatory conditions. Female Wistar rats were supplemented with (T) or (B), alongside a control group (C), over 21 days under healthy or LPS-induced inflammation. The present study reveals, for the first time, that insect consumption modulates taste receptor gene expression, mainly in the ascending colon. This modulation was not found under inflammation. Integrative analysis revealed colonic Tas1r1 as a key discriminator for insect consumption ( = 1.04 ± 0.32, = 1.78 ± 0.72, = 1.99 ± 0.82, -value <0.05 and 0.01, respectively). Additionally, correlation analysis showed the interplay between intestinal taste receptors and metabolic and inflammatory responses. These findings underscore how insect consumption modulates taste receptors, influencing intestinal function and broader physiological mechanisms.
PubMed: 38857423
DOI: 10.1021/acs.jafc.4c02408 -
Nihon Shokakibyo Gakkai Zasshi = the... 2024A 66-year-old male patient with a thyroid and nasopharyngeal cancer history visited our hospital because of a positive fecal occult blood test. Total colonoscopy...
A 66-year-old male patient with a thyroid and nasopharyngeal cancer history visited our hospital because of a positive fecal occult blood test. Total colonoscopy detected sessile or subpedunculated polyps in the ascending colon, sigmoid colon, and rectum. These polyps were endoscopically resected, and the rectal polyp was pathologically diagnosed as adenocarcinoma in adenoma and the others as adenomas. Additionally, multiple sessile lesions were revealed in the sigmoid colon and rectum. A complete gastrointestinal tract examination revealed multiple foci of glycogenic acanthosis in the esophagus, multiple sessile lesions in the stomach, multiple sessile lesions, clubbings (rod-shaped lesions), and venous malformations in the small bowel. Mucocutaneous examination indicated hemangiomas on the body trunk, patchy pigmentation on the glans penis, and keratotic papules in the inguinal region. The National Comprehensive Cancer Network diagnostic criteria for Cowden syndrome were used in this case. The patient met four major and two minor criteria;thus, Cowden syndrome was diagnosed. Moreover, the patient was had phosphatase and tensin homolog deleted on chromosome 10 gene mutation. This is the first reported case of metachronal triple cancers in a male patient with Cowden syndrome, and our results indicate the importance of cancer surveillance.
Topics: Humans; Male; Aged; Hamartoma Syndrome, Multiple; Neoplasms, Second Primary; Neoplasms, Multiple Primary; Adenocarcinoma
PubMed: 38853018
DOI: 10.11405/nisshoshi.121.489 -
International Journal of Biological... Jun 2024Sourdough bread enriched with soluble fiber (by in-situ exopolysaccharides production) and insoluble fiber (by gazpacho by-products addition) showed prebiotic effects an...
Sourdough bread enriched with soluble fiber (by in-situ exopolysaccharides production) and insoluble fiber (by gazpacho by-products addition) showed prebiotic effects an in vitro dynamic colonic fermentation performance with obese volunteer's microbiota. Bifidobacterium population was maintained whereas Lactobacillus increased throughout the colonic sections. Conversely, Enterobacteriaceae and Clostridium groups clearly decreased. Specific bacteria associated with beneficial effects increased in the ascending colon (Lactobacillus fermentum, Lactobacillus paracasei, Bifidobacterium longum and Bifidobacterium adolescentis) whereas Eubacterium eligens, Alistipes senegalensis, Prevotella copri and Eubacterium desmolans increased in the transversal and descending colon. Additionally, Blautia faecis and Ruminococcus albus increased in the transversal colon, and Bifidobacterium longum, Roseburia faecis and Victivallis vadensis in the descending colon. Bifidobacterium and Lactobacillus fermented the in-situ exopolysaccharides and released pectins from gazpacho by-products, as well as cellulosic degraded bacteria. This increased the short and medium chain fatty acids. Acetic acid, as well as butyric acid, increased throughout the colonic tract, which showed greater increases only in the transversal and descending colonic segments. Conversely, propionic acid was slightly affected by the colonic fermentation. These results show that sourdough bread is a useful food matrix for the enrichment of vegetable by-products (or other fibers) in order to formulate products with microbiota modulatory capacities.
Topics: Bread; Humans; Dysbiosis; Fermentation; Gastrointestinal Microbiome; Dietary Fiber; Polysaccharides, Bacterial; Colon; Bifidobacterium; Male; Lactobacillus
PubMed: 38851991
DOI: 10.1016/j.ijbiomac.2024.132906 -
Langenbeck's Archives of Surgery Jun 2024Limited data exist regarding the surgical outcomes of acute colonic pseudo-obstruction (ACPO), commonly referred to as Ogilvie syndrome, in modern clinical practice. The...
PURPOSE
Limited data exist regarding the surgical outcomes of acute colonic pseudo-obstruction (ACPO), commonly referred to as Ogilvie syndrome, in modern clinical practice. The prevailing belief is that surgery should be avoided due to previously reported high mortality rates. We aimed to describe the surgical results of ACPO treated within our institution.
METHODS
Our prospectively maintained colorectal surgery registry was queried for patients diagnosed with ACPO, who underwent surgery between 2009 and 2022. Postoperative complications were graded according to Clavien-Dindo (CD) classification. The primary outcome was postoperative mortality.
RESULTS
A total of 32 patients who underwent surgery for ACPO were identified. Overall, nonoperative therapy was initially administered to 21 patients (65.6%). The surgeries performed included total abdominal colectomy (15, 43.1%), ascending colectomy with end ileostomy (8, 25%), transverse colostomy (5, 15.6%), ileostomy and transverse colostomy (3, 9.4%), and Hartmann's operation (1, 3.1%). Severe postoperative complications (CD grade 3 or 4) occurred in five patients (15.6%). No recurrence of ACPO was observed and no patient required reoperation. The average postoperative length of stay was 14.5 days, 30-day mortality was 6.3% (n = 2), and 90-day mortality was 15.6% (n = 5) due to complications of underlying comorbidities.
CONCLUSIONS
Surgical treatment was effective for patients with ACPO refractory to medical therapy or presenting with acute complications. Although postoperative complications were frequent, both the 30- and 90-day mortality rates were lower than previously documented in the literature. Further investigations are warranted to determine the optimal surgical strategy, which may involve total or segmental colectomy, or diversion alone without resection.
Topics: Humans; Colonic Pseudo-Obstruction; Male; Female; Retrospective Studies; Aged; Middle Aged; Colectomy; Postoperative Complications; Acute Disease; Treatment Outcome; Adult; Aged, 80 and over; Length of Stay; Registries
PubMed: 38850452
DOI: 10.1007/s00423-024-03356-2 -
Pakistan Journal of Medical Sciences 2024In Pakistan, colon cancer ranks fourth in incidence, exhibiting survival rates of 90% to 14%, contingent on TNM staging and early detection. This research focuses on the...
OBJECTIVE
In Pakistan, colon cancer ranks fourth in incidence, exhibiting survival rates of 90% to 14%, contingent on TNM staging and early detection. This research focuses on the demographic involvement and short-term outcomes of elective colon cancer resections at a newly established tertiary care cancer center utilizing laparoscopic procedures.
METHOD
A retrospective analysis of elective laparoscopic colorectal resections at Shaukat Khanum Memorial Cancer Institute and Research Centre, Peshawar, from April 2021 to February 2022 was conducted. Out of 157 cases, 79 had colon cancer. Criteria included patients >18 years old with positive biopsies; consent non-providers were excluded. Statistical analysis employed descriptive statistics and cross-tabulations using SPSS-22.
RESULTS
The study encompassed biopsy-confirmed colon cancers in patients >18 years. 157 colorectal cases were performed, including 79 colon cancers. The sample comprised 61 males (77.2%) and 18 females (22.7%), mean age 42 years. Most patients (33%) were in the 36-45 age group. Majority were from KPK (69.6%), followed by Afghanistan (24%). Tumors were predominantly in the ascending colon (30.3%). Most were moderately differentiated (70.8%). Mean lymph node yield was 19.0, with 1.2% requiring open laparotomy. Post-discharge, one readmission occurred within 30 days. Mortality within 90 days was 2%, attributed to aspiration pneumonia and chemotherapy-related effects.
CONCLUSIONS
Elective laparoscopic colonic surgery exhibits safety and efficacy in treating colon cancer. The study provides evidence of minimal morbidity and mortality, low readmission rates, and absence of anastomotic leaks. Hence, elective laparoscopic colonic surgery should be favored due to fewer post-operative complications and superior short-term outcomes. Larger studies on colon cancer are imperative for enhanced healthcare delivery.
PubMed: 38827878
DOI: 10.12669/pjms.40.5.8732 -
Zhonghua Bing Li Xue Za Zhi = Chinese... Jun 2024To investigate the clinicopathological, immunophenotypic and molecular genetic characteristics, and differential diagnosis of NTRK-rearranged spindle cell neoplasms...
To investigate the clinicopathological, immunophenotypic and molecular genetic characteristics, and differential diagnosis of NTRK-rearranged spindle cell neoplasms (NTRK-RSCNs) in the gastrointestinal tract. Two NTRK-RSCNs diagnosed at the Department of Pathology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China and one case diagnosed at Zhengzhou Central Hospital, Zhengzhou, China from 2019 to 2022 were collected. The clinical data, histopathology, immunophenotypes and prognosis were analyzed. Fluorescence in situ hybridization (FISH) and next-generation sequencing (NGS) were used to detect NTRK gene rearrangements, while relevant literature was also reviewed and discussed. Two patients were male and one was female, with the age of 17, 47 and 62 years, respectively. The tumors were located in the duodenum, ascending colon and descending colon, respectively. The tumors were protuberant masses with gray and rubbery sections. Their maximum diameter was 2.5, 5.0 and 10.0 cm, respectively. Histologically, the tumors invaded mucosa, intrinsic muscle and serosal adipose tissue. Tumor cells consisted of spindle or oval shaped cells with monotonous morphology and arranged in bundles or stripes pattern. Spindle cells were mildly to moderately atypical, with slightly eosinophilic cytoplasm and inconspicuous nucleoli. Necrosis and mitotic figures were observed in one high-grade tumor. All tumors expressed CD34, S-100 and pan-TRK in varying degrees. FISH analysis showed that NTRK1 gene was break-apart in 1 case and NTRK2 gene break-apart in 2 cases. NGS technologies showed LMNA::NTRK1 fusion in one case, STRN::NTRK2 fusion in another case. All patients recovered well after the surgery without recurrence at the end of the follow-up. NTRK-RSCN is rarely diagnosed in the gastrointestinal tract and has significant variations in morphology. It overlaps with various other mesenchymal tumors which should be considered as differential diagnoses. Be familiar with the features of histological morphology in combination with immunophenotype and molecular genetic characteristics can not only help diagnose NTRK-RSCNs, but provide therapeutic targets for clinical treatment.
Topics: Humans; Male; Female; Middle Aged; Receptor, trkA; Gastrointestinal Neoplasms; Adolescent; In Situ Hybridization, Fluorescence; Gene Rearrangement; Diagnosis, Differential; High-Throughput Nucleotide Sequencing; Receptor, trkB
PubMed: 38825906
DOI: 10.3760/cma.j.cn112151-20231020-00280 -
Indian Journal of Nuclear Medicine :... 2024The primary objective was to establish the reference values for small-bowel and colonic transit within the context of the routine standard solid meal gastric emptying...
PURPOSE OF THE STUDY
The primary objective was to establish the reference values for small-bowel and colonic transit within the context of the routine standard solid meal gastric emptying scintigraphy (GES). The secondary objective was to compare the small-bowel and colonic transit between the anterior view and geometric mean methods.
MATERIALS AND METHODS
Twenty-nine healthy controls underwent routine GES, with additional imaging at 24 h if feasible. Small-bowel transit was assessed using the index of small-bowel transit (ISBT), calculated as the ratio of terminal ileal reservoir counts to total abdominal counts at 4 h. Colonic transit was evaluated using the colonic geometric center (CGC) by dividing the large bowel into four segments, with an additional fifth segment accounting for the eliminated counts. Reference values were established based on the fifth percentile or mean ± 1.96 standard deviations. Rapid small-bowel transit was visually determined. Paired Samples -test or Wilcoxon signed-rank test, as applicable, was used to compare the small-bowel and colonic transit between the anterior view and geometric mean methods. For comparing small-bowel and colonic transit between females and males, the Independent samples -test or Mann-Whitney -test was applied, as appropriate. The correlation between age and small-bowel and colonic transit was assessed using Spearman's rank correlation analysis.
RESULTS
The reference value for small-bowel transit using the geometric mean method was established as ISBT >37% at 4 h, whereas rapid small-bowel transit was defined as the first visualization of activity in the cecum-ascending colon within 2 h. For colonic transit, the reference range was established as CGC 2.8-4.4 at 24 h. Comparing the anterior view and geometric mean methods, there were no significant differences in ISBT and CGC values ( ≥ 0.125). Gender did not affect small-bowel and colonic transit in both methods ( ≥ 0.378), and age showed no significant correlations ( ≥ 0.053).
CONCLUSION
This study determined the reference values for small-bowel and colonic transit in the Indian population using routine GES, avoiding the need for additional complex procedures. The results may be generalized to the Indian population, emphasizing the importance of assessing small-bowel and colonic transit in patients with normal gastric emptying parameters to enhance gastrointestinal transit evaluation.
PubMed: 38817721
DOI: 10.4103/ijnm.ijnm_64_23 -
Journal of Surgical Case Reports May 2024Adult colonic intussusception, is a rare entity that is typically associated with underlying organic pathologies, notably colorectal tumors, unlike pediatric cases,...
Adult colonic intussusception, is a rare entity that is typically associated with underlying organic pathologies, notably colorectal tumors, unlike pediatric cases, which are mostly idiopathic. We present a unique case of a 42-year-old female with ascending colon adenocarcinoma, where ileocecal intussusception served as the initial clinical manifestation. The patient's non-specific symptoms, familial history of colon cancer and subsequent diagnostic evaluations underscore the importance of considering malignancy in such presentations. Successful laparoscopic right hemicolectomy resolved the intussusception. This case, which is the first case to be reported in Sudan, highlights the clinical complexities of adult colonic intussusception, emphasizing the need for a heightened index of suspicion for underlying malignancy and the significance of timely surgical intervention. Furthermore, the challenges encountered in resource-limited settings underscore the necessity for genetic testing to guide familial screenings and identify hereditary factors contributing to colon cancer, providing valuable insights for clinicians managing similar cases.
PubMed: 38812576
DOI: 10.1093/jscr/rjae337