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At least 253 records · Page 14Linked to original sources
PubMed1980

Circadian phase-dependent stimulatory effects of epidermal growth factor on deoxyribonucleic acid synthesis in the duodenum, jejunum, ileum, caecum, colon, and rectum of the adult male mouse.

Epidermal growth factor (EGF) previously isolated from the submandibular salivary glands of mice was injected ip at five different circadian phases into separate sub-groups of adult male CD2F1 mice that had been standardized to 12 h of light alternating with 12 h of darkness. Comparable control groups were injected only with the carrier substance. Four, 8, and 12 h after each of the five injection times, subgroups of five mice were killed. Thirty minutes before sacrifice, each mouse was injected ip with 24 mu Ci tritiated thymidine ([3H]-TdR). Incorporation of [3H]TdR into the DNA of the duodenum, jejunum, ileum, cecum, colon, and rectum was determined. The results demonstrate for the first time that EGF has a stimulatory effect on DNA synthesis in these tissues, particularly in the colon and rectum. Under the conditions of this study, the stimulatory effects of EGF on DNA synthesis in the cecum, colon, and rectum were more dramatic than those in the three regions of the small intestine; in fact, DNA synthesis in the latter was occasionally statistically significantly decreased, particularly for mice killed during the dark phase. Stimulatory effects of EGF on DNA synthesis in the cecum, colon, and rectum were noticed as early as 4 h after injection; however, maximal stimulation occurred 8 and 12 h post injection.

Animals↗
PubMed1979

Cyclic adenosine 3',5'-monophosphate levels in response to norepinephrine in rectum of postnatal rats.

Age-related changes in cyclic adenosine 3',5'-monophosphate levels in response to norepinephrine (NE) in the rectum of postnatal rats and the localization of cyclic AMP in the rectum were studied. During the first 2 weeks after birth, the basal levels of cyclic AMP were high, NE responses to cyclic AMP contents were minimal and thereafter, the basal cyclic AMP levels rapidly declined, while NE response significantly increased compared to those seen in tissues from adult rats. Furthermore, cyclic AMP immunofluorescence was visualized in smooth muscle and postganglionic neurons of the myenteric plexus. NE application produced an increase of cyclic AMP immunofluorescence in smooth muscle. These results indicate that NE response to cyclic AMP levels in rat rectum is age-dependent and suggest that the majority of beta-adrenoceptors associated with cyclic AMP generating system are localized in the smooth muscle of rat rectum.

Adrenergic beta-Antagonists↗
PubMed1996

Development of an experimental model for high dose rate endocavitary irradiation of the rat rectum.

Experimental data indicate a greater tolerance for endocavitary than for external beam irradiation of the normal rectal tissue in the rat. Increased tolerance has been attributed to temperature induced rectal hypoxia and a reduction of the dose to the mesentery. The general scarcity of experimental work in the field and the problems concerning hypoxia and dosimetry motivated the development of the current model. An 8 mm diameter endocavitary applicator was used for symmetrical dilatation and central introduction of the 192Ir source into the rectum of male Fischer F344 rats. Pulse oximetry and pO2-electrode readings from the intubated rectum gave no indication of radiobiological hypoxia. In vitro and in vivo thermoluminescence dosimetry (TLD) was supported by MRI based ferrous sulphate gel dosimetry. Using a 25 mm length source configuration the 90% isodose incorporated a 13 mm length segment of the rectum, and a 5.6% maximum deviation from the calculated dose was observed by the TLD and MRI based gel dosimetry. The ureters, the bladder and the skin were the only organs other than the target organ which received doses greater than 10% of the rectal dose. The model seems to be suitable for dose effect studies since endocavitary irradiation of the rat rectum can be performed without induction of local tissue hypoxia.

Animals↗
PubMed2004

Identification of interstitial cells of Cajal in the human rectum.

It is postulated that the electric waves of the gut are generated by interstitial cells of Cajal (ICC). We hypothesized the presence of ICC in the rectum as initiating the rectal electric activity. The current study investigated this hypothesis. Two rectal specimens were taken from healthy areas of excised rectum of 22 rectal cancer patients (age 44.6+/-.2 SD years, 12 men, 10 women). The study specimens were subjected to c-kit immunohistochemistry. Controls for antisera specificity consisted of tissue incubation with normal rabbit serum substituted for the primary antiserum. C-kit positive branched ICC-like cells were detected in the rectal musculature of the studied specimens. They were distinguishable from the c-kit-negative non-branched smooth muscle cells and from the c-kit positive but non-branched mast cells. Immunoreactivity was absent in the negative controls. We have identified in the rectum for the first time cells with morphologic and immunologic phenotypes similar to the ICC of the gut. The role of these cells in normal physiologic and pathologic conditions of the rectum needs further studies.

Adult↗
PubMed2006

Functional activity of the rectum: A conduit organ or a storage organ or both?

AIM: To investigate whether the degree of rectal distension could define the rectum functions as a conduit or reservoir. METHODS: Response of the rectal and anal pressure to 2 types of rectal balloon distension, rapid voluminous and slow gradual distention, was recorded in 21 healthy volunteers (12 men, 9 women, age 41.7 +/- 10.6 years). The test was repeated with sphincteric squeeze on urgent sensation. RESULTS: Rapid voluminous rectal distension resulted in a significant rectal pressure increase (P < 0.001), an anal pressure decline (P < 0.05) and balloon expulsion. The subjects felt urgent sensation but did not feel the 1st rectal sensation. On urgent sensation, anal squeeze caused a significant rectal pressure decrease (P < 0.001) and urgency disappearance. Slow incremental rectal filling drew a rectometrogram with a "tone" limb representing a gradual rectal pressure increase during rectal filling, and an "evacuation limb" representing a sharp pressure increase during balloon expulsion. The curve recorded both the 1st rectal sensation and the urgent sensation. CONCLUSION: The rectum has apparently two functions: transportation (conduit) and storage, both depending on the degree of rectal filling. If the fecal material received by the rectum is small, it is stored in the rectum until a big volume is reached that can affect a degree of rectal distension sufficient to initiate the defecation reflex. Large volume rectal distension evokes directly the rectoanal inhibitory reflex with a resulting defecation.

Adult↗
PubMed1999

[Surgical management of villous and tubulovillous adenomas of the rectum].

One hundred four cases of middle and low rectal villous and tubulovillous adenomas have been operated on with transanal polypectomy (8), transanal endoscopic microsurgery--TEM (80), anterior rectum resection with double stapled straight sigmoideorectosomy (7), and deep rectum resection, bi-directional mucosectomy and hand sutured straight sigmoideoanostomy (9). The option of the authors to remove the tumours in 5 cm to the dentate line are the transanal polypectomy or transanal mucosectomy corresponding to their size. The transanal endoscopic microsurgical technic is recommended to manage the polyps smaller than 4 to 5 cm in the middle rectum. The best radicallity in removal of the circular, extended villous adenomas could be achieved with deep rectum resection, bi-directional mucosectomy and transanal straight, hand sewn sigmoideoanostomy.

Adenoma, Villous↗
PubMed2000

[Foreign bodies of the rectum].

During the 22 years period there were 26 patients (23 men and 3 women) aged from 18 to 71 with foreign bodies in the rectum introduced through the anal canal. The main causes of the appearance of foreign bodies in the rectum were anal masturbation (in 12 patients) and forced introduction of the objects by other people (in 10 patients). Among the foreign bodies prevailing were plastic and glass bottles, cucumbers and carrots, wooden and rubber objects in the from of the phallus. Typical were large sizes of the most objects introduced (the diametrical size more than 6 cm and the length more than 15 cm) which was responsible for the development of complications and made the removal difficult. The symptoms of the presence of foreign bodies in the rectum were determined as well as the optimum methods of diagnosis. A classification of rectal foreign bodies is proposed for the solution of medico-tactical tasks. The transcanal removal of the foreign bodies was fulfilled in 23 patients. The standardized technique of the transcanal removal of the objects is thought by the authors to include 10 principal propositions. Open operative interventions (removal of the foreign body, suturing the rupture, drainage of the abdominal cavity or of the perirectal space, sigmostomy) were performed in 4 patients with penetrating injuries of the rectum wall. The results of the treatment including removal of all foreign bodies were good, without lethal outcomes.

Adolescent↗
PubMedDate not supplied

The lateral ligaments of the rectum: myth or reality?

The modern approach to rectal surgery aims at preserving the nerves to the urogenital system. The relationships between the lateral aspects of the rectum and the surrounding structures represent one of the most controversial points in the surgical anatomy of this area. This study was conducted on 27 fresh cadavers and 5 frozen pelvises. All dissections were performed with a technique similar to that used for the surgical mobilisation of the rectum. The lateral ligaments can be considered extensions of the mesorectum; they originate laterally to the middle portion of the rectum and descend posterolaterally to anchor to the endopelvic fascia. The lateral neurovascular pedicle of the rectum, comprising the middle rectal artery and the transverse autonomic nervous fibres, courses partially beneath the lateral ligament. The urogenital nervous bundle runs close to the point of insertion of the lateral ligaments in the endopelvic fascia, but is not covered with the same layer that forms the ligament itself. Anatomical dissection of cadavers is of invaluable help to the surgeon as it represents the basis for easy recognition of all the various structures in the rectal area.

Cadaver↗
PubMedDate not supplied

Mantle cell lymphoma of the rectum at an early stage: a case report.

We report a very rare early-stage case of mantle cell lymphoma, which arose from the rectum. A 60-year-old man presented with a small elastically hard polypoid lesion in the rectum. The lesion was 1.2 x 1.2 cm in size. As a preoperatively barium enema and endoscopy suggested a benign tumor of the rectum, he underwent local excision of a rectal polypoid mass transanally under spinal anesthesia. However, histological examination revealed a malignant lymphoma, because the lesion was histologically characterized by solid growths of small to medium-sized round cells. Furthermore, immunohistochemical tests revealed B-cell marker positivity and CD5 positivity, but cyclin D1 negativity. Since it was reported that lymphomas with a mantle cell lymphoma morphology and CD5 expression, but without cyclin D1 overexpression, exist in about 10% of mantle cell lymphoma cases, we diagnosed his disease as mantle cell lymphoma. To our knowledge, this is the first reported case of an early-stage mantle cell lymphoma, originating from the rectum.

Biomarkers, Tumor↗
PubMed2001

[New method of abdominal cavity opening in surgery of rectum].

The paper presents a new method of surgical access to the small pelvis in which laparotomy is performed by using the transverse incision through both inguinal canals and cutting off the public insertions of the straight muscles of the abdomen. The inguinal canals with the posterior wall were opened according to the Shouldice procedure, and they were closed suturing the public insertions of rectus abdominis, in 8 cases the inguinal canals were repaired by using the Halsted procedure with our modification [1] and in three case our own method was used [2]. From April 28, 1998 to September 06, 2000, 11 operations for rectal carcinoma were performed using this method. Simultaneously, in 5 patients inguinal hernias were repaired. In 6 cases of rectal carcinoma, the abdominoperineal resection of the rectum was performed using the Miles method (in one case accompanied by total hysterotomy, partial ileoectomy and appendectomy, "en bloc"). In 2 cases resection of the rectum using the Hartman method was done. In 2 case the anterior rectal resection by the Dixon method and in another one partial rectalctomy were performed. The abdominal wounds healed by first intension. Among complications showed: difficult healing of the perineal wound was observed in 1 patient, another one required reoperation due to obstruction, in 1 patient inguinal reherniation was found and in another one the hernia around the colostomy occurred. Surgical access suggested by us enables extensive removal of the tissues around the rectum, including adjacent organs (considering easy technical terms), the simultaneous supply of inguinal hernias, in the cases of abdominoperineal resection of the rectum the abdominal anus was created through the left straight muscle of the abdomen, leaving more than 4 cm between a colostomy and an abdominal wound. The low, transverse incision caused only slight surgical discomfort (and patients quickly resumed ambulation) and good cosmetic effect of scar.

Abdomen↗
PubMed1975

Dynamics of the rectum and anus.

The anorectum is a continuously active area with integration of smooth and striated muscle sphincters. Their responses to the entry of material from the colon into the rectum are usually at a subconscious level but voluntary control can be exerted. In the accommodation response the rectum adapts to the presence of faeces and the rise in rectal pressure caused by their entry into the rectum passes off in a few minutes. The sampling response consists of transient relaxation of the upper part of the internal anal sphincter which allows the rectal content to come in contact with the somatic sensory area in the anal canal to assess the nature of the content. Defaecation is the most complex response. Controlled defaecation occurs when a moderate stimulus from the full rectum reaches consciousness by release of cortical inhibition. When the rectal stimulus is greater and combined with stimulation of the anal canal urgent defaecation takes place.

Afferent Pathways↗
PubMed2002

[Endoscopic treatment of intestinal anastomotic leakage in low anterior resection of the rectum by using fibrin adhesive. Our experience].

BACKGROUND: Personal experience about treatment of anastomotic leakage in low anterior resection of the rectum by using human fibrin adhesive "Tissucol" is reported. METHODS: Eight cases of anastomotic leakage treated with using human fibrin adhesive "Tissucol", are analyzed in a retrospective study. Patients had three/six months-one year follow up. Treatment with human fibrin adhesive "Tissucol" was performed in our Endoscopic ambulatory. Six cases had either an immediate resolution or an ambulatorial follow-up; in 2 cases only, general complications forced to a prolonged hospital stay. The study concerns 58 patients subjected to low anterior resection of the rectum and endoscopic treatment of 8/58 patients with anastomotic leakage. Fistulas were sealed with human fibrin adhesive "Tissucol" by using flexible endoscope. Anastomotic leakage identification leakage was made and low anterior resection of the rectum and sealing with human fibrin adhesive "Tissucol" were performed. RESULTS: Complete sealing of fistula and rectum patent. CONCLUSIONS: The excellent results obtained with this non invasive and fast treatment, easily practicable even in ambulatorial regimen, lead the authors to consider it effective and as first-choice treatment of this dangerous complication. The cost/benefit ratio is favorable if compared with the long hospital stay required for other treatments, which also present loaded high morbidity and mortality.

Aged↗
PubMed2003

[FTIR spectroscopic study of normal and malignant tissues of rectum].

Fourier transform infrared (FTIR) spectroscopy was used to study the normal and malignant tissues of rectum. The FTIR spectra of tissues were measured by Nicolet Magna IR-750 spectrometer equipped with mid-infrared fiber optics. The results show that the intensity ratios of five pairs of bands can be used to distinguish the normal and malignant tissues. In the spectra of malignant tissues the relative intensities ratios of I2,873/I2,852 and I1,312/I1,245 were higher than those of normal ones; however, the ratios of I1,745/I1,643, I1,458/I1,400 and I1,162/I1,082 were lower. These results, proved by data-analysis of spectra from 21 patients, were generally shown in the spectra of rectum tissues. The study of near-malignant tissues (one centimeter beside the malignant point) of rectum by FTIR shows that these ratios of bands were in a transient state between normal and malignant rectum tissues.

Humans↗
PubMed1992

[Surgical treatment of carcinoma of the middle and lower rectum. Report of 949 cases].

Carcinoma of the rectum in 949 cases (484 cases of middle rectum and 465 cases of lower rectum) was resected from 1954 to 1986. There were 296 (31.99%) cases of sphincter-saving resection (SSR). The results of SSR before 1980 were compared with those after 1980. The operative mortality of curative resection decreased from 1.52% to 0.34%. The overall survival rate was 74.20 +/- 2.16% (life table method), for abdominoperineal resection (A-P resection) was 61.67 +/- 3.62% and for SSR was 84.12 +/- 2.40% Respectively. The local recurrence after curative resection in all cases was 14.02%, after A-P resection-15.44%, and after SSR-10.92%. The local recurrence after SSR before 1980 was just the same as after 1980. The results in this series showed the rationality of SSR in the treatment of carcinoma of the middle and lower rectum.

Adenocarcinoma↗
PubMedDate not supplied

[Anterior resection of the rectum for rectal cancer--options, limits, immediate complications].

A number of factors have recently led to a more conservative approach for middle or low rectal cancers, making possible sphincter preservation and reducing the number of abdomino perineal excisions of the rectum. We have performed a retrospective analysis on 510 patients operated on in our unit between 1994 and 2003 for rectal cancer. There were a number of 118 anterior resection of rectum; in 20 cases the TME has been performed and in 6 cases a very low anterior resection of rectum was done. The overall operative morbidity rate was 16.10% in direct relation with the distal limit of resection. We note urinary dysfunctions, anastomotic leakage, recto-vaginal fistulas as immediate postoperative complications. With the practice of total mesorectal excision, the use of abdomino perineal excision of the rectum is decreasing. The use of preoperative radiotherapy can increase the rate of operative morbidity but despite of these, its long-term benefit, is important.

Adenocarcinoma↗
PubMed1992

[Abdomino-perineal rectum amputation for therapy of locoregional recurrence after anterior resection].

In a retrospective study (1979-1988) we evaluated the outcome of the abdominoperineal amputations of the rectum in 9 patients for local recurrence after anterior resection. The technical feasibility of the secondary rectum amputation, early and late results and indications for the operation are discussed. The secondary rectum amputation for local recurrence after primary anterior resection is a difficult operation. A low morbidity and a zero mortality are reported. Late results are bad; 8 of 9 reoperated patients are deceased 22 (6-60) months and 1 patient is alive 32 months after the rectum amputation. The only indication for reoperation is an operation with curative intention. The early recognition of a local recurrence is of up-most importance. It is reported that with endorectal ultrasound it is possible to pick up small and asymptomatic local recurrences. Perhaps the recognition of a small local recurrence with endoluminal sonography enables to ameliorate the late results of this rare intervention.

Abdomen↗
PubMed1989

[A case report of leiomyosarcoma of the rectum].

A case of leiomyosarcoma of the rectum and a review of the relevant Japanese literature is reported. A 33-year-old man, suspected of having a rectal tumor was admitted to out hospital for though examination. The tumor was located at the anterior wall of the rectum behind the prostatic gland. A preoperative perineal biopsy was done and the pathological diameters was a leiomyosarcoma. The abdominoperineal resection was performed but the nerve was able to be preserved. The postoperative quality of life has been good. The difficulties in arriving at a histological differentiation of a simple tumors of the rectum from a malignant smooth muscle tumor of the rectum is discussed.

Adult↗
PubMed1987

[Cancer of the middle third of the rectum].

Anterior resection and abdominoperineal resection are standard procedures to treat cancer in the upper and the lower third of the rectum, respectively. The area of interest today is the middle third of the rectum, i.e. the part 7.5-12 cm above the anal verge. Surgical therapy is mainly based on prognostic tumor factors and preoperative staging. The degree of tumor infiltration of the rectal wall and the number of positive lymph nodes are of paramount importance. For preoperative staging the results of digital examination are improved by new imaging techniques. Endorectal ultrasound is able to oklineate tumor infiltration of the rectal wall, whereas computed tomography is better suited to identify tumor infiltration outside the rectum. Preoperative lymph node staging is still not reliable. The surgeon, therefore, has to decide on the surgical therapy intraoperatively. Local tumor excision is possible only if the tumor can be reached by the finger of the surgeon, i.e. if located not more than 10 cm above the anal verge. Local excision is an acceptable procedure in high grade cancers of less than 3 cm diameter and infiltration of the muscularis propria, preferably submucosa only. Further studies are needed to evaluate the long term results. Adjuvant preoperative radiation therapy is applied increasingly in tumors infiltrating beyond the rectal wall. There is at present no apparent benefit from chemotherapy for carcinoma of the rectum.

Combined Modality Therapy↗