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Sample records for t3 mid-distal rectal

  1. Preoperative infusional chemoradiation therapy for stage T3 rectal cancer

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    Rich, T.A.; Skibber, J.M.; Ajani, J.A. [Univ. of Texas M. D. Anderson Cancer Center, Houston, TX (United States)] [and others

    1995-07-15

    To evaluate preoperative infusional chemoradiation for patients with operable rectal cancer. Preoperative chemoradiation therapy using infusional 5-fluorouracil (5-FU), (300 mg/m{sup 2}/day) together with daily irradiation (45 Gy/25 fractions/5 weeks) was administered to 77 patients with clinically Stage T3 rectal cancer. Endoscopic ultrasound confirmed the digital rectal exam in 63 patients. Surgery was performed approximately 6 weeks after the completion of chemoradiation therapy and included 25 abdominoperineal resections and 52 anal-sphincter-preserving procedures. Posttreatment tumor stages were T1-2, N0 in 35%, T3, N0 in 25%, and T1-3, N1 in 11%; 29% had no evidence of tumor. Local tumor control after chemoradiation was seen in 96% (74 out of 77); 2 patients had recurrent disease at the anastomosis site and were treated successfully with abdominoperineal resection. Overall, pelvic control was obtained in 99% (76 out of 77). The survival after chemoradiation was higher in patients without node involvement than in those having node involvement (p = n.s.). More patients with pathologic complete responses or only microscopic foci survived than did patients who had gross residual tumor (p = 0.07). The actuarial survival rate was 83% at 3 years; the median follow-up was 27 months, with a range of 3 to 68 months. Acute, perioperative, and late complications were not more numerous or more severe with chemoradiation therapy than with traditional radiation therapy (XRT) alone. Excellent treatment response allowed two-thirds of the patients to have an anal-sphincter-sparing procedure. Gross residual disease in the resected specimen indicates a poor prognosis, and therapies specifically targeting these patients may improve survival further. 22 refs., 2 figs., 3 tabs.

  2. The location of locoregional recurrence in pathologic T3N0, non-irradiated lower rectal cancer

    International Nuclear Information System (INIS)

    Kim, Mi Sun; Keum, Ki Chang; Rhee, Woo Joong; Kim, Hyun Ju; Kim, Min Ji; Choi, Seo Hee; Nam, Ki Chang; Koom, Woong Sub

    2013-01-01

    To investigate the patterns of locoregional recurrence of pathologic T3N0 (pT3N0) lower rectal cancer omitting postoperative radiotherapy (RT) and explore the potential of modification of a RT field. From Jan 2003 to Nov 2011, 35 patients omitting preoperative or postoperative RT for pT3N0 lower rectal cancer were included. We defined the lower rectal cancer as the tumor with the inferior margin located below the virtual line-a convergent level between rectal wall and levator ani muscle. All patients had radiologic examinations for recurrence evaluation during the follow-up duration. The median follow-up duration was 66.4 months (range, 1.4 to 126.1 months). Eight (22.9%) of the 35 patients had recurrence. Three (8.6%) was local recurrence (LR) only, 3 (8.6%) was distant metastasis (DM) only, and 2 (5.7%) was LR with DM. All LR were located at primary tumor sites. The overall survival rate, LR-free survival rate, and DM-free survival rate at 5 years was 79.8%, 83%, and 87%, respectively. All LR developed from tumors over 5 cm. However, there was no statistical significance (p = 0.065). There was no other risk factor for LR. Even though the patients included in this study had pathologically favorable pT3N0 rectal cancer, LR developed in 14.3% of patients. Most of the LR was located at primary tumor sites prior to surgery. Based on these findings, it might seem reasonable to consider postoperative RT with a smaller radiation field to the primary tumor site rather than the conventional whole pelvic irradiation.

  3. Feasibility of mesorectal vascular invasion in predicting early distant metastasis in patients with stage T3 rectal cancer based on rectal MRI

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    Kim, Young Chul; Kim, Jai Keun; Lee, Jei Hee [Ajou University School of Medicine, Department of Radiology, Suwon, Gyeonggi-do (Korea, Republic of); Kim, Myeong-Jin [Yonsei University Health system, Department of Diagnostic Radiology, Institute of Gastroenterology, Research Institute of Radiological Science, Seoul (Korea, Republic of); Kim, Young Bae [Ajou University School of Medicine, Department of Pathology, Suwon (Korea, Republic of); Shin, Sung Jae [Ajou University School of Medicine, Department of Gastroenterology, Suwon (Korea, Republic of)

    2016-02-15

    To evaluate the feasibility of mesorectal vascular invasion (MVI) in predicting early distant metastasis developed within 1 year of diagnosis of T3 rectal cancer using magnetic resonance imaging (MRI) Sixty-five patients with T3 rectal cancer (early metastasis, n = 28; non-metastasis, n = 37) were enrolled in this study. Early distant metastases developed in 28 patients (liver, n = 15; lung, n = 9; both, n = 4). Logistic regression was used to determine the independent predictors for early distant metastasis. In univariate analysis, tumour location, carcinoembryonic antigen (CEA), lymphovascular invasion (LVI), MRI-detected MVI, and mesorectal fat infiltration (MFI) (odds ratio [OR], 4.533, 9.583, 5.539, 27.046, and 5.539, respectively) were associated with early distant metastasis. Multivariate analysis demonstrated that MVI (OR, 29.949; P < 0.002) and LVI (OR, 6.684; P = 0.033) were independent factors for early distant metastasis. Specificity and positive predictive value (PPV) of MVI (94.59 %, and 89.47 %, respectively) were significantly higher than those of LVI (64.86 %, and 61.76 %), but sensitivity and negative predictive value were not significantly different between MVI (60.71 %, and 76.09 %) and LVI (75.00 %, and 77.42 %). While sensitivity of MRI-detected MVI was equal to that of CEA in predicting early distant metastasis from T3 rectal cancer, specificity and PPV may be improved by assessing MVI. (orig.)

  4. Could a wait and see policy be justified in T3/4 rectal cancers after chemo-radiotherapy?

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    Hughes, Robert; Harrison, Mark; Glynne-Jones, Robert

    2010-01-01

    Chemoradiotherapy (CRT) followed by total mesorectal excision is the standard when MRI staging demonstrates threatened surgical margins in locally advanced rectal cancer (LARC). Interest in non-surgical management of LARC as an alternative to a resection has been provoked by published excellent long-term outcomes of patients who achieve clinical complete responses (cCR) after CRT. The present retrospective study aimed to determine whether similar rates of local disease control are seen in a UK cancer centre in patients with T3-4 tumours, who obtained a cCR after preoperative CRT, but did not undergo surgery. Method. The outcome and treatment details of 266 patients who underwent CRT for clinically staged T3-4 rectal adenocarcinomas between 1993 and 2005 were reviewed. Results. Fifty-eight patients did not proceed to surgery, 10 of whom were identified as having a cCR. Six of these 10 patients subsequently developed intrapelvic recurrent disease with a median time to local progression of 20 months. Local relapse preceded the development of metastatic disease or occurred simultaneously. No patients underwent salvage resection. Conclusion. CRT alone in cT3/T4 rectal cancers has a high rate of local relapse even after cCR. Delaying or avoiding surgery might be appropriate for cT1 or cT2 tumours, or elderly and frail patients with co-morbidity, but these results do not support the current uncritical move to extrapolate this approach to all surgically fit patients with rectal cancer

  5. Pre-operative radio-chemo-thermotherapy for advanced (T3-4) and/or recurrent rectal carcinomas

    International Nuclear Information System (INIS)

    Wust, P.; Gremmler, M.; Rau, B.; Loeffel, J.; Gellermann, J.; Stahl, H.; Vogl, T.; Riess, H.; Schlag, P.; Felix, R.

    1995-01-01

    Objective: Recent studies suggest that pre-operative radio-chemotherapy in locally advanced rectal cancer can increase resectability and local control (T4 stages), and might facilitate sphincter-preserving surgery (T3 stages). However, response rates are still unsatisfactory for radiotherapy alone, and are only slightly better for radio-chemotherapy. Radiofrequency hyperthermia has now achieved a technical stage already suitable for treating this tumor entity effectively in clinical practice. Therefore, a trimodal pre-operative approach for T3-4 rectal carcinomas has been investigated in a phase I/II study. Materials and Methods: A phase I/II study was conducted on 30 pts with advanced and/or recurrent rectal cancer. (7(30)) pts had recurrences, (9(30)) uT3, (14(30)) T4-stage of the primary. Initial tumor stage was assessed by endosonography, CT and occasionally MRI (T1-w ± Echovist, T2-w, proton density). Radiotherapy was delivered in prone position using a belly-board, three-field technique, standard blocks, 5x1.8 → 45 Gy in 5 weeks. In parallel, 5-FU (300-350 mg/kg, dose escalation) and folinic acid (50 mg) on days 1-5 and days 22-28. Regional hyperthermia was administered using the annular phased array applicator SIGMA-60 once a week. Index temperatures T x were deduced from thermal mapping scans in endocavitary/intratumoral catheters. Re-staging was done by endosonography and CT. Four weeks after radiotherapy, surgery was performed with preference to continence preserving operations. If the tumor remained unresectable, a boost to a total tumor dose of 60 Gy was claimed. Results: (7(30)) pts (23%) did not undergo resection because their tumors remained technically non-resectable: 4 pts with persistent local control of 12-18 mts, 2 pts with progressive disease, 1 pt with too short observation time. (23(30)) pts underwent surgery: only 1 R2-resection, 22 R0-resections. The patho-histological analysis documented 4 CR (17%) at the primary tumor, 12 PR

  6. Effect of preoperative treatment strategies on the outcome of patients with clinical T3, non-metastasized rectal cancer: A comparison between Dutch and Canadian expert centers.

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    Breugom, A J; Vermeer, T A; van den Broek, C B M; Vuong, T; Bastiaannet, E; Azoulay, L; Dekkers, O M; Niazi, T; van den Berg, H A; Rutten, H J T; van de Velde, C J H

    2015-08-01

    High-dose-rate brachytherapy (HDRBT) appears to be associated with less treatment-related toxicity compared with external beam radiotherapy in patients with rectal cancer. The present study compared the effect of preoperative treatment strategies on overall survival, cancer-specific deaths, and local recurrences between a Dutch and Canadian expert center with different preoperative treatment strategies. We included 145 Dutch and 141 Canadian patients with cT3, non-metastasized rectal cancer. All patients from Canada were preoperatively treated with HDRBT. The preoperative treatment strategy for Dutch patients consisted of either no preoperative treatment, short-course radiotherapy, or chemoradiotherapy. Cox proportional hazards models were used to estimate hazard ratios (HR) with 95% confidence intervals (CIs) comparing overall survival. We adjusted for age, cN stage, (y)pT stage, comorbidity, and type of surgery. Primary endpoint was overall survival. Secondary endpoints were cancer-specific deaths and local recurrences. Five-year overall survival was 70.9% (95% CI 62.6%-77.7%) in Dutch patients compared with 86.9% (80.1%-91.6%) in Canadian patients, resulting in an adjusted HR of 0.70 (95% CI 0.39-1.26; p = 0.233). Of 145 Dutch patients, 6.9% (95% CI 2.8%-11.0%) had a local recurrence and 17.9% (95% CI 11.7%-24.2%) patients died of rectal cancer, compared with 4.3% (95% CI 0.9%-7.5%) local recurrences and 10.6% (95% CI 5.5%-15.7%) rectal cancer deaths out of 141 Canadian patients. We did not detect statistically significant differences in overall survival between a Dutch and Canadian expert center with different treatment strategies. This finding needs to be further investigated in a randomized controlled trial. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Minimally invasive plating osteosynthesis for mid-distal third humeral shaft fractures.

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    Lian, Kejian; Wang, Lei; Lin, Dasheng; Chen, Zhiwen

    2013-08-01

    Mid-distal third humeral shaft fractures can be effectively treated with minimally invasive plating osteosynthesis and intramedullary nailing (IMN). However, these 2 treatments have not been adequately compared. Forty-seven patients (47 fractures) with mid-distal third humeral shaft fractures were randomly allocated to undergo either minimally invasive plating osteosynthesis (n=24) or IMN (n=23). The 2 groups were similar in terms of fracture patterns, fracture location, age, and associated injuries. Intraoperative measurements included blood loss and operative time. Clinical outcome measurements included fracture healing, radial nerve recovery, and elbow and shoulder discomfort. Radiographic measurements included fracture alignment, time to healing, delayed union, and nonunion. Functional outcome was satisfactory in both groups. Mean American Shoulder and Elbow Surgeons score and Mayo score were both better for the minimally invasive plating osteosynthesis group than for the IMN group (98.2 vs 97.6, respectively, and 93.5 vs 94.1, respectively; Pshaft fractures. Minimally invasive plating osteosynthesis is more suitable for complex fractures, especially for radial protection and motion recovery of adjacent joints, compared with IMN for simple fractures. Copyright 2013, SLACK Incorporated.

  8. Preliminary results of pre-operative 5-FU, low dose leucovorin (LV), and concurrent radiation therapy (RT) for resectable T3 rectal cancer

    International Nuclear Information System (INIS)

    Grann, Alison; Minsky, Bruce D.; Cohen, Alfred M.; Saltz, Leonard; Kelsen, David P.; Kemeny, Nancy; Ilson, David; Guillem, Jose G.; Paty, Philip B.; Bass, Joanne

    1996-01-01

    PURPOSE: We report the downstaging, acute toxicity, and preliminary local control and survival of pre-op 5-FU, low dose LV, and concurrent RT followed by post-op LV/5-FU for pts with clinically resectable, T3 rectal cancer. MATERIALS AND METHODS: A total of 32 pts (M:26, F:6) were prospectively treated from 12/91-8/95. Eligibility criteria included adequate hematologic indicies, primary adenocarcinoma limited to the pelvis, and T3 disease confirmed by transrectal ultrasound. Twenty five pts were considered clinically to require an APR on initial (pre-treatment) assessment by their operating surgeon. The median age was 56 (range: 24-80), and the median distance from the anal verge was 5.0cm (range: 3-9cm). Pts received 2 monthly cycles (bolus daily X 5) of LV (20mg/m2) and 5-FU (325mg/m2), beginning concurrently with day 1 of RT, followed by surgery 4-5 weeks later. RT included 4680 cGy to the pelvis followed by a boost to 5040 cGy. Post-operatively, pts received a median of 2 monthly cycles (range: 0-10 cycles) of LV (20 mg/m2) and 5-FU (425mg/m2). A toxicity assessment was performed at each visit using the NCI toxicity criteria modified for gastrointestinal toxicity. The median follow-up was 12 months (range: 3-48 months). All 32 patients were included in the analysis of toxicity, sphincter preservation, and downstaging. Analysis of patterns of failure and survival was limited to the 15 pts who had a minimum follow-up of 1yr or developed failure prior to 1 yr. For this subset the median follow-up was 24 months (range: 3-48 months). RESULTS: During the pre-op segment, individual grade 3+ acute toxicities were; diarrhea: 16%, bowel movements: 16%, leukopenia: 12%. The incidence of total toxicity was 25% ((8(32))). The median nadir counts were; WBC: 2.9 (range: 1.7-5.6), HGB: 12.4 (range: 7.1-15.0), and PLT (X1000): 161 (range: 113-237). The pathologic complete response rate was 9% ((3(32))). An additional 13% ((4(32))) had negative lymph nodes and 1-2 microscopic

  9. Can histopathologic assessment of circumferential margin after preoperative pelvic chemoradiotherapy for T3-T4 rectal cancer predict for 3-year disease-free survival?

    International Nuclear Information System (INIS)

    Mawdsley, Suzannah; Glynne-Jones, Rob; Grainger, Juliet; Richman, Paul; Makris, Andreas; Harrison, Mark; Ashford, Richard; Harrison, Richard A.; Osborne, Melanie; Livingstone, Jeremy I.; MacDonald, Peter; Mitchell, Ian C.; Meyrick-Thomas, John; Northover, John; Windsor, Alastair; Novell, Richard; Wallace, Marina

    2005-01-01

    Purpose: This study set out to determine the impact of a positive circumferential resection margin (CRM) (R1-R2) and pathologic downstaging on local recurrence and survival in patients with borderline resectable or unresectable rectal adenocarcinoma treated with neoadjuvant chemoradiotherapy (CRT). Methods and Materials: A total of 150 patients with locally advanced rectal cancer were treated with long-course neoadjuvant CRT using low-dose folinic acid and 5-fluorouracil. CRT was followed 6-12 weeks later by surgical excision. The CRM rate and incidence, site, and pattern of local and systemic recurrences were recorded. The median follow-up was 25 months. Results: The overall median survival was 37 months, with a 5-year overall survival rate of 34%. Of the 150 patients, 122 underwent curative resection; 12% had a complete pathologic response, and downstaging to pT1-T2 occurred in an additional 16%. A negative CRM (R0) was achieved in 65% overall (98 of 150). Local recurrence occurred in 10% of those with R0 resection and 62% of those with R1-R2 resections. Distant metastases occurred in 29% of those with R0 resections and 75% of those with R1-R2 resections. The 3-year disease-free and 3-year overall survival rate was 9% and 25% and 52% and 64%, respectively, for patients with and without a histologically positive CRM. Conclusion: After 5-fluorouracil-based CRT, a positive CRM predicted for a high risk of subsequent local recurrence and a 3-year disease-free survival rate of only 9%. For this reason, the CRM should be considered a major prognostic factor and should be validated in future trials as an early alternative clinical endpoint

  10. Rectal Prolapse

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    ... ball”. Rectal prolapse may be confused with significant hemorrhoid disease and can even be confusing at times ... and treating this problem. A = Rectal Prolapse B = Hemorrhoids Once a prolapse is apparent, fecal incontinence (inability ...

  11. Hydrocortisone Rectal

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    ... also used to relieve itching and swelling from hemorrhoids and other rectal problems. Hydrocortisone is in a ... may improve within 5 to 7 days.For hemorrhoids, hydrocortisone rectal cream usually is used in adults ...

  12. Bisacodyl Rectal

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    Bisac-Evac® Suppositories ... Dulcolax® Suppositories ... Rectal bisacodyl comes as a suppository and enema to use rectally. It is usually used at the time that a bowel movement is desired. The suppositories usually ...

  13. Mesalamine Rectal

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    Rectal mesalamine comes as a suppository and an enema to use in the rectum. The suppository and the enema are usually used once a day at bedtime. ... rectal mesalamine without talking to your doctor.Mesalamine suppositories and enemas may stain clothing and other fabrics, ...

  14. Rectal lymphoscintigraphy

    International Nuclear Information System (INIS)

    Bucci, L.; Salfi, R.; Meraviglia, F.; Mazzeo, F.

    1984-01-01

    Regional lymph nodes of the rectum are not demonstrable by pedal lymphoscintigraphy. The authors have evaluated the technique of rectal lymphoscintigraphy, using a technique similar to that which has been used in the assessment of lymph nodes in breast and prostatic cancer. Thirty-five patients were studied: ten normal subjects and 25 patients with rectal cancer. In normal subjects, the lymph nodes accompanying the superior hemorrhoidal artery and the inferior mesenteric artery are demonstrable in succession; after three hours the aortic lymph nodes are demonstrable. The 25 patients with rectal cancer underwent resection of their primary tumor and the stage was defined according to Dukes (1932). In five patients (stage A) no alteration was demonstrable. In 11 patients (stage B) the demonstration of regional lymph nodes was delayed vs. the control group. In nine cases (stage C) the demonstration of regional lymph nodes was delayed and defective versus the control group

  15. Rectal duplication.

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    Kulkarni B

    1995-04-01

    Full Text Available Duplications of the alimentary tract are of a great rarity, particularly so in the rectum. Because of its rarity, the difficulty of making a correct diagnosis and of selection of proper approach for treatment, this entity bears a special significance. The present case report deals with a female newborn who presented with imperforate anus and a rectovestibular fistula and a mass prolapsing at the introitus. Complete excision of the mass was carried out through the perineal approach and the child then underwent, a PSARP for the correction of the rectal anomaly. Histology confirmed the mass to be a rectal duplication.

  16. Rectal carcinoma

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    Fossati, V; Antognoni, P; Villa, E and others

    1985-01-01

    Records of 135 patients with rectal carcinoma were reviewed and correlations between survival rate, extent of tumor and radiotherapy were investigated. The survival rate at 5 years was 16% for C Astler Coller's stage patients and without metastases, but the prognosis was much less favourable for advanced tumors and/or subjects with distant metastases. Preliminary results of another series of patients treated with adjuvant radiotherapy are discussed.

  17. Lower rectal cancer. Preoperative staging with CT air enema technique

    International Nuclear Information System (INIS)

    Kanazawa, Amane; Fujii, Shouichi; Iwata, Seiichirou

    2009-01-01

    Preoperative assessment of rectal cancer wall invasion is an important indication of the need for lateral side wall dissection. The purpose of this study was to determine the accuracy rates and clinical usefulness of air-enema CT in preoperative staging of lower rectal cancer. A total of 88 patients diagnosed with lower rectal cancer were examined with an air-enema CT preoperatively and had surgical resection performed. One group was T1-T2 while the other was T3-T4. Forty-two patients were T1-T2, and 46 patients were T3-T4. In univariate and multivariate analysis, irregularities of the rectal wall and spiculated appearance of the rectal wall were significant predictive factors in T3-T4. In patients with air-enema CT findings of rectal wall irregularities and speculated appearance, the accuracy rate for detecting T3-T4 was 85.2-86.45 percent. These results show that air-enema CT is useful for determining the preoperative staging of lower rectal cancer and indication of the need for lateral side wall dissection. (author)

  18. Neoadjuvant Treatment in Rectal Cancer: Actual Status

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    Garajová, Ingrid; Di Girolamo, Stefania; de Rosa, Francesco; Corbelli, Jody; Agostini, Valentina; Biasco, Guido; Brandi, Giovanni

    2011-01-01

    Neoadjuvant (preoperative) concomitant chemoradiotherapy (CRT) has become a standard treatment of locally advanced rectal adenocarcinomas. The clinical stages II (cT3-4, N0, M0) and III (cT1-4, N+, M0) according to International Union Against Cancer (IUCC) are concerned. It can reduce tumor volume and subsequently lead to an increase in complete resections (R0 resections), shows less toxicity, and improves local control rate. The aim of this review is to summarize actual approaches, main problems, and discrepancies in the treatment of locally advanced rectal adenocarcinomas. PMID:22295206

  19. Digital rectal exam

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    ... this page: //medlineplus.gov/ency/article/007069.htm Digital rectal exam To use the sharing features on this page, please enable JavaScript. A digital rectal exam is an examination of the lower ...

  20. Anal and Rectal Disorders

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    ... Abscess Anorectal Fistula Foreign Objects in the Rectum Hemorrhoids Levator Syndrome Pilonidal Disease Proctitis Rectal Prolapse The ... cancer Foreign objects in the anus and rectum Hemorrhoids Levator syndrome Pilonidal disease Proctitis Rectal prolapse Diagnosis ...

  1. Intrarectal ultrasound accuracy in preoperative staging of lower rectal cancer

    International Nuclear Information System (INIS)

    Vallone, G.; Della Vecchia, A.; Di Capua, V.; Rengo, C.; Spirito, M.; Romano, G.

    1988-01-01

    The capabilities were evaluated of endorectal ultrasound in assessing the local extension of rectal carcinomas. The study population consisted of 50 patients with histologically proven rectal cancer. A CT scan was also performed on 45 patients, and the results were then compared to post-operative histologic findings. Endorectal US allowed the correct staging of 39/45 tumors (86.6%), with 1 false positive (overstaging T1 as T2), and 5 false negatives (understaging 3xT3 as T2; 2xT4 as T3). CT allowed the correct staging of 37/45 tumors (82.2%), with 5 false positives (overstaging T1 as T2) and 3 false negatives (understaging T3 as T2). Our results prove endorectal US to be a reliable method for the local staging of rectal cancers, limited to mucosa, submucosa and muscular layers of the rectal wall (T1 and T2 tumors). CT does not allow proper evaluation of T1 and T2 tumors, but provides with a better assessment of tumors (T3 and T4). Both C and endorectal US should, therefore, be used as complementary diagnostic techniques for an accurate evaluation of the local extension of lower rectal cancers

  2. Radical radiotherapy for T3 laryngeal cancers

    International Nuclear Information System (INIS)

    Uno, T.; Itami, J.; Kotaka, K.; Toriyama, M.

    1996-01-01

    From 1974 through 1992, 37 previously untreated patients with T3 laryngeal cancer (supraglottic 15, glottic 22) were treated with initial radical radiotherapy and surgery for salvage. Two-year local control rate with radiotherapy alone, ultimate voice preservation rate, and ultimate local control rate for T3 supraglottic cancer were 33%, 33%, and 60%, respectively. Corresponding figures for T3 glottic cancer were 32%, 23%, and 77%, respecitvely. Five-year cause-specific survival rate for T3 supraglottic cancer and glottic cancer were 47% and 77%, respectively. In T3 supraglottic cancer, none of the 4 patients with subglottic tumor extension attained local control by radiotherapy alone, and local-regional recurrence-free time were significantly shorter in patients with subglottic tumor extension or tracheostomy before radiotherapy. There were no serious late complications such as chondronecrosis, rupture of carotid artery attributed to radical radiotherapy, while 3 patients had severe laryngeal edema requiring total laryngectomy. (orig.) [de

  3. Clinical and endorectal ultrasound staging of circumferential rectal cancers

    International Nuclear Information System (INIS)

    Smith, A.; Farmer, K.C.; Chapple, K.

    2008-01-01

    Full text: Circumferential rectal cancers present at a more advanced stage than those located in a single quadrant. Although accurate staging is an important aspect of the preoperative management of the patient with a rectal cancer, the clinical and radiological staging of this subgroup of rectal cancer patients has been poorly studied. All patients with a rectal cancer were assessed clinically (by digital rectal examination and rigid sigmoidoscopy) before the radiological assessment by endorectal ultrasound (ERUS). Data collected included tumour height (distance from anal verge in centimetre) and tumour type (circumferential or non-circumferential). Radiological tumour staging was with the TNM system. Fifty-nine subjects (33 men, 26 women; median age 65 years (range 38-86 years)) were identified with a circumferential rectal cancer. Mean height of the cancer was 8 - 0.4 cm (standard error of the mean; range 2-13 cm). Forty-two cancers were palpable, and 17 cancers were impalpable. All cancers assessed clinically as circumferential were confirmed as circumferential on ERUS scanning. Tumour stage as assessed by ERUS was either T3 (n = 57) or T4 (n = 2). Nodal status was NO (n = 29) and N1 (n = 30). All rectal cancers assessed as circumferential on clinical examination have an ERUS stage of T3 or greater.

  4. Radical radiotherapy for T3 laryngeal cancers

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    Uno, T. [International Medical Center of Japan, Tokyo (Japan). Dept. of Radiation Therapy; Itami, J. [International Medical Center of Japan, Tokyo (Japan). Dept. of Radiation Therapy; Kotaka, K. [International Medical Center of Japan, Tokyo (Japan). Dept. of Radiation Therapy; Toriyama, M. [International Medical Center of Japan, Tokyo (Japan). Dept. of Otolaryngology

    1996-08-01

    From 1974 through 1992, 37 previously untreated patients with T3 laryngeal cancer (supraglottic 15, glottic 22) were treated with initial radical radiotherapy and surgery for salvage. Two-year local control rate with radiotherapy alone, ultimate voice preservation rate, and ultimate local control rate for T3 supraglottic cancer were 33%, 33%, and 60%, respectively. Corresponding figures for T3 glottic cancer were 32%, 23%, and 77%, respecitvely. Five-year cause-specific survival rate for T3 supraglottic cancer and glottic cancer were 47% and 77%, respectively. In T3 supraglottic cancer, none of the 4 patients with subglottic tumor extension attained local control by radiotherapy alone, and local-regional recurrence-free time were significantly shorter in patients with subglottic tumor extension or tracheostomy before radiotherapy. There were no serious late complications such as chondronecrosis, rupture of carotid artery attributed to radical radiotherapy, while 3 patients had severe laryngeal edema requiring total laryngectomy. (orig.) [Deutsch] Von 1974 bis 1992 wurden 37 zuvor nicht behandelte Patienten mit T3-Larynxkarzinomen (15 supraglottisch, 22 glottisch) primaer kurativ bestrahlt und, wenn erforderlich, einer Salvage-Operation unterzogen. Die Zwei-Jahres-Kontrollrate bei alleiniger Strahlentherapie, die Rate der Stimmerhaltung sowie die unter Einschluss der Operation erreichbare lokale Kontrollrate bei supraglottischen T3-Larynxkarzinomen betrugen 33%, 33% und 60%. Bei glottischen T3-Karzinomen wurden jeweils 32%, 23% und 77% erreicht. Die Fuenf-Jahres-Ueberlebensrate betrug 47% bei supraglottischen T3-Karzinomen und 77% bei den glottischen Karzinomen. Im Fall von supraglottischen Karzinomen erreichte keiner der vier Patienten mit subglottischer Tumorausdehnung eine lokale Kontrolle durch alleinige Strahlentherapie. Die lokoregionale rezidivfreie Zeit war bei den Patienten mit subglottischer Tumorausdehnung oder Tracheostomie vor Einleitung der

  5. In vitro diagnosis of T3-thyrotoxicosis

    International Nuclear Information System (INIS)

    Semenov, V.D.

    1983-01-01

    A study was made of the importance of various radioimmunoassays and their reliability in the diagnosis of functional activity of the thyroid parenchyma in patients with nodular goiter. To define the effect of the globulin thyroxine binding ability on the level of general serum triiodothyronine (T 3 ), the index of triiodothyronine and the index of elevated serum triiodothyronine (IEST 3 ) were calculated. A comprehensive procedure of test registration reflecting hypophyseal-thyroid function was used to reveal 3 types of thyrotoxicoses: Tsub(3/4)-thyrotoxicosis, T 3 -thyrotoxicosis and T 4 -thyrotoxicosis. A high informative value of the main tests - the determination of the content of general thyroxine (T 4 ), T 3 and effective thyroxine factor - was established. The IEST 3 is of the utmost diagnostic value, particularly in diagnosing T 3 -thyrotoxicosis

  6. The Prognostic Value of Circumferential Resection Margin Involvement in Patients with Extraperitoneal Rectal Cancer.

    Science.gov (United States)

    Shin, Dong Woo; Shin, Jin Yong; Oh, Sung Jin; Park, Jong Kwon; Yu, Hyeon; Ahn, Min Sung; Bae, Ki Beom; Hong, Kwan Hee; Ji, Yong Il

    2016-04-01

    The prognostic influence of circumferential resection margin (CRM) status in extraperitoneal rectal cancer probably differs from that of intraperitoneal rectal cancer because of its different anatomical and biological behaviors. However, previous reports have not provided the data focused on extraperitoneal rectal cancer. Therefore, the aim of this study was to examine the prognostic significance of the CRM status in patients with extraperitoneal rectal cancer. From January 2005 to December 2008, 248 patients were treated for extraperitoneal rectal cancer and enrolled in a prospectively collected database. Extraperitoneal rectal cancer was defined based on tumors located below the anterior peritoneal reflection, as determined intraoperatively by a surgeon. Cox model was used for multivariate analysis to examine risk factors of recurrence and mortality in the 248 patients, and multivariate logistic regression analysis was performed to identify predictors of recurrence and mortality in 135 patients with T3 rectal cancer. CRM involvement for extraperitoneal rectal cancer was present in 29 (11.7%) of the 248 patients, and was the identified predictor of local recurrence, overall recurrence, and death by multivariate Cox analysis. In the 135 patients with T3 cancer, CRM involvement was found to be associated with higher probability of local recurrence and mortality. In extraperitoneal rectal cancer, CRM involvement is an independent risk factor of recurrence and survival. Based on the results of the present study, it seems that CRM involvement in extraperitoneal rectal cancer is considered an indicator for (neo)adjuvant therapy rather than conventional TN status.

  7. Rectal prolapse in infancy

    DEFF Research Database (Denmark)

    Qvist, N; Rasmussen, L; Klaaborg, K E

    1986-01-01

    In infancy there are two types of rectal prolapse. One type is less pronounced and intermittent. This type occurred in 9 out of 17 children referred for rectal prolapse and ceased after a few weeks' conservative treatment. The other type is a more pronounced prolapse occurring at nearly each...

  8. T3 receptors in human pituitary tumors.

    Science.gov (United States)

    Machiavelli, Gloria A; Pauni, Micaela; Heredia Sereno, Gastón M; Szijan, Irene; Basso, Armando; Burdman, José A

    2009-11-01

    The purpose of this work was to investigate the synthesis of T3 receptors in human tumors of the anterior pituitary gland, its relationship with the hormone synthesized and/or secreted by the tumor and the post-surgical evolution of the patient. Patients were evaluated clinically and by magnetic nuclear resonance to classify the adenoma according to their size. Hormonal concentrations in sera were determined by radioimmunoassay. Immunohistochemistry of the pituitary hormones was performed in the tumors. Tumors were obtained at surgery and immediately frozen in ice, transported to the laboratory and stored at -70 degrees C. Reverse transcription was performed with purified RNA from the tumors. Out of 33 pituitary tumors, 29 had RNA for T3 receptors synthesis (88%). They were present in different histological specimens, the tumors were grades 1-4 according to their size, and there was no relationship between the size of the tumor and the presence of T3 receptor RNAs. The post-surgical evolution of the patient was mostly dependent on the size and not on the presence of T3 receptors. The presence of thyroid hormone receptors in pituitary tumors is in line with two important characteristics of these tumors: they are histologically benign and well differentiated.

  9. Preoperative chemoradiation of locally advanced T3 rectal cancer combined with an endorectal boost

    DEFF Research Database (Denmark)

    Jakobsen, Anders; Mortensen, John P; Bisgaard, Claus

    2006-01-01

    (TRG) system. TRG1 was recorded in 27% of the patients, and a further 27% were classified as TRG2. TRG3 was found in 40%, and 6% had TRG4. The toxicity was low. CONCLUSION: The results indicate that high-dose radiation with concurrent chemotherapy and endorectal brachytherapy is feasible with a high...

  10. Rectal culture (image)

    Science.gov (United States)

    A rectal culture test is performed by inserting a cotton swab in the rectum. The swab is rotated gently, and withdrawn. A smear of the swab is placed in culture media to encourage the growth of microorganisms. The ...

  11. Rectal cancer: a review

    Science.gov (United States)

    Fazeli, Mohammad Sadegh; Keramati, Mohammad Reza

    2015-01-01

    Rectal cancer is the second most common cancer in large intestine. The prevalence and the number of young patients diagnosed with rectal cancer have made it as one of the major health problems in the world. With regard to the improved access to and use of modern screening tools, a number of new cases are diagnosed each year. Considering the location of the rectum and its adjacent organs, management and treatment of rectal tumor is different from tumors located in other parts of the gastrointestinal tract or even the colon. In this article, we will review the current updates on rectal cancer including epidemiology, risk factors, clinical presentations, screening, and staging. Diagnostic methods and latest treatment modalities and approaches will also be discussed in detail. PMID:26034724

  12. Intratumoral Heterogeneity of MicroRNA Expression in Rectal Cancer

    DEFF Research Database (Denmark)

    Eriksen, Anne Haahr Mellergaard; Andersen, Rikke Fredslund; Nielsen, Boye Schnack

    2016-01-01

    study was to assess the heterogeneity of a panel of selected miRNAs in rectal cancer, using two different technical approaches. MATERIALS AND METHODS: The expression of the investigated miRNAs was analysed by real-time quantitative polymerase chain reaction (RT-qPCR) and in situ hybridization (ISH......) in tumour specimens from 27 patients with T3-4 rectal cancer. From each tumour, tissue from three different luminal localisations was examined. Inter- and intra-patient variability was assessed by calculating intraclass correlation coefficients (ICCs). Correlations between RT-qPCR and ISH were evaluated...

  13. Rectal duplication cyst presenting as rectal prolapse in an infant

    Directory of Open Access Journals (Sweden)

    Maher Zaiem

    2018-05-01

    Full Text Available Rectal duplication is a rare variety of gastrointestinal duplication. It accounts 4% of the total gastrointestinal duplications.In this paper, we are reporting a case of an 8 months old male who presented with rectal prolapse. Digital rectal examination revealed a soft mass bulging through the posterior wall of rectum. Computed tomography (CT scan showed a cystic mass compressing the posterior wall of the rectum. The mass was excised using a Muscle Complex Saving Posterior Sagittal approach (MCS-PSA. The pathology report confirmed the diagnosis of the rectal duplication cyst. The postoperative recovery was uneventful. Keywords: Intestinal duplication, Cystic rectal duplication, Rectal prolapse

  14. Production of sheep anti triiodothyronine T3 antisera for development of T3 RIA kit

    International Nuclear Information System (INIS)

    Elsadig, M. G.; Abdalla, O. M.; Eltayed, E. A.

    2009-01-01

    This study was a trial to produce antisera against triiodothyronine T 3 . Small amounts of antibodies were detected due to a poor response of sheep to immunization. Consequently the amount of T 3 tracer bound by antibodies was found to be less than 10% with weak discrimination between zero and high standard doses in all bleeds which dose not satisfy radioimmunoassay (RIA) technique requirements. In this study, two local male Sudanese sheep (ovis aries) were immunized with T 3 -immuno gen intramuscularly and subcutaneously in different sites along their backs. Sheep (I) was immunized with 25μg of antigen per kg body weight in first and boosting injections, while the dose was only 10μg per kg body weight for sheep (II). T 3 -immunogen was emulsified in FCA for the first injection and in FIA for the boosting injections. The sera obtained from both sheep after each injection were subjected to evaluation for the levels of circulating anti T 3 antibodies through both qualitative and quantitative tests. The tests were performed for both purified and non-purified forms of antibodies with different separation techniques. Theses me methods include, precipitation by second antibody assisted by polyethylene glycol (PEG), polystyrene beads, and liquid phase separation techniques.(Author)

  15. Production of sheep anti triiodothyronine (T3) antisera for development of T3 RIA kit

    International Nuclear Information System (INIS)

    Karar, M. G. E.

    2006-11-01

    This study is a trial to produce antisera against triiodothyronine (T 3 ) which resulted in a poor response of sheep to immunization, since small amount of antibodies were detected, hence the amount of T 3 tracer bound by the antibodies in terms of percentage was found to be less than 10% with weak discrimination between zero and high standard doses in all bleeds which dose not satisfy radioimmunoassay (RIA) technique requirements. In this study, two local males Sudanese sheep (ovis aries) were immunized with T 3 -immuno gen intramuscularly and subcutaneously in different sites along their backs. Sheep (I) was immunized with 25μg of antigen per kg body weight in first and boosting injections, while the dose was only 10μg per kg body weight for sheep(II). T 3 -immuno gen was emulsified in FCA for the first injection and in FIA for the boosting injections. The sera obtained from both sheep after each injection were subjected to evaluation for the levels of circulating anti-T 3 antibodies through both qualitative and quantitative tests (titration test). The tests were performed for both purified and non-purified from with different separation methods, these methods included, precipitation by second antibody assisted by polyethylene glycol (PEG), polystyrene beads, and liquid phase separation technique. Tests for the quality and success of polystyrene beads coating process for the titration were done using pre characterized antibodies, namely anti progesterone antibodies and anti thyroxine antibodies. These tests revels that, the coating process including the activation of polystyrene beads, was of good quality, and the results obtained was due to weak response to T 3 -immuno gen. The results obtained from qualitative tests of the two sheep sera did not show clear precipitate, in spite of the positive result obtained in a neat sera, which was an indication for weak antibody formation. The result of the titration tests for all bleeds (third, forth, fifth, sixth, and

  16. The frequencies and clinical implications of mutations in 33 kinase-related genes in locally advanced rectal cancer: a pilot study.

    LENUS (Irish Health Repository)

    Abdul-Jalil, Khairun I

    2014-08-01

    Locally advanced rectal cancer (LARC: T3\\/4 and\\/or node-positive) is treated with preoperative\\/neoadjuvant chemoradiotherapy (CRT), but responses are not uniform. The phosphatidylinositol 3-kinase (PI3K), MAP kinase (MAPK), and related pathways are implicated in rectal cancer tumorigenesis. Here, we investigated the association between genetic mutations in these pathways and LARC clinical outcomes.

  17. Rectal fistulas after prostate brachytherapy

    International Nuclear Information System (INIS)

    Tran, Audrey; Wallner, Kent; Merrick, Gregory; Seeberger, Jergen M.S.; Armstrong, Julius R.T.T.; Mueller, Amy; Cavanagh, William M.S.; Lin, Daniel; Butler, Wayne

    2005-01-01

    Purpose: To compare the rectal and prostatic radiation doses for a prospective series of 503 patients, 44 of whom developed persistent rectal bleeding, and 2 of whom developed rectal-prostatic fistulas. Methods and Materials: The 503 patients were randomized and treated by implantation with 125 I vs. 103 Pd alone (n = 290) or to 103 Pd with 20 Gy vs. 44 Gy supplemental external beam radiotherapy (n = 213) and treated at the Puget Sound Veterans Affairs Medical Center (n = 227), Schiffler Cancer Center (n 242) or University of Washington (n = 34). Patients were treated between September 1998 and October 2001 and had a minimum of 24 months of follow-up. The patient groups were treated concurrently. Treatment-related morbidity was monitored by mailed questionnaires, using standard American Urological Association and Radiation Therapy Oncology Group criteria, at 1, 3, 6, 12, 18, and 24 months. Patients who reported Grade 1 or greater Radiation Therapy Oncology Group rectal morbidity were interviewed by telephone to clarify details regarding their rectal bleeding. Those who reported persistent bleeding, lasting for >1 month were included as having Grade 2 toxicity. Three of the patients with rectal bleeding required a colostomy, two of whom developed a fistula. No patient was lost to follow-up. The rectal doses were defined as the rectal volume in cubic centimeters that received >50%, 100%, 200%, or 300% of the prescription dose. The rectum was considered as a solid structure defined by the outer wall, without attempting to differentiate the inner wall or contents. Results: Persistent rectal bleeding occurred in 44 of the 502 patients, 32 of whom (73%) underwent confirmatory endoscopy. In univariate analysis, multiple parameters were associated with late rectal bleeding, including all rectal brachytherapy indexes. In multivariate analysis, however, only the rectal volume that received >100% of the dose was significantly predictive of bleeding. Rectal fistulas occurred

  18. Conservative treatment of premature rectal cancer

    International Nuclear Information System (INIS)

    Torres, M.

    2010-01-01

    Objectives: The largest radical resections in rectal cancer with significant morbidity and mortality (Urinary dysfunction, sexual dysfunction, permanent colostomy, etc.), on certain occasions and with high selectivity, they can be avoided with the implementation of local resections. Our intention is to assess the results of conservative treatment of rectal cancer early. Material and Methods: Between 01.01.89 and 31.12.09 14 consecutive patients were treated carriers rectal adenocarcinoma who had never received prior cancer treatment and a second simultaneous showed no neoplasia. The age of the patients presented a range between 44 and 72 years with a mean of 60.4 years; sex similarly partitioned and according to ECOG performance status was 0≤2. All patients were operated through a anal resection of which 4 were performed a submucosal tumor excision (T1) and 10 excision was entire rectal wall and tumor invaded the muscularis propria (T2). For this one type of surgery patients were selected the following criteria: tumor ≤6 cm. the anal verge, size ≤3 cm., GH I-II, vegetative, mobile, and T1-2, N0 by EER. After intervention, the pathological examination of the surgical specimen showed that 4 patients GH III, lymphovascular invasion and / or peri neural, or close surgical margins (+) (≤3 mm.) And T3, so underwent Miles operation (March 1 T1 and T2). Subsequently the rest of the patients (10) underwent concomitant radio chemotherapy. Radiation therapy was similar all using megavoltage photons (CO-60, 18mV) to the entire pelvic volume in a normofraccionamiento to complete 50.40 Gy (1.8 Gy / 28) using multiple fields (box technique). Chemotherapy was prepared 5FU + LV in the first patient (4), in following (4) was used 5FU continuous infusion (1st and 5th week) and the remaining (2) Capecitabine. Follow up was complete. Results: In our sample we extract local failure was 4 (29%), distant failure 3 (20%) and two local and distant failures (14%) so it follows that

  19. Capacity for cooperative binding of thyroid hormone (T3) receptor dimers defines wild type T3 response elements.

    Science.gov (United States)

    Brent, G A; Williams, G R; Harney, J W; Forman, B M; Samuels, H H; Moore, D D; Larsen, P R

    1992-04-01

    Thyroid hormone response elements (T3REs) have been identified in a variety of promoters including those directing expression of rat GH (rGH), alpha-myosin heavy chain (rMHC), and malic enzyme (rME). A detailed biochemical and genetic analysis of the rGH element has shown that it consists of three hexamers related to the consensus [(A/G)GGT(C/A)A]. We have extended this analysis to the rMHC and rME elements. Binding of highly purified thyroid hormone receptor (T3R) to T3REs was determined using the gel shift assay, and thyroid hormone (T3) induction was measured in transient tranfections. We show that the wild type version of each of the three elements binds T3R dimers cooperatively. Mutational analysis of the rMHC and rME elements identified domains important for binding T3R dimers and allowed a direct determination of the relationship between T3R binding and function. In each element two hexamers are required for dimer binding, and mutations that interfere with dimer formation significantly reduce T3 induction. Similar to the rGH element, the rMHC T3RE contains three hexameric domains arranged as a direct repeat followed by an inverted copy, although the third domain is weaker than in rGH. All three are required for full function and T3R binding. The rME T3RE is a two-hexamer direct repeat T3RE, which also binds T3R monomer and dimer. Across a series of mutant elements, there was a strong correlation between dimer binding in vitro and function in vivo for rMHC (r = 0.99, P less than 0.01) and rME (r = 0.67, P less than 0.05) T3REs. Our results demonstrate a similar pattern of T3R dimer binding to a diverse array of hexameric sequences and arrangements in three wild type T3REs. Addition of nuclear protein enhanced T3R binding but did not alter the specificity of binding to wild type or mutant elements. Binding of purified T3R to T3REs was highly correlated with function, both with and without the addition of nuclear protein. T3R dimer formation is the common

  20. Preoperative staging of rectal cancer.

    Science.gov (United States)

    Smith, Neil; Brown, Gina

    2008-01-01

    Detailed preoperative staging using high resolution magnetic resonance imaging (MRI) enables the selection of patients that require preoperative therapy for tumour regression. This information can be used to instigate neoadjuvant therapy in those patients with poor prognostic features prior to disturbing the tumour bed and potentially disseminating disease. The design of trials incorporating MR assessment of prognostic factors prior to therapy has been found to be of value in assessing treatment modalities and outcomes that are targeted to these preoperative prognostic subgroups and in providing a quantifiable assessment of the efficacy of particular chemoradiation treatment protocols by comparing pre-treatment MR staging with post therapy histology assessment. At present, we are focused on achieving clear surgical margins of excision (CRM) to avoid local recurrence. We recommend that all patients with rectal cancer should undergo pre-operative MRI staging. Of these, about half will have good prognosis features (T1-T3b, N0, EMVI negative, CRM clear) and may safely undergo primary total mesorectal excision. Of the remainder, those with threatened or involved margins will certainly benefit from pre-operative chemoradiotherapy with the aim of downstaging to permit safe surgical excision. In the future, our ability to recognise features predicting distant failure, such as extramural vascular invasion (EMVI) may be used to stratify patients for neo-adjuvant systemic chemotherapy in an effort to prevent distant relapse. The optimal pre-operative treatment regimes for these patients (radiotherapy alone, systemic chemotherapy alone or combination chemo-radiotherapy) is the subject of current and future trials.

  1. Preoperative chemoradiation therapy for advanced rectal cancer

    International Nuclear Information System (INIS)

    Tsujinaka, Toshimasa; Murotani, Masahiro; Iihara, Keisuke

    1997-01-01

    Preoperative concurrent chemoradiation therapy with 5-fluorouracil and cisplatin was applied for advanced rectal cancer. Eligible criteria were as follows: no previous treatment, more than hemicircular occupation, T 3 or more, invasion to adjacent organs or lymph node metastasis on CT scan, tumor fixation by digital examination. Eleven patients were enrolled with this regimen consisting of 5-FU; 500 mg/day x 5/w x 4, CDDP; 10 mg/day x 5/w x 4 and radiation; 2 Gy x 5/w x 4. As a toxicity, grade 2 leukopenia in 2 cases, grade 2 GI symptoms in one case and radiation dermatitis was observed in 8 cases. As a local response, there were PR in 10 cases and NC in 1 case. Surgical resection was performed on 8 patients. Histological responses in the resected specimens were grade 2, 5 cases; grade 1b, 1 case; and grade 1a, 2 cases. Operative radicalities were grade A, 3 cases; grade B, 3 cases; and grade C, 2 cases. Preoperative chemoradiation is one of the effective options in multimodal treatment for advanced rectal cancer. (author)

  2. Conservative management of anal and rectal cancer

    International Nuclear Information System (INIS)

    Gerard, J.P.; Romestaing, P.; Montbarbon, X.

    1989-01-01

    The role of irradiation in the management of anal and rectal cancer has changed during the past ten years. In small epidermoid carcinomas of the anal canal (T1 T2) irradiation is in most departments considered the primary treatment, giving a 5-year survival rate of between 60 and 80% with good sphincter preservation. Even in larger tumors, irradiation can still offer some chance of cure without colostomy. Surgery remains the basic treatment of rectal cancer but irradiation is used in association with surgery in many cases. Radiotherapy is of value in the conservative management of cancer of the rectum in three situations: In small polypoid cancers contact X-ray therapy can give local control in about 90%. In cancers of the middle rectum, preoperative external irradiation may increase the chances of restorative surgery and reduce the risk of local relapse. In inoperable patients, external radiotherapy and/or intracavitary irradiation may cure some patients with infiltrating tumors (T2 T3) without colostomy. (orig.)

  3. High-dose chemoradiotherapy and watchful waiting for distal rectal cancer

    DEFF Research Database (Denmark)

    Appelt, Ane L; Pløen, John; Harling, Henrik

    2015-01-01

    -dose radiotherapy with concomitant chemotherapy followed by observation (watchful waiting) was successful for non-surgical management of low rectal cancer. METHODS: Patients with primary, resectable, T2 or T3, N0-N1 adenocarcinoma in the lower 6 cm of the rectum were given chemoradiotherapy (60 Gy in 30 fractions...

  4. Rectal bladder-type: ileum-sigma-rectum pouch

    International Nuclear Information System (INIS)

    Krajka, K.; Mikszewicz, A.; Stachurski, L.; Perkowski, D.

    1994-01-01

    The paper presents a method of creating rectal bladder by using the proximal part of rectum, the distal part of sigma and a 40 cm long segment of detubularized ileum. Ureters were attached to the proximal end of ileal segment by Wallace-I technique. Initially the retrograde pyelonephritis was to be prevented by intussuscepting a 4 cm long part of the uretero-ilea anastomosis and by positioning isoperistaltically a 15-16 cm long part of the ileal segment. Because of the insufficiency of such a mechanism, in 4 latest cases the intussuscepted segment was increased to 8 cm. 8 patients suffering from stage T3a and T3b invasive carcinoma of the bladder were treated by this procedure. The ureteral stens were led out via the rectal tube. They were removed days after the operation. The whole post-operative period was uneventful. The patients were under close follow-up from 5 to 22 months. Three of them died due to a progression of the disease. All the patients had 3-4 watery stools a day and one at night. Check-ups performed three and six months after the operation revealed a proper out flow of contrast medium from kidneys and a reduction in the dilatation of ureters. In one case the kidney that failed to function before the procedure, restored its secretion afterwards. The contrast medium reached colon descendens only when more than 350 ml of it were infused into the rectal bladder. (author)

  5. Breast metastases from rectal carcinoma

    Institute of Scientific and Technical Information of China (English)

    LI Jia; FANG Yu; LI Ang; LI Fei

    2011-01-01

    Metastases to the breast from extramammary neoplasms are very rare, constituting 2.7% of all malignant breast tumours. The most common primary tumor metastatic to the breast is primary breast cancer. Rectal cancer metastasizing to the breast is extremely rare. We report a case of aggressive rectal carcinoma with metastasis to the breast.

  6. Rectal carcinoids: a systematic review.

    LENUS (Irish Health Repository)

    McDermott, Frank D

    2014-07-01

    Rectal carcinoids are increasing in incidence worldwide. Frequently thought of as a relatively benign condition, there are limited data regarding optimal treatment strategies for both localized and more advanced disease. The aim of this study was to summarize published experiences with rectal carcinoids and to present the most current data.

  7. Irradiation of low rectal cancers

    International Nuclear Information System (INIS)

    Ardiet, J.M.; Coquard, R.; Romestaing, P.; Fric, D.; Baron, M.H.; Rocher, F.P.; Sentenac, I.; Gerard, J.P.

    1994-01-01

    The low rectal cancers are treated by anorectal amputation and pose the problem of the sphincter conservation. Some authors extend the clinical definition to developed injuries until 12 cm from the anal margin. The rectal cancer is a frequent tumour which remains serious. When the tumour is low, the treatment consists in an anorectal amputation with a permanent colostomy. The radical non preserving surgery is the usual treatment of these injuries. Until 1960 the rectal adenocarcinoma was considered as a radioresistant tumour because of the impossibility to deliver an enough dose to the tumour by external radiotherapy. But other studies showed that those lesions were radiosensitive and often radiocurable. The medical treatments haven't yet demonstrated their efficiency in the treatment of the rectal cancer. We'll study the radiotherapy in the treatment of the low rectal cancer, solely radiotherapy, radiosurgical associations. 32 refs., 5 tabs

  8. Risk factors of circumferential resection margin involvement in the patients with extraperitoneal rectal cancer.

    Science.gov (United States)

    Oh, Sung Jin; Shin, Jin Yong

    2012-03-01

    Currently, circumferential resection margins (CRM) are used as a clinical endpoint in studies on the prognosis of rectal cancer. Although the concept of a circumferential resection margin in extraperitoneal rectal cancer differs from that in intraperitoneal rectal cancer due to differences in anatomical and biologic behaviors, previous reports have provided information on CRM involvement in all types of rectal cancer including intraperitoneal lesions. Therefore, the aim of this study was to analyze risk factors of CRM involvement in extraperitoneal rectal cancer. From January 2005 to December 2008, 306 patients with extraperitoneal rectal cancer were enrolled in a prospectively collected database. Multivariate logistic regression analysis was used to identify predictors of CRM involvement. The overall rate of CRM involvement was found to be 16.0%. Multivariate analysis showed that male sex, larger tumor size (≥4 cm), stage higher than T3, nodal metastasis, tumor perforation and non-sphincter preserving proctectomy (NSPP) were risk factors for CRM involvement. Male sex, larger tumor size (≥4 cm), advanced T stage, nodal metastasis, tumor perforation, and NSPP are significant risk factors of CRM involvement in extraperitoneal rectal cancer. Given that postoperative chemoradiotherapy is recommended for patients with a positive CRM, further oncologic studies are warranted to ascertain which patients with these risk factors would require adjuvant therapy.

  9. Development and characterization of radioimmunoassay methods for the measurement of iodothyronines (T4, T3 and rT3)

    International Nuclear Information System (INIS)

    Russo, E.M.K.; Vieira, J.G.H.; Barros Maciel, R.M. de; Fonseca, R.M.G.

    1982-01-01

    The experience acquired in the development of radioimmunoassay for T 4 , T 3 and rT 3 in unextrated serum is described. Antisera were produced in rabbits using iodothyronines conjugated to bovine serum albumin: the antisera selected provided the development of sensitive and specific radioassay methods. Stable high activity T 3 , T 4 and rT 3 tracers were prepared by iodination of 3,5 T 2 , T 3 and 3,3' T 2 by the chloramine-T method, and purified by column chromatography on Sephadex G25. Binding of those iodothyronines to endogenous serum proteins was blocked by including 8-aniline-1-naphtalene sulphonic acid (ANSA) in the T 4 and T 3 assays and thymerosal in the rT 3 assay. Normal values were defined in 46 healthy euthyroid adults of both sexes: T 4 = 7,1 +- 1,3μg/dl; T 3 = 139 +- 35ng/dl and rT 3 = 18,0 +- 7,9ng/dl. (Author) [pt

  10. Role and efforts of T3C in corrosion economics

    International Nuclear Information System (INIS)

    Perrigo, L.D.; Appleman, B.R.; Pamer, R.I.; Thompson, J.L.

    1979-11-01

    The basic purpose of T3C activity is to show how to acquire specific corrosion cost information so that overall costs for doing business can be reduced. The scope of T3C is to accumulate data, appraise methods, develop recommended practices, promote knowledge and communicate relative to the economic evaluation of corrosion and counter corrosion techniques

  11. Treatment tactics in patient with rectal cancer complicating ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Yu. A. Barsukov

    2012-01-01

    Full Text Available A successful treatment of a young patient with a 15-year anamnesis of ulcerative colitis, who has been diagnosed with rectal cancer, is presented in this case report. A non-standard surgical intervention has been performed following all principles of oncologic surgery. A subtotal colectomy has been performed with ultra-low anterior resection of rectum. Ascendoanal anastomosis has been performed forming the neo-rectum. There were no complications in postoperative period. Considering disease stage (T3N1M0 adjuvant XELOX was administered for 6 months along with 2 cycles of prophylactic treatment with 5-aminosalycilic acid. During 2-years follow-up there are no signs of rectal cancer and ulcerative colitis progression. After pelvic electrostimulation defecation frequency decreased to 3–4 times per day, a patient has complete social rehabilitation.

  12. A multidisciplinary treatment strategy for locally advanced rectal cancer

    International Nuclear Information System (INIS)

    Kimura, F.; Yanagi, Hidenori; Atono, R.

    2012-01-01

    The aim of this study is to examine the therapeutic effects and adverse events of preoperative chemoradiation therapy (CRT) for locally advanced rectal cancer in different radiation doses and fractions. A total of 142 consecutive patients with locally advanced (cT3-4 and/or cN1-2) adenocarcinoma of the rectum were treated with preoperative CRT and were operated radically. 121 patients with resectable cT3 or N1-2 rectal adenocarcinoma were assigned to receive pelvic radiation with single fractions of 2.5 Gy twice daily to a total dose of 25 Gy (Short CRT). Surgery was undergone within two weeks. 21 patients with clinical unresectable or marginally resectable cT4 rectal cancer were assigned to receive preoperative pelvic radiation therapy 45 to 50.4 Gy at 1.8 Gy per day. Surgery was performed 6 to 8 weeks after completion of neoadjuvant therapy (Long CRT). We examined retrospectively the preoperative therapeutic effect and adverse event of Short CRT and Long CRT. Short CRT; Overall R0 resection rate was 98%. Anus preserving rate was 95%. pCR rate was 5%. Median follow-up was 62 months. The actuarial 5-year-local-control rate was 94%. Overall survival for 5 years was 92%. Long neoadjuvant chemoradiation therapy (NCRT); Overall R0 resection rate was 90%. Anus preserving rate was 86%. pCR rate was 24%. Median follow-up was 60 months. The actuarial 5-year-local-control rate was 88%. Overall survival rate for 5 years was 88%. Radiation related adverse event such as pelvic infection and skin trouble was significantly higher in the long CRT group. Local control in primarily resectable rectal cancer after short chemoradiation was excellent. Long chemoradiation for unresectable or marginal cT4 rectum cancer was higher response ratio, but induced more radiation related adverse event than short course CRT. (author)

  13. Modulation of nuclear T3 binding by T3 in a human hepatocyte cell-line (Chang-liver) - T3 stimulation of cell growth but not of malic enzyme, glucose-6-phosphatdehydrogenase or 6-phosphogluconate-dehydrogenase

    DEFF Research Database (Denmark)

    Matzen, L E; Kristensen, S R; Kvetny, J

    1991-01-01

    The T3 modulation of nuclear T3 binding (NBT3), the T3 effect on cell growth, and the T3 and insulin effects on malic enzyme (ME), glucose-6-phosphat-dehydrogenase (G6PD) and 6-phosphogluconat-dehydrogenase (G6PD) were studied in a human hepatocyte cell-line (Chang-liver). T3 was bound to a high ...

  14. Rectal duplication with sciatic hernia.

    Science.gov (United States)

    Nosek, Marzena; Golonka, Anna; Kalińska-Lipert, Anita; Nachulewicz, Paweł

    2015-07-01

    Rectal duplications represent 5% of all duplications in the alimentary tract, and they are very rarely diagnosed during the neonatal period. The authors present the method of investigation and the results of surgical treatment of a full-term neonate with a sciatic hernia containing a rectal duplication. The procedure started with three-port laparoscopy, but excision of the tubular duplication of the rectum was possible only by a transanal endorectal pull-through approach. The sciatic hernia was closed, and plastic sutures on the buttock finished the procedure. The coincidence of sciatic hernia with rectal duplication is extremely rare, and the method of treatment depends exclusively on the anatomical conditions.

  15. Increased reverse T3 concentration in patients with anorexia nerrosa

    International Nuclear Information System (INIS)

    Baranowska, B.; Kaniewski, M.; Zgliczynski, S.

    1980-01-01

    In 20 female patients with anorexia nervosa, aging 16 - 26 years, the thyroid function was estimated by +- determining TSH secretion in response to TRH, and serum thyroxine (T 4 ), 3,5,3'L-triiodothyronine (T 3 ) and 3,3',5'L-triiodothyronine (reverse T 3 ) concentrations. 14 healthy women of the same age were included into the control group. If compared with control group, a marked supression of TRH stimulated TSH secretion and a lowering of serum T 3 concentration was found in patients with anorexia nervosa. On the other hand, serum reverse T 3 concentration was markedly higher in patients with anorexia nervosa than in control ones. Gain of body weight leads to normalization of thyroid hormones level in the serum. Obtained results show for peripheral mechanism of described hormonal disorders. (author)

  16. Phosphatidylcholine induces apoptosis of 3T3-L1 adipocytes

    Directory of Open Access Journals (Sweden)

    Li Hailan

    2011-12-01

    Full Text Available Abstract Background Phosphatidylcholine (PPC formulation is used for lipolytic injection, even though its mechanism of action is not well understood. Methods The viability of 3T3-L1 pre-adipocytes and differentiated 3T3-L1 cells was measured after treatment of PPC alone, its vehicle sodium deoxycholate (SD, and a PPC formulation. Western blot analysis was performed to examine PPC-induced signaling pathways. Results PPC, SD, and PPC formulation significantly decreased 3T3-L1 cell viability in a concentration-dependent manner. PPC alone was not cytotoxic to CCD-25Sk human fibroblasts at concentrations Conclusions PPC results in apoptosis of 3T3-L1 cells.

  17. Basic and clinical investigation of T3 immunoassay kit

    International Nuclear Information System (INIS)

    Konishi, Junji; Nakajima, Akiko; Morita, Rikushi; Endo, Keigo; Ikekubo, Katsuji

    1976-01-01

    T 3 immunoassay kit was investigated basically and clinically. A good result was obtained at the prescribed incubation temperature and for 16 hours of incubation time. Moreover, it was thought to be possible that incubation time could be shortened to 1 - 4 hours at 37 0 C. Specificity of antibody was good. Recovery of added T 3 was 100+-5 (S.D.) % on an average and parallel of dilution curve of high T 3 serum was also good. Variation coefficient of accuracy of this kit was 1.5 - 2.1 % and that of reproducibility was 1.3 - 6.6 %. Mild hemolysis did not affect measurement value. Serum T 3 level in normals, untreated patients with Basedow's disease and patients with primary hypothyroidism was 142+-21 ng/100 ml, 452+-156 ng/100 ml and 67+-17 ng/100 ml, respectively. Serum T 3 level in patients with Hashimoto's disease was distributed to a wide extent, but that of patients with goiter and simple goiter ranged within normal range. On the other side, serum T 3 level of normal pregnant woman was high and that of patients with anorexia nervosa showed low level. From the above mentioned results, it was concluded that this kit was simple in method and good in sensitivity, specificity and reproducibility and it was also useful for clinical applications. (M. Tsunoda)

  18. Early rectal stenosis following stapled rectal mucosectomy for hemorrhoids

    Directory of Open Access Journals (Sweden)

    Schuster Anja

    2004-05-01

    Full Text Available Abstract Background Within the last years, stapled rectal mucosectomy (SRM has become a widely accepted procedure for second and third degree hemorrhoids. One of the delayed complications is a stenosis of the lower rectum. In order to evaluate the specific problem of rectal stenosis following SRM we reviewed our data with special respect to potential predictive factors or stenotic events. Methods A retrospective analysis of 419 consecutive patients, which underwent SRM from December 1998 to August 2003 was performed. Only patients with at least one follow-up check were evaluated, thus the analysis includes 289 patients with a mean follow-up of 281 days (±18 days. For statistic analysis the groups with and without stenosis were evaluated using the Chi-Square Test, using the Kaplan-Meier statistic the actuarial incidence for rectal stenosis was plotted. Results Rectal stenosis was observed in 9 patients (3.1%, eight of these stenoses were detected within the first 100 days after surgery; the median time to stenosis was 95 days. Only one patient had a rectal stenosis after more than one year. 8 of the 9 patients had no obstructive symptoms, however the remaining patients complained of obstructive defecation and underwent surgery for transanal strictureplasty with electrocautery. A statistical analysis revealed that patients with stenosis had significantly more often prior treatment for hemorrhoids (p Conclusion Rectal stenosis is an uncommon event after SRM. Early stenosis will occur within the first three months after surgery. The majority of the stenoses are without clinical relevance. Only one of nine patients had to undergo surgery for a relevant stenosis. The predictive factor for stenosis in the patient-characteristics is previous interventions for hemorrhoids, severe postoperative pain might also predict rectal stenosis.

  19. Mediator subunit MED1 is a T3-dependent and T3-independent coactivator on the thyrotropin β gene promoter

    Energy Technology Data Exchange (ETDEWEB)

    Matsui, Keiji; Oda, Kasumi; Mizuta, Shumpei; Ishino, Ruri; Urahama, Norinaga; Hasegawa, Natsumi [Laboratory of Hematology, Division of Medical Biophysics, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe 654-0142 (Japan); Roeder, Robert G. [Laboratory of Biochemistry and Molecular Biology, The Rockefeller University, 1230 York Avenue, New York, NY 10065 (United States); Ito, Mitsuhiro, E-mail: itomi@med.kobe-u.ac.jp [Laboratory of Hematology, Division of Medical Biophysics, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe 654-0142 (Japan); Laboratory of Biochemistry and Molecular Biology, The Rockefeller University, 1230 York Avenue, New York, NY 10065 (United States); Department of Family and Community Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 654-0142 (Japan); Consolidated Research Institute for Advanced Science and Medical Care, Waseda University, 3-4-1 Okubo, Shinjuku-ku, Tokyo 159-8555 (Japan)

    2013-10-11

    Highlights: •MED1 is a bona fide T3-dependent coactivator on TSHB promoter. •Mice with LxxLL-mutant MED1 have attenuated TSHβ mRNA and thyroid hormone levels. •MED1 activates TSHB promoter T3-dependently in cultured cells. •T3-dependent MED1 action is enhanced when SRC1/SRC2 or HDAC2 is downregulated. •MED1 is also a T3-independent GATA2/Pit1 coactivator on TSHB promoter. -- Abstract: The MED1 subunit of the Mediator transcriptional coregulator complex is a nuclear receptor-specific coactivator. A negative feedback mechanism of thyroid-stimulating hormone (TSH, or thyrotropin) expression in the thyrotroph in the presence of triiodothyronine (T3) is employed by liganded thyroid hormone receptor β (TRβ) on the TSHβ gene promoter, where conventional histone-modifying coactivators act as corepressors. We now provide evidence that MED1 is a ligand-dependent positive cofactor on this promoter. TSHβ gene transcription was attenuated in MED1 mutant mice in which the nuclear receptor-binding ability of MED1 was specifically disrupted. MED1 stimulated GATA2- and Pit1-mediated TSHβ gene promoter activity in a ligand-independent manner in cultured cells. MED1 also stimulated transcription from the TSHβ gene promoter in a T3-dependent manner. The transcription was further enhanced when the T3-dependent corepressors SRC1, SRC2, and HDAC2 were downregulated. Hence, MED1 is a T3-dependent and -independent coactivator on the TSHβ gene promoter.

  20. Germline polymorphisms may act as predictors of response to preoperative chemoradiation in locally advanced T3 rectal tumors

    DEFF Research Database (Denmark)

    Spindler, Karen-Lise G; Nielsen, Jens N; Lindebjerg, Jan

    2007-01-01

    ) followed by total mesorectal excision eight weeks after treatment. Pathologic response was evaluated according to the tumor regression grade system. RESULTS: Thirty percent (18/60) of patients presented with complete pathologic response. Patients with thymidylate synthase genotype 2/2 had a significantly...

  1. Preoperative treatment with capecitabine, cetuximab and radiotherapy for primary locally advanced rectal cancer : A phase II clinical trial

    NARCIS (Netherlands)

    Eisterer, Wolfgang; de Vries, Alexander; Öfner, Dietmar; Rabl, Hans; Koplmüller, Renate; Greil, Richard; Tschmelitsch, Jöerg; Schmid, Rainer; Kapp, Karin; Lukas, Peter; Sedlmayer, Felix; Höfler, Gerald; Gnant, Michael; Thaler, Josef; Widder, Joachim

    2014-01-01

    BACKGROUND/AIM: To investigate the feasibility and safety of preoperative capecitabine, cetuximab and radiation in patients with MRI-defined locally advanced rectal cancer (LARC, cT3/T4). PATIENTS AND METHODS: 31 patients with LARC were treated with cetuximab and capecitabine concomitantly with 45

  2. Association of rectal toxicity with thermal dose parameters in treatment of locally advanced prostate cancer with radiation and hyperthermia

    International Nuclear Information System (INIS)

    Hurwitz, Mark D.; Kaplan, Irving D.; Hansen, Jorgen L.; Prokopios-Davos, Savina; Topulos, George P.; Wishnow, Kenneth; Manola, Judith; Bornstein, Bruce A.; Hynynen, Kullervo

    2002-01-01

    Purpose: Although hyperthermia has been used for more than two decades in the treatment of pelvic tumors, little is known about the potential impact of heat on rectal toxicity when combined with other treatment modalities. Because rectal toxicity is a concern with radiation and may be exacerbated by hyperthermia, definition of the association of thermal dose parameters with rectal toxicity is important. In this report, we correlate rectal toxicity with thermal dose parameters for patients treated with hyperthermia and radiation for prostate cancer. Methods and Materials: Thirty patients with T2b-T3b disease (1992 American Joint Committee On Cancer criteria) enrolled in a Phase II study of external beam radiation ± androgen-suppressive therapy with two transrectal ultrasound hyperthermia treatments were assessed for rectal toxicity. Prostatic and anterior rectal wall temperatures were monitored for all treatments. Rectal wall temperatures were limited to 40 deg. C in 19 patients, 41 deg. C in 3 patients, and 42 deg. C in 8 patients. Logistic regression was used to estimate the log hazard of developing National Cancer Institute Common Toxicity Criteria Grade 2 toxicity based on temperature parameters. The following were calculated: hazard ratios, 95% confidence intervals, p values for statistical significance of each parameter, and proportion of variability explained for each parameter. Results: Gastrointestinal toxicity was limited to Grade 2. The rate of acute Grade 2 proctitis was greater for patients with an allowable rectal wall temperature of >40 deg. C. In this group, 7 of 11 patients experienced acute Grade 2 proctitis, as opposed to 3 of 19 patients in the group with rectal wall temperatures limited to 40 deg. C (p=0.004). Preliminary assessment of long-term toxicity revealed no differences in toxicity. Hazard ratios for acute Grade 2 proctitis for allowable rectal wall temperature, average rectal wall Tmax, and average prostate Tmax were 9.33 (p=0.01), 3

  3. Rectal cancer: The radiation basis of radiotherapy, target volume

    International Nuclear Information System (INIS)

    Bosset, J.F.; Servagi-Vernat, S.; Crehange, G.; Azria, D.; Gerard, J.P.; Hennequin, C.

    2011-01-01

    Since the implementation of preoperative chemo-radiotherapy and meso-rectal excision, the 5-year rates of locoregional failures in T3-T4 N0-N1M0 rectal cancer fell from 25-30% thirty years ago to 5-8% nowadays. A critical analysis of the locoregional failures sites and mechanisms, as well as the identification of nodal extension, helps the radiation oncologist to optimize the radiotherapy target definition. The upper limit of the clinical target volume is usually set at the top of the third sacral vertebra. The lateral pelvic nodes should be included when the tumor is located in the distal part of the rectum. The anal sphincter and the levator muscles should be spared when a conservative surgery is planned. In case of abdomino-perineal excision, the ischio-rectal fossa and the sphincters should be included in the clinical target volume. A confrontation with radiologist and surgeon is mandatory to improve the definition of the target volumes to be treated. (authors)

  4. Immunohistochemical findings in rectal duplication mimicking rectal prolapse.

    Science.gov (United States)

    Cortese, M G; Pucci, A; Macchieraldo, R; Sacco Casamassima, M G; Canavese, F

    2008-08-01

    Alimentary tract duplications represent rare anomalies, with only 5 % occurring in the rectum. The variety in clinical presentation may lead to a delay in diagnosis or to incorrect and multiple surgical procedures. We report the clinical, histological and immunohistochemical characteristics of a rectal duplication occurring in a 3-month-old male with an unusual clinical presentation. Using routine histology and immunohistochemistry, the rectal duplication showed the diffuse presence of gastric mucosa with a characteristic immunophenotype (i.e., diffuse cytokeratin 7 positivity and scattered chromogranin immunoreactivity). As far as we know, this is the first report showing an immunohistochemical differentiation pattern of gastric lining in a rectal duplication. Our results, showing the presence of gastric mucosa, are suggestive of a possible origin from the embryonic foregut.

  5. Late rectal toxicity after conformal radiotherapy of prostate cancer (I): multivariate analysis and dose-response

    International Nuclear Information System (INIS)

    Skwarchuk, Mark W.; Jackson, Andrew; Zelefsky, Michael J.; Venkatraman, Ennapadam S.; Cowen, Didier M.; Levegruen, Sabine; Burman, Chandra M.; Fuks, Zvi; Leibel, Steven A.; Ling, C. Clifton

    2000-01-01

    Purpose: The purpose of this paper is to use the outcome of a dose escalation protocol for three-dimensional conformal radiation therapy (3D-CRT) of prostate cancer to study the dose-response for late rectal toxicity and to identify anatomic, dosimetric, and clinical factors that correlate with late rectal bleeding in multivariate analysis. Methods and Materials: Seven hundred forty-three patients with T1c-T3 prostate cancer were treated with 3D-CRT with prescribed doses of 64.8 to 81.0 Gy. The 5-year actuarial rate of late rectal toxicity was assessed using Kaplan-Meier statistics. A retrospective dosimetric analysis was performed for patients treated to 70.2 Gy (52 patients) or 75.6 Gy (119 patients) who either exhibited late rectal bleeding (RTOG Grade 2/3) within 30 months after treatment (i.e., 70.2 Gy--13 patients, 75.6 Gy--36 patients) or were nonbleeding for at least 30 months (i.e., 70.2 Gy--39 patients, 75.6 Gy--83 patients). Univariate and multivariate logistic regression was performed to correlate late rectal bleeding with several anatomic, dosimetric, and clinical variables. Results: A dose response for ≥ Grade 2 late rectal toxicity was observed. By multivariate analysis, the following factors were significantly correlated with ≥ Grade 2 late rectal bleeding for patients prescribed 70.2 Gy: 1) enclosure of the outer rectal contour by the 50% isodose on the isocenter slice (i.e., Iso50) (p max (p max

  6. Radiological imaging of rectal cancer

    Directory of Open Access Journals (Sweden)

    Lidija Lincender-Cvijetić

    2012-11-01

    Full Text Available This article discusses the possibilities of diagnosing abdominal imaging in patients with rectal cancer, detecting lesions and assessing the stage of the lesions, in order to select the appropriate therapy. Before the introduction of imaging technologies, the diagnosis of colorectal pathology was based on conventional methods of inspecting intestines with a barium enema, with either a single or double contrast barium enema. Following the development of endoscopic methods and the wide use of colonoscopy, colonoscopy became the method of choice for diagnosing colorectal diseases. The improvement of Computerized Tomography (CT and Magnetic Resonance Imaging (MRI, gave us new possibilities for diagnosing colorectal cancer. For rectal cancer, trans-rectal US (TRUS or endo-anal US (EAUS have a significant role. For staging rectal cancer, the Multi Slice Computed Tomography (MSCT is not the method of choice, but Magnetic Resonance Imaging (MRI is preferred when it comes to monitoring the rectum. Therole of the MRI in the T staging of rectal cancer is crucial in preoperative assessment of: thickness – the width of the tumor, the extramural invasion, the circumference of resection margin (CRM, andthe assessment of the inclusion of mesorectal fascia. For successful execution of surgical techniques, good diagnostic imaging of the cancer is necessary in order to have a low level of recurrence. According to medical studies, the sensitivity of FDG-PET in diagnosing metastatic nodals is low, but for now it is not recommended in routine diagnosis of metastatic colorectal carcinoma.

  7. ACR Appropriateness Criteria on Resectable Rectal Cancer

    International Nuclear Information System (INIS)

    Suh, W. Warren; Blackstock, A. William; Herman, Joseph; Konski, Andre A.; Mohiuddin, Mohammed; Poggi, Matthew M.; Regine, William F.; Cosman, Bard C.; Saltz, Leonard; Johnstone, Peter A.S.

    2008-01-01

    The American College of Radiology (ACR) Appropriateness Criteria on Resectable Rectal Cancer was updated by the Expert Panel on Radiation Oncology-Rectal/Anal Cancer, based on a literature review completed in 2007

  8. Image-guided intensity-modulated radiotherapy for prostate cancer: Dose constraints for the anterior rectal wall to minimize rectal toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, Jennifer L., E-mail: peterson.jennifer2@mayo.edu [Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, FL (United States); Buskirk, Steven J. [Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, FL (United States); Heckman, Michael G.; Diehl, Nancy N. [Section of Biostatistics, Mayo Clinic Florida, Jacksonville, FL (United States); Bernard, Johnny R. [Section of Biostatistics, Mayo Clinic Florida, Jacksonville, FL (United States); Department of Radiation Oncology, Southern Ohio Medical Center, Portsmouth, OH (United States); Tzou, Katherine S.; Casale, Henry E.; Bellefontaine, Louis P.; Serago, Christopher; Kim, Siyong; Vallow, Laura A.; Daugherty, Larry C.; Ko, Stephen J. [Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, FL (United States)

    2014-04-01

    Rectal adverse events (AEs) are a major concern with definitive radiotherapy (RT) treatment for prostate cancer. The anterior rectal wall is at the greatest risk of injury as it lies closest to the target volume and receives the highest dose of RT. This study evaluated the absolute volume of anterior rectal wall receiving a high dose to identify potential ideal dose constraints that can minimize rectal AEs. A total of 111 consecutive patients with Stage T1c to T3a N0 M0 prostate cancer who underwent image-guided intensity-modulated RT at our institution were included. AEs were graded according to the Common Terminology Criteria for Adverse Events, version 4.0. The volume of anterior rectal wall receiving 5 to 80 Gy in 2.5-Gy increments was determined. Multivariable Cox regression models were used to identify cut points in these volumes that led to an increased risk of early and late rectal AEs. Early AEs occurred in most patients (88%); however, relatively few of them (13%) were grade ≥2. At 5 years, the cumulative incidence of late rectal AEs was 37%, with only 5% being grade ≥2. For almost all RT doses, we identified a threshold of irradiated absolute volume of anterior rectal wall above which there was at least a trend toward a significantly higher rate of AEs. Most strikingly, patients with more than 1.29, 0.73, or 0.45 cm{sup 3} of anterior rectal wall exposed to radiation doses of 67.5, 70, or 72.5 Gy, respectively, had a significantly increased risk of late AEs (relative risks [RR]: 2.18 to 2.72; p ≤ 0.041) and of grade ≥ 2 early AEs (RR: 6.36 to 6.48; p = 0.004). Our study provides evidence that definitive image-guided intensity-modulated radiotherapy (IG-IMRT) for prostate cancer is well tolerated and also identifies dose thresholds for the absolute volume of anterior rectal wall above which patients are at greater risk of early and late complications.

  9. Image-guided intensity-modulated radiotherapy for prostate cancer: Dose constraints for the anterior rectal wall to minimize rectal toxicity

    International Nuclear Information System (INIS)

    Peterson, Jennifer L.; Buskirk, Steven J.; Heckman, Michael G.; Diehl, Nancy N.; Bernard, Johnny R.; Tzou, Katherine S.; Casale, Henry E.; Bellefontaine, Louis P.; Serago, Christopher; Kim, Siyong; Vallow, Laura A.; Daugherty, Larry C.; Ko, Stephen J.

    2014-01-01

    Rectal adverse events (AEs) are a major concern with definitive radiotherapy (RT) treatment for prostate cancer. The anterior rectal wall is at the greatest risk of injury as it lies closest to the target volume and receives the highest dose of RT. This study evaluated the absolute volume of anterior rectal wall receiving a high dose to identify potential ideal dose constraints that can minimize rectal AEs. A total of 111 consecutive patients with Stage T1c to T3a N0 M0 prostate cancer who underwent image-guided intensity-modulated RT at our institution were included. AEs were graded according to the Common Terminology Criteria for Adverse Events, version 4.0. The volume of anterior rectal wall receiving 5 to 80 Gy in 2.5-Gy increments was determined. Multivariable Cox regression models were used to identify cut points in these volumes that led to an increased risk of early and late rectal AEs. Early AEs occurred in most patients (88%); however, relatively few of them (13%) were grade ≥2. At 5 years, the cumulative incidence of late rectal AEs was 37%, with only 5% being grade ≥2. For almost all RT doses, we identified a threshold of irradiated absolute volume of anterior rectal wall above which there was at least a trend toward a significantly higher rate of AEs. Most strikingly, patients with more than 1.29, 0.73, or 0.45 cm 3 of anterior rectal wall exposed to radiation doses of 67.5, 70, or 72.5 Gy, respectively, had a significantly increased risk of late AEs (relative risks [RR]: 2.18 to 2.72; p ≤ 0.041) and of grade ≥ 2 early AEs (RR: 6.36 to 6.48; p = 0.004). Our study provides evidence that definitive image-guided intensity-modulated radiotherapy (IG-IMRT) for prostate cancer is well tolerated and also identifies dose thresholds for the absolute volume of anterior rectal wall above which patients are at greater risk of early and late complications

  10. Multidisciplinary team conferences promote treatment according to guidelines in rectal cancer

    DEFF Research Database (Denmark)

    Brännström, Fredrik; Kroll Bjerregaard, Jon; Winbladh, Anders

    2015-01-01

    BACKGROUND: Multidisciplinary team (MDT) conferences have been introduced into standard cancer care, though evidence that it benefits the patient is weak. We used the national Swedish Rectal Cancer Register to evaluate predictors for case discussion at a MDT conference and its impact on treatment...... radiotherapy. These results indirectly support the introduction into clinical practice of discussing all rectal cancer patients at MDT conferences, not least those being treated at low-volume hospitals....... on the implementation of preoperative radiotherapy was evaluated in 1043 patients with pT3c-pT4 M0 tumours, and in 1991 patients with pN+ M0 tumours. RESULTS: Hospital volume, i.e. the number of rectal cancer surgical procedures performed per year, was the major predictor for MDT evaluation. Patients treated...... at hospitals with

  11. Chronophysiological modifications of the triiodothyronine's peripheral metabolism(T3)

    International Nuclear Information System (INIS)

    Watanabe, Tomas; Degrossi, O.J.; Altschuler, Noe; Garcia del Rio, Hernan

    1984-01-01

    An interesting aspect relative to the thyroid function consists in determining the variations produced by the age. Though this relation has been referred to T 4 related with age, there are no differences about T 3 kinetics. For this purpose, different parameters were studied in 68 euthyroid controls of both sexs, in good nutritional state and normal activity, whose ages oscillate between 6 and 83 years old. A kinetic study method of single i.v. T 3 -I 125 injection was used, employing 0,5 μCi/Kg of body weight with maximum activity of 10 μCi to 10 years old; 15 μCi to 15 years old and 30 μCi above this age. Determinations of T 4 , T 3 and TSH serum by radioimmunoassay were carried out. From these studies, the following conclusions were obtained: T 4 and TSH are within the normal values, while a decrease of T 3 related with age was observed. Parallely to said decrease, a prolongation of plasmatic half time and a decrease of the daily value production, which is expressed statistically by a double exponential function are appreciated. The first one, which is of fast slope, corresponds to subjects below 10 years old and the second one, which is slower, starts from that age to the seventh decade of life. (M.E.L.) [es

  12. Fetal extraperitoneal rectal perforation: a case report

    African Journals Online (AJOL)

    Buttock swelling from a perineal hernia through a levator ani defect has been reported previously [12]. There have also been similar presentations due to rupture of rectal diverticular duplications [6]. Apart from the embryological causes, rectal perforation has been also reported because of rectal thermometers or probes and ...

  13. Preoperative chemoradiation using oral capecitabine in locally advanced rectal cancer

    International Nuclear Information System (INIS)

    Kim, Jun-Sang; Kim, Jae-Sung; Cho, Moon-June; Song, Kyu-Sang; Yoon, Wan-Hee

    2002-01-01

    Purpose: Capecitabine (Xeloda) is a new orally administered fluoropyrimidine carbamate that was rationally designed to exert its effect by tumor-selective activation. We attempted to evaluate the efficacy and toxicity of preoperative chemoradiation using capecitabine in locally advanced rectal cancer. Methods and Materials: Between July 1999 and March 2001, 45 patients with locally advanced rectal cancer (cT3/T4 or N+) were treated with preoperative chemoradiation. Radiation of 45 Gy/25 fractions was delivered to the pelvis, followed by a 5.4 Gy/3 fractions boost to the primary tumor. Chemotherapy was administered concurrent with radiotherapy and consisted of 2 cycles of 14-day oral capecitabine (1650 mg/m 2 /day) and leucovorin (20 mg/m 2 /day), each of which was followed by a 7-day rest period. Surgery was performed 6 weeks after the completion of chemoradiation. Results: Thirty-eight patients received definitive surgery. Primary tumor and node downstaging occurred in 63% and 90% of patients, respectively. The overall downstaging rate, including both primary tumor and nodes, was 84%. A pathologic complete response was achieved in 31% of patients. Twenty-one patients had tumors located initially 5 cm or less from the anal verge; among the 18 treated with surgery, 72% received sphincter-preserving surgery. No Grade 3 or 4 hematologic toxicities developed. Other Grade 3 toxicities were as follows: hand-foot syndrome (7%), fatigue (4%), diarrhea (4%), and radiation dermatitis (2%). Conclusion: These preliminary results suggest that preoperative chemoradiation with capecitabine is a safe, well-tolerated, and effective neoadjuvant treatment modality for locally advanced rectal cancer. In addition, this preoperative treatment has a considerable downstaging effect on the tumor and can increase the possibility of sphincter preservation in distal rectal cancer

  14. The curative management of synchronous rectal and prostate cancer

    Science.gov (United States)

    Kavanagh, Dara O; Martin, Joseph; Small, Cormac; Joyce, Myles R; Faul, Clare M; Kelly, Paul J; O'Riordain, Michael; Gillham, Charles M; Armstrong, John G; Salib, Osama; McNamara, Deborah A; McVey, Gerard; O'Neill, Brian D P

    2016-01-01

    Objective: Neoadjuvant “long-course” chemoradiation is considered a standard of care in locally advanced rectal cancer. In addition to prostatectomy, external beam radiotherapy and brachytherapy with or without androgen suppression (AS) are well established in prostate cancer management. A retrospective review of ten cases was completed to explore the feasibility and safety of applying these standards in patients with dual pathology. To our knowledge, this is the largest case series of synchronous rectal and prostate cancers treated with curative intent. Methods: Eligible patients had synchronous histologically proven locally advanced rectal cancer (defined as cT3-4Nx; cTxN1-2) and non-metastatic prostate cancer (pelvic nodal disease permissible). Curative treatment was delivered to both sites simultaneously. Follow-up was as per institutional guidelines. Acute and late toxicities were reviewed, and a literature search performed. Results: Pelvic external beam radiotherapy (RT) 45–50.4 Gy was delivered concurrent with 5-fluorouracil (5FU). Prostate total dose ranged from 70.0 to 79.2 Gy. No acute toxicities occurred, excluding AS-induced erectile dysfunction. Nine patients proceeded to surgery, and one was managed expectantly. Three relapsed with metastatic colorectal cancer, two with metastatic prostate cancer. Five patients have no evidence of recurrence, and four remain alive with metastatic disease. With a median follow-up of 2.2 years (range 1.2–6.3 years), two significant late toxicities occurred; G3 proctitis in a patient receiving palliative bevacizumab and a G3 anastomotic stricture precluding stoma reversal. Conclusion: Patients proceeding to synchronous radical treatment of both primary sites should receive 45–50.4 Gy pelvic RT with infusional 5FU. Prostate dose escalation should be given with due consideration to the potential impact of prostate cancer on patient survival, as increasing dose may result in significant late morbidity

  15. Thrombosed hemorrhoid mimicking rectal carcinoma at CT

    International Nuclear Information System (INIS)

    Ben-Chetrit, E.; Bar-Ziv, J.

    1992-01-01

    A 46-year-old male with cirrhosis and portal hypertension complained of lower pelvic pain. CT of the rectum raised a strong suspicion of a rectal tumor. However, rectal examination, anoscopy, direct rectoscopy, and, unfortunately, post-mortem dissection, failed to confirm its existence. Nevertheless, large flat hemorrhoids were evident. Review of the patient's chart disclosed the presence of large thrombosed hemorrhoids detected by rectal examination prior to the CT examination. It is suggested that rectal hemorrhoids be included in the differential diagnosis of rectal tumor shown by CT in patients with portal hypertension. (orig.)

  16. Thrombosed hemorrhoid mimicking rectal carcinoma at CT

    Energy Technology Data Exchange (ETDEWEB)

    Ben-Chetrit, E.; Bar-Ziv, J. (Dept. of Medicine, Dept. of Radiology, Hadassah Univ. Hospital, Jerusalem (Israel))

    1992-09-01

    A 46-year-old male with cirrhosis and portal hypertension complained of lower pelvic pain. CT of the rectum raised a strong suspicion of a rectal tumor. However, rectal examination, anoscopy, direct rectoscopy, and, unfortunately, post-mortem dissection, failed to confirm its existence. Nevertheless, large flat hemorrhoids were evident. Review of the patient's chart disclosed the presence of large thrombosed hemorrhoids detected by rectal examination prior to the CT examination. It is suggested that rectal hemorrhoids be included in the differential diagnosis of rectal tumor shown by CT in patients with portal hypertension. (orig.).

  17. Mesorectal Invasion Depth in Rectal Carcinoma Is Associated With Low Survival.

    Science.gov (United States)

    Lino-Silva, Leonardo S; Loaeza-Belmont, Reynaldo; Gómez Álvarez, Miguel A; Vela-Sarmiento, Itzel; Aguilar-Romero, José M; Domínguez-Rodríguez, Jorge A; Salcedo-Hernández, Rosa A; Ruiz-García, Erika B; Maldonado-Martínez, Héctor A; Herrera-Gómez, Ángel

    2017-03-01

    Most cases of rectal cancer (RC) in our institution are in pathologic stage T3. They are a heterogeneous group but have been classified in a single-stage category. We performed the present study to validate the prognostic significance of the mesorectal extension depth (MED) in T3 RC measured in millimeters beyond the muscularis propria plane. We performed a retrospective analysis of 104 patients with T3 RC who had undergone curative surgery after a course of preoperative chemoradiotherapy at a tertiary referral cancer hospital. The patients were grouped by MED (T3a,  5-10 mm; and T3d > 10 mm). The clinicopathologic data and disease-free survival were analyzed. The 5-year disease-free survival rate according to the T3 subclassification was 87.5% for those with T3a, 57.9% for T3b, 38.7% for T3c, and 40.3% for those with T3d tumors (P = .050). On univariate and multivariate analysis, the prognostic factors affecting survival were overall recurrence (hazard ratio [HR], 3.670; 95% confidence interval [CI], 1.710-7.837; P = .001), histologic grade (HR, 2.204; 95% CI, 1.156-4.199; P = .016), mesorectal invasion depth (HR, 1.885; 95% CI, 1.164-3.052; P = .010), and lymph node metastasis (HR, 1.211; 95% CI, 1.015-1.444; P = .033). MED is a significant prognostic factor in patients with T3 RC who have undergone neoadjuvant chemoradiotherapy, especially when the MED is > 5 mm. The MED could be as important as other clinicopathologic factors in predicting disease-specific survival. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. rectal temp sajsm ver 5

    African Journals Online (AJOL)

    impo

    temperature, heart rate (HR), and altitude during road and cycle racing. This technology has the potential to ... tion to rectal temperature, the logging time decreases in direct proportion to the time interval between heart ... with metabolic rate and course terrain, the former normally being a function of the latter. In addition ...

  19. Rectal duplication: a case report.

    Science.gov (United States)

    Didden, K; Masereel, B; Geyskens, P

    2013-01-01

    Gastrointestinal tract duplications are uncommon congenital abnormalities, that may occur anywhere along the alimentary tract. Most frequently they occur at the level of the small bowel tract and are symptomatic before the age of two. In our case we report the history of a 68-years old women with a colon duplication, especially a rectal duplication. This is very exceptional.

  20. CT diagnosis of rectal cancer

    International Nuclear Information System (INIS)

    Kanda, Hiroshi; Hachisuka, Kitao; Yamaguchi, Akihiro

    1986-01-01

    Preoperative diagnosis of the depth of invasion and lymph node metastasis of rectal cancer were studied using the findings of computed tomography (CT). Of one hundred and four cases operated on for rectal cancer over a period of 32 months, thirty five cases were examined by CT with the use of olive oil enema and contrast enhancement using a 60 % Conray drip infusion with reference to the histological findings. For direct invasion into the wall, the diagnoses by CT were coincident with microscopic findings in 75 % of cancers of the rectosigmoid, in 75 % of the upper rectum and in 84 % of the lower rectum. Of all cases, 28 (80 %) were diagnosed correctly. As to local lymph node metastasis, 74 % of all diagnoses by CT corresponded with the histological diagnosis. Moreover, seventeen cases were evaluated for lateral lymph node metastasis, and the diagnostic accuracy by CT was 88 %. In conclusion, preoperative CT evaluation of the extension into the rectal wall and lymph node metastasis in rectal cancer was considesed useful. (author)

  1. Approach to Rectal Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Terence C. Chua

    2012-01-01

    Full Text Available Rectal cancer is a distinct subset of colorectal cancer where specialized disease-specific management of the primary tumor is required. There have been significant developments in rectal cancer surgery at all stages of disease in particular the introduction of local excision strategies for preinvasive and early cancers, standardized total mesorectal excision for resectable cancers incorporating preoperative short- or long-course chemoradiation to the multimodality sequencing of treatment. Laparoscopic surgery is also increasingly being adopted as the standard rectal cancer surgery approach following expertise of colorectal surgeons in minimally invasive surgery gained from laparoscopic colon resections. In locally advanced and metastatic disease, combining chemoradiation with radical surgery may achieve total eradication of disease and disease control in the pelvis. Evidence for resection of metastases to the liver and lung have been extensively reported in the literature. The role of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal metastases is showing promise in achieving locoregional control of peritoneal dissemination. This paper summarizes the recent developments in approaches to rectal cancer surgery at all these time points of the disease natural history.

  2. Rectal Prolapse in An Emu

    African Journals Online (AJOL)

    USER

    was presented at the surgery clinic of the. INTRODUCTION. Rectal prolapsed is the protrusion of all layers of the rectum through the anal orifice as an elongated cylindrical mass. (Aronson 2003). It usually occurs in patients secondary to tenesmus from urogenital or anorectal disease. It has been reported in small animals ...

  3. Operation and maintenance of the T-3 cask system

    International Nuclear Information System (INIS)

    Hussey, M.W.; Berger, J.D.; Peterson, J.M.

    1983-01-01

    The T-3 cask system consists of three lead-shielded casks and the associated payload containers, internal fixturing, tiedowns, transportation trailers and handling devices. The three casks were designed to meet the requirements of Title 10 of the Code of Federal Regulations, Part 71. The Nuclear Regulatory Commission cask licensing activities for original design and for licensing revisions have required significant analytical support. Commercial transportation contractors can provide needed services including provisions of suitable equipment, compliances with security requirements, and safe movement of the shipment at a potential savings over DOE-owned transportation systems. Proper periodic inspection/maintenance activities supported by adequate decontamination facilities are a must in keeping the T-3 casks available for service

  4. Characterization of 2024-T3: An aerospace aluminum alloy

    International Nuclear Information System (INIS)

    Huda, Zainul; Taib, Nur Iskandar; Zaharinie, Tuan

    2009-01-01

    The 2024-T3 aerospace aluminum alloy, reported in this investigation, was acquired from a local aerospace industry: Royal Malaysian Air Force (RMAF). The heat treatable 2024-T3 aluminum alloy has been characterized by use of modern metallographic and material characterization techniques (e.g. EPMA, SEM). The microstructural characterization of the metallographic specimen involved use of an optical microscope linked with a computerized imaging system using MSQ software. The use of EPMA and electron microprobe elemental maps enabled us to detect three types of inclusions: Al-Cu, Al-Cu-Fe-Mn, and Al-Cu-Fe-Si-Mn enriched regions. In particular, the presence of Al 2 CuMg (S-phase) and the CuAl 2 (θ') phases indicated precipitation strengthening in the aluminum alloy

  5. Characterization of 2024-T3: An aerospace aluminum alloy

    Energy Technology Data Exchange (ETDEWEB)

    Huda, Zainul [Department of Mechanical Engineering, University of Malaya, Kuala Lumpur (Malaysia)], E-mail: drzainulhuda@hotmail.com; Taib, Nur Iskandar [Department of Geology, University of Malaya, Kuala Lumpur (Malaysia)], E-mail: ntaib@alumni.indiana.edu; Zaharinie, Tuan [Department of Mechanical Engineering, University of Malaya, Kuala Lumpur (Malaysia)], E-mail: rinie_3483@hotmail.com

    2009-02-15

    The 2024-T3 aerospace aluminum alloy, reported in this investigation, was acquired from a local aerospace industry: Royal Malaysian Air Force (RMAF). The heat treatable 2024-T3 aluminum alloy has been characterized by use of modern metallographic and material characterization techniques (e.g. EPMA, SEM). The microstructural characterization of the metallographic specimen involved use of an optical microscope linked with a computerized imaging system using MSQ software. The use of EPMA and electron microprobe elemental maps enabled us to detect three types of inclusions: Al-Cu, Al-Cu-Fe-Mn, and Al-Cu-Fe-Si-Mn enriched regions. In particular, the presence of Al{sub 2}CuMg (S-phase) and the CuAl{sub 2} ({theta}') phases indicated precipitation strengthening in the aluminum alloy.

  6. Phenomenology of the Gowdy Universe on $T^3 \\times R$

    OpenAIRE

    Berger, Beverly K.; Garfinkle, David

    1997-01-01

    Numerical studies of the plane symmetric, vacuum Gowdy universe on $T^3 \\times R$ yield strong support for the conjectured asymptotically velocity term dominated (AVTD) behavior of its evolution toward the singularity except, perhaps, at isolated spatial points. A generic solution is characterized by spiky features and apparent ``discontinuities'' in the wave amplitudes. It is shown that the nonlinear terms in the wave equations drive the system generically to the ``small velocity'' AVTD regi...

  7. Risk Factors Associated With Circumferential Resection Margin Positivity in Rectal Cancer: A Binational Registry Study.

    Science.gov (United States)

    Warrier, Satish K; Kong, Joseph Cherng; Guerra, Glen R; Chittleborough, Timothy J; Naik, Arun; Ramsay, Robert G; Lynch, A Craig; Heriot, Alexander G

    2018-04-01

    Rectal cancer outcomes have improved with the adoption of a multidisciplinary model of care. However, there is a spectrum of quality when viewed from a national perspective, as highlighted by the Consortium for Optimizing the Treatment of Rectal Cancer data on rectal cancer care in the United States. The aim of this study was to assess and identify predictors of circumferential resection margin involvement for rectal cancer across Australasia. A retrospective study from a prospectively maintained binational colorectal cancer database was interrogated. This study is based on a binational colorectal cancer audit database. Clinical information on all consecutive resected rectal cancer cases recorded in the registry from 2007 to 2016 was retrieved, collated, and analyzed. The primary outcome measure was positive circumferential resection margin, measured as a resection margin ≤1 mm. A total of 3367 patients were included, with 261 (7.5%) having a positive circumferential resection margin. After adjusting for hospital and surgeon volume, hierarchical logistic regression analysis identified a 6-variable model encompassing the independent predictors, including urgent operation, abdominoperineal resection, open technique, low rectal cancer, T3 to T4, and N1 to N2. The accuracy of the model was 92.3%, with an receiver operating characteristic of 0.783 (p risk associated with circumferential resection margin positivity ranged from risk factors) to 43% (6 risk factors). This study was limited by the lack of recorded long-term outcomes associated with circumferential resection margin positivity. The rate of circumferential resection margin involvement in patients undergoing rectal cancer resection in Australasia is low and is influenced by a number of factors. Risk stratification of outcome is important with the increasing demand for publicly accessible quality data. See Video Abstract at http://links.lww.com/DCR/A512.

  8. Correlation between tumor regression grade and rectal volume in neoadjuvant concurrent chemoradiotherapy for rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hong Seok; Choi, Doo Ho; Park, Hee Chul; Park, Won; Yu, Jeong Il; Chung, Kwang Zoo [Dept. of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2016-09-15

    To determine whether large rectal volume on planning computed tomography (CT) results in lower tumor regression grade (TRG) after neoadjuvant concurrent chemoradiotherapy (CCRT) in rectal cancer patients. We reviewed medical records of 113 patients treated with surgery following neoadjuvant CCRT for rectal cancer between January and December 2012. Rectal volume was contoured on axial images in which gross tumor volume was included. Average axial rectal area (ARA) was defined as rectal volume divided by longitudinal tumor length. The impact of rectal volume and ARA on TRG was assessed. Average rectal volume and ARA were 11.3 mL and 2.9 cm². After completion of neoadjuvant CCRT in 113 patients, pathologic results revealed total regression (TRG 4) in 28 patients (25%), good regression (TRG 3) in 25 patients (22%), moderate regression (TRG 2) in 34 patients (30%), minor regression (TRG 1) in 24 patients (21%), and no regression (TRG0) in 2 patients (2%). No difference of rectal volume and ARA was found between each TRG groups. Linear correlation existed between rectal volume and TRG (p = 0.036) but not between ARA and TRG (p = 0.058). Rectal volume on planning CT has no significance on TRG in patients receiving neoadjuvant CCRT for rectal cancer. These results indicate that maintaining minimal rectal volume before each treatment may not be necessary.

  9. Correlation between tumor regression grade and rectal volume in neoadjuvant concurrent chemoradiotherapy for rectal cancer

    International Nuclear Information System (INIS)

    Lee, Hong Seok; Choi, Doo Ho; Park, Hee Chul; Park, Won; Yu, Jeong Il; Chung, Kwang Zoo

    2016-01-01

    To determine whether large rectal volume on planning computed tomography (CT) results in lower tumor regression grade (TRG) after neoadjuvant concurrent chemoradiotherapy (CCRT) in rectal cancer patients. We reviewed medical records of 113 patients treated with surgery following neoadjuvant CCRT for rectal cancer between January and December 2012. Rectal volume was contoured on axial images in which gross tumor volume was included. Average axial rectal area (ARA) was defined as rectal volume divided by longitudinal tumor length. The impact of rectal volume and ARA on TRG was assessed. Average rectal volume and ARA were 11.3 mL and 2.9 cm². After completion of neoadjuvant CCRT in 113 patients, pathologic results revealed total regression (TRG 4) in 28 patients (25%), good regression (TRG 3) in 25 patients (22%), moderate regression (TRG 2) in 34 patients (30%), minor regression (TRG 1) in 24 patients (21%), and no regression (TRG0) in 2 patients (2%). No difference of rectal volume and ARA was found between each TRG groups. Linear correlation existed between rectal volume and TRG (p = 0.036) but not between ARA and TRG (p = 0.058). Rectal volume on planning CT has no significance on TRG in patients receiving neoadjuvant CCRT for rectal cancer. These results indicate that maintaining minimal rectal volume before each treatment may not be necessary

  10. Diagnostic value of multidetector row CT in rectal cancer staging: comparison of multiplanar and axial images with histopathology

    International Nuclear Information System (INIS)

    Sinha, R.; Verma, R.; Rajesh, A.; Richards, C.J.

    2006-01-01

    Aim: Although magnetic resonance (MR) imaging is widely used for rectal cancer staging, many centres in the UK perform computed tomography (CT) for staging rectal cancer at present. Furthermore in a small proportion of cases contraindications to MR imaging may lead to staging using CT. The purpose of this study was to evaluate the accuracy of current generation multidetector row CT (MDCT) in local staging of rectal cancer. In particular the accuracy of multiplanar (MPR) versus axial images in the staging of rectal cancer was assessed. Material and methods: Sixty-nine consecutive patients were identified who had undergone staging of rectal cancer on CT. The imaging data were reviewed as axial images and then as MPR images (coronal and sagittal) perpendicular and parallel to the tumour axis. CT staging on axial and MPR images was then compared to histopathological staging. Results: MPR images detected more T4 and T3 stage tumours than axial images alone. The overall accuracy of T-staging on MPR images was 87.1% versus 73.0% for axial images alone. The overall accuracy of N staging on MPR versus axial images was 84.8% versus 70.7%. There was a statistically significant difference in the staging of T3 tumours between MPR and axial images (p < 0.001). Conclusion: Multidetector row CT has high accuracy for local staging of rectal cancer. Addition of MPR images to standard axial images provides higher accuracy rates for T and N staging of rectal cancer than axial images alone

  11. Nuclear fusion rate of the muonic T3 molecule

    International Nuclear Information System (INIS)

    Faghihi, F.; Eskandari, M. R.

    2004-01-01

    The ground state binding energy, size and effective nuclear charge of the muonic T 3 molecule are calculated using Born-Oppenheimer adiabatic approximation. The system possesses two minimum positions, one at typically muonic and the second at the atomic distances. A symmetric planar vibrational model between two minima is assumed and the approximated potential are calculated. Moreover, nuclear fusion rate calculations of the short-life molecule is carried out due to the overlap integral of the resonance nuclear compound nucleus and the molecular wave functions

  12. Determination of triiodothyronine using RIA-Mat T3 kit

    International Nuclear Information System (INIS)

    Hara, Masao

    1975-01-01

    A RIA-Mat T 3 kit was used for an in vitro measurement of triiodothyronine in serum. A resin strip was utilized to absorb free triiodothyronine after the serum was incubated with antibody against triiodothyronine. This test was easy to manipulate and the reproducibility test with same sera, dilution test, and recovery test were also satisfactory. The normal range of triiodothyronine determined with this test kit was 119 +- 40 ng/dl using 50 test sera. Ninety sera with various thyroid diseases were also determined. (auth.)

  13. Radiologic spectrum of rectal stenosis

    International Nuclear Information System (INIS)

    Yamamoto, T.; Hayashi, N.; Ishii, Y.; Hayakawa, K.; Nishimura, K.

    2000-01-01

    Rectal stenosis is a common condition caused by a wide variety of diseases, including both intrinsic and extrinsic disorders, as well as both malignant and benign pathologies. Barium enema, CT, and MRI are the primary modalities for the evaluation of the disease, and careful observation of the characteristic radiologic features usually leads to correct diagnosis. However, some of the lesions looks very similar and are difficult to differentiate from each other. The purpose of this study is to review the literature on diseases that cause rectal stenosis, to clarify the characteristics of radiologic features, and to suggest the limitations in differential diagnosis. Deliberate analysis of these imaging features and correlation with clinical manifestations can facilitate a more specific diagnosis. (orig.)

  14. Radiologic spectrum of rectal stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, T.; Hayashi, N.; Ishii, Y. [Department of Radiology, Fukui Medical University School of Medicine, Matsuoka-cho, Yoshida-gun, Fukui (Japan); Hayakawa, K.; Nishimura, K. [Department of Radiology, Kyoto City Hospital, Mibu, Nakagyo-ku, Kyoto (Japan)

    2000-08-01

    Rectal stenosis is a common condition caused by a wide variety of diseases, including both intrinsic and extrinsic disorders, as well as both malignant and benign pathologies. Barium enema, CT, and MRI are the primary modalities for the evaluation of the disease, and careful observation of the characteristic radiologic features usually leads to correct diagnosis. However, some of the lesions looks very similar and are difficult to differentiate from each other. The purpose of this study is to review the literature on diseases that cause rectal stenosis, to clarify the characteristics of radiologic features, and to suggest the limitations in differential diagnosis. Deliberate analysis of these imaging features and correlation with clinical manifestations can facilitate a more specific diagnosis. (orig.)

  15. Preoperative staging of rectal cancer

    International Nuclear Information System (INIS)

    Schaefer, A.O.; Baumann, T.; Pache, G.; Langer, M.; Wiech, T.

    2007-01-01

    Accurate preoperative staging of rectal cancer is crucial for therapeutic decision making, as local tumor extent, nodal status, and patterns of metastatic spread are directly associated with different treatment strategies. Recently, treatment approaches have been widely standardized according to large studies and consensus guidelines. Introduced by Heald, total mesorectal excision (TME) is widely accepted as the surgical procedure of choice to remove the rectum together with its enveloping tissues and the mesorectal fascia. Neoadjuvant radiochemotherapy also plays a key role in the treatment of locally advanced stages, while the use of new drugs will lead to a further improvement in oncological outcome. Visualization of the circumferential resection margin is the hallmark of any preoperative imaging and a prerequisite for high-quality TME surgery. The aim of this article is to present an overview on current cross-sectional imaging with emphasis on magnetic resonance imaging. Future perspectives in rectal cancer imaging are addressed. (orig.)

  16. Steady-State Serum T3 Concentrations for 48 Hours Following the Oral Administration of a Single Dose of 3,5,3'-Triiodothyronine Sulfate (T3S).

    Science.gov (United States)

    Santini, Ferruccio; Giannetti, Monica; Ricco, Ilaria; Querci, Giorgia; Saponati, Giorgio; Bokor, Daniela; Rivolta, Giovanni; Bussi, Simona; Braverman, Lewis E; Vitti, Paolo; Pinchera, Aldo

    2014-07-01

    Sulfate conjugation of thyroid hormones is an alternate metabolic pathway that facilitates the biliary and urinary excretion of iodothyronines and enhances their deiodination rate, leading to the generation of inactive metabolites. A desulfating pathway reverses this process, and thyromimetic effects have been observed following the parenteral administration of 3,5,3'-triiodothyronine (T3) sulfate (T3S) in rats. The present study investigated whether T3S is absorbed after oral administration in humans and if it represents a source of T3. Twenty-eight hypothyroid patients (7 men and 21 women; mean age, 44 ± 11 years) who had a thyroidectomy for thyroid carcinoma were enrolled. Replacement thyroid hormone therapy was withdrawn (42 days for thyroxine, 14 days for T3) prior to 131I remnant ablation. A single oral dose of 20, 40, 80 (4 patients/group), or 160 μg (16 patients/group) of T3S was administered 3 days before the planned administration of 131I. Blood samples for serum T3S and total T3 (TT3) concentrations were obtained at various times up to 48 hours after T3S administration. At all T3S doses, serum T3S concentrations increased, reaching a peak at 2 to 4 hours and progressively returning to basal levels within 8 to 24 hours. The T3S maximum concentration (Cmax) and area under the 0- to 48-hour concentration-time curve (AUC0-48h) were directly and significantly related to the administered dose. An increase in serum TT3 concentration was observed (significant after 1 hour), and the concentration increased further at 2 and 4 hours and then remained steady up to 48 hours after T3S administration. There was a significant direct correlation between the TT3 AUC0-48h and the administered dose of T3S. No changes in serum free thyroxine (T4) concentrations during the entire study period were observed, whereas serum thyroid-stimulating hormone levels increased slightly at 48 hours, but this was not related to the dose of T3S. No adverse events were reported. (1) T3S is

  17. Tumor vascularity evaluated by transrectal color Doppler US in predicting therapy outcome for low-lying rectal cancer

    International Nuclear Information System (INIS)

    Barbaro, Brunella; Valentini, Vincenzo; Coco, Claudio; Mancini, Anna Paola; Gambacorta, Maria Antonietta; Vecchio, Fabio Maria; Bonomo, Lorenzo

    2005-01-01

    Purpose: To evaluate the impact on T downstaging of the vasculature supplying blood flow to rectal cancer evaluated by color Doppler ultrasound. Methods and Materials: Color Doppler images were graded in 29 T3-staged rectal carcinoma patients sonographically just before chemoradiation. Any arterial vessels detected in rectal masses were assigned one of two grades: vascularity was considered as grade 1 for vessels feeding the periphery and as grade 2 for vessels coursing in all rectal masses within its peripheral and central portions. The pulsatility indices (PI = peak systolic velocity - end-diastolic velocity/time-averaged maximum velocity) were calculated in the central and peripheral portions. Results: The pathologic observations showed a change in stage in 15 of the 23 patients graded 2, positive predictive value 65.2% (p = 0.047), and in one of the six rectal cancers graded 1 (negative predictive value, 83.3%). The minimal peripheral PI values in rectal cancer graded 2 were higher in nonresponding (2.2 ± 1.3) than in responding lesions (1.6 ± 0.7) p = 0.01. Conclusion: Vascularity graded 2 associated with low peripheral PI values are indicators of therapy outcome. Vascularity graded 1 and high peripheral PI values in graded 2 have negative predictive value

  18. Aspartame downregulates 3T3-L1 differentiation.

    Science.gov (United States)

    Pandurangan, Muthuraman; Park, Jeongeun; Kim, Eunjung

    2014-10-01

    Aspartame is an artificial sweetener used as an alternate for sugar in several foods and beverages. Since aspartame is 200 times sweeter than traditional sugar, it can give the same level of sweetness with less substance, which leads to lower-calorie food intake. There are reports that consumption of aspartame-containing products can help obese people lose weight. However, the potential role of aspartame in obesity is not clear. The present study investigated whether aspartame suppresses 3T3-L1 differentiation, by downregulating phosphorylated peroxisome proliferator-activated receptor γ (p-PPARγ), peroxisome proliferator-activated receptor γ (PPARγ), fatty acid-binding protein 4 (FABP4), CCAAT/enhancer-binding protein α (C/EBPα), and sterol regulatory element-binding protein 1 (SREBP1), which are critical for adipogenesis. The 3T3-L1 adipocytes were cultured and differentiated for 6 d in the absence and presence of 10 μg/ml of aspartame. Aspartame reduced lipid accumulation in differentiated adipocytes as evidenced by Oil Red O staining. qRT-PCR analysis showed that the PPARγ, FABP4, and C/EBPα mRNA expression was significantly reduced in the aspartame-treated adipocytes. Western blot analysis showed that the induction of p-PPARγ, PPARγ, SREBP1, and adipsin was markedly reduced in the aspartame-treated adipocytes. Taken together, these data suggest that aspartame may be a potent substance to alter adipocyte differentiation and control obesity.

  19. Quantum effects in the Gowdy T3 cosmology

    International Nuclear Information System (INIS)

    Berger, B.K.

    1984-01-01

    The Gowdy T 3 Cosmology is an exact solution to the vacuum Einstein equations interpreted to be a single polarization of gravitational waves propagating in an anisotropic, spatially inhomogeneous background. The classical behavior is reviewed and related to standard cosmological parameters. Canonical quantization of the dynamical degrees of freedom is reviewed. An adiabatic vacuum state is constructed. Adiabatic regularization if used to obtain non-divergent stress-energy tensor vacuum expectation values. Casimir energy terms due to T 3 imposed discrete modes are evaluated. The vacuum expectation values are analyzed in early and late time limits and evaluated numerically. The regularized expectation value is used as a source for the classical background spacetime in the spirit of semi-classical gravity. An entirely vacuum expectation value source term produces essentially the time reverse of the classical evolution. Classical stress-energy added to the source restores the classical behavior at lates times only. The combined system collapses from infinite to small but non-zero volume and reexpands. The classical singularity is replaced by a symmetric bounce

  20. An Unusual Cause of Rectal Stenosis

    Directory of Open Access Journals (Sweden)

    Maja Gruber

    2016-08-01

    Full Text Available Solitary rectal ulcer syndrome (SRUS is a benign disease that is often misdiagnosed. It is characterized by a combination of symptoms, endoscopic findings and histology. Patients present with constipation, rectal bleeding, mucous discharge, pain and a sensation of incomplete defecation. There are many different manifestations of this disease, with or without rectal prolapse. We report an unusual presentation of SRUS as a circular stenosis in a middle-aged male.

  1. Anterior colorectal duplication presenting as rectal prolapse.

    Science.gov (United States)

    Ramirez-Resendiz, Amador; Asz, Jose; Medina-Vega, F Antonio; Ortega-Salgado, J Arturo

    2007-09-01

    Duplications of the gastrointestinal (GI) tract are rare. Only 5% of them are rectal and there are very few reports of rectal prolapse (RP) caused by a duplication. An 11 month-old female presented with a RP caused by a blind-ended anterior tubular colorectal duplication. The duplication was successfully opened and connected to the normal rectum without complications. Although infrequent, a rectal duplication should be considered in the differential diagnosis of RP.

  2. Chemoradiotherapy response in recurrent rectal cancer

    International Nuclear Information System (INIS)

    Yu, Stanley K T; Bhangu, Aneel; Tait, Diana M; Tekkis, Paris; Wotherspoon, Andrew; Brown, Gina

    2014-01-01

    The efficacy of response to preoperative chemoradiotherapy (CRT) in recurrent versus primary rectal cancer has not been investigated. We compared radiological downsizing between primary and recurrent rectal cancers following CRT and determined the optimal size reduction threshold for response validated by survival outcomes. The proportional change in tumor length for primary and recurrent rectal cancers following CRT was compared using the independent sample t-test. Overall survival (OS) was calculated using the Kaplan–Meier product limit method and differences between survival for tumor size reduction thresholds of 30% (response evaluation criteria in solid tumors [RECIST]), 40%, and 50% after CRT in primary and recurrent rectal cancer groups. A total of 385 patients undergoing CRT were analyzed, 99 with recurrent rectal cancer and 286 with primary rectal cancer. The mean proportional reduction in maximum craniocaudal length was significantly higher for primary rectal tumors (33%) compared with recurrent rectal cancer (11%) (P < 0.01). There was no difference in OS for either primary or recurrent rectal cancer when ≤30% or ≤40% definitions were used. However, for both primary and recurrent tumors, significant differences in median 3-year OS were observed when a RECIST cut-off of 50% was used. OS was 99% versus 77% in primary and 100% versus 42% in recurrent rectal cancer (P = 0.002 and P = 0.03, respectively). Only patients that demonstrated >50% size reduction showed a survival benefit. Recurrent rectal cancer appears radioresistant compared with primary tumors for tumor size after CRT. Further investigation into improving/intensifying chemotherapy and radiotherapy for locally recurrent rectal cancer is justified

  3. Chemoradiotherapy response in recurrent rectal cancer.

    Science.gov (United States)

    Yu, Stanley K T; Bhangu, Aneel; Tait, Diana M; Tekkis, Paris; Wotherspoon, Andrew; Brown, Gina

    2014-02-01

    The efficacy of response to preoperative chemoradiotherapy (CRT) in recurrent versus primary rectal cancer has not been investigated. We compared radiological downsizing between primary and recurrent rectal cancers following CRT and determined the optimal size reduction threshold for response validated by survival outcomes. The proportional change in tumor length for primary and recurrent rectal cancers following CRT was compared using the independent sample t-test. Overall survival (OS) was calculated using the Kaplan-Meier product limit method and differences between survival for tumor size reduction thresholds of 30% (response evaluation criteria in solid tumors [RECIST]), 40%, and 50% after CRT in primary and recurrent rectal cancer groups. A total of 385 patients undergoing CRT were analyzed, 99 with recurrent rectal cancer and 286 with primary rectal cancer. The mean proportional reduction in maximum craniocaudal length was significantly higher for primary rectal tumors (33%) compared with recurrent rectal cancer (11%) (P rectal cancer when ≤30% or ≤40% definitions were used. However, for both primary and recurrent tumors, significant differences in median 3-year OS were observed when a RECIST cut-off of 50% was used. OS was 99% versus 77% in primary and 100% versus 42% in recurrent rectal cancer (P = 0.002 and P = 0.03, respectively). Only patients that demonstrated >50% size reduction showed a survival benefit. Recurrent rectal cancer appears radioresistant compared with primary tumors for tumor size after CRT. Further investigation into improving/intensifying chemotherapy and radiotherapy for locally recurrent rectal cancer is justified. © 2013 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  4. Treatment of locally recurrent rectal cancer

    International Nuclear Information System (INIS)

    Kococik, Z.; Kococik, M.

    2007-01-01

    The suggested classifications of locally recurrent rectal cancer are based on the presence of symptoms and the degree of tumour fixation to the pelvic wall, or, otherwise, account for factor T in the TMN system. Although the results of rectal cancer treatment have improved, which may be attributed to total meso rectal excision and application of perioperative radiotherapy and radiochemotherapy, the ratio of cases of locally recurrent rectal cancer still amount from several to over a dozen percent. Among the available diagnostic methods for detecting locally recurrent rectal cancer after anterior rectal resection, endorectal sonography is of special importance. In the estimation of prognostic factors the lack of vascular invasion in recurrent cancer and the long period between the treatment of primary rectal cancer and the development of recurrence are a sign of good prognosis, while pain prior to recurrence treatment and male sex diminish the chances for cure. Locally recurrent rectal cancer impairs the patient's quality of life in all measurable aspects, but even after complete recovery we observe severe disturbances of sexual activity in most patients, and a number of patients require hygiene pads or suffer from chronic pain. Local recurrence of rectal cancer is more commonly qualified for excision after surgical treatment only, than after preoperative radiotherapy. The probability of total recurrent rectal cancer excision increases when the patient is younger, the primary tumours was less advanced and the first operation was sphincter-sparing surgery. Progress in the surgical treatment of recurrent rectal cancer was brought on by the introduction of the composite musculocutaneous flap to compensate the loss of perineal tissue. The application of intraoperative radiotherapy improves treatment results of recurrent rectal cancer, however at the cost of more frequent, serious postoperative complications and intense pain. In inoperable cases high dose regional

  5. Late rectal toxicity: dose-volume effects of conformal radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Huang, Eugene H.; Pollack, Alan; Levy, Larry; Starkschall, George; Lei Dong; Rosen, Isaac; Kuban, Deborah A.

    2002-01-01

    Purpose: To identify dosimetric, anatomic, and clinical factors that correlate with late rectal toxicity after three-dimensional conformal radiotherapy (3D-CRT) for prostate cancer. Methods and Materials: We retrospectively analyzed the dose-volume histograms and clinical records of 163 Stage T1b-T3c prostate cancer patients treated between 1992 and 1999 with 3D-CRT, to a total isocenter dose of 74-78 Gy at The University of Texas M. D. Anderson Cancer Center. The median follow-up was 62 months (range 24-102). All late rectal complications were scored using modified Radiation Therapy Oncology Group and Late Effects Normal Tissue Task Force criteria. The 6-year toxicity rate was assessed using Kaplan-Meier analysis and the log-rank test. A univariate proportional hazards regression model was used to test the correlation between Grade 2 or higher toxicity and the dosimetric, anatomic, and clinical factors. In a multivariate regression model, clinical factors were added to the dosimetric and anatomic variables to determine whether they significantly altered the risk of developing late toxicity. Results: At 6 years, the rate of developing Grade 2 or higher late rectal toxicity was 25%. A significant volume effect was observed at rectal doses of 60, 70, 75.6, and 78 Gy, and the risk of developing rectal complications increased exponentially as greater volumes were irradiated. Although the percentage of rectal volume treated correlated significantly with the incidence of rectal complications at all dose levels (p 3 of the rectum. Of the clinical variables tested, only a history of hemorrhoids correlated with rectal toxicity (p=0.003). Multivariate analysis showed that the addition of hemorrhoids increased the risk of toxicity for each dosimetric variable found to be significant on univariate analysis (p<0.05 for all comparisons). Conclusion: Dose-volume histogram analyses clearly indicated a volume effect on the probability of developing late rectal complications

  6. Evaluating the effect of rectal distension and rectal movement on prostate gland position using cine MRI

    International Nuclear Information System (INIS)

    Padhani, Anwar R.; Khoo, Vincent S.; Suckling, John; Husband, Janet E.; Leach, Martin O.; Dearnaley, David P.

    1999-01-01

    Purpose: To evaluate the dynamic interrelationship between rectal distension and rectal movements, and to determine the effect of rectal movement on the position of the prostatic gland using cine magnetic resonance imaging (MRI). Methods and Materials: Fifty-five patients with biopsy-proven or suspected prostate cancer were examined in the axial plane using repeated spoiled gradient-echo sequences every 10 seconds for 7 minutes. Twenty-four patients received bowel relaxants before imaging. Images were analyzed for the degree of rectal distension, for the incidence, magnitude, and number of rectal and prostate movements. Results: Rectal movements were seen in 28 (51%) patients overall, in 10 (42%) of those receiving bowel relaxants and in 18 (58%) not receiving bowel relaxants. The incidence of rectal movements correlated with the degree of rectal distension (p = 0.0005), but the magnitude of rectal movements did not correlate with the degree of rectal distension. Eighty-six rectal movements resulting in 33 anterior-posterior (AP) prostate movements were seen. The magnitude of rectal movements correlated well with degree of prostate movements (p < 0.001). Prostate movements in the AP direction were seen in 16 (29%) patients, and in 9 (16%) patients the movement was greater than 5 mm. The median prostate AP displacement was anterior by 4.2 (-5 to +14 mm). Conclusions: Cine MRI is able to demonstrate near real time rectal and associated prostate movements. Rectal movements are related to rectal distension and result in significant displacements of the prostate gland over a time period similar to that used for daily fractionated radiotherapy treatments. Delivery of radiotherapy needs to take into account these organ movements

  7. Klein tunneling in the α -T3 model

    Science.gov (United States)

    Illes, E.; Nicol, E. J.

    2017-06-01

    We investigate Klein tunneling for the α -T3 model, which interpolates between graphene and the dice lattice via parameter α . We study transmission across two types of electrostatic interfaces: sharp potential steps and sharp potential barriers. We find both interfaces to be perfectly transparent for normal incidence for the full range of the parameter α for both interfaces. For other angles of incidence, we find that transmission is enhanced with increasing α . For the dice lattice, we find perfect, all-angle transmission across a potential step for incoming electrons with energy equal to half of the height of the potential step. This is analogous to the "super", all-angle transmission reported for the dice lattice for Klein tunneling across a potential barrier.

  8. Pathological response of locally advanced rectal cancer to preoperative chemotherapy without pelvic irradiation.

    Science.gov (United States)

    Bensignor, T; Brouquet, A; Dariane, C; Thirot-Bidault, A; Lazure, T; Julié, C; Nordlinger, B; Penna, C; Benoist, S

    2015-06-01

    Pathological response to chemotherapy without pelvic irradiation is not well defined in rectal cancer. This study aimed to evaluate the objective pathological response to preoperative chemotherapy without pelvic irradiation in middle or low locally advanced rectal cancer (LARC). Between 2008 and 2013, 22 patients with middle or low LARC (T3/4 and/or N+ and circumferential resection margin rectal resection after preoperative chemotherapy. The pathological response of rectal tumour was analysed according to the Rödel tumour regression grading (TRG) system. Predictive factors of objective pathological response (TRG 2-4) were analysed. All patients underwent rectal surgery after a median of six cycles of preoperative chemotherapy. Of these, 20 (91%) had sphincter saving surgery and an R0 resection. Twelve (55%) patients had an objective pathological response (TRG 2-4), including one complete response. Poor response (TRG 0-1) to chemotherapy was noted in 10 (45%) patients. In univariate analyses, none of the factors examined was found to be predictive of an objective pathological response to chemotherapy. At a median follow-up of 37.2 months, none of the 22 patients experienced local recurrence. Of the 19 patients with Stage IV rectal cancer, 15 (79%) had liver surgery with curative intent. Preoperative chemotherapy without pelvic irradiation is associated with objective pathological response and adequate local control in selected patients with LARC. Further prospective controlled studies will address the question of whether it can be used as a valuable alternative to radiochemotherapy in LARC. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  9. Health-related Quality of Life after complex rectal surgery for primary advanced rectal cancer and locally recurrent rectal cancer

    DEFF Research Database (Denmark)

    Thaysen, Henriette Vind

    2013-01-01

    postoperative morbidity, Health-related Quality of Life (HRQoL) is an important issue. The overall aim of this thesis was therefore to evaluate HRQoL in patients with PARC and LRRC treated with COMP-RCS and curative intent. In study I a review of the literature was undertaken to provide an overview of HRQo......Advances in the treatment of rectal cancer, have made it possible to perform complex rectal cancer surgery (COMP-RCS) with curative intent in patients with primary advanced rectal caner (PARC) and local recurrent rectal cancer (LRRC). Due to the complexity of the treatment and its high...... in the study was 164 (86%) patients treated with standard rectal cancer surgery (STAN-RCS). The Danish version showed satisfactory psychometric properties for the scales concerning body image, sexual functioning, male sexual problems and defecations problems. Reduced psychometric properties were found...

  10. [A Case of Pathological Complete Response after Neoadjuvant Chemotherapy(S-1 plus Oxaliplatin)and Laparoscopic Low Anterior Resection for Rectal Cancer].

    Science.gov (United States)

    Ichinohe, Daichi; Morohashi, Hajime; Umetsu, Satoko; Yoshida, Tatsuya; Wakasa, Yusuke; Odagiri, Tadashi; Kimura, Toshirou; Suto, Akiko; Saito, Takeshi; Yoshida, Eri; Akasaka, Harue; Jin, Hiroyuki; Miura, Takuya; Sakamoto, Yoshiyuki; Hakamada, Kenichi

    2016-11-01

    We report a case of pathological complete response after neoadjuvant chemotherapy(NAC)(S-1 plus oxaliplatin)for rectal cancer. The patient was a 50-year-old man who had type 3 circumferential rectal cancer. An abdominal CT scan revealed locally advanced rectal cancer(cT3N2H0P0M0, cStage III b)with severe stenosis and oral-side intestinal dilatation. The patient was treated with NAC after loop-ileostomy. After 3 courses of chemotherapy, a CT scan revealed significant tumor reduction. Laparoscopic low anterior resection and bilateral lymph node dissection were performed 5 weeks after the last course of chemotherapy. The pathological diagnosis was a pathological complete response(no residual cancer cells). This case suggests that laparoscopic low anterior resection after NAC with S-1 plus oxaliplatin for locally advanced rectal cancer is a potentially effective procedure.

  11. Neoadjuvant therapy in rectal cancer

    International Nuclear Information System (INIS)

    Della Valle, A.; Roldán, G.; Suárez, L.; Rodríguez, R.; Quarneti, A.

    2004-01-01

    Introduction: Rectal cancer causes about 500 deaths a year in our country. Radio chemotherapy (RTCT) is part of the treatment of rectal tumors especially in stages II and III. The indication for neoadjuvant aims to preserve the sphincter at low tumors and potentially make initially unresectable tumors resectable. Objective: To analyze the indications, treatment, toxicity and development of adenocarcinoma patients receiving treatment rectum preoperative R T ± Q T. Patients and Methods: Retrospective analysis of 31 records of patients rectal adenocarcinoma treated with neoadjuvant in Oncology Services Hospital and Central Clinical Hospital of the Armed Forces between 1994 and , 2003. Results: Men / Women: 1.3. Median age 64 years. Eight patients (30%) endorectal ultrasound as preoperative staging were performed. patients matched 20 (65%) stage II, 6 (19%) stage III, 5 (16%) stage IV with potentially resectable liver metastases. The median dose of R T was 50 Gy (35.8-63 Gy) with a median duration was 5 weeks (4-12). One patient (3%) received exclusive R T. Plans Q T used: 5-F U in I / C 52%, 5-F U bolus and 42% leucovorin and 5-F U bolus 3%. Surgery was achieved with sphincter preservation in 7/31 cases (23%). The most common toxicity was diarrhea and radiodermatitis were the cause of discontinuation in 4 patients. Control hematologic weekly was 38% during the RTCT. Responses were achieved Full 5% partial 39%, 17% and stabilization lesion progression 39%. Discussion: The lack of information recorded in the medical records hindered the Analysis of this work. 70% of stage II and III patients were incompletely staged (30% endorectal ultrasound) and controls during treatment were suboptimal. Only 23% of patients achieved sphincter preservation, lower than the figures reported in the literature (65-

  12. Endocavitary radiotherapy of rectal cancer

    International Nuclear Information System (INIS)

    Schild, Steven E.; Martenson, James A.; Gunderson, Leonard L.

    1996-01-01

    Purpose: This analysis was performed to evaluate the results of endocavitary radiotherapy (RT) administered for early rectal cancer at our institution. Methods and Materials: Patient charts were retrospectively reviewed to determine the results of endocavitary RT regarding survival, local control, and complications. Between 1987 and 1994, 25 patients were treated with endocavitary RT for early rectal cancer. Twenty had early, low grade tumors and met the criteria for treatment with curative intent. Five had more advanced, high grade, or multiple recurrent tumors and were treated with palliative intent. The tumors were treated to between 20 and 155 Gy in one to four fractions with 50 KV x-rays given through a specialized proctoscope. Patients were followed for 5 to 84 months (median = 55 months) after therapy. Local control and survival were determined using the Kaplan-Meier method. Results: Local control was achieved in 18 of the 20 patients treated with curative intent and 4 of 5 treated with palliative intent. For those patients treated with curative intent, the 5-year local control rate was 89% and the 5-year survival rate was 76%. The most significant toxicity was ulceration that occurred in 5 of the 25 patients. The ulcers were asymptomatic in three cases and associated with bleeding in one case. The fifth patient had pain. One ulcer was biopsied, resulting in perforation that was treated with an abdominal perineal resection (APR). There was no tumor found upon pathologic evaluation. Conclusions: Endocavitary RT can be used to treat patients with early, low-grade rectal cancers and will yield a high level of disease control and a low risk of serious complications. Major advantages of this treatment technique are that it requires neither general anesthesia nor hospitalization

  13. Rectal cancer surgery: volume-outcome analysis.

    LENUS (Irish Health Repository)

    Nugent, Emmeline

    2010-12-01

    There is strong evidence supporting the importance of the volume-outcome relationship with respect to lung and pancreatic cancers. This relationship for rectal cancer surgery however remains unclear. We review the currently available literature to assess the evidence base for volume outcome in relation to rectal cancer surgery.

  14. Severe rectal complications after prostate brachytherapy

    International Nuclear Information System (INIS)

    Wallner, Kent; Sutlief, Stephen; Bergsagel, Carl; Merrick, Gregory S.

    2015-01-01

    Purpose: Some investigators have reported severe rectal complications after brachytherapy. Due to the low number of such events, their relationship to dosimetric parameters has not been well characterized. Methods and materials: A total of 3126 patients were treated with low dose rate brachytherapy from 1998 through 2010. 2464 had implant alone, and 313 had implant preceded by 44–46 Gy supplemental external beam radiation (EBRT). Post-implant dosimetry was based on a CT scan obtained on the day of implant, generally within 30 min of the procedure. Every patient’s record was reviewed for occurrence of rectal complications. Results: Eight of 2464 patients (0.32%) treated with brachytherapy alone developed a radiation-related rectal fistula. Average prostatic and rectal dose parameters were moderately higher for fistula patients than for patients without a severe rectal complication. For instance, the average R100 was 1.2 ± 0.75 cc for fistula patients, versus 0.37 ± 0.88 cc for non-fistula patients. However, the fistula patients’ values were well within the range of values for patients without a rectal complication. Four patients had some attempt at repair or reconstruction, but long-term functional outcomes were not favorable. Conclusions: Rectal fistulas are a very uncommon potential complication of prostate brachytherapy, which can occur even in the setting of acceptable day 0 rectal doses. Their occurrence is not easily explained by standard dosimetric or clinical factors

  15. Rectal bleeding in children: endoscopic evaluation revisited

    NARCIS (Netherlands)

    de Ridder, Lissy; van Lingen, Anna V.; Taminiau, Jan A. J. M.; Benninga, Marc A.

    2007-01-01

    Objectives Rectal bleeding is an alarming event both for the child and parents. It is hypothesized that colonoscopy instead of sigmoidoscopy and adding esophago-gastro-duodenoscopy in case of accompanying complaints, improves the diagnostic accuracy in children with prolonged rectal bleeding. Study

  16. Fournier gangrene: rare complication of rectal cancer.

    Science.gov (United States)

    Ossibi, Pierlesky Elion; Souiki, Tarik; Ibn Majdoub, Karim; Toughrai, Imane; Laalim, Said Ait; Mazaz, Khalid; Tenkorang, Somuah; Farih, My Hassan

    2015-01-01

    Fournier's Gangrene is a rare complication of rectal cancer. Its discovery is often delayed. It's incidence is about 0.3/100,000 populations in Western countries. We report a patient with peritoneal perforation of rectal cancer revealed by scrotal and perineal necrotizing fasciitis.

  17. Masquerading Mycobacterium: Rectal Growth or Tuberculosis ...

    African Journals Online (AJOL)

    ABSTRACT: A 37-year old male presented to us with history of lower abdominal pain for 6 months. His physical examination revealed a rectal mass of approximately 1centimeter. He was investigated for possible rectal growth with sigmoidoscopy and biopsy. The histopathological examination (HPE) showed a non-specific ...

  18. Potential of DNA methylation in rectal cancer as diagnostic and prognostic biomarkers

    Science.gov (United States)

    Exner, Ruth; Pulverer, Walter; Diem, Martina; Spaller, Lisa; Woltering, Laura; Schreiber, Martin; Wolf, Brigitte; Sonntagbauer, Markus; Schröder, Fabian; Stift, Judith; Wrba, Fritz; Bergmann, Michael; Weinhäusel, Andreas; Egger, Gerda

    2015-01-01

    Background: Aberrant DNA methylation is more prominent in proximal compared with distal colorectal cancers. Although a number of methylation markers were identified for colon cancer, yet few are available for rectal cancer. Methods: DNA methylation differences were assessed by a targeted DNA microarray for 360 marker candidates between 22 fresh frozen rectal tumour samples and 8 controls and validated by microfluidic high-throughput and methylation-sensitive qPCR in fresh frozen and formalin-fixed paraffin-embedded (FFPE) samples, respectively. The CpG island methylator phenotype (CIMP) was assessed by MethyLight in FFPE material from 78 patients with pT2 and pT3 rectal adenocarcinoma. Results: We identified and confirmed two novel three-gene signatures in fresh frozen samples that can distinguish tumours from adjacent tissue as well as from blood with a high sensitivity and specificity of up to 1 and an AUC of 1. In addition, methylation of individual CIMP markers was associated with specific clinical parameters such as tumour stage, therapy or patients' age. Methylation of CDKN2A was a negative prognostic factor for overall survival of patients. Conclusions: The newly defined methylation markers will be suitable for early disease detection and monitoring of rectal cancer. PMID:26335606

  19. Remission of Unresectable Lung Metastases from Rectal Cancer After Herbal Medicine Treatment: A Case Report.

    Science.gov (United States)

    Kim, Kyungsuk; Lee, Sanghun

    2016-01-01

    Lung metastasis is frequent in rectal cancer patients and has a poor prognosis, with an expected three-year survival rate of about 10%. Though western medicine has made great strides in the curative resection of liver metastases, resection of lung metastases has lagged far behind. Many preclinical studies have suggested that herbal treatments block metastasis, but few clinical studies have addressed this topic. We present the case of a 57-year-old Asian male with lung metastases from rectal cancer. He first underwent resection of the primary lesion (stage IIA, T3N0M0) and six cycles of adjuvant chemotherapy. Unfortunately, lung metastases were confirmed about one year later. Palliative chemotherapy was begun, but his disease continued to progress after three cycles and chemotherapy was halted. The patient was exclusively treated with herbal medicine-standardized allergen-removed Rhus verniciflua stokes extract combined with Dokhwaljihwang-tang (Sasang constitutional medicine in Korea). After seven weeks of herbal medicine treatment, the lung metastases were markedly improved. Regression of lung metastases has continued; also, the patient's rectal cancer has not returned. He has been receiving herbal medicine for over two years and very few side effects have been observed. We suggest that the herbal regimen used in our patient is a promising candidate for the treatment of lung metastases secondary to rectal cancer, and we hope that this case stimulates further investigation into the efficacy of herbal treatments for metastatic colorectal cancer patients. Copyright © 2016. Published by Elsevier Inc.

  20. Rectal duplication cyst in a cat.

    Science.gov (United States)

    Kook, Peter H; Hagen, Regine; Willi, Barbara; Ruetten, Maja; Venzin, Claudio

    2010-12-01

    Enteric duplication is a rare developmental malformation in people, dogs and cats. The purpose of the present report is to describe the first case of a rectal duplication cyst in a 7-year-old domestic shorthair cat presenting for acute constipation and tenesmus. On rectal palpation a spherical mass compressing the lumen of the rectum could be felt in the dorsal wall of the rectum. A computed tomography (CT) scan confirmed the presence of a well demarcated cystic lesion in the pelvic canal, dorsal to the rectum. The cyst was surgically removed via a perineal approach. No communication with the rectal lumen could be demonstrated. Histopathological examination was consistent with a rectal duplication cyst. Clinical signs resolved completely after excision of this conjoined non-communicating cystic rectal duplicate. Copyright © 2010 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

  1. Total mesorectal excision for the treatment of rectal cancer.

    Science.gov (United States)

    Zedan, Ali; Salah, Tareq

    2015-12-01

    In the surgical treatment of rectal cancer, a clear circumferential resection margin and distal resection margin should be obtained. The aim of this study was to determine the morbidity, mortality, survival outcome, and local failure after total mesorectal excision (TME) in the surgical treatment of rectal cancer. This retrospective study was conducted on 101 patients treated for rectal cancer using low anterior resection (LAR), abdominoperinial resection (APR), or Hartmaan's technique. In all operative procedures, total mesorectal excisions (TMEs) were done. The patients were treated from November 2000 to April 2011 in the South Egypt Cancer Institute (SECI) of Assuit University (Egypt). Neo-adjuvant therapy was given to those patients with serosalin filtration, lymph node involvement, and sexual and urinary function impairment. Data were analyzed using IBM-SPSS version 21, and survival rates were estimated using the Kaplan-Meier method. One hundred one patients were evaluable (61 males, 40 females). Regarding the operative procedure used, it was: (APR), LAR, Hartmaan's technique in 15.8%, 71.3%, and 12.9% of patients, respectively. Operation-related mortality during the 30 days after surgery was 3%. The operations resulted in morbidity in 25% of the patients, anastomotic site leak in 5.9% of the patients, urinary dysfynction in 9.9% of the patients, and erectile dysfunction in 15.8% of the male patients. Regarding safety margin, the median distances were distal/radial margin, 23/12 mm, distal limit 7 cm. Median lymph nodes harvest 19 nodes. Primary tumor locations were anteriorly 23.8%, laterally 13.9%, posteriorly 38.6%, and circumferential 23.8%. Protective stoma 16.8%. Primary Tumor TNM classification (T1, T2, T3, and T4; 3, 28.7, 55.4, and 12.9%, respectively). Nodes Metastases (N0, N1, and N2; 57.4, 31.7, and 10.9%, respectively). TNM staging (I, II, III, and IV; 15.8, 29.7, 46.5, and 7.9%, respectively). Chemotherapy was administered to 67.3% of the

  2. Clonal nature of spontaneously immortalized 3T3 cells.

    Science.gov (United States)

    Rittling, S R

    1996-11-25

    Mouse embryo fibroblasts (MEFs), when plated at appropriate densities, proliferate vigorously for several passages, and then the growth rate of the culture slows considerably. If the cells are plated at a high enough density and continuously passed, the cultures will eventually overcome this "crisis" period and resume rapid growth. Here, we have addressed the question of what the changes are that cells undergo in overcoming the growth restraints of crisis. Primary MEF cells were infected with a retrovirus which confers G418 resistance and selected in G418. The resultant pre-crisis population comprised cells which each contained a retrovirus integrated at a unique genomic location. These cells were then passed according to the 3T3 protocol until immortal, rapidly growing cells emerged. The integration pattern of the retrovirus in the immortal population was examined. In two independent experiments, the immortal population of cells grown in the presence of G418 comprised two independent clones of cells, with additional clones undetectable at the level of detection of the assays used. The integration pattern was also examined in parallel infected cultures grown in the absence of selection. In one experiment the unselected immortal population contained the same labeled clone that appeared in the sister infected culture, indicating that an immortal precursor was present in the precrisis population. These results are consistent with the idea that a mutation is responsible for the immortal phenotype.

  3. Progress in Rectal Cancer Treatment

    Science.gov (United States)

    Ceelen, Wim P.

    2012-01-01

    The dramatic improvement in local control of rectal cancer observed during the last decades is to be attributed to attention to surgical technique and to the introduction of neoadjuvant therapy regimens. Nevertheless, systemic relapse remains frequent and is currently insufficiently addressed. Intensification of neoadjuvant therapy by incorporating chemotherapy with or without targeted agents before the start of (chemo)radiation or during the waiting period to surgery may present an opportunity to improve overall survival. An increasing number of patients can nowadays undergo sphincter preserving surgery. In selected patients, local excision or even a “wait and see” approach may be feasible following active neoadjuvant therapy. Molecular and genetic biomarkers as well as innovative imaging techniques may in the future allow better selection of patients for this treatment option. Controversy persists concerning the selection of patients for adjuvant chemotherapy and/or targeted therapy after neoadjuvant regimens. The currently available evidence suggests that in complete pathological responders long-term outcome is excellent and adjuvant therapy may be omitted. The results of ongoing trials will help to establish the ideal tailored approach in resectable rectal cancer. PMID:22970381

  4. Effects of previous protein intake on rectal temperature, blood glucose, plasma thyroid hormone and minerals by laying hens during a forced molt

    International Nuclear Information System (INIS)

    Rodrigues, G.A.; Moraes, V.M.B.; Cherici, I; Furlan, R.L.; Macari, M.

    1991-01-01

    The effects of forced molting on blood glucose, rectal temperature, plasma T4, T3 and minerals were studied in hens previously fed rations with different protein contents (14, 17 and 20% crude protein). Blood samples were obtained from brachial veins for blood glucose, T4 and T3 were measured by radioimmunoassay, and plasma minerals were determined by atomic absorption spectroscopy. Blood glucose and rectal temperature were reduced during fasting regardless of previous protein intake. Pre molting T4 plasma level was higher in laying hens fed higher protein ration, but feed deprivation reduced T 4 and T 3 concentrations irrespective of protein intake, except T 4 level for 14% crude protein fed birds that increased during fasting. The data obtained in this experiment suggest that previous protein intake does not interfere with the metabolic changes during forced molt. (author). 19 refs, 1 fig, 4 tabs

  5. Interstitial irradiation of rectal carcinoma with rectal template

    International Nuclear Information System (INIS)

    Ikeda, Hiroshi; Nishiyama, Kinji; Tanaka, Ken; Nakanishi, Makoto; Inoue, Takehiro

    1984-01-01

    Using Iridium-192 wires through a rectal template after Syed, interstitial brachytherapy was conducted in a patient with inoperable adenocarcinoma of the rectum. 67-year-old man with constipation and change in the stool caliber underwent external radiotherapy (4,000cGy/4W) to the whole pelvis including the perineum, followed by interstitial implant using a template, at the Department of Radiology, Osaka University Hospital. Marked tumor regression, marked circumferential fibrosis and a remarkable decline of CEA titers (pre-RT: 35.8ng/ml, post-RT: 6.2ng/ml) were observed until 7 months post-RT. The domestic production of Iridium-192 wires has made possible the intergrated use of brachytherapy in the perineal region in Japan. (author)

  6. Cold exposure rapidly induces virtual saturation of brown adipose tissue nuclear T3 receptors

    International Nuclear Information System (INIS)

    Bianco, A.C.; Silva, J.E.

    1988-01-01

    Cold exposure induces a rapid increase in uncoupling protein (UCP) concentration in the brown adipose tissue (BAT) of euthyroid, but not hypothyroid, rats. To normalize this response with exogenous 3,5,3'-triiodothyronine (T 3 ), it is necessary to cause systemic hyperthyroidism. In contrast, the same result can be obtained with just replacement doses of thyroxine (T 4 ) and, in euthyroid rats, the normal response of UCP to cold occurs without hyperthyroid plasma T 3 levels. Consequently, the authors explored the possibility that the cold-induced activation of the type II 5'-deiodinase resulted in high levels of nuclear T 3 receptor occupancy in euthyroid rats. Studies were performed with pulse injections of tracer T 3 or T 4 in rats exposed to 4 degree C for different lengths of time (1 h-3 wk). Within 4 h of cold exposure, they observed a significant increase in the nuclear [ 125 I]T 3 derived from the tracer [ 125 I]T 4 injections (T 3 [T 4 ]) and a significant reduction in the nuclear [ 125 I]T 3 derived from [ 125 I]T 3 injections (T 3 [T 3 ]). The number of BAT nuclear T 3 receptors did not increase for up to 3 wk of observation at 4 degree C. The mass of nuclear-bound T 3 was calculated from the nuclear tracer [ 125 I]T 3 [T 3 ] and [ 125 I]T 3 [T 4 ] at equilibrium and the specific activity of serum T 3 and T 4 , respectively. By 4 h after the initiation of the cold exposure, the receptors were >95% occupied and remained so for the 3 weeks of observation. They conclude that the simultaneous activation of the deiodinase with adrenergic BAT stimulation serves the purpose of nearly saturating the nuclear T 3 receptors. This makes possible the realization of the full thermogenic potential of the tissue without causing systemic hyperthyroidism

  7. High-Resolution MRI in Rectal Cancer

    International Nuclear Information System (INIS)

    Dieguez, Adriana

    2010-01-01

    High-resolution MRI is the best method of assessing the relation of the rectal tumor with the potential circumferential resection margin (CRM). Therefore it is currently considered the method of choice for local staging of rectal cancer. The primary surgery of rectal cancer is total mesorectal excision (TME), which plane of dissection is formed by the mesorectal fascia surrounding mesorectal fat and rectum. This fascia will determine the circumferential margin of resection. At the same time, high resolution MRI allows adequate pre-operative identification of important prognostic risk factors, improving the selection and indication of therapy for each patient. This information includes, besides the circumferential margin of resection, tumor and lymph node staging, extramural vascular invasion and the description of lower rectal tumors. All these should be described in detail in the report, being part of the discussion in the multidisciplinary team, the place where the decisions involving the patient with rectal cancer will take place. The aim of this study is to provide the information necessary to understand the use of high resolution MRI in the identification of prognostic risk factors in rectal cancer. The technical requirements and standardized report for this study will be describe, as well as the anatomical landmarks of importance for the total mesorectal excision (TME), as we have said is the surgery of choice for rectal cancer. (authors) [es

  8. Phase II trial evaluating the feasibility of interdigitating folfox with chemoradiotherapy in locally advanced and metastatic rectal cancer.

    Science.gov (United States)

    Michael, M; Chander, S; McKendrick, J; MacKay, J R; Steel, M; Hicks, R; Heriot, A; Leong, T; Cooray, P; Jefford, M; Zalcberg, J; Bressel, M; McClure, B; Ngan, S Y

    2014-11-11

    Patients (pts) with metastatic rectal cancer and symptomatic primary, require local and systemic control. Chemotherapy used during chemoradiotherapy (CRT) is adequate for radiosensitisation, but suboptimal for systemic control. The aim of this phase II study was to assess tolerability, local/systemic benefits, of a novel regimen delivering interdigitating intensive chemotherapy with radical CRT. Eligible pts had untreated synchronous symptomatic primary/metastatic rectal cancer. A total of 12 weeks of treatment with split-course pelvic CRT (total 50.4 Gy with concurrent oxaliplatin and 5-FU infusion) alternating with FOLFOX chemotherapy. All pts staged with CT, MRI and FDG-PET pre and post treatment. Twenty-six pts were treated. Rectal primary MRI stage: T3 81% and T4 15%. Liver metastases in 81%. Twenty-four pts (92%) completed the 12-week regimen. All patients received planned RT dose, and for both agents over 88% of patients achieved a relative dose intensity of >75%. Grade 3 toxicities: neutropenia 23%, diarrhoea 15%, and radiation skin reaction 12%. Grade 4 toxicity: neutropenia 15%. FDG-PET metabolic response rate for rectal primary 96%, and for metastatic disease 60%. Delivery of interdigitating chemotherapy with radical CRT was feasible to treat both primary and metastatic rectal cancer. High completion and response rates were encouraging.

  9. Rectal Duplication Cyst: A Rare Cause of Rectal Prolapse in a Toddler.

    Science.gov (United States)

    Khushbakht, Samreen; ul Haq, Anwar

    2015-12-01

    Rectal duplication cysts are rare congenital anomalies. They constitute only 4% of the total gastrointestinal anomalies. They usually present in childhood. The common presenting symptoms are mass or pressure effects like constipation, tenesmus, urinary retention, local infection or bleeding due to presence of ectopic gastric mucosa. We are reporting a rare presenting symptom of rectal duplication cyst in a 4-year-old boy/toddler who presented with rectal prolapse. He also had bleeding per rectum. Rectal examination revealed a soft mass palpable in the posterior rectal wall. CT scan showed a cystic mass in the posterior wall of the rectum. It was excised trans-anally and the postoperative recovery was uneventful. Biopsy report showed rectal duplication cyst.

  10. PET-MRI in Diagnosing Patients With Colon or Rectal Cancer

    Science.gov (United States)

    2015-11-25

    Recurrent Colon Cancer; Recurrent Rectal Cancer; Stage IIA Colon Cancer; Stage IIA Rectal Cancer; Stage IIB Colon Cancer; Stage IIB Rectal Cancer; Stage IIC Colon Cancer; Stage IIC Rectal Cancer; Stage IIIA Colon Cancer; Stage IIIA Rectal Cancer; Stage IIIB Colon Cancer; Stage IIIB Rectal Cancer; Stage IIIC Colon Cancer; Stage IIIC Rectal Cancer; Stage IVA Colon Cancer; Stage IVA Rectal Cancer; Stage IVB Colon Cancer; Stage IVB Rectal Cancer

  11. ENDOSCOPIC TECHNOLOGIES IN EARLY RECTAL CANCER TREATMENT

    Directory of Open Access Journals (Sweden)

    D. V. Samsonov

    2015-01-01

    Full Text Available Total mesorectal excision is the “golden standard” of surgical treatment for rectal cancer. Development of endoscopic technologies allowed to implement the benefits of minimally invasive surgery in early rectal cancer treatment, decrease morbidity and mortality, improve functional outcome and quality of life. Oncological safety of this method is still a subject for discussion due to lack of lymph node harvest. Endoscopic operations for early rectal cancer are being actively implemented in daily practice, but lack of experience does not allow to include this method in national clinical prac-tice guidelines.

  12. National and international guidelines for rectal cancer

    DEFF Research Database (Denmark)

    Nielsen, Liv Bjerre Juul; Wille-Jørgensen, P

    2014-01-01

    , this might not be the case between guidelines. No formal evaluation of the contrasting guidance has been reported. METHOD: A systematic search for national and international guidelines on rectal cancer was performed. Eleven guidelines were identified for further analysis. RESULTS: There was no consensus...... concerning the definition of rectal cancer. Ten of the 11 guidelines use the TNM staging system and there was general agreement regarding the recommendation of MRI and CT in rectal cancer. There was consensus concerning a multidisciplinary approach, preoperative chemoradiotherapy (CRT) and total mesorectal...

  13. Evidences in multidisciplinary management of rectal cancer

    International Nuclear Information System (INIS)

    De Bari, B.; Bosset, J.F.; Gerard, J.P.; Maingon, P.; Valentini, V.

    2012-01-01

    In the last 10 years, a number of important European randomized published studies investigated the optimal management of rectal cancer. In order to define an evidence-based approach of the clinical practice based, an international consensus conference was organized in Italy under the endorsement of European Society of Medical Oncology (ESMO), European Society of Surgical Oncology (ESSO) and European Society of Therapeutic Radiation Oncology (ESTRO). The aim of this article is to present highlights of multidisciplinary rectal cancer management and to compare the conclusions of the international conference on 'Multidisciplinary Rectal Cancer Treatment: looking for an European Consensus' (EURECA-CC2) with the new National Comprehensive Cancer Network (NCCN) guidelines. (authors)

  14. Local radiological staging of rectal cancer

    International Nuclear Information System (INIS)

    Goh, V.; Halligan, S.; Bartram, C.I.

    2004-01-01

    Rectal cancer is a common malignancy with a highly variable outcome. Local recurrence is dependent upon tumour stage and surgical technique. The role of pre-operative imaging is to determine which patients may be safely managed by surgery alone and which need additional therapy in order to facilitate surgery and improve outcome. This decision depends on the distinction between those with early and advanced disease. While trans-rectal ultrasound has traditionally been used to answer this question, a role for magnetic resonance imaging (MRI) is increasingly argued. This review will focus on the treatment options for rectal cancer and the clinical questions that subsequently arise for the radiologist to answer

  15. Perineal mass protrusion with rectal mucosa: a rectal duplication that underwent exstrophy.

    Science.gov (United States)

    Sun, Junjie; Vongphet, Soulithone; Zhang, Zhichong; Mo, Jiacong

    2011-08-01

    We present a rare case of a male neonate with a perineal mass with rectal mucosa, diagnosed as an exstrophic duplication of the rectum. It was accompanied by a cord that was deeply invested in the pelvic diaphragm and was composed of smooth muscle, fibrous tissue, and some rectal glands. The association of exstrophic rectal duplication with a bifid scrotum, hypospadias, and normal anus has not been described previously in the literature. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Rectal perforation by compressed air.

    Science.gov (United States)

    Park, Young Jin

    2017-07-01

    As the use of compressed air in industrial work has increased, so has the risk of associated pneumatic injury from its improper use. However, damage of large intestine caused by compressed air is uncommon. Herein a case of pneumatic rupture of the rectum is described. The patient was admitted to the Emergency Room complaining of abdominal pain and distension. His colleague triggered a compressed air nozzle over his buttock. On arrival, vital signs were stable but physical examination revealed peritoneal irritation and marked distension of the abdomen. Computed tomography showed a large volume of air in the peritoneal cavity and subcutaneous emphysema at the perineum. A rectal perforation was found at laparotomy and the Hartmann procedure was performed.

  17. Radiotherapy for early rectal cancer

    International Nuclear Information System (INIS)

    Rich, T.A.

    1988-01-01

    A literature review of 10 series using electrocoagulation, fulguration, or local excision demonstrates that about 70% of all patients had tumors smaller than 3 cm and the remainder had tumors measuring between 4 cm and 7 cm. Although primary tumor size in rectal cancer has little prognostic value per se, it is obviously important when determining the appropriateness of local therapy. Selecting patients for local therapy based on tumor size alone seems reasonable, since the recurrence and survival rates for the patients are similar to those achieved with radical surgery. Since patients treated with local excision alone have predominantly T1 or T2 tumors, a comparison with the data of others illustrates the prognostic utility of the degree of bowel penetration and shows five-year survival rates of 71% to 76% for patients with limited disease. In this chapter, the author describes an additional group of patients who also did well following postoperative radiotherapy after conservative surgical treatment

  18. Transvaginal ultrasonography of rectal endometriosis

    DEFF Research Database (Denmark)

    Egekvist, Anne Gisselmann; Seyer-Hansen, Mikkel; Forman, Axel

    Objectives: The aim of this present study was to evaluate the interobserver variation of transvaginal ultrasonographic measurements of endometriosis infiltrating the rectosigmoid wall. Methods: Transvaginal ultrasonography was performed independently by two observers. Observer 1 had several years...... of experience in ultrasonography while observer 2 was a medical student with no prior experience in ultrasonography or endometriosis. In 24 patient length, width and depth of endometriosis infiltrating the rectosigmoid bowel was measured. The differences between the observers were analysed by Bland and Altman...... for a relatively short period gives comparable scanning results between the two observers. It seems that transvaginal ultrasound could be used as a diagnostic tool for rectal endometriosis in most departments. However, the irregular morphology of the lesions makes the measurements very complex, and a strict...

  19. Rectal cooling test in the differentiation between constipation due to rectal inertia and anismus.

    Science.gov (United States)

    Shafik, A; Shafik, I; El Sibai, O; Shafik, A A

    2007-03-01

    The differentiation between constipation due to rectal inertia and that due to outlet obstruction from non-relaxing puborectalis muscle (PRM) is problematic and not easily achieved with one diagnostic test. Therefore, we studied the hypothesis that the rectal cooling test (RCT) can effectively be used to differentiate between those two forms of constipation. The study enrolled 28 patients with constipation and abnormal transit study in whom radio-opaque markers accumulated in the rectum; 15 healthy volunteers acted as controls. Electromyographic activity of the external anal sphincter (EAS) and PRM was initially recorded. Subsequently rectal wall tone was assessed by a barostat system during rectal infusion with normal saline at 30 degrees C and at 4 degrees C with simultaneous electromyography (EMG). There was a significant increase in EMG activity of the EAS and PRM on strain- ing (panismus, in 10 of 28 patients and 0 of 15 controls. Rectal tone in controls did not respond to saline infusion at 30 degrees C, but it increased at 4 degrees C (panismus (panismus while it had no effect in the remaining patients. Lack of increase of rectal tone may be secondary to rectal inertia. According to these preliminary observations, the rectal cooling test may be useful in differentiating between rectal inertia and anismus.

  20. Digital rectal examination and transrectal ultrasonography in staging of rectal cancer

    DEFF Research Database (Denmark)

    Rafaelsen, Søren Rafael; Kronborg, Ole; Fenger, Claus

    1994-01-01

    Staging of rectal carcinoma before surgical treatment was performed in a prospective blind study, comparing digital rectal exploration and transrectal linear ultrasonography (TRUS) with the resulting pathological examination. TRUS underestimated depth of penetration in 3 of 33 patients...... and overestimation resulted in 9 of 74. The figures for digital examination were 5 of 18 and 20 of 76, respectively. Penetration of the rectal wall was correctly identified in 56 of 61 patients by digital examination and in 59 of 61 by TRUS. Specimens without penetration of the rectal wall were identified in 26...

  1. The Rectal Cancer Female Sexuality Score

    DEFF Research Database (Denmark)

    Thyø, Anne; Emmertsen, Katrine J; Laurberg, Søren

    2018-01-01

    BACKGROUND: Sexual dysfunction and impaired quality of life is a potential side effect to rectal cancer treatment. OBJECTIVE: The objective of this study was to develop and validate a simple scoring system intended to evaluate sexual function in women treated for rectal cancer. DESIGN......: This is a population-based cross-sectional study. SETTINGS: Female patients diagnosed with rectal cancer between 2001 and 2014 were identified by using the Danish Colorectal Cancer Group's database. Participants filled in the validated Sexual Function Vaginal Changes questionnaire. Women declared to be sexually active...... in the validation group. PATIENTS: Female patients with rectal cancer above the age of 18 who underwent abdominoperineal resection, Hartmann procedure, or total/partial mesorectal excision were selected. MAIN OUTCOME MEASURES: The primary outcome measured was the quality of life that was negatively affected because...

  2. Drugs Approved for Colon and Rectal Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for use in colon cancer and rectal cancer. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters.

  3. Meat and colo-rectal cancer.

    Science.gov (United States)

    Hill, M J

    1999-05-01

    In early epidemiological studies of diet and cancer the stress was on the search for causal factors. Population (ecological) studies tended to show a strong correlation between meat intake, particularly red meat, and the risk of colo-rectal cancer. They also tended to show meat to be strongly inversely correlated with cancers of the stomach and oesophagus and liver. Early case-control studies tended to support the postulated role for red meat in colo-rectal carcinogenesis, although more recent case-control studies, particularly those from Europe, have tended to show no relationship. The cohort studies in general failed to detect any relationship between meat intake and colo-rectal cancer risk. The available evidence points to the intake of protective factors such as vegetables and whole-grain cereals being the main determinants of colo-rectal cancer risk, with meat intake only coincidentally related.

  4. Management of Civilian Extraperitoneal Rectal Injuries

    Directory of Open Access Journals (Sweden)

    Nawaf J. Shatnawi

    2006-01-01

    Conclusion: Rectal injuries are serious additive mortality and morbidity factors in multi-injured patients. Regardless of treatment modality, wound infection is associated with shock at presentation and more than 6 hours' delay in treatment.

  5. Treatment of Rectal Hemorrhage by Coil Embolization

    International Nuclear Information System (INIS)

    Dobson, Craig Charles; Nicholson, Anthony A.

    1998-01-01

    Four patients, aged 54-84 years, presenting with life-threatening rectal bleeding from the superior hemorrhoidal artery, underwent percutaneous fibered platinum coil embolization via coaxial catheters. Pre-procedure sigmoidoscopy had failed to identify the source of hemorrhage, because the rectum was filled with fresh blood. Embolization was technically and clinically successful in all four patients. Subsequent sigmoidoscopy confirmed the diagnoses in three patients as a solitary rectal ulcer, iatrogenic traumatic ulceration following manual evacuation, and a rectal Dieulafoy's lesion. The other case was angiographically seen to be due to a rectal angiodysplasia. Embolization is an effective procedure in life-threatening superior hemorrhoidal arterial bleeding when endoscopic treatment fails, and should be preferred to rectosigmoid resection

  6. Rectal dihydroartemisinin versus intravenous quinine in the ...

    African Journals Online (AJOL)

    Rectal dihydroartemisinin versus intravenous quinine in the treatment of severe malaria: A randomised clinical trial. F Esamai, P Ayuo, W Owino-Ongor, J Rotich, A Ngindu, A Obala, F Ogaro, L Quoqiao, G Xingbo, L Guangqian ...

  7. Defecography of rectal wall prolapse conditions

    International Nuclear Information System (INIS)

    Salzano, A.; Muto, M.; De Rosa, A.; Ginolfi, F.; Carbone, M.; Amodio, F.; Rossi, E.; Tuccillo, M.

    1999-01-01

    Pelvic floor and rectal prolapse conditions have greatly benefited by new imaging and instrumental diagnostic approaches, and especially defecography, for both pathophysiological interpretation and differential diagnosis. The authors investigated the efficacy of defecography in the assessment of rectal prolapse, and in particular the role of videproctography in diagnosis such dynamic disorders. The dynamic changes of ampulla are well depicted by videoproctography, which showed anorectum normalization and spontaneous reduction of invagination after intussusception. Defecography exhibited good capabilities in showing rectal wall function abnormalities. Finally, some features of videoproctography such as low radiation dose, non-invasiveness and ease of execution, make the examination acceptable to patients with anorectal disorders and for the follow-up of rectal prolapse [it

  8. Wind sock deformity in rectal atresia

    International Nuclear Information System (INIS)

    Hosseini, Seyed M V; Ghahramani, Farhad; Shamsaeefar, Alireza; Razmi, Tannaz; Zarenezhad, Mohammad

    2009-01-01

    Rectal atresia is a rare anorectal deformity. It usually presents with neonatal obstruction and it is often a complete membrane or severe stenosis. Windsock deformity has not been reported in rectal atresia especially, having been missed for 2 years. A 2-year-old girl reported only a severe constipation despite having a 1.5-cm anal canal in rectal examination with scanty discharge. She underwent loop colostomy and loopogram, which showed a wind sock deformity of rectum with mega colon. The patient underwent abdominoperineal pull-through with good result and follow-up. This is the first case of the wind sock deformity in rectal atresia being reported after 2 years of age. (author)

  9. Low Rectal Cancer Study (MERCURY II)

    Science.gov (United States)

    2016-03-11

    Adenocarcinoma; Adenocarcinoma, Mucinous; Carcinoma; Neoplasms, Glandular and Epithelial; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Cystic, Mucinous, and Serous; Colorectal Neoplasms; Intestinal Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Digestive System Diseases; Gastrointestinal Diseases; Intestinal Diseases; Rectal Diseases

  10. Technological advances in radiotherapy of rectal cancer

    DEFF Research Database (Denmark)

    Appelt, Ane L; Sebag-Montefiore, David

    2016-01-01

    PURPOSE OF REVIEW: This review summarizes the available evidence for the use of modern radiotherapy techniques for chemoradiotherapy for rectal cancer, with specific focus on intensity-modulated radiotherapy (IMRT) and volumetric arc therapy (VMAT) techniques. RECENT FINDINGS: The dosimetric...

  11. Appendiceal Adenocarcinoma Presenting as a Rectal Polyp

    Directory of Open Access Journals (Sweden)

    Erin Fitzgerald

    2016-02-01

    Full Text Available Appendiceal adenocarcinoma typically presents as an incidentally noted appendiceal mass, or with symptoms of right lower quadrant pain that can mimic appendicitis, but local involvement of adjacent organs is uncommon, particularly as the presenting sign. We report on a case of a primary appendiceal cancer initially diagnosed as a rectal polyp based on its appearance in the rectal lumen. The management of the patient was in keeping with standard practice for a rectal polyp, and the diagnosis of appendiceal adenocarcinoma was made intraoperatively. The operative strategy had to be adjusted due to this unexpected finding. Although there are published cases of appendiceal adenocarcinoma inducing intussusception and thus mimicking a cecal polyp, there are no reports in the literature describing invasion of the appendix through the rectal wall and thus mimicking a rectal polyp. The patient is a 75-year-old female who presented with spontaneous hematochezia and, on colonoscopy, was noted to have a rectal polyp that appeared to be located within a diverticulum. When endoscopic mucosal resection was not successful, she was referred to colorectal surgery for a low anterior resection. Preoperative imaging was notable for an enlarged appendix adjacent to the rectum. Intraoperatively, the appendix was found to be densely adherent to the right lateral rectal wall. An en bloc resection of the distal sigmoid colon, proximal rectum and appendix was performed, with pathology demonstrating appendiceal adenocarcinoma that invaded through the rectal wall. The prognosis in this type of malignancy weighs heavily on whether or not perforation and spread throughout the peritoneal cavity have occurred. In this unusual presentation, an en bloc resection is required for a complete resection and to minimize the risk of peritoneal spread. Unusual appearing polyps do not always originate from the bowel wall. Abnormal radiographic findings adjacent to an area of

  12. Anterior rectal duplication: a diagnostic challenge.

    Science.gov (United States)

    Amjadi, K; Poenaru, D; Soboleski, D; Hurlbut, D; Kamal, I

    2000-04-01

    The authors present an anterior rectal cyst in a 14-month-old girl. This rare variant of rectal duplications presented with recurrent urinary infections. The diagnosis was challenging in view of the multiple differential diagnoses to be considered. Magnetic resonance imaging appeared to be the most accurate preoperative investigation. The cyst was removed uneventfully by partial excision and mucosal ablation. An awareness of this variant can lead to early diagnosis and curative resection.

  13. Rectal Cancer Survivors' Participation in Productive Activities.

    Science.gov (United States)

    Hornbrook, Mark C; Grant, Marcia; Wendel, Christopher; Bulkley, Joanna E; Mcmullen, Carmit K; Altschuler, Andrea; Temple, Larissa Kf; Herrinton, Lisa J; Krouse, Robert S

    2017-01-01

    Rectal cancer and its treatment impair survivors' productivity. To assess determinants of market and nonmarket employment, job search, volunteering, and homemaking among survivors five years or longer after diagnosis. We mailed questionnaires to 1063 survivors who were members of Kaiser Permanente (Northern California, Northwest) during 2010 and 2011. Productive activities, functional health status, and bowel management at the time of the survey. Response rate was 60.5% (577/953). Higher comorbidity burdens were associated with lower productivity for men and women rectal cancer survivors. Productive survivors were younger and had lower disease stage and age at diagnosis, higher household income and educational attainment, and fewer comorbidity burdens and workplace adjustments than did nonproductive survivors (p < 0.05 each; 2-sided). Productive rectal cancer survivors were evenly split by sex. Staying productive is associated with better mental health for rectal cancer survivors. Rectal cancer survivors with multiple chronic conditions, higher disease stage, lower productive activities, and older age need better access to medical care and closer monitoring of the quality of their care, including self-care. To capture the full extent of the involvement of survivors in all types of productive activities, research should routinely include measures of employment, searching for employment, homemaking, and volunteering. Counting market and nonmarket productive activities is innovative and recognizes the continuum of contributions survivors make to families and society. Health care systems should routinely monitor rectal cancer survivors' medical care access, comorbidities, health-related quality of life, and productive activities.

  14. Staging of rectal cancer by transrectal US

    International Nuclear Information System (INIS)

    Choi, Bo Whan; Ryu, Sie Tae; Park, Ki Soon; Lee, Yul; Chung, Soo Young

    1994-01-01

    To evaluate the accuracy of preoperative staging of rectal cancer by transrectal US(7.5MHz linear array transducer), 17 cases with primary rectal cancer who were examined by transrectal US and histopathologically proven, were analyzed. We correlated the sonographic features of the depth of rectal wall invasion, perirectal fat infiltration and perirectal lymph node metastasis with histopathologic findings. The tumor staging was analyzed according to the TNM classification. The depth of rectal wall invasion was in accordance with histopathologic findings in 15 of 17 cases (accuracy:88.2%). The sensitivity and specificity of transrectal US in predicting perirectal lymph node metastasis were 20% and 75%, respectively (accuracy : 58.8%). The sensitivity and specificity in predicting perirectal fat infiltration were 92.9% and 100%, respectively (accuracy : 94%). Perirectal fat infiltration and depth of rectal wall invasion were preoperatively diagnosed with relatively high accuracy, while perirectal lymph node metastasis with low accuracy. In conclusion, transrectal US is a useful imaging modality for preoperative staging of rectal cancer

  15. A method of analyzing rectal surface area irradiated and rectal complications in prostate conformal radiotherapy

    International Nuclear Information System (INIS)

    Lu Yong; Song, Paul Y.; Li Shidong; Spelbring, Danny R.; Vijayakumar, Srinivasan; Haraf, Daniel J.; Chen, George T.Y.

    1995-01-01

    Purpose: To develop a method of analyzing rectal surface area irradiated and rectal complications in prostate conformal radiotherapy. Methods and Materials: Dose-surface histograms of the rectum, which state the rectal surface area irradiated to any given dose, were calculated for a group of 27 patients treated with a four-field box technique to a total (tumor minimum) dose ranging from 68 to 70 Gy. Occurrences of rectal toxicities as defined by the Radiation Therapy Oncology Group (RTOG) were recorded and examined in terms of dose and rectal surface area irradiated. For a specified end point of rectal complication, the complication probability was analyzed as a function of dose irradiated to a fixed rectal area, and as a function of area receiving a fixed dose. Lyman's model of normal tissue complication probability (NTCP) was used to fit the data. Results: The observed occurrences of rectal complications appear to depend on the rectal surface area irradiated to a given dose level. The patient distribution of each toxicity grade exhibits a maximum as a function of percentage surface area irradiated, and the maximum moves to higher values of percentage surface area as the toxicity grade increases. The dependence of the NTCP for the specified end point on dose and percentage surface area irradiated was fitted to Lyman's NTCP model with a set of parameters. The curvature of the NTCP as a function of the surface area suggests that the rectum is a parallel structured organ. Conclusions: The described method of analyzing rectal surface area irradiated yields interesting insight into understanding rectal complications in prostate conformal radiotherapy. Application of the method to a larger patient data set has the potential to facilitate the construction of a full dose-surface-complication relationship, which would be most useful in guiding clinical practice

  16. Dose-volume analysis of predictors for chronic rectal toxicity after treatment of prostate cancer with adaptive image-guided radiotherapy

    International Nuclear Information System (INIS)

    Vargas, Carlos; Martinez, Alvaro; Kestin, Larry L.; Yan Di; Grills, Inga; Brabbins, Donald S.; Lockman, David M.; Liang Jian; Gustafson, Gary S.; Chen, Peter Y.; Vicini, Frank A.; Wong, John W.

    2005-01-01

    Purpose We analyzed our experience treating localized prostate cancer with image-guided off-line correction with adaptive high-dose radiotherapy (ART) in our Phase II dose escalation study to identify factors predictive of chronic rectal toxicity. Materials and Methods From 1999-2002, 331 patients with clinical stage T1-T3N0M0 prostate cancer were prospectively treated in our Phase II 3D conformal dose escalation ART study to a median dose of 75.6 Gy (range, 63.0-79.2 Gy), minimum dose to confidence limited-planning target volume (cl-PTV) in 1.8 Gy fractions (median isocenter dose = 79.7 Gy). Seventy-four patients (22%) also received neoadjuvant/adjuvant androgen deprivation therapy. A patient-specific cl-PTV was constructed using 5 computed tomography scans and 4 sets of electronic portal images by applying an adaptive process to assure target accuracy and minimize PTV margin. For each case, the rectum (rectal solid) was contoured from the sacroiliac joints or rectosigmoid junction (whichever was higher) to the anal verge or ischial tuberosities (whichever was lower), with a median volume of 81.2 cc. The rectal wall was defined using the rectal solid with an individualized 3-mm wall thickness (median volume = 29.8 cc). Rectal wall dose-volume histogram was used to determine the prescribed dose. Toxicity was quantified using the National Cancer Institute Common Toxicity Criteria 2.0. Multiple dose-volume endpoints were evaluated for their association with chronic rectal toxicity. Results Median follow-up was 1.6 years. Thirty-four patients (crude rate 10.3%) experienced Grade 2 chronic rectal toxicity at a median interval of 1.1 years. Nine patients (crude rate = 2.7%) experienced Grade ≥3 chronic rectal toxicity (1 was Grade 4) at a median interval of 1.2 years. The 3-year rates of Grade ≥2 and Grade ≥3 chronic rectal toxicity were 20% and 4%, respectively. Acute toxicity predicted for chronic: Acute Grade 2-3 rectal toxicity (p 40% respectively. The volume

  17. External cystic rectal duplication: an unusual presentation of rectal duplication cyst.

    Science.gov (United States)

    Karaman, I; Karaman, A; Arda, N; Cakmak, O

    2007-11-01

    Duplications of gastrointestinal tract are rare anomalies, and rectal duplications account for five percent of the alimentary tract duplications. We present an unusual case of rectal duplication, which was located externally in a newborn female, and discuss the types of distal hindgut duplications.

  18. Intracavitary radiation for rectal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Basrur, V.R. (Ontario Cancer Treatment and Research Foundation, Hamilton (Canada). Hamilton Clinic); Knight, P.R. (McMaster Univ., Hamilton, Ontario (Canada))

    1983-03-01

    Thirty-five patients with low-lying rectal adenocarcinoma have been treated with intra-cavitary radiation (Papillon's technique). Twenty-three were treated for cure and 12 for palliation. The indications for curative intracavity radiation were mobile polypoid tumors, less than 3 cm in diameter, with Broder's Grades 1 and 2 differentiation lying less than 11 cm from the anal verge. Doses between 2000 and 4000 cGy were delivered to a total of 7000 to 20000 cGy with complete resolution of the tumors. Eighty-seven per cent in the curative group are alive and well up to 42 months after treatment with a minimum follow-up of six months. Of the 23 patients treated for cure, three patients had recurrences within 18 months of therapy. Two of the three patients are alive following surgery. The third patient died in the postoperative period. The results of intracavitary radiation are comparable to ablative surgery and avoid a permanent colostomy. Age, frailty, or other medical conditions do not preclude this treatment. Anesthesia and hospitalization are not required. This method can also be used for palliation of recurrent tumors and in patients who are unsuitable for surgery.

  19. Locally advanced rectal cancer: management challenges

    Directory of Open Access Journals (Sweden)

    Kokelaar RF

    2016-10-01

    Full Text Available RF Kokelaar, MD Evans, M Davies, DA Harris, J Beynon Department of Colorectal Surgery, Singleton Hospital, Swansea, UK Abstract: Between 5% and 10% of patients with rectal cancer present with locally advanced rectal cancer (LARC, and 10% of rectal cancers recur after surgery, of which half are limited to locoregional disease only (locally recurrent rectal cancer. Exenterative surgery offers the best long-term outcomes for patients with LARC and locally recurrent rectal cancer so long as a complete (R0 resection is achieved. Accurate preoperative multimodal staging is crucial in assessing the potential operability of advanced rectal tumors, and resectability may be enhanced with neoadjuvant therapies. Unfortunately, surgical options are limited when the tumor involves the lateral pelvic sidewall or high sacrum due to the technical challenges of achieving histological clearance, and must be balanced against the high morbidity associated with resection of the bony pelvis and significant lymphovascular structures. This group of patients is usually treated palliatively and subsequently survival is poor, which has led surgeons to seek innovative new solutions, as well as revisit previously discarded radical approaches. A small number of centers are pioneering new techniques for resection of beyond-total mesorectal excision tumors, including en bloc resections of the sciatic notch and composite resections of the first two sacral vertebrae. Despite limited experience, these new techniques offer the potential for radical treatment of previously inoperable tumors. This narrative review sets out the challenges facing the management of LARCs and discusses evolving management options. Keywords: rectal cancer, exenteration, pelvic sidewall, sacrectomy

  20. Piggy-back Hepatic Transplant Technique and Veno-venous Bypass Without Cardiac Arrest: A Multidisciplinary Approach in Borderline T3b/T3c Renal Tumors

    Directory of Open Access Journals (Sweden)

    Nechifor-Boila IA

    2015-06-01

    Full Text Available Surgery for renal cell carcinomas with tumor thrombus extending in the Inferior Vena Cava (IVC can be particularly challenging, especially in the retrohepatic and intraatrial situations (T3b and T3c. Classically, these tumors require the intraoperative use of cardio-pulmonary by-pass (CPB and deep hypothermic circulatory arrest (DHCA, that can result in specific complications (stroke, platelet dysfunction, with increased postoperative morbidity rates.

  1. Importance of Preoperative Rectal Ultrasound and CT in Rectal Tumors

    International Nuclear Information System (INIS)

    Schnellyova, T.

    2011-01-01

    Introduction: The reason of high mortality of colorectal carcinoma is above all the fact, that majority of diseases are detected in progressive stage. Radical change in this unfavorable mortality rate can be achieved only by targeted search for early stages of the disease. Early diagnostics consists in rectoscopy and colonoscopy. Regarding X-ray methods it is X-ray irigography. Regarding CT examinations it is CT irigography, virtual colonoscopy. Another examination can be USG examination of abdomen and endo sonographic examination of rectum. Materials and methods: In the period from June 2006 to December 2010, in 60 patients out of the total number 106 examined patients, tumorous affection of rectum CT examination of pelvis and abdomen separately or pelvisand abdomen at one session was made in 3186 patients. In 115 patients we discovered malign tumorous illness of colon. Metastatic affection in the form of distant metastases was proven n 63 patients. 403 patients had CT irigography examination. In 77 out of them we diagnosed colon carcinoma. CT colonoscopy did not discover in our group of 30 patients examined the presence of colon carcinoma. Results: In the group of 60 patients who were diagnosed rectal carcinoma, in 29 patients expansive infiltrative affection was evaluated in endorectal sonography, histologically confirmed in 28 patients - 96,5 %, expansive affection in 41 patients with histological verification in 100 %. With CT we diagnosed 52 expansive tumorous processes, histologically confirmed in 47 patients - 90,38 %. In 63 patients expansive infiltrative process was evaluated, histologically confirmed in 52 patients 82,53 %. In total of 115 examinations there was conformance with histological examination in 99 patients - 86,08 %. In CT irigography we diagnosed colon tumour in 77 patients. Expansive growth was evaluated in 40 patients, histologically confirmed in 37 patients - 92,5 %. Expansive infiltrative expansion was evaluated in 37 patients, with

  2. Association between obesity and local control of advanced rectal cancer after combined surgery and radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yun Seon; Park, Sung Kwang; Cho, Heung Lae; Ahn, Ki Jung [Dept. of Radiation Oncology, (Korea, Republic of); Lee, Yun Han [Dept. of Molecular Medicine, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2016-06-15

    The association between metabolism and cancer has been recently emphasized. This study aimed to find the prognostic significance of obesity in advanced stage rectal cancer patients treated with surgery and radiotherapy (RT). We retrospectively reviewed the medical records of 111 patients who were treated with combined surgery and RT for clinical stage 2–3 (T3 or N+) rectal cancer between 2008 and 2014. The prognostic significance of obesity (body mass index [BMI] ≥25 kg/m{sup 2}) in local control was evaluated. The median follow-up was 31.2 months (range, 4.1 to 85.7 months). Twenty-five patients (22.5%) were classified as obese. Treatment failure occurred in 33 patients (29.7%), including local failures in 13 patients (11.7%), regional lymph node failures in 5, and distant metastases in 24. The 3-year local control, recurrence-free survival, and overall survival rates were 88.7%, 73.6%, and 87.7%, respectively. Obesity (n = 25) significantly reduced the local control rate (p = 0.045; 3-year local control, 76.2%), especially in women (n = 37, p = 0.021). Segregation of local control was best achieved by BMI of 25.6 kg/m{sup 2} as a cutoff value. Obese rectal cancer patients showed poor local control after combined surgery and RT. More effective local treatment strategies for obese patients are warranted.

  3. Association between obesity and local control of advanced rectal cancer after combined surgery and radiotherapy

    International Nuclear Information System (INIS)

    Choi, Yun Seon; Park, Sung Kwang; Cho, Heung Lae; Ahn, Ki Jung; Lee, Yun Han

    2016-01-01

    The association between metabolism and cancer has been recently emphasized. This study aimed to find the prognostic significance of obesity in advanced stage rectal cancer patients treated with surgery and radiotherapy (RT). We retrospectively reviewed the medical records of 111 patients who were treated with combined surgery and RT for clinical stage 2–3 (T3 or N+) rectal cancer between 2008 and 2014. The prognostic significance of obesity (body mass index [BMI] ≥25 kg/m 2 ) in local control was evaluated. The median follow-up was 31.2 months (range, 4.1 to 85.7 months). Twenty-five patients (22.5%) were classified as obese. Treatment failure occurred in 33 patients (29.7%), including local failures in 13 patients (11.7%), regional lymph node failures in 5, and distant metastases in 24. The 3-year local control, recurrence-free survival, and overall survival rates were 88.7%, 73.6%, and 87.7%, respectively. Obesity (n = 25) significantly reduced the local control rate (p = 0.045; 3-year local control, 76.2%), especially in women (n = 37, p = 0.021). Segregation of local control was best achieved by BMI of 25.6 kg/m 2 as a cutoff value. Obese rectal cancer patients showed poor local control after combined surgery and RT. More effective local treatment strategies for obese patients are warranted

  4. Lysophosphatidic acid receptor-5 negatively regulates cellular responses in mouse fibroblast 3T3 cells

    Energy Technology Data Exchange (ETDEWEB)

    Dong, Yan; Hirane, Miku; Araki, Mutsumi [Division of Cancer Biology and Bioinformatics, Department of Life Science, Faculty of Science and Engineering, Kinki University, 3-4-1, Kowakae, Higashiosaka, Osaka 577-8502 (Japan); Fukushima, Nobuyuki [Division of Molecular Neurobiology, Department of Life Science, Faculty of Science and Engineering, Kinki University, 3-4-1, Kowakae, Higashiosaka, Osaka 577-8502 (Japan); Tsujiuchi, Toshifumi, E-mail: ttujiuch@life.kindai.ac.jp [Division of Cancer Biology and Bioinformatics, Department of Life Science, Faculty of Science and Engineering, Kinki University, 3-4-1, Kowakae, Higashiosaka, Osaka 577-8502 (Japan)

    2014-04-04

    Highlights: • LPA{sub 5} inhibits the cell growth and motile activities of 3T3 cells. • LPA{sub 5} suppresses the cell motile activities stimulated by hydrogen peroxide in 3T3 cells. • Enhancement of LPA{sub 5} on the cell motile activities inhibited by LPA{sub 1} in 3T3 cells. • The expression and activation of Mmp-9 were inhibited by LPA{sub 5} in 3T3 cells. • LPA signaling via LPA{sub 5} acts as a negative regulator of cellular responses in 3T3 cells. - Abstract: Lysophosphatidic acid (LPA) signaling via G protein-coupled LPA receptors (LPA{sub 1}–LPA{sub 6}) mediates a variety of biological functions, including cell migration. Recently, we have reported that LPA{sub 1} inhibited the cell motile activities of mouse fibroblast 3T3 cells. In the present study, to evaluate a role of LPA{sub 5} in cellular responses, Lpar5 knockdown (3T3-L5) cells were generated from 3T3 cells. In cell proliferation assays, LPA markedly stimulated the cell proliferation activities of 3T3-L5 cells, compared with control cells. In cell motility assays with Cell Culture Inserts, the cell motile activities of 3T3-L5 cells were significantly higher than those of control cells. The activity levels of matrix metalloproteinases (MMPs) were measured by gelatin zymography. 3T3-L5 cells stimulated the activation of Mmp-2, correlating with the expression levels of Mmp-2 gene. Moreover, to assess the co-effects of LPA{sub 1} and LPA{sub 5} on cell motile activities, Lpar5 knockdown (3T3a1-L5) cells were also established from Lpar1 over-expressing (3T3a1) cells. 3T3a1-L5 cells increased the cell motile activities of 3T3a1 cells, while the cell motile activities of 3T3a1 cells were significantly lower than those of control cells. These results suggest that LPA{sub 5} may act as a negative regulator of cellular responses in mouse fibroblast 3T3 cells, similar to the case for LPA{sub 1}.

  5. Lysophosphatidic acid receptor-5 negatively regulates cellular responses in mouse fibroblast 3T3 cells

    International Nuclear Information System (INIS)

    Dong, Yan; Hirane, Miku; Araki, Mutsumi; Fukushima, Nobuyuki; Tsujiuchi, Toshifumi

    2014-01-01

    Highlights: • LPA 5 inhibits the cell growth and motile activities of 3T3 cells. • LPA 5 suppresses the cell motile activities stimulated by hydrogen peroxide in 3T3 cells. • Enhancement of LPA 5 on the cell motile activities inhibited by LPA 1 in 3T3 cells. • The expression and activation of Mmp-9 were inhibited by LPA 5 in 3T3 cells. • LPA signaling via LPA 5 acts as a negative regulator of cellular responses in 3T3 cells. - Abstract: Lysophosphatidic acid (LPA) signaling via G protein-coupled LPA receptors (LPA 1 –LPA 6 ) mediates a variety of biological functions, including cell migration. Recently, we have reported that LPA 1 inhibited the cell motile activities of mouse fibroblast 3T3 cells. In the present study, to evaluate a role of LPA 5 in cellular responses, Lpar5 knockdown (3T3-L5) cells were generated from 3T3 cells. In cell proliferation assays, LPA markedly stimulated the cell proliferation activities of 3T3-L5 cells, compared with control cells. In cell motility assays with Cell Culture Inserts, the cell motile activities of 3T3-L5 cells were significantly higher than those of control cells. The activity levels of matrix metalloproteinases (MMPs) were measured by gelatin zymography. 3T3-L5 cells stimulated the activation of Mmp-2, correlating with the expression levels of Mmp-2 gene. Moreover, to assess the co-effects of LPA 1 and LPA 5 on cell motile activities, Lpar5 knockdown (3T3a1-L5) cells were also established from Lpar1 over-expressing (3T3a1) cells. 3T3a1-L5 cells increased the cell motile activities of 3T3a1 cells, while the cell motile activities of 3T3a1 cells were significantly lower than those of control cells. These results suggest that LPA 5 may act as a negative regulator of cellular responses in mouse fibroblast 3T3 cells, similar to the case for LPA 1

  6. Complete pathological response (ypT0N0M0) after preoperative chemotherapy alone for stage IV rectal cancer.

    Science.gov (United States)

    Naiken, Surennaidoo P; Toso, Christian; Rubbia-Brandt, Laura; Thomopoulos, Theodoros; Roth, Arnaud; Mentha, Gilles; Morel, Philippe; Gervaz, Pascal

    2014-01-17

    Complete pathological response occurs in 10-20% of patients with rectal cancer who are treated with neoadjuvant chemoradiation therapy prior to pelvic surgery. The possibility that complete pathological response of rectal cancer can also occur with neoadjuvant chemotherapy alone (without radiation) is an intriguing hypothesis. A 66-year old man presented an adenocarcinoma of the rectum with nine liver metastases (T3N1M1). He was included in a reverse treatment, aiming at first downsizing the liver metastases by chemotherapy, and subsequently performing the liver surgery prior to the rectum resection. The neoadjuvant chemotherapy consisted in a combination of oxaliplatin, 5-FU, irinotecan, leucovorin and bevacizumab (OCFL-B). After a right portal embolization, an extended right liver lobectomy was performed. On the final histopathological analysis, all lesions were fibrotic, devoid of any viable cancer cells. One month after liver surgery, the rectoscopic examination showed a near-total response of the primary rectal adenocarcinoma, which convinced the colorectal surgeon to perform the low anterior resection without preoperative radiation therapy. Macroscopically, a fibrous scar was observed at the level of the previously documented tumour, and the histological examination of the surgical specimen did not reveal any malignant cells in the rectal wall as well as in the mesorectum. All 15 resected lymph nodes were free of tumour, and the final tumour stage was ypT0N0M0. Clinical outcome was excellent, and the patient is currently alive 5 years after the first surgery without evidence of recurrence. The presented patient with stage IV rectal cancer and liver metastases was in a unique situation linked to its inclusion in a reversed treatment and the use of neoadjuvant chemotherapy alone. The observed achievement of a complete pathological response after chemotherapy should promote the design of prospective randomized studies to evaluate the benefits of chemotherapy

  7. MicroRNA expression profile associated with response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer patients

    International Nuclear Information System (INIS)

    Svoboda, Marek; Sana, Jiri; Fabian, Pavel; Kocakova, Ilona; Gombosova, Jana; Nekvindova, Jana; Radova, Lenka; Vyzula, Rostislav; Slaby, Ondrej

    2012-01-01

    Rectal cancer accounts for approximately one third of all colorectal cancers (CRC), which belong among leading causes of cancer deaths worldwide. Standard treatment for locally advanced rectal cancer (cT3/4 and/or cN+) includes neoadjuvant chemoradiotherapy with fluoropyrimidines (capecitabine or 5-fluorouracil) followed by radical surgical resection. Unfortunately, a significant proportion of tumors do not respond enough to the neoadjuvant treatment and these patients are at risk of relapse. MicroRNAs (miRNAs) are small non-coding RNAs playing significant roles in the pathogenesis of many cancers including rectal cancer. MiRNAs could present the new predictive biomarkers for rectal cancer patients. We selected 20 patients who underwent neoadjuvant chemoradiotherapy for advanced rectal cancer and whose tumors were classified as most sensitive or resistant to the treatment. These two groups were compared using large-scale miRNA expression profiling. Expression levels of 8 miRNAs significantly differed between two groups. MiR-215, miR-190b and miR-29b-2* have been overexpressed in non-responders, and let-7e, miR-196b, miR-450a, miR-450b-5p and miR-99a* have shown higher expression levels in responders. Using these miRNAs 9 of 10 responders and 9 of 10 non-responders (p < 0.05) have been correctly classified. Our pilot study suggests that miRNAs are part of the mechanisms that are involved in response of rectal cancer to the chemoradiotherapy and that miRNAs may be promising predictive biomarkers for such patients. In most miRNAs we identified (miR-215, miR-99a*, miR-196b, miR-450b-5p and let-7e), the connection between their expression and radioresistance or chemoresistance to inhibitors of thymidylate synthetase was already established

  8. Preparation of high specific activity labelled triiodothyronine (T3) for radioimmunoassay

    International Nuclear Information System (INIS)

    Pillai, M.R.A.; Nagvekar, U.H.; Desai, C.N.; Mani, R.S.

    1981-01-01

    A method standardized for the preparation of high specific activity labelled triiodothyronine (T 3 ) is discussed. Iodine-125 labelled T 3 with a specific activity of 3 mCi μg was prepared by iodinating 3,5-diiodothyronine (T 2 ) and purifying it over Sephadex G-25 gel. Radochemical purity and stability evaluations were done by paper chromatography. Specific activity of the labelled T 3 prepared was estimated by the self-displacement method. The use of this high specific activity labelled T 3 in radioimmunoassay increased the sensitivity considerably. The advantage of this procedure is that the specific activity of labelled T 3 formed is independent of reaction yield and labelled T 3 yield. (author)

  9. Initial experience with 3T 3D-TOF MRA in the diagnosis of intracranial aneurysms

    International Nuclear Information System (INIS)

    Senba, Yoshiki; Takahashi, Shizue; Matsubara, Ichiro; Sadamoto, Kazuhiko; Miki, Hitoshi; Mochizuki, Teruhito

    2006-01-01

    We assessed the value of 3T 3D-time of flight (TOF) MR angiography (MRA) in the diagnosis of intracranial aneurysms compared with 1.5T 3D-TOF MRA. Twenty-one patients with 22 aneurysms underwent MRA at 1.5T and 3T. Images were interpreted by two radiologists. Each of nine aneurysms that had been considered ''definite'' at 1.5T 3D-TOF MRA were considered ''definite'' at 3T 3D-TOF MRA. Seven aneurysms that had been considered ''suspicious'' at 1.5T MRA were considered ''definite'' at 3T. And four aneurysms that had been considered ''suspicious'' at 1.5T were considered ''negative'' at 3T. We concluded that 3T 3D-TOF MRA is superior to 1.5T 3D-TOF MRA in the diagnosis of intracranial aneurysms. (author)

  10. Diagnosis and Management of Rectal Neuroendocrine Tumors

    Directory of Open Access Journals (Sweden)

    Shreya Chablaney

    2017-11-01

    Full Text Available The incidence of rectal neuroendocrine tumors (NETs has increased by almost ten-fold over the past 30 years. There has been a heightened awareness of the malignant potential of rectal NETs. Fortunately, many rectal NETs are discovered at earlier stages due to colon cancer screening programs. Endoscopic ultrasound is useful in assessing both residual tumor burden after retrospective diagnosis and tumor characteristics to help guide subsequent management. Current guidelines suggest endoscopic resection of rectal NETs ≤10 mm as a safe therapeutic option given their low risk of metastasis. Although a number of endoscopic interventions exist, the best technique for resection has not been identified. Endoscopic submucosal dissection (ESD has high complete and en-bloc resection rates, but also an increased risk of complications including perforation. In addition, ESD is only performed at tertiary centers by experienced advanced endoscopists. Endoscopic mucosal resection has been shown to have variable complete resection rates, but modifications to the technique such as the addition of band ligation have improved outcomes. Prospective studies are needed to further compare the available endoscopic interventions, and to elucidate the most appropriate course of management of rectal NETs.

  11. Rectal and colon cancer : Not just a different anatomic site

    NARCIS (Netherlands)

    Tamas, K.; Walenkamp, A. M. E.; de Vries, E. G. E.; van Vugt, M. A. T. M.; Beets-Tan, R. G.; van Etten, B.; de Groot, D. J. A.; Hospers, G. A. P.

    Due to differences in anatomy, primary rectal and colon cancer require different staging procedures, different neo-adjuvant treatment and different surgical approaches. For example, neoadjuvant radiotherapy or chemoradiotherapy is administered solely for rectal cancer. Neoadjuvant therapy and total

  12. Pengaruh Rapat Arus Anodizing terhadap Nilai Kekerasan pada Plat Aluminium Paduan Aa Seri 2024-t3

    OpenAIRE

    Fajar Nugroho

    2015-01-01

    Aluminum alloy AA 2024-T3 is widely applied in the aircraft industry because it has good mechanical properties such as; light weight, good conductivity and the corrosion resistance. However Aluminium 2024-T3 susceptible to wearing. One method to improve the wear resistance o f AA 2024-T3 is the anodizing process. The aims of this research to study the effect of current density and anodizing time against the hardness of aluminum alloy AA 2024-T3. The process of anodizing was carried out using ...

  13. High Performance Programming Using Explicit Shared Memory Model on the Cray T3D

    Science.gov (United States)

    Saini, Subhash; Simon, Horst D.; Lasinski, T. A. (Technical Monitor)

    1994-01-01

    The Cray T3D is the first-phase system in Cray Research Inc.'s (CRI) three-phase massively parallel processing program. In this report we describe the architecture of the T3D, as well as the CRAFT (Cray Research Adaptive Fortran) programming model, and contrast it with PVM, which is also supported on the T3D We present some performance data based on the NAS Parallel Benchmarks to illustrate both architectural and software features of the T3D.

  14. Effects of Maillard reaction on allergenicity of buckwheat allergen Fag t 3 during thermal processing.

    Science.gov (United States)

    Yang, Zhen-Huang; Li, Chen; Li, Yu-Ying; Wang, Zhuan-Hua

    2013-04-01

    Fag t 3 is a major allergenic protein in tartary buckwheat. The Maillard reaction commonly occurs in food processing, but few studies have been conducted on the influence of thermal processing on the allergenic potential of buckwheat allergen. The aim of the present study was to investigate the effects of autologous plant polysaccharides on the immunoreactivity of buckwheat Fag t 3 (11S globulin) following the Maillard reaction. Fag t 3 and crude polysaccharides were prepared from tartary buckwheat (Fagopyrum tataricum) flour. After heating, the polysaccharides were covalently linked to Fag t 3 via a Maillard reaction, and the IgE/IgG-binding properties of Fag t 3 decreased dramatically, with significant changes also being observed in the electrophoretic mobility, secondary structure and solubility of the glycated Fag t 3. The great influence of glycation on IgE/IgG binding to Fag t 3 was correlated with a significant change in the structure and epitopes of the allergenic protein. These data indicated that conjugation of polysaccharides to Fag t 3 markedly reduced the allergen's immunoreactivity. Glycation that occurs via the Maillard reaction during the processing of buckwheat food may be an efficient method to reduce Fag t 3 allergenicity. © 2012 Society of Chemical Industry.

  15. Capecitabine and Oxaliplatin Before, During, and After Radiotherapy for High-Risk Rectal Cancer.

    Science.gov (United States)

    Larsen, Finn Ole; Markussen, Alice; Jensen, Benny V; Fromm, Anne L; Vistisen, Kirsten K; Parner, Vibeke K; Linnemann, Dorte; Hansen, Rasmus H; Johannesen, Helle H; Schou, Jakob V

    2017-06-01

    To evaluate the effect of capecitabine and oxaliplatin before, during, and after radiotherapy for high-risk rectal cancer. Patients with rectum cancer T4 or T3 involving the mesorectal fascia was included in a prospective phase 2 trial. Liver or lung metastases were accepted if the surgeons found them resectable. The patients received 6 weeks of capecitabine and oxaliplatin before chemoradiotherapy (CRT), continued capecitabine and oxaliplatin during radiotherapy, and received 4 weeks of capecitabine and oxaliplatin after CRT. The patients received radiotherapy as intensity-modulated radiotherapy. Total mesorectal excision was planned 8 weeks after CRT. The patients were evaluated with magnetic resonance imaging (MRI) before start of treatment, after 6 weeks of chemotherapy, and again just before the operation. The European Organization for Research and Treatment of Cancer (EORTC) QLQ-CR29 scoring system was used to evaluate adverse events. Fifty-two patients were enrolled between 2009 and 2012. The treatment was well tolerated, with only one death during treatment. Eighty percent of assessable patients experienced response to chemotherapy alone as evaluated by MRI, which increased to 94% after complete oncologic treatment. Forty-nine patients had a total mesorectal excision performed, all with a R0 resection and with a pathologic complete response of 20% for patients with T3 tumor and 7% for patients with T4 tumor. Five patients had metastases at study entry, while 47 patients had locally advanced rectal cancer without metastases. Of these 47 patients, overall survival and progression-free survival at 5 years was 72% and 62%, respectively, with a median follow-up of 60 months. This aggressive approach with capecitabine and oxaliplatin before, during, and after radiotherapy for high-risk rectal cancer is safe and feasible; it also has an impressive response rate as measured by MRI and a promising 5-year overall survival. Copyright © 2016 Elsevier Inc. All rights

  16. The predictive and prognostic potential of plasma telomerase reverse transcriptase (TERT) RNA in rectal cancer patients

    Science.gov (United States)

    Rampazzo, Enrica; Del Bianco, Paola; Bertorelle, Roberta; Boso, Caterina; Perin, Alessandro; Spiro, Giovanna; Bergamo, Francesca; Belluco, Claudio; Buonadonna, Angela; Palazzari, Elisa; Leonardi, Sara; De Paoli, Antonino; Pucciarelli, Salvatore; De Rossi, Anita

    2018-01-01

    Background: Preoperative chemoradiotherapy (CRT) followed by surgery is the standard care for locally advanced rectal cancer, but tumour response to CRT and disease outcome are variable. The current study aimed to investigate the effectiveness of plasma telomerase reverse transcriptase (TERT) levels in predicting tumour response and clinical outcome. Methods: 176 rectal cancer patients were included. Plasma samples were collected at baseline (before CRT=T0), 2 weeks after CRT was initiated (T1), post-CRT and before surgery (T2), and 4–8 months after surgery (T3) time points. Plasma TERT mRNA levels and total cell-free RNA were determined using real-time PCR. Results: Plasma levels of TERT were significantly lower at T2 (P<0.0001) in responders than in non-responders. Post-CRT TERT levels and the differences between pre- and post-CRT TERT levels independently predicted tumour response, and the prediction model had an area under curve of 0.80 (95% confidence interval (CI) 0.73–0.87). Multiple analysis demonstrated that patients with detectable TERT levels at T2 and T3 time points had a risk of disease progression 2.13 (95% CI 1.10–4.11)-fold and 4.55 (95% CI 1.48–13.95)-fold higher, respectively, than those with undetectable plasma TERT levels. Conclusions: Plasma TERT levels are independent markers of tumour response and are prognostic of disease progression in rectal cancer patients who undergo neoadjuvant therapy. PMID:29449673

  17. The Great Pretender: Rectal Syphilis Mimic a Cancer

    Directory of Open Access Journals (Sweden)

    Andrea Pisani Ceretti

    2015-01-01

    Full Text Available Rectal syphilis is a rare expression of the widely recognised sexual transmitted disease, also known as the great imitator for its peculiarity of being confused with mild anorectal diseases because of its vague symptoms or believed rectal malignancy, with the concrete risk of overtreatment. We present the case of a male patient with primary rectal syphilis, firstly diagnosed as rectal cancer; the medical, radiological, and endoscopic features are discussed below.

  18. Clinical target volume for rectal cancer. Preoperative radiotherapy

    International Nuclear Information System (INIS)

    Lorchel, F.; Bossel, J.F.; Baron, M.H.; Goubard, O.; Bartholomot, B.; Mantion, G.; Pelissier, E.P.; Maingon, P.

    2001-01-01

    The total meso-rectal excision allows the marked increase of the local control rate in rectal cancer. Therefore, the meso-rectal space is the usual field for the spread of rectal cancer cells. It could therefore be considered as the clinical target volume in the preoperative plan by the radiation oncologist. We propose to identify the mesorectum on anatomical structures of a treatment-position CT scan. (authors)

  19. Magnetic resonance in the diagnosing of rectal cancer

    International Nuclear Information System (INIS)

    Perczynski, W.; Walecki, J.; Schier, J.F.; Salamon, Z.

    1994-01-01

    MR has not yet come into widespread use for the staging of rectal cancer. However use of MR imaging in diagnosis of rectal cancer gains clinical acceptance. Use contrast media enables exact staging of rectal cancer. MR multiplaner and noninvasive imaging with excellent spatial and contrast resolution has rising popularity in diagnosis of rectal cancer, especially in cases where it is impossible to insert endorectal US-probe because of stenosis. (author)

  20. Prostatic sarcoma after treatment of rectal cancer

    Directory of Open Access Journals (Sweden)

    Hill Andrew G

    2007-07-01

    Full Text Available Abstract Background The relationship between radiation exposure for treatment of cancer and occurrence of a second primary cancer at the irradiated site is well known. This phenomenon is however rare in prostate. Case presentation A 75-year-old farmer was treated for rectal cancer with preoperative 45 Gy of radiotherapy and abdominoperineal resection. Four years later he developed symptoms of bladder outlet obstruction and acute urinary retention. He underwent a transurethral resection of the prostate. Histological examination of the removed prostate tissue and immunohistochemistry revealed it to be a poorly differentiated sarcoma. Conclusion We believe this to be the first reported case of radiation-induced sarcoma following radiotherapy treatment for rectal cancer. Since radiotherapy plays a pivotal role in the contemporary treatment of rectal adenocarcinoma, it is relevant to be aware of the potential long-term carcinogenic complications of radiotherapy of the pelvis.

  1. Anorectal function orientated surgery for rectal prolapse

    International Nuclear Information System (INIS)

    Takao, Yoshihiko; Tsujizuka, Kazuyuki; Kikuchi, Kiyoshi; Okuda, Makoto

    2007-01-01

    Until quite recently, rectal prolapse was regarded as being a simple condition to treat. Surgical control of the prolapse was largely regarded as a successful outcome. However, recent detailed clinical assessment indicate that many patients have a rectal prolapse which is successfully controlled by surgical operation, yet suffer severe symptoms of disordered defecation, which either persists, or develops as a result of operative treatment. Difficulty with rectal evacuation, persistent incontinence and continuing mucus discharge are recognized as important, despite successful repair of the prolapse itself. There are two major theory of the pathology; circumferential intussusception and sliding hernia. However, many other multifarious factors are concomitant with the condition. These factors often need to be balanced against one another. Usually, a single surgical procedure will not be able to solve the problems. Therefore, the choice of treatment tailored for the individual patient. (author)

  2. [Severe vaginal discharge following rectal surgery].

    Science.gov (United States)

    Burg, L C; Bremers, A J A; Heesakkers, J P F A; Kluivers, K B

    2018-01-01

    Almost 50% of women who have had rectal surgery subsequently develop vaginal discharge. Due to the recurrent and unexpected nature of this heavy discharge, they often experience it as very distressing. Many of these women undergo extensive diagnostic tests that are mainly focused on identifying fistula formation. If no fistula is found, in most cases no other cause for severe vaginal discharge can be demonstrated. In our practice, we saw three patients (49-, 54- and 74-years-old, respectively) with similar severe vaginal discharge after rectal surgery and in whom no explanation for the vaginal discharge could be found. For this reason we conducted a literature search into this condition. Anatomical changes appear to be responsible for heavy vaginal discharge following rectal surgery. Changes in pelvic floor muscles and compression of the distal part of the vagina may lead to pooling of fluid in the proximal part of the vagina, resulting in severe discharge. Symptomatic treatment may reduce the symptoms.

  3. Influence of Preoperative Chemoradiotherapy on the Surgical Strategy According to the Clinical T Stage of Patients With Rectal Cancer

    Science.gov (United States)

    Park, In Ja; Lee, Jong Lyul; Yoon, Yong Sik; Kim, Chan Wook; Lim, Seok-Byung; Lee, Jong Seok; Park, Seong Ho; Park, Jin Hong; Kim, Jong Hoon; Yu, Chang Sik; Kim, Jin Cheon

    2015-01-01

    Abstract The aim of this study was to evaluate the pathologic responses and changes to surgical strategies following preoperative chemoradiotherapy (PCRT) in rectal cancer patients according to their clinical T stage (cT). The use of PCRT has recently been extended to less advanced disease. The authors enrolled 650 patients with cT2 to 4 mid and low rectal cancer who received both PCRT and surgical resection. The rate of total regression and the proportion of local excision were compared according to the cT category. The 3-year recurrence-free survival (RFS) rate was compared using the log-rank test according to patient cT category, pathologic stage, and type of surgical treatment. Patients with cT2 were older (P = 0.001), predominately female (P = 0.028), and had low-lying rectal cancer (P = 0.008). Pathologic total regression was achieved most frequently in cT2 patients (54% of cT2 versus 17.6% of cT3 versus 8.2% of cT4; P rectal cancer, optimal surgical treatment may be achieved with the tailored use of PCRT. PMID:26717384

  4. Satisfaction with life after rectal prolapse surgery.

    Science.gov (United States)

    Winiarski, Michał; Jóźwiak, Daria; Pusty, Michal; Dziki, Adam

    2013-01-01

    Assessment of satisfaction with life, as a result of comparing own life situation with the individualised personal standards, is an important element for measuring satisfaction with life of the patients suffering from somatic disorders. Literature provides numerous data on satisfaction with life of different groups of patients suffering from somatic disorders. Little space is devoted to the study of the level of satisfaction of patients with rectal prolapse, which is particularly evident in relation to the Polish patient population. The aim of the study was planned to determine the level of satisfaction with life and its determinants among patients with full-thickness rectal prolapse surgery as well as to assess the improvement of continence after this surgery. The study group consisted of 20 patients operated on for full-thickness rectal prolapse in the Department of General and Colorectal Surgery, Medical University in Lódź. SWLS (Satisfaction with Life Scale) Diener et al. in the Polish adaptation by Juczyński was used to assess global life satisfaction. Assessment of the incontinence severity and the postoperative improvement was made with Jorge and Wexner scale. The average level of global life satisfaction among patients with rectal prolapse surgery is 21.05 (SD = 4.68) and it corresponds to the level of satisfaction of the total population. In the study group, there were no statistically significant differences in the level of global satisfaction with life depending on age, disease recurrence and continence improvement after surgery. The continence after rectal prolapse surgery improved significantly (plife satisfaction of patients operated on for rectal prolapse.

  5. Intestinal Obstruction Due to Rectal Endometriosis: A Surgical Enigma

    Directory of Open Access Journals (Sweden)

    Razman Jarmin

    2006-07-01

    Full Text Available Obstructed rectal endometriosis is an uncommon presentation. The clinical and intraoperative presentation may present as malignant obstruction. The difficulty in making the diagnosis may delay the definitive management of the patient. We report a unique case of rectal endometriosis mimicking malignant rectal mass causing intestinal obstruction and discuss the management of the case.

  6. Clinical Fact of Rectal Duplication with gastric heterotopy | Atmani ...

    African Journals Online (AJOL)

    Enteric duplication could occur through the entire alimentary tract. A case of rectal duplication cyst with heterotopic gastric mucosa in a chid is described. MRI scan is shown useful in the diagnosis of the duplication. The treatment is the complete local resection of the rectal duplication. Keywords: duplication, rectal, MRI, ...

  7. Sphincter Saving Surgery in Low Rectal Carcinoma in a Resource ...

    African Journals Online (AJOL)

    Background: Surgery is the principal modality of treatment of rectal carcinoma in order to achieve cure. Sphincter saving surgery improves the quality of life of patients with low rectal carcinoma. Aim: To report a case of sphincter saving low anterior resection for low rectal cancer with hand sown colorectal anastomosis

  8. Effects of previous protein intake on rectal temperature, blood glucose, plasma thyroid hormone and minerals by laying hens during a forced molt

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigues, G A; Moraes, V M.B.; Cherici, I; Furlan, R L; Macari, M [UNESP, Jaboticabal, SP (Brazil). Faculdade de Ciencias Agrarias e Veterinarias

    1991-12-01

    The effects of forced molting on blood glucose, rectal temperature, plasma T4, T3 and minerals were studied in hens previously fed rations with different protein contents (14, 17 and 20% crude protein). Blood samples were obtained from brachial veins for blood glucose, T4 and T3 were measured by radioimmunoassay, and plasma minerals were determined by atomic absorption spectroscopy. Blood glucose and rectal temperature were reduced during fasting regardless of previous protein intake. Pre molting T4 plasma level was higher in laying hens fed higher protein ration, but feed deprivation reduced T{sub 4} and T{sub 3} concentrations irrespective of protein intake, except T{sub 4} level for 14% crude protein fed birds that increased during fasting. The data obtained in this experiment suggest that previous protein intake does not interfere with the metabolic changes during forced molt. (author). 19 refs, 1 fig, 4 tabs.

  9. Osteoblast-like MC3T3-E1 Cells Prefer Glycolysis for ATP Production but Adipocyte-like 3T3-L1 Cells Prefer Oxidative Phosphorylation.

    Science.gov (United States)

    Guntur, Anyonya R; Gerencser, Akos A; Le, Phuong T; DeMambro, Victoria E; Bornstein, Sheila A; Mookerjee, Shona A; Maridas, David E; Clemmons, David E; Brand, Martin D; Rosen, Clifford J

    2018-06-01

    Mesenchymal stromal cells (MSCs) are early progenitors that can differentiate into osteoblasts, chondrocytes, and adipocytes. We hypothesized that osteoblasts and adipocytes utilize distinct bioenergetic pathways during MSC differentiation. To test this hypothesis, we compared the bioenergetic profiles of preosteoblast MC3T3-E1 cells and calvarial osteoblasts with preadipocyte 3T3L1 cells, before and after differentiation. Differentiated MC3T3-E1 osteoblasts met adenosine triphosphate (ATP) demand mainly by glycolysis with minimal reserve glycolytic capacity, whereas nondifferentiated cells generated ATP through oxidative phosphorylation. A marked Crabtree effect (acute suppression of respiration by addition of glucose, observed in both MC3T3-E1 and calvarial osteoblasts) and smaller mitochondrial membrane potential in the differentiated osteoblasts, particularly those incubated at high glucose concentrations, indicated a suppression of oxidative phosphorylation compared with nondifferentiated osteoblasts. In contrast, both nondifferentiated and differentiated 3T3-L1 adipocytes met ATP demand primarily by oxidative phosphorylation despite a large unused reserve glycolytic capacity. In sum, we show that nondifferentiated precursor cells prefer to use oxidative phosphorylation to generate ATP; when they differentiate to osteoblasts, they gain a strong preference for glycolytic ATP generation, but when they differentiate to adipocytes, they retain the strong preference for oxidative phosphorylation. Unique metabolic programming in mesenchymal progenitor cells may influence cell fate and ultimately determine the degree of bone formation and/or the development of marrow adiposity. © 2018 American Society for Bone and Mineral Research. © 2018 American Society for Bone and Mineral Research.

  10. Clinical significance of macroscopic completeness of mesorectal resection in rectal cancer.

    Science.gov (United States)

    Leite, J S; Martins, S C; Oliveira, J; Cunha, M F; Castro-Sousa, F

    2011-04-01

    Local recurrence after resection of rectal cancer is usually regarded as being due to a 'failure' of surgery. The completeness of resection of the mesorectum has been proposed as an indicator of the 'quality' of the resection. We determined the prognostic value of macroscopic evaluation of rectal cancer resection specimens and the circumferential resection margin (CRM) after curative surgery. From 1999 to 2006, the macroscopic quality of the mesorectum and the CRM were prospectively assessed in 127 patients who underwent rectal cancer resection with curative intent (R0+R1). Chemoradiotherapy was administered for 61 tumours staged as locally advanced tumours (T3, T4 and N+). Univariate analysis of time to local recurrence and cancer-free survival were tested (Kaplan-Meier) and multivariate analysis calculated with a Cox regression model. The mesorectum was incomplete in 34 (26.8%) patients. At a median follow up of 34 months (range, 9-96 months), in the group with an adequate mesorectal excision, the cumulative risk of local recurrence at 5 years was 10%. This was 25% if the mesorectum was incomplete (P CRM and the mesorectal score as independent factors for local recurrence, and T and N status and the mesorectal score as independent factors for disease-free survival. The outcome of surgical treatment of rectal cancer is related to the completeness of mesorectal excision. It is a more discriminative prognostic factor than the classic tumour-node-metastasis (TNM) system. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

  11. Complete Neoadjuvant Treatment for Rectal Cancer: The Brown University Oncology Group CONTRE Study.

    Science.gov (United States)

    Perez, Kimberly; Safran, Howard; Sikov, William; Vrees, Matthew; Klipfel, Adam; Shah, Nishit; Schechter, Steven; Oldenburg, Nicklas; Pricolo, Victor; Rosati, Kayla; Dipetrillo, Thomas

    2017-06-01

    Following preoperative chemoradiation and surgery, many patients with stage II to III rectal cancer are unable to tolerate full-dose adjuvant chemotherapy. BrUOG R-224 was designed to assess the impact of COmplete Neoadjuvant Treatment for REctal cancer (CONTRE), primary chemotherapy followed by chemoradiation and surgery, on treatment delivery, toxicities, and pathologic response at surgery. Patients with clinical stage II to III (T3 to T4 and/or N1 to N2) rectal cancer received 8 cycles of modified FOLFOX6 followed by capecitabine 825 mg/m bid concurrent with 50.4 Gy intensity-modulated radiation therapy. Surgery was performed 6 to 10 weeks after chemoradiation. Thirty-nine patients were enrolled between August 2010 and June 2013. Median age was 61 years (30 to 79 y); 7 patients (18%) were clinical stage II and 32 (82%) stage III. Thirty-six patients (92%) received all 8 cycles of mFOLFOX6, of whom 35 completed subsequent chemoradiation; thus 89% of patients received CONTRE as planned. No unexpected toxicities were reported. All patients had resolution of bleeding and improvement of obstructive symptoms, with no complications requiring surgical intervention. Pathologic complete response (ypT0N0) was demonstrated in 13 patients (33%; 95% CI, 18.24%-47.76%). CONTRE seems to be a well-tolerated alternative to the current standard treatment sequence. Evaluating its impact on long-term outcomes would require a large randomized trial, but using pathologic response as an endpoint, it could serve as a platform for assessing the addition of novel agents to preoperative treatment in stage II to III rectal cancer.

  12. Improved survival after rectal cancer in Denmark

    DEFF Research Database (Denmark)

    Bülow, S; Harling, H; Iversen, L H

    2010-01-01

    Objective In 1995, an analysis showed an inferior prognosis after rectal cancer in Denmark compared with the other Scandinavian countries. The Danish Colorectal Cancer Group (DCCG) was established with the aim of improving the prognosis, and in this study we present a survival analysis of patients...... treated from 1994 to 2006. Method The study was based on the National Rectal Cancer Registry and the National Colorectal Cancer Database, supplemented with data from the Central Population Registry. The analysis included actuarial overall and relative survival. Results A total of 10 632 patients were...

  13. UFT (tegafur-uracil) in rectal cancer

    DEFF Research Database (Denmark)

    Casado, E; Pfeiffer, P; Feliu, J

    2008-01-01

    BACKGROUND: Major achievements in the treatment of localised rectal cancer include the development of total mesorectal excision and the perioperative administration of radiotherapy in combination with continuous infusion (CI) 5-fluorouracil (5-FU). This multimodal approach has resulted in extended...... and abstracts relating to clinical studies of UFT in the treatment of locally advanced rectal cancer (LARC). Pre- and postoperative studies carried out in patients with newly diagnosed or recurrent disease were included. RESULTS: The combination of UFT and radiotherapy was effective and well tolerated...

  14. Rectal drug administration: clinical pharmacokinetic considerations.

    Science.gov (United States)

    de Boer, A G; Moolenaar, F; de Leede, L G; Breimer, D D

    1982-01-01

    The human rectum represents a body cavity in which drugs can be easily introduced and retained and from which absorption is well possible. There are important therapeutic reasons why it is sometimes preferable to give a drug rectally rather than orally, e.g. in cases of nausea and vomiting. Drawbacks of rectal drug administration include the interruption of absorption by defaecation and lack of patient acceptability. The mechanism of drug absorption from the rectum is probably no different to that in the upper part of the gastrointestinal tract, despite the fact that the physiological circumstances (e.g. pH, fluid content) differ substantially, Absorption from aqueous and alcoholic solutions may occur very rapidly, which has proved to be of considerable therapeutic value in the rapid suppression of acute convulsive attacks by diazepam (e.g. in children), but absorption from suppositories is generally slower and very much dependent on the nature of the suppository base, the use of surfactants or other additives, particle size of the active ingredient, etc. There is some evidence that hepatic first-pass elimination of high clearance drugs is partially avoided after rectal administration, e.g. lignocaine. This can be explained by the rectal venous blood supply: the upper part is connected with the portal system, whereas the lower part is directly connected with the systemic circulation. Plasma concentration data following rectal administration of representatives of several classes of drugs are reviewed: anticonvulsants, non-narcotic analgesics and non-steroidal anti-inflammatory agents, hypnosedatives and anaesthetics, strong analgesics, theophylline and derivatives, corticosteroids, antibacterial agents, thiazinamium, promethazine, hyoscine-N-butyl-bromide, streptokinase, progesterone, ergotamine tartrate and levodopa. Only limited number of cases has it been adequately shown that the rectal route of administration gives plasma concentrations which are comparable to

  15. Can we eliminate neoadjuvant chemoradiotherapy in favor of neoadjuvant multiagent chemotherapy for select stage II/III rectal adenocarcinomas: Analysis of the National Cancer Data base.

    Science.gov (United States)

    Cassidy, Richard J; Liu, Yuan; Patel, Kirtesh; Zhong, Jim; Steuer, Conor E; Kooby, David A; Russell, Maria C; Gillespie, Theresa W; Landry, Jerome C

    2017-03-01

    Stage II and III rectal cancers have been effectively treated with neoadjuvant chemoradiotherapy (NCRT) followed by definitive resection. Advancements in surgical technique and systemic therapy have prompted investigation of neoadjuvant multiagent chemotherapy (NMAC) regimens with the elimination of radiation (RT). The objective of the current study was to investigate factors that predict for the use of NCRT versus NMAC and compare outcomes using the National Cancer Data Base (NCDB) for select stage II and III rectal cancers. In the NCDB, 21,707 patients from 2004 through 2012 with clinical T2N1 (cT2N1), cT3N0, or cT3N1 rectal cancers were identified who had received NCRT or NMAC followed by low anterior resection. Kaplan-Meier analyses, log-rank tests, and Cox-proportional hazards regression analyses were conducted along with propensity score matching analysis to reduce treatment selection bias. The 5-year actuarial overall survival (OS) rate was 75% for patients who received NCRT versus 67.2% for those who received NMAC (P elimination of neoadjuvant RT for select patients with stage II and III rectal adenocarcinoma was associated with worse OS and should not be recommended outside of a clinical trial. Cancer 2017;123:783-93. © 2016 American Cancer Society. © 2016 American Cancer Society.

  16. Kinetic studies of triiodothyronine (T3) in subjects with autonomous thyroid nodule using specific antiserum for the determination of labelled T3 in plasma

    International Nuclear Information System (INIS)

    Bianchi, R.; Zucchelli, G.C.; Giannessi, D.; Pilo, A.; Toni, M.G.; Carpi, A.

    1976-01-01

    The triiodothyronine (T 3 ) kinetics have been evaluated using a 125 I-T 3 and single injection technique; five patients with autonomously functioning thyroid nodule clinically euthyroid, one hypothyroid patient and three control subjects have been studied. Serum-labelled T 3 concentration has been measured by a new method based on extraction of the hormone on small Sephadex G-25 columns, followed by elution with specific antiserum. The analysis of experimental data has been performed using noncompartmental treatment (integral approach). Single compartment analysis of the same data has been also done and results presented for comparison. Average value of metabolic clearance rate was 26.0 1/day in control subjects while larger values (range 28.9 - 53.4 1/day) were found in patients with autonomous nodule and total inhibition of extranodular parenchyma

  17. T3i: A Tool for Generating and Querying Test Suites for Java

    NARCIS (Netherlands)

    Prasetya, I.S.W.B.

    2015-01-01

    T3i is an automated unit-testing tool to test Java classes. To expose interactions T3i generates test-cases in the form of sequences of calls to the methods of the target class. What separates it from other testing tools is that it treats test suites as first class objects and allows users to e.g.

  18. An evaluation of the Cray T3D programming paradigms in atmospheric chemistry/transport models

    NARCIS (Netherlands)

    J.G. Blom (Joke); C. Keßler (Carsten); J.G. Verwer (Jan)

    1996-01-01

    textabstractIn this paper we compare the different programming paradigms available on the Cray T3D for the implementation of a 3D prototype of an Atmospheric Chemistry/Transport Model. We discuss the amount of work needed to convert existing codes to the T3D and the portability of the resulting

  19. Hemangioma colorretal Colon rectal hemangioma

    Directory of Open Access Journals (Sweden)

    João Batista Pinheiro Barreto

    2007-06-01

    Full Text Available O hemangioma colorretal (HCR é uma lesão vascular benigna rara, com manifestação clínica geralmente entre 5 e 25 anos de idade. Faz parte do diagnóstico diferencial das causas de hemorragia digestiva baixa, sendo confundido, na maioria das vezes, com entidades mais comuns, como hemorróidas e doenças inflamatórias intestinais. O retardo do diagnóstico ocorre freqüentemente devido ao desconhecimento da doença, com taxas de mortalidade alcançando 40 a 50% na presença de sangramento importante. O caso relatado é de uma paciente de 17 anos de idade, admitida no Serviço de Colo-proctologia do Hospital Universitário - HUUFMA, em setembro de 2005, com anemia e sangramento retal, desde a infância, de forma intermitente e não dolorosa. Apresentado sua história clínica e propedêutica diagnóstica, realizada por meio de exames laboratoriais, endoscopia digestiva alta, colonoscopia e arteriografia de mesentéricas e ilíacas internas. O tratamento cirúrgico realizado foi retossigmoidectomia convencional com anastomose colorretal baixa, com boa evolução pós-operatória, tendo o exame histopatológico da peça cirúrgica ressecada, confirmado o diagnostico.The colon and rectum hemangioma is a rare benign vascular lesion, with clinical features usually between 5 and 25 years of age. It is included in the differential diagnose of the lower digestive bleeding causes, and has been frequently misdiagnosed with other more common entities, like hemorrhoids and bowel inflammatory disease. The late diagnose occurs usually because of the rarity of the disease, with mortality rates reaching 40 to 50% in presence of severe bleeding. We report a case of a 17 years old girl who was admitted at the Coloproctology Service of the Academic Hospital - HUUFMA, in September 2005, with anemia and intermittent rectal bleeding since childhood. Laboratorial findings included laboratorial exams, GI endoscopy, colonoscopy and arteriography of mesenteric and

  20. Long-term L-Triiodothyronine (T3) treatment in stable systolic heart failure patients

    DEFF Research Database (Denmark)

    Holmager, Pernille; Schmidt, Ulla; Mark, Peter

    2015-01-01

    %, range: 37-52 and serum T3 levels 1·4 nmol/l (0·9-1·6). The T3 dose was 20 μg per day (10-40). TSH levels did not change between groups, whereas serum T3 levels increased in the active arm. Cardiac function as measured by LVEF, end-diastolic and end-systolic volumes and cardiac output did not change...... during T3-treatment and neither did the neurohormonal profile. There were no side-effects in terms of cardiac arrhythmias and no change in resting heart rate. CONCLUSIONS: This study does not support the hypothesis that oral T3 treatment might be beneficial to patients with chronic, stable systolic HF...

  1. A randomised trial of preoperative radiotherapy for stage T3 adenocarcinoma of rectum (TROG 01.04): a progress report

    International Nuclear Information System (INIS)

    Ngan, S.; Fisher, R.; McKay, M.J.; McClure, B.; Burmeister, B.H.; Schache, D.; Joseph, D.; Solomon, M.; Ackland, S.P.; Goldstein, D.; McLachlan, S.; Dhillon, H.; Thompson, P.

    2003-01-01

    To provide a progress report of the conduct of the randomised trial TROG 01.04. This is a randomised Australian and New Zealand multi-centre trial of preoperative radiotherapy for rectal cancer currently being conducted under the auspices of Trans-Tasman Radiation Oncology Group, Australasian Gastrointestinal Trials Group, Colorectal Surgical Society of Australasia, and Royal Australasian College of Surgeons. The trial comprises two studies, each with its own main objective. These objectives are, in patients with T3 clinically resectable carcinoma of the rectum, to demonstrate that (Study 1) the local recurrence rate in patients treated with a long course (LC) of pre-operative radiotherapy with continuous infusion 5-FU is lower than that in patients treated with a short course (SC) of pre-operative radiotherapy with early surgery; and (Study 2) the local recurrence rate in patients given pre-operative radiotherapy and chemotherapy is lower than that in patients treated with initial surgery. Over 150 patients have been accrued from 21 centres in the first 21 months. All patients were enrolled on Study 1, SC versus LC pre-operative radiotherapy. Study 2 has enrolled no patients in 15 months and has been discontinued. There was no obvious difference in rates of serious adverse events of SC and LC. An Independent Data Monitoring Committee is monitoring these and other aspects of the trial. The trial of SC versus LC is progressing well: such a trial is clearly feasible in Australia and New Zealand. It is however not feasible to compare initial surgery with preoperative radiotherapy

  2. Long-term results of a randomized trial in locally advanced rectal cancer: no benefit from adding a brachytherapy boost

    DEFF Research Database (Denmark)

    Appelt, Ane L; Vogelius, Ivan R; Pløen, John

    2014-01-01

    PURPOSE/OBJECTIVE(S): Mature data on tumor control and survival are presented from a randomized trial of the addition of a brachytherapy boost to long-course neoadjuvant chemoradiation therapy (CRT) for locally advanced rectal cancer. METHODS AND MATERIALS: Between March 2005 and November 2008, 248...... patients with T3-4N0-2M0 rectal cancer were prospectively randomized to either long-course preoperative CRT (50.4 Gy in 28 fractions, per oral tegafur-uracil and L-leucovorin) alone or the same CRT schedule plus a brachytherapy boost (10 Gy in 2 fractions). The primary trial endpoint was pathologic...... on stratification for tumor regression grade and resection margin status indicated the presence of response migration. CONCLUSIONS: Despite increased pathologic tumor regression at the time of surgery, we observed no benefit on late outcome. Improved tumor regression does not necessarily lead to a relevant clinical...

  3. Prognostic significance of classified extramural tumor deposits and extracapsular lymph node invasion in T3–4 colorectal cancer: a retrospective single-center study

    International Nuclear Information System (INIS)

    Yamano, Tomoki; Semba, Shuho; Noda, Masafumi; Yoshimura, Mie; Kobayashi, Masayoshi; Hamanaka, Michiko; Beppu, Naohito; Yano, Aya; Tsukamoto, Kiyoshi; Matsubara, Nagahide; Tomita, Naohiro

    2015-01-01

    Extramural tumor deposits (TDs) and extracapsular lymph node involvement (ECLNI) are considered to be poor prognostic factors in patients with T3–4, N0–2, M0 colorectal cancer (CRC). Although TDs are known to have multiple origins and pleomorphic features, the prognostic significances of the different type of TDs have not yet been established. We performed a retrospective review of 385 consecutive patients with T3–4, N0–2, M0 CRC who received curative resection at our institution between 2006 and 2012. We classified the TDs into two groups: invasive-type TD (iTD), which is characterized by the presence of lymphatic invasion, vascular invasion, perineural invasion, or undefined cancer cell clusters and nodular-type TD (nTD), which is characterized by a smooth or irregular-shaped tumor nodule other than an iTD. ECLNI was defined as invasion of cancer cells into capsular collagen tissues or adipose tissues beyond the capsular collagen. Multivariate analyses were used to assess the prognostic significance of iTD, ND, and ECLNI for relapse-free survival (RFS), disease-specific survival (DSS), and sites of recurrence. In patients without lymph node (LN) metastasis, the incidences of iTD and nTD were both in the range of 2–3 %. Conversely, in patients with LN metastasis, the incidences of iTD, nTD, and ECLNI were 31, 22, and 34 %, respectively. iTD, nTD, and ECLNI were all significant independent adverse factors for RFS in rectal cancer, and were all associated with pT, pN, and LN ratio. iTD was a significant independent adverse prognostic factor for DSS in rectal cancer, metastasis to the liver in colorectal cancer, and distant LN metastasis in colon cancer. ECLNI was a significant independent prognostic factor for RFS in colon cancer. Classifying TDs and assessing ECLNI may help establish significant prognostic factors for patients with T3–4, N0–2, M0 CRC

  4. Comparison of the methods for tissue triiodothyronine T(3) extraction and subsequent radioimmunoassay

    International Nuclear Information System (INIS)

    Takaishi, M.; Miyachi, Y.; Aoki, M.; Shishiba, Y.; Asahi Life Foundation, Tokyo

    1978-01-01

    Although there have been various reports on tissue T 3 concentration, the examination of the quality of radioimmunoassay has not been available. In the present study, we tried to determine whether the available methods for T 3 extraction are adequate for the various methods of T 3 radioimmunoassays used. T 3 was extracted from liver by ethanol extraction or by acid butanol extraction (Flock's method) and the extract was applied to radioimmunoassay either by Seralute T 3 column, ANS-double antibody or the ANS-charcoal method. The values of T 3 were compared with those obtained by isotope-equilibration method. The dilution curve of ethanol extract was not parallel with that of the standard in ANS-charcoal or ANS-double antibody technique. When the extract was tested by Seralate method, the dilution curve was parallel to the standard, whereas the T 3 value obtained with this method was two-fold higher than that with the isotope equilibration technique. The analysis of the ethanol extract suggested that the lipid extracted by ethanol interfered with the assay. The acid butanol extract when tested either by the ANS-double antibody or Seralate method, showed parallelism to the standard curve and gave T 3 values almost identical with those by the isotope-equilibration method. When tested by ANS-charcoal method, the dilution curve of the acid butanol extract was not parallel to the standard. Thus, to obtain reliable results, tissue extraction by Flock's method and subsequent T 3 radioimmunoassay by either ANS-double antibody or Seralate T 3 method are recommended. (author)

  5. The use of PET in assessing tumor response after neoadjuvant chemoradiation for rectal cancer

    International Nuclear Information System (INIS)

    Mak, Daisy; Joon, Daryl Lim; Chao, Michael; Wada, Morikatsu; Joon, Michael Lim; See, Andrew; Feigen, Malcolm; Jenkins, Patricia; Mercuri, Angelina; McNamara, Joanne; Poon, Aurora; Khoo, Vincent

    2010-01-01

    Purpose: To assess the correlation of 18F-FDG-PET (PET) response to pathological response after neoadjuvant chemoradiation (CRT) for locally advanced rectal cancer. Methods and materials: Twenty patients with locally advanced rectal cancer were identified between 2001 and 2005. The median age was 57 years (range 37-72) with 14 males and 6 females. All patients were staged with endorectal ultrasound and/or MRI, CT, and PET. The clinical staging was T3N0M0 (16), T3N1M0 (2), and T3N0M1 (2). Restaging PET was performed after CRT, and prior to definitive surgery. The response on PET and pathology was assessed and correlated. Patient outcome according to PET response was also assessed. Results: Following CRT, a complete PET response occurred in 7 patients, incomplete response in 10, and no response in 3 patients. At surgery, complete pathological response was recorded in 7 patients, incomplete response in 10 and no response in 3. There was a good correlation of PET and pathological responses in complete responders (5/7 cases) and non-responders (3/3 cases). After a median follow-up of 62 months (range 7-73), twelve patients were alive with no evidence of disease. All patients achieving complete metabolic response were alive with no evidence of disease, while as those who had no metabolic response, all died as a result of metastatic disease. Conclusions: PET is a promising complementary assessment tool for assessing tumor response after CRT if there is a complete or no response. PET response may also predict for outcome.

  6. Phase II Study of Preoperative Helical Tomotherapy With a Simultaneous Integrated Boost for Rectal Cancer

    International Nuclear Information System (INIS)

    Engels, Benedikt; Tournel, Koen; Everaert, Hendrik; Hoorens, Anne; Sermeus, Alexandra; Christian, Nicolas; Storme, Guy; Verellen, Dirk; De Ridder, Mark

    2012-01-01

    Purpose: The addition of concomitant chemotherapy to preoperative radiotherapy is considered the standard of care for patients with cT3–4 rectal cancer. The combined treatment modality increases the complete response rate and local control (LC), but has no impact on survival or the incidence of distant metastases. In addition, it is associated with considerable toxicity. As an alternative strategy, we explored prospectively, preoperative helical tomotherapy with a simultaneous integrated boost (SIB). Methods and Materials: A total of 108 patients were treated with intensity-modulated and image-guided radiotherapy using the Tomotherapy Hi-Art II system. A dose of 46 Gy, in daily fractions of 2 Gy, was delivered to the mesorectum and draining lymph nodes, without concomitant chemotherapy. Patients with an anticipated circumferential resection margin (CRM) of less than 2 mm, based on magnetic resonance imaging, received a SIB to the tumor up to a total dose of 55.2 Gy. Acute and late side effects were scored using the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. Results: A total of 102 patients presented with cT3–4 tumors; 57 patients entered the boost group and 51 the no-boost group. One patient in the no-boost group developed a radio-hypersensitivity reaction, resulting in a complete tumor remission, a Grade 3 acute and Grade 5 late enteritis. No other Grade ≥3 acute toxicities occurred. With a median follow-up of 32 months, Grade ≥3 late gastrointestinal and urinary toxicity were observed in 6% and 4% of the patients, respectively. The actuarial 2-year LC, progression-free survival and overall survival were 98%, 79%, and 93%. Conclusions: Preoperative helical tomotherapy displays a favorable acute toxicity profile in patients with cT3–4 rectal cancer. A SIB can be safely administered in patients with a narrow CRM and resulted in a promising LC.

  7. Laparoscopic excision of a newborn rectal duplication cyst.

    Science.gov (United States)

    Hartin, Charles W; Lau, Stanley T; Escobar, Mauricio A; Glick, Philip L

    2008-08-01

    Congenital rectal duplication cyst is a rare entity treated with surgical excision. Without treatment, a rectal duplication cyst may cause a variety of complications, most notably, transforming into a malignancy. We report on a 7-week-old girl who was found to have a rectal duplication cyst. The rectal duplication cyst was successfully excised laparoscopically. Rectal duplication cysts are rare alimentary tract anomalies generally discovered during childhood. Complications include symptoms arising from the cyst and the possibility of malignant degeneration. They are typically managed by surgical excision.

  8. Stapled transanal rectal resection in solitary rectal ulcer associated with prolapse of the rectum: a prospective study.

    Science.gov (United States)

    Boccasanta, Paolo; Venturi, Marco; Calabro, Giuseppe; Maciocco, Marco; Roviaro, Gian Carlo

    2008-03-01

    At present, none of the conventional surgical treatments of solitary rectal ulcer associated with internal rectal prolapse seems to be satisfactory because of the high incidence of recurrence. The stapled transanal rectal resection has been demonstrated to successfully cure patients with internal rectal prolapse associated with rectocele, or prolapsed hemorrhoids. This prospective study was designed to evaluate the short-term and long-term results of stapled transanal rectal resection in patients affected by solitary rectal ulcer associated with internal rectal prolapse and nonresponders to biofeedback therapy. Fourteen patients were selected on the basis of validated constipation and continence scorings, clinical examination, anorectal manometry, defecography, and colonoscopy and were submitted to biofeedback therapy. Ten nonresponders were operated on and followed up with incidence of failure, defined as no improvement of symptoms and/or recurrence of rectal ulceration, as the primary outcome measure. Operative time, hospital stay, postoperative pain, time to return to normal activity, overall patient satisfaction index, and presence of residual rectal prolapse also were evaluated. At a mean follow-up of 27.2 (range, 24-34) months, symptoms significantly improved, with 80 percent of excellent/good results and none of the ten operated patients showed a recurrence of rectal ulcer. Operative time, hospital stay, and time to return to normal activity were similar to those reported after stapled transanal rectal resection for obstructed defecation, whereas postoperative pain was slightly higher. One patient complained of perineal abscess, requiring surgery. The stapled transanal rectal resection is safe and effective in the cure of solitary rectal ulcer associated with internal rectal prolapse, with minimal complications and no recurrences after two years. Randomized trials with sufficient number of patients are necessary to compare the efficacy of stapled transanal

  9. Effect of rectal enemas on rectal dosimetric parameters during high-dose-rate vaginal cuff brachytherapy. A prospective trial

    International Nuclear Information System (INIS)

    Sabater, Sebastia; Andres, Ignacio; Sevillano, Marimar; Berenguer, Roberto; Aguayo, Manuel; Villas, Maria Victoria; Gascon, Marina; Arenas, Meritxell; Rovirosa, Angeles; Camacho-Lopez, Cristina

    2016-01-01

    To evaluate the effects of rectal enemas on rectal doses during postoperative high-dose-rate (HDR) vaginal cuff brachytherapy (VCB). This prospective trial included 59 patients. Two rectal cleansing enemas were self-administered before the second fraction, and fraction 1 was considered the basal status. Dose-volume histogram (DVH) values were generated for the rectum and correlated with rectal volume variation. Statistical analyses used paired and unpaired t-tests. Despite a significant 15 % reduction in mean rectal volume (44.07 vs. 52.15 cc, p = 0.0018), 35.6 % of patients had larger rectums after rectal enemas. No significant rectal enema-related DVH differences were observed compared to the basal data. Although not statistically significant, rectal cleansing-associated increases in mean rectal DVH values were observed: D 0.1 cc : 6.6 vs. 7.21 Gy; D 1 cc : 5.35 vs. 5.52 Gy; D 2 cc : 4.67 vs. 4.72 Gy, before and after rectal cleaning, respectively (where D x cc is the dose to the most exposed x cm 3 ). No differences were observed in DVH parameters according to rectal volume increase or decrease after the enema. Patients whose rectal volume increased also had significantly larger DVH parameters, except for D 5 % , D 25 % , and D 50 % . In contrast, in patients whose rectal volume decreased, significance was only seen for D 25 % and D 50 % (D x % dose covering x % of the volume). In the latter patients, nonsignificant reductions in D 2 cc , D 5 cc and V 5 Gy (volume receiving at least 5 Gy) were observed. The current rectal enemas protocol was ineffective in significantly modifying rectal DVH parameters for HDR-VCB. (orig.) [de

  10. Massive rectal bleeding from colonic diverticulosis

    African Journals Online (AJOL)

    ABEOLUGBENGAS

    Rapport De Cas: Nous mettons un cas d'un homme de 79 ans quiàprésente une hémorragie rectal massive ... cause of overt lower gastrointestinal (GI) ... vessels into the intestinal lumen results in ... placed on a high fibre diet, and intravenous.

  11. Rectal Lipoma Associated with Genital Prolapse

    African Journals Online (AJOL)

    female genital prolapse. In the present case, as the patient is post‑menopausal and with co‑existing partial rectal prolapse, vaginal hysterectomy was carried out. Diagnostic approaches usually include endoscopy, contrast‑enhanced CT scan of the abdomen, and barium enema. Endoscopic biopsies usually fail to diagnose ...

  12. Management of synchronous rectal and prostate cancer.

    LENUS (Irish Health Repository)

    Kavanagh, D O

    2012-11-01

    Although well described, there is limited published data related to management on the coexistence of prostate and rectal cancer. The aim of this study was to describe a single institution\\'s experience with this and propose a treatment algorithm based on the best available evidence.

  13. Current management of locally recurrent rectal cancer

    DEFF Research Database (Denmark)

    Nielsen, Mette Bak; Laurberg, Søren; Holm, Thorbjörn

    2011-01-01

    ABSTRACT Objective: A review of the literature was undertaken to provide an overview of the surgical management of locally recurrent rectal cancer (LRRC) after the introduction of total mesorectal excision (TME). Method: A systematic literature search was undertaken using PubMed, Embase, Web...

  14. [Severe vaginal discharge following rectal surgery

    NARCIS (Netherlands)

    Burg, L.C.; Bremers, A.J.A.; Heesakkers, J.P.; Kluivers, K.B.

    2018-01-01

    BACKGROUND: Almost 50% of women who have had rectal surgery subsequently develop vaginal discharge. Due to the recurrent and unexpected nature of this heavy discharge, they often experience it as very distressing. Many of these women undergo extensive diagnostic tests that are mainly focused on

  15. T3SEdb: data warehousing of virulence effectors secreted by the bacterial Type III Secretion System.

    Science.gov (United States)

    Tay, Daniel Ming Ming; Govindarajan, Kunde Ramamoorthy; Khan, Asif M; Ong, Terenze Yao Rui; Samad, Hanif M; Soh, Wei Wei; Tong, Minyan; Zhang, Fan; Tan, Tin Wee

    2010-10-15

    Effectors of Type III Secretion System (T3SS) play a pivotal role in establishing and maintaining pathogenicity in the host and therefore the identification of these effectors is important in understanding virulence. However, the effectors display high level of sequence diversity, therefore making the identification a difficult process. There is a need to collate and annotate existing effector sequences in public databases to enable systematic analyses of these sequences for development of models for screening and selection of putative novel effectors from bacterial genomes that can be validated by a smaller number of key experiments. Herein, we present T3SEdb http://effectors.bic.nus.edu.sg/T3SEdb, a specialized database of annotated T3SS effector (T3SE) sequences containing 1089 records from 46 bacterial species compiled from the literature and public protein databases. Procedures have been defined for i) comprehensive annotation of experimental status of effectors, ii) submission and curation review of records by users of the database, and iii) the regular update of T3SEdb existing and new records. Keyword fielded and sequence searches (BLAST, regular expression) are supported for both experimentally verified and hypothetical T3SEs. More than 171 clusters of T3SEs were detected based on sequence identity comparisons (intra-cluster difference up to ~60%). Owing to this high level of sequence diversity of T3SEs, the T3SEdb provides a large number of experimentally known effector sequences with wide species representation for creation of effector predictors. We created a reliable effector prediction tool, integrated into the database, to demonstrate the application of the database for such endeavours. T3SEdb is the first specialised database reported for T3SS effectors, enriched with manual annotations that facilitated systematic construction of a reliable prediction model for identification of novel effectors. The T3SEdb represents a platform for inclusion of

  16. T3SEdb: data warehousing of virulence effectors secreted by the bacterial Type III Secretion System

    Directory of Open Access Journals (Sweden)

    Tong Minyan

    2010-10-01

    Full Text Available Abstract Background Effectors of Type III Secretion System (T3SS play a pivotal role in establishing and maintaining pathogenicity in the host and therefore the identification of these effectors is important in understanding virulence. However, the effectors display high level of sequence diversity, therefore making the identification a difficult process. There is a need to collate and annotate existing effector sequences in public databases to enable systematic analyses of these sequences for development of models for screening and selection of putative novel effectors from bacterial genomes that can be validated by a smaller number of key experiments. Results Herein, we present T3SEdb http://effectors.bic.nus.edu.sg/T3SEdb, a specialized database of annotated T3SS effector (T3SE sequences containing 1089 records from 46 bacterial species compiled from the literature and public protein databases. Procedures have been defined for i comprehensive annotation of experimental status of effectors, ii submission and curation review of records by users of the database, and iii the regular update of T3SEdb existing and new records. Keyword fielded and sequence searches (BLAST, regular expression are supported for both experimentally verified and hypothetical T3SEs. More than 171 clusters of T3SEs were detected based on sequence identity comparisons (intra-cluster difference up to ~60%. Owing to this high level of sequence diversity of T3SEs, the T3SEdb provides a large number of experimentally known effector sequences with wide species representation for creation of effector predictors. We created a reliable effector prediction tool, integrated into the database, to demonstrate the application of the database for such endeavours. Conclusions T3SEdb is the first specialised database reported for T3SS effectors, enriched with manual annotations that facilitated systematic construction of a reliable prediction model for identification of novel effectors

  17. Rectal hydrocortisone during vomiting in children with adrenal insufficiency.

    Science.gov (United States)

    Ní Chróinín, M; Fallon, M; Kenny, D; Moriarty, S; Hoey, H; Costigan, C

    2003-01-01

    To evaluate rectal hydrocortisone as an emergency glucocorticoid replacement therapy in adrenal insufficient children. A parental questionnaire evaluated preferred treatment, problems or benefits of i.m. and rectal hydrocortisone, frequency and indications for administration and who administered treatment. Admissions of children with adrenal insufficiency were monitored. There were 39/52 families who responded to the questionnaire. 93% (26/28) preferred rectal hydrocortisone. Parents or children who previously received emergency treatment from a doctor now self-administered rectal hydrocortisone. The cost of suppositories and i.m. hydrocortisone is similar; however, storage of suppositories was inconvenient. One girl presented with pneumonia and collapse despite rectal hydrocortisone and a hydrocortisone level at admission of >2000 nmol/l with normal electrolytes. Rectal hydrocortisone is an acceptable and safe emergency therapy. We still advise i.m. hydrocortisone if rectal administration is not possible or with suppository extrusion.

  18. MRI in staging of rectal carcinoma

    International Nuclear Information System (INIS)

    Gourtsoyianni, S.

    2012-01-01

    Full text: MRI of the rectum is performed for initial local staging of primary rectal cancer in order to identify locally advanced rectal cancers and for assessment of treatment response after completion of neoadjuvant therapy. Introduction of new generation MRI scanners with optimal phased array body coils, resulting in improved contrast and spatial resolution images due to better signal to noise ratio, have contributed to production of high resolution images in which visualization of anatomical details such as the mesorectal fascia and the bowel wall layers are feasible. Pre-operative MRI of the rectum using mainly high resolution T2 weighted sequences has gained significant accreditation, especially after the introduction of total mesorectal excision (TME) surgery and neoadjuvant therapy in the treatment regimen of rectal cancer. MR Imaging is so far the only method that can preoperatively identify patients most likely to benefit from neoadjuvant therapy as well as demonstrate high risk patients for local recurrence. Regarding N stage besides of mesorectal lymph nodes which are removed during TME, especially in case of low lying rectal cancers, MRI may provide information regarding external/internal iliac lymph node involvement. High resolution MRI images may demonstrate lymph nodes with a diameter down to 2 mm, however these are still characterized based on their morphological features. Patients identified at initial MRI staging as having locally advanced rectal cancer undergo neoadjuvant chemoradiation therapy (CRT) in order for their tumor to be downsized and downstaged, especially in low rectal cancers so that sphincter sparing surgery may be performed. In 15-30% of patients complete pathological response is achieved. Reimaging with MRI at 6 weeks post treatment is of great importance for assessing tumor response. Conventional MRI has a reported moderate accuracy for prediction of mesorectal fascia (MF) involvement after CRT therapy, mainly due to its

  19. Prediction of pathologic staging with magnetic resonance imaging after preoperative chemoradiotherapy in rectal cancer: pooled analysis of KROG 10-01 and 11-02.

    Science.gov (United States)

    Lee, Jong Hoon; Jang, Hong Seok; Kim, Jun-Gi; Lee, Myung Ah; Kim, Dae Yong; Kim, Tae Hyun; Oh, Jae Hwan; Park, Sung Chan; Kim, Sun Young; Baek, Ji Yeon; Park, Hee Chul; Kim, Hee Cheol; Nam, Taek-Keun; Chie, Eui Kyu; Jung, Ji-Han; Oh, Seong Taek

    2014-10-01

    The reported overall accuracy of MRI in predicting the pathologic stage of nonirradiated rectal cancer is high. However, the role of MRI in restaging rectal tumors after neoadjuvant CRT is contentious. Thus, we evaluate the accuracy of restaging magnetic resonance imaging (MRI) for rectal cancer patients who receive preoperative chemoradiotherapy (CRT). We analyzed 150 patients with locally advanced rectal cancer (T3-4N0-2) who had received preoperative CRT. Pre-CRT MRI was performed for local tumor and nodal staging. All patients underwent restaging MRI followed by total mesorectal excision after the end of radiotherapy. The primary endpoint of the present study was to estimate the accuracy of post-CRT MRI as compared with pathologic staging. Pathologic T classification matched the post-CRT MRI findings in 97 (64.7%) of 150 patients. 36 (24.0%) of 150 patients were overstaged in T classification, and the concordance degree was moderate (k=0.33, prectal cancer patients who received preoperative CRT. The diagnostic accuracy of restaging MRI is relatively high in rectal cancer patients who achieved clinical downstaging after CRT. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Induction and prevention of low-T3 syndrome in exercising women.

    Science.gov (United States)

    Loucks, A B; Callister, R

    1993-05-01

    To investigate the influence of exercise on thyroid metabolism, 46 healthy young regularly menstruating sedentary women were randomly assigned to a 3 x 2 experimental design of aerobic exercise and energy availability treatments. Energy availability was defined as dietary energy intake minus energy expenditure during exercise. After 4 days of treatments, low energy availability (8 vs. 30 kcal.kg body wt-1.day-1) had reduced 3,5,3'-triiodothyronine (T3) by 15% and free T3 (fT3) by 18% and had increased thyroxine (T4) by 7% and reverse T3 (rT3) by 24% (all P Exercise quantity (0 vs. 1,300 kcal/day) and intensity (40 vs. 70% of aerobic capacity) did not affect any thyroid hormone (all P > 0.10). That is, low-T3 syndrome was induced by the energy cost of exercise and was prevented in exercising women by increasing dietary energy intake. Selective observation of low-T3 syndrome in amenorrheic and not in regularly menstruating athletes suggests that exercise may compromise the availability of energy for reproductive function in humans. If so, athletic amenorrhea might be prevented or reversed through dietary reform without reducing exercise quantity or intensity.

  1. Triiodothyronine (T3)-associated upregulation and downregulation of nuclear T3 binding in the human fibroblast cell (MRC-5)--stimulation of malic enzyme, glucose-6-phosphate-dehydrogenase, and 6-phosphogluconate-dehydrogenase by insulin, but not by T3

    DEFF Research Database (Denmark)

    Matzen, L E; Kristensen, S R; Kvetny, J

    1991-01-01

    The specific nuclear binding of triiodothyronine (T3) (NBT3) and the activity of malic enzyme (ME), glucose-6-phosphate-dehydrogenase (G6PD), and 6-phosphogluconate-dehydrogenase (6PGD) were studied in the human fibroblast cell (MRC-5). The overall apparent binding affinity (Ka) was 2.7 x 10(9) L.......mol-1 estimated from kinetic studies of nuclear T3 binding, and 2.5 x 10(9) L.mol-1 estimated from equilibrium studies. The scatchard plots were curvilinear and composed of a high-affinity binding site with Ka1 3.4 +/- 0.7 x 10(9) L.mol-1 and maximal binding capacity (MBC) MBC1 57.0 +/- 11.9 fmol/mg DNA...... and a low-affinity binding site with Ka2 2.9 +/- 1.1 x 10(8) L.mol-1 and MBC2 124.7 +/- 22.1 fmol/mg DNA (n = 6). Incubation of cells with 6 nmol/L T3 for 20 hours reduced NBT3 to 62.2% +/- 15.7% (P less than .01, n = 11). The Ka estimated from kinetic studies was reduced to 6.7 x 10(7) L.mol-1...

  2. Active form Notch4 promotes the proliferation and differentiation of 3T3-L1 preadipocytes

    Energy Technology Data Exchange (ETDEWEB)

    Lai, Peng-Yeh [Institute of Molecular Biology and Department of Life Science, National Chung Cheng University, Chiayi 621, Taiwan, ROC (China); Tsai, Chong-Bin [Institute of Molecular Biology and Department of Life Science, National Chung Cheng University, Chiayi 621, Taiwan, ROC (China); Department of Ophthalmology, Chiayi Christian Hospital, Chiayi 600, Taiwan, ROC (China); Tseng, Min-Jen, E-mail: biomjt@ccu.edu.tw [Institute of Molecular Biology and Department of Life Science, National Chung Cheng University, Chiayi 621, Taiwan, ROC (China)

    2013-01-18

    Highlights: ► Notch4IC modulates the ERK pathway and cell cycle to promote 3T3-L1 proliferation. ► Notch4IC facilitates 3T3-L1 differentiation by up-regulating proadipogenic genes. ► Notch4IC promotes proliferation during the early stage of 3T3-L1 adipogenesis. ► Notch4IC enhances differentiation during subsequent stages of 3T3-L1 adipogenesis. -- Abstract: Adipose tissue is composed of adipocytes, which differentiate from precursor cells in a process called adipogenesis. Many signal molecules are involved in the transcriptional control of adipogenesis, including the Notch pathway. Previous adipogenic studies of Notch have focused on Notch1 and HES1; however, the role of other Notch receptors in adipogenesis remains unclear. Q-RT-PCR analyses showed that the augmentation of Notch4 expression during the differentiation of 3T3-L1 preadipocytes was comparable to that of Notch1. To elucidate the role of Notch4 in adipogenesis, the human active form Notch4 (N4IC) was transiently transfected into 3T3-L1 cells. The expression of HES1, Hey1, C/EBPδ and PPARγ was up-regulated, and the expression of Pref-1, an adipogenic inhibitor, was down-regulated. To further characterize the effect of N4IC in adipogenesis, stable cells expressing human N4IC were established. The expression of N4IC promoted proliferation and enhanced differentiation of 3T3-L1 cells compared with those of control cells. These data suggest that N4IC promoted proliferation through modulating the ERK pathway and the cell cycle during the early stage of 3T3-L1 adipogenesis and facilitated differentiation through up-regulating adipogenic genes such as C/EBPα, PPARγ, aP2, LPL and HSL during the middle and late stages of 3T3-L1 adipogenesis.

  3. TRH and T3 suppression tests after 131I therapy of thyrotoxicosis

    International Nuclear Information System (INIS)

    Tamai, Hajime; Tsushimi, Takashi; Shizume, Kazuo; Kuma, Kanji; Suematsu, Hiroyuki.

    1976-01-01

    TRH and T 3 suppression tests were performed on patients (124 cases) with Graves' disease who underwent radiotherapy. TRH test was performed at 4 - 6 months (Group I), 6 - 12 months (Group II), 12 - 24 months (Group III) and 24 - 50 months (Group IV) after final radiotherapy, and T 3 suppression test was performed just after each TRH test. Among 124 patients in Group I to IV who were clinically euthyroid and whose T 3 -RU and T 4 values were normal, compared with other groups, Group IV (2 - 4.2 Y) showed a significantly higher percentage of positive responses to both TRH and T 3 suppression tests. However, among 49 of 124 patients whose T 3 was also normal, there were no significant differences between the groups. The value of triiodothyronine was above the normal range in many cases up to 2 years after radiotherapy (in Group I, II, III). There were no significant differences in the percentage of hyperresponses between any of the four groups. Half of the patients who showed positive responses to TRH test showed exaggerated responses. In all cases when the responses to TRH and T 3 suppression tests changed from negative to positive, thyroxine and triiodothyronine concentrations must be within the normal range. In particular, the major determinant seems to be the value of triiodothyronine. As in more than 30% of cases TRH and T 3 suppression tests remained negative even though their T 3 -RU, T 4 , T 3 , values became normal after radiotherapy, the regulation of hypothalamo-hypophyseal thyroid axis do not always return to normal even though circulating thyroidal hormone level return to an euthyroid state. (J.P.N.)

  4. Modelling the variation in rectal dose due to inter-fraction rectal wall deformation in external beam prostate treatments

    International Nuclear Information System (INIS)

    Booth, Jeremy; Zavgorodni, Sergei

    2005-01-01

    Prostate radiotherapy inevitably deposits radiation dose in the rectal wall, and the dose delivered to prostate is limited by the expected rectal complications. Accurate evaluation of the rectal dose is non-trivial due to a number of factors. One of these is variation of the shape and position of the rectal wall (with respect to the clinical target volume (CTV)), which may differ daily from that taken during planning CT acquisition. This study uses data currently available in the literature on rectal wall motion to provide estimates of mean population rectal wall dose. The rectal wall geometry is characterized by a population mean radius of the rectum as well as inter-patient and inter-fraction standard deviations in rectum radius. The model is used to evaluate the range of inter-fraction and inter-patient rectal dose variations. The simulation of individual patients with full and empty rectum in the planning CT scan showed that large variations in rectal dose (>15 Gy) are possible. Mean calculated dose accounting for treatment and planning uncertainties in the rectal wall surface was calculated as well as the map of planning dose over/underpredictions. It was found that accuracy of planning dose is dependent on the CTV-PTV margin size with larger margins producing more accurate estimates. Over a patient population, the variation in rectal dose is reduced by increasing the number of pre-treatment CT scans

  5. Radioimmunoassay for measurement of thyroxine (T4) and triiodothyonine (T3) in blood serum

    International Nuclear Information System (INIS)

    Chopra, I.J.

    1975-01-01

    This invention relates to a highly accurate, rapid and simple estimation of thyroxine (T 4 ) directly from blood serum and also relates to the accurate measurement of triiodo-L-thyronine (T 3 ) directly from blood serum. More specifically, the invention relates to a rapid, specific and reliable radioimmunoassay (RIA) technique for measurement of both T 4 and T 3 in unextracted serum. The method requires very small amounts of serum, e.g., 25 microliters (μl) to measure T 4 concentration in nearly all specimens representing clinical states of eu-, hypo- and hyperthyroidism, and 250 μl to measure T 3 concentrations in specimens representing most clinical states

  6. Preoperative hyperfractionated radiotherapy for locally advanced rectal cancers: a phase I-II trial

    International Nuclear Information System (INIS)

    Allal, Abdelkarim S.; Bieri, Sabine; Bruendler, Marie-Anne; Soravia, Claudio; Gertsch, Philippe; Bernier, Jacques; Morel, Philippe; Roth, Arnaud D.

    2002-01-01

    Purpose: To assess the toxicity, pathologic response rates, type of surgery, and oncologic results in a prospective Phase I-II trial using pure hyperfractionated radiotherapy (RT) preoperatively in locally advanced rectal cancer. Methods and Materials: Between September 1997 and April 2000, 50 patients with T3-T4 or N1 rectal cancers were treated preoperatively with 50 Gy (45 Gy to the pelvis and a 5-Gy tumor boost) in 40 fractions of 1.25 Gy during 4 weeks. The pretreatment tumor stage as determined by CT and endorectal ultrasonography (80% of patients) included 1 Stage T2 (2%), 45 T3 (90%), and 4 T4 (8%). Nodal involvement (N1) was documented in 26 patients (52%). Surgery was performed at a median interval of 45 days (range 26-114 days) after RT completion. Seventeen patients who presented with pT4 or pN1 and/or pM1 received 5-fluorouracil-based chemotherapy postoperatively. Results: All patients completed the RT schedule as planned. Severe acute toxicities included two Grade 3 skin reactions (4%) that did not require a break. The other acute toxicities were Grade 2 or less (skin, diarrhea, urinary, rectal tenesmus, and fatigue). A complete pathologic response was observed in 7 patients (14%), and microscopic residual cancer was found in 10 (20%). Of the 20 patients presenting with tumor located ≤6 cm from the anal verge, sphincter-saving surgery was performed in 14 (70%). At 3 years, the actuarial locoregional control rate was 90.5%, and the disease-free survival rate was 74.6%. At a median follow-up of 32 months, 4 patients (8%) presented with severe late complications (Grade 3-4) that might have been RT related (one rectovaginal fistula, two chronic perineal fistulas, and one bilateral ureteral stenosis). Conclusion: In locally advanced rectal cancer, preoperative hyperfractionated RT to a total dose of 50 Gy is feasible, with acceptable acute and late toxicity and an objective downstaging effect. In view of these results, this schedule might be used as a

  7. Changes in Treatment Volume of Hormonally Treated and Untreated Cancerous Prostate and its Impact on Rectal Dose

    International Nuclear Information System (INIS)

    Lilleby, Wolfgang; Dale, Einar; Olsen, Dag R.; Gude, Unn; Fossaa, Sophie D.

    2003-01-01

    Late chronic side effects of the rectum constitute one of the principal limiting factors for curative radiation therapy in patients with prostate cancer. The purpose of the study was to determine the impact of immediate androgen deprivation (IAD) prior to conformal radiotherapy on rectal volume exposed to high doses, as compared with a deferred treatment strategy (DAD). Twenty-five patients (13 in the IAD group and 12 in the DAD group) with bulky tumours of the prostate, T3pN1-2M0 from the prospective EORTC trial 30846 were analysed. Three-dimensional conformal radiation treatment plans (3D CRT) using a 4-field box technique were generated based on the digitized computed tomographic or magnetic resonance findings acquired during the first 9 months after inclusion in the EORTC trial. Dose-volume histograms (DVHs) were calculated for the prostate and rectum. In the DAD group, there was no obvious alteration in the mean size of the prostate or other evaluated structures. In the IAD patients, a statistically significant reduction of approximately 40% of the gross tumour volume (GTV) was reached after a 6 months' course of hormonal treatment (p<0.001). High-dose rectal volume was correlated with the volume changes of the GTV (p<0.001). Mean rectal volume receiving 95% or more of the target dose was significantly reduced by 20%. Our study confirms the effect of downsizing of locally advanced prostate tumours following AD treatment and demonstrates the interdependence of the high-dose rectal volume with the volume changes of the GTV. However, the mean beneficial sparing of rectal volume was outweighed in some patients by considerable inter-patient variations

  8. Accuracy of High-Resolution MRI with Lumen Distention in Rectal Cancer Staging and Circumferential Margin Involvement Prediction

    International Nuclear Information System (INIS)

    Iannicelli, Elsa; Di Renzo, Sara; Ferri, Mario; Pilozzi, Emanuela; Di Girolamo, Marco; Sapori, Alessandra; Ziparo, Vincenzo; David, Vincenzo

    2014-01-01

    To evaluate the accuracy of magnetic resonance imaging (MRI) with lumen distention for rectal cancer staging and circumferential resection margin (CRM) involvement prediction. Seventy-three patients with primary rectal cancer underwent high-resolution MRI with a phased-array coil performed using 60-80 mL room air rectal distention, 1-3 weeks before surgery. MRI results were compared to postoperative histopathological findings. The overall MRI T staging accuracy was calculated. CRM involvement prediction and the N staging, the accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were assessed for each T stage. The agreement between MRI and histological results was assessed using weighted-kappa statistics. The overall MRI accuracy for T staging was 93.6% (k = 0.85). The accuracy, sensitivity, specificity, PPV and NPV for each T stage were as follows: 91.8%, 86.2%, 95.5%, 92.6% and 91.3% for the group ≤ T2; 90.4%, 94.6%, 86.1%, 87.5% and 94% for T3; 98,6%, 85.7%, 100%, 100% and 98.5% for T4, respectively. The predictive CRM accuracy was 94.5% (k = 0.86); the sensitivity, specificity, PPV and NPV were 89.5%, 96.3%, 89.5%, and 96.3% respectively. The N staging accuracy was 68.49% (k = 0.4). MRI performed with rectal lumen distention has proved to be an effective technique both for rectal cancer staging and involved CRM predicting

  9. Accuracy of High-Resolution MRI with Lumen Distention in Rectal Cancer Staging and Circumferential Margin Involvement Prediction

    Energy Technology Data Exchange (ETDEWEB)

    Iannicelli, Elsa; Di Renzo, Sara [Radiology Institute, Faculty of Medicine and Psychology, University of Rome, Sapienza, Sant' Andrea Hospital, Rome 00189 (Italy); Department of Surgical and Medical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University of Rome, Sapienza, Sant' Andrea Hospital, Rome 00189 (Italy); Ferri, Mario [Department of Surgical and Medical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University of Rome, Sapienza, Sant' Andrea Hospital, Rome 00189 (Italy); Pilozzi, Emanuela [Department of Clinical and Molecular Sciences, Faculty of Medicine and Psychology, University of Rome, Sapienza, Sant' Andrea Hospital, Rome 00189 (Italy); Di Girolamo, Marco; Sapori, Alessandra [Radiology Institute, Faculty of Medicine and Psychology, University of Rome, Sapienza, Sant' Andrea Hospital, Rome 00189 (Italy); Department of Surgical and Medical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University of Rome, Sapienza, Sant' Andrea Hospital, Rome 00189 (Italy); Ziparo, Vincenzo [Department of Surgical and Medical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University of Rome, Sapienza, Sant' Andrea Hospital, Rome 00189 (Italy); David, Vincenzo [Radiology Institute, Faculty of Medicine and Psychology, University of Rome, Sapienza, Sant' Andrea Hospital, Rome 00189 (Italy); Department of Surgical and Medical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University of Rome, Sapienza, Sant' Andrea Hospital, Rome 00189 (Italy)

    2014-07-01

    To evaluate the accuracy of magnetic resonance imaging (MRI) with lumen distention for rectal cancer staging and circumferential resection margin (CRM) involvement prediction. Seventy-three patients with primary rectal cancer underwent high-resolution MRI with a phased-array coil performed using 60-80 mL room air rectal distention, 1-3 weeks before surgery. MRI results were compared to postoperative histopathological findings. The overall MRI T staging accuracy was calculated. CRM involvement prediction and the N staging, the accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were assessed for each T stage. The agreement between MRI and histological results was assessed using weighted-kappa statistics. The overall MRI accuracy for T staging was 93.6% (k = 0.85). The accuracy, sensitivity, specificity, PPV and NPV for each T stage were as follows: 91.8%, 86.2%, 95.5%, 92.6% and 91.3% for the group ≤ T2; 90.4%, 94.6%, 86.1%, 87.5% and 94% for T3; 98,6%, 85.7%, 100%, 100% and 98.5% for T4, respectively. The predictive CRM accuracy was 94.5% (k = 0.86); the sensitivity, specificity, PPV and NPV were 89.5%, 96.3%, 89.5%, and 96.3% respectively. The N staging accuracy was 68.49% (k = 0.4). MRI performed with rectal lumen distention has proved to be an effective technique both for rectal cancer staging and involved CRM predicting.

  10. Gadolinium-enhanced dynamic magnetic resonance imaging with endorectal coil for local staging of rectal cancer

    International Nuclear Information System (INIS)

    Tamakawa, Mitsuharu; Kawaai, Yuriko; Shirase, Ryuji

    2010-01-01

    The aim of this study was to evaluate the accuracy of dynamic gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) with endorectal coil for assessing tumor invasion based on simple classification criteria. A total of 58 patients with operable primary rectal cancer underwent preoperative MRI. An enhancement pattern in Gd-enhanced dynamic MRI with regard to tumor penetration was clarified. Retrospectively, two observers independently scored T2-weighted MRI and T2-weighted MRI combined with Gd-enhanced dynamic MRI for tumor penetration using the following criteria: With Gd-enhanced dynamic MRI, T1 tumors showed an early enhanced line around the tumor as rim enhancement; T2 tumors appeared as black lines or double layers, as the muscularis propria kept its integrity; T3 tumors showed partial discontinuity of the muscularis propria as a dotted line and a perforated area as an interrupted line. A confidence level scoring system was used, and receiver operating characteristic curves were generated. There were no significant differences at the T1 stage. There were significant differences for observer 1 (P=0.001 for observer 1) at the T2 stage. There were significant differences for both observers (P=0.001 for observer 1 and P=0.005 for observer 2) at the T3 stage. Our criteria for Gd-enhanced dynamic MRI were effective for T3 stage tumors. (author)

  11. Prognostic significance of clinical and pathological stages on locally advanced rectal carcinoma after neoadjuvant chemoradiotherapy

    International Nuclear Information System (INIS)

    Wen, Bixiu; Zhang, Luning; Wang, Chengtao; Huang, Rong; Peng, Haihua; Zhang, Tian; Dong, Jun; Xiao, Weiwei; Zeng, Zhifan; Liu, Mengzhong; Gao, Yuanhong

    2015-01-01

    To investigate prognostic significance of clinical and pathological stages in patients with locally advanced rectal carcinoma treated with neoadjuvant chemoradiotherapy (neo-CRT) and total mesorectal excision. 210 patients with locally advanced rectal carcinoma (cT3-4 or cN+) treated with neo-CRT followed by total mesorectal excision. Treatment outcomes were compared according to clinical and pathological stage. Overall survival (OS), disease free survival (DFS) among patients with different clinical stage and pathological stage after neo-CRT. The median follow-up time was 47 months (range, 14–98 months). Clinical T stage was associated with 5 year OS (p = 0.042) and 5 year DFS (p = 0.014) while clinical N stage was not associated with 5 year OS (p = 0.440), 5 year DFS (p = 0.711). Pathological T stage was associate with 5 year OS (p = 0.001) and 5 year DFS (p = 0.046); and N stage was associated with 5 year OS (p = 0.001), 5 year DFS (p = 0.002). The pathological stage was further classified into three groups: ypT0–2N0 in 91 patients (43.3 %), ypT3–4N0 in 69 patients (32.9 %) and ypT0–4N+ in 50 patients (23.8 %). While pathological stage (ypT0–2 vs ypT3–4N0 vs ypT0–4N+) was associated with 5 year OS (87.9 %, 75.5 %, 56.7 %, p = 0.000), 5 year DFS (74.5 %, 77.4 %, 50.5 %, p = 0.003). Multivariate analysis showed that ypN stage was an independent prognostic factor for patients 5 year DFS. Pathological stage is strongly associated with treatment outcomes in patients with locally advanced rectal carcinoma treated with neo-CRT followed by total mesorectal excision, which may be used as guidance for further individualized treatment

  12. Preparation of rT3 in human serum ria kit

    International Nuclear Information System (INIS)

    Zhang Peixuan; Han Shiquan; Zhang Liling

    1991-02-01

    A method for the measurement of rT 3 in serum by radioimmunoassay is presented. The double antibody plus polyethylene glycol was used as separating reagent. The method is simple, precise and sensitive. Serum rT 3 values of normal (n = 61) were 47.7 ± 11.34 x 10 -8 g/L (X-bar ± SD). Patients with hyperthyroidism (n = 8) serum rT 3 values were 272.2 ± 91.1 x 10 -8 g/L (X-bar ± SD) and patients with hypothyroidism (n = 2) serum rT 3 values were 11.4 ± 8.3 x 10 -8 g/L (X-bar ± SD). It appears to be a useful diagnostic procedure for thyroid diseases

  13. Evaluation of rectal bleeding factors associated with prostate brachytherapy

    International Nuclear Information System (INIS)

    Aoki, Manabu; Miki, Kenta; Sasaki, Hiroshi; Kido, Masato; Shirahama, Jun; Takagi, Sayako; Kobayashi, Masao; Honda, Chikara; Kanehira, Chihiro

    2009-01-01

    The purpose of this study was to analyze rectal bleeding prognostic factors associated with prostate brachytherapy (PB) or in combination with external-beam radiation therapy (EBRT) and to examine dosimetric indications associated with rectal bleeding. The study included 296 patients followed up for >36 months (median, 48 months). PB was performed alone in 252 patients and in combination with EBRT in 44 patients. PB combined with EBRT is indicated for patients with a Gleason score >6. The prescribed dose was 144 Gy for monotherapy and 110 Gy for PB+EBRT (44-46 Gy). Although 9.1% who received monotherapy had 2.3% grade 2 rectal bleeding, 36.3% who received combined therapy had 15.9% grade 2 rectal bleeding. Combined therapy was associated with higher incidence of rectal bleeding (P=0.0049) and higher percentage of grade 2 bleeding (P=0.0005). Multivariate analysis revealed that R-150 was the only significant factor for rectal bleeding, and modified Radiation Therapy Oncology Group (RTOG) grade in monotherapy and biologically equivalent dose (BED) were significant for combined therapy. Moreover, grade 2 rectal bleeding increased significantly at D90 >130 Gy. Although R-150 was the significant prognostic factor for rectal bleeding and modified RTOG rectal toxicity grade, BED was the significant prognostic factor for modified RTOG rectal toxicity grade. (author)

  14. Low T3 syndrome as a predictor of poor prognosis in chronic lymphocytic leukemia.

    Science.gov (United States)

    Gao, Rui; Chen, Rui-Ze; Xia, Yi; Liang, Jin-Hua; Wang, Li; Zhu, Hua-Yuan; Zhu Wu, Jia-; Fan, Lei; Li, Jian-Yong; Yang, Tao; Xu, Wei

    2018-02-19

    Low triiodothyronine (T3) state is associated with poor prognosis in critical acute and prolonged illness. However, the information on thyroid dysfunction and cancer is limited. The aim of our study was to evaluate the prognostic value of low T3 syndrome in chronic lymphocytic leukemia (CLL). Two hundred and fifty-eight patients with detailed thyroid hormone profile at CLL diagnosis were enrolled. Low T3 syndrome was defined by low free T3 (FT3) level accompanied by normal-to-low free tetraiodothyronine (FT4) and thyroid-stimulating hormone (TSH) levels. A propensity score-matched method was performed to balance the baseline characteristics. Multivariate Cox regression analyses screened the independent prognostic factors related to time-to-first-treatment (TTFT) and cancer-specific survival (CSS). Area under the curve (AUC) assessed the predictive accuracy of CLL-International Prognostic Index (IPI) together with low T3 syndrome. The results showed that 37 (14.34%) patients had low T3 syndrome, which was significantly associated with unfavorable TTFT and CSS in the propensity-matched cohort, and it was an independent prognostic indicator for both TTFT and CSS. Serum FT3 level was positively related to protein metabolism and anemia, and inversely related to inflammatory state. Patients with only low FT3 demonstrated better survival than those with synchronously low FT3 and FT4, while those with synchronously low FT3, FT4 and TSH had the worst clinical outcome. Low T3 syndrome together with CLL-IPI had larger AUCs compared with CLL-IPI alone in TTFT and CSS prediction. In conclusion, low T3 syndrome may be a good candidate for predicting prognosis in future clinical practice of CLL. © 2018 UICC.

  15. High-dose Resveratrol Inhibits Insulin Signaling Pathway in 3T3-L1 Adipocytes

    OpenAIRE

    Lee, Haemi; Kim, Jae-woo

    2013-01-01

    Background Insulin resistance is a major factor in the development of metabolic syndrome and is associated with central obesity and glucose intolerance. Resveratrol, a polyphenol found in fruits, has been shown to improve metabolic conditions. Although it has been widely studied how resveratrol affects metabolism, little is known about how resveratrol regulates lipogenesis with insulin signaling in 3T3-L1 adipocytes. Methods: We treated differentiated 3T3-L1 adipocytes with resveratrol to obs...

  16. Development of an 'In vitro' system for the caption essay of T3

    International Nuclear Information System (INIS)

    Lavalley, C.; Ferro, G.; Zambrano, F.; Lezama, J.

    1990-02-01

    Triiodothyronine uptake (T3U) is a qualitative technique for evaluation of the unsaturation capacity of thyroid binding globulin (TBG). This paper presents results related to a T3 standardized serum and the integration of T3-I-125, and adsorbent for labelled hormone. Labelled hormone were prepared by the chloramine T method and then purified by high performance liquid chromatography. The specific activity was 500 μ Ci/ μ g. Various adsorbents such as: Norit A Charcoal, calcium silicate, talc, bovine serum albumin macroaggregated (BSAM) were used in different buffers as: Tris-HCl, barbital and Michaelis. Standardized serum was prepared by mixing different euthyroid sera. Best conditions for T3U assays were achieved with 15 mg/ml. BSAM at pH 8.6 in presence of Tris-HCl buffer for hypothyroid and hyperthyroid sera, for which we obtained 1.1 ± 0.05 respectively as a T3U index with a 3.0 % of coefficient variation. The reagents so prepared can be conveniently used for T3U assays. (Author)

  17. Radioimmunoassay method for determination of 3, 3', 5'-triiodothyronine (reverse - T3)

    International Nuclear Information System (INIS)

    Kosowicz, J.

    1979-01-01

    To introduce radioimmunoassay, 3, 3', 5'-triiodothyronine (reverse-T 3 ) was coupled to bovine serum albumin by the carbodiimide technique and rabbits were immunized with the conjugates obtained. The immunizations were performed by multiple site intradermal injections at places in which cornynebacterium parvum was previously injected to enhance immunologic reaction. After 3 months the rabbits raised antisera to reverse-T 3 of a high titer and specificity. To obtain labelled 125 I-reverse T 3 , 3,3'-diiodothyronine was used. Iodination was performed by the chloramine T technique and the iodination mixture was subjected to gel filtration on Sephadex G-25 (fine) column. The purified monolabelled 125 I-reverse T 3 had a specific activity of 3,000 milli Curie/mg. The reverse T 3 radioimmunoassay of a high sensitivity (ca 2 pg/tube) was introduced in the clinical studies and facilitated direct determination of reverse T 3 in sera without the need of plasma extractions. The interference of serum proteins (TBG) was avoided by adding 8-anilino-1-naphtalene sulfonic acid to serum samples. Separation of free from antibody bound antigens was achieved by polyethylene glycol precipitation or immunoprecipitation. (author)

  18. Radial nerve palsy in mid/distal humeral fractures: is early exploration effective?

    Science.gov (United States)

    Keighley, Geffrey; Hermans, Deborah; Lawton, Vidya; Duckworth, David

    2018-03-01

    Radial nerve palsies are a common complication with displaced distal humeral fractures. This case series examines the outcomes of early operative exploration and decompression of the nerve with fracture fixation with the view that this provides a solid construct for optimisation of nerve recovery. A total of 10 consecutive patients with a displaced distal humeral fracture and an acute radial nerve palsy were treated by the senior author by open reduction and internal fixation of the distal humerus and exploration and decompression of the radial nerve. Motor function and sensation of the radial nerve was assessed in the post-operative period every 2 months or until full recovery of the radial nerve function had occurred. All patients (100%) had recovery of motor and sensation function of their upper limb in the radial nerve distribution over a 12-month period. Recovery times ranged between 4 and 32 weeks, with the median time to recovery occurring at 26 weeks and the average time to full recovery being 22.9 weeks. Wrist extension recovered by an average of 3 months (range 2-26 weeks) and then finger extension started to recover 2-6 weeks after this. Disability of the arm, shoulder and hand scores ranged from 0 to 11.8 at greater than 1 year post-operatively. Our study demonstrated that early operative exploration of the radial nerve when performing an open stabilization of displaced distal humeral fractures resulted in a 100% recovery of the radial nerve. © 2017 Royal Australasian College of Surgeons.

  19. Geochemical characterization of mid-distal Nisyros tephra on Datça peninsula (southwestern Anatolia)

    Science.gov (United States)

    Gençalioğlu-Kuşcu, Gonca; Uslular, Göksu

    2018-04-01

    We present new distal records of tephra deposits that overly the Kos ignimbrite in seven locations of Datça peninsula. Tephra in one of these locations were previously associated with Nisyros Kyra sub-unit based only on the field characteristics. We use different proxies such as field observations, petrography, mineral, glass, and whole-rock chemistry in order to characterize and correlate the previously and recently identified pumice fall deposits on Datça. The total thickness of the fall deposit reaches to 3.5 m. The size of the pumice clasts is generally within the range of lapilli, and they have vitrophyric texture consisting mainly of plagioclase (andesine to labradorite) with scarce clinopyroxene (diopside to augite), olivine (Fo48-50), amphibole (magnesio-hastingsite), and biotite crystals. Amphibole is a ubiquitous phenocryst in all Datça tephra units and used as a criterion for the correlation. Glass major element analyses by EMPA reveal two different groups with andesitic and dacitic compositions. Difference in silica content (up to ca. 4 wt%) detected in the same specimen also designates the heterogeneity in pumice glass. This heterogeneity in glass composition is also supported by the frequent occurrence of banded pumice clasts in Datça tephra. Whole-rock composition of the pumice is mainly andesitic with calc-alkaline affinity. Multi-element patterns on primitive-mantle normalized diagram display typical arc-magmatism signature (i.e. depletion in Nb, Ta, Ti, and P). In order to check and eliminate the potential alternatives, we compared the distal deposits on Datça not only with Kyra, but also with other Nisyros tephra units. Yet, Kyra is the only unit that has comparable depositional characteristics, calcic amphibole crystals, andesitic-dacitic glass and whole-rock chemistry, and distal tephra deposits on neighboring islands (Tilos and Chalki). Therefore, we associate Datça tephra deposits with some proximal Kyra subunits of intermediate composition. However, if further geochemical (especially glass and mineral chemistry) data are provided for the Lakkí and Melisserí tephra units, a more thorough tephra correlation will be possible. Finally, our results may have implications on Nisyros tephra dispersal and geochemical characterization. Table S2 Characteristics of Nisyros proximal tephra units in comparison to Datça tephra. Table S3 Depositional characteristics and nomenclature of proximal and distal Kyra subunits on Tilos.

  20. The effect of control of diabetes mellitus on plasma T4, T3, rT3 levels and half muscle relaxation period

    International Nuclear Information System (INIS)

    Ismail, A.A.; Hafiez, A.A.; Sayed, S.N.; Abbas, E.Z.; Halawa, F.A.; Youssef, M.M.

    1984-01-01

    25 diabetics of the maturity onset type who showed no clinical evidence of either peripheral neruropathy or diabetic amyotrophy were selected for this study. All patients were subjected to the following investigations: estimation of half muscle relaxation period of the quadriceps muscle knee-jerk, measurement of plasma levels of thyroxine (T 4 ), triiodothyronine (T 3 ) and reverse triiodothronine (rT 3 ), determination of fasting and two hours postprandial blood sugar levels. The quadriceps muscle relaxation period in uncontrolled diabetics was significantly longer than in normals. Control of diabetes by glibenclamide or gliclazide did not cause a significant change in muscle relaxation period. There was also no significant difference between the effects of the two drugs. (author)

  1. Evidence and research in rectal cancer

    International Nuclear Information System (INIS)

    Valentini, Vincenzo; Beets-Tan, Regina; Borras, Josep M.; Krivokapic, Zoran; Leer, Jan Willem; Pahlman, Lars; Roedel, Claus; Schmoll, Hans Joachim; Scott, Nigel; Velde, Cornelius Van de; Verfaillie, Christine

    2008-01-01

    The main evidences of epidemiology, diagnostic imaging, pathology, surgery, radiotherapy, chemotherapy and follow-up are reviewed to optimize the routine treatment of rectal cancer according to a multidisciplinary approach. This paper reports on the knowledge shared between different specialists involved in the design and management of the multidisciplinary ESTRO Teaching Course on Rectal Cancer. The scenario of ongoing research is also addressed. In this time of changing treatments, it clearly appears that a common standard for large heterogeneous patient groups have to be substituted by more individualised therapies based on clinical-pathological features and very soon on molecular and genetic markers. Only trained multidisciplinary teams can face this new challenge and tailor the treatments according to the best scientific evidence for each patient

  2. Postoperative radiotherapy for rectal and rectosigmoid cancer

    International Nuclear Information System (INIS)

    Aleman, B.M.P.; Lebesque, J.V.; Hart, A.A.M.

    1992-01-01

    Between 1984 and 1988, 206 patients were treated with pelvic radiotherapy after macroscopically complete surgery for rectal or (recto)sigmoid cancer. Depending on an estimation of the amount of small bowel in the intended treatment volume a total dose was, in general, 45 or 50 Gy. An additional boost of 10 Gy was given to 6 patients because of microscopically involved surgical margins. For tumor stage B a statistically significant trend (p=0.017) for higher local control with higher total dose was observed comparing patients treated with a total dose of 45 Gy or less, with more than 45 Gy but less than 50 Gy or with a total dose of 50 Gy or more. This finding illustrates the impact of total dose on local control for postoperative radiotherapy for rectal carcinoma. (author). 18 refs., 1 fig., 1 tab

  3. Management of rectal inflammatory myofibroblastic tumor recurrence

    Directory of Open Access Journals (Sweden)

    Lan Sun

    2014-01-01

    Full Text Available Inflammatory myofibroblastic tumor (IMT is an uncommon mesenchymal neoplasm of intermediate malignant potential. It may occur in various anatomic locations, but rarely in the rectum. This is a case discussion of a 36-year-old male patient with IMT of the rectum. After the patient underwent radical surgery, recurrence was seen after 18 months. Because the tumor was very close to the surrounding tissue, palliative tumor resection was performed followed by concurrent chemo-radiation and non-steroidal anti-inflammatory drugs (NSAID. After 2-year follow-up, the patient has no evidence of recurrence or metastasis. Surgical resection is very important for patient with rectal IMT, even in relapse cases. And adjuvant chemoradiotherapy and NSAID are in favor of the incompletely resected tumors as our case. But perhaps, the adjuvant treatments could be helpful after radical resection of rectal tumor.

  4. Follow-up after rectal cancer

    DEFF Research Database (Denmark)

    Hovdenak Jakobsen, Ida; Juul, Therese; Bernstein, Inge

    2017-01-01

    BACKGROUND: The main treatment for non-metastatic rectal cancer (RC) is surgical resection. Late adverse effects that are highly prevalent and negatively impact patients' symptom burden and quality of life are: bowel-, urological and sexual dysfunctions; psychological distress; fear of recurrence....... As a consequence, the randomized controlled trial Follow-up after Rectal Cancer (FURCA) has been launched, testing the effect of a new patient-led, follow-up program. The aim of this paper is to describe the methodology used in the FURCA study and to report results from the development of the patient-led, follow......, or a control group following the current follow-up program with routine medicals. The primary outcomes are symptom burden and quality of life, measured by the Functional Assessment of Cancer Therapy - Colorectal (FACT-C) questionnaire. Other outcome and demographic data are collected as patient...

  5. Histology and cell kinetics of rectal mucosa of A/HeJ mice administered syngeneic rectal antigen and its effects on radiation induced rectal cancer, 1

    International Nuclear Information System (INIS)

    Terada, Yoritaka

    1980-01-01

    1. Four-week-old A/HeJ mice were immunized by rectal antigen and at the age of 6 weeks the pelvic region was exposed to 2,000 rad of X-ray for two times. They were observed for a maximum period of 84 weeks. The first rectal cancer detected 36 days after irradiation was histologically found to be mucous-secreting-adenocarinoma. Within 32 weeks after irradiation, rectal cancer was observed in 21 (61.76%) of the 34 autopsied mice. During the entire period of observation, rectal cancer was observed in 25 (55.56%) of the 45 mice. 2. On the other hand, among the mice whose pelvic region was exposed to 2,000 rad for two times, the first cancer was observed 56 days after irradiation. Within 32 weeks after irradiation, rectal cancer was observed in 4 (18.18%) of the 22 autopsied mice. During the entire period of observation, rectal cancer was observed in 12 (33.33%) of the 36 mice. 3. In the group of 51 non-irradiated mice, no rectal cancer was observed. 4. The stainability of HID-AB stain of the histologically normal mucosa near irradiated site was compared between cancer induced cases and normal cases. In 22 (84.62%) mice among 26 with induced cancer and in 9 (45%) among 20 mice without cancer, rectal crypt with AB positive goblet cells could be observed. (author)

  6. Conformal irradiation of the prostate: estimating long-term rectal bleeding risk using dose-volume histograms

    International Nuclear Information System (INIS)

    Hartford, Alan C.; Niemierko, Andrzej; Adams, Judith A.; Urie, Marcia M.; Shipley, William U.

    1996-01-01

    Purpose: Dose-volume histograms (DVHs) may be very useful tools for estimating probability of normal tissue complications (NTCP), but there is not yet an agreed upon method for their analysis. This study introduces a statistical method of aggregating and analyzing primary data from DVHs and associated outcomes. It explores the dose-volume relationship for NTCP of the rectum, using long-term data on rectal wall bleeding following prostatic irradiation. Methods and Materials: Previously published data were reviewed and updated on 41 patients with Stages T3 and T4 prostatic carcinoma treated with photons followed by perineal proton boost, including dose-volume histograms (DVHs) of each patient's anterior rectal wall and data on the occurrence of postirradiation rectal bleeding (minimum FU > 4 years). Logistic regression was used to test whether some individual combination of dose and volume irradiated might best separate the DVHs into categories of high or low risk for rectal bleeding. Further analysis explored whether a group of such dose-volume combinations might be superior in predicting complication risk. These results were compared with results of the 'critical volume model', a mathematical model based on assumptions of underlying radiobiological interactions. Results: Ten of the 128 tested dose-volume combinations proved to be 'statistically significant combinations' (SSCs) distinguishing between bleeders (14 out of 41) and nonbleeders (27 out of 41), ranging contiguously between 60 CGE (Cobalt Gray Equivalent) to 70% of the anterior rectal wall and 75 CGE to 30%. Calculated odds ratios for each SSC were not significantly different across the individual SSCs; however, analysis combining SSCs allowed segregation of DVHs into three risk groups: low, moderate, and high. Estimates of probabilities of normal tissue complications (NTCPs) based on these risk groups correlated strongly with observed data (p = 0.003) and with biomathematical model-generated NTCPs

  7. Local resection of early rectal cancer

    DEFF Research Database (Denmark)

    Baatrup, Gunnar; Qvist, Niels

    2014-01-01

    The introduction of the National Danish screening programme for colorectal cancer will result in the detection of more early rectal cancers (ERC), which may be considered for local excision. For the low risk≤T1 cancer, the oncological outcome at local excision in smaller patient series has shown......, where rescue surgery may be considered. The establishment of a regional or national clinical database is necessary to improve the local treatment of ERC....

  8. [Rectal duplication cyst--case report].

    Science.gov (United States)

    Turyna, R; Horák, L; Kucera, E; Hejda, V; Krofta, L; Feyereisl, J

    2009-06-01

    The authors demonstrate a rare case of duplication anomaly of the rectum. Case report. Institute for the Care of Mother and Child, Prague. We present a rare case of cystic rectal duplication in adult, completely removed and histologically confirmed. A literature review was summarized. The case was complicated by delay in diagnosis, multiple operations, and by the association with endometriosis, as well. Mentioned anomaly is published in the Czech literature for the very first time.

  9. Spreading characteristics of proprietary rectal steroid preparations

    International Nuclear Information System (INIS)

    Hay, D.J.

    1982-01-01

    Three types of rectal steroid preparation were labelled with Technetium 99 or Indium 111, and the extent of spread of each within the bowel was followed, immediately after administration and at 2hrs, using a gamma camera. Patients with ulcerative colitis were compared with controls. Results indicate that 'Colifoam' enema and 'Predsol' suppository act mainly in the rectum, but 'Predsol retention' enema spreads further into the colon, making it more useful for patients with extensive ulcerative colitis. (U.K.)

  10. Effects of ethiodol on T3 kinetics in endemic goiter area

    International Nuclear Information System (INIS)

    Watanabe, Tomas; Degrossi, O.J.; Zaninovich, A.A.; Altschuler, Noe; Degrossi, E.B.

    1986-01-01

    T3 kinetics were carried out in 32 children (11-15 years old) of a mild endemic goiter area. The incidence of goiter of the whole school population was 19% (Ia or Ib degree of the WHO). The mean urinary iodine was 84 μ g/d+-3. Six months before this investigation, 10 of the children received 2 ml of ethiodol by mouth and the other 22 (control group-CG) a placebo. The kinetics studies were carried out using less than 0,5 μ Ci of I-125 per Kg b.w. and the single injection method, non compartimental analysis. The CG shows, distribution volumen (V) 20.1+-0.6; serum T3 (sT3) 1.55 ng/ml+-0.03; plasma T3 T1/2 21.6+-0.6 and production rate (PR) 27.4μ g/d+-1.2. The treated group (TG): V, 17.3+-0.6; sT3 1.48 ng/ml+-0.09; T1/2 17.6+-0.6 and PR 25.9μ g/d+-1.4. The TG, after 6 months of ethiodol administration, showed a decrease of the distribution volume and a slight reduction in serum T3 values. As a consequence a significant diminution on the T3 extrathyroidal pool and an increase on the T3 plasma clearance (0.68 l/h+-0.01 in CG versus 0.73+-0.3 in TG) were observed. The production ratewas similar in both groups. These results indicate that the administration of ethiodol to children of a not severe endemic goiter area, produces moderate changes in the different parameters of T3 peripheral metabolism, which compensate each other and lead to similar final values on T3-PR, that were previously normal in these cases. This mechanism reflects the role of thyroid homeostasis in maintaining euthyroidism in these children of an endemic goiter area with decreased iodine supply. (Author) [es

  11. Rectal balloon use limits vaginal displacement, rectal dose, and rectal toxicity in patients receiving IMRT for postoperative gynecological malignancies.

    Science.gov (United States)

    Wu, Cheng-Chia; Wuu, Yen-Ruh; Yanagihara, Theodore; Jani, Ashish; Xanthopoulos, Eric P; Tiwari, Akhil; Wright, Jason D; Burke, William M; Hou, June Y; Tergas, Ana I; Deutsch, Israel

    2018-01-01

    Pelvic radiotherapy for gynecologic malignancies traditionally used a 4-field box technique. Later trials have shown the feasibility of using intensity-modulated radiotherapy (IMRT) instead. But vaginal movement between fractions is concerning when using IMRT due to greater conformality of the isodose curves to the target and the resulting possibility of missing the target while the vagina is displaced. In this study, we showed that the use of a rectal balloon during treatment can decrease vaginal displacement, limit rectal dose, and limit acute and late toxicities. Little is known regarding the use of a rectal balloon (RB) in treating patients with IMRT in the posthysterectomy setting. We hypothesize that the use of an RB during treatment can limit rectal dose and acute and long-term toxicities, as well as decrease vaginal cuff displacement between fractions. We performed a retrospective review of patients with gynecological malignancies who received postoperative IMRT with the use of an RB from January 1, 2012 to January 1, 2015. Rectal dose constraint was examined as per Radiation Therapy Oncology Group (RTOG) 1203 and 0418. Daily cone beam computed tomography (CT) was performed, and the average (avg) displacement, avg magnitude, and avg magnitude of vector were calculated. Toxicity was reported according to RTOG acute radiation morbidity scoring criteria. Acute toxicity was defined as less than 90 days from the end of radiation treatment. Late toxicity was defined as at least 90 days after completing radiation. Twenty-eight patients with postoperative IMRT with the use of an RB were examined and 23 treatment plans were reviewed. The avg rectal V40 was 39.3% ± 9.0%. V30 was65.1% ± 10.0%. V50 was 0%. Separate cone beam computed tomography (CBCT) images (n = 663) were reviewed. The avg displacement was as follows: superior 0.4 + 2.99 mm, left 0.23 ± 4.97 mm, and anterior 0.16 ± 5.18 mm. The avg magnitude of displacement was superior

  12. Rectal Sedation with Thiopental in Children

    International Nuclear Information System (INIS)

    Granados, Ana Maria; Levy, Wilma; Badiel, Marisol; Cruz Libreros, Alejandro; Toro Gutierrez, Juan Sebastian

    2012-01-01

    Objective: to determine the effectiveness of a rectal sedation protocol with sodium thiopental in children undergoing diagnostic imaging studies in a level-four-complexity health care facility. Materials and Methods: this case series observational study was developed between the months of January and March 2004 in the Fundacion clinica Valle del Lili. All pediatric patients between the ages of three months and eight years of age who underwent an imaging study were included. A dose of 25-40 mg/kg of sodium thiopental was administered rectally. Successful sedation was defined as one that allowed the successful completion of the study with the least number of motion artifacts. The features of the sedation and the adverse effects were evaluated. Results: the study population included 103 children with a median age of two years. The imaging studies were successfully concluded in 97% of the patients. The average total time until complete awakening was 2.9 hours. With respect to the interruption of sedation, we found statistically significant differences between the children who were kept awake the night before the procedure and those who were not. The most common adverse effect was diarrhea, which was recorded in 13 patients. Five of the patients required a supplemental dose of the sedative. There were two cases of increased salivation and one of vomiting, yet they resolved spontaneously. Conclusions: this rectal sodium thiopental protocol is a safe and effective procedure for the completion of diagnostic imaging studies in the pediatric population at our health care center.

  13. Function-preserving surgery for rectal cancer

    International Nuclear Information System (INIS)

    Moriya, Yoshihiro

    2006-01-01

    When total mesorectal excision (TME) is accurately performed, dysfunction, theoretically, does not occur. However, there are differences among individuals in the running patterns and the volumes of nerve fibers, and if obesity or a narrow pelvis is present, nerve identification is difficult. Currently, the rate of urinary dysfunction after rectal surgery ranges from 33% to 70%. Many factors other than nerve preservation play a role in minor incontinence. Male sexual function shows impotence rates ranging from 20% to 46%, while 20%-60% of potent patients are unable to ejaculate. In women, information on sexual function is not easily obtained, and there are more unknown aspects than in men. As urinary, sexual, and defecation dysfunction due to adjuvant radiotherapy have been reported to occur at a high frequency, the creation of a protocol that enables analysis of long-term functional outcome will be essential for future clinical trials. In the treatment of rectal cancer, surgeon-related factors are extremely important, not only in achieving local control but also in preserving function. This article reviews findings from recent studies investigating urinary, sexual, and defecation dysfunction after rectal cancer surgery and discusses questions to be studied in the future. (author)

  14. Cytotoxic Vibrio T3SS1 Rewires Host Gene Expression to Subvert Cell Death Signaling and Activate Cell Survival Networks

    Science.gov (United States)

    De Nisco, Nicole J.; Kanchwala, Mohammed; Li, Peng; Fernandez, Jessie; Xing, Chao; Orth, Kim

    2017-01-01

    Bacterial effectors are potent manipulators of host signaling pathways. The marine bacterium Vibrio parahaemolyticus (V. para), delivers effectors into host cells through two type three secretion systems (T3SS). The ubiquitous T3SS1 is vital for V. para survival in the environment, whereas T3SS2 causes acute gastroenteritis in human hosts. Although the natural host is undefined, T3SS1 effectors attack highly conserved cellular processes and pathways to orchestrate non-apoptotic cell death. Much is known about how T3SS1 effectors function in isolation, but we wanted to understand how their concerted action globally affects host cell signaling. To assess the host response to T3SS1, we compared gene expression changes over time in primary fibroblasts infected with V. para that have a functional T3SS1 (T3SS1+) to those in cells infected with V. para lacking T3SS1 (T3SS1−). Overall, the host transcriptional response to both T3SS1+ and T3SS1− V. para was rapid, robust, and temporally dynamic. T3SS1 re-wired host gene expression by specifically altering the expression of 398 genes. Although T3SS1 effectors target host cells at the posttranslational level to cause cytotoxicity, network analysis indicated that V. para T3SS1 also precipitates a host transcriptional response that initially activates cell survival and represses cell death networks. The increased expression of several key pro-survival transcripts mediated by T3SS1 was dependent on a host signaling pathway that is silenced later in infection by the posttranslational action of T3SS1. Taken together, our analysis reveals a complex interplay between roles of T3SS1 as both a transcriptional and posttranslational manipulator of host cell signaling. PMID:28512145

  15. Radiologic features of the solitary rectal ulcer syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Castagnone, D.; Ranzi, T.; Velio, P.; Polli, E.E.; Bianchi, P.

    1984-05-01

    A radiologic study of 4 biopsy-proven cases of the solitary rectal ulcer (S.R.U.) syndrome was undertaken. The radiologic findings of S.R.U. were rectal stenosis (one with ulcer), polypoid rectal mass, and multiple sub-mucosal defects with shallow ulcers. The S.R.U., which is benign and requires only dietetic treatment, must be differentiated from other more serious entities such as neoplastic and inflammatory bowel disease.

  16. Directory of Colon and Rectal Cancer Specialist Teams

    OpenAIRE

    Department of Health; Social Services and Public Safety

    2004-01-01

    The Directory of Colon and Rectal Cancer Specialist Teams has been produced under the auspices of the Northern Ireland Regional Advisory Committee on Cancer. It contains details of the full membership of the clinical teams providing care for colon and rectal cancer in each of Health and Social Services Board Area. Lead Clinicians For Colon and Rectal Cancer Services (PDF 74 KB) EHSSB (PDF 198 KB) NHSSB (PDF 107 KB) SHSSB (PDF 130 KB) WHSSB (PDF 131 KB)

  17. Usefulness of Serum Triiodothyronine (T3) to Predict Outcomes in Patients Hospitalized With Acute Heart Failure.

    Science.gov (United States)

    Rothberger, Gary D; Gadhvi, Sonya; Michelakis, Nickolaos; Kumar, Amit; Calixte, Rose; Shapiro, Lawrence E

    2017-02-15

    Thyroid hormone plays an important role in cardiac function. Low levels of serum triiodothyronine (T 3 ) due to nonthyroidal illness syndrome may have adverse effects in heart failure (HF). This study was designed to assess the ability of T 3 to predict in-hospital outcomes in patients with acute HF. In total, 137 patients without thyroid disease or treatment with drugs which affect TH levels, who were hospitalized with acute HF were prospectively enrolled and studied. TH levels were tested upon hospital admission, and outcomes were compared between patients with low (<2.3 pg/ml) and normal (≥2.3 pg/ml) free T 3 levels as well as between those with low (<0.6 ng/ml) and normal (≥0.6 ng/ml) total T 3 levels. Low free T 3 correlated with an increased length of stay in the hospital (median 11 vs 7 days, p <0.001) and higher rates of intensive care unit admission (31.8% vs 16.9%, p = 0.047), with a trend toward increased need for invasive mechanical ventilation (9.0% vs 1.4%, p = 0.056). Low total T3 correlated with an increased length of stay in the hospital (median 11 vs 7 days, p <0.001) and increased need for invasive mechanical ventilation (9.8% vs 1.3%, p = 0.045). In conclusion, low T 3 predicts worse hospital outcomes in patients with acute HF and can be useful in the risk stratification of these patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. ACR Appropriateness Criteria®  Resectable Rectal Cancer

    Directory of Open Access Journals (Sweden)

    Jones William E

    2012-09-01

    Full Text Available Abstract The management of resectable rectal cancer continues to be guided by clinical trials and advances in technique. Although surgical advances including total mesorectal excision continue to decrease rates of local recurrence, the management of locally advanced disease (T3-T4 or N+ benefits from a multimodality approach including neoadjuvant concomitant chemotherapy and radiation. Circumferential resection margin, which can be determined preoperatively via MRI, is prognostic. Toxicity associated with radiation therapy is decreased by placing the patient in the prone position on a belly board, however for patients who cannot tolerate prone positioning, IMRT decreases the volume of normal tissue irradiated. The use of IMRT requires knowledge of the patterns of spreads and anatomy. Clinical trials demonstrate high variability in target delineation without specific guidance demonstrating the need for peer review and the use of a consensus atlas. Concomitant with radiation, fluorouracil based chemotherapy remains the standard, and although toxicity is decreased with continuous infusion fluorouracil, oral capecitabine is non-inferior to the continuous infusion regimen. Additional chemotherapeutic agents, including oxaliplatin, continue to be investigated, however currently should only be utilized on clinical trials as increased toxicity and no definitive benefit has been demonstrated in clinical trials. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every two years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to

  19. Akt Inhibitor MK2206 in Treating Patients With Previously Treated Colon or Rectal Cancer That is Metastatic or Locally Advanced and Cannot Be Removed by Surgery

    Science.gov (United States)

    2017-06-26

    Colon Mucinous Adenocarcinoma; Colon Signet Ring Cell Adenocarcinoma; Rectal Mucinous Adenocarcinoma; Rectal Signet Ring Cell Adenocarcinoma; Recurrent Colon Carcinoma; Recurrent Rectal Carcinoma; Stage IIIA Colon Cancer; Stage IIIA Rectal Cancer; Stage IIIB Colon Cancer; Stage IIIB Rectal Cancer; Stage IIIC Colon Cancer; Stage IIIC Rectal Cancer; Stage IVA Colon Cancer; Stage IVA Rectal Cancer; Stage IVB Colon Cancer; Stage IVB Rectal Cancer

  20. Comparison of the preventive analgesic effect of rectal ketamine and rectal acetaminophen after pediatric tonsillectomy

    Directory of Open Access Journals (Sweden)

    S Morteza Heidari

    2012-01-01

    Full Text Available Objectives: There is a little data about rectal administration of Ketamine as a postoperative analgesic, so we compared the efficacy of rectal ketamine with rectal acetaminophen, which is applied routinely for analgesia after painful surgeries like tonsillectomy. Methods: In this single-blinded comparative trial, we enrolled 70 children undergoing elective tonsillectomy, and divided them randomly in two groups. Patients received rectal ketamine (2 mg / kg or rectal acetaminophen (20 mg / kg at the end of surgery. The children′s Hospital of Eastern Ontario Pain scale was used to estimate pain in children. Also the vital signs, Wilson sedation scale, and side effects in each group were noted and compared for 24 hours. Results: The ketamine group had a lower pain score at 15 minutes and 60 minutes after surgery in Recovery (6.4 ± 0.8, 7.4 ± 1 vs. 7.1 ± 1.2, 7.8 ± 1.2 in the acetaminophen group, P < 0.05 and one hour and two hours in the ward (7.2 ± 0.7, 7 ± 0.5 vs. 7.9 ± 1.2, 7.5 ± 1.2 in the acetaminophen group, P < 0.05, with no significant differences till 24 hours. Dreams and hallucinations were not reported in the ketamine group. Systolic blood pressure was seen to be higher in the ketamine group (104.4 ± 7.9 vs. 99.8 ± 7.7 in the acetaminophen group and nystagmus was reported only in the ketamine group (14.2%. Other side effects were equivalent in both the groups. Conclusions: With low complications, rectal ketamine has analgesic effects, especially in the first hours after surgery in comparison with acetaminophen, and it can be an alternative analgesic with easy administration in children after tonsillectomy.

  1. Laparoscopic ventral rectopexy is effective for solitary rectal ulcer syndrome when associated with rectal prolapse.

    Science.gov (United States)

    Evans, C; Ong, E; Jones, O M; Cunningham, C; Lindsey, I

    2014-03-01

    Solitary rectal ulcer syndrome (SRUS) is uncommon and its management is controversial. The aim of this study was to evaluate the outcome of patients with SRUS who underwent laparoscopic ventral rectopexy (LVR). A review was performed of a prospective database at the Oxford Pelvic Floor Centre to identify patients between 2004 and 2012 with a histological diagnosis of SRUS. All were initially treated conservatively and surgical treatment was indicated only for patients with significant symptoms after failed conservative management. The primary end-point was healing of the ulcer. Secondary end-points included changes in the Wexner Constipation Score and Faecal Incontinence Severity Index (FISI). Thirty-six patients with SRUS were identified (31 women), with a median age of 44 (15–81) years. The commonest symptoms were rectal bleeding (75%) and obstructed defaecation (64%). The underlying anatomical diagnosis was internal rectal prolapse (n = 20), external rectal prolapse (n = 14) or anismus (n = 2). Twenty-nine patients underwent LVR and one a stapled transanal rectal resection (STARR) procedure. Nine (30%) required a further operation, six required posterior STARR for persistent SRUS and two a per-anal stricturoplasty for a narrowing at the healed SRUS site. Healing of the SRU was seen in 27 (90%) of the 30 patients and was associated with significant improvements in Wexner and FISI scores at a 3-year follow-up. Almost all cases of SRUS in the present series were associated with rectal prolapse. LVR resulted in successful healing of the SRUS with good function in almost all patients, but a significant number will require further surgery such as STARR for persistent obstructed defaecation.

  2. Rectal motility after sacral nerve stimulation for faecal incontinence

    DEFF Research Database (Denmark)

    Michelsen, H B; Worsøe, J; Krogh, K

    2010-01-01

    Sacral nerve stimulation (SNS) is effective against faecal incontinence, but the mode of action is obscure. The aim of this study was to describe the effects of SNS on fasting and postprandial rectal motility. Sixteen patients, 14 women age 33-73 (mean 58), with faecal incontinence of various...... contractions, total time with cyclic rectal contractions, the number of aborally and orally propagating contractions, the number of anal sampling reflexes or rectal wall tension during contractions. Postprandial changes in rectal tone were significantly reduced during SNS (P

  3. [Anterior rectal duplication in adult patient: a case report].

    Science.gov (United States)

    Rodríguez-Cabrera, J; Villanueva-Sáenz, E; Bolaños-Badillo, L E

    2009-01-01

    To report a case of rectal duplication in the adult and make a literature review. The intestinal duplications are injuries of congenital origin that can exist from the base of the tongue to the anal verge, being the most frequent site at level of terminal ileum (22%) and at the rectal level in 5% To date approximately exist 80 reports in world-wide Literature generally in the pediatric population being little frequent in the adult age. Its presentation could be tubular or cystic. The recommended treatment is the surgical resection generally in block with coloanal anastomosis. A case review of rectal duplication in the adult and the conducted treatment. The case of a patient appears with diagnose of rectal duplication with tubular type,whose main symptom was constipation and fecal impactation. In the exploration was detect double rectal lumen (anterior and posterior) that it above initiates by of the anorectal ring with fibrous ulcer of fibrinoid aspect of 3 approx cm of length x 1 cm wide, at level of the septum that separates both rectal lumina. The rectal duplication is a rare pathology in the adult nevertheless is due to suspect before the existence of alterations in the mechanics of the defecation, rectal prolapse and rectal bleeding,the election treatment is a protectomy with colonic pouch in "J" and coloanal anastomosis.

  4. Rectal mucosal electrosensitivity - what is being tested?

    Science.gov (United States)

    Meagher, A P; Kennedy, M L; Lubowski, D Z

    1996-01-01

    The results of rectal mucosal electrosensitivity (RME) testing have been used to support theories regarding the aetiology of both idiopathic constipation and bowel dysfunction following rectopexy. The aim of this study was to assess the validity of tests of RME. Sixty-eight patients, comprising three groups (group 1: 50 patients undergoing assessment in the Anorectal Physiology Unit, group 2: 10 patients with coloanal or ileoanal anastomosis, group 3: 8 patients with a stoma) underwent mucosal electrosensitivity testing, with the threshold stimulus required to elicit sensation being recorded. In addition the RME was measured in groups 1 and 2 when placing the electrode, mounted on a catheter with a central wire, against the anterior, posterior, right and left rectal or neorectal walls. To asses the influence on this test of loss of mucosal contact due to faeces, a further 8 cases with a normal rectum had RME performed with and without a layer of water soaked gauze around the electrode to stimulate faeces and prevent the electrode from making contact with the rectal mucosa. There was marked variance in the sensitivity of the different regions of rectal wall tested (P < 0.001). In group 1 patients the mean sensitivities were: central 36.6 mA, anterior 27.4 mA, posterior 37.9 mA, right 22.3 mA and left 25.6 mA. This circumferential variation suggests that the pelvic floor rather than rectal mucosa was being stimulated. All patients in group 2 had recordable sensitivities, and the mean sensitivity threshold was significantly higher than group 1 patients in the central (P = 0.03), right (P = 0.03) and left (P = 0.007) positions. In group 3 the sensitivity was greater within the stoma at the level of the abdominal wall muscle than intra-abdominally or subcutaneously, again suggesting an extra-colonic origin of the sensation. The sensitivity threshold was significantly greater with the electrode wrapped in gauze (P < 0.01), and loss of mucosal contact was not detected by

  5. Capecitabine and Oxaliplatin Before, During, and After Radiotherapy for High-Risk Rectal Cancer

    DEFF Research Database (Denmark)

    Larsen, Finn Ole; Markussen, Alice; Jensen, Benny V

    2017-01-01

    PURPOSE: To evaluate the effect of capecitabine and oxaliplatin before, during, and after radiotherapy for high-risk rectal cancer. PATIENTS AND METHODS: Patients with rectum cancer T4 or T3 involving the mesorectal fascia was included in a prospective phase 2 trial. Liver or lung metastases were...... accepted if the surgeons found them resectable. The patients received 6 weeks of capecitabine and oxaliplatin before chemoradiotherapy (CRT), continued capecitabine and oxaliplatin during radiotherapy, and received 4 weeks of capecitabine and oxaliplatin after CRT. The patients received radiotherapy...... as intensity-modulated radiotherapy. Total mesorectal excision was planned 8 weeks after CRT. The patients were evaluated with magnetic resonance imaging (MRI) before start of treatment, after 6 weeks of chemotherapy, and again just before the operation. The European Organization for Research and Treatment...

  6. Retroperitoneal and lateral pelvic lymphadenectomy mapped by lymphoscintigraphy for rectal adenocarcinoma staging

    International Nuclear Information System (INIS)

    Quadros, C.A.; Araujo, I.; Lopes, A.

    2010-01-01

    The good prognosis of retroperitoneal and lateral pelvic lymphadenectomy has raised the question of whether total mesorectal excision is suitable for adequate staging of rectal adenocarcinoma patients. The aims of this study were to determine the accuracy of dye and probe detection of metastatic retroperitoneal and/or lateral pelvic nodes and to define the upstaging impact of retroperitoneal and lateral pelvic lymphadenectomy in rectal adenocarcinoma patients. Ninety-seven rectal adenocarcinoma patients were submitted to total mesorectal excision and retroperitoneal and lateral pelvic lymphadenectomy. Lymphoscintigraphy using technetium-99 m-phytate and patent blue was performed to detect blue and/or radioactive retroperitoneal and/or lateral pelvic nodes which were examined histopathologically and immunohistochemically with a step-sectioning technique. Mesorectal mean node count was 11.5 and retroperitoneal and/or lateral pelvic node was 11.7. Retroperitoneal and lateral pelvic lymphadenectomy identified metastases in 17.5%, upstaging 8.2%. Variables related to metastatic retroperitoneal and/or lateral pelvic nodes were the following: Stage III in total mesorectal excision specimens (P<0.04), pT3/pT4 tumors (P=0.047), high levels of carcinoembryonic antigen (P=0.014) and large tumors (P=0.03). Marker migration to retroperitoneal and/or lateral pelvic nodes occurred in 37.1%, upstaging 11.1%. The markers' accuracy in the detection of metastatic retroperitoneal and/or lateral pelvic nodes was 100%. Retroperitoneal and lateral pelvic lymphadenectomy detected an important rate of metastatic retroperitoneal and/or lateral pelvic nodes (RLPN), resulting in upstaging. When markers migrated, they were able to detect RLPN metastases. The use of markers should be improved in the identification of RLPN metastases for selective indication of retroperitoneal and lateral pelvic lymphadenectomy. (author)

  7. Benchmarking circumferential resection margin (R1) resection rate for rectal cancer in the neoadjuvant era.

    Science.gov (United States)

    Chambers, W; Collins, G; Warren, B; Cunningham, C; Mortensen, N; Lindsey, I

    2010-09-01

    Circumferential resection margin (CRM) involvement (R1) is used to audit rectal cancer surgical quality. However, when downsizing chemoradiation (dCRT) is used, CRM audits both dCRT and surgery, its use reflecting a high casemix of locally advanced tumours. We aimed to evaluate predictors of R1 and benchmark R1 rates in the dCRT era, and to assess the influence of failure of steps in the multidisciplinary team (MDT) process to CRM involvement. A retrospective analysis of prospectively collected rectal cancer data was undertaken. Patients were classified according to CRM status. Uni- and multivariate analysis was undertaken of risk factors for R1 resection. The contribution of the steps of the MDT process to CRM involvement was assessed. Two hundred and ten rectal cancers were evaluated (68% T3 or T4 on preoperative staging). R1 (microscopic) and R2 (macroscopic) resections occurred in 20 (10%) and 6 patients (3%), respectively. Of several factors associated with R1 resections on univariate analysis, only total mesorectal excision (TME) specimen defects and threatened/involved CRM on preoperative imaging remained as independent predictors of R1 resections on multivariate analysis. Causes of R1 failure by MDT step classification found that less than half were associated with and only 15% solely attributable to a suboptimal TME specimen. Total mesorectal excision specimen defects and staging-predicted threatened or involved CRM are independent strong predictors of R1 resections. In most R1 resections, the TME specimen was intact. It is important to remember the contribution of both the local staging casemix and dCRT failure when using R1 rates to assess purely surgical competence.

  8. What is the significance of the circumferential margin in locally advanced rectal cancer after neoadjuvant chemoradiotherapy?

    Science.gov (United States)

    Trakarnsanga, Atthaphorn; Gonen, Mithat; Shia, Jinru; Goodman, Karyn A; Nash, Garrett M; Temple, Larissa K; Guillem, José G; Paty, Philip B; Garcia-Aguilar, Julio; Weiser, Martin R

    2013-04-01

    The circumferential resection margin (CRM) is highly prognostic for local recurrence in rectal cancer surgery without neoadjuvant treatment. However, its significance in the setting of long-course neoadjuvant chemoradiotherapy (nCRT) is not well defined. Review of a single institution's prospectively maintained database from 1998 to 2007 identified 563 patients with locally advanced rectal cancer (T3/T4 and/or N1) receiving nCRT, followed after 6 weeks by total mesorectal excision (TME). Kaplan-Meier, Cox regression, and competing risk analysis were performed. The authors noted that 75 % of all patients had stage III disease as determined by endorectal ultrasound (ERUS) and/or magnetic resonance imaging (MRI). With median follow-up of 39 months after resection, local and distant relapse were noted in 12 (2.1 %) and 98 (17.4 %) patients, respectively. On competing risk analysis, the optimal cutoff point of CRM was 1 mm for local recurrence and 2 mm for distant metastasis. Factors independently associated with local recurrence included CRM ≤1 mm, and high-grade tumor (p = 0.012 and 0.007, respectively). CRM ≤2 mm, as well as pathological, nodal, and overall tumor stage are also significant independent risk factors for distant metastasis (p = 0.025, 0.010, and dataset of locally advanced rectal cancer treated with nCRT followed by TME, CRM ≤1 mm is an independent risk factor for local recurrence and is considered a positive margin. CRM ≤2 mm was associated with distant recurrence, independent of pathological tumor and nodal stage.

  9. The effect of myostatin on proliferation and lipid accumulation in 3T3-L1 preadipocytes.

    Science.gov (United States)

    Zhu, Hui Juan; Pan, Hui; Zhang, Xu Zhe; Li, Nai Shi; Wang, Lin Jie; Yang, Hong Bo; Gong, Feng Ying

    2015-06-01

    Myostatin is a critical negative regulator of skeletal muscle development, and has been reported to be involved in the progression of obesity and diabetes. In the present study, we explored the effects of myostatin on the proliferation and differentiation of 3T3-L1 preadipocytes by using 3-[4,5-dimethylthiazol-2-yl] 2,5-diphenyl tetrazolium bromide spectrophotometry, intracellular triglyceride (TG) assays, and real-time quantitative RT-PCR methods. The results indicated that recombinant myostatin significantly promoted the proliferation of 3T3-L1 preadipocytes and the expression of proliferation-related genes, including Cyclin B2, Cyclin D1, Cyclin E1, Pcna, and c-Myc, and IGF1 levels in the medium of 3T3-L1 were notably upregulated by 35.2, 30.5, 20.5, 33.4, 51.2, and 179% respectively (all Pmyostatin-treated 3T3-L1 cells. Meanwhile, the intracellular lipid content of myostatin-treated cells was notably reduced as compared with the non-treated cells. Additionally, the mRNA levels of Pparγ, Cebpα, Gpdh, Dgat, Acs1, Atgl, and Hsl were significantly downregulated by 22-76% in fully differentiated myostatin-treated adipocytes. Finally, myostatin regulated the mRNA levels and secretion of adipokines, including Adiponectin, Resistin, Visfatin, and plasminogen activator inhibitor-1 (PAI-1) in 3T3-L1 adipocytes (all Pmyostatin promoted 3T3-L1 proliferation by increasing the expression of cell-proliferation-related genes and by stimulating IGF1 secretion. Myostatin inhibited 3T3-L1 adipocyte differentiation by suppressing Pparγ and Cebpα expression, which consequently deceased lipid accumulation in 3T3-L1 cells by inhibiting the expression of critical lipogenic enzymes and by promoting the expression of lipolytic enzymes. Finally, myostatin modulated the expression and secretion of adipokines in fully differentiated 3T3-L1 adipocytes. © 2015 Society for Endocrinology.

  10. The effect of reverse triiodothyronine (rT3) treatment on the plasma levels of iodothyronines in growing Japanese quails

    International Nuclear Information System (INIS)

    Niezgoda, J.; Wronska-Fortuna, D.; Sechman, A.; Bobek, S.; Sowa, J.

    1994-01-01

    It has been established that 3.3',5-triiodothyronine (T 3 ) acts hipermetabolically, whereas 3'3.5'-triiodothyronine (reverse T 3 , rT 3 ) acts hypometabolically. The normal ratio of T 3 to rT 3 in domestic flows fluctuates around 10. Since the excess of T 3 may promote catabolic processes and lower weight gain, the aim of this experiment was to find the optimal ratio of T 3 :rT 3 in blood plasma which corresponds with the greatest weight gain in Japanese quail. Reverse T 3 was given in drinking water (1 μg rT 3 /ml) for 3, 10, 20 or 30 days. It has been found that T 3 /rT 3 ratio of about 5, after 20 days of rT 3 administration, stimulated the weight gain of Japanese quail of both sexes from 7 to 44% with more pronounced effect in female birds. (author). 26 refs, 4 figs, 1 tab

  11. Isoproterenol Increases Uncoupling, Glycolysis, and Markers of Beiging in Mature 3T3-L1 Adipocytes.

    Directory of Open Access Journals (Sweden)

    Colette N Miller

    Full Text Available Beta-adrenergic activation stimulates uncoupling protein 1 (UCP1, enhancing metabolic rate. In vitro, most work has studied brown adipocytes, however, few have investigated more established adipocyte lines such as the murine 3T3-L1 line. To assess the effect of beta-adrenergic activation, mature 3T3-L1s were treated for 6 or 48 hours with or without isoproterenol (10 and 100 μM following standard differentiation supplemented with thyroid hormone (T3; 1 nM. The highest dose of isoproterenol increased lipid content following 48 hours of treatment. This concentration enhanced UCP1 mRNA and protein expression. The increase in UCP1 following 48 hours of isoproterenol increased oxygen consumption rate. Further, coupling efficiency of the electron transport chain was disturbed and an enhancement of glycolytic rate was measured alongside this, indicating an attempt to meet the energy demands of the cell. Lastly, markers of beige adipocytes (protein content of CD137 and gene transcript of CITED1 were also found to be upregulated at 48 hours of isoproterenol treatment. This data indicates that mature 3T3-L1 adipocytes are responsive to isoproterenol and induce UCP1 expression and activity. Further, this finding provides a model for further pharmaceutical and nutraceutical investigation of UCP1 in 3T3-L1s.

  12. Development of RIA reagents for detection of serum T3 using magnetic assay method

    International Nuclear Information System (INIS)

    Prasarnleungwirai, P.; Suprarop, P.; Tanjoy, V.; Saraneeyatham, T.

    1992-01-01

    The T3 RIA assay is widely used for diagnosis of the disease caused by malfunction of thyroid organ. The common methods used are: 1. Liquid phase, second antibody and PEG. 2. Solid phase, cellulose or sepharose. Since these two techniques need expensive refrigerated centrifuges to separate the bound from free, small labs in the remote part of the countries whose budgets are limited cannot use this technique. Magnetic assay technique for T3 detection employ strong magnetic plate for separation thus eliminate the use of costly refrigerated centrifuge. Preparation of magnetizable cellulose particles conjugated to proper anti T3 serum is done by activation of selected magnetizable cellulose particle with CDI (1,1 carbonyl dimidazole). The activated magnetic particles are then coupled to specific antibody in borate buffer pH 8. The assessment of prepared magnetic particle capture anti T3 are done by selecting the proper concentration of anti T3 magnetic particles. The result from both magnetic technique and second antibody/PEG are compared, and they show good correlation

  13. Stair-climbing capabilities of USU's T3 ODV mobile robot

    Science.gov (United States)

    Robinson, D. Reed; Wood, Carl G.

    2001-09-01

    A six-wheeled autonomous omni-directional vehicle (ODV) called T3 has been developed at Utah State University's (USU) Center for Self-Organizing and Intelligent Systems (CSOIS). This paper focuses on T3's ability to climb stairs using its unique configuration of 6 independently driven and steered wheels and active suspension height control. The ability of T3, or any similar vehicle, to climb stairs is greatly dependent on the chassis orientation relative to the stairs. Stability criteria is developed for any vehicle dimensions and orientation, on any staircase. All possible yaw and pitch angles on various staircases are evaluated to find vehicle orientations that will allow T3 to climb with the largest margin of stability. Different controller types are investigated for controlling vertical wheel movement with the objective of keeping all wheels in contact with the stairs, providing smooth load transfer between loaded and unloaded wheels, and maintaining optimum chassis pitch and roll angles. A controller is presented that uses feedback from wheel loading, vertical wheel position, and chassis orientation sensors. The implementation of the controller is described, and T3's stair climbing performance is presented and evaluated.

  14. Cytotoxicity of Titanate-Calcium Complexes to MC3T3 Osteoblast-Like Cells

    Science.gov (United States)

    Drury, Jeanie L.; Moussi, Joelle; Taylor-Pashow, Kathryn M. L.

    2016-01-01

    Monosodium titanates (MST) are a relatively novel form of particulate titanium dioxide that have been proposed for biological use as metal sorbents or delivery agents, most recently calcium (II). In these roles, the toxicity of the titanate or its metal complex is crucial to its biological utility. The aim of this study was to determine the cytotoxicity of MST and MST-calcium complexes with MC3T3 osteoblast-like cells; MST-Ca(II) complexes could be useful to promote bone formation in various hard tissue applications. MC3T3 cells were exposed to native MST or MST-Ca(II) complexes for 24–72 h. A CellTiter-Blue® assay was employed to assess the metabolic activity of the cells. The results showed that MST and MST-Ca(II) suppressed MC3T3 metabolic activity significantly in a dose-, time-, and cell-density-dependent fashion. MST-Ca(II) suppressed MC3T3 metabolism in a statistically identical manner as native MST at all concentrations. We concluded that MST and MST-Ca(II) are significantly cytotoxic to MC3T3 cells through a mechanism yet unknown; this is a potential problem to the biological utility of these complexes. PMID:28044136

  15. Cytotoxicity of Titanate-Calcium Complexes to MC3T3 Osteoblast-Like Cells

    Directory of Open Access Journals (Sweden)

    Yen-Wei Chen

    2016-01-01

    Full Text Available Monosodium titanates (MST are a relatively novel form of particulate titanium dioxide that have been proposed for biological use as metal sorbents or delivery agents, most recently calcium (II. In these roles, the toxicity of the titanate or its metal complex is crucial to its biological utility. The aim of this study was to determine the cytotoxicity of MST and MST-calcium complexes with MC3T3 osteoblast-like cells; MST-Ca(II complexes could be useful to promote bone formation in various hard tissue applications. MC3T3 cells were exposed to native MST or MST-Ca(II complexes for 24–72 h. A CellTiter-Blue® assay was employed to assess the metabolic activity of the cells. The results showed that MST and MST-Ca(II suppressed MC3T3 metabolic activity significantly in a dose-, time-, and cell-density-dependent fashion. MST-Ca(II suppressed MC3T3 metabolism in a statistically identical manner as native MST at all concentrations. We concluded that MST and MST-Ca(II are significantly cytotoxic to MC3T3 cells through a mechanism yet unknown; this is a potential problem to the biological utility of these complexes.

  16. Conservative management of anal and rectal cancer. The role of radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Gerard, J.P.; Romestaing, P.; Montbarbon, X. (Centre Hospitalier Lyon Sud, 69 - Pierre-Benite (France). Dept. of Radiotherapy)

    1989-01-01

    The role of irradiation in the management of anal and rectal cancer has changed during the past ten years. In small epidermoid carcinomas of the anal canal (T1 T2) irradiation is in most departments considered the primary treatment, giving a 5-year survival rate of between 60 and 80% with good sphincter preservation. Even in larger tumors, irradiation can still offer some chance of cure without colostomy. Surgery remains the basic treatment of rectal cancer but irradiation is used in association with surgery in many cases. Radiotherapy is of value in the conservative management of cancer of the rectum in three situations: In small polypoid cancers contact X-ray therapy can give local control in about 90%. In cancers of the middle rectum, preoperative external irradiation may increase the chances of restorative surgery and reduce the risk of local relapse. In inoperable patients, external radiotherapy and/or intracavitary irradiation may cure some patients with infiltrating tumors (T2 T3) without colostomy. (orig.).

  17. Future directions in combined modality therapy for rectal cancer: reevaluating the role of total mesorectal excision after chemoradiotherapy

    Directory of Open Access Journals (Sweden)

    Solanki AA

    2013-08-01

    Full Text Available Abhishek A Solanki,1 Daniel T Chang,2 Stanley L Liauw11Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA; 2Department of Radiation Oncology, Stanford University, Stanford, CA, USAAbstract: Most patients who develop rectal cancer present with locoregionally advanced (T3 or node-positive disease. The standard management of locoregionally advanced rectal cancer is neoadjuvant concurrent chemoradiotherapy (nCRT, followed by radical resection (low-anterior resection or abdominoperineal resection with total mesorectal excision. Approximately 15% of patients can have a pathologic complete response (pCR at the time of surgery, indicating that some patients can have no detectable residual disease after nCRT. The actual benefit of surgery in this group of patients is unclear. It is possible that omission of surgery in these patients, termed selective nonoperative management, can limit the toxicities associated with standard, multimodal combined modality therapy without compromising disease control. In this review, we discuss the clinical experiences to date using selective nonoperative management and various attempts at escalation of nCRT to improve the number of patients who have a pCR. We also explore several clinical, laboratory, imaging, histopathologic, and genetic biomarkers that have been tested as tools to predict which patients are most likely to have a pCR after nCRT.Keywords: rectal cancer, chemoradiotherapy, total mesorectal excision, nonoperative management, organ preservation

  18. Rectal cancer: The radiation basis of radiotherapy, target volume; Cancers du rectum: volumes cible de la radiotherapie, bases rationnelles

    Energy Technology Data Exchange (ETDEWEB)

    Bosset, J.F.; Servagi-Vernat, S. [Service oncologie-radiotherapie, CHU Jean-Minjoz, 3, boulevard Fleming, 25030 Besancon (France); Crehange, G. [Service oncologie-radiotherapie, centre Georges-Francois-Leclerc, 1, rue du Pr-Marion, 21079 Dijon cedex (France); Azria, D. [Service oncologie-radiotherapie, centre Val-d' Aurelle, rue Croix-Verte, 34298 Montpellier cedex 5 (France); Gerard, J.P. [Service oncologie-radiotherapie, centre Antoine-Lacassagne, 33, avenue Valombrose, 06189 Nice (France); Hennequin, C. [Service oncologie-radiotherapie, hopital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris (France)

    2011-10-15

    Since the implementation of preoperative chemo-radiotherapy and meso-rectal excision, the 5-year rates of locoregional failures in T3-T4 N0-N1M0 rectal cancer fell from 25-30% thirty years ago to 5-8% nowadays. A critical analysis of the locoregional failures sites and mechanisms, as well as the identification of nodal extension, helps the radiation oncologist to optimize the radiotherapy target definition. The upper limit of the clinical target volume is usually set at the top of the third sacral vertebra. The lateral pelvic nodes should be included when the tumor is located in the distal part of the rectum. The anal sphincter and the levator muscles should be spared when a conservative surgery is planned. In case of abdomino-perineal excision, the ischio-rectal fossa and the sphincters should be included in the clinical target volume. A confrontation with radiologist and surgeon is mandatory to improve the definition of the target volumes to be treated. (authors)

  19. External validation of models predicting the individual risk of metachronous peritoneal carcinomatosis from colon and rectal cancer.

    Science.gov (United States)

    Segelman, J; Akre, O; Gustafsson, U O; Bottai, M; Martling, A

    2016-04-01

    To externally validate previously published predictive models of the risk of developing metachronous peritoneal carcinomatosis (PC) after resection of nonmetastatic colon or rectal cancer and to update the predictive model for colon cancer by adding new prognostic predictors. Data from all patients with Stage I-III colorectal cancer identified from a population-based database in Stockholm between 2008 and 2010 were used. We assessed the concordance between the predicted and observed probabilities of PC and utilized proportional-hazard regression to update the predictive model for colon cancer. When applied to the new validation dataset (n = 2011), the colon and rectal cancer risk-score models predicted metachronous PC with a concordance index of 79% and 67%, respectively. After adding the subclasses of pT3 and pT4 stage and mucinous tumour to the colon cancer model, the concordance index increased to 82%. In validation of external and recent cohorts, the predictive accuracy was strong in colon cancer and moderate in rectal cancer patients. The model can be used to identify high-risk patients for planned second-look laparoscopy/laparotomy for possible subsequent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

  20. Calcification of MC3T3-E1 cells on titanium and zirconium.

    Science.gov (United States)

    Umezawa, Takayuki; Chen, Peng; Tsutsumi, Yusuke; Doi, Hisashi; Ashida, Maki; Suzuki, Shoichi; Moriyama, Keiji; Hanawa, Takao

    2015-01-01

    To confirm similarity of hard tissue compatibility between titanium and zirconium, calcification of MC3T3-E1 cells on titanium and zirconium was evaluated in this study. Mirror-polished titanium (Ti) and zirconium (Zr) disks and zirconium-sputter deposited titanium (Zr/Ti) were employed in this study. The surface of specimens were characterized using scanning electron microscopy and X-ray diffraction. Then, the cellular proliferation, differentiation and calcification of MC3T3-E1 cells on specimens were investigated. The surface of Zr/Ti was much smoother and cleaner than those of Ti and Zr. The proliferation of the cell was the same among three specimens, while the differentiation and calcification on Zr/Ti were faster than those on Ti and Zr. Therefore, Ti and Zr showed the identical hard tissue compatibility according to the evaluation with MC3T3-E1 cells. Sputter deposition may improve cytocompatibility.

  1. Cell Volume Regulation and Signaling in 3T3-L1 Pre-adipocytes and Adipocytes

    DEFF Research Database (Denmark)

    Eduardsen, Kathrine; Larsen, Susanne; Novak, Ivana

    2011-01-01

    Caveolae have been implicated in sensing of cell volume perturbations, yet evidence is still limited and findings contradictory. Here, we investigated the possible role of caveolae in cell volume regulation and volume sensitive signaling in an adipocyte system with high (3T3-L1 adipocytes......); intermediate (3T3-L1 pre-adipocytes); and low (cholesterol-depleted 3T3-L1 pre-adipocytes) caveolae levels. Using large-angle light scattering, we show that compared to pre-adipocytes, differentiated adipocytes exhibit several-fold increased rates of volume restoration following osmotic cell swelling (RVD......) and osmotic cell shrinkage (RVI), accompanied by increased swelling-activated taurine efflux. However, caveolin-1 distribution was not detectably altered after osmotic swelling or shrinkage, and caveolae integrity, as studied by cholesterol depletion or expression of dominant negative Cav-1, was not required...

  2. A simplified radioimmunoassay for triiodothyronine (T3) using pre-incubated labelled antigen and antibody

    International Nuclear Information System (INIS)

    Pillai, M.R.A.; Nagvekar, U.H.; Desai, C.N.; Mani, R.S.

    1986-01-01

    The development of a simplified radioimmunoassay for triiodothyronine (T 3 ) using pre-incubated labelled T 3 and antibody is described. The assay is carried out by adding 50 μl of standard or sample to 0.4 ml of pre-incubated reagent dispensed in assay tubes. The reaction was allowed to proceed for about four hours and the antigen-antibody complex precipitated by the addition of 1 cm 3 of 22% polyethylene glycol solution. Due to the high dissociation constant of T 3 -antibody complex at 37 deg C, the labelled antigen-antibody complex dissociates and thereby the unlabelled antigen binds with the antibody. The sensitivity of this assay is comparable to an assay done by the equilibrium method using the same antibody. Sixty serum samples were analyzed using this method and were compared with the equilibrium assay. (author)

  3. Thyrotropin (TSH) regulates triiodothyronine (T3) production in the unicellular Tetrahymena.

    Science.gov (United States)

    Csaba, G; Pállinger, Eva

    2011-09-01

    The aim of the experiments was to study the regulation of triiodothyronine (T3) production in the unicellular Tetrahymena. Untreated and troph-hormone treated specimen were prepared and in different timepoints T3 content was measured and compared by immunocytochemical flow cytometry. 0.1 or 0.001 IU TSH in tryptone-yeast medium stimulated T3 synthesis at 10, 20, 30 min, but does not stimulate after 1 h. The overlapping gonadotropic hormone (GTH) also did it, however only at 10 min. In Losina salt solution (physiological for Tetrahymena) the effect was weaker, however outer amino acid source was not absolutely needed for the production of the hormone. The results show that the TSH regulation of thyroid hormone synthesis (storage, secretion) and troph-hormone overlap can be deduced to a unicellular level. This may allow the hypothesis that the endocrine mechanisms proved at a low level of phylogeny are preserved for the higher ranked organisms.

  4. Cytotoxicity of Alpinia galanga Rhizome Crude Extract on NIH-3T3 Cells

    Directory of Open Access Journals (Sweden)

    Ferry Sandra

    2017-04-01

    Full Text Available BACKGROUND: Alpinia galanga (A. galanga was reported as a potential medicinal source due to its wide effect. A. galanga rhizome crude extract (ARCE was reported to have high cytotoxic effect in cancer cells, but low in normal cells. However half maximal inhibitory concentration (IC50 of ARCE is not clearly known yet. Hence, current study was conducted to investigate the IC50 of ARCE in normal standard fibroblast cell line, NIH-3T3 cells. METHODS: Rhizomes of A. galanga were collected, peeled, dried, milled and weighed. Extraction was performed using maceration method, then filtered and evaporated. ARCE with various concentrations were applied in NIH-3T3 cells for 24 or 48 hours. Cells were documented and counted with 3-(4,5-dimethylthiazol-2-yl-2,5-Diphenyltetrazolium bromide (MTT assay. RESULTS: Five hundreds grams of simplicia were macerated with ethanol and evaporated, 1 mg/mL crude extract with total volume of 114 mL was obtained. By addition of ARCE in NIH-3T3 cell culture, number of NIH-3T3 cells were shown less when treated with higher concentration of ARCE. Cell numbers of 0, 3.125, 6.25, 12.5, 25 and 50% ARCE treatment for 24 hours are 11,531, 11,352, 10,920, 10,365, 9,471, 8,360, respectively, meanwhile for 48 hours are 13,219, 12,686, 12,278, 11,390, 10,279, 8,390, respectively. CONCLUSION: IC50 of ARCE in 24 hours treatment was 620.5 mg/mL, while in 48 hours treatment was 666.6 mg/mL. Hence, ARCE is suggested to have low cytotoxic effect in NIH-3T3 cells. KEYWORDS: Alpinia galanga, ginger, extract, cytotoxic, MTT, NIH-3T3

  5. A fundamental research on T3 radioimmunoassay by polyethylene glycol (PEG) method

    International Nuclear Information System (INIS)

    Takahashi, Tadashige; Hayakawa, Susumu; Takagi, Atsushi; Sugisawa, Yoshihiko; Kurata, Kunio

    1976-01-01

    Since Chopra, et al. produced an antibody of triiodothyronine (T 3 ), measurement of serum T 3 by radioimmunoassay has been widely used as a clinical test. However, the dextran coated charcoal (DCC) method which is most commonly used for B/F separation requires strict control of incubation temperature and time. The authors reduced this disadvantage by using polyethylene glycol (PEG) instead of DCC for B/F separation. Crossreactivities of the antibody used with thyroxine, monoiodothyrosine and diiodotyrosine are less than 0.06% which is considered to be satisfactory in comparison with those previously reported. The recovery ratios of added T 3 were between 92.4 - 105.9% and that reflected T 3 concentration well. The dilution test showed good linearity. Correlation of T 3 values measured by DCC method and PEG method in 26 sera was good (r=0.99), and linear regression function was y=0.89x + 0.30 (y: PEG method and x: DCC method). No significant differences were observed in the results obtained by 2 hr incubation at 20 - 35 0 C and 24 hr incubation at 4 0 C. As for the volume of PEG solution, 1.0 ml was most suitable. Samples should be kept at 4 0 C when centrifugation is impossible within 30 min after addition of PEG. Also in various conditions of centrifugation, the authors obtained almost same results. As described above, the authors conquered the problem involved in the DCC method, and also simplified the assay procedure by using the PEG method for B/F separation. PEG method is considered to be the methods of choice for clinical routine test for serum T 3 levels (Evans, J.)

  6. Low T3 syndrome in neuromyelitis optica spectrum disorder: Associations with disease activity and disability.

    Science.gov (United States)

    Cho, Eun Bin; Min, Ju-Hong; Cho, Hye-Jin; Seok, Jin Myoung; Lee, Hye Lim; Shin, Hee Young; Lee, Kwang-Ho; Kim, Byoung Joon

    2016-11-15

    Neuromyelitis optica (NMO) sometimes coexists with serological marker-positive, non-organ-specific autoimmune disorders. We evaluated the prevalence of thyroid dysfunction and anti-thyroid antibodies in patients with NMO spectrum disorder (NMOSD) and investigated the associations between thyroid dysfunction/autoimmunity and clinical features of NMOSD. Forty-nine NMOSD patients with anti-aquaporin-4 antibody and 392 age- and sex-matched healthy controls were included. We measured the levels of thyroid hormones and anti-thyroid antibodies. The prevalence of clinical hypothyroidism, subclinical hyperthyroidism, and low T3 syndrome were higher in patients with NMOSD (4.1%, 12.2%, and 20.4%, respectively) compared with healthy controls (0.3%, 2.8%, and 0.5%, respectively; p=0.034, p=0.001, and p<0.001, respectively). However, anti-thyroperoxidase antibody (anti-TPO)-positivity did not significantly differ between NMOSD patients (20.4%) and controls (11.5%). Low T3 syndrome was more prevalent among patients during an attack (N=10/19, 52.6%) than those in remission (N=1/30, 3.3%). In addition, patients with low T 3 syndrome had significantly higher EDSS scores at the last visits as well as at sampling compared to those without low T3 syndrome. T3 levels were inversely correlated with EDSS score at the last visit after adjustment for age, sex, disease duration, clinical status (attack vs. remission), oral prednisolone use, iv methylprednisolone use, other immunosuppressive agents use, and the location of lesion (ρ=-0.416, p=0.010). Our study suggests that thyroid dysfunction is frequent in patients with NMOSD; particularly, serum T3 levels may be a useful indicator of disease activity and disability in NMOSD. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Five fractions of radiation therapy followed by 4 cycles of FOLFOX chemotherapy as preoperative treatment for rectal cancer.

    Science.gov (United States)

    Myerson, Robert J; Tan, Benjamin; Hunt, Steven; Olsen, Jeffrey; Birnbaum, Elisa; Fleshman, James; Gao, Feng; Hall, Lannis; Kodner, Ira; Lockhart, A Craig; Mutch, Matthew; Naughton, Michael; Picus, Joel; Rigden, Caron; Safar, Bashar; Sorscher, Steven; Suresh, Rama; Wang-Gillam, Andrea; Parikh, Parag

    2014-03-15

    Preoperative radiation therapy with 5-fluorouracil chemotherapy is a standard of care for cT3-4 rectal cancer. Studies incorporating additional cytotoxic agents demonstrate increased morbidity with little benefit. We evaluate a template that: (1) includes the benefits of preoperative radiation therapy on local response/control; (2) provides preoperative multidrug chemotherapy; and (3) avoids the morbidity of concurrent radiation therapy and multidrug chemotherapy. Patients with cT3-4, any N, any M rectal cancer were eligible. Patients were confirmed to be candidates for pelvic surgery, provided response was sufficient. Preoperative treatment was 5 fractions radiation therapy (25 Gy to involved mesorectum, 20 Gy to elective nodes), followed by 4 cycles of FOLFOX [5-fluorouracil, oxaliplatin, leucovorin]. Extirpative surgery was performed 4 to 9 weeks after preoperative chemotherapy. Postoperative chemotherapy was at the discretion of the medical oncologist. The principal objectives were to achieve T stage downstaging (ypT chemotherapy. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Divalent Metal Ions Induced Osteogenic Differentiation of MC3T3E1

    Science.gov (United States)

    Wang, Guoshou; Su, Wenta; Chen, Pohung; Huang, Teyang

    2017-12-01

    Biomaterial scaffolds blended with biochemical signal molecules with adequate osteoinductive and osteoconductive properties have attracted significant interest in bone tissue engineering regeneration. The divalent metal ions can gradually release from the scaffold into the culture medium and then induced osteoblastic differentiation of MC3T3E1. These MC3T3E1 cells expressed high activity of alkaline phosphatase, bone-related gene expression of collagen type I, Runx2, osteopontin, osteocalcin, and significantly enhanced deposited minerals on scaffold after 21 days of culture. This experiment provided a useful inducer for osteogenic differentiation in bone repair.

  9. Preparation of quality control samples for thyroid hormones T3 and T4 in radioimmunoassay techniques

    International Nuclear Information System (INIS)

    Ahmed, F.O.A.

    2006-03-01

    Today, the radioimmunoassay becomes one of the best techniques for quantitative analysis of very low concentration of different substances. RIA is being widely used in medical and research laboratories. To maintain high specificity and accuracy in RIA and other related techniques the quality controls must be introduced. In this dissertation quality control samples for thyroid hormones (Triiodothyronine T3 and Thyroxin T4), using RIA techniques. Ready made chinese T4, T3 RIA kits were used. IAEA statistical package were selected.(Author)

  10. An Evaluation of Thyroid Hormones (T4, T3, and Free T4) Concentrations During Pregnancy

    International Nuclear Information System (INIS)

    Lee, Kyu Bo; Kim, Ji Yeul

    1981-01-01

    Serum concentrations of T 4 , T 3 , and free T 4 were measured by radioimmunoassay in normal pregnant women at trimesters, in postpartum women, and cord blood of neonate. Total T 4 were increased during pregnancy, remarkably high in the first trimester, and also somewhat increased in postpartum, and normal in neonate. Total T 3 were in normal range during pregnancy, but increased in postpartum, whereas decreased in neonate. Free T 4 were decreased in 2nd and 3rd trimesters of pregnancy, however normal in postpartum and neonate.

  11. Treatment outcomes regarding the addition of targeted agents in the therapeutic portfolio for stage II-III rectal cancer undergoing neoadjuvant chemoradiation.

    Science.gov (United States)

    Liang, Jin-Tung; Chen, Tzu-Chun; Huang, John; Jeng, Yung-Ming; Cheng, Jason Chia-Hsien

    2017-11-24

    To evaluate the impact of targeted agents in stage II-III rectal cancer undergoing neoadjuvant concurrent chemoradiation therapy (CCRT). A retrospective study was performed in 124 consecutive patients with clinically T 3 N 0-2 M 0 -staged rectal cancer incorporating targeted agents in CCRT. Pathologic complete response was detected in 34.2% (n=26) of bevacizumab+FOLFOX-treated patients (n=76), which was significantly higher (p=0.019, post-hoc statistical power =35.87%) than that (n=10, 20.8%) of the cetuximab+FOLFOX-treated patients (n=48). Patients receiving cetuximab+FOLFOX therapy tended to develop severe liver toxicity (91.7%, n=44 versus 17.1%, n=13, panalysis within bevacizumab+FOLFOX-treated patients with either wild-type (n=36) or mutant (n=40) K-ras status indicated K-ras status did not significantly influence the treatment outcomes. The addition of bevacizumab instead of cetuximab to FOLFOX in the neoadjuvant settings for T 3 N 0-2 M 0 -staged rectal cancer could induce a promising rate of pathologic complete response and lesser hepatotoxicity.

  12. Multidisciplinary Rectal Cancer Management: 2nd European Rectal Cancer Consensus Conference (EURECA-CC2).

    NARCIS (Netherlands)

    Valentini, V.; Aristei, C.; Glimelius, B.; Minsky, B.D.; Beets-Tan, R.G.; Borras, J.M.; Haustermans, K.; Maingon, P.; Overgaard, J.; Pahlman, L.; Quirke, P.; Schmoll, H.J.; Sebag-Montefiore, D.; Taylor, I.; Cutsem, E. van; Velde, C. van de; Cellini, N.; Latini, P.

    2009-01-01

    BACKGROUND AND PURPOSE: During the first decade of the 21st century a number of important European randomized studies were published. In order to help shape clinical practice based on best scientific evidence from the literature, the International Conference on 'Multidisciplinary Rectal Cancer

  13. Tumor Volume Reduction Rate Measured by Magnetic Resonance Volumetry Correlated With Pathologic Tumor Response of Preoperative Chemoradiotherapy for Rectal Cancer

    International Nuclear Information System (INIS)

    Yeo, Seung-Gu; Kim, Dae Yong; Kim, Tae Hyun; Jung, Kyung Hae; Hong, Yong Sang; Chang, Hee Jin; Park, Ji Won; Lim, Seok-Byung; Choi, Hyo Seong; Jeong, Seung-Yong

    2010-01-01

    Purpose: To determine whether the tumor volume reduction rate (TVRR) measured using three-dimensional region-of-interest magnetic resonance volumetry correlates with the pathologic tumor response after preoperative chemoradiotherapy (CRT) for locally advanced rectal cancer. Methods and Materials: The study included 405 patients with locally advanced rectal cancer (cT3-T4) who had undergone preoperative CRT and radical proctectomy. The tumor volume was measured using three-dimensional region-of-interest magnetic resonance volumetry before and after CRT but before surgery. We analyzed the correlation between the TVRR and the pathologic tumor response in terms of downstaging and tumor regression grade (TRG). Downstaging was defined as ypStage 0-I (ypT0-T2N0M0), and the TRG proposed by Dworak et al. was used. Results: The mean TVRR was 65.0% ± 22.3%. Downstaging and complete regression occurred in 167 (41.2%) and 58 (14.3%) patients, respectively. The TVRRs according to ypT classification (ypT0-T2 vs. ypT3-T4), ypN classification (ypN0 vs. ypN1-N2), downstaging (ypStage 0-I vs. ypStage II-III), good regression (TRG 3-4 vs. TRG 1-2), and complete regression (TRG 4 vs. TRG 1-3) were all significantly different (p 80%), the rates of ypT0-T2, ypN0, downstaging, and good regression were all significantly greater for patients with a TVRR of ≥60%, as was the complete regression rate for patients with a TVRR >80% (p <.05). Conclusion: The TVRR measured using three-dimensional region-of-interest magnetic resonance volumetry correlated significantly with the pathologic tumor response in terms of downstaging and TRG after preoperative CRT for locally advanced rectal cancer.

  14. Combined curative radiation therapy alone in (T1) T2-3 rectal adenocarcinoma: a pilot study of 29 patients

    International Nuclear Information System (INIS)

    Gerard, J.P.; Roy, P.; Coquard, R.; Barbet, N.; Romestaing, P.; Ayzac, L.; Ardiet, J.M.; Thalabard, J.C.

    1996-01-01

    Aim: Analysis of a pilot study including 29 consecutive patients with high surgical risk or refusal of colostomy treated with radiation therapy alone with curative intent. Patients: Between 1986 and 1992, 29 patients were treated for infiltrating adenocarcinoma of the rectum. Median age was 72 years. Transrectal ultrasound staging was used in 24 patients (T1, 2; T2, 14; T3, 13; N0, 23; N1, 6). In 20 patients the lower border of the tumor was at 5 cm or less from the anal verge and in 19 patients the diameter exceeded 3 cm. CEA was elevated in seven cases. Treatment: Contact X-ray (50 kV) was given first (70 Gy/3 fractions). External beam radiation therapy used a three-field technique in the prone position. Accelerated schedule (39 Gy/13 fractions/17 days) with a concomitant boost 'field within the field' (4 Gy/4 fractions). Six weeks later an iridium-192 implant was performed in 21 (20 Gy/22 h). Results: Median follow-up time was 46 months. Overall and specific survival at 5 years was 68% (SE = 0.09) and 76% (SE = 0.08). Local control was obtained in (21(29)) patients (72%). There was one grade 2 rectal bleeding and five grade 2 rectal necroses. The overall tolerance was good in these frail patients. Discussion: For T2. T3 or T1 > 3 cm diameter rectal adenocarcinoma, where contact X-ray alone is not recommended, a combined treatment with radiation therapy alone is able to give good local control with acceptable toxicity. This treatment should be restricted to inoperable patients

  15. Solitary Rectal Ulcer Syndrome: A Biopsychosocial Assessment

    Directory of Open Access Journals (Sweden)

    Hamed Daghaghzadeh

    2016-06-01

    Full Text Available Background: Solitary rectal ulcer syndrome (SRUS is a chronic disorder of the gastrointestinal tract and its etiology is not well understood. There is no specific treatment for this syndrome and patients with SRUS may, for years, experience many complications. The aim of the present research was the biopsychosocial study of patients with SRUS.Methods: The study participants consisted of 16 patients with SRUS (7 men and 9 women. Their medical records were reviewed retrospectively to evaluate the clinical spectrum of the patients along with the endoscopic and histological findings. Moreover, psychiatric and personality disorders [based on Diagnostic and Statistical Manual of Mental Disorders, 4th ed, Text Revision (DSM IV-TR], psychosocial stressors, early life traumas, and coping mechanisms were assessed through structured interviews.Results: At presentation, mean age of the patients was 39 years (16 to 70. Common symptoms reported included rectal bleeding (93.8%, rectal self-digitations (81.2%, passage of mucous (75%, anal pain (75%, and straining (75%. Endoscopically, solitary and multiple lesions were present in 9 (60% and 4 (26.7% patients, respectively, and 87% of lesions were ulcerative and 13.3% polypoidal. The most common histological findings were superficial ulceration (92.85% and intercryptic fibromuscular obliteration (87.71%. Common psychosocial findings included anxiety disorders (50%, depression (37.5%, obsessive-compulsive personality disorder (OCPD or traits (62.5%, interpersonal problems (43.75%, marital conflicts (43.75%, occupational stress (37.5%, early life traumas, physical abuse (31.25%, sexual abuse (31.25%, dysfunctional coping mechanisms, emotional inhibition (50%, and non-assertiveness (37.5%.Conclusion: Given the evidence in this study, we cannot ignore the psychosocial problems of patients with SRUS and biopsychosocial assessment of SRUS is more appropriate than biomedical evaluation alone.

  16. Is rectal MRI beneficial for determining the location of rectal cancer with respect to the peritoneal reflection?

    International Nuclear Information System (INIS)

    Jung, Eun Joo; Ryu, Chun Geun; Kim, Gangmi; Kim, Su Ran; Nam, Sang Eun; Park, Hee Sun; Kim, Young Jun; Hwang, Dae-Yong

    2012-01-01

    An objective method for determining the location of the cancer with respect to peritoneal reflection would be helpful to decide the treatment modality for rectal cancer. This study was designed to evaluate the accuracy and usefulness of rectal MRI to determine spatial relations between the peritoneal reflection and rectal cancer and to compare these with operative findings. Patients that underwent a rectal cancer operation after a rectal MRI check between November 2008 and June 2010 were considered for the study. The patients that received preoperative concurrent chemoradiation or trans-anal local excision were excluded. Fifty-four patients constituted the study cohort. By comparing surgical and radiologic findings, the accuracy for predicting tumour location in relation to the peritoneal reflection by rectal MRI in all patients was 90.7%. In terms of tumour location in relation to peritoneal reflection, the accuracy of rectal MRI was 93.5% in patients with a tumour located above the peritoneal reflection, 90.0% in patients with a tumour located on the peritoneal reflection, and 84.6% in patients with a tumour located below the peritoneal reflection (p=0.061). When the cohort was subdivided by gender, body mass index (BMI), operative findings, or tumour size, no significant difference was observed among subgroups. Rectal MRI could be a useful tool for evaluating the relation between rectal cancer and peritoneal reflection especially when tumour size is less than 8cm. Rectal MRI can provide information regarding the location of rectal cancer in relation to the peritoneal reflection for treatment planning purposes

  17. Single-port laparoscopic rectal surgery - a systematic review

    DEFF Research Database (Denmark)

    Lolle, Ida; Rosenstock, Steffen; Bulut, Orhan

    2014-01-01

    INTRODUCTION: Single-port laparoscopic surgery (SPLS) for colonic disease has been widely described, whereas data for SPLS rectal resection are sparse. This review aimed to evaluate the feasibility, safety and complication profile of SPLS for rectal diseases. METHODS: A systematic literature search...

  18. Fournier gangrene: Rare complication of rectal cancer | Ossibi | Pan ...

    African Journals Online (AJOL)

    Fournier's Gangrene is a rare complication of rectal cancer. It's discovery is often delayed. It's incidence is about 0.3/100 000 populations in Western countries. We report a patient with peritoneal perforation of rectal cancer revealed by scrotal and perineal necrotizing fasciitis. AJOL African Journals Online. HOW TO USE ...

  19. Laparoscopic versus open surgery for rectal cancer (COLOR II)

    DEFF Research Database (Denmark)

    van der Pas, Martijn Hgm; Haglind, Eva; Cuesta, Miguel A

    2013-01-01

    Laparoscopic surgery as an alternative to open surgery in patients with rectal cancer has not yet been shown to be oncologically safe. The aim in the COlorectal cancer Laparoscopic or Open Resection (COLOR II) trial was to compare laparoscopic and open surgery in patients with rectal cancer....

  20. An Alternative Technique in the Control of Massive Presacral Rectal ...

    African Journals Online (AJOL)

    Bleeding control was provided by GORE‑TEX® graft. We conclude that fıxatıon of GORE‑TEX® aortic patch should be kept in mind for uncontrolled massive presacral bleeding. KEYWORDS: GORE‑TEX® graft, presacral bleeding, rectal cancer. An Alternative Technique in the Control of Massive Presacral Rectal. Bleeding: ...

  1. Rectal prolapse : in search of the holy grail

    NARCIS (Netherlands)

    van Iersel, Jan

    2017-01-01

    The treatment of (internal and external) rectal prolapse (IRP/ERP), and its affiliated rectocele and enterocele, has become an increasingly important part of health care over the years. Although benign, rectal prolapse is associated with a myriad of debilitating symptoms including fecal

  2. Rectal cancer and Fournier's gangrene - current knowledge and therapeutic options.

    Science.gov (United States)

    Bruketa, Tomislav; Majerovic, Matea; Augustin, Goran

    2015-08-14

    Fournier's gangrene (FG) is a rapid progressive bacterial infection that involves the subcutaneous fascia and part of the deep fascia but spares the muscle in the scrotal, perianal and perineal region. The incidence has increased dramatically, while the reported incidence of rectal cancer-induced FG is unknown but is extremely low. Pathophysiology and clinical presentation of rectal cancer-induced FG per se does not differ from the other causes. Only rectal cancer-specific symptoms before presentation can lead to the diagnosis. The diagnosis of rectal cancer-induced FG should be excluded in every patient with blood on digital rectal examination, when urogenital and dermatological causes are excluded and when fever or sepsis of unknown origin is present with perianal symptomatology. Therapeutic options are more complex than for other forms of FG. First, the causative rectal tumor should be removed. The survival of patients with rectal cancer resection is reported as 100%, while with colostomy it is 80%. The preferred method of rectal resection has not been defined. Second, oncological treatment should be administered but the timing should be adjusted to the resolution of the FG and sometimes for the healing of plastic reconstructive procedures that are commonly needed for the reconstruction of large perineal, scrotal and lower abdominal wall defects.

  3. Progress in the surgery of rectal cancer

    Directory of Open Access Journals (Sweden)

    Rudolf Schiessel

    2018-01-01

    Full Text Available The treatment of rectal cancer has been improved a great deal within the last 20 years. Major progress has been made in the preoperative evaluation by introducing MRI- imaging as a basis for the further management. Neoadjuvant radiochemotherapy has been shown to be effective in downstaging of advanced tumours. The surgical technique has been improved in many respects.- Total mesorectal excision has reduced local recurrences, sphincter saving techniques such as low anterior resection and intersphincteric resection reduced the need for a permanent stoma to 10%-20%. Recently the introduction of minimal invasive techniques and the application of robotic systems have reduced the surgical trauma.

  4. Rectal duplication presenting as colonic subocclusion.

    Science.gov (United States)

    Vuilleumier, H; Maternini, M

    2006-04-01

    Rectal duplication cyst is a rare congenital lesion which is known to be associated with other congenital defects, especially genitourinary and vertebral anomalies. Infections with fistulization, bleeding, and malignant degeneration are the major complications of developmental cysts. The case of an 83-year-old woman referred for acute constipation associated with abdominal distension is reported. CT and MRI showed a large cystic mass of the pelvis with extrinsic compression of the rectum. Surgical excision would have been the treatment of choice. In this case, the patient was unfortunately not eligible for surgery due to her poor general condition but responded well to conservative treatment.

  5. Efficacy and Safety of Low-Dose-Rate Endorectal Brachytherapy as a Boost to Neoadjuvant Chemoradiation in the Treatment of Locally Advanced Distal Rectal Cancer: A Phase-II Clinical Trial.

    Science.gov (United States)

    Omidvari, Shapour; Zohourinia, Shadi; Ansari, Mansour; Ghahramani, Leila; Zare-Bandamiri, Mohammad; Mosalaei, Ahmad; Ahmadloo, Niloofar; Pourahmad, Saeedeh; Nasrolahi, Hamid; Hamedi, Sayed Hasan; Mohammadianpanah, Mohammad

    2015-08-01

    Despite advances in rectal cancer treatment over the last decade, local control and risk of late side effects due to external beam radiation therapy (EBRT) remain as concerns. The present study aimed to investigate the efficacy and the safety of low-dose-rate endorectal brachytherapy (LDRBT) as a boost to neoadjuvant chemoradiation for use in treating locally advanced distal rectal adenocarcinomas. This phase-II clinical trial included 34 patients (as the study arm) with newly diagnosed, locally advanced (clinical T3-T4 and/or N1/N2, M0) lower rectal cancer. For comparative analysis, 102 matched patients (as the historical control arm) with rectal cancer were also selected. All the patients were treated with LDRBT (15 Gy in 3 fractions) and concurrent chemoradiation (45-50.4 Gy). Concurrent chemotherapy consisted of oxaliplatin 130 mg/m(2) intravenously on day 1 plus oral capecitabine 825 mg/m(2) twice daily during LDRBT and EBRT. The study results revealed a significant differences between the study arm and the control arm in terms in the pathologic tumor size (2.1 cm vs. 3.6 cm, P = 0.001), the pathologic tumor stage (35% T3-4 vs. 65% T3-4, P = 0.003), and the pathologic complete response (29.4% vs. 11.7%, P < 0.028). Moreover, a significantly higher dose of EBRT (P = 0.041) was found in the control arm, and a longer time to surgery was observed in the study arm (P < 0.001). The higher rate of treatment-related toxicities, such as mild proctitis and anemia, in the study arm was tolerable and easily manageable. A boost of LDRBT can optimize the pathologic complete response, with acceptable toxicities, in patients with distal rectal cancer.

  6. Continuous Effect of Radial Resection Margin on Recurrence and Survival in Rectal Cancer Patients Who Receive Preoperative Chemoradiation and Curative Surgery: A Multicenter Retrospective Analysis.

    Science.gov (United States)

    Sung, SooYoon; Kim, Sung Hwan; Lee, Joo Hwan; Nam, Taek Keun; Jeong, Songmi; Jang, Hong Seok; Song, Jin Ho; Lee, Jeong Won; Bae, Jung Min; Lee, Jong Hoon

    2017-07-01

    To elucidate the proper length and prognostic value of resection margins in rectal cancer patients who received preoperative chemoradiotherapy (CRT) followed by curative total mesorectal excision (TME). A total of 1476 rectal cancer patients staging cT3-4N0-2M0 were analyzed. All patients received radiation dose of 50.4 Gy in 28 fractions with concurrent 5-fluorouracil or capecitabine. Total mesorectal excision was performed 4 to 8 weeks after radiation therapy. The recurrence-free survival (RFS) at 5 years showed a significant difference between 3 groups: patients with circumferential resection margin (CRM) ≤1 mm, CRM 1.1 to 5 mm, and CRM >5 mm (46.2% vs 68.6% vs 77.5%, P5 mm. Distal resection margin (≤5 vs >5 mm) did not show any significant difference in cumulative incidence of locoregional recurrence (P=.310) and distant metastasis (P=.926). Rectal cancer patients with CRM ≤1 mm are a high-risk group, with the lowest RFS. Patients with CRM 1.1 to 5 mm may be at intermediate risk, with moderately increased distant recurrence. Distal resection margin was not significantly associated with RFS in rectal cancer after neoadjuvant CRT and total mesorectal excision. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. A Phase II study of preoperative radiotherapy and concomitant weekly irinotecan in combination with protracted venous infusion 5-fluorouracil, for resectable locally advanced rectal cancer

    International Nuclear Information System (INIS)

    Navarro, Matilde; Dotor, Emma; Rivera, Fernando; Sanchez-Rovira, Pedro; Vega-Villegas, Maria Eugenia; Cervantes, Andres; Garcia, Jose Luis; Gallen, Manel; Aranda, Enrique

    2006-01-01

    Purpose: The aim of this study was to evaluate the efficacy and tolerance of preoperative chemoradiotherapy (CRT) with irinotecan (CPT-11) and 5-fluorouracil (5-FU) in patients with resectable rectal cancer. Methods and Materials: Patients with resectable T3-T4 rectal cancer and Eastern Cooperative Oncology Group performance status 2 weekly) and 5-FU (225 mg/m 2 /day continuous infusion, 5 days/week) were concurrently administered with radiation therapy (RT) (45 Gy, 1.8 Gy/day, 5 days/week), during 5 weeks. Results: A total of 74 patients were enrolled: mean age, 59 years (20-74 years; SD, 11.7). Planned treatment was delivered to most patients (median relative dose intensity for both drugs was 100%). Grade 3/4 lymphocytopenia occurred in 35 patients (47%), neutropenia in 5 (7%), and anemia in 2 (3%). Main Grade 3 nonhematologic toxicities were diarrhea (14%), asthenia (9%), rectal mucositis (8%), and abdominal pain (8%). Of the 73 resected specimens, 13.7% (95% confidence interval [CI], 6.8-23.7) had a pathologic complete response and 49.3% (95% CI, 37.4-61.3) were downstaged. Additionally, 66.7% (95% CI, 51.1-80.0) of patients with ultrasound staged N1/N2 disease had no pathologic evidence of nodal involvement after CRT. Conclusions: This preoperative CRT schedule has been shown to be effective and feasible in a large population of patients with resectable rectal cancer

  8. Impact of T and N substage on survival and disease relapse in adjuvant rectal cancer: a pooled analysis

    International Nuclear Information System (INIS)

    Gunderson, Leonard L.; Sargent, Daniel J.; Tepper, Joel E.; O'Connell, Michael J.; Allmer, Cristine; Smalley, Steven R.; Martenson, James A.; Haller, Daniel G.; Mayer, Robert J.; Rich, Tyvin A.; Ajani, Jaffer A.; Macdonald, John S.; Goldberg, Richard M.

    2002-01-01

    Purpose: To determine the rates of survival and disease control by TNM and MAC stage in three randomized North American rectal adjuvant studies. Materials and Methods: Data were merged from 2551 eligible patients on NCCTG 79-47-51 (n=200), NCCTG 86-47-51 (n=656), and INT 114 (n=1695). All patients received postoperative radiation, and 96% were randomized to receive concomitant and maintenance chemotherapy. Five-year follow-up was available in 94% of patients and 7-yr follow-up in 84%. Kaplan-Meier curves were used to estimate the distribution of overall survival (OS) and disease-free survival (DFS), and p values were derived using the log-rank test. Time to local and distant relapse was estimated using cumulative incidence methodology. Analyses were adjusted for treatment effect using Cox proportional hazards models. Results: OS and DFS were dependent on both TN stage and NT stage (N substage within T stage and T substage within N stage). Even among N2 patients (4 or more LN+), T stage influenced 5-yr OS (T1-2, 69%; T3, 48%; T4, 38%). Three risk groups of patients were defined: (1) intermediate: T3N0, T1-2N1; (2) moderately high: T4N0, T1-2N2, T3N1; and (3) high: T3N2, T4N1, T4N2. For Group 1, 5-yr OS was 74% and 81%, and 5-yr DFS was 66% and 74%. For Group 2, 5-yr OS ranged from 61% to 69%, and for Group 3, OS ranged from 33% to 48%. Cumulative incidence rates of local relapse and distant metastases revealed similar differences by TN and NT stage, as seen in the survival analyses. Conclusion: Patients with a single high-risk factor of either extension beyond the rectal wall (T3N0) or nodal involvement (T1-2N1) have improved OS, DFS, and disease control when compared to those with both high risk factors. Different treatment strategies may be indicated for intermediate- (T3N0, T1-2N1) vs. moderately high or high-risk patients in view of differential survival and rates of relapse. For future trial design, it may be preferable to perform separate studies, or a planned

  9. Fluorescence lifetime imaging of lipids during 3T3-L1 cell differentiation

    Science.gov (United States)

    Song, Young Sik; Won, Young Jae; Lee, Sang-Hak; Kim, Dug Young

    2014-03-01

    Obesity is becoming a big health problem in these days. Since increased body weight is due to increased number and size of the triglyceride-storing adipocytes, many researchers are working on differentiation conditions and processes of adipocytes. Adipocytes also work as regulators of whole-body energy homeostasis by secreting several proteins that regulate processes as diverse as haemostasis, blood pressure, immune function, angiogenesis and energy balance. 3T3-L1 cells are widely used cell line for studying adipogenesis because it can differentiate into an adipocyte-like phenotype under appropriate conditions. In this paper, we propose an effective fluorescence lifetime imaging technique which can easily distinguish lipids in membrane and those in lipid droplets. Nile red dyes are attached to lipids in 3T3-L1 cells. Fluorescence lifetime images were taken for 2 week during differentiation procedure of 3T3-L1 cells into adipocytes. We used 488 nm pulsed laser with 5MHz repetition rate and emission wavelength is 520 nm of Nile Red fluorescent dye. Results clearly show that the lifetime of Nile red in lipid droplets are smaller than those in cell membrane. Our results suggest that fluorescence lifetime imaging can be a very powerful tool to monitor lipid droplet formation in adipocytes from 3T3-L1 cells.

  10. Anti-Obesity Effects of Starter Fermented Kimchi on 3T3-L1 Adipocytes

    Science.gov (United States)

    Lee, Kyung-Hee; Song, Jia-Le; Park, Eui-Seong; Ju, Jaehyun; Kim, Hee-Young; Park, Kun-Young

    2015-01-01

    The anti-obesity effects of starter (Leuconostoc mesenteroides+Lactobacillus plantarum) fermented kimchi on 3T3-L1 adipocyte were studied using naturally fermented kimchi (NK), a functional kimchi (FK, NK supplemented with green tea), and FK supplemented with added starters (FKS). Oil red O staining and cellular levels of triglyceride (TG) and glycerol were used to evaluate the in vitro anti-obesity effects of these kimchis in 3T3-L1 cells. The expressions of adipogenesis/lipogenesis-related genes of peroxisome proliferator-active receptor (PPAR)-γ, CCAAT/enhance-binding protein (C/EBP)-α, and fatty acid synthase (FAS) were determined by RT-PCR. Kimchis, especially FKS, markedly decreased TG levels and increased levels of intracellular glycerol and lipid lipolysis. In addition, FKS also reduced the mRNA levels of PPAR-γ, C/EBP-α, and FAS, which are related to adipogenesis/lipogenesis in 3T3-L1 cells. These results suggest the anti-obesity effects of FKS were to due to enhanced lipolysis and reduced adipogenesis/lipogenesis in 3T3-L1 adipocytes. PMID:26770918

  11. A T = 3/2 LEVEL IN Be9

    Energy Technology Data Exchange (ETDEWEB)

    Lauritsen, T.; Lynch, B.; Griffiths, G.

    1963-12-15

    Targets of Li7 were bombarded with a He3 beam from a tandem accelerator, and the resulting proton spectrum was studied to determined a T = 3/ 2 level in Be9 at about 14.5 Mev. (R.E.U.)

  12. Automated studies of radiation-induced changes in 3T3 cell motility and morphology

    International Nuclear Information System (INIS)

    Thurston, G.; Palcic, B.

    1985-01-01

    The most common endpoint in radiobiological studies is cell survival, as measured by colony forming ability. There is substantial experimental evidence that cell survival is related to the amount of radiation damage to the DNA. Radiation induces other changes in cell behaviour and morphology that may not be due to DNA damage alone. For example, low doses of radiation (<100 rads) were found to alter the ''phagokinetic tracks'' of moving 3T3 cells. They reported abnormal cell motility as demonstrated by a more random pattern of motion. 3T3 cells were also noted to show changes in morphology after exposure to x-rays. The fibroblast adhesion routine is disrupted by low doses of radiation (cell settling, microspike extension, lamellipodia flow, then cell spreading). An automated microscope system, DMIPS, is being used to automatically track 3T3 cells as they move and to correlate their movement with their morphology. An effort is being made to quantitate, for a large number of cells, the changes in 3T3 cell motility induced by radiation. The DMIPS procedure is compared to the gold dust technique

  13. Radioimmunoassay of serum T3, T4 and TSH during anesthesia and operation

    International Nuclear Information System (INIS)

    Gosheva-Antonova, Ts.; Zakharieva, B.; Kurtev, I.

    1987-01-01

    The serum concentrations of thyroxine (T 3 ), triiodothyronine (T 4 ) and thyroid-stimulating hormone (TSH) were determined in 31 partients before and during urologic operations on the 30th and 60th minute since the onset of the operation, performed under endotracheal halotane or neuroleptanesthesia (NLA) in assisted breathing and intravenous drip anesthesia with ketalar-diazepam in spontaneous breathing. There was statistically significant rise in T 4 level, decrease in T 3 and negligible changes in TSH level, in patients operated under halotane anesthesia. In those operated under NLA, T 4 tended initially to be elevated, with subseguent fall to starting level, with a tendency toward rise in TSH and stable unchanged T 3 level. Ketalar-diazepam anesthesia was applied only to patients subjected to transurethral resections. T 4 in them tended to be decreased, while T 3 and TSH showed negligible changes. Since the operations of patients anesthesized with halotane and NLA had similar localizations and severity, the differences in the thyroid hormone reactions could be associated with the type of anesthesia. The negligible changes in TSH are highly suggestive that this hormone is not influenced by the operation stress and anesthetics, and does hot exert regulating effect upon the thyroid status under these conditions. The milder reactions in patients operated under ketalar-diazepam anestesia may largely be associated with the milder operation stress in transurethal resection

  14. Central diabetes insipidus preceding acute myeloid leukemia with t(3;12)(q26;p12)

    NARCIS (Netherlands)

    Nieboer, P; Vellenga, E; Adriaanse, R; van de Loosdrecht, AA

    A 52-year-old woman presented with polyuria and polydipsia. ii diagnosis of central diabetes insipidus (DI) was made, which turned out to be the first sign of acute myeloid leukemia (AML). Cytogenetic analysis revealed a balanced translocation between chromosome 3 and 12 t(3;12)(q26;p12). The

  15. Rectal duplication cyst in adults treated with transanal endoscopic microsurgery.

    Science.gov (United States)

    Ben-Ishay, O; Person, B; Eran, B; Hershkovitz, D; Duek, D Simon

    2011-12-01

    Rectal duplication cyst is a rare entity that accounts for approximately 4% of all alimentary tract duplications. To the best of our knowledge, the presented cases are the first reports in the English literature of rectal duplication cyst resection by transanal endoscopic microsurgery. We present two patients; both are 41-year-old women with a palpable rectal mass. Workup revealed a submucosal posterior mass that was then resected by transanal endoscopic microsurgery. The pathology report described cystic lesions with squamous and columnar epithelium and segments of smooth muscle. These findings were compatible with rectal duplication cyst. Our limited experience showed good results with minimal morbidity and mortality for resection of rectal duplication cysts of limited size with no evidence of malignancy.

  16. MRI in local staging of rectal cancer: an update

    Science.gov (United States)

    Tapan, Ümit; Özbayrak, Mustafa; Tatlı, Servet

    2014-01-01

    Preoperative imaging for staging of rectal cancer has become an important aspect of current approach to rectal cancer management, because it helps to select suitable patients for neoadjuvant chemoradiotherapy and determine the appropriate surgical technique. Imaging modalities such as endoscopic ultrasonography, computed tomography, and magnetic resonance imaging (MRI) play an important role in assessing the depth of tumor penetration, lymph node involvement, mesorectal fascia and anal sphincter invasion, and presence of distant metastatic diseases. Currently, there is no consensus on a preferred imaging technique for preoperative staging of rectal cancer. However, high-resolution phased-array MRI is recommended as a standard imaging modality for preoperative local staging of rectal cancer, with excellent soft tissue contrast, multiplanar capability, and absence of ionizing radiation. This review will mainly focus on the role of MRI in preoperative local staging of rectal cancer and discuss recent advancements in MRI technique such as diffusion-weighted imaging and dynamic contrast-enhanced MRI. PMID:25010367

  17. Rectal prolapse as initial clinical manifestation of colon cancer.

    Science.gov (United States)

    Chen, C-W; Hsiao, C-W; Wu, C-C; Jao, S-W

    2008-04-01

    Rectal prolapse as the initial clinical manifestation of colorectal cancer is uncommon. We describe the case of a 75-year-old woman who was diagnosed as having adenocarcinoma of the sigmoid colon after presenting with complete rectal prolapse. The tumor caused rectosigmoid intussusception and then it prolapsed out through the anus. She underwent rectosigmoidectomy and rectopexy. The postoperative course was uneventful. The relationship between colorectal cancer and rectal prolapse has not been clearly established. This case report describes an unusual presentation of colorectal cancer. It suggests that rectal prolapse can present as the initial symptom of colorectal cancer and may also be a presenting feature of the occult intra-abdominal pathology. The importance of adequate investigation such as colonoscopy should be emphasized in patients who develop a new onset of rectal prolapse.

  18. Use of Molecular Imaging to Predict Clinical Outcome in Patients With Rectal Cancer After Preoperative Chemotherapy and Radiation

    International Nuclear Information System (INIS)

    Konski, Andre; Li Tianyu; Sigurdson, Elin; Cohen, Steven J.; Small, William; Spies, Stewart; Yu, Jian Q.; Wahl, Andrew; Stryker, Steven; Meropol, Neal J.

    2009-01-01

    Purpose: To correlate changes in 2-deoxy-2-[18F]fluoro-D-glucose (18-FDG) positron emission tomography (PET) (18-FDG-PET) uptake with response and disease-free survival with combined modality neoadjuvant therapy in patients with locally advanced rectal cancer. Methods and Materials: Charts were reviewed for consecutive patients with ultrasound-staged T3x to T4Nx or TxN1 rectal adenocarcinoma who underwent preoperative chemoradiation therapy at Fox Chase Cancer Center (FCCC) or Robert H. Lurie Comprehensive Cancer Center of Northwestern University with 18-FDG-PET scanning before and after combined-modality neoadjuvant chemoradiation therapy . The maximum standardized uptake value (SUV) was measured from the tumor before and 3 to 4 weeks after completion of chemoradiation therapy preoperatively. Logistic regression was used to analyze the association of pretreatment SUV, posttreatment SUV, and % SUV decrease on pathologic complete response (pCR), and a Cox model was fitted to analyze disease-free survival. Results: A total of 53 patients (FCCC, n = 41, RLCCC, n = 12) underwent pre- and postchemoradiation PET scanning between September 2000 and June 2006. The pCR rate was 31%. Univariate analysis revealed that % SUV decrease showed a marginally trend in predicting pCR (p = 0.08). In the multivariable analysis, posttreatment SUV was shown a predictor of pCR (p = 0.07), but the test results did not reach statistical significance. None of the investigated variables were predictive of disease-free survival. Conclusions: A trend was observed for % SUV decrease and posttreatment SUV predicting pCR in patients with rectal cancer treated with preoperative chemoradiation therapy. Further prospective study with a larger sample size is warranted to better characterize the role of 18-FDG-PET for response prediction in patients with rectal cancer.

  19. Osteogenic gene expression of murine osteoblastic (MC3T3-E1) cells under cyclic tension

    International Nuclear Information System (INIS)

    Kao, C T; Chen, C C; Cheong, U-I; Liu, S L; Huang, T H

    2014-01-01

    Low-level laser therapy (LLLT) can promote cell proliferation. The remodeling ability of the tension side of orthodontic teeth affects post-orthodontic stability. The purpose of the present study was to investigate the osteogenic effects of LLLT on osteoblast-like cells treated with a simulated tension system that provides a mechanical tension regimen. Murine osteoblastic (MC3T3-E1) cells were cultured in a Flexcell strain unit with programmed loads of 12% elongation at a frequency of 0.5 Hz for 24 and 48 h. The cultured cells were treated with a low-level diode laser using powers of 5 J and 10 J. The proliferation of MC3T3-E1 cells was determined using the Alamar Blue assay. The expression of osteogenic genes (type I collagen (Col-1), osteopontin (OPN), osteocalcin (OC), osteoprotegerin (OPG), receptor activator of nuclear factor kappa B ligand (RANKL), bone morphologic protein (BMP-2), and bone morphologic protein (BMP-4)) in MC3T3-E1 cells was analyzed using reverse transcription polymerase chain reaction (RT-PCR). The data were analyzed using one-way analysis of variance. The proliferation rate of tension-cultured MC3T3-E1 cells under 5 J and 10 J LLLT increased compared with that of the control group (p < 0.05). Prominent mineralization of the MC3T3-E1 cells was visible using a von Kossa stain in the 5 J LLLT group. Osteogenic genes (Col-1, OC, OPG and BMP-2) were significantly expressed in the MC3T3-E1 cells treated with 5 J and 10 J LLLT (p < 0.05). LLLT in tension-cultured MC3T3-E1 cells showed synergistic osteogenic effects, including increases in cell proliferation and Col-1, OPN, OC, OPG and BMP-2 gene expression. LLLT might be beneficial for bone remodeling on the tension side of orthodontics. (paper)

  20. Acute treatment-related diarrhea during postoperative adjuvant therapy for high-risk rectal carcinoma

    International Nuclear Information System (INIS)

    Miller, Robert C.; Martenson, James A.; Sargent, Daniel J.; Kahn, Michael J.; Krook, James E.

    1998-01-01

    Purpose: The combination of pelvic radiotherapy and 5-fluorouracil-based chemotherapy is associated with an increase in acute gastrointestinal toxicity during rectal adjuvant therapy, most notably an increased incidence of diarrhea. Previous randomized, prospective studies have limited their analysis to presenting rates of severe and life-threatening diarrhea (Grade 3 or greater), and few data are available detailing the extent of mild to moderate diarrhea. To provide baseline data for future studies, we conducted a detailed analysis of diarrhea from a prior clinical trial of adjuvant therapy for rectal cancer. Methods and Materials: In a multiinstitutional clinical trial, 204 eligible patients with rectal carcinoma that either was deeply invasive (T3-T4) or involved regional lymph nodes were randomized to receive either postoperative pelvic radiotherapy alone (45 to 50.4 Gy) or pelvic radiotherapy and bolus 5-fluorouracil-based chemotherapy. Toxicity was assessed prospectively. Results: For the 99 eligible patients who received pelvic radiotherapy alone, rates of Grades 0, 1, 2, 3, and 4 diarrhea during treatment were 59, 20, 17, 4, and 0%, respectively. For the 96 eligible patients who received radiotherapy and 5-fluorouracil, the overall rates of grades 0, 1, 2, 3, and 4 diarrhea were 21, 34, 23, 20, and 2%, respectively. The increased rates of diarrhea during adjuvant rectal therapy were manifested across all toxicity levels for patients receiving chemotherapy and pelvic radiotherapy. Of primary clinical importance is the substantial increase in severe or life-threatening diarrhea (Grade 3 or more) (22 vs. 4%, p = 0.001) Additionally, increased rates of any diarrhea and also severe or life-threatening diarrhea were observed in patients who had a low anterior resection compared with those who had an abdominoperineal resection (p < 0.001 and p = 0.006, respectively). Conclusion: These results will be of value as a baseline for investigators who want to use

  1. Rectal cancer and inflammatory bowel disease: natural history and implications for radiation therapy

    International Nuclear Information System (INIS)

    Green, Sheryl; Stock, Richard; Greenstein, Adrian

    1995-01-01

    PURPOSES/OBJECTIVE: There exists little information concerning the natural history of rectal cancer in patients with inflammatory bowel disease. In addition, the tolerance of pelvic irradiation in these patients is unknown. We analyzed the largest series of patients with inflammatory bowel disease and rectal cancer in order to determine the natural history of the disease as well as the effect and tolerance of pelvic irradiation. MATERIAL AND METHODS: A retrospective analysis of 47 patients with inflammatory bowel disease and rectal cancer treated over a 34 year period (1960-1994) was performed. Thirty five patients had Ulcerative Colitis and 12 patients had Crohn's Disease. There were 31 male patients and 16 female patients. The stage (AJC) distribution was as follows: stage 0 in 5 patients, stage I in 13 patients, stage II in 7 patients, stage III in 13 patients and stage IV in 9 patients. Surgical resection was performed in 44 patients. In 2 of these patients, preoperative pelvic irradiation was given followed by surgery. Twenty of these patients underwent post-operative adjuvant therapy (12 were treated with chemotherapy and pelvic irradiation and 8 with chemotherapy alone). Three patients were found to have unresectable disease and were treated with chemotherapy alone (2 patients) or chemotherapy and radiation therapy (1 patient). Radiation complications were graded using the RTOG acute and late effects scoring criteria. Follow up ranged from 4 to 250 months (median - 24 months). RESULTS: The 5 year actuarial results revealed an overall survival (OS) of 42%, a disease free survival (DFS) of 43%, a pelvic control rate (PC) of 67% and a freedom from distant failure (FFDF) of 47%. DFS decreased with increasing T stage with a 5 year rate of 86% for patients with Tis - T2 disease compared to 10% for patients with T3-T4 disease (p ) were noted in 3 patients (20%) receiving radiation therapy and these included two cases of grade 3 skin reactions and one case of grade

  2. Comparison of Immunoassay methods for T3, T4 and TSH

    International Nuclear Information System (INIS)

    Alonso Rodríguez, Celia A.

    2016-01-01

    Measurements of T3, T4 and TSH have been considered very important in the diagnosis and monitoring of thyroid diseases both overt and subclinical. These subclinical diseases are actively seeking for years, both in healthy patients and hospitalized for other illnesses; and in the population over 35 years, especially women, in health checkups. The active search for these diseases requires the use of rapid and reliable techniques; that can be developed massively, with good level of detectability and comparable. The overall objective is to present the evaluation of different immunoassay techniques with respect to the RIA and IRMA: ELISA, chemiluminescence, Amplified Chemiluminescence, electrochemiluminescence Immunofluorescence. Compare including automatic methods and analyze the cost and feasibility of them for laboratory immunoassay. ELISA colorimetric technique for dosing was comparable to RIA T4, not for T3. Chemiluminescence (AMERLITE) compared to dosing RIA and IRMA T4 to TSH proved to be valid for both. Amplified Chemiluminescence (Immulite) compared to IRMA for TSH was no significant difference. Electrochemiluminescence (Elecsys 2010) compared to T3 and T4 RIA and IRMA for TSH, no significant differences for T4 and TSH; but no variation to T3. Immunofluorescence (AIA-600) used to compare with RIA for T3 and T4, and TSH IRMA, no significant differences for the measured analytes. Benchmarking of automatic methods suggests that the most thrifty of trials is Immunofluorescence the AIA-600, regarding calibration and control, programming time, randomization and the ability to save the value of the fluorescence deferred calculations for tests without valid at the time of realizing calibration. Analyzing the cost and feasibility of these methods for laboratory immunoassay, we must consider that their characteristics electrochemiluminescence is the fastest, but its price is prohibitive for our health systems. The AIA-600 appears to be the method of choice for its

  3. Combination L-T3 and L-T4 therapy for hypothyroidism.

    Science.gov (United States)

    Wartofsky, Leonard

    2013-10-01

    Because of the longstanding controversy regarding whether hypothyroid patients can be optimally replaced by treatment with levothyroxine (L-T4) alone, numerous studies have addressed potential benefits of combined therapy of triiodothyronine (T3) with L-T4. Results of these studies have failed to support a potential benefit of combined therapy. A strong argument for the addition of L-T3 to L-T4 monotherapy has been lacking until recent genetic studies indicated a rationale for such therapy among a small fraction of the hypothyroid patient population. Interest in this issue has focused on the importance of the deiodinases in maintaining the euthyroid state and the role of genetic polymorphisms in the deiodinase genes that would affect thyroid hormone concentrations in both blood and tissues. One such polymorphism in the D2 gene, Thr92Ala, is associated with reduced T4 to T3 activation in skeletal muscle and thyroid, linked to obesity and alterations in thyroid-pituitary feedback, and in responses to thyroid hormone treatment. Although our professional organizations continue to recommend L-T4 alone for the treatment of hypothyroidism, the possibility of a D2 gene polymorphism should be considered in patients on L-T4 monotherapy who continue to complain of fatigue in spite of dosage achieving low normal serum thyroid stimulating hormone levels. A suggestive clue to the presence of this polymorphism could be a higher than normal free T4/free T3 ratio. Clinicians could consider adding T3 as a therapeutic trial in selected patients. Future well controlled clinical trials will be required to more fully resolve the controversy.

  4. High Performance Programming Using Explicit Shared Memory Model on Cray T3D1

    Science.gov (United States)

    Simon, Horst D.; Saini, Subhash; Grassi, Charles

    1994-01-01

    The Cray T3D system is the first-phase system in Cray Research, Inc.'s (CRI) three-phase massively parallel processing (MPP) program. This system features a heterogeneous architecture that closely couples DEC's Alpha microprocessors and CRI's parallel-vector technology, i.e., the Cray Y-MP and Cray C90. An overview of the Cray T3D hardware and available programming models is presented. Under Cray Research adaptive Fortran (CRAFT) model four programming methods (data parallel, work sharing, message-passing using PVM, and explicit shared memory model) are available to the users. However, at this time data parallel and work sharing programming models are not available to the user community. The differences between standard PVM and CRI's PVM are highlighted with performance measurements such as latencies and communication bandwidths. We have found that the performance of neither standard PVM nor CRI s PVM exploits the hardware capabilities of the T3D. The reasons for the bad performance of PVM as a native message-passing library are presented. This is illustrated by the performance of NAS Parallel Benchmarks (NPB) programmed in explicit shared memory model on Cray T3D. In general, the performance of standard PVM is about 4 to 5 times less than obtained by using explicit shared memory model. This degradation in performance is also seen on CM-5 where the performance of applications using native message-passing library CMMD on CM-5 is also about 4 to 5 times less than using data parallel methods. The issues involved (such as barriers, synchronization, invalidating data cache, aligning data cache etc.) while programming in explicit shared memory model are discussed. Comparative performance of NPB using explicit shared memory programming model on the Cray T3D and other highly parallel systems such as the TMC CM-5, Intel Paragon, Cray C90, IBM-SP1, etc. is presented.

  5. Isolation and characterization of NIH 3T3 cells expressing polyomavirus small T antigen

    International Nuclear Information System (INIS)

    Noda, T.; Satake, M.; Robins, T.; Ito, Y.

    1986-01-01

    The polyomavirus small T-antigen gene, together with the polyomavirus promoter, was inserted into retrovirus vector pGV16 which contains the Moloney sarcoma virus long terminal repeat and neomycin resistance gene driven by the simian virus 40 promoter. This expression vector, pGVST, was packaged into retrovirus particles by transfection of PSI2 cells which harbor packaging-defective murine retrovirus genome. NIH 3T3 cells were infected by this replication-defective retrovirus containing pGVST. Of the 15 G418-resistant cell clones, 8 express small T antigen at various levels as revealed by immunoprecipitation. A cellular protein with an apparent molecular weight of about 32,000 coprecipitates with small T antigen. Immunofluorescent staining shows that small T antigen is mainly present in the nuclei. Morphologically, cells expressing small T antigen are indistinguishable from parental NIH 3T3 cells and have a microfilament pattern similar to that in parental NIH 3T3 cells. Cells expressing small T antigen form a flat monolayer but continue to grow beyond the saturation density observed for parental NIH 3T3 cells and eventually come off the culture plate as a result of overconfluency. There is some correlation between the level of expression of small T antigen and the growth rate of the cells. Small T-antigen-expressing cells form small colonies in soft agar. However, the proportion of cells which form these small colonies is rather small. A clone of these cells tested did not form tumors in nude mice within 3 months after inoculation of 10 6 cells per animal. Thus, present studies establish that the small T antigen of polyomavirus is a second nucleus-localized transforming gene product of the virus (the first one being large T antigen) and by itself has a function which is to stimulate the growth of NIH 3T3 cells beyond their saturation density in monolayer culture

  6. Rectal dexmedetomidine in rats: evaluation of sedative and mucosal effects

    Directory of Open Access Journals (Sweden)

    Volkan Hanci

    2015-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: In this study, we investigated the anesthetic and mucosal effects of the rectal application of dexmedetomidine to rats. METHODS: Male Wistar albino rats weighing 250-300 g were divided into four groups: Group S (n = 8 was a sham group that served as a baseline for the normal basal values; Group C (n = 8 consisted of rats that received the rectal application of saline alone; Group IPDex (n = 8 included rats that received the intraperitoneal application of dexmedetomidine (100 µg kg-1; and Group RecDex (n = 8 included rats that received the rectal application of dexmedetomidine (100 µg kg-1. For the rectal drug administration, we used 22 G intravenous cannulas with the stylets removed. We administered the drugs by advancing the cannula 1 cm into the rectum, and the rectal administration volume was 1 mL for all the rats. The latency and anesthesia time (min were measured. Two hours after rectal administration, 75 mg kg-1 ketamine was administered for intraperitoneal anesthesia in all the groups, followed by the removal of the rats' rectums to a distal distance of 3 cm via an abdominoperineal surgical procedure. We histopathologically examined and scored the rectums. RESULTS: Anesthesia was achieved in all the rats in the Group RecDex following the administration of dexmedetomidine. The onset of anesthesia in the Group RecDex was significantly later and of a shorter duration than in the Group IPDEx (p < 0.05. In the Group RecDex, the administration of dexmedetomidine induced mild-moderate losses of mucosal architecture in the colon and rectum, 2 h after rectal inoculation. CONCLUSION: Although 100 µg kg-1 dexmedetomidine administered rectally to rats achieved a significantly longer duration of anesthesia compared with the rectal administration of saline, our histopathological evaluations showed that the rectal administration of 100 µg kg-1 dexmedetomidine led to mild-moderate damage to the mucosal structure of the

  7. Comparison of rectal and axillary temperatures in dogs and cats.

    Science.gov (United States)

    Goic, Joana B; Reineke, Erica L; Drobatz, Kenneth J

    2014-05-15

    To compare rectal versus axillary temperatures in dogs and cats. Prospective observational study. 94 dogs and 31 cats. Paired axillary and rectal temperatures were measured in random order with a standardized method. Animal signalment, initial complaint, blood pressure, blood lactate concentration, and variables associated with vascular perfusion and coat were evaluated for associations with axillary and rectal temperatures. Axillary temperature was positively correlated with rectal temperature (ρ = 0.75 in both species). Median axillary temperature (38.4°C [101.1°F] in dogs, and 38.4°C [101.2°F] in cats) was significantly different from median rectal temperature in dogs (38.9°C [102.0°F]) but not in cats (38.6°C [101.5°F]). Median rectal-axillary gradient (difference) was 0.4°C (0.7°F; range, -1.3° to 2.3°C [-2.4° to 4.1°F]) in dogs and 0.17°C (0.3°F; range -1.1° to 1.6°C [-1.9° to 3°F]) in cats. Sensitivity and specificity for detection of hyperthermia with axillary temperature were 57% and 100%, respectively, in dogs and 33% and 100%, respectively, in cats; sensitivity and specificity for detection of hypothermia were 86% and 87%, respectively, in dogs and 80% and 96%, respectively, in cats. Body weight (ρ = 0.514) and body condition score (ρ = 0.431) were correlated with rectal-axillary gradient in cats. Although axillary and rectal temperatures were correlated in dogs and cats, a large gradient was present between rectal temperature and axillary temperature, suggesting that axillary temperature should not be used as a substitute for rectal temperature.

  8. Anaphylaxis to gelatin-containing rectal suppositories.

    Science.gov (United States)

    Sakaguchi, M; Inouye, S

    2001-12-01

    Some children--though the number is few-have been sensitized with gelatin. To investigate the relationship between the presence of antigelatin IgE and anaphylaxis to gelatin-containing rectal suppository, we measured antigelatin IgE in the sera of the children with anaphylaxis. Ten children showed systemic allergic reactions, including anaphylaxis, to a chloral hydrate rectal suppository containing gelatin (231 mg/dose) that had been used as a sedative. These children's clinical histories and serum samples were submitted from physicians to the National Institute of Infectious Diseases during a 2-year period from 1996 to 1997. Of the 10 children, 5 showed apparent anaphylaxis, including hypotension and/or cyanosis, along with urticaria or wheezing; 2 showed both urticaria and wheezing without hypotension or cyanosis; the other 3 showed only urticaria. All of the children had antigelatin IgE (mean value +/- SD, 7.9 +/- 8.4 Ua/mL). As a control, samples from 250 randomly selected children had no antigelatin IgE. These findings suggest that the 10 children's systemic allergic reactions to this suppository were caused by the gelatin component. Gelatin-containing suppositories must be used with the same caution as gelatin-containing vaccines and other medications.

  9. The prognostic value of lymph node metastases and tumour regression grade in rectal cancer patients treated with long-course preoperative chemoradiotherapy

    DEFF Research Database (Denmark)

    Lindebjerg, J; Spindler, Karen-Lise Garm; Ploen, J

    2009-01-01

    to the tumour regression grade system and lymph node status in the surgical specimen was assessed. The prognostic value of clinico-pathological parameters was analysed using univariate analysis and Kaplan-Meier methods for comparison of groups. RESULTS: All patients responded to treatment and 47% had a major......OBJECTIVE: The purpose of the present study was to investigate the impact of tumour regression and the post-treatment lymph node status on the prognosis of rectal cancer treated by preoperative neoadjuvant chemoradiotherapy. METHOD: One hundred and thirty-five patients with locally advanced T3.......01). CONCLUSION: The combined assessment of lymph-node status and tumour response has strong prognostic value in locally advanced rectal cancer patient treated with preoperative long-course chemoradiation....

  10. Rectal HSV-2 Infection May Increase Rectal SIV Acquisition Even in the Context of SIVΔnef Vaccination.

    Directory of Open Access Journals (Sweden)

    Natalia Guerra-Pérez

    Full Text Available Prevalent HSV-2 infection increases the risk of HIV acquisition both in men and women even in asymptomatic subjects. Understanding the impact of HSV-2 on the mucosal microenvironment may help to identify determinants of susceptibility to HIV. Vaginal HSV-2 infection increases the frequency of cells highly susceptible to HIV in the vaginal tissue of women and macaques and this correlates with increased susceptibility to vaginal SHIV infection in macaques. However, the effect of rectal HSV-2 infection on HIV acquisition remains understudied. We developed a model of rectal HSV-2 infection in macaques in combination with rectal SIVmac239Δnef (SIVΔnef vaccination and our results suggest that rectal HSV-2 infection may increase the susceptibility of macaques to rectal SIVmac239 wild-type (wt infection even in SIVΔnef-infected animals. Rectal SIVΔnef infection/vaccination protected 7 out of 7 SIVΔnef-infected macaques from SIVmac239wt rectal infection (vs 12 out of 16 SIVΔnef-negative macaques, while 1 out of 3 animals co-infected with SIVΔnef and HSV-2 acquired SIVmac239wt infection. HSV-2/SIVmac239wt co-infected animals had increased concentrations of inflammatory factors in their plasma and rectal fluids and a tendency toward higher acute SIVmac239wt plasma viral load. However, they had higher blood CD4 counts and reduced depletion of CCR5+ CD4+ T cells compared to SIVmac239wt-only infected animals. Thus, rectal HSV-2 infection generates a pro-inflammatory environment that may increase susceptibility to rectal SIV infection and may impact immunological and virological parameters during acute SIV infection. Studies with larger number of animals are needed to confirm these findings.

  11. Adoption of Preoperative Radiation Therapy for Rectal Cancer From 2000 to 2006: A Surveillance, Epidemiology, and End Results Patterns-of-Care Study

    International Nuclear Information System (INIS)

    Mak, Raymond H.; McCarthy, Ellen P.; Das, Prajnan; Hong, Theodore S.; Mamon, Harvey J.; Hoffman, Karen E.

    2011-01-01

    Purpose: The German rectal study determined that preoperative radiation therapy (RT) as a component of combined-modality therapy decreased local tumor recurrence, increased sphincter preservation, and decreased treatment toxicity compared with postoperative RT for rectal cancer. We evaluated the use of preoperative RT after the presentation of the landmark German rectal study results and examined the impact of tumor and sociodemographic factors on receiving preoperative RT. Methods and Materials: In total, 20,982 patients who underwent surgical resection for T3-T4 and/or node-positive rectal adenocarcinoma diagnosed from 2000 through 2006 were identified from the Surveillance, Epidemiology, and End Results tumor registries. We analyzed trends in preoperative RT use before and after publication of the findings from the German rectal study. We also performed multivariate logistic regression to identify factors associated with receiving preoperative RT. Results: Among those treated with RT, the proportion of patients treated with preoperative RT increased from 33.3% in 2000 to 63.8% in 2006. After adjustment for age; gender; race/ethnicity; marital status; Surveillance, Epidemiology, and End Results registry; county-level education; T stage; N stage; tumor size; and tumor grade, there was a significant association between later year of diagnosis and an increase in preoperative RT use (adjusted odds ratio, 1.26/y increase; 95% confidence interval, 1.23-1.29). When we compared the years before and after publication of the German rectal study (2000-2003 vs. 2004-2006), patients were more likely to receive preoperative RT than postoperative RT in 2004-2006 (adjusted odds ratio, 2.35; 95% confidence interval, 2.13-2.59). On multivariate analysis, patients who were older, who were female, and who resided in counties with lower educational levels had significantly decreased odds of receiving preoperative RT. Conclusions: After the publication of the landmark German rectal

  12. Finding dose-volume constraints to reduce late rectal toxicity following 3D-conformal radiotherapy (3D-CRT) of prostate cancer

    International Nuclear Information System (INIS)

    Greco, Carlo; Mazzetta, Chiara; Cattani, Federica; Tosi, Giampiero; Castiglioni, Simona; Fodor, Andrei; Orecchia, Roberto

    2003-01-01

    Background and purpose: The rectum is known to display a dose-volume effect following high-dose 3D-conformal radiotherapy (3D-CRT). The aim of the study is to search for significant dose-volume combinations with the specific treatment technique and patient set-up currently used in our institution. Patients and methods: We retrospectively analyzed the dose-volume histograms (DVH) of 135 patients with stage T1b-T3b prostate cancer treated consecutively with 3D-CRT between 1996 and 2000 to a total dose of 76 Gy. The median follow-up was 28 months (range 12-62). All late rectal complications were scored using RTOG criteria. Time to late toxicity was assessed using the Kaplan-Meyer method. The association between variables at baseline and ≥2 rectal toxicity was tested using χ 2 test or Fisher's exact test. A multivariate analysis using logistic regression was performed. Results: Late rectal toxicity grade ≥2 was observed in 24 of the 135 patients (17.8%). A 'grey area' of increased risk has been identified. Average DVHs of the bleeding and non-bleeding patients were generated. The area under the percent volume DVH for the rectum of the bleeding patients was significantly higher than that of patients without late rectal toxicity. On multivariate analysis the correlation between the high risk DVHs and late rectal bleeding was confirmed. Conclusions: The present analysis confirms the role of the rectal DVH as a tool to discriminate patients undergoing high-dose 3D-CRT into a low and a high risk of developing late rectal bleeding. Based on our own results and taking into account the data published in the literature, we have been able to establish new dose-volume constraints for treatment planning: if possible, the percentage of rectal volume exposed to 40, 50, 60, 72 and 76 Gy should be limited to 60, 50, 25, 15 and 5%, respectively

  13. An unusual presentation of a rectal duplication cyst.

    Science.gov (United States)

    Jackson, Katharine L; Peche, William J; Rollins, Michael D

    2012-01-01

    Intestinal duplications are rare developmental anomalies that can occur anywhere along the gastrointestinal tract. Rectal duplication cysts account for approximately 4% of all duplication cysts. They usually present in childhood with symptoms of mass effect, local infection or more rarely with rectal bleeding from ectopic gastric mucosa. A 26year old male presented with a history of bright red blood per rectum. On examination a mucosal defect with an associated cavity adjacent to the rectum was identified. This was confirmed with rigid proctoscopy and CT scan imaging. A complete transanal excision was performed. Rectal duplication cysts are more common in pediatric patients. They more frequently present with symptoms of mass effect or local infection than with rectal bleeding. In adult patients they are a rare cause of rectal bleeding. Definitive treatment is with surgical excision. A transanal, transcoccygeal, posterior sagittal or a combined abdominoperineal approach may be used depending on anatomic characteristics of the duplication cyst. We present a rare case of a rectal duplication cyst presenting in adulthood with rectal bleeding, managed with transanal excision. Published by Elsevier Ltd.

  14. Rectal Balloon for the Immobilization of the Prostate Internal Motion

    International Nuclear Information System (INIS)

    Lee, Sang Kyu; Beak, Jong Geal; Kim, Joo Ho; Jeon, Byong Chul; Cho, Jeong Hee; Kim, Dong Wook; Song, Tae Soo; Cho, Jae Ho; Na, Soo Kyong

    2005-01-01

    The using of endo-rectal balloon has proposed as optimal method that minimized the motion of prostate and the dose of rectum wall volume for treated prostate cancer patients, so we make the customized rectal balloon device. In this study, we analyzed the efficiency of the Self-customized rectal balloon in the aspects of its reproducibility. In 5 patients, for treatment planning, each patient was acquired CT slice images in state of with and without rectal balloon. Also they had CT scanning same repeated third times in during radiation treatment (IMRT). In each case, we analyzed the deviation of rectal balloon position and verified the isodose distribution of rectum wall at closed prostate. Using the rectal balloon, we minimized the planning target volume (PTV) by decreased the internal motion of prostate and overcome the dose limit of radiation therapy in prostate cancer by increased the gap between the rectum wall and high dose region. The using of rectal balloon, although, was reluctant to treat by patients. View a point of immobilization of prostate internal motion and dose escalation of GTV (gross tumor volume), its using consider large efficient for treated prostate cancer patients.

  15. Rectal and colon cancer: Not just a different anatomic site.

    Science.gov (United States)

    Tamas, K; Walenkamp, A M E; de Vries, E G E; van Vugt, M A T M; Beets-Tan, R G; van Etten, B; de Groot, D J A; Hospers, G A P

    2015-09-01

    Due to differences in anatomy, primary rectal and colon cancer require different staging procedures, different neo-adjuvant treatment and different surgical approaches. For example, neoadjuvant radiotherapy or chemoradiotherapy is administered solely for rectal cancer. Neoadjuvant therapy and total mesorectal excision for rectal cancer might be responsible in part for the differing effect of adjuvant systemic treatment on overall survival, which is more evident in colon cancer than in rectal cancer. Apart from anatomic divergences, rectal and colon cancer also differ in their embryological origin and metastatic patterns. Moreover, they harbor a different composition of drug targets, such as v-raf murine sarcoma viral oncogene homolog B (BRAF), which is preferentially mutated in proximal colon cancers, and the epidermal growth factor receptor (EGFR), which is prevalently amplified or overexpressed in distal colorectal cancers. Despite their differences in metastatic pattern, composition of drug targets and earlier local treatment, metastatic rectal and colon cancer are, however, commonly regarded as one entity and are treated alike. In this review, we focused on rectal cancer and its biological and clinical differences and similarities relative to colon cancer. These aspects are crucial because they influence the current staging and treatment of these cancers, and might influence the design of future trials with targeted drugs. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Lymphogranuloma venereum as a cause of rectal strictures.

    Science.gov (United States)

    Papagrigoriadis, S.; Rennie, J. A.

    1998-01-01

    Rectal strictures are uncommon in young patients without a history of malignancy, inflammatory bowel disease or previous surgery. Lymphogranuloma venereum of the rectum has been described as a rare cause of rectal strictures in the western world, mainly in homosexual men and in blacks. It presents with nonspecific symptoms, rectal ulcer, proctitis, anal fissures, abscesses and rectal strictures. Clinical and endoscopic findings as well as histology resemble Crohn's disease, which may be misdiagnosed. Serology is often positive for Chlamydia trachomatis but negative serology is not uncommon. We present two young black women who suffered from chronic diarrhoea, abdominal pain and weight loss. There was no previous history and investigations showed in both cases a long rectal stricture. Serology was positive in one patient. They were treated with erythromycin and azithromycin and they both underwent an anterior resection of the rectum. Postoperative histology confirmed the presence of lymphogranuloma venereum of the rectum. We conclude that rectal lymphogranuloma venereum is a rare cause of rectal strictures but surgeons should be aware of its existence and include it in the differential diagnosis of unexplained strictures in high-risk patients. Images Figure 1 Figure 2 PMID:9640444

  17. Gene expression analysis and microdialysis suggest hypothalamic triiodothyronine (T3) gates daily torpor in Djungarian hamsters (Phodopus sungorus).

    Science.gov (United States)

    Bank, Jonathan H H; Cubuk, Ceyda; Wilson, Dana; Rijntjes, Eddy; Kemmling, Julia; Markovsky, Hanna; Barrett, Perry; Herwig, Annika

    2017-07-01

    Thyroid hormones play an important role in regulating seasonal adaptations of mammals. Several studies suggested that reduced availability of 3,3',5-triiodothyronine (T3) in the hypothalamus is required for the physiological adaptation to winter in Djungarian hamsters. We have previously shown that T3 is involved in the regulation of daily torpor, but it remains unclear, whether T3 affects torpor by central or peripheral mechanisms. To determine the effect of T3 concentrations within the hypothalamus in regulating daily torpor, we tested the hypothesis that low hypothalamic T3 metabolism would favour torpor and high T3 concentrations would not. In experiment 1 gene expression in torpid hamsters was assessed for transporters carrying thyroid hormones between cerebrospinal fluid and hypothalamic cells and for deiodinases enzymes, activating or inactivating T3 within hypothalamic cells. Gene expression analysis suggests reduced T3 in hypothalamic cells during torpor. In experiment 2, hypothalamic T3 concentrations were altered via microdialysis and torpor behaviour was continuously monitored by implanted body temperature transmitters. Increased T3 concentrations in the hypothalamus reduced expression of torpor as well as torpor bout duration and depth. Subsequent analysis of gene expression in the ependymal layer of the third ventricle showed clear up-regulation of T3 inactivating deiodinase 3 but no changes in several other genes related to photoperiodic adaptations in hamsters. Finally, serum analysis revealed that increased total T3 serum concentrations were not necessary to inhibit torpor expression. Taken together, our results are consistent with the hypothesis that T3 availability within the hypothalamus significantly contributes to the regulation of daily torpor via a central pathway.

  18. Bupivacaine administered intrathecally versus rectally in the management of intractable rectal cancer pain in palliative care

    Directory of Open Access Journals (Sweden)

    Zaporowska-Stachowiak I

    2014-10-01

    Full Text Available Iwona Zaporowska-Stachowiak,1,2 Grzegorz Kowalski,3 Jacek Łuczak,2 Katarzyna Kosicka,4 Aleksandra Kotlinska-Lemieszek,3 Maciej Sopata,3 Franciszek Główka4 1Chair and Department of Pharmacology, Poznan University of Medical Sciences, Poznan, Poland; 2Palliative Medicine In-patient Unit, University Hospital of Lord's Transfiguration, Poznan University of Medical Sciences, Poznan, Poland; 3Palliative Medicine Chair and Department, Poznan University of Medical Sciences, Poznan, Poland; 4Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Poznan, Poland Background: Unacceptable adverse effects, contraindications to and/or ineffectiveness of World Health Organization step III "pain ladder" drugs causes needless suffering among a population of cancer patients. Successful management of severe cancer pain may require invasive treatment. However, a patient's refusal of an invasive procedure necessitates that clinicians consider alternative options. Objective: Intrathecal bupivacaine delivery as a viable treatment of intractable pain is well documented. There are no data on rectal bupivacaine use in cancer patients or in the treatment of cancer tenesmoid pain. This study aims to demonstrate that bupivacaine administered rectally could be a step in between the current treatment options for intractable cancer pain (conventional/conservative analgesia or invasive procedures, and to evaluate the effect of the mode of administration (intrathecal versus rectal on the bupivacaine plasma concentration.Cases: We present two Caucasian, elderly inpatients admitted to hospice due to intractable rectal/tenesmoid pain. The first case is a female with vulvar cancer, and malignant infiltration of the rectum/vagina. Bupivacaine was used intrathecally (0.25–0.5%, 1–2 mL every 6 hours. The second case is a female with ovarian cancer and malignant rectal infiltration. Bupivacaine was adminstered rectally (0.05–0.1%, 100 m

  19. Expression of Nanog gene promotes NIH3T3 cell proliferation

    International Nuclear Information System (INIS)

    Zhang Jingyu; Wang Xia; Chen Bing; Suo Guangli; Zhao Yanhong; Duan Ziyuan; Dai Jianwu

    2005-01-01

    Cells are the functional elements in tissue engineering and regenerative medicine. A large number of cells are usually needed for these purposes. However, there are numbers of limitations for in vitro cell proliferation. Nanog is an important self-renewal determinant in embryonic stem cells. However, it remains unknown whether Nanog will influence the cell cycle and cell proliferation of mature cells. In this study, we expressed Nanog in NIH3T3 cells and showed that expression of Nanog in NIH3T3 promoted cells to enter into S phase and enhanced cell proliferation. This suggests that Nanog gene might function in a similar fashion in mature cells as in ES cells. In addition, it may provide an approach for in vitro cell expansion

  20. Model of iodine metabolism in a T3-thyrotoxic patient undergoing I-131 therapy

    International Nuclear Information System (INIS)

    Ahuja, S.; Price, R.; Brill, A.B.; Dobyns, B.M.; Berman, M.

    Data on radioactivity in the thyroid, urine, serum, butanol-extractable iodine (BEI) and chromatographic fractionations of BEI, obtained during four I-131 therapeutic treatments of a T 3 -thyrotoxic patient, have been analyzed and simulated with the help of a 7-compartment model. Good fits to most of the data can be obtained with both the dose-independent and dose-dependent models. A model with 3 or 4 compartments, which provides adequate fits to iodine kinetic data in most euthyroid and hyperthyroid patients is not satisfactory in the case of this patient. Thus, to represent iodine metabolism during T 3 -thyrotoxicosis therapy, we find that it is necessary to provide for separate biochemical pathways for the BEI components as well as the butanol-insoluble compounds released by the thyroid gland

  1. Investigation of Droplet Deposition for Suspensions Usable for Thermoplastic 3D Printing (T3DP)

    Science.gov (United States)

    Scheithauer, Uwe; Johne, Robert; Weingarten, Steven; Schwarzer, Eric; Richter, Hans-Jürgen; Moritz, Tassilo; Michaelis, Alexander

    2018-01-01

    Thermoplastic 3D printing (T3DP) is an additive manufacturing (AM) technology, which can be used for the production of dense single- and especially multi-material components. This becomes possible because of the combination of the precise deposition of small droplets of molten thermoplastic suspensions containing ceramic or metal particles, and a curing mechanism caused on cool down increasing the viscosity. In this paper, the droplet formation behavior of zirconia suspensions for T3DP (82 and 84 wt.%) was investigated. The droplet fusion factor (dff) is introduced to calculate the necessary distance between two droplets to form filament-like structures by fusion of adjacent droplets. Filament-like structures with a smooth surface and a nearly homogeneous cross section were manufactured for both suspensions with a dff of 44% or higher.

  2. Investigation of AA2024-T3 surfaces modified by cerium compounds: A localized approach

    International Nuclear Information System (INIS)

    Paussa, L.; Andreatta, F.; De Felicis, D.; Bemporad, E.; Fedrizzi, L.

    2014-01-01

    Highlights: •The precipitation of cerium compounds occurs on the entire AA2024-T3 surface. •The matrix is less involved in the cerium precipitation. •Cerium intensely precipitates on Mg-rich IM particles. •The electrochemical behavior of Mg-rich IM particles influences the mechanism of cerium precipitation. -- Abstract: The precipitation of cerium compounds on polished AA2024-T3 surfaces was investigated following an electrochemical and microstructural localized approach. It was found that cerium precipitation occurs on the entire surface covering intermetallic particles and the matrix as well. The matrix is the region where the precipitation of cerium is less favoured. The highest amount of cerium was observed on magnesium-rich intermetallic particles. The localized analyses suggest that precipitation of cerium on magnesium-rich intermetallic particles could happen following two mechanisms: the former based on a potential reversal of the intermetallic particles and the latter due to a partial magnesium dissolution

  3. Development of a solid phase technic for radioimmunoassay of triiodothyronine (T3) in serum

    International Nuclear Information System (INIS)

    Hamada, M.M.; Mesquita, C.H.; Silva, C.P.G. da.

    1988-10-01

    We have developed a solid phase radioimmunoassay (RIA) system for triiodothyronine (T 3 ), by immobilizing triiodothyronine antibodies on the inner wall of reaction tubes. The antibody-coated tubes were made via reaction of antibody with glutaraldeyde residue pre coated on the inner wall of the tubes by alkaline self-polimerization. The quality of the coated tubes was tested through its performance in the RIA methodology, by analysing the following RIA parameters: minimum detectable dose (MDD), nonspecific binding (NSB), ''X 50% '', slope of the standard curve, intra and inter-assay precision, accuracy of the method and figure of merit. The serum levels of T 3 in hypothyroid and hyperthyroid patients and the normal values range were determined for the solid phase RIA system. The results are in agreement with found in the literature. (author) [pt

  4. Exogenous T3 toxicosis following consumption of a contaminated weight loss supplement.

    Science.gov (United States)

    D'Arcy, R; McDonnell, M; Spence, K; Courtney, C H

    2017-01-01

    A 42-year-old male presented with a one-week history of palpitations and sweating episodes. The only significant history was of longstanding idiopathic dilated cardiomyopathy. Initial ECG demonstrated a sinus tachycardia. Thyroid function testing, undertaken as part of the diagnostic workup, revealed an un-measureable thyroid-stimulating hormone (TSH) and free thyroxine (T 4 ). Upon questioning the patient reported classical thyrotoxic symptoms over the preceding weeks. Given the persistence of symptoms free tri-iodothyronine (T 3 ) was measured and found to be markedly elevated at 48.9 pmol/L (normal range: 3.1-6.8 pmol/L). No goitre or nodular disease was palpable in the neck. Historically there had never been any amiodarone usage. Radionucleotide thyroid uptake imaging ( 123 I) demonstrated significantly reduced tracer uptake in the thyroid. Upon further questioning the patient reported purchasing a weight loss product online from India which supposedly contained sibutramine. He provided one of the tablets and laboratory analysis confirmed the presence of T 3 in the tablet. Full symptomatic resolution and normalised thyroid function ensued upon discontinuation of the supplement. Free tri-iodothyronine (T 3 ) measurement may be useful in the presence of symptoms suggestive of thyrotoxicosis with discordant thyroid function tests.Thyroid uptake scanning can be a useful aid to differentiating exogenous hormone exposure from endogenous hyperthyroidism.Ingestion of thyroid hormone may be inadvertent in cases of exogenous thyrotoxicosis.Medicines and supplements sourced online for weight loss may contain thyroxine (T 4 ) or T 3 and should be considered as a cause of unexplained exogenous hyperthyroidism.

  5. Comparison of rectal volume definition techniques and their influence on rectal toxicity in patients with prostate cancer treated with 3D conformal radiotherapy: a dose-volume analysis

    International Nuclear Information System (INIS)

    Onal, Cem; Topkan, Erkan; Efe, Esma; Yavuz, Melek; Sonmez, Serhat; Yavuz, Aydin

    2009-01-01

    To evaluate the impact of four different rectum contouring techniques and rectal toxicities in patients with treated with 3D conformal radiotherapy (3DCRT). Clinical and dosimetric data were evaluated for 94 patients who received a total dose 3DCRT of 70 Gy, and rectal doses were compared in four different rectal contouring techniques: the prostate-containing CT sections (method 1); 1 cm above and below the planning target volume (PTV) (method 2); 110 mm starting from the anal verge (method 3); and from the anal verge to the sigmoid flexure (method 4). The percentage of rectal volume receiving RT doses (30–70 Gy) and minimum, mean rectal doses were assessed. Median age was 69 years. Percentage of rectal volume receiving high doses (≥ 70 Gy) were higher with the techniques that contoured smaller rectal volumes. In methods 2 and 3, the percentage of rectal volume receiving ≥ 70 Gy was significantly higher in patients with than without rectal bleeding (method 2: 30.8% vs. 22.5%, respectively (p = 0.03); method 3: 26.9% vs. 18.1%, respectively (p = 0.006)). Mean rectal dose was significant predictor of rectal bleeding only in method 3 (48.8 Gy in patients with bleeding vs. 44.4 Gy in patients without bleeding; p = 0.02). Different techniques of rectal contouring significantly influence the calculation of radiation doses to the rectum and the prediction of rectal toxicity. Rectal volume receiving higher doses (≥ 70 Gy) and mean rectal doses may significantly predict rectal bleeding for techniques contouring larger rectal volumes, as was in method 3

  6. Ginkgolide C Suppresses Adipogenesis in 3T3-L1 Adipocytes via the AMPK Signaling Pathway

    Directory of Open Access Journals (Sweden)

    Chian-Jiun Liou

    2015-01-01

    Full Text Available Ginkgolide C, isolated from Ginkgo biloba leaves, is a flavone reported to have multiple biological functions, from decreased platelet aggregation to ameliorating Alzheimer disease. The study aim was to evaluate the antiadipogenic effect of ginkgolide C in 3T3-L1 adipocytes. Ginkgolide C was used to treat differentiated 3T3-L1 cells. Cell supernatant was collected to assay glycerol release, and cells were lysed to measure protein and gene expression related to adipogenesis and lipolysis by western blot and real-time PCR, respectively. Ginkgolide C significantly suppressed lipid accumulation in differentiated adipocytes. It also decreased adipogenesis-related transcription factor expression, including peroxisome proliferator-activated receptor and CCAAT/enhancer-binding protein. Furthermore, ginkgolide C enhanced adipose triglyceride lipase and hormone-sensitive lipase production for lipolysis and increased phosphorylation of AMP-activated protein kinase (AMPK, resulting in decreased activity of acetyl-CoA carboxylase for fatty acid synthesis. In coculture with an AMPK inhibitor (compound C, ginkgolide C also improved activation of sirtuin 1 and phosphorylation of AMPK in differentiated 3T3-L1 cells. The results suggest that ginkgolide C is an effective flavone for increasing lipolysis and inhibiting adipogenesis in adipocytes through the activated AMPK pathway.

  7. Endoplasmic reticulum stress suppresses lipin-1 expression in 3T3-L1 adipocytes

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Nobuhiko, E-mail: ntkhs@hoku-iryo-u.ac.jp [Department of Internal Medicine, School of Dentistry, Health Sciences University of Hokkaido, 1757, Kanazawa, Ishikari-Toubetsu, Hokkaido 061-0023 (Japan); Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1-1-1, Midorigaoka-Higashi, Asahikawa, Hokkaido 078-8510 (Japan); Yoshizaki, Takayuki [Innovation Center, Kagoshima University, 1-21-40, Korimoto, Kagoshima 890-0065 (Japan); Hiranaka, Natsumi; Suzuki, Takeshi [Department of Internal Medicine, School of Dentistry, Health Sciences University of Hokkaido, 1757, Kanazawa, Ishikari-Toubetsu, Hokkaido 061-0023 (Japan); Yui, Tomoo; Akanuma, Masayoshi [Department of Fixed Prosthodontics and Oral Implantology, School of Dentistry, Health Sciences University of Hokkaido, 1757, Kanazawa, Ishikari-Toubetsu, Hokkaido 061-0023 (Japan); Kanazawa, Kaoru [Department of Dental Anesthesiology, School of Dentistry, Health Sciences University of Hokkaido, 1757, Kanazawa, Ishikari-Toubetsu, Hokkaido 061-0023 (Japan); Yoshida, Mika; Naito, Sumiyoshi [Department of Clinical Laboratory, Health Sciences University of Hokkaido, 1757, Kanazawa, Ishikari-Toubetsu, Hokkaido 061-0023 (Japan); Fujiya, Mikihiro; Kohgo, Yutaka [Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1-1-1, Midorigaoka-Higashi, Asahikawa, Hokkaido 078-8510 (Japan); Ieko, Masahiro [Department of Internal Medicine, School of Dentistry, Health Sciences University of Hokkaido, 1757, Kanazawa, Ishikari-Toubetsu, Hokkaido 061-0023 (Japan)

    2013-02-01

    Highlights: ► Lipin-1 involves lipid metabolism, adipocyte differentiation, and inflammation. ► Adipose lipin-1 expression is reduced in obesity. ► ER stress suppresses lipin-1 expression in 3T3-L1 adipocytes. ► Activation of PPAR-γ recovers ER stress-induced lipin-1 reduction. -- Abstract: Lipin-1 plays crucial roles in the regulation of lipid metabolism and cell differentiation in adipocytes. In obesity, adipose lipin-1 mRNA expression is decreased and positively correlated with systemic insulin sensitivity. Amelioration of the lipin-1 depletion might be improved dysmetabolism. Although some cytokines such as TNF-α and interleukin-1β reduces adipose lipin-1 expression, the mechanism of decreased adipose lipin-1 expression in obesity remains unclear. Recently, endoplasmic reticulum (ER) stress is implicated in the pathogenesis of obesity. Here we investigated the role of ER stress on the lipin-1 expression in 3T3-L1 adipocytes. We demonstrated that lipin-1 expression was suppressed by the treatment with ER stress inducers (tunicamycin and thapsigargin) at transcriptional level. We also showed that constitutive lipin-1 expression could be maintained by peroxisome proliferator-activated receptor-γ in 3T3-L1 adipocytes. Activation of peroxisome proliferator-activated receptor-γ recovered the ER stress-induced lipin-1 suppression. These results suggested that ER stress might be involved in the pathogenesis of obesity through lipin-1 depletion.

  8. Drinking water disinfection byproduct iodoacetic acid induces tumorigenic transformation of NIH3T3 cells.

    Science.gov (United States)

    Wei, Xiao; Wang, Shu; Zheng, Weiwei; Wang, Xia; Liu, Xiaolin; Jiang, Songhui; Pi, Jingbo; Zheng, Yuxin; He, Gengsheng; Qu, Weidong

    2013-06-04

    Iodoacetic acid (IAA) and iodoform (IF) are unregulated iodinated disinfection byproducts (DBPs) found in drinking water. Their presence in the drinking water of China has not been documented. Recently, the carcinogenic potential of IAA and IF has been a concern because of their mutagenicity in bacteria and genotoxicity in mammalian cells. Therefore, we measured their concentrations in Shanghai drinking water and assessed their cytotoxicity, genotoxicity, and ability to transform NIH3T3 cells to tumorigenic lines. The concentrations of IAA and IF in Shanghai drinking water varied between summer and winter with maximum winter levels of 2.18 μg/L IAA and 0.86 μg/L IF. IAA with a lethal concentration 50 (LC50) of 2.77 μM exhibited more potent cytotoxicity in NIH3T3 cells than IF (LC50 = 83.37 μM). IAA, but not IF, induced a concentration-dependent DNA damage measured by γ-H2AX staining and increased tail moment in single-cell gel electrophoresis. Neither IAA nor IF increased micronucleus frequency. Prolonged exposure of NIH3T3 cells to IAA increased the frequencies of transformed cells with anchorage-independent growth and agglutination with concanavalin A. IAA-transformed cells formed aggressive fibrosarcomas after inoculation into Balb/c nude mice. This study demonstrated that IAA has a biological activity that is consistent with a carcinogen and human exposure should be of concern.

  9. Stevioside from Stevia rebaudiana Bertoni Increases Insulin Sensitivity in 3T3-L1 Adipocytes

    Directory of Open Access Journals (Sweden)

    Nabilatul Hani Mohd-Radzman

    2013-01-01

    Full Text Available Stevioside from Stevia rebaudiana has been reported to exert antihyperglycemic effects in both rat and human subjects. There have been few studies on these effects in vitro. In this paper, radioactive glucose uptake assay was implemented in order to assess improvements in insulin sensitivity in 3T3-L1 cells by elevation of glucose uptake following treatment with stevioside. Oil Red-O staining and MTT assay were utilized to confirm adipocyte differentiation and cell viability, respectively. Findings from this research showed a significant increase in absorbance values in mature adipocytes following Oil Red-O staining, confirming the differentiation process. Stevioside was noncytotoxic to 3T3-L1 cells as cell viability was reduced by a maximum of 17%, making it impossible to determine its IC50. Stevioside increased glucose uptake activities by 2.1 times (p<0.001 in normal conditions and up to 4.4 times (p<0.001 in insulin-resistant states. At times, this increase was higher than that seen in positive control group treated with rosiglitazone maleate, an antidiabetic agent. Expressions of pY20 and p-IRS1 which were measured via Western blot were improved by stevioside treatment. In conclusion, stevioside has direct effects on 3T3-L1 insulin sensitivity via increase in glucose uptake and enhanced expression of proteins involved in insulin-signalling pathway.

  10. The lipid fraction of human milk initiates adipocyte differentiation in 3T3-L1 cells.

    Science.gov (United States)

    Fujisawa, Yasuko; Yamaguchi, Rie; Nagata, Eiko; Satake, Eiichiro; Sano, Shinichiro; Matsushita, Rie; Kitsuta, Kazunobu; Nakashima, Shinichi; Nakanishi, Toshiki; Nakagawa, Yuichi; Ogata, Tsutomu

    2013-09-01

    The prevalence of childhood obesity has increased worldwide over the past decade. Despite evidence that human milk lowers the risk of childhood obesity, the mechanism is not fully understood. We investigated the direct effect of human milk on differentiation of 3T3-L1 preadipocytes. 3T3-L1 preadipocytes were treated with donated human milk only or the combination of the standard hormone mixture; insulin, dexamethasone (DEX), and 3-isobututyl-1-methylxanthine (IBMX). Furthermore, the induction of preadipocyte differentiation by extracted lipids from human milk was tested in comparison to the cells treated with lipid extracts from infant formula. Adipocyte differentiation, specific genes as well as formation of lipid droplets were examined. We clearly show that lipids present in human milk initiate 3T3-L1 preadipocyte differentiation. In contrast, this effect was not observed in response to lipids present in infant formula. The initiation of preadipocyte differentiation by human milk was enhanced by adding the adipogenic hormone, DEX or insulin. The expression of late adipocyte markers in Day 7 adipocytes that have been induced into differentiation with human milk lipid extracts was comparable to those in control cells initiated by a standard adipogenic hormone cocktail. These results demonstrate that human milk contains bioactive lipids that can initiate preadipocyte differentiation in the absence of the standard adipogenic compounds via a unique pathway. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. WEHI-3 cells inhibit adipocyte differentiation in 3T3-L1 cells

    Energy Technology Data Exchange (ETDEWEB)

    Lai, Jing [The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong (China); Liu, Gexiu [Institute of Hematology, School of Medicine, Jinan University, Guangzhou, Guangdong (China); Yan, Guoyao [The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong (China); He, Dongmei [Institute of Hematology, School of Medicine, Jinan University, Guangzhou, Guangdong (China); Zhou, Ying [The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong (China); Chen, Shengting, E-mail: shengtingchen@sina.cn [The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong (China)

    2015-06-26

    By investigating the anti-adipogenic effects of WEHI-3 cells – a murine acute myelomonocytic leukemia cell line – we sought to improve the efficiency of hematopoietic stem cell transplantation (HSCT). Analysis of Oil Red O staining and the expression of adipogenic genes, including PPARγ, C/EBPα, FAS and LPL, indicated that WEHI-3 cells significantly inhibited 3T3-L1 mouse preadipocyte cells from differentiating into adipocytes. In vivo, fat vacuoles in mice injected with WEHI-3 cells were also remarkably reduced in the murine bone marrow pimelosis model. Moreover, the key gene in the Rho signaling pathway, ROCKII, and the key gene in the Wnt signaling pathway, β-catenin, were both upregulated compared with the control group. siRNA-mediated knockdown of ROCKII and β-catenin reversed these WEHI-3-mediated anti-adipogenic effects. Taken together, these data suggest that WEHI-3 cells exert anti-adipogenic effects and that both ROCKII and β-catenin are involved in this process. - Highlights: • WEHI-3, an acute myelomonocytic leukemia cell line, inhibited 3T3-L1 preadipocyte from differentiating into adipocyte. • WEHI-3 cells can arrest 3T3-L1 cells in G0/G1 phase by secreting soluble factors and thus inhibit their proliferation. • WEHI-3 cells reduced bone marrow pimelosis in the murine model. • Both ROCKII and β-catenin were involved in the WEHI-3-mediated anti-adipogenic effects.

  12. Finite element modelling of aluminum alloy 2024-T3 under transverse impact loading

    Science.gov (United States)

    Abdullah, Ahmad Sufian; Kuntjoro, Wahyu; Yamin, A. F. M.

    2017-12-01

    Fiber metal laminate named GLARE is a new aerospace material which has great potential to be widely used in future lightweight aircraft. It consists of aluminum alloy 2024-T3 and glass-fiber reinforced laminate. In order to produce reliable finite element model of impact response or crashworthiness of structure made of GLARE, one can initially model and validate the finite element model of the impact response of its constituents separately. The objective of this study was to develop a reliable finite element model of aluminum alloy 2024-T3 under low velocity transverse impact loading using commercial software ABAQUS. Johnson-Cook plasticity and damage models were used to predict the alloy's material properties and impact behavior. The results of the finite element analysis were compared to the experiment that has similar material and impact conditions. Results showed good correlations in terms of impact forces, deformation and failure progressions which concluded that the finite element model of 2024-T3 aluminum alloy under low velocity transverse impact condition using Johnson-Cook plastic and damage models was reliable.

  13. Endoplasmic reticulum stress suppresses lipin-1 expression in 3T3-L1 adipocytes

    International Nuclear Information System (INIS)

    Takahashi, Nobuhiko; Yoshizaki, Takayuki; Hiranaka, Natsumi; Suzuki, Takeshi; Yui, Tomoo; Akanuma, Masayoshi; Kanazawa, Kaoru; Yoshida, Mika; Naito, Sumiyoshi; Fujiya, Mikihiro; Kohgo, Yutaka; Ieko, Masahiro

    2013-01-01

    Highlights: ► Lipin-1 involves lipid metabolism, adipocyte differentiation, and inflammation. ► Adipose lipin-1 expression is reduced in obesity. ► ER stress suppresses lipin-1 expression in 3T3-L1 adipocytes. ► Activation of PPAR-γ recovers ER stress-induced lipin-1 reduction. -- Abstract: Lipin-1 plays crucial roles in the regulation of lipid metabolism and cell differentiation in adipocytes. In obesity, adipose lipin-1 mRNA expression is decreased and positively correlated with systemic insulin sensitivity. Amelioration of the lipin-1 depletion might be improved dysmetabolism. Although some cytokines such as TNF-α and interleukin-1β reduces adipose lipin-1 expression, the mechanism of decreased adipose lipin-1 expression in obesity remains unclear. Recently, endoplasmic reticulum (ER) stress is implicated in the pathogenesis of obesity. Here we investigated the role of ER stress on the lipin-1 expression in 3T3-L1 adipocytes. We demonstrated that lipin-1 expression was suppressed by the treatment with ER stress inducers (tunicamycin and thapsigargin) at transcriptional level. We also showed that constitutive lipin-1 expression could be maintained by peroxisome proliferator-activated receptor-γ in 3T3-L1 adipocytes. Activation of peroxisome proliferator-activated receptor-γ recovered the ER stress-induced lipin-1 suppression. These results suggested that ER stress might be involved in the pathogenesis of obesity through lipin-1 depletion

  14. Pseudomonas aeruginosa uses T3SS to inhibit diabetic wound healing.

    Science.gov (United States)

    Goldufsky, Josef; Wood, Stephen J; Jayaraman, Vijayakumar; Majdobeh, Omar; Chen, Lin; Qin, Shanshan; Zhang, Chunxiang; DiPietro, Luisa A; Shafikhani, Sasha H

    2015-01-01

    Diabetic foot ulcers are responsible for more hospitalizations than any other complication of diabetes. Bacterial infection is recognized as an important factor associated with impaired healing in diabetic ulcers. Pseudomonas aeruginosa is the most frequently detected Gram-negative pathogen in diabetic ulcers. P. aeruginosa infection has been shown to impair healing in diabetic wounds in a manner that correlates with its ability to form biofilm. While the majority of infections in diabetic ulcers are biofilm associated, 33% of infections are nonbiofilm in nature. P. aeruginosa is the most prevalent Gram-negative pathogen in all diabetic wound types, which suggests that the deleterious impact of P. aeruginosa on healing in diabetic wounds goes beyond its ability to form biofilm and likely involves other factors. The Type III Secretion System (T3SS) virulence structure is required for the pathogenesis of all P. aeruginosa clinical isolates, suggesting that it may also play a role in the inhibition of wound repair in diabetic skin ulcers. We evaluated the role of T3SS in mediating P. aeruginosa-induced tissue damage in the wounds of diabetic mice. Our data demonstrate that P. aeruginosa establishes a robust and persistent infection in diabetic wounds independent of its ability to form biofilm and causes severe wound damage in a manner that primarily depends on its T3SS. © 2015 by the Wound Healing Society.

  15. Conversion of the thyroxin (T4) in 3,5,3'-triiodothyronin (T3) and 3,3',5'-triiodothyronin (T3 reverse) in human leukocytes suspensions. Hyperthyroidism and hypothyroidism studies

    International Nuclear Information System (INIS)

    Bianco, A.C.; Douglas, C.R.; Marone, M.M.; Scalissi, N.M.; Correa, P.H.S.

    1984-01-01

    The peripheral metabolism of thyroid hormones was studied in suspensions of human leukocytes through the evaluation of in vitro generation of T 3 and rT 3 (RIA) from non-radioactive T 4 . Increased in vitro generation of T 3 and rT 3 was observed in suspensions from hyperthyroid patients, while a significant decrease was evidenced when leukocytes from hypothyroid patients were used. These alterations are apparently due to the excess and lack of thyroid hormones, respectively, since they could be reserved in both cases by specific clinical treatment. (author) [pt

  16. How to identify rectal sub-regions likely involved in rectal bleeding in prostate cancer radiotherapy

    Science.gov (United States)

    Dréan, G.; Acosta, O.; Ospina, J. D.; Voisin, C.; Rigaud, B.; Simon, A.; Haigron, P.; de Crevoisier, R.

    2013-11-01

    Nowadays, the de nition of patient-speci c constraints in prostate cancer radiotherapy planning are solely based on dose-volume histogram (DVH) parameters. Nevertheless those DVH models lack of spatial accuracy since they do not use the complete 3D information of the dose distribution. The goal of the study was to propose an automatic work ow to de ne patient-speci c rectal sub-regions (RSR) involved in rectal bleeding (RB) in case of prostate cancer radiotherapy. A multi-atlas database spanning the large rectal shape variability was built from a population of 116 individuals. Non-rigid registration followed by voxel-wise statistical analysis on those templates allowed nding RSR likely correlated with RB (from a learning cohort of 63 patients). To de ne patient-speci c RSR, weighted atlas-based segmentation with a vote was then applied to 30 test patients. Results show the potentiality of the method to be used for patient-speci c planning of intensity modulated radiotherapy (IMRT).

  17. Disseminated lung cancer presenting as a rectal mass

    DEFF Research Database (Denmark)

    Noergaard, Mia M; Stamp, Inger M H; Bodtger, Uffe

    2016-01-01

    Primary lung cancer is the leading cause of cancer-related deaths globally, and approximately 50% had metastatic disease at the time of diagnosis. A rectal mass and unintended weight loss are common manifestations of rectal cancer. Our case presented with a rectal mass, but workup revealed...... a metastatic lesion from lung cancer. Lung cancer metastases to the lower gastrointestinal tract imply reduced survival compared with the already poor mean survival of stage IV lung cancer. Despite relevant therapy, the patient died 5 months after referral....

  18. Fournier gangrene: first manifestation of occult rectal cancer.

    Science.gov (United States)

    Ruiz-Tovar, J; Córdoba, L; Devesa, J M

    2011-01-01

    Fournier gangrene is a necrotizing fasciitis of the genital and perineal region. Diverse factors predispose to Fournier gangrene, such as diabetes mellitus, ethylism, liver dysfunction, haematological disorders, obesity or recent regional instrumentation. Rectal tumours can also predispose to Fournier gangrene; most of the reported cases are perforated or unresectable colorectal tumours, but some cases of anorectal cancer diagnosed after recovery from Fournier gangrene have also been reported. In these cases, the presence of a rectal tumour at the time of, or prior to, diagnosis of Fournier gangrene could not be ruled out. We present three cases of rectal cancer whose first manifestation was as Fournier gangrene.

  19. Benign (solitary) ulcer of the rectum - another cause for rectal stricture

    Energy Technology Data Exchange (ETDEWEB)

    Chapa, H.J.; Smith, H.J.; Dickinson, T.A.

    1981-01-15

    Benign rectal ulcer syndrome is an uncommon cause of lower gastrointestinal bleeding. Patients may present with mild, often recurrent, rectal bleeding frequently ascribed to hemorrhoids. Barium enema may be normal during the early, nonulcerative phase of proctitis. Single (or multiple) ulcers with or without rectal stricture are the hallmarks of the radiographic diagnosis. Radiologic demonstration of the ulcer(s) is not required, however, for the diagnosis. Benign rectal ulcer should be included in the differential diagnosis of benign-appearing rectal strictures.

  20. 'Microerosions' in rectal biopsies in Crohn's disease

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier

    1984-01-01

    Small (less than 1 mm), superficial erosions ('microerosions') have been observed stereo-microscopically in surface-stained rectal biopsies in Crohn's disease (CD). Biopsy specimens from 97 patients with CD, 225 with ulcerative colitis (UC), and a control material of 161 patients were investigated....... Granulomas were identified in 62% of the biopsies with microerosions and by examination of two consecutive biopsies from each of these patients, in 85% indicating a positive correlation. In patients with microerosions and a primary diagnosis of UC, granulomas were found in 38% and by examination of two...... biopsies in 54%. Patients with granulomas and a few other patients were reclassified as CD, but there still remained some patients with microerosions, who most probably had UC. In conclusion, microerosions are observed mainly in CD with colonic involvement. There is a high incidence of granulomas in biopsy...

  1. Rectal neoplasms. Postoperative follow-up

    International Nuclear Information System (INIS)

    Galano Urgelles, Rolando; Rodriguez Fernandez, Zenen; Casaus Prieto, Arbelio

    1997-01-01

    A study of 31 patients operated on for rectal neoplasms between September, 1989 and September, 1995 in SantiAug de Cuba was performed. Patients Webre followed-up during this period for the purpose of the study. There was a frank predominance of males and ages between 45 and 64, of the stage II and the groups BI and BII according to Dukes' classification. Most patients received 5-fluoracil, without tumor relapses. The current survival rate of the series was 76 % at the end of the investigation. It is recommended that all patients operated on for this segment be followed-up after the operation; to continue with cytostatic treatment using 5-fluoracil, and to emphasize the importance of the use of tumor markers during the follow-up, in addition to transrectal ultrasound, as well as to make an early diagnosis through mass screening methods

  2. Radiation therapy for operable rectal cancer

    International Nuclear Information System (INIS)

    Bondar, G.V.; Semikoz, N.G.; Bashejev, V.Kh.; Borota, O.V.; Bondarenko, M.V.; Kiyashko, O.Yu.

    2012-01-01

    The authors present a review of the literature on modern tendencies of radiation therapy application to treatment of operable rectal cancer. Many randomized control studies compared the efficacy of combination of radiation therapy (pre-operative or post-operative) and surgery versus surgery only demonstrating various results. Meta-analysis of the data on efficacy of combination of radiation therapy and standard surgery revealed 22 randomized control studies (14 with pre-operative radiation therapy and 8 with post-operative radiation therapy) with total number of 8507 patients (Colorectal Cancer Collaborative Group, 2000). The use of combination treatment reduced the number of isolated locoregional relapses both with pre-operative (22.5 - 12.5 %; p < 0.00001) and post-operative radiation therapy (25.8 - 16.7 %; p - 0.00001). The influence on total survival was not significant (62 % vs. 63 %; p - 0.06).

  3. Acute toxicity of chemoradiation for rectal cancer

    International Nuclear Information System (INIS)

    Roedel, C.; Fietkau, R.; Keilholz, L.; Grabenbauer, G.G.; Kessler, H.; Martus, P.; Sauer, R.

    1997-01-01

    Between 1987 and 1995, 120 patients with rectal cancer (73 patients with primary tumor, 47 with recurrent disease) received chemoradiation for rectal cancer. Fifty-six patients received preoperative chemoradiation, 64 patients were treated postoperatively. Radiation was given by 4-field box technique with 6 to 10 MV-photons. Daily fraction size was 1.8 Gy, total dose 50.4 Gy (range: 41,4 to 56 Gy) ± 5.4 Gy (range: 3.6 to 19.8 Gy) local boost in selected cases, specified to the ICRU reference point. During the first and fifth week of radiation 5-FU at a dose of 1000 m 2 /d for 120 hours was administered by continuous infusion. Toxicity was recorded following (modified) WHO-criteria. Results: Acute grade 3 toxicity occurred mainly as diarrhea (33%), perineal skin reaction (37%), and leukopenia (10%). Extension of the treatment volume including paraaortic lymph nodes (L3) led to a significant increase of grade 3-diarrhea (68% vs. 25%, p = 0.0003) and grade 3-leukopenia (18% vs. 8%, p 0.03). After abdominoperineal resection less patients suffered from grade 3-diarrhea (8% vs. 47% after sphincter preserving procedures, p = 0.0006), whereas severe perineal erythema occurred more frequently (56% vs. 29%, p 0.02). Women had significantly more toxic side effects (grade 3-diarrhea: 39% vs. 16% in men, p = 0,04; grade 2 to 3-nausea/emesis: 21% vs 8% in men, p 0.018; grade 2 to 3-leukopenia 53% vs. 31% in men, p = 0.02). After preoperative chemoradiation a significant reduction of grade 3-diarrhea (11% vs 29%, p 0.03) and grade 3-erythema (16% vs. 41%, p = 0.04) was noted. (orig./AJ) [de

  4. Effects of caloric deprivation on thyroid hormone tissue uptake and generation of low-T3 syndrome

    International Nuclear Information System (INIS)

    van der Heyden, J.T.M.; Docter, R.; van Toor, H.; Wilson, J.H.P.; Hennemann, G.; Krenning, E.P.

    1986-01-01

    Changes in thyroid hormone metabolism in the low-3,5,3'-triiodothyronine (T 3 ) syndrome cannot be fully explained in all conditions by a decrease in 5'-deiodinase activity. Recent observations showed that in rat hepatocytes iodothyronines are taken up by an active transport mechanism. To investigate whether regulation, i.e., inhibition of active transmembraneous transport for iodothyronines in humans may contribute to the generation of the low-T 3 syndrome, tracer thyroxine (T 4 ) and T 3 kinetic studies were performed in 10 obese subjects before and after 7 days on a 240 kcal diet. Kinetics analyses were performed according to a three-pool model of distribution and metabolism for both T 4 and T 3 . For T 4 kinetics, during caloric deprivation serum total T 4 and plasma pool did not change and production rate and metabolic clearance rate (MCR) were significantly lower. Despite a significantly higher serum free T 4 , the mass transfer rate to the rapidly equilibrating pool (REP) and the slowly equilibrating pool (SEP) diminished significantly, leading to smaller tissue pools. For T 3 kinetics, both serum total T 3 , free T 3 , plasma pool, and production rate diminished significantly, while MCR remained unchanged. These changes cannot be fully explained by a similar decrease of serum free T 3 (only 25%), indicating a diminished transport efficiency for T 3 . In conclusion, during caloric restriction, transport of T 4 and T 3 into tissues is diminished, and this phenomenon is much more pronounced for T 4 transport per se may contribute to low-T 3 production and low-T 3 serum levels due to less substrate (i.e., T 4 ) availability in tissues

  5. Increased thyroidal T4 to T3 conversion in autonomously functioning thyroid adenoma: from euthyroidism to thyrotoxicosis.

    LENUS (Irish Health Repository)

    Solter, M

    2012-01-31

    AIM: The aim was to investigate whether the intrathyroid conversion of T4 to T3 in autonomously functioning thyroid adenoma (AFTA) tissue could influence serum T3 levels and suppression of TSH, especially in patients with borderline thyroid function. PATIENTS AND METHODS: In ten patients with AFTA, thyroidal conversion of T4 to T3 was investigated in nodular and paranodular, TSH-suppressed tissue. All patients had normal serum T4 and suppressed TSH. Serum T3 was normal in six, and borderline or slightly increased in four. AFTA and paranodular tissues were surgically removed and frozen at -70 degrees C, then homogenized in a glass homogenizer, centrifuged at 100,000xg, and particulate fraction collected as a pellet. Analysis mixture consisted of thyroid enzyme suspension in 50 mumol\\/L TRIS buffer with 5 mumol DTT and 200 muL 1.3 mumol T4. Incubation was performed at 37 degrees C and the generation of T3 measured after 5, 10, 20 and 40 minutes respectively. RESULTS: T3 production (pmol\\/mg protein) was significantly higher in AFTA than in paranodular tissues (8.8 1.2\\/Mean +\\/- SE\\/vs. 1.8 +\\/- 0.2; p<0.01), and excessively high (9.8, 14.1, 14.2 and 15.0) in four patients with borderline or slightly supranormal serum T3. A significant correlation was found between serum T3 concentrations and T3 generation (T4 conversion) in AFTA tissues. CONCLUSION: Results suggest that increased thyroidal T4 to T3 conversion in AFTA tissue could be involved in an increased delivery of T3, increased serum T3 and suppressed serum TSH, particularly in patients with the disease evolving from euthyroid to an early hyperthyroid phase.

  6. Thyroid hormone uptake and T4 derived T3 formation in different skeletal muscle types of normal and hyperthyroid rats

    International Nuclear Information System (INIS)

    Hardeveld, C. van; Kassenaar, A.A.H.

    1978-01-01

    In this study hind-limb perfusion was used to investigate conversion of T 4 to T 3 in skeletal muscle tissue. For this purpose the rats were depleted of thyroid hormones by thyroid ablation with 0.75 mCi 131 I and were perfused 2 weeks later, when the skeletal muscle tissue consumed oxygen at a normal rate due to one subcutaneous dose of 10 μg T 3 /100 g b. w. 3 days before the perfusion experiments were started. T 4 * of high specific activity (> 2000 μCi/μg) was added to the perfusate. In the muscle (mixed type) a mean T 4 → T 3 conversion of 2% (range 0.5-3.9) was found after 120 min of perfusion. T 3 generation from T 4 in skeletal muscle did not correspond with T 3 muscle uptake. This observation makes a significant overestimation of T 3 by selective uptake of a small contamination of T 3 * in the T 4 * preparation highly improbable. In red muscle the T 4 and T 3 uptake was about 50 % higher than in white muscle. The observed Tetracsup(c) and T 3 sup(c) were significantly higher in red than in white muscle. The uptake of thyroid hormones by both muscle types was not changed in hyperthyroid rats. The Tetrac and T 3 formation from T 4 , however, was increased in red muscles of hyperthyroid rats. The results show that thyroid hormone metabolism can vary markedly depending upon the type of muscle studied and they present a basis for a better understanding of clinical and biochemical evidence for a different susceptibility of red and white muscle fibers to thyroid hormones. (Abbreviations: *= 125 I; **= 131 I; T 3 sup(c)=T 4 derived T 3 ; Tetracsup(c)=T 4 derived Tetrac) (author)

  7. Studies on the T3 suppression test with reference to the thyrodial 123I uptake in Graves' disease

    International Nuclear Information System (INIS)

    Yamaguchi, Takahiko; Kobayashi, Isao; Yamaguchi, Yoshiyuki; Iwashita, Akira; Inukai, Toshihiko; Ohshima, Kihachi; Shimomura, Yohnosuke; Kobayashi, Setsuo

    1990-01-01

    Eighty-three patients with Graves' disease had been treated with methylmercaptoimidazole (MMI). They were prescribed a maintenance dose of antithyroid drug (MMI, 5 mg/day) at the time of a T 3 suppression test. The 3-hour and 24-hour thyroidal 123 I uptake after T 3 administration (75 μg/day, 2 weeks) were measured (post T 3 uptake). In 38 patients whose post T 3 uptake was below 35% in post T 3 24-hour uptake, treatment was stopped. The T 3 suppression test was then repeated 1 and 3 months later. During a one-year follow up, 26 remained well, while 12 relapsed within 6 to 12 months. We have observed a good correlation between 3-hour uptake and 24-hour uptake of 123 I after T 3 administration (r=0.847, p 3 suppression, most patients with MMI withdrawal produced a marked overshoot of post T 3 3-hour and 24-hour uptake at one month. Retrospective analysis indicated that there was no significant difference in circulating thyroid hormone levels between remission and relapse groups. The present study provides evidence that 3-hour uptake values are able to be substituted for 24-hour uptake values during a T 3 suppression test. In addition, overshoot of thyroidal uptake after antithyroid drug withdrawal was observed in 3-hour values, similar to 24-hour values. (author)

  8. Five Fractions of Radiation Therapy Followed by 4 Cycles of FOLFOX Chemotherapy as Preoperative Treatment for Rectal Cancer

    International Nuclear Information System (INIS)

    Myerson, Robert J.; Tan, Benjamin; Hunt, Steven; Olsen, Jeffrey; Birnbaum, Elisa; Fleshman, James; Gao, Feng; Hall, Lannis; Kodner, Ira; Lockhart, A. Craig; Mutch, Matthew; Naughton, Michael; Picus, Joel; Rigden, Caron; Safar, Bashar; Sorscher, Steven; Suresh, Rama; Wang-Gillam, Andrea; Parikh, Parag

    2014-01-01

    Background: Preoperative radiation therapy with 5-fluorouracil chemotherapy is a standard of care for cT3-4 rectal cancer. Studies incorporating additional cytotoxic agents demonstrate increased morbidity with little benefit. We evaluate a template that: (1) includes the benefits of preoperative radiation therapy on local response/control; (2) provides preoperative multidrug chemotherapy; and (3) avoids the morbidity of concurrent radiation therapy and multidrug chemotherapy. Methods and Materials: Patients with cT3-4, any N, any M rectal cancer were eligible. Patients were confirmed to be candidates for pelvic surgery, provided response was sufficient. Preoperative treatment was 5 fractions radiation therapy (25 Gy to involved mesorectum, 20 Gy to elective nodes), followed by 4 cycles of FOLFOX [5-fluorouracil, oxaliplatin, leucovorin]. Extirpative surgery was performed 4 to 9 weeks after preoperative chemotherapy. Postoperative chemotherapy was at the discretion of the medical oncologist. The principal objectives were to achieve T stage downstaging (ypT < cT) and preoperative grade 3+ gastrointestinal morbidity equal to or better than that of historical controls. Results: 76 evaluable cases included 7 cT4 and 69 cT3; 59 (78%) cN+, and 7 cM1. Grade 3 preoperative GI morbidity occurred in 7 cases (9%) (no grade 4 or 5). Sphincter-preserving surgery was performed on 57 (75%) patients. At surgery, 53 patients (70%) had ypT0-2 residual disease, including 21 (28%) ypT0 and 19 (25%) ypT0N0 (complete response); 24 (32%) were ypN+. At 30 months, local control for all evaluable cases and freedom from disease for M0 evaluable cases were, respectively, 95% (95% confidence interval [CI]: 89%-100%) and 87% (95% CI: 76%-98%). Cases were subanalyzed by whether disease met requirements for the recently activated PROSPECT trial for intermediate-risk rectal cancer. Thirty-eight patients met PROSPECT eligibility and achieved 16 ypT0 (42%), 15 ypT0N0 (39%), and 33 ypT0-2 (87

  9. Five Fractions of Radiation Therapy Followed by 4 Cycles of FOLFOX Chemotherapy as Preoperative Treatment for Rectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Myerson, Robert J., E-mail: rmyerson@radonc.wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Tan, Benjamin [Division of Medical Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Hunt, Steven [Section of Colorectal Surgery, Washington University School of Medicine, St. Louis, Missouri (United States); Olsen, Jeffrey [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Birnbaum, Elisa; Fleshman, James [Section of Colorectal Surgery, Washington University School of Medicine, St. Louis, Missouri (United States); Gao, Feng [Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri (United States); Hall, Lannis [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Kodner, Ira [Section of Colorectal Surgery, Washington University School of Medicine, St. Louis, Missouri (United States); Lockhart, A. Craig [Division of Medical Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Mutch, Matthew [Section of Colorectal Surgery, Washington University School of Medicine, St. Louis, Missouri (United States); Naughton, Michael; Picus, Joel; Rigden, Caron [Division of Medical Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Safar, Bashar [Section of Colorectal Surgery, Washington University School of Medicine, St. Louis, Missouri (United States); Sorscher, Steven; Suresh, Rama; Wang-Gillam, Andrea [Division of Medical Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Parikh, Parag [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States)

    2014-03-15

    Background: Preoperative radiation therapy with 5-fluorouracil chemotherapy is a standard of care for cT3-4 rectal cancer. Studies incorporating additional cytotoxic agents demonstrate increased morbidity with little benefit. We evaluate a template that: (1) includes the benefits of preoperative radiation therapy on local response/control; (2) provides preoperative multidrug chemotherapy; and (3) avoids the morbidity of concurrent radiation therapy and multidrug chemotherapy. Methods and Materials: Patients with cT3-4, any N, any M rectal cancer were eligible. Patients were confirmed to be candidates for pelvic surgery, provided response was sufficient. Preoperative treatment was 5 fractions radiation therapy (25 Gy to involved mesorectum, 20 Gy to elective nodes), followed by 4 cycles of FOLFOX [5-fluorouracil, oxaliplatin, leucovorin]. Extirpative surgery was performed 4 to 9 weeks after preoperative chemotherapy. Postoperative chemotherapy was at the discretion of the medical oncologist. The principal objectives were to achieve T stage downstaging (ypT < cT) and preoperative grade 3+ gastrointestinal morbidity equal to or better than that of historical controls. Results: 76 evaluable cases included 7 cT4 and 69 cT3; 59 (78%) cN+, and 7 cM1. Grade 3 preoperative GI morbidity occurred in 7 cases (9%) (no grade 4 or 5). Sphincter-preserving surgery was performed on 57 (75%) patients. At surgery, 53 patients (70%) had ypT0-2 residual disease, including 21 (28%) ypT0 and 19 (25%) ypT0N0 (complete response); 24 (32%) were ypN+. At 30 months, local control for all evaluable cases and freedom from disease for M0 evaluable cases were, respectively, 95% (95% confidence interval [CI]: 89%-100%) and 87% (95% CI: 76%-98%). Cases were subanalyzed by whether disease met requirements for the recently activated PROSPECT trial for intermediate-risk rectal cancer. Thirty-eight patients met PROSPECT eligibility and achieved 16 ypT0 (42%), 15 ypT0N0 (39%), and 33 ypT0-2 (87

  10. Release of obstructing rectal cuff following transanal endorectal ...

    African Journals Online (AJOL)

    symptoms after transanal endorectal pullthrough for ... In both patients, the obstructing symptoms were because of a rectal cuff ... widely adopted for the treatment of Hirschsprung's disease ... The cuff was identified and cut strictly in the midline.

  11. [Rectal tonsil or lymphoid follicular hyperplasia of the rectum].

    Science.gov (United States)

    Trillo Fandiño, L; Arias González, M; Iglesias Castañón, A; Fernández Eire, M P

    2014-01-01

    The rectal tonsil is a reactive proliferation of lymphoid tissue located in the rectum. The morphology of the lymphoid proliferation of the colon is usually polypoid or, less commonly, nodular. Only in exceptional cases does lymphoid proliferation of the colon present as a mass in the rectum (rectal tonsil), although this is the most common presentation in middle-aged patients. It is important to be familiar with the rectal tonsil because in cases of exuberant growth it can be difficult to distinguish it from other types of masses. We present the case of rectal tonsil in a four-year-old girl. We describe the magnetic resonance imaging findings and review the literature. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  12. Value of intraoperative radiotherapy in locally advanced rectal cancer

    NARCIS (Netherlands)

    Ferenschild, Floris T. J.; Vermaas, Maarten; Nuyttens, Joost J. M. E.; Graveland, Wilfried J.; Marinelli, Andreas W. K. S.; van der Sijp, Joost R.; Wiggers, Theo; Verhoef, Cornelis; Eggermont, Alexander M. M.; de Wilt, Johannes H. W.

    PURPOSE: This study was designed to analyze the results of a multimodality treatment using preoperative radiotherapy, followed by surgery and intraoperative radiotherapy in patients with primary locally advanced rectal cancer. METHODS: Between 1987 and 2002, 123 patients with initial unresectable

  13. Laparoscopic resection for low rectal cancer: evaluation of oncological efficacy.

    LENUS (Irish Health Repository)

    Moran, Diarmaid C

    2011-09-01

    Laparoscopic resection of low rectal cancer poses significant technical difficulties for the surgeon. There is a lack of published follow-up data in relation to the surgical, oncological and survival outcomes in these patients.

  14. Recurrent rectal prolapse caused by colonic duplication in a dog.

    Science.gov (United States)

    Landon, B P; Abraham, L A; Charles, J A; Edwards, G A

    2007-09-01

    A 9-month-old female Shar Pei cross-bred dog was presented with a history of recurrent rectal prolapse over 7 months. Repeated reduction and anal purse string sutures and subsequent incisional colopexy failed to prevent recurrent rectal prolapse. Digital rectal examination following reduction of the prolapse identified a faeces-filled sac within the ventral wall of the rectum and an orifice in the ventral colonic wall, cranial to the pubic brim. A ventral, communicating tubular colonic duplication was diagnosed by means of a barium enema. Surgical excision of the duplicated colonic tube was performed via a caudal ventral midline laparotomy. At 20 weeks post-operation, there has been no recurrence of rectal prolapse.

  15. Refining Preoperative Therapy for Locally Advanced Rectal Cancer

    Science.gov (United States)

    In the PROSPECT trial, patients with locally advanced, resectable rectal cancer will be randomly assigned to receive either standard neoadjuvant chemoradiation therapy or neoadjuvant FOLFOX chemotherapy, with chemoradiation reserved for nonresponders.

  16. Rectal route in the 21st Century to treat children.

    Science.gov (United States)

    Jannin, Vincent; Lemagnen, Gilles; Gueroult, Pascale; Larrouture, Denis; Tuleu, Catherine

    2014-06-01

    The rectal route can be considered a good alternative to the oral route for the paediatric population because these dosage forms are neither to be swallowed nor need to be taste-masked. Rectal forms can also be administered in an emergency to unconscious or vomiting children. Their manufacturing cost is low with excipients generally regarded as safe. Some new formulation strategies, including mucoadhesive gels and suppositories, were introduced to increase patient acceptability. Even if recent paediatric clinical studies have demonstrated the equivalence of the rectal route with others, in order to enable the use of this promising route for the treatment of children in the 21st Century, some effort should be focused on informing and educating parents and care givers. This review is the first ever to address all the aforementioned items, and to list all drugs used in paediatric rectal forms in literature and marketed products in developed countries. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Rectal absorption of homatropine [14C] methylbromide in the rat

    International Nuclear Information System (INIS)

    Cramer, M.B.; Cates, L.A.; Clarke, D.E.

    1978-01-01

    Homatropine [ 14 C]methylbromide (HMB- 14 C) was administered to rats by intramuscular injection, oral gavage and rectal suppository. Plasma concentrations of 14 C were measured over the subsequent 12 h. Peak plasma concentrations were higher and achieved more rapidly after rectal administration than by other routes whether HMB- 14 C was administered in a water-soluble suppository base or in aqueous solution. Twelve h after the suppositories were inserted and retained 28% of the 14 C had been excreted in the urine while 56% remained in the large intestine. Unlabelled HMB, given in rectal suppositories to anaesthetized rats, caused prompt blockade of the effects of vagal stimulation on pulse rate and of intravenous acetylcholine on blood pressure. These results confirm the rapid rectal absorption of the drug. (author)

  18. Magnetic resonance imaging for clinical management of rectal cancer

    DEFF Research Database (Denmark)

    Beets-Tan, Regina G H; Lambregts, Doenja M J; Maas, Monique

    2018-01-01

    OBJECTIVES: To update the 2012 ESGAR consensus guidelines on the acquisition, interpretation and reporting of magnetic resonance imaging (MRI) for clinical staging and restaging of rectal cancer. METHODS: Fourteen abdominal imaging experts from the European Society of Gastrointestinal and Abdomin...

  19. US and CT findings of rectal amebian abscess

    International Nuclear Information System (INIS)

    Guelek, B.; Oenel, S.

    1999-01-01

    An interesting case of rectal amebic abscess is presented. Ultrasound and CT images provided the diagnosis of a cystic intramural mass at the rectal wall of a young man, who complained of pelvic pain, constipation, and fever. His clinical history of amebiasis and the finding of trophozoids and cysts at the stool swap confirmed the diagnosis. Intravenous metronidazole therapy cured the disease and led to total disappearance of the mass, and clinical well-being. (orig.)

  20. MRI in children following surgery for anal and rectal atresia

    International Nuclear Information System (INIS)

    Krahe, T.; Herold, A.; Doelken, W.; Hoecht, B.; Wuerzburg Univ.

    1989-01-01

    MRI of the pelvis was performed in 17 children following surgical correction of anal and rectal atresias and in five children without ano-rectal malformations. A muscle score was used to characterize the muscles of the pelvic floor and their relationship to the rectum. There was close agreement between the MRI muscle score and clinical continence. MRI provided additional information that should improve continence following conservative and surgical treatment. (orig.) [de

  1. High-dose chemoradiotherapy and watchful waiting for distal rectal cancer: a prospective observational study.

    Science.gov (United States)

    Appelt, Ane L; Pløen, John; Harling, Henrik; Jensen, Frank S; Jensen, Lars H; Jørgensen, Jens C R; Lindebjerg, Jan; Rafaelsen, Søren R; Jakobsen, Anders

    2015-08-01

    Abdominoperineal resection is the standard treatment for patients with distal T2 or T3 rectal cancers; however, the procedure is extensive and mutilating, and alternative treatment strategies are being investigated. We did a prospective observational trial to assess whether high-dose radiotherapy with concomitant chemotherapy followed by observation (watchful waiting) was successful for non-surgical management of low rectal cancer. Patients with primary, resectable, T2 or T3, N0-N1 adenocarcinoma in the lower 6 cm of the rectum were given chemoradiotherapy (60 Gy in 30 fractions to tumour, 50 Gy in 30 fractions to elective lymph node volumes, 5 Gy endorectal brachytherapy boost, and oral tegafur-uracil 300 mg/m(2)) every weekday for 6 weeks. Endoscopies and biopsies of the tumour were done at baseline, throughout the course of treatment (weeks 2, 4, and 6), and 6 weeks after the end of treatment. We allocated patients with complete clinical tumour regression, negative tumour site biopsies, and no nodal or distant metastases on CT and MRI 6 weeks after treatment to the observation group (watchful waiting). We referred all other patients to standard surgery. Patients under observation were followed up closely with endoscopies and selected-site biopsies, with surgical resection given for local recurrence. The primary endpoint was local tumour recurrence 1 year after allocation to the observation group. This study is registered with ClinicalTrials.gov, number NCT00952926. Enrolment is closed, but follow-up continues for secondary endpoints. Between Oct 20, 2009, and Dec 23, 2013, we enrolled 55 patients. Patients were recruited from three surgical units throughout Denmark and treated in one tertiary cancer centre (Vejle Hospital, Vejle, Denmark). Of 51 patients who were eligible, 40 had clinical complete response and were allocated to observation. Median follow-up for local recurrence in the observation group was 23·9 months (IQR 15·3-31·0). Local recurrence in the

  2. Rectal cancer and inflammatory bowel disease: natural history and implications for radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Green, Sheryl; Stock, Richard; Greenstein, Adrian

    1995-07-01

    PURPOSES/OBJECTIVE: There exists little information concerning the natural history of rectal cancer in patients with inflammatory bowel disease. In addition, the tolerance of pelvic irradiation in these patients is unknown. We analyzed the largest series of patients with inflammatory bowel disease and rectal cancer in order to determine the natural history of the disease as well as the effect and tolerance of pelvic irradiation. MATERIAL AND METHODS: A retrospective analysis of 47 patients with inflammatory bowel disease and rectal cancer treated over a 34 year period (1960-1994) was performed. Thirty five patients had Ulcerative Colitis and 12 patients had Crohn's Disease. There were 31 male patients and 16 female patients. The stage (AJC) distribution was as follows: stage 0 in 5 patients, stage I in 13 patients, stage II in 7 patients, stage III in 13 patients and stage IV in 9 patients. Surgical resection was performed in 44 patients. In 2 of these patients, preoperative pelvic irradiation was given followed by surgery. Twenty of these patients underwent post-operative adjuvant therapy (12 were treated with chemotherapy and pelvic irradiation and 8 with chemotherapy alone). Three patients were found to have unresectable disease and were treated with chemotherapy alone (2 patients) or chemotherapy and radiation therapy (1 patient). Radiation complications were graded using the RTOG acute and late effects scoring criteria. Follow up ranged from 4 to 250 months (median - 24 months). RESULTS: The 5 year actuarial results revealed an overall survival (OS) of 42%, a disease free survival (DFS) of 43%, a pelvic control rate (PC) of 67% and a freedom from distant failure (FFDF) of 47%. DFS decreased with increasing T stage with a 5 year rate of 86% for patients with Tis - T2 disease compared to 10% for patients with T3-T4 disease (p < 0.0001). The presence of lymph node metastases also resulted in a decrease in DFS with a 5 year rate of 67% for patients with N0 disease

  3. Chronic rectal bleeding after high-dose conformal treatment of prostate cancer warrants modification of existing morbidity scales

    International Nuclear Information System (INIS)

    Hanlon, Alexandra L.; Schultheiss, Timothy E.; Hunt, Margie A.; Movsas, Benjamin; Peter, Ruth S.; Hanks, Gerald E.

    1997-01-01

    Purpose: Serious late morbidity (Grade (3(4))) from the conformal treatment of prostate cancer has been reported in <1% to 6% of patients based on existing late gastrointestinal (GI) morbidity scales. None of the existing morbidity scales include our most frequently observed late GI complication, which is chronic rectal bleeding requiring multiple fulgerations. This communication documents the frequency of rectal bleeding requiring multiple fulgerations and illustrates the variation in reported late serious GI complication rates by the selection of morbidity scale. Methods and Materials: Between May 1989 and December 1993, 352 patients with T1-T3 nonmetastatic prostate cancers were treated with our four-field conformal technique without special rectal blocking. This technique includes a 1-cm margin from the clinical target volume (CTV) to the planning target volume (PTV) in all directions. The median follow-up for these patients was 36 months (range 2-76), and the median center of prostate dose was 74 Gy (range 63-81). Three morbidity scales are assessed: the Radiation Therapy Oncology Group (RTOG), the Late Effects Normal Tissue Task Force (LENT), and our modification of the LENT (FC-LENT). This modification registers chronic rectal bleeding requiring at least one blood transfusion and/or more than two coagulations as a Grade 3 event. Estimates for Grade (3(4)) late GI complication rates were determined using Kaplan-Meier methodology. The duration of severe symptoms with chronic rectal bleeding is measured from the first to the last transrectal coagulation. Latency is measured from the end of radiotherapy to surgery, first blood transfusion, or third coagulation procedure. Results: Sixteen patients developed Grade (3(4)) complications by one of the three morbidity scales. Two patients required surgery (colostomy or sigmoid resection), three required multiple blood transfusions, two required one or two blood transfusions, and nine required at least three

  4. Laparoscopic rectal cancer surgery: Where do we stand?

    Institute of Scientific and Technical Information of China (English)

    Mukta K Krane; Alessandro Fichera

    2012-01-01

    Large comparative studies and multiple prospective randomized control trials (RCTs) have reported equivalence in short and long-term outcomes between the open and laparoscopic approaches for the surgical treatment of colon cancer which has heralded widespread acceptance for laparoscopic resection of colon cancer.In contrast,laparoscopic total mesorectal excision (TME) for the treatment of rectal cancer has been welcomed with significantly less enthusiasm.While it is likely that patients with rectal cancer will experience the same benefits of early recovery and decreased postoperative pain from the laparoscopic approach,whether the same oncologic clearance,specifically an adequate TME can be obtained is of concern.The aim of the current study is to review the current level of evidence in the literature on laparoscopic rectal cancer surgery with regard to short-term and long-term oncologic outcomes.The data from 8 RCTs,3 metaanalyses,and 2 Cochrane Database of Systematic Reviews was reviewed.Current data suggests that laparoscopic rectal cancer resection may benefit patients with reduced blood loss,earlier retum of bowel function,and shorter hospital length of stay.Concerns that laparoscopic rectal cancer surgery compromises shortterm oncologic outcomes including number of lymph nodes retrieved and circumferential resection margin and jeopardizes long-term oncologic outcomes has not conclusively been refuted by the available literature.Laparoscopic rectal cancer resection is feasible but whether or not it compromises short-term or long-term results still needs to be further studied.

  5. Nebivolol stimulates mitochondrial biogenesis in 3T3-L1 adipocytes

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Chenglin; Chen, Dongrui; Xie, Qihai [State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Vascular Biology, Department of Hypertension, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025 (China); Yang, Ying, E-mail: yangying_sh@yahoo.com [Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025 (China); Shen, Weili, E-mail: weili_shen@hotmail.com [State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Vascular Biology, Department of Hypertension, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025 (China)

    2013-08-16

    Highlights: •Nebivolol may act as a partial agonist of β3-adrenergic receptor (AR). •Nebivolol stimulates mitochondrial DNA replication and protein expression. •Nebivolol promotes mitochondrial synthesis via activation of eNOS by β3-AR. -- Abstract: Nebivolol is a third-generation β-adrenergic receptor (β-AR) blocker with additional beneficial effects, including the improvement of lipid and glucose metabolism in obese individuals. However, the underlying mechanism of nebivolol’s role in regulating the lipid profile remains largely unknown. In this study, we investigated the role of nebivolol in mitochondrial biogenesis in 3T3-L1 adipocytes. Exposure of 3T3-L1 cells to nebivolol for 24 h increased mitochondrial DNA copy number, mitochondrial protein levels and the expression of transcription factors involved in mitochondrial biogenesis, including PPAR-γ coactivator-1α (PGC-1α), Sirtuin 3 (Sirt3), mitochondrial transcription factor A (Tfam) and nuclear related factor 1 (Nrf1). These changes were accompanied by an increase in oxygen consumption and in the expression of genes involved in fatty acid oxidation and antioxidant enzymes in 3T3-L1 adipocytes, including nebivolol-induced endothelial nitric oxide synthase (eNOS), as well as an increase in the formation of cyclic guanosine monophosphate (cGMP). Pretreatment with NG-nitro-L-arginine methyl ester (l-NAME) attenuated nebivolol-induced mitochondrial biogenesis, as did the soluble guanylate cyclase inhibitor, ODQ. Treatment with nebivolol and β3-AR blocker SR59230A markedly attenuated PGC-1α, Sirt3 and manganese superoxide dismutase (MnSOD) protein levels in comparison to treatment with nebivolol alone. These data indicate that the mitochondrial synthesis and metabolism in adipocytes that is promoted by nebivolol is primarily mediated through the eNOS/cGMP-dependent pathway and is initiated by the activation of β3-AR receptors.

  6. Conventional kinesin KIF5B mediates adiponectin secretion in 3T3-L1 adipocytes

    Energy Technology Data Exchange (ETDEWEB)

    Cui, Ju, E-mail: juzi.cui@gmail.com [The Key Laboratory of Geriatrics, Beijing Hospital and Beijing Institute of Geriatrics, Beijing (China); Pang, Jing; Lin, Ya-Jun; Jiang, Ping; Gong, Huan [The Key Laboratory of Geriatrics, Beijing Hospital and Beijing Institute of Geriatrics, Beijing (China); Wang, Zai [Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing (China); Li, Jian; Cai, Jian-Ping [The Key Laboratory of Geriatrics, Beijing Hospital and Beijing Institute of Geriatrics, Beijing (China); Huang, Jian-Dong, E-mail: jdhuang@hku.hk [School of Biomedical Sciences and Shenzhen Institute of Research and Innovation, The University of Hong Kong, Pokfulam (Hong Kong); The Centre for Synthetic Biology Engineering Research, Shenzhen Institutes of Advanced Technology, Shenzhen (China); Zhang, Tie-Mei, E-mail: tmzhang126@126.com [The Key Laboratory of Geriatrics, Beijing Hospital and Beijing Institute of Geriatrics, Beijing (China)

    2016-08-05

    Insulin stimulates adiponectin secretion and glucose transporter type 4 (GLUT4) translocation in adipocyte to regulate metabolism homeostasis. Similar to GLUT4 translocation, intracellular trafficking and release of adiponectin in adipocytes relies on the trans-Golgi network and endosomal system. Recent studies show that the heavy chain of conventional kinesin (KIF5B) mediates GLUT4 translocation in murine 3T3-L1 adipocytes, however, the motor machinery involved in mediating intracellular trafficking and release of adiponectin is unknown. Here, we examined the role of KIF5B in the regulation of adiponectin secretion. The KIF5B level was up-regulated during 3T3-L1 adipogenesis. This increase in cytosolic KIF5B was synchronized with the induction of adiponectin. Endogenous KIF5B and adiponectin were partially colocalized at the peri-nuclear and cytosolic regions. In addition, adiponectin-containing vesicles were co-immunoprecipitated with KIF5B. Knockdown of KIF5B resulted in a marked inhibition of adiponectin secretion and overexpression of KIF5B enhanced adiponectin release, whereas leptin secretion was not affected by changes in KIF5B expression. These data suggest that the secretion of adiponectin, but not leptin, is dependent on functional KIF5B. - Highlights: • The KIF5B level was up regulated during 3T3-L1 adipogenesis. • Endogenous KIF5B and adiponectin were partially colicalized. • Adiponectin-containing vesicles were co-immunoprecipitated with KIF5B. • The secretion of adiponectin, but not leptin, is dependent on functional KIF5B.

  7. Conventional kinesin KIF5B mediates adiponectin secretion in 3T3-L1 adipocytes

    International Nuclear Information System (INIS)

    Cui, Ju; Pang, Jing; Lin, Ya-Jun; Jiang, Ping; Gong, Huan; Wang, Zai; Li, Jian; Cai, Jian-Ping; Huang, Jian-Dong; Zhang, Tie-Mei

    2016-01-01

    Insulin stimulates adiponectin secretion and glucose transporter type 4 (GLUT4) translocation in adipocyte to regulate metabolism homeostasis. Similar to GLUT4 translocation, intracellular trafficking and release of adiponectin in adipocytes relies on the trans-Golgi network and endosomal system. Recent studies show that the heavy chain of conventional kinesin (KIF5B) mediates GLUT4 translocation in murine 3T3-L1 adipocytes, however, the motor machinery involved in mediating intracellular trafficking and release of adiponectin is unknown. Here, we examined the role of KIF5B in the regulation of adiponectin secretion. The KIF5B level was up-regulated during 3T3-L1 adipogenesis. This increase in cytosolic KIF5B was synchronized with the induction of adiponectin. Endogenous KIF5B and adiponectin were partially colocalized at the peri-nuclear and cytosolic regions. In addition, adiponectin-containing vesicles were co-immunoprecipitated with KIF5B. Knockdown of KIF5B resulted in a marked inhibition of adiponectin secretion and overexpression of KIF5B enhanced adiponectin release, whereas leptin secretion was not affected by changes in KIF5B expression. These data suggest that the secretion of adiponectin, but not leptin, is dependent on functional KIF5B. - Highlights: • The KIF5B level was up regulated during 3T3-L1 adipogenesis. • Endogenous KIF5B and adiponectin were partially colicalized. • Adiponectin-containing vesicles were co-immunoprecipitated with KIF5B. • The secretion of adiponectin, but not leptin, is dependent on functional KIF5B.

  8. Lysophosphatidic acid induces chemotaxis in MC3T3-E1 osteoblastic cells

    Energy Technology Data Exchange (ETDEWEB)

    Masiello, Lisa M.; Fotos, Joseph S.; Galileo, Deni S.; Karin, Norm J.

    2006-07-01

    Lysophosphatidic acid (LPA) is a bioactive lipid that has pleiotropic effects on a variety of cell types and enhances the migration of endothelial and cancer cells, but it is not known if this lipid can alter osteoblast motility. We performed transwell migration assays using MC3T3-E1 osteoblastic cells and found LPA to be a potent chemotactic agent. Quantitative time-lapse video analysis of osteoblast migration after wounds were introduced into cell monolayers indicated that LPA stimulated both migration velocity and the average migration distance per cell. LPA also elicited substantial changes in cell shape and actin cytoskeletal structure; lipid-treated cells contained fewer stress fibers and displayed long membrane processes that were enriched in F-actin. Quantitative RT-PCR analysis showed that MC3T3-E1 cells express all four known LPA-specific G protein-coupled receptors (LPA1-LPA4) with a relative mRNA abundance of LPA1 > LPA4 > LPA2 >> LPA3. LPA-induced changes in osteoblast motility and morphology were antagonized by both pertussis toxin and Ki16425, a subtype-specific blocker of LPA1 and LPA3 receptor function. Cell migration in many cell types is linked to changes in intracellular Ca2+. Ki16425 also inhibited LPA-induced Ca2+ signaling in a dose-dependent manner, suggesting a link between LPA-induced Ca2+ transients and osteoblast chemotaxis. Our data show that LPA stimulates MC3T3-E1 osteoblast motility via a mechanism that is linked primarily to the G protein-coupled receptor LPA1.

  9. Nitridation Of The A A 2024 T3 Aluminium By The Glow Discharge Plasma Technique

    International Nuclear Information System (INIS)

    Mudjiman, Supardjono; Sujitno, Tjipto; Sudjatmoko

    1996-01-01

    Nitridation of A A 2024 T3 aluminium by means of plasma glow discharge technique has been carried out. For this purpose, the experiments were carried out at the temperature 30 o C, 60 o C, 100 o C, 150 o C, 200 o C, and 250 o C whereas the nitridation time were varied at 5 minutes, 15 minutes, 40 minutes, 90 minutes and 180 minutes. The results showed that the optimum temperature and time of nitridation were 60 o C and 90 minutes respectively and the hardness increased from 115 to 166 KHN

  10. Transformation of Balb 3T3 cells exposed to a germicidal UV lamp and a sunlamp

    International Nuclear Information System (INIS)

    Withrow, T.J.; Lugo, M.H.; Dempsey, M.J.

    1980-01-01

    The effect of germicidal UV and sunlamp exposure on direct and simian virus-40 (SV-40) transformatioon of Balb 3T3 cells was studied. Transformation was determined by the ability of transformed cells to grow as clones in agar. Radiation from these lamps enhanced direct transformation, and enhanced viral transformation to approximately the same degree. Enhanced transformation was seen with exposures of light that caused no measurable cell killing, which suggests that the induction of new transformants is involved rather than the selection of pre-existing transformants. Induction is also suggested by post-irradiation growth kinetics experiments. (author)

  11. Effects of dietary phytoestrogens on plasma testosterone and triiodothyronine (T3) levels in male goat kids

    Science.gov (United States)

    2009-01-01

    Background Exposure to xenoestrogens in humans and animals has gained increasing attention due to the effects of these compounds on reproduction. The present study was undertaken to investigate the influence of low-dose dietary phytoestrogen exposure, i.e. a mixture of genistein, daidzein, biochanin A and formononetin, on the establishment of testosterone production during puberty in male goat kids. Methods Goat kids at the age of 3 months received either a standard diet or a diet supplemented with phytoestrogens (3 - 4 mg/kg/day) for ~3 months. Plasma testosterone and total and free triiodothyronine (T3) concentrations were determined weekly. Testicular levels of testosterone and cAMP were measured at the end of the experiment. Repeated measurement analysis of variance using the MIXED procedure on the generated averages, according to the Statistical Analysis System program package (Release 6.12, 1996, SAS Institute Inc., Cary, NC, USA) was carried out. Results No significant difference in plasma testosterone concentration between the groups was detected during the first 7 weeks. However, at the age of 5 months (i.e. October 1, week 8) phytoestrogen-treated animals showed significantly higher testosterone concentrations than control animals (37.5 nmol/l vs 19.1 nmol/l). This elevation was preceded by a rise in plasma total T3 that occurred on September 17 (week 6). A slightly higher concentration of free T3 was detected in the phytoestrogen group at the same time point, but it was not until October 8 and 15 (week 9 and 10) that a significant difference was found between the groups. At the termination of the experiment, testicular cAMP levels were significantly lower in goats fed a phytoestrogen-supplemented diet. Phytoestrogen-fed animals also had lower plasma and testicular testosterone concentrations, but these differences were not statistically significant. Conclusion Our findings suggest that phytoestrogens can stimulate testosterone synthesis during puberty in

  12. Effects of dietary phytoestrogens on plasma testosterone and triiodothyronine (T3 levels in male goat kids

    Directory of Open Access Journals (Sweden)

    Ekstedt Elisabeth

    2009-12-01

    Full Text Available Abstract Background Exposure to xenoestrogens in humans and animals has gained increasing attention due to the effects of these compounds on reproduction. The present study was undertaken to investigate the influence of low-dose dietary phytoestrogen exposure, i.e. a mixture of genistein, daidzein, biochanin A and formononetin, on the establishment of testosterone production during puberty in male goat kids. Methods Goat kids at the age of 3 months received either a standard diet or a diet supplemented with phytoestrogens (3 - 4 mg/kg/day for ~3 months. Plasma testosterone and total and free triiodothyronine (T3 concentrations were determined weekly. Testicular levels of testosterone and cAMP were measured at the end of the experiment. Repeated measurement analysis of variance using the MIXED procedure on the generated averages, according to the Statistical Analysis System program package (Release 6.12, 1996, SAS Institute Inc., Cary, NC, USA was carried out. Results No significant difference in plasma testosterone concentration between the groups was detected during the first 7 weeks. However, at the age of 5 months (i.e. October 1, week 8 phytoestrogen-treated animals showed significantly higher testosterone concentrations than control animals (37.5 nmol/l vs 19.1 nmol/l. This elevation was preceded by a rise in plasma total T3 that occurred on September 17 (week 6. A slightly higher concentration of free T3 was detected in the phytoestrogen group at the same time point, but it was not until October 8 and 15 (week 9 and 10 that a significant difference was found between the groups. At the termination of the experiment, testicular cAMP levels were significantly lower in goats fed a phytoestrogen-supplemented diet. Phytoestrogen-fed animals also had lower plasma and testicular testosterone concentrations, but these differences were not statistically significant. Conclusion Our findings suggest that phytoestrogens can stimulate testosterone

  13. Experimental plasma astrophysics using a T3 (Table-top Terawatt) laser

    International Nuclear Information System (INIS)

    Tajima, T.

    1996-11-01

    Lasers that can deliver immense power of Terawatt (10 12 W) and can still compactly sit on a Table-Top (T 3 lasers) emerged in the 1990s. The advent of these lasers allows us to access to regimes of astronomical physical conditions that once thought impossible to realize in a terrestrial laboratory. We touch on examples that include superhigh pressure materials that may resemble the interior of giant planets and white dwarfs and of relativistic temperature plasmas that may exist in the early cosmological epoch and in the neighborhood of the blackhole event horizon

  14. Characterization of Catalase from Psychrotolerant Psychrobacter piscatorii T-3 Exhibiting High Catalase Activity

    OpenAIRE

    Kimoto, Hideyuki; Yoshimune, Kazuaki; Matsuyma, Hidetoshi; Yumoto, Isao

    2012-01-01

    A psychrotolerant bacterium, strain T-3 (identified as Psychrobacter piscatorii), that exhibited an extraordinarily high catalase activity was isolated from the drain pool of a plant that uses H2O2 as a bleaching agent. Its cell extract exhibited a catalase activity (19,700 U·mg protein−1) that was higher than that of Micrococcus luteus used for industrial catalase production. Catalase was approximately 10% of the total proteins in the cell extract of the strain. The catalase (PktA) was purif...

  15. Acute diarrhea during adjuvant therapy for rectal cancer: a detailed analysis from a randomized intergroup trial

    International Nuclear Information System (INIS)

    Miller, Robert C.; Sargent, Daniel J.; Martenson, James A.; Macdonald, John S.; Haller, Daniel; Mayer, Robert J.; Gunderson, Leonard L.; Rich, Tyvin A.; Cha, Stephen S.; O'Connell, Michael J.

    2002-01-01

    Purpose: During adjuvant radiotherapy (RT) for rectal cancer, patients receiving 5-fluorouracil (5-FU) by protracted venous infusion have a higher risk of diarrhea than have patients receiving bolus 5-FU. Toxicity from a previously reported randomized clinical trial was analyzed to quantify the difference in this risk. Additionally, the persistence of diarrhea after RT was analyzed. Methods and Materials: A total of 656 patients were eligible. Patients with T3-4 N0-2 M0 or T1-2 N1-2 M0 resected, high-risk rectal cancer were randomly allocated to receive 5-FU by either protracted venous infusion or bolus during RT (50.4-54.0 Gy). Two cycles of bolus 5-FU were given before and after RT. One-half of the first 445 patients were also randomly allocated to receive lomustine in conjunction with the bolus 5-FU. The incidence and severity of diarrhea in relation to patient and treatment characteristics were evaluated. Results: The rate of diarrhea was significantly greater in patients receiving 5-FU by protracted venous infusion than in patients receiving bolus 5-FU; the difference was most pronounced for Grade 3 (severe) diarrhea (21% versus 13%, p=0.007). The incidence and magnitude of diarrhea before and after RT were similar. Patients treated with an anterior resection had a higher rate of severe or life-threatening diarrhea than did patients treated with an abdominoperineal resection (31% vs. 12%, p<0.001). Conclusions: During pelvic RT, patients who receive 5-FU by protracted venous infusion rather than by bolus have a higher risk of severe or life-threatening diarrhea during RT. This risk does not appear to persist during chemotherapy after completion of pelvic RT

  16. Preoperative Therapy for Lower Rectal Cancer and Modifications in Distance From Anal Sphincter

    International Nuclear Information System (INIS)

    Gavioli, Margherita; Losi, Lorena; Luppi, Gabriele; Iacchetta, Francesco; Zironi, Sandra; Bertolini, Federica; Falchi, Anna Maria; Bertoni, Filippo; Natalini, Gianni

    2007-01-01

    Purpose: To assess the frequency and magnitude of changes in lower rectal cancer resulting from preoperative therapy and its impact on sphincter-saving surgery. Preoperative therapy can increase the rate of preserving surgery by shrinking the tumor and enhancing its distance from the anal sphincter. However, reliable data concerning these modifications are not yet available in published reports. Methods and Materials: A total of 98 cases of locally advanced cancer of the lower rectum (90 Stage uT3-T4N0-N+ and 8 uT2N+M0) that had undergone preoperative therapy were studied by endorectal ultrasonography. The maximal size of the tumor and its distance from the anal sphincter were measured in millimeters before and after preoperative therapy. Surgery was performed 6-8 weeks after therapy, and the histopathologic margins were compared with the endorectal ultrasound data. Results: Of the 90 cases, 82.5% showed tumor downsizing, varying from one-third to two-thirds or more of the original tumor mass. The distance between the tumor and the anal sphincter increased in 60.2% of cases. The median increase was 0.73 cm (range, 0.2-2.5). Downsizing was not always associated with an increase in distance. Preserving surgery was performed in 60.6% of cases. It was possible in nearly 30% of patients in whom the cancer had reached the anal sphincter before the preoperative therapy. The distal margin was tumor free in these cases. Conclusion: The results of our study have shown that in very low rectal cancer, preoperative therapy causes tumor downsizing in >80% of cases and in more than one-half enhances the distance between the tumor and anal sphincter. These modifications affect the primary surgical options, facilitating or making sphincter-saving surgery possible

  17. Influence of preoperative (hyperthermic) radiochemotherapy on manometric anal sphincter function in locally advanced rectal cancer

    International Nuclear Information System (INIS)

    Fritzmann, J.; Huenerbein, M.; Slisow, W.; Rau, B.; Gellermann, J.; Wust, P.

    2004-01-01

    Background and purpose: preoperative radiochemotherapy (RCT) followed by curative surgery is a well-accepted therapeutic option in the treatment of advanced rectal cancer. Usually, the anal sphincter is located in the irradiation area of a preoperative RCT regime. The aim of this study is to evaluate the influence of preoperative RCT on anal sphincter function. Patients and methods: between 1994 and 2000, 102 patients with rectal cancer stage uT3/uT4 were analyzed. All patients underwent radiotherapy with 45 Gy (5 x 1.8 Gy) including two cycles of 5-fluorouracil (5-FU)/leucovorin (folinic acid) chemotherapy. 46 patients were treated additionally with up to five sessions of locoregional hyperthermia. The sphincter function was analyzed by perfusion manometry before preoperative therapy and 4 weeks after pretreatment had been finished. For statistics, the Wilcoxon signed rank test and mann-whitney U-test were used (SPSS 9.0 for Windows trademark). Results: the mean value of all 102 patients showed a significant reduction of the mean maximum resting pressure from 97 to 89 mmHg (p = 0.02). For the mean maximal squeeze pressure no significant difference could be shown (178 vs. 176 mmHg). For patients with distal (≤ 7.5 cm from anal verge) tumors the difference was highly significant (92 vs. 79 mmHg). Locoregional hyperthermia had no additional influence on sphincter function. Conclusion: preoperative RCT impairs sphincter function especially in patients with distal tumors. In addition, RCT could have a negative influence on the continence of patients who received sphincter-preserving surgery. (orig.) [de

  18. PROSPECT Eligibility and Clinical Outcomes: Results From the Pan-Canadian Rectal Cancer Consortium.

    Science.gov (United States)

    Bossé, Dominick; Mercer, Jamison; Raissouni, Soundouss; Dennis, Kristopher; Goodwin, Rachel; Jiang, Di; Powell, Erin; Kumar, Aalok; Lee-Ying, Richard; Price-Hiller, Julie; Heng, Daniel Y C; Tang, Patricia A; MacLean, Anthony; Cheung, Winson Y; Vickers, Michael M

    2016-09-01

    The PROSPECT trial (N1048) is evaluating the selective use of chemoradiation in patients with cT2N1 and cT3N0-1 rectal cancer undergoing sphincter-sparing low anterior resection. We evaluated outcomes of PROSPECT-eligible and -ineligible patients from a multi-institutional database. Data from patients with locally advanced rectal cancer who received chemoradiation and low anterior resection from 2005 to 2014 were retrospectively collected from 5 Canadian centers. Overall survival, disease-free survival (DFS), recurrence-free survival (RFS), and time to local recurrence (LR) were estimated using the Kaplan-Meier method, and a multivariate analysis was performed adjusting for prognostic factors. A total of 566 (37%) of 1531 patients met the PROSPECT eligibility criteria. Eligible patients were more likely to have better PS (P = .0003) and negative circumferential resection margin (P PROSPECT eligibility was associated with improved DFS (hazard ratio [HR], 0.75; 95% confidence interval [CI], 0.61-0.91), overall survival (HR, 0.73; 95% CI, 0.57-0.95), and RFS (HR, 0.68; 95% CI, 0.54-0.86) in univariate analyses. In multivariate analysis, only RFS remained significantly improved for PROSPECT-eligible patients (HR, 0.75; 95% CI, 0.57-1.00, P = .0499). The 3-year DFS and freedom from LR for PROSPECT-eligible patients were 79.1% and 97.4%, respectively, compared to 71.1% and 96.8% for PROSPECT-ineligible patients. Real-world data corroborate the eligibility criteria used in the PROSPECT study; the criteria identify a subgroup of patients in whom risk of recurrence is lower and in whom selective use of chemoradiation should be actively examined. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Rectal toxicity after intensity modulated radiotherapy for prostate cancer: Which rectal dose volume constraints should we use?

    International Nuclear Information System (INIS)

    Fonteyne, Valérie; Ost, Piet; Vanpachtenbeke, Frank; Colman, Roos; Sadeghi, Simin; Villeirs, Geert; Decaestecker, Karel; De Meerleer, Gert

    2014-01-01

    Background: To define rectal dose volume constraints (DVC) to prevent ⩾grade2 late rectal toxicity (LRT) after intensity modulated radiotherapy (IMRT) for prostate cancer (PC). Material and methods: Six hundred thirty-seven PC patients were treated with primary (prostate median dose: 78 Gy) or postoperative (prostatic bed median dose: 74 Gy (adjuvant)–76 Gy (salvage)) IMRT while restricting the rectal dose to 76 Gy, 72 Gy and 74 Gy respectively. The impact of patient characteristics and rectal volume parameters on ⩾grade2 LRT was determined. DVC were defined to estimate the 5% and 10% risk of developing ⩾grade2 LRT. Results: The 5-year probability of being free from ⩾grade2 LRT, non-rectal blood loss and persisting symptoms is 88.8% (95% CI: 85.8–91.1%), 93.4% (95% CI: 91.0–95.1%) and 94.3% (95% CI: 92.0–95.9%) respectively. There was no correlation with patient characteristics. All volume parameters, except rectal volume receiving ⩾70 Gy (R70), were significantly correlated with ⩾grade2 LRT. To avoid 10% and 5% risk of ⩾grade2 LRT following DVC were derived: R40, R50, R60 and R65 <64–35%, 52–22%, 38–14% and 5% respectively. Conclusion: Applying existing rectal volume constraints resulted in a 5-year estimated risk of developing late ⩾grade2 LRT of 11.2%. New rectal DVC for primary and postoperative IMRT planning of PC patients are proposed. A prospective evaluation is needed

  20. Limited segmental rectal resection in the treatment of deeply infiltrating rectal endometriosis: 10 years’ experience from a tertiary referral unit

    OpenAIRE

    English, James; Sajid, Muhammad S.; Lo, Jenney; Hudelist, Guy; Baig, Mirza K.; Miles, William A.

    2014-01-01

    Background. The management of symptomatic rectal endometriosis is a challenging condition that may necessitate limited stripping or limited segmental anterior rectal resection (LSARR) depending upon the extent and severity of the disease. Objective. To report the efficacy of LSARR in terms of pain, quality of life and short- and long-term complications—in particular, those pertaining to bowel function. Methods. The case notes of all patients undergoing LSARR were reviewed. The analysed variab...

  1. Evaluation and clinical application of a new commercial test kit (Seralute-Total T3 RIA) for triiodothyronine radioimmunoassay

    International Nuclear Information System (INIS)

    Doi, Kei; Yamamoto, Toshihide

    1975-01-01

    A new radioimmunoassay kit (Seralute) for serum triiodothyronine (T 3 ) was evaluated, and serum T 3 was measured in sera from a variety of thyroid disorders and other conditions associated with altered serum thyroid hormone binding proteins. One or two hundred μl of sera to be measured were mixed with an alkaline solution of 125 I-T 3 on the top of small Sephadex column, by which T 3 was freed from serum binding proteins and adsorbed onto Sephadex. Anti-T 3 anti-body was added to the Sephadex column, and incubation was carried out at room temperature for two hours. The % of free hormone remained on the column after washing the column with buffer. Serum T 3 was assessed from a standard curve. The least detectable T 3 concentration was 10 ng/dl. The intra- and inter-assay variability was approximately 3.0%. The measured T 3 of sera from various thyroid disorders and conditions associated with altered thyroid hormone binding proteins were as follows: euthyroid, 159 +- 29 ng/dl (n=40), hypothyroid, 65 +- 31 ng/dl (n=20), hyperthyroid 450 +- 174 ng/dl (n=20), normal pregnancy 224 +- 38 ng/dl (n=10), idiopathic increase of thyroxine binding globlin (TBG) 224 - 328 ng/dl, idiopathic decrease of TBG 50 - 98 ng/dl, and nephrotic syndrome and cirrhosis of the liver, 58 - 115 ng/dl. (auth.)

  2. Draft genome sequence of Serratia sp. strain M24T3, isolated from pinewood disease nematode Bursaphelenchus xylophilus.

    Science.gov (United States)

    Proença, Diogo Neves; Espírito Santo, Christophe; Grass, Gregor; Morais, Paula V

    2012-07-01

    Here we report the draft genome sequence of Serratia sp. strain M24T3, which is associated with pinewood nematode Bursaphelenchus xylophilus, the causative agent of pine wilt disease. Serratia sp. strain M24T3 has been identified as a bionematocide for B. xylophilus in vitro, and multiple genes potentially involved in virulence and nematotoxity were identified.

  3. Draft Genome Sequence of Serratia sp. Strain M24T3, Isolated from Pinewood Disease Nematode Bursaphelenchus xylophilus

    OpenAIRE

    Proença, Diogo Neves; Espírito Santo, Christophe; Grass, Gregor; Morais, Paula V.

    2012-01-01

    Here we report the draft genome sequence of Serratia sp. strain M24T3, which is associated with pinewood nematode Bursaphelenchus xylophilus, the causative agent of pine wilt disease. Serratia sp. strain M24T3 has been identified as a bionematocide for B. xylophilus in vitro, and multiple genes potentially involved in virulence and nematotoxity were identified.

  4. Palliative reirradiation of recurrent rectal carcinoma

    International Nuclear Information System (INIS)

    Lingareddy, Vasudha; Ahmad, Neelofur; Mohiuddin, Mohammed

    1995-01-01

    PURPOSE: This report will summarize symptom palliation, complication rate, and survival outcome of an aggressive reirradiation policy for patients with recurrent rectal cancer. MATERIALS and METHODS: From 1987 - 1993, 83 patients with recurrent rectal adenocarcinoma following previous pelvic irradiation (RT) underwent reirradiation. Thirty-one patients were treated with radical intent, and underwent reirradiation followed by planned surgical resection. The remaining fifty-two patients underwent reirradiation alone and are the basis of this study. Median initial RT dose was 50.4 Gy (range 40.0 - 70.2 Gy), and median time to recurrence was 24 months. Reirradiation was delivered with two lateral fields (7x7 - 12x10 cm) encompassing recurrent tumor with a minimum of 2 cm margin and excluding all small bowel. Thirty patients received 1.8 - 2.0 Gy daily fractions, and 22 patients received 1.2 Gy BID fractions. Median reirradiation dose was 30.6 Gy (range 19.8 - 40.8 Gy). Median total cumulative dose was 84.6 Gy (range 66.6 - 104.9 Gy). Forty-seven of the 52 patients received concurrent 5-FU based chemotherapy. Median follow up for the entire group was 16 months (range 2 - 53 months). Eight patients who remain alive at the time of this study had a median follow up of 22 months (range 13 - 48 months). RESULTS: Patients' presenting symptoms included bleeding, pain and mass effect. Results of treatment are shown in Table 1. Treatment was well tolerated. Using the RTOG toxicity scale, 16 patients required a treatment break for grade 3 toxicity including severe diarrhea, moist desquamation, and mucositis. No patient developed grade 4 acute toxicity. Eighteen patients (35%) developed late grade 3 or 4 morbidity, including bowel obstruction in 9 patients, cystitis in 3 patients, fistula in 4 patients and skin ulceration in 1 patient. There was no difference in incidence of late complications by time to recurrence, reirradiation dose, or total cumulative dose. However, there was

  5. Alterations in expression of senescence marker protein-30 gene by 3,3',5-triiodo-L-thyronine (T3).

    Science.gov (United States)

    Sar, Pranati; Rath, Bandita; Subudhi, Umakanta; Chainy, Gagan Bihari Nityananda; Supakar, Prakash Chandra

    2007-09-01

    Thyroid hormone (T3) is essential for normal development, differentiation, and metabolic balance of the body. A toxic dose of T(3) in animals increases the basal metabolic rate and reactive oxygen species production, resulting more oxidative stress through Ca(2+) influx to cytoplasm. Senescence Marker Protein-30 (SMP30) is preferentially expressed in the liver and protects cells against various injuries by enhancement of Ca(2+) efflux to either extra cellular space or intraorganellar spaces through membrane Ca(2+) pump activity. In this paper we report an alteration in the level of SMP30 gene expression using RT-PCR and western blot analysis in T(3) treated female Wistar rats. The results indicate that there is an induction of SMP30 expression during early hours of T(3 )treatment and it declines in severe hyperthyroidism. Therefore, we speculate that SMP30 is regulated by T(3) and might play a protective role in hyperthyroidism.

  6. Cost-effectiveness of preoperative radiotherapy in rectal cancer: results from the Swedish Rectal Cancer Trial

    International Nuclear Information System (INIS)

    Dahlberg, Michael; Stenborg, Anna; Paahlman, Lars; Glimelius, Bengt

    2002-01-01

    Purpose: The Swedish Rectal Cancer Trial (SRCT) demonstrated that a short-term regimen of high-dose fractionated preoperative radiotherapy (5 x 5 Gy) reduced the local recurrence rates and improved overall survival. This has had an impact on the primary treatment of rectal cancer. The current study investigated the cost-effectiveness of the new combined approach. Methods and Materials: After an 8-year follow-up, in-hospital and outpatient costs related to the treatment of rectal cancer and its complications were analyzed for 98 randomly allocated patients who participated in the SRCT from a single Swedish health care region. The costs were then related to the clinical data from the SRCT regarding complications, local and distant recurrences, and survival. Results: The total cost for a nonirradiated patient was US$30,080 compared with US$35,268 for an irradiated patient. The surgery-alone group had increased costs related to local recurrences, and the radiotherapy group had increased costs for irradiation and complications. With a survival benefit of 21 months (retrieved from the SRCT), the cost for a saved year was US$3654. Sensitivity analyses for different rates of local recurrences, the costs related to complications and less marked survival benefit showed that this figure could vary up to US$15,228. Conclusion: The cost for a life-year saved in these data was US$3654. This figure could reach US$15,228 in the most pessimistic setting of the sensitivity tests, a cost still comparable with other well-accepted medical interventions

  7. Rectal microbicides: clinically relevant approach to the design of rectal specific placebo formulations

    Directory of Open Access Journals (Sweden)

    Dezzutti Charlene

    2011-03-01

    Full Text Available Abstract Background The objective of this study is to identify the critical formulation parameters controlling distribution and function for the rectal administration of microbicides in humans. Four placebo formulations were designed with a wide range of hydrophilic characteristics (aqueous to lipid and rheological properties (Newtonian, shear thinning, thermal sensitive and thixotropic. Aqueous formulations using typical polymers to control viscosity were iso-osmotic and buffered to pH 7. Lipid formulations were developed from lipid solvent/lipid gelling agent binary mixtures. Testing included pharmaceutical function and stability as well as in vitro and in vivo toxicity. Results The aqueous fluid placebo, based on poloxamer, was fluid at room temperature, thickened and became shear thinning at 37°C. The aqueous gel placebo used carbopol as the gelling agent, was shear thinning at room temperature and showed a typical decrease in viscosity with an increase in temperature. The lipid fluid placebo, myristyl myristate in isopropyl myristate, was relatively thin and temperature independent. The lipid gel placebo, glyceryl stearate and PEG-75 stearate in caprylic/capric triglycerides, was also shear thinning at both room temperature and 37°C but with significant time dependency or thixotropy. All formulations showed no rectal irritation in rabbits and were non-toxic using an ex vivo rectal explant model. Conclusions Four placebo formulations ranging from fluid to gel in aqueous and lipid formats with a range of rheological properties were developed, tested, scaled-up, manufactured under cGMP conditions and enrolled in a formal stability program. Clinical testing of these formulations as placebos will serve as the basis for further microbicide formulation development with drug-containing products.

  8. The "T3 Support Centre" (Teaching, Technology and Testing - Not just another help desk

    Directory of Open Access Journals (Sweden)

    Carol Miles

    2005-10-01

    Full Text Available Many faculty members embrace the challenge of responding to rising student demands for more technically advanced course supports by offering their courseware through a variety of media. However, it is often difficult for them to find the time required to become proficient in the use of the software packages, course management systems and web technologies at their disposal. These new realities of teaching point to the need for support systems for faculty members that go beyond the traditional computer services "help desk" with a more comprehensive support service that actually becomes involved in the development and modification of technology-based course materials and computerized test marking and analysis. Increasing demand for these types of services at Carleton University resulted in the establishment of the T3 (Teaching...Technology...Testing Support Centre. The service offers faculty members extended-hour phone-in and walk-in support as well as a variety of resources such as Scantron and Item Analysis service for multiple choice exams, the use of scanners and colour printers, as well as a variety of teaching publications and contacts. This paper details the planning, administration, and services offered of the T3 Service, including advice those attempting to establish a similar service. Usage statistics from the first year of operations will be delineated.

  9. Oxidative changes and apoptosis induced by 1800-MHz electromagnetic radiation in NIH/3T3 cells.

    Science.gov (United States)

    Hou, Qingxia; Wang, Minglian; Wu, Shuicai; Ma, Xuemei; An, Guangzhou; Liu, Huan; Xie, Fei

    2015-03-01

    To investigate the potential adverse effects of mobile phone radiation, we studied reactive oxygen species (ROS), DNA damage and apoptosis in mouse embryonic fibroblasts (NIH/3T3) after intermittent exposure (5 min on/10 min off, for various durations from 0.5 to 8 h) to an 1800-MHz GSM-talk mode electromagnetic radiation (EMR) at an average specific absorption rate of 2 W/kg. A 2',7'-dichlorofluorescin diacetate fluorescence probe was used to detect intracellular ROS levels, immunofluorescence was used to detect γH2AX foci as a marker for DNA damage, and flow cytometry was used to measure apoptosis. Our results showed a significant increase in intracellular ROS levels after EMR exposure and it reached the highest level at an exposure time of 1 h (p < 0.05) followed by a slight decrease when the exposure continued for as long as 8 h. No significant effect on the number of γH2AX was detected after EMR exposure. The percentage of late-apoptotic cells in the EMR-exposed group was significantly higher than that in the sham-exposed groups (p < 0.05). These results indicate that an 1800-MHz EMR enhances ROS formation and promotes apoptosis in NIH/3T3 cells.

  10. Combination treatment with T4 and T3: toward personalized replacement therapy in hypothyroidism?

    Science.gov (United States)

    Biondi, Bernadette; Wartofsky, Leonard

    2012-07-01

    Levothyroxine therapy is the traditional lifelong replacement therapy for hypothyroid patients. Over the last several years, new evidence has led clinicians to evaluate the option of combined T(3) and T(4) treatment to improve the quality of life, cognition, and peripheral parameters of thyroid hormone action in hypothyroidism. The aim of this review is to assess the physiological basis and the results of current studies on this topic. We searched Medline for reports published with the following search terms: hypothyroidism, levothyroxine, triiodothyronine, thyroid, guidelines, treatment, deiodinases, clinical symptoms, quality of life, cognition, mood, depression, body weight, heart rate, cholesterol, bone markers, SHBG, and patient preference for combined therapy. The search was restricted to reports published in English since 1970, but some reports published before 1970 were also incorporated. We supplemented the search with records from personal files and references of relevant articles and textbooks. Parameters analyzed included the rationale for combination treatment, the type of patients to be selected, the optimal T(4)/T(3) ratio, and the potential benefits of this therapy on symptoms of hypothyroidism, quality of life, mood, cognition, and peripheral parameters of thyroid hormone action. The outcome of our analysis suggests that it may be time to consider a personalized regimen of thyroid hormone replacement therapy in hypothyroid patients. Further prospective randomized controlled studies are needed to clarify this important issue. Innovative formulations of the thyroid hormones will be required to mimic a more perfect thyroid hormone replacement therapy than is currently available.

  11. SIGNIFICANCE OF THYROID PROFILE (Serum T3, T4 & TSH IN INFERTILE WOMEN

    Directory of Open Access Journals (Sweden)

    Bindu Sharma

    2012-06-01

    Full Text Available Objective: To evaluate the relation of female infertility to thyroid dysfunction. Material & Methods: The present study was carried out in the department of Biochemistry in collaboration with the Gynae & Obst deptt., Subharti Medical College & Hospital Meerut. Serum T3, T4 and TSH estimation was done by Enzyme Linked Fluorescent Assay. Results: Serum T3 level in control group was 1.8 ± 0.64 nmol/L while it was 10.5 ± 0.5 nmol/L in hyperthyroid (p value 0.05, i.e., not significant. Serum TSH in control group was 3.5 ± 1.71 mIU/L, while it was 0.14 ± 0.01 mIU/L (p value <0.001, i.e., highly significant in hyperthyroidism, 8.4 ± 1.06 mIU/L in hypothyroidism (p value <0.001, i.e., highly significant. Out of 65 patients of study group thyroid dysfunction was associated with 25 (38.5% infertile women. 23 (35.4% women had hypothyroidism, 2 (3.1% women had hyperthyroidism and 40 women (61.5% were with euthyroid state, while in control group all the 25 women had euthyroid profile. Conclusions: Every infertile woman with ovulatory dysfunction should also investigated thyroid profile along with other investigations, to open better prospects of conception for such desperate infertile women.

  12. Characterization of dextransucrase from Leuconostoc mesenteroides T3, water kefir grains isolate

    Directory of Open Access Journals (Sweden)

    Miljković Miona G.

    2017-01-01

    Full Text Available The production of dextransucrase (DS by Leuconostoc mesenteroides T3, novel isolate from water kefir grain, was studied and optimized. Bacterial supernatant reached activity of 3.1 U/ml when the culture was grown at 23 C and under static culture condition using classical Tsuchiya medium for DS production. The increase of sucrose concentration to 7% led to an increase of DS activity by 52% compared to the control. Medium with 2% beef extract and 1% yeast extract resulted in 4.52 U/ml, which was 47% higher than in the control (with 2% yeast extract. Finally, the increase of K2HPO4 concentration from 2 to 3% resulted in the increased enzyme activity by 28%. Enzyme purified by polyethylene glycol 400 fractionation displayed maximum activity at 30°C and pH 5.4. Zymogram analysis confirmed the presence of DS of approximately 180 kDa. The addition of divalent cations Ca2+, Mg2+, Fe2+ and Co2+ led to a minor increase of DS activity, while the addition of Mn2+ was the most prominent with 73% increase. These findings classify dextransucrase from Leuconostoc mesenteroides T3 as promising candidate for production of dextran, which has numerous applications in various industries. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. TR 31035

  13. Hormonal evaluation of T4 and T3 through radioimmunoassay in younglings of rats with hypothyroidism

    International Nuclear Information System (INIS)

    Silveira, M.F.G.; Silva, I.M.S.; Pereira, S.S.L.; Souza, G.M.L.; Carvalho, E.F.M.B.; Cavalcante, C.V.G.; Lima Filho, G.L.; Catanho, M.T.J.A.

    2000-01-01

    The onset of fetal thyroid function occurs about 17-18 days after conception in the rat. The maternal hypothyroidism which occurs during gestation provokes alteration in the rat after birth. Due to this alteration, we decided to analyze the hormonal modification in the newborn rats. The hypothyroidism was induced in normal dams, which were being treated for 7 days with MMI (in the concentration of 0,03% in drinking water) before mating. Another dam group which was submitted to an induction of hypothyroidism maintained the treatment with MMI for 13 days during gestation. The hormones were assessed by radioimmunoassay technique. It was seen that the rats which were born from hypothyroid dams suffered alterations on its T 4 and T 3 hormone levels concerning to 10, 30 and 60 days after birth. There was also modifications on their weight and size. The growth is affected throughout post-natal life by thyroid hormones, which has a facilitator influence on growth hormone economy, as opposed to the inhibitory effects on TSH economy. The administration of MMI bars the fetal thyroid gland function, causing a decrease of both T 4 and T 3 levels, even after the birth, indicating that the maternal hypothyroidism influences on the post-natal life of the rat. (author)

  14. Length quantization of DNA partially expelled from heads of a bacteriophage T3 mutant

    Energy Technology Data Exchange (ETDEWEB)

    Serwer, Philip, E-mail: serwer@uthscsa.edu [Department of Biochemistry, The University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 (United States); Wright, Elena T. [Department of Biochemistry, The University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 (United States); Liu, Zheng; Jiang, Wen [Markey Center for Structural Biology, Department of Biological Sciences, Purdue University, West Lafayette, IN 47907 (United States)

    2014-05-15

    DNA packaging of phages phi29, T3 and T7 sometimes produces incompletely packaged DNA with quantized lengths, based on gel electrophoretic band formation. We discover here a packaging ATPase-free, in vitro model for packaged DNA length quantization. We use directed evolution to isolate a five-site T3 point mutant that hyper-produces tail-free capsids with mature DNA (heads). Three tail gene mutations, but no head gene mutations, are present. A variable-length DNA segment leaks from some mutant heads, based on DNase I-protection assay and electron microscopy. The protected DNA segment has quantized lengths, based on restriction endonuclease analysis: six sharp bands of DNA missing 3.7–12.3% of the last end packaged. Native gel electrophoresis confirms quantized DNA expulsion and, after removal of external DNA, provides evidence that capsid radius is the quantization-ruler. Capsid-based DNA length quantization possibly evolved via selection for stalling that provides time for feedback control during DNA packaging and injection. - Graphical abstract: Highlights: • We implement directed evolution- and DNA-sequencing-based phage assembly genetics. • We purify stable, mutant phage heads with a partially leaked mature DNA molecule. • Native gels and DNase-protection show leaked DNA segments to have quantized lengths. • Native gels after DNase I-removal of leaked DNA reveal the capsids to vary in radius. • Thus, we hypothesize leaked DNA quantization via variably quantized capsid radius.

  15. The depletion of nuclear glutathione impairs cell proliferation in 3t3 fibroblasts.

    Directory of Open Access Journals (Sweden)

    Jelena Markovic

    2009-07-01

    Full Text Available Glutathione is considered essential for survival in mammalian cells and yeast but not in prokaryotic cells. The presence of a nuclear pool of glutathione has been demonstrated but its role in cellular proliferation and differentiation is still a matter of debate.We have studied proliferation of 3T3 fibroblasts for a period of 5 days. Cells were treated with two well known depleting agents, diethyl maleate (DEM and buthionine sulfoximine (BSO, and the cellular and nuclear glutathione levels were assessed by analytical and confocal microscopic techniques, respectively. Both agents decreased total cellular glutathione although depletion by BSO was more sustained. However, the nuclear glutathione pool resisted depletion by BSO but not with DEM. Interestingly, cell proliferation was impaired by DEM, but not by BSO. Treating the cells simultaneously with DEM and with glutathione ethyl ester to restore intracellular GSH levels completely prevented the effects of DEM on cell proliferation.Our results demonstrate the importance of nuclear glutathione in the control of cell proliferation in 3T3 fibroblasts and suggest that a reduced nuclear environment is necessary for cells to progress in the cell cycle.

  16. Quantitation of T-3 (triiodothyronine) and T-4 (thyroxine) in serum and plasma. Draft report

    International Nuclear Information System (INIS)

    Ceglowski, W.; Williams, R.B.

    1981-12-01

    This report summarizes an examination of the published literature concerning the quantitation of thyroxine and triiodothyronine in the clinical laboratory. It therefore details the precision, accuracy, sensitivity, and specificity obtainable in various commercial systems and those devised in the clinical laboratory. The data produced by several of the procedures often indicate that improvements in these parameters would enhance overall assay performance and increase the reliability of the clinical interpretation derivable from assay results. For T-3 and T-4 in vitro assays a very large number of systems exist and are currently being utilized in clinical laboratories in this country. For the sake of brevity some systems, while mentioned, are not reviewed in exhaustive detail. Radioimmunoassay, as the most frequently performed assay for both T-3 and T-4 is extensively reviewed. Also discussed with particular interest are assay systems which will undoubtedly impact on the future course of thyroid hormone assessment in the clinical laboratory, namely enzyme immunoassay and fluorescent immunoassay. The state of the art in T-4 measurements in neonates, because it is such a critical area for application of in vitro thyroid testing, is given detailed review. The quantitation of free thyroxine has been discussed in detail. These assays have been gaining more frequent use in the clinical laboratory and increased commercial system development

  17. TC10 is regulated by caveolin in 3T3-L1 adipocytes.

    Directory of Open Access Journals (Sweden)

    Dave Bridges

    Full Text Available TC10 is a small GTPase found in lipid raft microdomains of adipocytes. The protein undergoes activation in response to insulin, and plays a key role in the regulation of glucose uptake by the hormone.TC10 requires high concentrations of magnesium in order to stabilize guanine nucleotide binding. Kinetic analysis of this process revealed that magnesium acutely decreased the nucleotide release and exchange rates of TC10, suggesting that the G protein may behave as a rapidly exchanging, and therefore active protein in vivo. However, in adipocytes, the activity of TC10 is not constitutive, indicating that mechanisms must exist to maintain the G protein in a low activity state in untreated cells. Thus, we searched for proteins that might bind to and stabilize TC10 in the inactive state. We found that Caveolin interacts with TC10 only when GDP-bound and stabilizes GDP binding. Moreover, knockdown of Caveolin 1 in 3T3-L1 adipocytes increased the basal activity state of TC10.Together these data suggest that TC10 is intrinsically active in vivo, but is maintained in the inactive state by binding to Caveolin 1 in 3T3-L1 adipocytes under basal conditions, permitting its activation by insulin.

  18. Exogenous T3 toxicosis following consumption of a contaminated weight loss supplement

    Directory of Open Access Journals (Sweden)

    R D’Arcy

    2017-09-01

    Full Text Available A 42-year-old male presented with a one-week history of palpitations and sweating episodes. The only significant history was of longstanding idiopathic dilated cardiomyopathy. Initial ECG demonstrated a sinus tachycardia. Thyroid function testing, undertaken as part of the diagnostic workup, revealed an un-measureable thyroid-stimulating hormone (TSH and free thyroxine (T4. Upon questioning the patient reported classical thyrotoxic symptoms over the preceding weeks. Given the persistence of symptoms free tri-iodothyronine (T3 was measured and found to be markedly elevated at 48.9 pmol/L (normal range: 3.1–6.8 pmol/L. No goitre or nodular disease was palpable in the neck. Historically there had never been any amiodarone usage. Radionucleotide thyroid uptake imaging (123I demonstrated significantly reduced tracer uptake in the thyroid. Upon further questioning the patient reported purchasing a weight loss product online from India which supposedly contained sibutramine. He provided one of the tablets and laboratory analysis confirmed the presence of T3 in the tablet. Full symptomatic resolution and normalised thyroid function ensued upon discontinuation of the supplement.

  19. Characterization of Catalase from Psychrotolerant Psychrobacter piscatorii T-3 Exhibiting High Catalase Activity

    Science.gov (United States)

    Kimoto, Hideyuki; Yoshimune, Kazuaki; Matsuyma, Hidetoshi; Yumoto, Isao

    2012-01-01

    A psychrotolerant bacterium, strain T-3 (identified as Psychrobacter piscatorii), that exhibited an extraordinarily high catalase activity was isolated from the drain pool of a plant that uses H2O2 as a bleaching agent. Its cell extract exhibited a catalase activity (19,700 U·mg protein−1) that was higher than that of Micrococcus luteus used for industrial catalase production. Catalase was approximately 10% of the total proteins in the cell extract of the strain. The catalase (PktA) was purified homogeneously by only two purification steps, anion exchange and hydrophobic chromatographies. The purified catalase exhibited higher catalytic efficiency and higher sensitivity of activity at high temperatures than M. luteus catalase. The deduced amino acid sequence showed the highest homology with catalase of Psycrobacter cryohalolentis, a psychrotolelant bacterium obtained from Siberian permafrost. These findings suggest that the characteristics of the PktA molecule reflected the taxonomic relationship of the isolate as well as the environmental conditions (low temperatures and high concentrations of H2O2) under which the bacterium survives. Strain T-3 efficiently produces a catalase (PktA) at a higher rate than Exiguobacterium oxidotolerans, which produces a very strong activity of catalase (EktA) at a moderate rate, in order to adapt to high concentration of H2O2. PMID:22408420

  20. Agarose Gel Electrophoresis Reveals Structural Fluidity of a Phage T3 DNA Packaging Intermediate

    Science.gov (United States)

    Serwer, Philip; Wright, Elena T.

    2012-01-01

    We find a new aspect of DNA packaging-associated structural fluidity for phage T3 capsids. The procedure is (1) glutaraldehyde cross-linking of in vivo DNA packaging intermediates for stabilization of structure and then (2) determining of effective radius by two-dimensional agarose gel electrophoresis (2d-AGE). The intermediates are capsids with incompletely packaged DNA (ipDNA) and without an external DNA segment; these intermediates are called ipDNA-capsids. We initially increase production of ipDNA-capsids by raising NaCl concentration during in vivo DNA packaging. By 2d-AGE, we find a new state of contracted shell for some particles of one previously identified ipDNA-capsid. The contracted shell-state is found when ipDNA length/mature DNA length (F) is above 0.17, but not at lower F. Some contracted-shell ipDNA-capsids have the phage tail; others do not. The contracted-shell ipDNA-capsids are explained by premature DNA maturation cleavage that makes accessible a contracted-shell intermediate of a cycle of the T3 DNA packaging motor. The analysis of ipDNA-capsids, rather than intermediates with uncleaved DNA, provides a simplifying strategy for a complete biochemical analysis of in vivo DNA packaging. PMID:22222979

  1. Radioimmunological determination of triiodo-thyronine (T3) and thyroidastimulating hormone (TSH) in routine diagnosis

    International Nuclear Information System (INIS)

    Vollmer, U.J.; Schmidt, H.A.E.

    1974-01-01

    The radioimmunological determination of triiodothyronine and thyroid-stimulating hormone (TSH) provides two new methods for functional diagnoses of the thyroid. Changes and disturbances of the control mechanism had been difficult to detect with conventional methods. The measurement of the basal TSH rate has further therapeutic and diagnostic consequences such as, e.g., the determination of growth stages of strumae or preclinical hypothyreosis on the basis of increased basal TSH values. The results of the TRH test enable a more exact clarification. Substitution therapy should take into account the rate of the remaining basal TSH secretion as well as the clinical picture. The determination of the serum T 3 concentration enables the diagnosis of isolated triiodothyronine hyperthyreosis. Continuous control of the thyrostatic therapy by T 3 and TSH determination helps to prevent a condition in which hyperthyreosis persists even though all the normal parameters indicate a euthyroid function. The development of a preclinical hypothyreosis can also be detected early. The increased basal TSH secretion after strumectomy is a further proof of the urgent need for consequent prophylaxis of relapses (orig./AK) [de

  2. Agarose gel electrophoresis reveals structural fluidity of a phage T3 DNA packaging intermediate.

    Science.gov (United States)

    Serwer, Philip; Wright, Elena T

    2012-01-01

    We find a new aspect of DNA packaging-associated structural fluidity for phage T3 capsids. The procedure is (i) glutaraldehyde cross-linking of in vivo DNA packaging intermediates for the stabilization of structure and then (ii) determining effective radius by two-dimensional agarose gel electrophoresis (2D-AGE). The intermediates are capsids with incompletely packaged DNA (ipDNA) and without an external DNA segment; these intermediates are called ipDNA-capsids. We initially increase the production of ipDNA-capsids by raising NaCl concentration during in vivo DNA packaging. By 2D-AGE, we find a new state of contracted shell for some particles of one previously identified ipDNA-capsid. The contracted shell-state is found when the ipDNA length/mature DNA length (F) is above 0.17, but not at lower F. Some contracted-shell ipDNA-capsids have the phage tail; others do not. The contracted-shell ipDNA-capsids are explained by premature DNA maturation cleavage that makes accessible a contracted-shell intermediate of a cycle of the T3 DNA packaging motor. The analysis of ipDNA-capsids, rather than intermediates with uncleaved DNA, provides a simplifying strategy for a complete biochemical analysis of in vivo DNA packaging. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. CORROSION RESISTANT SOL–GEL COATING ON 2024-T3 ALUMINUM

    Directory of Open Access Journals (Sweden)

    S. Yazdani

    2016-06-01

    Full Text Available The inherent reactivity of the Al–Cu alloys is such that their use for structural, marine, and aerospace components and structures would not be possible without prior application of a corrosion resistance system. Historically these corrosion resistance coatings were based on the use of chemicals containing Cr (VI compounds. Silane coatings are of increasing interest in industry due to their potential application for the replacement of current toxic hexavalent chromate based treatments. In this study, hydrophobic coating sol was prepared with methyltriethoxysilane (MTES, methanol (MeOH, and water (as 7M NH4OH at a molar ratio of 1:25:4.31 respectively. The coatings were applied by a dip-technique to 2024-T3 Al alloy, and subsequently cured at room temperature and there after heat treated in an oven at 150°C. The anticorrosion properties of the coatings within 3.5 wt% NaCl solution were studied by Tafel polarization technique. The sol–gel coating exhibited good anticorrosion properties providing an adherent protection film on the Al 2024-T3 substrate. The surface properties were characterized by water contact angle measurement, scanning electron microscopy (SEM, and the composition was studied by Fourier transform infrared spectroscopy (FTIR.

  4. T3 glottic cancer: an analysis of dose time-volume factors

    International Nuclear Information System (INIS)

    Harwood, A.R.; Beale, F.A.; Cummings, B.J.; Hawkins, N.V.; Keane, T.J.; Rider, W.D.

    1980-01-01

    This report analyzes dose-time-volume factors in 112 patients with T3N0M0 glottic cancer who were treated with radical radiotherapy with surgery for salvage between 1963 and 1977. 55% of the patients are alive and well 5 years following treatment; 26% died of glottic cancer and 19% died of intercurrent disease. In the 1965 to 1969 time period, 31% died of tumor as compared to 16% in the 1975 to 1977 time period. Overall local control by radiotherapy was 51%; 2/3 of the failures were surgically salvaged. 44% were locally controlled by radiotherapy in the 1965 to 1969 time period and 57% in the 1975 to 1977 time period. Analysis of dose-time-volume factors reveals that the optimal dose is greater than 1700 ret and a minimal volume of 6 x 8 cm should be used. A dose-cure curve for T3 glottic cancer is constructed and compared with the dose complication curve for the larynx and the dose-cure curve for T1N0M0 glottic cancer. A comparison of cure rates between 112 patients treated with radical radiotherapy and surgery for salvage versus 28 patients treated with combined pre-operative irradiation and surgery reveals no difference in the proportion of patients who died of glottic cancer or in the number of patients alive at 5 years following treatment

  5. EURECCA consensus conference highlights about rectal cancer clinical management: The radiation oncologist’s expert review

    International Nuclear Information System (INIS)

    Valentini, Vincenzo; Glimelius, Bengt; Haustermans, Karin; Marijnen, Corrie A.M.; Rödel, Claus; Gambacorta, Maria Antonietta; Boelens, Petra G.; Aristei, Cynthia; Velde, Cornelis J.H. van de

    2014-01-01

    Background and Purpose: Although rectal and colon cancer management has progressed greatly in the last few decades clinical outcomes still need to be optimized. Furthermore, consensus is required on several issues as some of the main international guidelines provide different recommendations. The European Registration of Cancer Care (EURECCA) drew up documents to standardize management and care in Europe and aid in decision-making. Material and Methods: In the present section the panel of experts reviews and discusses data from the literature on rectal cancer, focusing on recommendations for selecting between short-course radiotherapy (SCRT) and long-course radio-chemotherapy (LCRTCT) as preoperative treatment as well as on the controversies about adjuvant treatment in patients who had received a pre-operative treatment. Results: The starting-point of the present EURECCA document is that adding SCRT or LCRTCT to TME improved loco-regional control but did not increase overall survival in any single trial which, in any case, had improved with the introduction of total mesorectal excision (TME) into clinical practice. Moderate consensus was achieved for cT3 anyNM0 disease. In this frame, agreement was reached on either SCRT followed by immediate surgery or LCRTCT with delayed surgery for mesorectal fascia (MRF) negative tumors at presentation. LCRTCT was recommended for tumor shrinkage in MRF+ at presentations but if patients were not candidates for chemotherapy, SCRT with delayed surgery is an option/alternative. LCRTCT was recommended for cT4 anycNM0. SCRT offers the advantages of less acute toxicity and lower costs, and LCRTCT tumor shrinkage and down-staging, with 13–36% pathological complete response (pCR) rates. To improve the efficacy of preoperative treatment both SCRT and LCRTCT have been, or are being, associated with diverse schedules of chemotherapy and even new targeted therapies but without any definitive evidence of benefit. Nowadays, standard

  6. Identification of novel substrates of Shigella T3SA through analysis of its virulence plasmid-encoded secretome

    Science.gov (United States)

    Pinaud, Laurie; Ferrari, Mariana L.; Friedman, Robin; Jehmlich, Nico; von Bergen, Martin; Phalipon, Armelle; Sansonetti, Philippe J.

    2017-01-01

    Many human Gram-negative bacterial pathogens express a Type Three Secretion Apparatus (T3SA), including among the most notorious Shigella spp., Salmonella enterica, Yersinia enterocolitica and enteropathogenic Escherichia coli (EPEC). These bacteria express on their surface multiple copies of the T3SA that mediate the delivery into host cells of specific protein substrates critical to pathogenesis. Shigella spp. are Gram-negative bacterial pathogens responsible for human bacillary dysentery. The effector function of several Shigella T3SA substrates has largely been studied but their potential cellular targets are far from having been comprehensively delineated. In addition, it is likely that some T3SA substrates have escaped scrutiny as yet. Indeed, sequencing of the virulence plasmid of Shigella flexneri has revealed numerous open reading frames with unknown functions that could encode additional T3SA substrates. Taking advantage of label-free mass spectrometry detection of proteins secreted by a constitutively secreting strain of S. flexneri, we identified five novel substrates of the T3SA. We further confirmed their secretion through the T3SA and translocation into host cells using β-lactamase assays. The coding sequences of two of these novel T3SA substrates (Orf13 and Orf131a) have a guanine-cytosine content comparable to those of T3SA components and effectors. The three other T3SA substrates identified (Orf48, Orf86 and Orf176) have significant homology with antitoxin moieties of type II Toxin-Antitoxin systems usually implicated in the maintenance of low copy plasmids. While Orf13 and Orf131a might constitute new virulence effectors contributing to S. flexneri pathogenicity, potential roles for the translocation into host cells of antitoxins or antitoxin-like proteins during Shigella infection are discussed. PMID:29073283

  7. Identification of novel substrates of Shigella T3SA through analysis of its virulence plasmid-encoded secretome.

    Directory of Open Access Journals (Sweden)

    Laurie Pinaud

    Full Text Available Many human Gram-negative bacterial pathogens express a Type Three Secretion Apparatus (T3SA, including among the most notorious Shigella spp., Salmonella enterica, Yersinia enterocolitica and enteropathogenic Escherichia coli (EPEC. These bacteria express on their surface multiple copies of the T3SA that mediate the delivery into host cells of specific protein substrates critical to pathogenesis. Shigella spp. are Gram-negative bacterial pathogens responsible for human bacillary dysentery. The effector function of several Shigella T3SA substrates has largely been studied but their potential cellular targets are far from having been comprehensively delineated. In addition, it is likely that some T3SA substrates have escaped scrutiny as yet. Indeed, sequencing of the virulence plasmid of Shigella flexneri has revealed numerous open reading frames with unknown functions that could encode additional T3SA substrates. Taking advantage of label-free mass spectrometry detection of proteins secreted by a constitutively secreting strain of S. flexneri, we identified five novel substrates of the T3SA. We further confirmed their secretion through the T3SA and translocation into host cells using β-lactamase assays. The coding sequences of two of these novel T3SA substrates (Orf13 and Orf131a have a guanine-cytosine content comparable to those of T3SA components and effectors. The three other T3SA substrates identified (Orf48, Orf86 and Orf176 have significant homology with antitoxin moieties of type II Toxin-Antitoxin systems usually implicated in the maintenance of low copy plasmids. While Orf13 and Orf131a might constitute new virulence effectors contributing to S. flexneri pathogenicity, potential roles for the translocation into host cells of antitoxins or antitoxin-like proteins during Shigella infection are discussed.

  8. [A Case of Rectal Syphilis Incidentally Found at Regular Medical Check-up].

    Science.gov (United States)

    You, Ji Hong; Cho, Ki Won; Cha, Yoon Jin; Park, Hyo Jin

    2016-10-25

    Syphilis is a rare disease in the rectum. It is difficult to diagnose because the characteristics of the rectal syphilis rectal lesion are highly varied. The endoscopic findings of rectal syphilis are proctitis, ulcers, and masses. If rectal syphilis is suspected to be the cause for rectal lesions, it is important for physicians to consider the sexual history and sexual orientation of the patient. We report a case of incidental rectal syphilis in a 41-year-old man diagnosed during a regular medical check-up.

  9. Pretreatment Evaluation of Microcirculation by Dynamic Contrast-Enhanced Magnetic Resonance Imaging Predicts Survival in Primary Rectal Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    DeVries, Alexander Friedrich [Department of Radio-Oncology, Academic Teaching Hospital Feldkirch, Feldkirch (Austria); Piringer, Gudrun, E-mail: gudrun.piringer@hotmail.com [Department of Oncology, Wels-Grieskirchen Medical Hospital, Wels (Austria); Kremser, Christian; Judmaier, Werner [Department of Radiology, Innsbruck Medical University, Innsbruck (Austria); Saely, Christoph Hubert [Department of Medicine and Cardiology, Academic Teaching Hospital Feldkirch, Feldkirch (Austria); Lukas, Peter [Department of Radio-Oncology, Innsbruck Medical University, Innsbruck (Austria); Öfner, Dietmar [Department of Surgery, Paracelsus Medical University, Salzburg (Austria)

    2014-12-01

    Purpose: To investigate the prognostic value of the perfusion index (PI), a microcirculatory parameter estimated from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), which integrates information on both flow and permeability, to predict overall survival and disease-free survival in patients with primary rectal cancer. Methods and Materials: A total of 83 patients with stage cT3 rectal cancer requiring neoadjuvant chemoradiation were investigated with DCE-MRI before start of therapy. Contrast-enhanced dynamic T{sub 1} mapping was obtained, and a simple data analysis strategy based on the calculation of the maximum slope of the tissue concentration–time curve divided by the maximum of the arterial input function was used as a measure of tumor microcirculation (PI), which integrates information on both flow and permeability. Results: In 39 patients (47.0%), T downstaging (ypT0-2) was observed. During a mean (±SD) follow-up period of 71 ± 29 months, 58 patients (69.9%) survived, and disease-free survival was achieved in 45 patients (54.2%). The mean PI (PImean) averaged over the group of nonresponders was significantly higher than for responders. Additionally, higher PImean in age- and gender-adjusted analyses was strongly predictive of therapy nonresponse. Most importantly, PImean strongly and significantly predicted disease-free survival (unadjusted hazard ratio [HR], 1.85 [ 95% confidence interval, 1.35-2.54; P<.001)]; HR adjusted for age and sex, 1.81 [1.30-2.51]; P<.001) as well as overall survival (unadjusted HR 1.42 [1.02-1.99], P=.040; HR adjusted for age and sex, 1.43 [1.03-1.98]; P=.034). Conclusions: This analysis identifies PImean as a novel biomarker that is predictive for therapy response, disease-free survival, and overall survival in patients with primary locally advanced rectal cancer.

  10. FDG-PET/CT Imaging for Staging and Target Volume Delineation in Preoperative Conformal Radiotherapy of Rectal Cancer

    International Nuclear Information System (INIS)

    Bassi, Maria Chiara; Turri, Lucia; Sacchetti, Gianmauro; Loi, Gianfranco; Cannillo, Barbara; La Mattina, Pierdaniele; Brambilla, Marco; Inglese, Eugenio; Krengli, Marco

    2008-01-01

    Purpose: To investigate the potential impact of using 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) on staging and target volume delineation for patients affected by rectal cancer and candidates for preoperative conformal radiotherapy. Methods and Materials: Twenty-five patients diagnosed with rectal cancer T3-4 N0-1 M0-1 and candidates for preoperative radiotherapy underwent PET/CT simulation after injection of 5.18 MBq/kg of FDG. Clinical stage was reassessed on the basis of FDG-PET/CT findings. The gross tumor volume (GTV) and the clinical target volume (CTV) were delineated first on CT and then on PET/CT images. The PET/CT-GTV and PET/CT-CTV were analyzed and compared with CT-GTV and CT-CTV, respectively. Results: In 4 of 25 cases (24%), PET/CT affected tumor staging or the treatment purpose. In 3 of 25 cases (12%) staged N0 M0, PET/CT showed FDG uptake in regional lymph nodes and in a case also in the liver. In a patient with a single liver metastasis PET/CT detected multiple lesions, changing the treatment intent from curative to palliative. The PET/CT-GTV and PET/CT-CTV were significantly greater than the CT-GTV (p = 0.00013) and CT-CTV (p = 0.00002), respectively. The mean difference between PET/CT-GTV and CT-GTV was 25.4% and between PET/CT-CTV and CT-CTV was 4.1%. Conclusions: Imaging with PET/CT for preoperative radiotherapy of rectal cancer may lead to a change in staging and target volume delineation. Stage variation was observed in 12% of cases and a change of treatment intent in 4%. The GTV and CTV changed significantly, with a mean increase in size of 25% and 4%, respectively

  11. Preoperative radiation therapy for rectal cancer

    International Nuclear Information System (INIS)

    Sarashina, Hiromi; Saito, Norio; Nunomura, Masao; Takiguchi, Nobuhiro; Koda, Keishi; Sano, Takahisa; Nakashima, Nobuyuki

    1992-01-01

    Eighty patients with rectal cancer received a total of 30.6 Gy to the whole pelvic cavity and then a 12 Gy boost (4 fractions) especially to the pelvis minor including tumor. Tumor reduction, as found on X-ray film, endoscopy, endoscopic ultrasonography, CT and MRI, was proportional to histological outcome. Pathological effectiveness was reversely associated with tubular infiltration and extramural invasion. Definite cancer invasion into the adventitia, 2 mm or less from the surgical margin, and lymph node metastasis to group II were significantly responsive to irradiation. In these cases, local failure was also controlled by irradiation. The loco-regional occurrence rate was 6.0% in the irradiated group and 28.0% in the non-irradiated group; and the 5-year survival rate was 69.2% in the irradiated group and 56.0% in the non-irradiated group. It was also significantly higher in patients histopathologically judged as effective than the other patients. (N.K.)

  12. Digital rectal examination in Indian graduates.

    Science.gov (United States)

    Beena, Aishwarya; Jagadisan, Barath

    2018-02-12

    Digital rectal examination (DRE) is an important component of physical examination and an essential skill for medical graduates. DRE is often underutilised in clinical practice. The lack of confidence and expertise and also underutilization of DRE have been associated with inadequate training of medical students during their undergraduate studies. The training of Indian undergraduates in DRE has not been studied. A questionnaire on undergraduate training in DRE was administered to students from various medical colleges joining specialty postgraduate courses in Jawaharlal Institute of Postgraduate Medical Education and Research. A total of 101 out of 131 students participated in the survey. Ninety-one percent of students were taught DRE as undergraduates but only three-quarters had performed DRE on patients. Among the respondents who had performed DRE, two-thirds had performed fewer than five DREs before the completion of their medical education. Respondents who had performed fewer DREs were less confident about performing DRE (p importance given to DRE training of undergraduate students and huge gaps in imparting this clinical skill. Training may be improved by introducing manikins, changing attitudes to DRE by incorporating it in clinical problem solving, and with more frequent opportunities to practise under supervision. © 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  13. External beam radiotherapy for rectal adenocarcinoma

    International Nuclear Information System (INIS)

    Taylor, R.E.; Kerr, G.R.; Arnott, S.J.

    1987-01-01

    A series of 243 patients with adenocarcinoma of the rectum treated with radiotherapy is presented. Radiotherapy was combined with 5-fluorouracil, or given alone. Seventy-four patients were treated with radical external beam radiotherapy for recurrent or inoperable rectal adenocarcinoma. One hundred and forty-five patients with advanced pelvic tumours or metastases were treated with palliative pelvic radiotherapy. Twenty-four patients with small-volume residual pelvic tumour or who were felt to be at high risk of pelvic recurrence following radical resection received postoperative radiotherapy. Complete tumour regression was seen in 38% of radically treated patients, and 24% of palliatively treated patients. Partial regression was observed in 56% of radically treated patients, and 58% of palliatively treated patients. Long-term local tumour control was more commonly observed for small tumours (< 5 cm diameter). Fifty-eight % of patients treated with postoperative radiotherapy remained free of local recurrence. Survival was significantly better with small tumours. The addition of 5FU did not appear to improve survival or tumour control. (author)

  14. Relative bioavailability, metabolism and tolerability of rectally administered oxcarbazepine suspension.

    Science.gov (United States)

    Clemens, Pamela L; Cloyd, James C; Kriel, Robert L; Remmel, Rory P

    2007-01-01

    Maintenance of effective drug concentrations is essential for adequate treatment of epilepsy. Some antiepileptic drugs can be successfully administered rectally when the oral route of administration is temporarily unavailable. Oxcarbazepine is a newer antiepileptic drug that is rapidly converted to a monohydroxy derivative, the active compound. This study aimed to characterise the bioavailability, metabolism and tolerability of rectally administered oxcarbazepine suspension using a randomised, crossover design in ten healthy volunteers. Two subjects received 300 mg doses of oxcarbazepine suspension via rectal and oral routes and eight received 450 mg doses. A washout period of at least 2 weeks elapsed between doses. The rectal dose was diluted 1:1 with water. Blood samples and urine were collected for 72 hours post-dose. Adverse effects were assessed at each blood collection time-point using a self-administered questionnaire. Plasma was assayed for oxcarbazepine and monohydroxy derivative; urine was assayed for monohydroxy derivative and monohydroxy derivative-glucuronide. Maximum plasma concentration (C(max)) and time to reach C(max) (t(max)) were obtained directly from the plasma concentration-time curves. The areas under the concentration-time curve (AUCs) were determined via non-compartmental analysis. Relative bioavailability was calculated and the C(max) and AUCs were compared using Wilcoxon signed-rank tests. Mean relative bioavailability calculated from plasma AUCs was 8.3% (SD 5.5%) for the monohydroxy derivative and 10.8% (SD 7.3%) for oxcarbazepine. Oxcarbazepine and monohydroxy derivative C(max) and AUC values were significantly lower following rectal administration (p effects were headache and fatigue with no discernible differences between routes. Monohydroxy derivative bioavailability following rectal administration of oxcarbazepine suspension is significantly lower than following oral administration, most likely because of poor oxcarbazepine water

  15. Reverse-hybrid robotic mesorectal excision for rectal cancer.

    Science.gov (United States)

    Park, In Ja; You, Y Nancy; Schlette, Erika; Nguyen, Sa; Skibber, John M; Rodriguez-Bigas, Miguel A; Chang, George J

    2012-02-01

    The robotic system offers potential technical advantages over laparoscopy for total mesorectal excision with radical lymphadenectomy for rectal cancer. However, the requirement for fixed docking limits its utility when the working volume is large or patient repositioning is required. The purpose of this study was to evaluate short-term outcomes associated with a novel setup to perform total mesorectal excision and radical lymphadenectomy for rectal cancer by the use of a "reverse" hybrid robotic-laparoscopic approach. This is a prospective consecutive cohort observational study of patients who underwent robotic rectal cancer resection from January 2009 to March 2011. During the study period, a technique of reverse-hybrid robotic-laparoscopic rectal resection with radical lymphadenectomy was developed. This technique involves reversal of the operative sequence with lymphovascular and rectal dissection to precede proximal colonic mobilization. This technique evolved from a conventional-hybrid resection with laparoscopic vascular control, colonic mobilization, and robotic pelvic dissection. Perioperative and short-term oncologic outcomes were analyzed. Thirty patients underwent reverse-hybrid resection. Median tumor location was 5 cm (interquartile range 3-9) from the anal verge. Median BMI was 27.6 (interquartile range 25.0-32.1 kg/m). Twenty (66.7%) received neoadjuvant chemoradiation. There were no conversions. Median blood loss was 100 mL (interquartile range 75-200). Total operation time was a median 369 (interquartile range 306-410) minutes. Median docking time was 6 (interquartile range 5-8) minutes, and console time was 98 (interquartile range 88-140) minutes. Resection was R0 in all patients; no patients had an incomplete mesorectal resection. Six patients (20%) underwent extended lymph node dissection or en bloc resection. Reverse-hybrid robotic surgery for rectal cancer maximizes the therapeutic applicability of the robotic and conventional laparoscopic

  16. Temporal Patterns of Fatigue Predict Pathologic Response in Patients Treated With Preoperative Chemoradiation Therapy for Rectal Cancer

    International Nuclear Information System (INIS)

    Park, Hee Chul; Janjan, Nora A.; Mendoza, Tito R.; Lin, Edward H.; Vadhan-Raj, Saroj; Hundal, Mandeep; Zhang Yiqun; Delclos, Marc E.; Crane, Christopher H.; Das, Prajnan; Wang, Xin Shelley; Cleeland, Charles S.; Krishnan, Sunil

    2009-01-01

    Purpose: To investigate whether symptom burden before and during preoperative chemoradiation therapy (CRT) for rectal cancer predicts for pathologic tumor response. Methods and Materials: Fifty-four patients with T3/T4/N+ rectal cancers were treated on a Phase II trial using preoperative capecitabine and concomitant boost radiotherapy. Symptom burden was prospectively assessed before (baseline) and weekly during CRT by patient self-reported questionnaires, the MD Anderson Symptom Inventory (MDASI), and Brief Fatigue Inventory (BFI). Survival probabilities were estimated using the Kaplan-Meier method. Symptom scores according to tumor downstaging (TDS) were compared using Student's t tests. Logistic regression was used to determine whether symptom burden levels predicted for TDS. Lowess curves were plotted for symptom burden across time. Results: Among 51 patients evaluated for pathologic response, 26 patients (51%) had TDS. Fatigue, pain, and drowsiness were the most common symptoms. All symptoms increased progressively during treatment. Patients with TDS had lower MDASI fatigue scores at baseline and at completion (Week 5) of CRT (p = 0.03 for both) and lower levels of BFI 'usual fatigue' at baseline. Conclusion: Lower levels of fatigue at baseline and completion of CRT were significant predictors of pathologic tumor response gauged by TDS, suggesting that symptom burden may be a surrogate for tumor burden. The relationship between symptom burden and circulating cytokines merits evaluation to characterize the molecular basis of this phenomenon.

  17. Contact X-ray Therapy for Rectal Cancer: Experience in Centre Antoine-Lacassagne, Nice, 2002-2006

    International Nuclear Information System (INIS)

    Gerard, Jean-Pierre; Ortholan, Cecile; Benezery, Karene; Ginot, Aurelie; Hannoun-Levi, Jean-Michel; Chamorey, Emmanuel; Benchimol, Daniel; Francois, Eric

    2008-01-01

    Purpose: To report the results of using contact X-ray (CXR), which has been used in the Centre-Lacassagne since 2002 for rectal cancer. Methods and Materials: A total of 44 patients were treated between 2002 and 2006 using four distinct clinical approaches. Patients with Stage T1N0 tumors were treated with transanal local excision (TLE) and adjuvant CXR (45 Gy in three fractions) (n = 7). The 11 inoperable (or who had refused surgery) patients with Stage T2-T3 disease were treated with CXR plus external beam radiotherapy (EBRT). Those with Stage T3N0-N2 tumors were treated with preoperative CXR plus EBRT (with or without concurrent chemotherapy) followed by surgery (n = 21). Finally, the patients with Stage T2 disease were treated with CXR plus EBRT followed by TLE (n = 5). Results: The median follow-up was 25 months. In the 7 patients who underwent TLE first, no local failure was observed, and their anorectal function was good. Of the 11 inoperable patients who underwent CXR plus EBRT alone, 10 achieved local control. In the third group (preoperative CXR plus EBRT), anterior resection was performed in 16 of 21 patients. Complete sterilization of the operative specimen was seen in 4 cases (19%). No local recurrence occurred. Finally, of the 5 patients treated with CXR plus EBRT followed by TLE, a complete or near complete clinical response was observed in all. TLE with a R0 resection margin was performed in all cases. The rectum was preserved with good function in all 5 patients. Conclusion: These early results have confirmed that CXR combined with surgery (or alone with EBRT) can play a major role in the conservative and curative treatment of rectal cancer

  18. Local control of T3 carcinomas after accelerated fractionation: a look at the 'gap'

    International Nuclear Information System (INIS)

    Wang, C.C.; Efird, Jimmy; Nakfoor, Bruce; Martins, Patricia

    1996-01-01

    Purpose: To study the effects of midcourse treatment break or gaps related to the local control of T3 carcinoma of the oropharynx and larynx following accelerated hyperfractionated radiation therapy. Methods and Materials: All patients were treated at the Massachusetts General Hospital from 1979 through 1994 with treatment consisting of 1.6 Gy per fraction, two fractions a day for the treatment of T3 carcinoma of the oropharynx and larynx. They were entered in the head and neck data base. Their treatment dates, treatment breaks, and doses vs. local control were analyzed and compared. A p-value of 0.05 was considered statistically significant. Results: A total of 162 patients were available for review. Due to the acute severe mucosal effects, most of the patients required a midcourse pause or 'break' after a dose of 38.4-48 Gy before treatment could be resumed and completed. The data indicate that (a) prolongation of the treatment gap for more than 14 days, (b) total treatment course longer than 45 days, (c) total dose less than 67 Gy, and (d) male gender adversely affected local control. In spite of the gaps, the female patients with advanced carcinomas enjoyed the benefits of improved local control after the accelerated hyperfractionated radiation therapy. Conclusions: Accelerated hyperfractionation radiation therapy using 1.6 Gy per fraction/twice-a-day (b.i.d.) for a total dose of 70.4 Gy in 6 weeks is effective in achieving high local control of T3 squamous cell carcinoma of the oropharynx and larynx. The midcourse treatment gap should be as short as possible with the projected total dose and time. Should the gaps be unduly prolonged due to various circumstances, further increase in the total dose, for example, 72-75 Gy, and/or increase of the fraction sizes, for example, 1.8-2.0 Gy/f b.i.d. after the gap may be necessary to compensate for the adverse effects of the tumor regeneration from the prolonged gap

  19. Ursolic acid inhibits adipogenesis in 3T3-L1 adipocytes through LKB1/AMPK pathway.

    Directory of Open Access Journals (Sweden)

    Yonghan He

    Full Text Available BACKGROUND: Ursolic acid (UA is a triterpenoid compound with multiple biological functions. This compound has recently been reported to possess an anti-obesity effect; however, the mechanisms are less understood. OBJECTIVE: As adipogenesis plays a critical role in obesity, the present study was conducted to investigate the effect of UA on adipogenesis and mechanisms of action in 3T3-L1 preadipocytes. METHODS AND RESULTS: The 3T3-L1 preadipocytes were induced to differentiate in the presence or absence of UA for 6 days. The cells were determined for proliferation, differentiation, fat accumulation as well as the protein expressions of molecular targets that regulate or are involved in fatty acid synthesis and oxidation. The results demonstrated that ursolic acid at concentrations ranging from 2.5 µM to 10 µM dose-dependently attenuated adipogenesis, accompanied by reduced protein expression of CCAAT element binding protein β (C/EBPβ, peroxisome proliferator-activated receptor γ (PPARγ, CCAAT element binding protein α (C/EBPα and sterol regulatory element binding protein 1c (SREBP-1c, respectively. Ursolic acid increased the phosphorylation of acetyl-CoA carboxylase (ACC and protein expression of carnitine palmitoyltransferase 1 (CPT1, but decreased protein expression of fatty acid synthase (FAS and fatty acid-binding protein 4 (FABP4. Ursolic acid increased the phosphorylation of AMP-activated protein kinase (AMPK and protein expression of (silent mating type information regulation 2, homolog 1 (Sirt1. Further studies demonstrated that the anti-adipogenic effect of UA was reversed by the AMPK siRNA, but not by the Sirt1 inhibitor nicotinamide. Liver kinase B1 (LKB1, the upstream kinase of AMPK, was upregulated by UA. When LKB1 was silenced with siRNA or the inhibitor radicicol, the effect of UA on AMPK activation was diminished. CONCLUSIONS: Ursolic acid inhibited 3T3-L1 preadipocyte differentiation and adipogenesis through the LKB1/AMPK

  20. Effects of T3 treatment on brown adipose tissue and energy expenditure in a patient with craniopharyngioma and hypothalamic obesity.

    Science.gov (United States)

    van Santen, Hanneke M; Schouten-Meeteren, Antoinette Y; Serlie, Mireille; Meijneke, Ruud W H; van Trotsenburg, A S; Verberne, Hein; Holleman, Frits; Fliers, Eric

    2015-01-01

    Patients treated for childhood craniopharyngioma often develop hypothalamic obesity (HO), which has a huge impact on the physical condition and quality of life of these patients. Treatment for HO thus far has been disappointing, and although several different strategies have been attempted, all interventions had only transient effects. Since thyroid hormones increase energy expenditure metabolism (thyroid hormone induced thermogenesis), it was speculated that treatment with tri-iodothyronine (T3) may be beneficial. In 2002, a case report was published on reduction of body weight after T3 treatment for HO. No studies have been reported since. Recent experimental studies in rodents showed that T3 increases brown adipose tissue (BAT) activity via (pre)sympathetic pathways between the hypothalamus and BAT. Our aim was to investigate whether T3 treatment increases BAT activity in a patient with HO resulting from (treatment of) childhood craniopharyngioma. Thyroxine treatment for central hypothyroidism was switched to T3 monotherapy. Serum T3 and free thyroxine (FT4) concentrations were measured twice weekly for 2 months. ¹²³I-MIBG and ¹⁸F-FDG-PET after induction of non-shivering thermogenesis for the assessment of sympathetic and metabolic activity of BAT as well as indirect calorimetry for assessment of resting energy expenditure were performed before and during T3 treatment. No change in sympathetic and metabolic BAT activity, energy expenditure, or BMI was seen during T3 treatment despite the expected changes in thyroid hormone plasma concentrations. We conclude that T3 monotherapy does not seem to be effective in decreasing HO in childhood craniopharyngioma.

  1. Familial Longevity Is Associated With Higher TSH Secretion and Strong TSH-fT3 Relationship

    DEFF Research Database (Denmark)

    Jansen, Steffy W; Roelfsema, Ferdinand; van der Spoel, Evie

    2015-01-01

    and in their partners, ultradian and circadian rhythmicity of TSH, temporal relationship, and feedback and forward interplay between TSH and TH. METHODS: We collected blood samples every 10 minutes for 24 hours for TSH and TH profiles. We used a deconvolution analysis to estimate basal (nonpulsatile), pulsatile......, and other secretion parameters to characterize ultradian rhythmicity and locally weighted polynomial regression of TSH to assess circadian rhythmicity. A cross-correlation analysis was used to investigate the temporal relationship between TSH and TH and cross-approximate entropy to assess feedback...... TSH secretion and a strong temporal relationship between TSH and free T3 but not with differences in ultradian or circadian TSH rhythmicity or feedback and forward interplay between TSH and TH....

  2. Production of antisera and development of radioimmunoassay for serum T3, T4, and ferritin

    International Nuclear Information System (INIS)

    Elhag, Omer Mohamed Abdalla

    1998-05-01

    In this study twelve local rabbits and sixteen New-zealand rabbits were subjected to immunization against T3 and T4 immunogens. Two local sheep (ovis aris) were immunized against human liver ferritin. The T3 and T4 immunogens were prepared by conjugation of the haptens to carrier proteins (bovine serum albumin ''BSA'' and horse serum protein ''HSP''), using water soluble carboiimide as coupling agent. The local and New-zealand rabbits were immunized against these conjugates emulsified in freund's complete adjuvant (FCA) in the first and second injections, and emulsified in freund's incomplete adjuvant (FIA) in the following injections. The blood samples obtained from rabbits after each injection were tested for antibodies as well as for the effect of immunization on rabbits biochemical and haematological parameters. The blood samples obtained from sheep were tested for anti-ferritin antibodies using crude antiserum, then this antiserum was purified using ammonium sulphate. A part of it was adsorbed physically onto polystyrene beads while the other part was linked chemically to magnitisable particles inorder to develop to IRMAs. The purified antiferritin antibody was diluted 200,000 folds before being coated to polystyrene beads, and different dilutions were tried with coupling to magnetic solid phase. Optimization and validation procedures for the two IRMAs ferritin were performed. The results obtained showed poor response of rabbits to immunization against T3 and T4 immunogen conjugates, where the percent bound (B%) of tracer with the antibody ranged from (0.0-22%) for local rabbits using charcoal seperation technique, and (0.0-2.9%) using second antibody precipitation technique. The B% for the antiserum obtained from New-zealand rabbits ranged from (0.0-18.1) using second antibody precipitation technique. Serum T3, T4 and TSH of the immunized rabbits were measured and found to be not significantly different form the controls (p=0.2211, 0.098, 0.35 respectively

  3. The time development of hadronic showers and the T3B experiment

    International Nuclear Information System (INIS)

    Soldner, Christian

    2013-01-01

    The compact linear collider (CLIC) is a future linear e + e - collider operated at a center of mass energy of up to 3 TeV and with a collision rate of particle bunches of up to 2 GHz. This poses challenging requirements on the detector system. The accumulation of background events, such as γγ→hadrons resulting from Beamstrahlung, must be minimized through a precise time stamping capability in all subdetector systems. In the event reconstruction, the energy depositions within the calorimeters will be used to assign events precisely to a small set of consecutive bunch crossings. The finite time evolution of hadronic showers, on the other hand, requires an extended integration time to achieve a satisfactory energy resolution in the calorimeter. The energy resolution is also deteriorated by the leakage of shower particles. Tungsten is foreseen as dense absorber material, but the time evolution of hadron showers within such a calorimeter is not sufficiently explored yet. In the context of this thesis, the T3B experiment (short for Tungsten Timing Test Beam) was designed and constructed. It is optimized to measure the time development and the contribution of delayed energy depositions within hadronic cascades. The T3B experiment consists of 15 scintillator cells assembled in a strip. The scintillation light generated within the cells is detected by novel silicon photomultiplier whose signal is read out with fast oscilloscopes providing a sampling rate of 1.25 GHz. This strip was positioned behind two different calorimeter prototypes of the CALICE collaboration which use a tungsten and steel (for comparison) absorber structure. T3B was part of the CALICE test beam campaign 2010/2011 carried out at the PS and SPS at CERN and acquired data on hadronic showers in an energy range of 2-300 GeV. A test beam optimized data acquisition software was developed from scratch. With the development and application of a novel waveform decomposition algorithm, the time of arrival of

  4. Fatigue crack growth in 2024-T3 aluminum under tensile and transverse shear stresses

    Science.gov (United States)

    Viz, Mark J.; Zehnder, Alan T.

    1994-01-01

    The influence of transverse shear stresses on the fatigue crack growth rate in thin 2024-T3 aluminum alloy sheets is investigated experimentally. The tests are performed on double-edge cracked sheets in cyclic tensile and torsional loading. This loading generates crack tip stress intensity factors in the same ratio as the values computed for a crack lying along a lap joint in a pressurized aircraft fuselage. The relevant fracture mechanics of cracks in thin plates along with the details of the geometrically nonlinear finite element analyses used for the test specimen calibration are developed and discussed. Preliminary fatigue crack growth data correlated using the fully coupled stress intensity factor calibration are presented and compared with fatigue crack growth data from pure delta K(sub I)fatigue tests.

  5. Production of antisera and development of radioimmunoassay for serum T3, T4, and ferritin

    Energy Technology Data Exchange (ETDEWEB)

    Elhag, Omer Mohamed Abdalla [Department of Biochemistry, Faculty of Veterinary Science, University of Khartoum, Khartoum (Sudan)

    1998-05-01

    In this study twelve local rabbits and sixteen New-zealand rabbits were subjected to immunization against T3 and T4 immunogens. Two local sheep (ovis aris) were immunized against human liver ferritin. The T3 and T4 immunogens were prepared by conjugation of the haptens to carrier proteins (bovine serum albumin ``BSA`` and horse serum protein ``HSP``), using water soluble carboiimide as coupling agent. The local and New-zealand rabbits were immunized against these conjugates emulsified in freund`s complete adjuvant (FCA) in the first and second injections, and emulsified in freund`s incomplete adjuvant (FIA) in the following injections. The blood samples obtained from rabbits after each injection were tested for antibodies as well as for the effect of immunization on rabbits biochemical and haematological parameters. The blood samples obtained from sheep were tested for anti-ferritin antibodies using crude antiserum, then this antiserum was purified using ammonium sulphate. A part of it was adsorbed physically onto polystyrene beads while the other part was linked chemically to magnitisable particles inorder to develop to IRMAs. The purified antiferritin antibody was diluted 200,000 folds before being coated to polystyrene beads, and different dilutions were tried with coupling to magnetic solid phase. Optimization and validation procedures for the two IRMAs ferritin were performed. The results obtained showed poor response of rabbits to immunization against T3 and T4 immunogen conjugates, where the percent bound (B%) of tracer with the antibody ranged from (0.0-22%) for local rabbits using charcoal seperation technique, and (0.0-2.9%) using second antibody precipitation technique. The B% for the antiserum obtained from New-zealand rabbits ranged from (0.0-18.1) using second antibody precipitation technique. Serum T3, T4 and TSH of the immunized rabbits were measured and found to be not significantly different form the controls (p=0.2211, 0.098, 0.35 respectively

  6. Irradiation of Polystyrene and Polypropylene to study NIH 3T3 fibroblasts adhesion

    International Nuclear Information System (INIS)

    Arbeitman, C.R.; Grosso, M.F. del; Ibanez, I.; Garcia Bermudez, G.; Duran, H.; Chappa, V.C.; Mazzei, R.; Behar, M.

    2010-01-01

    When polymers are irradiated with heavy ions new chemical groups are created in a few microns of the material. The irradiation changed the polarity and wettability on the surface so that could enhance the biocompatibility of the modified polymer. The study of chemistry and nanoscale topography of the biomaterial is important in determining its potential applications in medicine and biotechnology, because their strong influence on cell function, adhesion and proliferation. In this study, thin films of Polystyrene and Polypropylene samples were modified by irradiation with low energy ion beams (30-150 keV) and swift heavy ions both with various fluences and energies. The changes were evaluated with different methods. Adhesion of NIH 3T3 fibroblasts onto unirradiated and irradiated surfaces has been studied by in vitro techniques. The correlations between physicochemical properties as a function of different irradiations parameters were compared with cell adhesion on the modified polymer surface.

  7. Duality symmetry of N=4 Yang-Mills theory on T3

    International Nuclear Information System (INIS)

    Hacquebord, F.; Verlinde, H.

    1997-01-01

    We study the spectrum of BPS states in N=4 supersymmetric U(N) Yang-Mills theory. This theory has been proposed to describe M-theory on T 3 in the discrete light-cone formalism. We find that the degeneracy of irreducible BPS bound states in this model exhibits a (partially hidden) SL(5,Z) duality symmetry. Besides the electro-magnetic symmetry, this duality group also contains Nahm-like transformations that interchange the rank N of the gauge group with some of the magnetic or electric fluxes. In the M-theory interpretation, this mapping amounts to a reflection that interchanges the longitudinal direction with one of the transverse directions. (orig.)

  8. The time development of hadronic showers and the T3B experiment

    Energy Technology Data Exchange (ETDEWEB)

    Soldner, Christian

    2013-06-06

    The compact linear collider (CLIC) is a future linear e{sup +}e{sup -} collider operated at a center of mass energy of up to 3 TeV and with a collision rate of particle bunches of up to 2 GHz. This poses challenging requirements on the detector system. The accumulation of background events, such as {gamma}{gamma}{yields}hadrons resulting from Beamstrahlung, must be minimized through a precise time stamping capability in all subdetector systems. In the event reconstruction, the energy depositions within the calorimeters will be used to assign events precisely to a small set of consecutive bunch crossings. The finite time evolution of hadronic showers, on the other hand, requires an extended integration time to achieve a satisfactory energy resolution in the calorimeter. The energy resolution is also deteriorated by the leakage of shower particles. Tungsten is foreseen as dense absorber material, but the time evolution of hadron showers within such a calorimeter is not sufficiently explored yet. In the context of this thesis, the T3B experiment (short for Tungsten Timing Test Beam) was designed and constructed. It is optimized to measure the time development and the contribution of delayed energy depositions within hadronic cascades. The T3B experiment consists of 15 scintillator cells assembled in a strip. The scintillation light generated within the cells is detected by novel silicon photomultiplier whose signal is read out with fast oscilloscopes providing a sampling rate of 1.25 GHz. This strip was positioned behind two different calorimeter prototypes of the CALICE collaboration which use a tungsten and steel (for comparison) absorber structure. T3B was part of the CALICE test beam campaign 2010/2011 carried out at the PS and SPS at CERN and acquired data on hadronic showers in an energy range of 2-300 GeV. A test beam optimized data acquisition software was developed from scratch. With the development and application of a novel waveform decomposition algorithm

  9. Electrosynthesized polyaniline for the corrosion protection of aluminum alloy 2024-T3

    Directory of Open Access Journals (Sweden)

    Huerta-Vilca Domingo

    2003-01-01

    Full Text Available Adherent polyaniline films on aluminum alloy 2024-T3 have been prepared by electrodeposition from aniline containing oxalic acid solution. The most appropriate method to prepare protective films was a successive galvanostatic deposition of 500 seconds. With this type of film, the open circuit potential of the coating shifted around 0.065V vs. SCE compared to the uncoated alloy. The polyaniline coatings can be considered as candidates to protect copper-rich (3 - 5% aluminum alloys by avoiding the galvanic couple between re-deposited copper on the surface and the bulk alloy. The performance of the polyaniline films was verified by immersion tests up to 2.5 months. It was good with formation of some aluminum oxides due to electrolyte permeation so, in order to optimize the performance a coating formulation would content an isolation topcoat.

  10. Averrhoa carambola L. peel extract suppresses adipocyte differentiation in 3T3-L1 cells.

    Science.gov (United States)

    Rashid, Asyifah Mohamed; Lu, Kaihui; Yip, Yew Mun; Zhang, Dawei

    2016-02-01

    Obesity is associated with an increased risk of many chronic diseases. Recently, a growing body of evidence has shown that phytochemicals may inhibit adipogenesis and obesity. In this study, we report for the first time, the ability of Averrhoa carambola L. peel extract commonly known as star fruit (SFP) to effectively suppress adipocyte differentiation in 3T3-L1 preadipocytes and therefore, address it as a potential candidate to treat obesity and its related diseases. (-)-Epicatechin was identified as a bioactive compound likely responsible for this suppression. As the genetic expression studies revealed that the adipogenic activity of SFP extract was due to the simultaneous downregulation of the C/EBPα and PPARγ as well as the upregulation of PPARα receptor genes, a detailed computational docking study was also elucidated to reveal the likely binding mode of (-)-epicatechin to the receptor of interest, accounting for the likely mechanism that results in the overall suppression of adipocyte differentiation.

  11. Feasibility study of a biocompatible pneumatic dispensing system using mouse 3T3-J2 fibroblasts

    Science.gov (United States)

    Lee, Sangmin; Kim, Hojin; Kim, Joonwon

    2017-12-01

    This paper presents results for dispensing living cells using a pneumatic dispensing system to verify the feasibility of using this system to fabricate biomaterials. Living cells (i.e., mouse 3T3-J2 fibroblast) were dispensed with different dispensing pressures in order to evaluate the effect of dispensing process on cell viability and proliferation. Based on the results of a live-dead assay, more than 80% of cell viability has been confirmed which was reasonably similar to that in the control group. Furthermore, measurement of cell metabolic activity after dispensing confirmed that the dispensed cell proliferated at a rate comparable to that of the control group. These results demonstrate that the pneumatic dispensing system is a promising tool for fabrication of biomaterials.

  12. Friction stir spot welding of 2024-T3 aluminum alloy with SiC nanoparticles

    Energy Technology Data Exchange (ETDEWEB)

    Paidar, Moslem; Sarab, Mahsa Laali [Islamic Azad University, Tehran (Iran, Islamic Republic of)

    2016-01-15

    In this study, the Friction stir spot welding (FSSW) of 2024-T3 aluminum alloy with 1.6 mm thickness was investigated. The effects of the silicon carbide (SiC) nanoparticles on the metallurgical and mechanical properties were discussed. The effects of particles on tension shear and wear tests were also investigated. The process was conducted at a constant rotational speed of 1000 rpm. Results showed that adding SiC nanoparticles to the weld during FSSW had a major effect on the mechanical properties. In fact, the addition of nanoparticles as barriers prevented grain growth in the Stir zone (SZ). The data obtained in the tensile-shear and wear tests showed that tensile-shear load and wear resistance increased with the addition of SiC nanoparticles, which was attributed to the fine grain size produced in the SZ.

  13. Nomogram to predict rectal toxicity following prostate cancer radiotherapy.

    Directory of Open Access Journals (Sweden)

    Jean-Bernard Delobel

    Full Text Available To identify predictors of acute and late rectal toxicity following prostate cancer radiotherapy (RT, while integrating the potential impact of RT technique, dose escalation, and moderate hypofractionation, thus enabling us to generate a nomogram for individual prediction.In total, 972 patients underwent RT for localized prostate cancer, to a total dose of 70 Gy or 80 Gy, using two different fractionations (2 Gy or 2.5 Gy/day, by means of several RT techniques (3D conformal RT [3DCRT], intensity-modulated RT [IMRT], or image-guided RT [IGRT]. Multivariate analyses were performed to identify predictors of acute and late rectal toxicity. A nomogram was generated based on the logistic regression model used to predict the 3-year rectal toxicity risk, with its accuracy assessed by dividing the cohort into training and validation subgroups.Mean follow-up for the entire cohort was 62 months, ranging from 6 to 235. The rate of acute Grade ≥2 rectal toxicity was 22.2%, decreasing when combining IMRT and IGRT, compared to 3DCRT (RR = 0.4, 95%CI: 0.3-0.6, p<0.01. The 5-year Grade ≥2 risks for rectal bleeding, urgency/tenesmus, diarrhea, and fecal incontinence were 9.9%, 4.5%, 2.8%, and 0.4%, respectively. The 3-year Grade ≥2 risk for overall rectal toxicity increased with total dose (p<0.01, RR = 1.1, 95%CI: 1.0-1.1 and dose per fraction (2Gy vs. 2.5Gy (p = 0.03, RR = 3.3, 95%CI: 1.1-10.0, and decreased when combining IMRT and IGRT (RR = 0.50, 95% CI: 0.3-0.8, p<0.01. Based on these three parameters, a nomogram was generated.Dose escalation and moderate hypofractionation increase late rectal toxicity. IMRT combined with IGRT markedly decreases acute and late rectal toxicity. Performing combined IMRT and IGRT can thus be envisaged for dose escalation and moderate hypofractionation. Our nomogram predicts the 3-year rectal toxicity risk by integrating total dose, fraction dose, and RT technique.

  14. Mobile phone base station radiation does not affect neoplastic transformation in BALB/3T3 cells.

    Science.gov (United States)

    Hirose, H; Suhara, T; Kaji, N; Sakuma, N; Sekijima, M; Nojima, T; Miyakoshi, J

    2008-01-01

    A large-scale in vitro study focusing on low-level radiofrequency (RF) fields from mobile radio base stations employing the International Mobile Telecommunication 2000 (IMT-2000) cellular system was conducted to test the hypothesis that modulated RF fields affect malignant transformation or other cellular stress responses. Our group previously reported that DNA strand breaks were not induced in human cells exposed to 2.1425 GHz Wideband Code Division Multiple Access (W-CDMA) radiation up to 800 mW/kg from mobile radio base stations employing the IMT-2000 cellular system. In the current study, BALB/3T3 cells were continuously exposed to 2.1425 GHz W-CDMA RF fields at specific absorption rates (SARs) of 80 and 800 mW/kg for 6 weeks and malignant cell transformation was assessed. In addition, 3-methylcholanthrene (MCA)-treated cells were exposed to RF fields in a similar fashion, to assess for effects on tumor promotion. Finally, the effect of RF fields on tumor co-promotion was assessed in BALB/3T3 cells initiated with MCA and co-exposed to 12-O-tetradecanoylphorbol-13-acetate (TPA). At the end of the incubation period, transformation dishes were fixed, stained with Giemsa, and scored for morphologically transformed foci. No significant differences in transformation frequency were observed between the test groups exposed to RF signals and the sham-exposed negative controls in the non-, MCA-, or MCA plus TPA-treated cells. Our studies found no evidence to support the hypothesis that RF fields may affect malignant transformation. Our results suggest that exposure to low-level RF radiation of up to 800 mW/kg does not induce cell transformation, which causes tumor formation. (c) 2007 Wiley-Liss, Inc.

  15. ATF3 inhibits adipocyte differentiation of 3T3-L1 cells

    International Nuclear Information System (INIS)

    Jang, Min Kyung; Kim, Cho Hee; Seong, Je Kyung; Jung, Myeong Ho

    2012-01-01

    Highlights: ► Overexpression of ATF3 inhibits adipocyte differentiation in 3T3-L1 cells. ► Overexpression of ATF3 represses C/EBPα expression. ► ATF3 directly binds to mouse C/EBPα promoter spanning from −1928 to −1907. ► ATF3 may play a role in hypoxia-mediated inhibition of adipocyte differentiation. -- Abstract: ATF3 is a stress-adaptive gene that regulates proliferation or apoptosis under stress conditions. However, the role of ATF3 is unknown in adipocyte cells. Therefore, in this study, we investigated the functional role of ATF3 in adipocytes. Both lentivirus-mediated overexpression of ATF3 and stably-overexpressed ATF3 inhibited adipocyte differentiation in 3T3-L1 cells, as revealed by decreased lipid staining with oil red staining and reduction in adipogenic genes. Thapsigargin treatment and overexpression of ATF3 decreased C/EBPα transcript and repressed the activity of the 3.6-kb mouse C/EBPα promoter, demonstrating that ATF3 downregulates C/EBPα expression. Transfection studies using mutant constructs containing 5′-deletions in the C/EBPα promoter revealed that a putative ATF/CRE element, GGATGTCA, is located between −1921 and −1914. Electrophoretic mobility shift assay and chromatin immunoprecipitation assay demonstrated that ATF3 directly binds to mouse C/EBPα promoter spanning from −1928 to −1907. Both chemical hypoxia-mimetics or physical hypoxia led to reduce the C/EBPα mRNA and repress the promoter activity of the C/EBPα gene, whereas increase ATF3 mRNA, suggesting that ATF3 may contribute to the inhibition of adipocyte differentiation in hypoxia through downregulation of C/EBPα expression. Collectively, these results demonstrate that ATF3 represses the C/EBPα gene, resulting in inhibition of adipocyte differentiation, and thus plays a role in hypoxia-mediated inhibition of adipocyte differentiation.

  16. Tumor budding is a strong and reproducible prognostic marker in T3N0 colorectal cancer.

    LENUS (Irish Health Repository)

    Wang, Lai Mun

    2012-02-01

    BACKGROUND: Tumor budding along the advancing front of colorectal adenocarcinoma is an early event in the metastatic process. A reproducible, prognostic budding scoring system based on outcomes in early stage colorectal cancer has not been established. DESIGN: One hundred twenty-eight T3N0M0 colorectal carcinoma patients with known outcome were identified. Tumor budding was defined as isolated tumor cells or clusters of <5 cells at the invasive tumor front. Tumor bud counts were generated in 5 regions at 200x by 2 pathologists (conventional bud count method). The median bud count per case was used to divide cases into low (median=0) and high budding (median > or =1) groups. Forty cases were reevaluated to assess reproducibility using the conventional and a novel rapid bud count method. RESULTS: Fifty-seven (45%) carcinomas had high and 71 (55%) had low budding scores. High budding was associated with an infiltrative growth pattern (P<0.0001) and lymphovascular invasion (P=0.005). Five-year cancer-specific survival was significantly poorer in high compared with low budding groups: 63% versus 91%, respectively, P<0.0001. Multivariate analysis demonstrated tumor budding to be independently prognostic (hazard ratio=4.76, P<0.001). Interobserver agreement was at least equivalent comparing the conventional to the rapid bud count methods: 87.5% agreement (kappa=0.75) versus 92.5% agreement (kappa=0.85), respectively. CONCLUSIONS: Tumor budding is a strong, reproducible, and independent prognostic marker of outcome that is easily assessed on hematoxylin and eosin slides. This may be useful for identifying the subset of T3N0M0 patients at high risk of recurrence who may benefit from adjuvant therapy.

  17. Monoterpene limonene induces brown fat-like phenotype in 3T3-L1 white adipocytes.

    Science.gov (United States)

    Lone, Jameel; Yun, Jong Won

    2016-05-15

    Several dietary compounds that are able to induce the brown fat-like phenotype in white adipocytes have been considered for treatment of obesity due to their ability to increase energy expenditure. Here, we report that limonene induces the brown fat-like phenotype in 3T3-L1 adipocytes by increasing expression of brown adipocyte-specific genes and proteins. Limonene-induced browning in white adipocytes was investigated by determining expression levels of brown fat-specific genes and proteins by real-time RT-PCR, immunoblot analysis, and immunocytochemical staining. Limonene enhanced mitochondrial biogenesis, as evidenced by increased mitochondrial content and immunofluorescent intensity. Limonene also significantly elevated protein levels of HSL, PLIN, p-AMPK, p-ACC, ACO, COX4, CPT1, and CYT C, suggesting its possible role in enhancement of lipolysis and lipid catabolism. Increased expression of PRDM16, UCP1, C/EBPβ, and other brown fat-specific markers by limonene was possibly mediated by activation of β3-adnergenic receptor (β3-AR), as inhibition of β3-AR inhibited up-regulation of brown fat-specific markers. Similarly, limonene-mediated activation of ERK and up-regulation of key brown adipocyte specific markers were eliminated by treatment with ERK antagonist. Taken together, these results suggest that limonene induces browning of 3T3-L1 adipocytes via activation of β3-AR and the ERK signaling pathway. In conclusion, our findings suggest that limonene plays a dual modulatory role in induction of the brown adipocyte-like phenotype as well as promotion of lipid metabolism and thus may have potential therapeutic implications for treatment of obesity. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. ATP-Driven Contraction of Phage T3 Capsids with DNA Incompletely Packaged In Vivo

    Directory of Open Access Journals (Sweden)

    Philip Serwer

    2017-05-01

    Full Text Available Adenosine triphosphate (ATP cleavage powers packaging of a double-stranded DNA (dsDNA molecule in a pre-assembled capsid of phages that include T3. Several observations constitute a challenge to the conventional view that the shell of the capsid is energetically inert during packaging. Here, we test this challenge by analyzing the in vitro effects of ATP on the shells of capsids generated by DNA packaging in vivo. These capsids retain incompletely packaged DNA (ipDNA and are called ipDNA-capsids; the ipDNA-capsids are assumed to be products of premature genome maturation-cleavage. They were isolated via preparative Nycodenz buoyant density centrifugation. For some ipDNA-capsids, Nycodenz impermeability increases hydration and generates density so low that shell hyper-expansion must exist to accommodate associated water. Electron microscopy (EM confirmed hyper-expansion and low permeability and revealed that 3.0 mM magnesium ATP (physiological concentration causes contraction of hyper-expanded, lowpermeability ipDNA-capsids to less than mature size; 5.0 mM magnesium ATP (border of supraphysiological concentration or more disrupts them. Additionally, excess sodium ADP reverses 3.0 mM magnesium ATP-induced contraction and re-generates hyper-expansion. The Nycodenz impermeability implies assembly perfection that suggests selection for function in DNA packaging. These findings support the above challenge and can be explained via the assumption that T3 DNA packaging includes a back-up cycle of ATP-driven capsid contraction and hyper-expansion.

  19. Differential metamorphosis alters the endocrine response in anuran larvae exposed to T3 and atrazine

    International Nuclear Information System (INIS)

    Freeman, Jennifer L.; Beccue, Nathan; Rayburn, A. Lane

    2005-01-01

    Pesticide chemical contamination is one of the suspected contributors of the amphibian population decline. The herbicide atrazine is one of the major surface water contaminants in the U.S. A previous study has shown that atrazine at concentrations as low as 100 parts per billion (ppb) increased the time to metamorphosis in Xenopus laevis tadpoles. However, questions remain as to the applicability of a study of a non-native species to a native organism. The possible effects of atrazine on developing Bufo americanus were explored. Atrazine at potentially (albeit high) environmental concentrations was found not to delay the metamorphosis of developing B. americanus tadpoles as observed in X. laevis. Several studies have indicated that atrazine affects thyroid hormones. Since thyroid hormones are critical in amphibian metamorphosis, B. americanus and X. laevis tadpoles were exposed to exogenous 3,5,3'-triiodothyronine (T 3 ). X. laevis were found to be more responsive to the effects of exogenous T 3 compared to B. americanus, indicating that X. laevis may be more sensitive to endocrine active chemicals than B. americanus. In X. laevis, nuclear heterogeneity has been associated with metamorphosis. Flow cytometric analysis of the nuclei of normal metamorphing B. americanus indicates a decrease in the amount of thyroid mediated chromatin alterations relative to the nuclei of metamorphing X. laevis. Indications are that the differential response to endocrine disruption is due to the differential role of chromatin associated gene expression during metamorphosis of B. americanus versus X. laevis. A second native species, Hyla versicolor, was observed to have the X. laevis nuclear pattern with respect to metamorphosis. As such, sensitivity to endocrine disruption is hypothesized not to be limited to laboratory non-native species

  20. Microstructure Stability During Creep of Friction Stir Welded AA2024-T3 Alloy

    Science.gov (United States)

    Regev, Michael; Rashkovsky, Tal; Cabibbo, Marcello; Spigarelli, Stefano

    2018-01-01

    The poor weldability of the AA2024 aluminum alloy limits its use in industrial applications. Because friction stir welding (FSW) is a non-fusion welding process, it seems to be a promising solution for welding this alloy. In the current study, FSW was applied to butt weld AA2024-T3 aluminum alloy plates. Creep tests were conducted at 250 and at 315 °C on both the parent material and the friction stir welded specimens. The microstructures of the welded and non-welded AA2024-T3 specimens before and after the creep tests were studied and compared. A comprehensive transmission electron microscopy study together with a high-resolution scanning electron microscopy study and energy-dispersive x-ray spectroscopy analysis was conducted to investigate the microstructure stability. The parent material seems to contain two kinds of Cu-rich precipitates—coarse precipitates of a few microns each and uniformly dispersed fine nanosized precipitates. Unlike the parent material, the crept specimens were found to contain the two kinds of precipitates mentioned above together with platelet-like precipitates. In addition, extensive decoration of the grain boundaries with precipitates was clearly observed in the crept specimens. Controlled aging experiments for up to 280 h at the relevant temperatures were conducted on both the parent material and the welded specimens in order to isolate the contribution of exposure to high temperatures to the microstructure changes. TEM study showed the development of dislocation networks into a cellular dislocation structure in the case of the parent metal. Changes in the dislocation structure as a function of the creep strain and the FSW process were recorded. A detailed creep data analysis was conducted, taking into account the instability of the microstructure.

  1. Rectal cancer: involved circumferential resection margin - a root cause analysis.

    Science.gov (United States)

    Youssef, H; Collantes, E C; Rashid, S H; Wong, L S; Baragwanath, P

    2009-06-01

    An involved circumferential resection margin (CRM) following surgery for rectal cancer is the strongest predictor of local recurrence and may represent a failure of the multidisciplinary team (MDT) process. The study analyses the causes of positive CRM in patients undergoing elective surgery for rectal cancer with respect to the decision-making process of the MDT, preoperative rectal cancer staging and surgical technique. From March 2002 to September 2005, data were collected prospectively on all patients undergoing elective rectal cancer surgery with curative intent. The data on all patients identified with positive CRM were analysed. Of 158 patients (male:female = 2.2:1) who underwent potentially curative surgery, 16 (10%) patients had a positive CRM on postoperative histology. Four were due to failure of the pelvic magnetic resonance imaging (MRI) staging scans to predict an involved margin, two with an equivocal CRM on MRI did not have preoperative radiotherapy, one had an inaccurate assessment of the site of primary tumour and in one intra-operative difficulty was encountered. No failure of staging or surgery was identified in the remaining eight of the 16 patients. Abdominoperineal resection (APR) was associated with a 26% positive CRM, compared with 5% for anterior resection. No single consistent cause was found for a positive CRM. The current MDT process and/or surgical technique may be inadequate for low rectal tumours requiring APR.

  2. Sexual Function in Males After Radiotherapy for Rectal Cancer

    International Nuclear Information System (INIS)

    Bruheim, Kjersti; Guren, Marianne G.; Dahl, Alv A.; Skovlund, Eva; Balteskard, Lise; Carlsen, Erik; Fossa, Sophie D.; Tveit, Kjell Magne

    2010-01-01

    Purpose: Knowledge of sexual problems after pre- or postoperative radiotherapy (RT) with 50 Gy for rectal cancer is limited. In this study, we aimed to compare self-rated sexual functioning in irradiated (RT+) and nonirradiated (RT-) male patients at least 2 years after surgery for rectal cancer. Methods and Materials: Patients diagnosed with rectal cancer from 1993 to 2003 were identified from the Norwegian Rectal Cancer Registry. Male patients without recurrence at the time of the study. The International Index of Erectile Function, a self-rated instrument, was used to assess sexual functioning, and serum levels of serum testosterone were measured. Results: Questionnaires were returned from 241 patients a median of 4.5 years after surgery. The median age was 67 years at survey. RT+ patients (n = 108) had significantly poorer scores for erectile function, orgasmic function, intercourse satisfaction, and overall satisfaction with sex life compared with RT- patients (n = 133). In multiple age-adjusted analysis, the odds ratio for moderate-severe erectile dysfunction in RT+ patients was 7.3 compared with RT- patients (p <0.001). Furthermore, erectile dysfunction of this degree was associated with low serum testosterone (p = 0.01). Conclusion: RT for rectal cancer is associated with significant long-term effects on sexual function in males.

  3. Iatrogenic Rectal Injury During Radical Prostatectomy: Is Colostomy Inevitable End?

    Directory of Open Access Journals (Sweden)

    Ramazan Topaktas

    2014-12-01

    Full Text Available Aim: Radical prostatectomy (RP is the gold standard treatment method for localized prostate cancer, because of its high oncological success. Iatrogenic rectal injury (IRI during RP is rarely seen, but it may causes serious complications because of the close anatomic relationship between the prostate and rectum. Aim is to present our series about management of IRI without colostomy. Material and Method: Between June 1999 and June 2013, radical retropubic prostatectomy (RRP was performed to 372 patients by a single surgeon. 10 cases (%2,6 were complicated by a rectal injury during RRP. Instant rectal closure was performed in 3 layers without a diverting colostomy, at the time of surgery. Omental vascular flap was placed between rectum and vesicourethral anastomosis. Results: The clinical stages of IRI cases were T1c, T2a and T2c in 2, 3 and 5 patients, respectively. Their preoperative Gleason scores were 6, 7 and 8 in 3, 5 and 2 patient, respectively. None of the 10 had undergone previous prostatic or rectal surgery, or received preoperative radiotherapy or hormonal therapy. Discussion: Instant diagnosis and rectal wall closures by three layers are essential for successful repair. Our technique seems as a safe, minimal invasive and highly effective option for the management of IRI.

  4. Association of anorectal malformation with anal and rectal duplication

    Directory of Open Access Journals (Sweden)

    Karla A. Santos-Jasso

    2014-08-01

    We present three cases of rectal duplications with anorectal malforma- tion with recto-perineal fistula and colonic duplication. Two of them with delayed diagnosis and bowel obstruction, treated with laparotomy, colostomy and side-to-side anastomosis of the proximal colonic duplica- tion; in the third case the diagnosis of the colonic and rectal duplication was made during a colostomy opening. For definitive correction, the three patients underwent abdomino-perineal approach and side-to-side anastomosis of the rectal duplication, placement of the rectum within the muscle complex, and later on colostomy closure. In a fourth patient with anorectal malformation and colostomy after birth, the perineal electro-stimulation showed two muscle complexes. A posterior sagittal approach in both showed two separate blind rectal pouches; an end- to-side anastomosis of the dilated rectum was made, and the muscle complex with stronger contraction was used for the anoplasty. The posterior sagittal approach is the best surgical option to preserve the muscle complex, with a better prognosis for rectal continence.

  5. Cystic rectal duplication: a rare cause of neonatal intestinal obstruction.

    Science.gov (United States)

    Mboyo, A; Monek, O; Massicot, R; Martin, L; Destuynder, O; Lemouel, A; Aubert, D

    1997-07-01

    A case of cystic rectal duplication revealed on day 2 of life by a low intestinal occluding syndrome is reported. Radiologic imaging (ultrasonography, cystography, rectography) showed a large, retrorectal liquid formation in the pelvis and abdomen, with pelvic compression of the terminal alimentary canal and lower urinary tract. Magnetic resonance imaging demonstrated a liquid formation with clearly defined edges and no medullary involvement, thus ruling out the possibility of a previous meningeal hernia. Biological markers were within normal limits. On day 4, a 9 x 6-cm cystic rectal duplication was removed, followed by a temporary colostomy. Pathologic examination demonstrated typical rectal architecture with ciliated cells. Radiologic and clinical findings at 2-month follow-up were reassuring. This case report is exceptional for the following reasons: (1) As a rule, rectal duplications are relatively rare (70 cases reported in the literature); (2) The means of disclosing a neonatal rectal duplication is unusual (4 cases reported in the literature); (3) The volume of the malformation was considerable; and (4) Heterotopic ciliated epithelium was present.

  6. Intersphincteric Resection for Low Rectal Cancer – Case Report

    Directory of Open Access Journals (Sweden)

    Russu Cristian

    2016-03-01

    Full Text Available Introduction: Surgical treatment for low rectal cancer represents a challenge: to perform a radical resection and to preserve the sphincter’s function. We report a case of intersphincteric resection in a combined multimodality treatment for low rectal cancer, with good oncologic and functional outcome. Case presentation: We report a case of a 73 years old woman admitted in April 2014 in surgery, for low rectal cancer. The diagnostic was established by colonoscopy and malignancy confirmed by biopsy. Complete imaging was done using computed tomography and magnetic resonance to establish the exact stage of the disease. The interdisciplinary individualized treatment began with radiotherapy (total dose of 50 Gy, administered in 25 fractions followed by surgery after eight weeks. We performed intersphincteric rectal resection by a modified Schiessel technique. There were no postoperative complications and the oncologic and functional results were very good at one year follow up. Conclusions: Intersphincteric resection, in this selected case of low rectal cancer, represented an efficient surgical treatment, with good functional results and quality of life for the patient. A multidisciplinary team is an invaluable means of assessing and further managing the appropriate, tailored to the case, treatment in the aim of achieving best results.

  7. Changing practice of rectal cancer surgery in Pakistan

    International Nuclear Information System (INIS)

    Shaikh, A.R.; Muneer, A.; Laghari, Z.H.

    2010-01-01

    Objective: To describe the presentation and pathology of rectal cancer, and to evaluate the local experience after total meso rectal excision at a tertiary care hospital in Pakistan. Methodology: A retrospective study of two hundred cases of carcinoma rectum that had undergone total meso rectal excision at Liaquat University Hospital Jamshoro Pakistan was carried out from January 1998 to December 2007.The cases were admitted through outpatient and emergency departments. The demographic details of each patient and variables such as clinical presentation, tumor location, Dukes staging, TNM staging, operations and complications were recorded on proformas. Each patient was followed up at two months for one year, every four months for three years and annually thereafter. Results: Male to female ratio being almost equal 1.6:1, Age ranged from 14-70 years. Site of tumor at upper one third 25%, middle one third 30% and lower one third 45%. Majority of patients (more than 62%) were in Dukes B Group.There were no postoperative deaths, complications occurred in a total of 59 (29.5%) patients, which were mostly colostomy related (13.0%). The abdominal wound infection 5%, anastomotic dehiscence 1.0%, urinary tract infection 5%, and impotence occurred in 1.5%. In 20% patients local recurrence was detected. Conclusion: Total meso rectal excision is a safe and feasible technique for rectal cancer surgery with acceptable perioperative morbidity and adequate local disease control. (author)

  8. Rectal Injuries after Radiotherapy for Carcinoma of the Uterine Cervix

    International Nuclear Information System (INIS)

    Kim, Jung Jin

    1983-01-01

    47 out of 56 cases of intact uterine cervix cancer treated by radiation at the Hanyang University Hospital were followed 18 months or more after treatment. (7 patients died before 18 months, 2 cases lost to follow-up). Age distribution reveal 5 cases in 30's, 18 cases in 40's, 17 cases in 50's, 7 cases in 60's. Histologically, all cases were squamous cell type except one case of adenocarcinoma. 1. 45 cases were treated by combined external Co-60 irradiation and intracavitary irradiation by Cs-137 small sources. 1 case was treated by external irradiation only, and 1 case by intracavitary only. 2. Rectal injuries were observed in 13 cased (27.6%), 4 cases in Grade 1, 8 cased in Grade 2 and 1 cases in Grade 3 which needed surgical management. 3. Average intervals of rectal injury and point A dose reveal 6 cases between 7000-7999 rad and 6 cases between 8000-8999 rad and 1 case above 9000 rad. Even though there is no direct relation between point A dose and rectal injury, it is expected that rectal injury increases as point A dose increase. 4. In the normal condition, rectal injury can't be attributed to one major cause. Radiation dose, small source distribution, general condition of patients, local anatomy of the individual patient, history of PID and previous surgery, all play complex roles

  9. Rectal volvulus following laparoscopic left hemicolectomy

    Science.gov (United States)

    Sutton, Paul Anthony; Lee, Han Sian; Din, Islah; Vimalachandran, Dale

    2013-01-01

    A 60-year-old lady with a history of Dukes B2 (T3N0M0) colorectal cancer presented some 2 years following a laparoscopic left hemicolectomy with a 4-day history of absolute constipation. A plain radiograph demonstrated large bowel obstruction, and subsequent CT of the abdomen showed the level of the obstruction to be at the rectum. Initially the aetiology was believed to be recurrence at the site of the anastomosis; however, subsequent review of the imaging and indeed endoscopic examination of the rectum showed it to be volvulus. This was initially treated with endoscopic decompression and later by the insertion of a flatus tube to good effect. The patient was discharged 3 days later with no recurrence of her symptoms at 2 months. PMID:23608861

  10. Multigradient Field Active Contour for Multilayer Detection of Ultrasound Rectal Wall Image

    National Research Council Canada - National Science Library

    Xiao, Di

    2001-01-01

    .... One of the aims is to apply this technique for multilayer boundary detection of ultrasound rectal wall image, which is important in colorectal clinical diagnosis for rectal tumor staging The core...

  11. Chemoembolization Using Irinotecan in Treating Patients With Liver Metastases From Metastatic Colon or Rectal Cancer

    Science.gov (United States)

    2015-09-10

    Liver Metastases; Mucinous Adenocarcinoma of the Colon; Mucinous Adenocarcinoma of the Rectum; Recurrent Colon Cancer; Recurrent Rectal Cancer; Signet Ring Adenocarcinoma of the Colon; Signet Ring Adenocarcinoma of the Rectum; Stage IV Colon Cancer; Stage IV Rectal Cancer

  12. Functional results after treatment for rectal cancer

    Directory of Open Access Journals (Sweden)

    Katrine Jossing Emmertsen

    2014-01-01

    Full Text Available Introduction: With improving survival of rectal cancer, functional outcome has become in- creasingly important. Following sphincter-preserving resection many patients suffer from severe bowel dysfunction with an impact on quality of life (QoL – referred to as low ante- rior resection syndrome (LARS. Study objective: To provide an overview of the current knowledge of LARS regarding symp- tomatology, occurrence, risk factors, pathophysiology, evaluation instruments and treat- ment options. Results: LARS is characterized by urgency, frequent bowel movements, emptying difficulties and incontinence, and occurs in up to 50-75% of patients on a long-term basis. Known risk factors are low anastomosis, use of radiotherapy, direct nerve injury and straight anasto- mosis. The pathophysiology seems to be multifactorial, with elements of anatomical, sen- sory and motility dysfunction. Use of validated instruments for evaluation of LARS is es- sential. Currently, there is a lack of evidence for treatment of LARS. Yet, transanal irrigation and sacral nerve stimulation are promising. Conclusion: LARS is a common problem following sphincter-preserving resection. All pa- tients should be informed about the risk of LARS before surgery, and routinely be screened for LARS postoperatively. Patients with severe LARS should be offered treatment in order to improve QoL. Future focus should be on the possibilities of non-resectional treatment in order to prevent LARS. Resumo: Introdução: Com o aumento da sobrevida após câncer retal, o resultado funcional se tornou cada vez mais importante. Após ressecção com preservação do esfíncter, muitos pacientes sofrem de disfunção intestinal com um impacto sobre a qualidade de vida (QdV – denomi- nada síndrome da ressecção anterior baixa (LARS. Objetivo do estudo: Fornecer uma visão geral do conhecimento atual da LARS com relação à sintomatologia, à ocorrência, aos fatores de risco, à fisiopatologia, aos

  13. Development of an 'In vitro' system for the caption essay of T3; Desarrollo de un sistema 'In vitro' para el ensayo de captacion de T3

    Energy Technology Data Exchange (ETDEWEB)

    Lavalley, C.; Ferro, G.; Zambrano, F.; Lezama, J

    1990-02-15

    Triiodothyronine uptake (T3U) is a qualitative technique for evaluation of the unsaturation capacity of thyroid binding globulin (TBG). This paper presents results related to a T3 standardized serum and the integration of T3-I-125, and adsorbent for labelled hormone. Labelled hormone were prepared by the chloramine T method and then purified by high performance liquid chromatography. The specific activity was 500 {mu} Ci/ {mu} g. Various adsorbents such as: Norit A Charcoal, calcium silicate, talc, bovine serum albumin macroaggregated (BSAM) were used in different buffers as: Tris-HCl, barbital and Michaelis. Standardized serum was prepared by mixing different euthyroid sera. Best conditions for T3U assays were achieved with 15 mg/ml. BSAM at pH 8.6 in presence of Tris-HCl buffer for hypothyroid and hyperthyroid sera, for which we obtained < 0.9 {+-} 0.04 and > 1.1 {+-} 0.05 respectively as a T3U index with a 3.0 % of coefficient variation. The reagents so prepared can be conveniently used for T3U assays. (Author)

  14. Heuristics and bias in rectal surgery.

    Science.gov (United States)

    MacDermid, Ewan; Young, Christopher J; Moug, Susan J; Anderson, Robert G; Shepherd, Heather L

    2017-08-01

    Deciding to defunction after anterior resection can be difficult, requiring cognitive tools or heuristics. From our previous work, increasing age and risk-taking propensity were identified as heuristic biases for surgeons in Australia and New Zealand (CSSANZ), and inversely proportional to the likelihood of creating defunctioning stomas. We aimed to assess these factors for colorectal surgeons in the British Isles, and identify other potential biases. The Association of Coloproctology of Great Britain and Ireland (ACPGBI) was invited to complete an online survey. Questions included demographics, risk-taking propensity, sensitivity to professional criticism, self-perception of anastomotic leak rate and propensity for creating defunctioning stomas. Chi-squared testing was used to assess differences between ACPGBI and CSSANZ respondents. Multiple regression analysis identified independent surgeon predictors of stoma formation. One hundred fifty (19.2%) eligible members of the ACPGBI replied. Demographics between ACPGBI and CSSANZ groups were well-matched. Significantly more ACPGBI surgeons admitted to anastomotic leak in the last year (p < 0.001). ACPGBI surgeon age over 50 (p = 0.02), higher risk-taking propensity across several domains (p = 0.044), self-belief in a lower-than-average anastomotic leak rate (p = 0.02) and belief that the average risk of leak after anterior resection is 8% or lower (p = 0.007) were all independent predictors of less frequent stoma formation. Sensitivity to criticism from colleagues was not a predictor of stoma formation. Unrecognised surgeon factors including age, everyday risk-taking, self-belief in surgical ability and lower probability bias of anastomotic leak appear to exert an effect on decision-making in rectal surgery.

  15. Decision-making in rectal surgery.

    Science.gov (United States)

    MacDermid, E; Young, C J; Young, J; Solomon, M

    2014-03-01

    The decision to create a stoma after anterior resection has significant consequences. Decisions under uncertainty are made with a variety of cognitive tools, or heuristics. Past experience has been shown to be a powerful heuristic in other domains. Our aim was to identify whether the misfortune of recent anastomotic leakage or surgeon propensity to take everyday risks would affect their decision to defunction a range of anastomoses. Questionnaires were sent to members of the Colorectal Surgical Society of Australia and New Zealand. Participants were asked for demographic information, questions regarding risk-taking propensity, when their last anastomotic leakage occurred and whether they would defunction a range of hypothetical rectal anastomoses grouped according to height, American Society of Anesthesiologists grade and use of preoperative radiotherapy. Scores were derived for hypothetical patient likelihood of having a stoma created and individual surgeon propensity for stoma formation. Hazard regression analysis was used to assess demographic predictors of stoma formation. In total, 110 (75.3%) of 146 surveyed surgeons replied; 72 (65.5%) reported anastomotic leakage within the last 12 months. Surgeons' propensity for risk-taking was comparable (24.6 vs 27.53, 95% confidence interval, Mann-Whitney-U) to previously studied participants in economic models. Surgeon age (< 50 years) and lower propensity for risk-taking were demonstrated to be independent predictors of stoma formation on regression analysis. Although the decision to create a stoma after anterior resection may be made in the belief that its foundation derives from rational thought, it appears that other unrecognized operator factors such as age and risk-taking exert an effect. Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.

  16. A Single Centre Retrospective Evaluation of Laparoscopic Rectal Resection with TME for Rectal Cancer: 5-Year Cancer-Specific Survival

    Directory of Open Access Journals (Sweden)

    Raoul Quarati

    2011-01-01

    Full Text Available Laparoscopic colon resection has established its role as a minimally invasive approach to colorectal diseases. Better long-term survival rate is suggested to be achievable with this approach in colon cancer patients, whereas some doubts were raised about its safety in rectal cancer. Here we report on our single centre experience of rectal laparoscopic resections for cancer focusing on short- and long-term oncological outcomes. In the last 13 years, 248 patients underwent minimally invasive approach for rectal cancer at our centre. We focused on 99 stage I, II, and III patients with a minimum follow-up period of 5 years. Of them 43 had a middle and 56 lower rectal tumor. Laparoscopic anterior rectal resection was performed in 71 patients whereas laparoscopic abdomino-perineal resection in 28. The overall mortality rate was 1%; the overall morbidity rate was 29%. The 5-year disease-free survival rate was 69.7%, The 5-year overall survival rate was 78.8%.

  17. Archive of Geosample Data and Information from the University of Wisconsin Ice Island T3 Core Collection

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — From 1963 to 1972, 349 piston cores were collected from the Arctic Ocean using Ice Island T3 as a sampling platform and sent to the University of Wisconsin-Madison...

  18. Neorectal hyposensitivity after neoadjuvant therapy for rectal cancer

    International Nuclear Information System (INIS)

    Bregendahl, Sidse; Emmertsen, Katrine Jøssing; Fassov, Janne; Krogh, Klaus; Zhao, Jingbo; Gregersen, Hans; Laurberg, Søren

    2013-01-01

    Background and purpose: Preoperative radiotherapy for rectal cancer has a detrimental effect on long-term anorectal function and quality of life, additional to that observed after rectal resection. The exact physiological mechanisms for the excess impairment remain unknown. We aimed to investigate neorectal and anal sphincter properties in patients treated with neoadjuvant therapy (NT) prior to total mesorectal excision (TME). Material and methods: Sixteen patients (NT+ patients) were examined by multimodal neorectal stimulation and standard anorectal physiological testing. Data were compared to the results of 23 patients, who underwent TME without NT (NT− patients). Results: NT+ patients had elevated sensory thresholds to heat (median temperature, 60 vs. 55 °C; p 2 O; p = 0.05). Conclusions: Pelvic radiotherapy causes neorectal hyposensitivity to mechanical and thermal stimuli in patients receiving NT prior to TME surgery for rectal cancer, possibly due to impaired afferent nerve function

  19. Effects of Aglumin on the rectal bleeding following radiotherapy

    International Nuclear Information System (INIS)

    Yamashita, Michitaka; Tanaka, Motoshi; Yoshimura, Osamu; Matsubayashi, Shigeru

    1978-01-01

    Aglumin was administered to 20 cases which had rectal bleeding following radiotherapy. The results were as follows. Rectal bleeding decreased in 16 of 20 cases (80%): remarkably effective, 15%; effective, 25%; slightly effective, 40%. Bleeding time decreased in 11 cases (55%). Rumpel-Leede test gave remarkable improvement in 10 of 14 cases which had been abnormal (71.4%). Platelet increased in 18 of 20 cases (90%). Liver function test and peripheral blood findings showed no remarkable changes. No side effects such as intestinal disturbance etc were noted. In the series of symptomatic treatment for rectal disturbance resulting from radiotherapy, this drug had considerable effect of hemostasis. It was concluded that this drug is useful in combined use with other antiphlogistics, analgesic, and hematinic etc. (Ueda, J.)

  20. Endoscopic ultrasonography and rectal duplication cyst in an adult.

    Science.gov (United States)

    Castro-Poças, Fernando M; Araújo, Tarcísio P; Silva, Jorge D; Gonçalves, Vicente S

    2017-01-01

    Rectal duplication cysts account for 4% of all duplications of the alimentary tract. Presentation in adulthood is rare. An asymptomatic 54-year-old man was referred for endoscopic colorectal cancer screening. A bulging mass covered by normal mucosa was identified in the rectum. Endoscopic ultrasonography (EUS) with fine needle aspiration (FNA) was made for a diagnosis of rectal duplication cyst. The patient was operated and the diagnosis was confirmed. The diagnosis of the rectal duplication cyst is a challenge. EUS may have a singular role when identifying a muscular layer, because this is the only absolutely necessary criterion for the diagnosis. FNA by EUS may eventually identify colorectal and/or heterotypic epithelium that are the other diagnostic criteria of the duplication cyst.

  1. Rectal bleeding and its management after irradiation for cervix cancer

    International Nuclear Information System (INIS)

    Chun, Mi Son; Kang, Seung Hee; Kil, Hoon Jong; Oh, Young Taek; Sohn, Jeong Hye; Ryu, Hee Suk; Lee, Kwang Jae; Jung, Hye Young

    2002-01-01

    Radiotherapy is the main treatment modality for uterine cervix cancer. Since the rectum is in the radiation target volume, rectal bleeding is a common late side effect. The study evaluates the risk factors of radiation induced rectal bleeding and discusses its optimal management. A total of 213 patients who completed external beam radiation therapy (EBRT) and intracavitary radiation (ICR) between September 1994 and December 1999 were included in this study. No patient had undergone concurrent chemo-radiotherapy. Ninety patients received radiotherapy according to a modified hyperfractionated schedule. A midl