-
Cureus May 2022Colorectal carcinoma is the third most malignant and second leading cause of death from cancer. The cruelty of this entity is that it takes decades to be symptomatic and... (Review)
Review
Colorectal carcinoma is the third most malignant and second leading cause of death from cancer. The cruelty of this entity is that it takes decades to be symptomatic and is known to be detected late in its timeline by a screening technique. The fatality of this carcinoma only means heightened importance of screening guidelines to be laid down and strict follow-ups by the healthcare providers. A novel method, a potential competitor that could now replace the present screening techniques for colorectal carcinoma, is computed tomographic colonography (CTC) or virtual colonoscopy. Though it first came into existence in 1994, this method is yet to be deeply studied and scrutinized for it to be the next benchmark modality. This review has mainly focused on the various features of CTC. It is contrasted against the gold standard colonoscopy for its superiority, efficacy, cost-effectiveness, patient logistics, and role in detecting extra-colonic lesions. The main focus would be laid on CTC being a screening modality. The review also emphasized why there is a need for the current healthcare providers to incorporate this modality into their practice widely. Although much has been said about CTC and its various aspects of cost-effectiveness, about it being replaced or supplemented for cancer screening, a collaborative effort has to be made by both the fields of radiology and gastroenterology to investigate the outcomes of this not so new technique in daily practice and to avoid misinterpretation of the results due to lack of skill and proficiency.
PubMed: 35719832
DOI: 10.7759/cureus.24916 -
Evidence-based Complementary and... 2022Colon cancer is a common digestive system malignancy with nonspecific early symptoms, which necessitates better early detection methods. The present study was conducted...
Colon cancer is a common digestive system malignancy with nonspecific early symptoms, which necessitates better early detection methods. The present study was conducted to assess the accuracy and clinical value of multislice spiral CT (MSCT) plus magnetic resonance imaging (MRI) for colon cancer. Between January 2019 and July 2020, 100 patients with pathologically confirmed colon cancer treated in Wuxi People's Hospital were assessed for eligibility and recruited. All eligible patients received MRI and MSCT without any treatment prior to scanning. The accuracy of preoperative diagnosis and staging of colon cancer by MRI, MSCT, and MRI plus MSCT were analyzed using postoperative pathological results as the gold standard, and consistency analysis was performed. The receiver operating characteristic curve (ROC) was plotted, and the area under the curve (AUC) was obtained to analyze the preoperative diagnostic value. The accuracy of MRI, MSCT, and MRI plus MSCT was 98.00%, 96.00%, and 100% with good consistency (Kappa = 0.732, 0.703, and 0.756). The AUC of MRI, MSCT, and MRI plus MSCT was 0.889, 0.861, and 0.903, respectively. The preoperative diagnostic accuracy of MRI for colon cancer at T1, T2, T3, and T4 stages was 76.92%, 82.61%, 73.47%, and 86.67%, respectively, those of MSCT was 53.85%, 69.57%, 63.27%, and 40.00%, respectively, and those of MRI plus MSCT was 100.00%, 95.65%, 95.92%, and 86.67%, respectively. Consistency analysis yielded good consistency for the diagnosis of the T-staging of colon cancer (Kappa = 0.754, 0.731, 0.776). MSCT plus MRI yielded higher accuracy, specificity, and sensitivity in the detection of colon cancer versus the standalone MRI or MSCT, which demonstrated great potential in the early detection of colon cancer with a high clinical value.
PubMed: 35685721
DOI: 10.1155/2022/6507865 -
Computational and Mathematical Methods... 2022To clarify the application value of magnetic resonance imaging (MRI) combined with multislice spiral computed tomography (MSCT) in the diagnosis and staging of colon...
OBJECTIVE
To clarify the application value of magnetic resonance imaging (MRI) combined with multislice spiral computed tomography (MSCT) in the diagnosis and staging of colon carcinoma (CC).
METHODS
A total of 103 patients with histopathologically diagnosed CC were enrolled. Patient clinical and imaging data were collected, and MRI and MSCT images were analyzed to assess the accuracy of MRI, MSCT, and their combination in diagnosing tumor (T) staging of CC.
RESULTS
Among the 103 cases of histopathologically diagnosed CC, 26 cases (25.24) were in stage T1-2, 72 cases (69.90) were in stage T3, and 5 cases (4.85) were in stage T4. The accuracy of MRI in diagnosing stage T1-2, T3, and T4 was 80.77%, 88.89%, and 60.00%, respectively, with an average of 76.55%. The accuracy rates of MSCT in diagnosing T1-2, T3, and T4 stages were 73.08%, 90.27%, and 60.00%, respectively, with an average of 74.45%. The accuracy rates of MRI+MSCT in diagnosing T1-2, T3, and T4 were 88.46%, 95.83%, and 80.00%, respectively, with an average of 88.10%.
CONCLUSIONS
Compared with single use of MRI or MSCT, MRI+MSCT provides accurate imaging data with higher accuracy, which is more helpful for the T-staging evaluation of CC.
Topics: Carcinoma; Colonic Neoplasms; Humans; Magnetic Resonance Imaging; Neoplasm Staging; Tomography, Spiral Computed
PubMed: 35651927
DOI: 10.1155/2022/2593844 -
Frontiers in Nutrition 2022Short bowel syndrome (SBS), secondary to any natural loss or after any extensive bowel resection for congenital malformations or acquired disease, is the most common... (Review)
Review
Short bowel syndrome (SBS), secondary to any natural loss or after any extensive bowel resection for congenital malformations or acquired disease, is the most common cause of intestinal failure in children. Extensive introduction of parenteral nutrition (PN) has dramatically changed the outcome of these patients, allowing for long-term survival. The main goal in children with SBS remains to be increasing enteral tolerance and weaning from PN support. Post resection intestinal adaptation allows for achievement of enteral autonomy in a subset of these patients, but the inability to progress in enteral tolerance exposes others to long-term complications of PN. Autologous intestinal reconstruction surgery (AIRS) can facilitate the fulfilment of enteral autonomy, maximizing the absorptive potential of the remaining gut. All the different intestinal reconstruction techniques, from simple procedures like tapering, reversed segments, and colon interposition, to more complex lengthening procedures (LILT: longitudinal intestinal lengthening and tailoring, STEP: serial transverse enteroplasty, and SILT: spiral intestinal lengthening and tailoring) and techniques designed for peculiar problems like controlled intestinal tissue expansion or duodenal lengthening are presented. AIRS indications, clinical applications, and results reported in the literature are reviewed.
PubMed: 35463997
DOI: 10.3389/fnut.2022.861093 -
Late presentation of congenital type IV esophageal hiatus hernia in a 9-year-old boy: a case report.Journal of Medical Case Reports Mar 2022Congenital diaphragmatic hernia affects 1 in every 2000-5000 live births. The mediastinum shifts to the opposite side, the lungs are hypoplastic, and the arterioles are...
BACKGROUND
Congenital diaphragmatic hernia affects 1 in every 2000-5000 live births. The mediastinum shifts to the opposite side, the lungs are hypoplastic, and the arterioles are abnormal, resulting in pulmonary hypertension. Respiratory and cardiovascular functions are severely impaired at birth, resulting in significant mortality and morbidity as a result of the associated malformations.
CASE PRESENTATION
A 9-year-old persian boy was referred with complaint of intermittent abdominal pain in the left lower quadrant and an episode of vomiting. The patient was tachypneic, and the abdomen was nontender on examination. Lung sounds on the left side were considerably decreased, whereas heart sounds on the right side were louder. There was no history of underlying disease in the patient. Initial laboratory blood tests, chest x-ray, spiral computed tomography scan, and chest sonography were requested. Blood tests were normal, and chest x-ray revealed a round-shaped lesion with relatively clear boundaries containing air-fluid level and shift of the heart and mediastinum to the right. A spiral computed tomography scan of the lungs demonstrated the shift of the heart and mediastinum to the right side was due to dilated stomach and colon pressure, and chest sonography revealed that half of the stomach was inside the thorax. Laparotomy surgery was performed. The patient had no complications following surgery.
CONCLUSIONS
Herniation of abdominal contents through the diaphragmatic hiatus should be suspected in patients with tachypnea and mediastinal shift to the right side. Rapid diagnosis and early surgical treatment are necessary to avert any potentially life-threatening complications.
Topics: Abdominal Pain; Child; Diaphragm; Hernia, Hiatal; Hernias, Diaphragmatic, Congenital; Humans; Infant, Newborn; Male; Thorax
PubMed: 35287701
DOI: 10.1186/s13256-022-03331-9 -
Journal of Applied Clinical Medical... Oct 2021This provides a benchmark of dosimetric benefit and clinical cost of cone-beam CT-based online adaptive radiotherapy (ART) technology for cervical and rectal cancer...
PURPOSE
This provides a benchmark of dosimetric benefit and clinical cost of cone-beam CT-based online adaptive radiotherapy (ART) technology for cervical and rectal cancer patients.
METHODS
An emulator of a CBCT-based online ART system was used to simulate more than 300 treatments for 13 cervical and 15 rectal cancer patients. CBCT images were used to generate adaptive replans. To measure clinical resource cost, the six phases of the workflow were timed. To evaluate the dosimetric benefit, changes in dosimetric values were assessed. These included minimum dose (Dmin) and volume receiving 95% of prescription (V95%) for the planning target volume (PTV) and the clinical target volume (CTV), and maximum 2 cc's (D2cc) of the bladder, bowel, rectum, and sigmoid colon.
RESULTS
The average duration of the workflow was 24.4 and 9.2 min for cervical and rectal cancer patients, respectively. A large proportion of time was dedicated to editing target contours (13.1 and 2.7 min, respectively). For cervical cancer patients, the replan changed the Dmin to the PTVs and CTVs for each fraction 0.25 and 0.25 Gy, respectively. The replan changed the V95% by 9.2 and 7.9%. The D2cc to the bladder, bowel, rectum, and sigmoid colon for each fraction changed -0.02, -0.08, -0.07, and -0.04 Gy, respectively. For rectal cancer patients, the replan changed the Dmin to the PTVs and CTVs for each fraction of 0.20 and 0.24 Gy, respectively. The replan changed the V95% by 4.1 and 1.5%. The D2cc to the bladder and bowel for each fraction changed 0.02 and -0.02 Gy, respectively.
CONCLUSIONS
Dosimetric benefits can be achieved with CBCT-based online ART that is amenable to conventional appointment slots. The clinical significance of these benefits remains to be determined. Managing contours was the primary factor affecting the total duration and is imperative for safe and effective adaptive radiotherapy.
Topics: Female; Humans; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted; Radiotherapy, Image-Guided; Radiotherapy, Intensity-Modulated; Rectum; Spiral Cone-Beam Computed Tomography; Uterine Cervical Neoplasms
PubMed: 34529332
DOI: 10.1002/acm2.13425 -
The Journal of Veterinary Medical... Sep 2021Three eastern bongos (Tragelaphus eurycerus isaaci) presented acutely with hemorrhagic diarrhea at the Singapore Zoo, thought to be caused by a mouldy batch of hay....
Three eastern bongos (Tragelaphus eurycerus isaaci) presented acutely with hemorrhagic diarrhea at the Singapore Zoo, thought to be caused by a mouldy batch of hay. Repeated fecal tests were negative of parasites and common gastrointestinal bacteria including salmonella and campylobacter. The diarrhea resolved for all individuals after a week of leaf-only diet. However, 2 individuals developed signs of colic. Both animals were anesthetized for examination including blood tests and imaging studies. The findings were consistent of gastrointestinal ileus and a possible impaction. With intensive treatment involving repeated sedations for fluid therapy administration and treatments for gastrointestinal impaction, one individual eventually made a full recovery, but the other individual died due to septic peritonitis secondary to a rupture in the spiral colon. Persistent supportive therapy may be vital in treating severe gastrointestinal disease in this species.
Topics: Animals; Antelopes; Diet; Enteritis; Singapore
PubMed: 34248105
DOI: 10.1292/jvms.21-0096 -
Animals : An Open Access Journal From... Jun 2021RASopathies are a group of developmental disorders caused by dominant mutations in genes that encode components of the Ras/mitogen-activated protein kinase (MAPK) cell...
RASopathies are a group of developmental disorders caused by dominant mutations in genes that encode components of the Ras/mitogen-activated protein kinase (MAPK) cell signaling pathway. The goal of this study was to characterize the pathological phenotype of a Romagnola stillborn calf with skeletal-cardio-enteric dysplasia and to identify a genetic cause by whole-genome sequencing (WGS). The calf showed reduced fetal growth, a short-spine, a long and narrow face, cardiac defects and heterotopy of the spiral colon. Genetic analysis revealed a private heterozygous missense variant in p.Arg179Trp, located in the protein kinase domain in the calf, and not found in more than 4500 control genomes including its sire. The identified variant affecting a conserved residue was predicted to be deleterious and most likely occurred de novo. This represents the first example of a dominant acting, and most likely pathogenic, variant in in domestic animals, thereby providing the first -related large animal model, especially in respect to the enteric malformation. In addition, this study demonstrates the utility of WGS-based precise diagnostics for understanding sporadic congenital syndromic anomalies in cattle and the general utility of continuous surveillance for rare hereditary defects in cattle.
PubMed: 34209498
DOI: 10.3390/ani11071931 -
World Journal of Surgical Oncology Jun 2021Understanding the vascular anatomy is critical for performing central vascular ligation (CVL) in right hemicolectomy with complete mesocolic excision (CME). This study...
Predictive value of computed tomography with coronal reconstruction in right hemicolectomy with complete mesocolic excision for right colon cancers: a retrospective study.
BACKGROUND
Understanding the vascular anatomy is critical for performing central vascular ligation (CVL) in right hemicolectomy with complete mesocolic excision (CME). This study aimed to investigate the predictive value of multi-slice spiral computed tomography (MSCT) with coronal reconstruction in right hemicolectomy with CME.
METHODS
This is a retrospective descriptive study. Eighty patients with right colon cancer who underwent right hemicolectomy from December 2015 to January 2020 were included. The intraoperative reports (including imaging data) and MSCT images with coronal reconstruction were analysed and compared. The detection rates of the ileocolic vein (ICV) and ileocolic artery (ICA) roots and the accuracy in predicting their anatomical relationship were analysed. The detection rate and accuracy in predicting the location of the gastrocolic trunk of Henle (GTH), middle colic artery (MCA) and middle colic vein (MCV) were analysed. The distance from the ICV root to the GTH root (ICV-GTH distance) was measured and analysed. The maximum distance from the left side of the superior mesenteric artery (SMA) to the right side of the superior mesenteric vein (SMV), named the 'lsSMA-rsSMV distance', was also measured and analysed.
RESULTS
In seventy-four (92.5%) patients, both the ICV and ICA roots were located; their anatomical relationship was determined by MSCT, and the accuracy of the prediction was 97.2% (72/74). The GTH was located by MSCT in 75 (93.7%) patients, and the accuracy of the prediction was 97.33% (73/75). The MCA was located by MSCT in 47 (58.75%) patients, and the accuracy was 78.72% (37/47). The MCV was located by MSCT in 51 (63.75%) patients, and the accuracy of the prediction was 84.31% (43/51). The ICV-GTH distance was measured in 73 (91.2%) patients, and the mean distance was 4.28 ± 2.5 cm. The lsSMA-rsSMV distance was measured in 76 (95%) patients, and the mean distance was 2.21 ± 0.6 cm.
CONCLUSIONS
With its satisfactory accuracy in predicting and visualising the information of key anatomical sites, MSCT with coronary reconstruction has some predictive value in CME with CVL in right hemicolectomy.
Topics: Colectomy; Colonic Neoplasms; Humans; Laparoscopy; Mesocolon; Prognosis; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 34183028
DOI: 10.1186/s12957-021-02307-1 -
Life (Basel, Switzerland) Apr 2021Initial enteric microbial colonisation influences animal health and disease, hence an understanding of the first microbial colonisers within the piglet is important. The...
Initial enteric microbial colonisation influences animal health and disease, hence an understanding of the first microbial colonisers within the piglet is important. The spiral colon of piglets that were stillborn ( = 20), born-alive ( = 10), and born alive and had sucked ( = 9) were collected from 28 sows to investigate whether initial microbial colonisation occurs pre- or post-partum and how it develops during the first 24 h post-partum. To examine this, DNA was extracted and 16S rRNA amplicon analysis was performed to allow analysis of microbial communities. The results indicate that microbial colonisation of the spiral colon had occurred in stillborn pigs, suggesting microbial exposure prior to birth. Alpha diversity metrics indicated that the number of taxa and community richness were higher in piglets that sucked ( < 0.001) and community evenness was lower in stillborns in comparison to born-alive ( < 0.001) but was not affected by colostrum consumption ( < 0.001). Additionally, when compared with stillborn piglets, the bacteria colonising the spiral colon during the first 24 h post-partum included the potentially pathogenic bacteria , and , and potentially beneficial bacteria and . The relative presence of Archaea was high in stillborn piglets but decreased with post-natal environmental exposure. It is evident that stillborn piglets have bacteria present within their spiral colon, however further studies are needed in order to determine the time at which colonisation is initiated and the mechanisms determining how colonisation occurs. Additionally, as expected, the immediate post-natal environment largely influences the microorganisms colonising, while colostrum consumption further contributes to the microbial community enrichment.
PubMed: 33918395
DOI: 10.3390/life11040312