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PubMed1989

Intraoperative antegrade colon irrigation--in the management of obstructing left-sided colon cancer.

The management of obstructing left-sided colon cancer remains controversial. The advent of intraoperative antegrade colonic irrigation (I.A.C.I.) has allowed primary anastomosis to be performed in the obstructed bowel. From July 1985 to Feb. 1989, there were eleven patients with obstructing left-sided colon cancer admitted to Changhwa Christian Hospital. Eight of these patients, five men and three women, age ranged from 31 to 80 years old, accepted the I.A.C.I. procedure and followed by the one-staged operations. The I.A.C.I. procedure was advocated by Dudley et al in 1980. Postoperatively, there was no case which suffered from clinical leakage or sepsis, except two cases with mild wound infection. Consequently, there was no operative mortality.

Adult↗
PubMedDate not supplied

Oncogene expression in adenocarcinomas of the colon and in colon tumor-derived cell lines.

Six colon cancer cell lines, 13 colon tumors and ten normal colon tissues were analyzed for RNA expression using probes for c-myc, c-k-ras, c-myb, and c-fos and for the p53, TGF-alpha, and EGF receptor genes. No aberrant transcripts were detected. Levels of expression in tumors ranged from two-fold below that of normal tissue when the v-fos probe was used to 10 fold above the normal level when the c-myc probe was used. Enhanced c-myc expression was also observed in the cell lines. Southern and DNA dot blot analyses revealed c-myc amplification in three of the six cell lines.

Actins↗
PubMed1986

[Clinical and instrumental evaluation by multiple colonic manometry of tiropramide, trimebutine and octylonium bromide in irritable colon. II. Repeated oral administration].

Sixty out-patients with acute or sub-acute irritable colon were randomly allocated to receive 3 daily doses of 100 mg tiropramide, 150 mg trimebutine maleate or 20 mg octilonium bromide, orally during 5 consecutive days. Before and after treatment, multiple colonic manometry was performed, monitoring tonus, intensity and frequency of sinusoid contraction waves, transitories and vibrations, as well as the voluntary contraction capacity. Before treatment and after 2 and 5 days, the specific symptoms were also monitored, scored and recorded. Significant variations in tonus were not observed with any drug, but while tiropramide left unmodified the voluntary contractile ability, a significant inhibition was observed with trimebutine and, mainly, with octilonium. The overall power of spontaneous colonic contractions did not vary significantly with any drug. However, while with tiropramide a significant redistribution of muscular power was observed so as to increase propulsion waves and to decrease the ineffective transitory and vibrational contractions, with octilonium and trimebutine no clinically relevant redistribution of the power wasted in transient spasms was observed. Based on these observations, tiropramide was considered to be at least as effective an antispasmodic as octilonium and at least as effective a synchronizer as trimebutine, but was different from both reference drugs because it was the only one to act simultanously as both an antispasmodic and a synchronizer. The three drugs produced an improvement in each and all monitored symptoms as well as in the overall symptom intensity. Tiropramide, however, produced an improvement significantly faster, more progressively and to a greater extent than either reference drug.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1986

[Clinical and instrumental evaluation by multiple colonic manometry of tiropramide, trimebutine and octylonium bromide in the irritable colon: I. Administration by single i.v].

Sixty out-patients with acute or sub-acute irritable colon were randomly allocated to receive a single intravenous dose of 50 mg tiropramide, 50 mg trimebutine maleate or 10 mg octilonium bromide. Before and after injection, multiple colonic manometry was performed, monitoring tonus, intensity and frequency of sinusoid contraction waves, transitories and vibrations, as well as the voluntary contraction capacity. Significant variations in tonus were not observed with any drug, but, while tiropramide left unmodified the voluntary contractile ability, a significant inhibition was observed with trimebutine and octilonium. The overall power of spontaneous colonic contractions did not vary significantly with tiropramide, whereas some decrease was observed with trimebutine, and a substantial one with octilonium. Moreover, while with tiropramide and, to a lesser extent, with trimebutine there was a significant redistribution of muscular power so as to increase phasic propulsion waves and to decrease the ineffective transitory and vibrational contractions, with octilonium only a decreased wave amplitude was recorded without alteration of the frequency of transient spasms. Based on these observations, tiropramide was evaluated as being at least as effective an antispasmodic as octilonium and at least as effective a synchronizer as trimebutine, while setting itself aside from both reference drugs as it was the only one to act contemporarily as both an antispasmodic and a synchronizer.

Adult↗
PubMed1982

Mucosal microhernias in the nonhuman primate colon: their role in the pathogenesis of colonic disease.

Microhernias of colonic mucosal glands through the muscularis mucosae are common in human and nonhuman primate colons, and are related to submucosal lymphoid nodules. In nonhuman primates they have been shown to play an important role in the spread of inflammatory diseases from the lamina propria to the submucosa by allowing the infective agents to pass through the muscularis mucosae. The lymphoid tissue of the alimentary tract is composed predominantly of B lymphocytes and produces humoral antibodies. This property of the lymphoid component of these microhernias may thus play a significant role in determining which infective colonic diseases penetrate into the submucosa and which remain largely confined to the lamina propria.

Animals↗
PubMed1983

Differential susceptibility of AKR, C57BL/6J, and CF1 mice to 1,2-dimethylhydrazine-induced colonic tumor formation predicted by proliferative characteristics of colonic epithelial cells.

The proliferative characteristics of the colonic mucosae of various mouse strains were examined to determine their value in forecasting the differential susceptibility of each to 1,2-dimethylhydrazine (DMH)-induced tumor formation. The control labeling index (LI) was highest (9.9 +/- 2.6) and the proliferative compartment (PC) widest in the DMH-sensitive CF1 strain, whereas the LI was lowest (7.3 +/- 1.3) (P greater than 0.01) and the PC shortest in the AKR resistant strain. The size of the PC and the LI for moderately resistant C57BL/6J mice lay between these values (8.5 +/- 1.1). Pooled data from 1 week after the fifth and sixth injections and 12 weeks after the first injection of six showed elevated LI in the distal colons of all DMH-treated mice. Distribution analyses of [3H]thymidine-labeled cells indicated extension of the PC (Stage II abnormality) in all strains with a shift of DNA-synthesizing cells from the major zone or lower third to the middle and upper thirds of the crypt (Stage II abnormality) occurring primarily in the CF1 strain. Cytotoxicity measurements at 6 hours and compensatory DNA synthesis at 3 and 4 days after DMH injection (20 mg/kg body wt) revealed similar relative response levels in CF1 and AKR mice, which suggested induction initially of like numbers of mutations. Indigenous conditions shown to influence the expression of colonic neoplasia are the level of DNA synthesis and the dimensions of the PC within the mucosa.

Animals↗
PubMed1982

Mucosal microhernias in the nonhuman primate colon: their role in the pathogenesis of colonic disease.

Microhernias of colonic mucosal glands through the muscularis mucosae are common in human and nonhuman primate colons, and are related to submucosal lymphoid nodules. In nonhuman primates they have been shown to play an important role in the spread of inflammatory diseases from the lamina propria to the submucosa by allowing the infective agents to pass through the muscularis mucosae. The lymphoid tissue of the alimentary tract is composed predominantly of B lymphocytes and produces humoral antibodies. This property of the lymphoid component of these microhernias may thus play a significant role in determining which infective colonic diseases penetrate into the submucosa and which remain largely confined to the lamina propria.

Animals↗
PubMed1982

[Giant diverticulum of the sigmoid colon. A rare complication of colonic diverticulosis. Review of the literature apropos of a case].

The authors report a case of giant diverticulum of the sigmoid colon, a very rare complication of diverticulosis of the colon, since only 38 cases have been reported in the literature. The diverticulum was seen at barium enema in a 66-year-old man complaining of digestive symptoms consisting of lower abdominal pain, tenesmus, diarrhea and fever. Segmental resection of the sigmoid colon including the site of implantation of the diverticulum with end-to-end anastomosis at the same operative stage led to definitive cure. On the basis of a study of the literature, the authors define the clinical, diagnostic and pathogenic characteristics of the condition.

Aged↗
PubMed1994

Intraoperative colonic lavage and primary anastomosis--an alternative to Hartmann procedure in emergency surgery of the left colon.

OBJECTIVE: To assess whether intraoperative lavage and primary resection with anastomosis is a safe alternative to a Hartmann procedure in emergency surgery of the left colon. DESIGN: Retrospective study. SETTING: University hospital. MATERIAL: 101 consecutive patients (39 emergency and 62 elective) who underwent a left-sided colonic resection during a 3-year-period. INTERVENTIONS: 17 of the emergency procedures comprised an intraoperative lavage followed by resection and primary anastomosis without faecal diversion; 17 were Hartmann procedures and 5 patients had primary resection without lavage. MAIN OUTCOME MEASURES: Postoperative mortality, morbidity and duration of hospital stay in these two groups compared with these after a contemporary series of elective resections. RESULTS: There were no postoperative deaths and no clinical anastomotic leaks in the lavage group. The duration of hospital stay (median 11 days) was similar in both groups (overall and sigmoid resection respectively). In the Hartmann group, there were two deaths and the postoperative stay in hospital was significantly longer. CONCLUSIONS: Primary resection with intraoperative lavage can be done successfully in patients with acute obstruction of the left colon and the duration of hospital stay and morbidity are similar to those seen in patients operated on electively.

Adult↗
PubMedDate not supplied

[Cytometric study of colonic tumors in a model of experimental colonic cancer. Impact of the diet].

Butyrate is a short chain fatty acid, made up of four carbon atoms. Along with acetate and propionate, they are the main volatile fatty acids formed by the microbial fermentation of the carbohydrates of dietary fibre in the colon, mainly in the caecum. Additionally, they acidify the intracolonic pH, and they play an important role in the regulation of the absorption of water and sodium. On the other hand, they are, especially butyrate, preferred by the colon cell, as sources of energy alternative to glucose. Besides this, butyrate, in cellular cultures, is a known antineoplasic agent which is characterized by doubling the cellular duplication time for cells in the G1 phase, it increases the activity of certain enzymes, it stimulates the effects of interferon, it modifies the morphology of the cells, which in some cases leads to the reversion of the characteristic transformations of the cancerous cells, and it produces alterations in the chromatin, the nucleoli, elements of the cytoskeleton and the Golgi apparatus. Even though it is not known how it causes these actions, it is thought that the acetylization of histones which it produces, may be an important mechanism. We analyzed the effect of this substance in a colonic carcinogenesis model in Sprague-Dawley rats, in which the tumors were induced with the alkylating agent 1,2-dimethylhydrazide, observing the cytometric pattern of the tumors, and the possible differences between both groups. In one of them, sodium butyrate was continuously infused by means of a intrathecal catheter at a rhythm of 1.5 ml/hour during the tumoral induction which lasted four weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1976

[Multiple adenomatous papillary colonic polyps in a family with frequent cases of stomach carcinoma--a new phenotype of familial colonic polyposis].

A kindred of "minor adenomatous polyposis" associated with a high incidence of gastric cancer is described. Five out of 14 mainly asymptomatic individuals in 2 generations of kindred examined clinically, by panendoscopy and coloscopy exhibited multiple polyps of colon or/and stomach and jejunum. Single or multiple papillary adenomas were detected mainly in the right or middle colon (3 times or in the jejunum (once). Hyperplastic polyps were found in the stomach (3 times) and in the colon (twice of these 5 individuals. Our findings suggest that "minor adenomatous polyposis" associated with gastric cancer may represent another, hitherto unrecognized, phenotype of familial multiple polyposis.

Colonic Diseases↗
PubMed1996

High-resolution chromoendoscopy for the diagnosis of diminutive colon polyps: implications for colon cancer screening.

BACKGROUND & AIMS: A visual, nonbiopsy technique that could reliably determine the histology of diminutive colorectal polyps could greatly reduce the cost of colon cancer screening. This study was designed to report our experience using a high-resolution colonoscope combined with indigo carmine dye to diagnosis diminutive colorectal polyps. METHODS: Colonoscopy using a Fujinon EC-400 HM/HL was performed in 36 patients with polyps <10mm in diameter. Polyps from the first 12 patients (phase 1) were sprayed with 10 mL of 0.2% indigo carmine dye, and a biopsy was performed or a specimen removed and submitted for histological analysis. The morphological data were used to predict polyp histology in the subsequent 24 patients (phase 2). RESULTS: Hyperplastic polyps had a characteristic surface "pit pattern" of orderly arranged "dots" that resembled the surrounding, nonpolypoid mucosa. Adenomatous polyps had surface "grooves" or "sulci." Sensitivity and specificity of our techniques in distinguishing adenomatous from nonadenomatous colorectal polyps were 93% and 95% respectively. CONCLUSIONS: High-resolution chromoendoscopy provides morphological detail of diminutive colorectal polyps that correlates well with polyp histology. If incorporated into colon cancer screening, these techniques may limit the need for biopsy and/or subsequent colonoscopy and ultimately decrease costs.

Adult↗
PubMed1993

Identification of a colon mucosa gene that is down-regulated in colon adenomas and adenocarcinomas.

A cDNA, which we call DRA (for down-regulated in adenoma) has been isolated. Its mRNA is expressed exclusively in normal colon tissue, probably only in the mucosal epithelia. Expression of the DRA gene is significantly decreased in adenomas (polyps) and adenocarcinomas of the colon. The DRA gene appears to be a single-copy gene present on chromosome 7, a chromosome associated with colorectal tumorigenesis. The predicted DRA polypeptide is an 84,500-Da protein that contains charged clusters of amino acids, primarily at the NH2 and COOH termini. Together with potential nuclear targeting motifs, an acidic transcriptional activation domain, and a homeobox domain, these elements suggest a transcription factor or a protein that may interact with transcription factors. Such a function may be consistent with a role in tissue-specific gene expression and/or as a candidate tumor-suppressor gene.

Adenocarcinoma↗
PubMed2006

Role of colonic fermentation in the perception of colonic distention in irritable bowel syndrome and functional bloating.

BACKGROUND & AIMS: Bloating represents a frequent gastrointestinal symptom, but the pathophysiologic mechanism responsible for its onset is still largely unknown. Patients very frequently attribute the sensation of bloating to the presence of excessive bowel gas, but not all patients with gas-related symptoms exhibit increased intestinal production of gas. It is therefore possible that other still unrecognized mechanisms might contribute to its pathophysiology. Our aim was to evaluate whether a subgroup of patients affected by functional abdominal bloating presents hypersensitivity to colonic fermentation. METHODS: Sixty patients affected by functional gastrointestinal disorders (11 functional bloating, 36 constipation-predominant, and 13 diarrhea-predominant irritable bowel syndrome) and moderate to severe bloating took part in the study. Twenty sex- and age-matched healthy volunteers were enrolled as a control group. All the subjects underwent a preliminary evaluation of breath hydrogen excretion after oral lactulose. Then, on a separate day, an evaluation of sensitivity thresholds at rectal level was performed with a barostat before and after the induction of colonic fermentation with oral lactulose. A control test with electrolyte solution was also performed. RESULTS: Both breath hydrogen excretion and mouth-to-cecum transit time did not differ between the 4 groups studied. Neither electrolyte solution nor lactulose modified sensitivity thresholds in healthy volunteers. In low hydrogen producers, basal perception and discomfort thresholds were similar to high hydrogen producers, but after lactulose both perception and discomfort thresholds were significantly reduced only in low hydrogen producers. CONCLUSIONS: A subgroup of patients with functional gastrointestinal disorders and moderate to severe bloating might have hypersensitivity to products of colonic fermentation.

Adult↗
PubMed2002

Apolipoprotein E and colon cancer. Expression in normal and malignant human intestine and effect on cultured human colonic adenocarcinoma cells.

Background: Apolipoprotein E (apo E) is a key regulatory protein in lipoprotein metabolism and it is also a potent inhibitor of cell proliferation. Although genetic alterations of apo E affect enterohepatic cholesterol transport and, presumably, the risk of colon carcinoma, the expression and potential functions of apo E in the human intestine are poorly known. Methods: The localization of apo E in normal and malignant gastrointestinal tract was studied using immunohistochemistry and in situ hybridization. The effect of apo E3 on cell polarity and the distribution of beta-catenin was examined in HT29 human colon adenocarcinoma cell lines. Results: Both apo E protein and mRNA were present throughout human intestine. The macrophages in the superficial lamina propria of normal colon were more strongly positive for apo E than those in the small intestine, where the most positively stained cells were dendritic cells and macrophages in the germinal centers of lymphoid follicles. In carcinomas, intensely positive macrophages surrounded the tumor area. In cultured undifferentiated HT29 cells, treatment with apo E improved cell polarity and translocated beta-catenin from the cytoplasm to cell--cell adhesion sites. Conclusions: Mononuclear phagocytes and endocrine cells are the main source of apo E in the gastrointestinal tract. We hypothesize that macrophage-derived apo E may modulate epithelial integrity and thus contribute to cell growth.

Journal Article↗
PubMed1998

Derangement of mucosal barrier function by bacteria colonizing the rat colonic mucosa.

BACKGROUND: Interaction between gut flora and the intestinal barrier may involve changes in permeability. METHODS: Rats with a colonic segment excluded from faecal transit were surgically prepared. Matched groups were either kept on luminal antibiotics to prevent colonization of the segment or recolonized with mixed rat flora. Permeability to low-dose trinitrobenzenesulphonic acid (TNBS) or trinitrophenol (TNP), and mucosal injury by the compounds at a high dose were tested in antibiotic and recolonized rats (the compounds differ in water solubility but share a common antigenic domain). RESULTS: Lumen to blood clearance of the hydrophilic probe (TNBS) was faster in recolonized than in antibiotic rats. The hydrophobic compound TNP was absorbed at faster rates than TNBS, but there was no difference between antibiotic and recolonized rats. Instillation of TNBS at a high dose induced mucosal release of inflammatory mediators and tissue myeloperoxidase accumulation in recolonized rats but not in antibiotic rats. Large necrotic lesions with submucosal involvement after TNBS were only observed in recolonized rats. In contrast, TNP induced mucosal inflammation and large lesions with submucosal necrosis both in recolonized and in antibiotic rats. CONCLUSION: Colonizing bacteria may increase intestinal permeability to hydrophilic compounds and render the mucosa susceptible to injury.

Animals↗
PubMed2006

Colon-specific delivery and enhanced colonic absorption of [Asu(1,7)]-eel calcitonin using chitosan capsules containing various additives in rats.

The objective of this study was to estimate the colon-specific delivery of [Asu1,7]-eel calcitonin (ECT) using chitosan capsules in rats. The intestinal absorption of ECT was evaluated by measuring the plasma calcium levels after oral administration of the chitosan capsules containing ECT and different combinations of additives. The same combinations were investigated by an in situ absorption experiment prior to in vivo administration of capsules. A marked decrease in plasma calcium levels was observed following the oral administration of chitosan capsules containing ECT, S-nitroso-N-acetyl-dl-penicillamine (SNAP), sodium glycocholate, bacitracin and aprotinin (pharmacological availability (PA)% = 6.344%), as compared with capsules containing only ECT (PA% = 0.551%) or capsules containing ECT with SNAP only (PA% = 1.651%). The hypocalcemic effect started 6-8 h after oral administration of capsules and sustained for 24 h. These findings suggest that colon-specific delivery of ECT can be achieved using chitosan capsules and these additives may be useful for improving the colonic absorption of ECT in rats.

Animals↗
PubMed1977

Rectal colonization with group B streptococcus: relation to vaginal colonization of pregnant women.

Anorectal carriage as a possible primary source of vaginal colonization by group B Streptococcus was investigated. The study was performed during two separate periods and included 789 pregnant women and 422 neonates. Specimens from multiple sites were obtained for culture from all women and infants and were streaked onto blood agar plates containing 8 mug of gentamicin sulfate/ml and 15 mug of nalidixic acid/ml, which allow selective growth of streptococci. Cultures positive for group B streptococci were obtained from 162 (20.5%) of the pregnant women and from 50 (11.8%) of the neonates. Rectal cultures were positive for streptococci in 142 (17.9%) of the women, and vaginal cultures gave positive results in 81 (10.2%). The higher incidence of positive results in rectal as opposed to vaginal cultures (ratio of 2:1) was encountered during all phases of the study. This finding suggests that the gastrointestinal tract may be the primary site of colonization by group B Streptococcus and that vaginal colonization may represent contamination from this source.

Culture Media↗