Colonic Wall Research Articles

Cloacally Located Kidney Prolapsing in a Kingsnake Species (Lampropeltis spp.)

An 8 1/2 year old, female, Kingsnake (Lampropeltis spp.) presented for apparent constipation of 1 month duration. The physical exam revealed moderate constipation based on coelomic palpation. Radiographs confirmed probable follicular tissue in the mid-coelomic region and more radiodense fecal material within the distal colon. The snake was given an enema and, in the process, prolapsed a firm mass on a pedunculated stalk. The stalk was immediately ligated and transected due to mild hemorrhaging. Histopathology confirmed that the mass consisted of kidney tissue affected with a bacterial nephritis and contained granulomas and gouty tophi. Necropsy of the animal confirmed that the left kidney was missing within the coelomic cavity and had migrated to within the cloacal lumen. Additionally, the animal had severe folliculostasis and a bacterial cloacitis with foreign material (hair shafts) imbedded within the colonic body wall.

What are the problems with the current staging of discontinuous tumour nodules (DTNs) in colorectal carcinoma? Is there a better way?

Discontinuous extramural tumour nodules (DTNs) are deposits of metastatic carcinoma in soft tissue not associated with lymph nodes. Although they are established as an adverse prognostic factor in colorectal carcinoma (CRC), under the AJCC eighth edition staging system their presence does not upstage patients who also have lymph node metastases. Counterintuitively, in some situations the presence of lymph node metastases may in effect downstage a patient with DTNs from pN1c to pN1a/b. Therefore, we sought to critically assess the significance of DTNs in a large unselected single institution cohort of patients undergoing surgical resection for CRC. Of 3822 CRC patients undergoing surgical resection from 2005 to 2021, DTNs were present in 686 (18.0%). In univariate (HR=2.687, 95CI 2.355-3.065; p<0.001) and multivariate analysis (HR=1.805, 95CI 1.529-2.132; p<0.001) in a model including age, gender, stage, grade, location, lymph node ratio and apical lymph node status, DTNs were associated with worse overall survival (OS). N1c patients (DTN present but no nodal metastasis) demonstrated worse OS compared to the current pN1a group (p<0.001) and were least different to the current pN2a group (p=0.571). Within the current N1a (p=0.013), N1b (p=0.004) and N2a (p=0.002) groups, patients who also had DTNs had worse OS. DTNs were associated with worse OS for all stage III CRCs combined (p<0.001), and for stage IIIB (p<0.001) and stage IIIC (p=0.007) individually. We conclude that DTNs are an independent adverse prognostic factor that should be considered in the staging system in a way that is additional to (rather than integrated with) the number of involved lymph nodes. We then assess a simple suggestion for how this could be achieved by increasing the overall stage by one group in the presence of DTNs (requiring the creation of a new stage IIID).

Barley Leaf Ameliorates Citrobacter rodentium-Induced Colitis through Preventive Effects

The incidence and prevalence of inflammatory bowel disease (IBD) have been increasing globally and progressively in recent decades. Barley leaf (BL) is a nutritional supplement that is shown to have health-promoting effects on intestinal homeostasis. Our previous study demonstrated that BL could significantly attenuate Citrobacter rodentium (CR)-induced colitis, but whether it exerts a prophylactic or therapeutic effect remains elusive. In this study, we supplemented BL before or during CR infestation to investigate which way BL acts. The results showed that BL supplementation prior to infection significantly reduced the disease activity index (DAI) score, weight loss, colon shortening, colonic wall swelling, and transmissible murine colonic hyperplasia. It significantly reduced the amount of CR in the feces and also markedly inhibited the extraintestinal transmission of CR. Meanwhile, it significantly reduced the levels and expression of tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFNγ), and interleukin-1β (IL1β). In addition, pretreatment with BL improved CR-induced gut microbiota dysbiosis by reducing the content of Proteobacteria, while increasing the content of Lactobacillus. In contrast, the effect of BL supplementation during infestation on the improvement of CR-induced colitis was not as good as that of pretreatment with BL. In conclusion, BL protects against CR-caused colitis in a preventive manner.

Histological and histochemical study of large intestine in Camel (Camelus Dromedarius)

Current study was performed to describe the Histohistological and histochemical structures of the large intestine in Iraqi one humped camel (Camelus Dromedarius). Five healthy male camels Approximately 3 to 4 years old were chosen and their specimens from cecum, colon and rectum. The specimens were directly transferred after the animal’s slaughtering to the histology lab at College of Veterinary Medicine for subsequent histological techniques. Tissue specimensfrom various parts of the large intestine (cecum, colon and rectum) were collected and fixed with 10% neutral buffered formalin then subjected to routine tissue processing. Sections of 6 micrometers thickness were prepared and stained with hematoxylin and eosin (H&amp;E) for general histology and Periodic Acid Schiff combine with Alcian blue (AB–PAS), Masson's trichrome as well as Verhoeff stains for histochemical description. Microscopic findings revealed four tunicae constructing the wall of cecum, colon and rectum mucosa, that were from the inner most mucosa, submucosa, muscularis and the outer most either serosa or adventitia. The tunica mucosa characterized by simple columnar epithelium rested on basement membrane and the presence of muscularis mucosa which separated mucosa from the underneath submucosa. Crypts of Lieberkühn and goblet cells were abundant in the colonic epithelium. The submucosa was made up of irregular connective tissue rich with adipose tissue and was supplied well with many blood vessels. Tunica muscularis in all over the three parts of large intestine was made up of inner circular smooth muscle fibers and outer longitudinal smooth muscle fibers. The tunica serosa, and in parts replaced by adventitia, was made up of loose connective tissues.

P9.54: Graft Versus Host Disease Following Liver Transplantation: A Serious Complication

Introduction: Graft-versus-host-disease (GVHD) after liver transplantation (LT) is a severe complication with high mortality rate (85%). Risk factors, diagnosis and management is challenging. Donor T-lymphocytes play a main role in the immunological attack against the host. We report a case and a comprehensive review of the literature. Around 160 patients are reported in literature with an estimated incidence of 0.5 to 2% of liver transplant. Liver transplantation from hepatocellular carcinoma (HCC) and alcoholic liver disease seems to be the main prevalent diagnosis of patients who developed GVHD. Method: We present a 62-years old male patient with hepatitis C-virus (HCV) cirrhosis and successfully downstaged to Milan criteria HCC. Orthotopic liver transplantation was performed after 6 months of surveillance and discharged uneventfully after 7 days. One month later patient developed abdominal cramps, diarrhea and cutaneous erythema. Mild leukopenia with normal liver and renal function, blood and stool samples were negative, clostridium and other pathogens were also ruled out. Abdominal CT-scan showed moderate distal ileum and colon wall edema. At colonoscopy stellate ulcers was found, biopsy was taken as well to skin lesions. Colon biopsy showed acute inflammation with severe mucosal damage and apoptosis. Skin biopsy showed interphase vacuolar dermatitis. GVHD was suspected and donor lymphocyte chimerism was positive with 5%.Results: Methylprednisolone was initiated then anti-thymocyte globulin and adalimumab were added. Bacterial, viral and fungal prophylaxis were given. The patient recovered and discharged in good conditions. Five months later the patient developed acute severe pneumonia with extensive lung necrosis that required mechanical ventilation but progressed to refractory respiratory distress and the patient died after 6 months following liver transplantation. Conclusion: This is the first GVHD case after liver transplantation reported in Mexico. The diagnosis requires a high level of clinical suspicion. There is no strong consensus about the best management, but literature agrees that steroids, IL-2 antibodies, alpha-tumor necrosis factor inhibitors and antibiotics for opportunistic pathogens must be considered.

Akkermansia muciniphila Reduces Peritonitis and Improves Intestinal Tissue Wound Healing after a Colonic Transmural Defect by a MyD88-Dependent Mechanism.

Anastomotic leakage is a major complication following colorectal surgery leading to peritonitis, complications, and mortality. Akkermansia muciniphila has shown beneficial effects on the gut barrier function. Whether A. muciniphila reduces peritonitis and mortality during colonic leakage is unknown. Whether A. muciniphila can directly modulate the expression of genes in the colonic mucosa in humans has never been studied. We investigated the effects of a pretreatment (14 days) with live A. muciniphila prior to surgical colonic perforation on peritonitis, mortality, and wound healing. We used mice with an inducible intestinal-epithelial-cell-specific deletion of MyD88 (IEC-MyD88 KO) to investigate the role of the innate immune system in this context. In a proof-of-concept pilot study, healthy humans were exposed to A. muciniphila for 2 h and colonic biopsies taken before and after colonic instillation for transcriptomic analysis. Seven days after colonic perforation, A.-muciniphila-treated mice had significantly lower mortality and severity of peritonitis. This effect was associated with significant improvements of wound histological healing scores, higher production of IL22, but no changes in the mucus layer thickness or genes involved in cell renewal, proliferation, or differentiation. All these effects were abolished in IEC-MyD88 KO mice. Finally, human subjects exposed to A. muciniphila exhibited an increased level of the bacterium at the mucus level 2 h after instillation and significant changes in the expression of different genes involved in the regulation of cell cycling, gene transcription, immunity, and inflammation in their colonic mucosa. A. muciniphila improves wound healing during transmural colonic wall defect through mechanisms possibly involving IL22 signaling and requiring MyD88 in the intestinal cells. In healthy humans, colonic administration of A. muciniphila is well tolerated and changes the expression of genes involved in the immune pathways.

Influence of coliform bacteria infection on intestinal goblet cells secretory activity of germ-free piglets

Abstract Recently, influence of bacteria colonization on development and maturation of gut wall is getting more into the focus of gastrointestinal research. For years, the main interest and research were aimed to the development and maturation of gut wall and its functional properties in normal conditions, less attention has been paid on the germ-free animals. Germ-free (GF) piglets have clear microbiological background and are reared in sterile environment. GF piglets are regarded as clinically relevant models for studying of human diseases, as these piglets’ manifest similar clinical symptoms to humans. In this study we briefly summarised the main characteristics in the distribution of goblet cells in the wall of jejunum and colon of GF piglets as healthy control (HC) group and piglets, which were experimentally infected by E. coli O149:K88 as ECK group. Neutral mucins were stained with periodic acid-Shiff (PAS) whereas acidic mucins are stained with Alcian blue. Numbers of goblet cells containing total acidic mucins in both, the jejunum and colon, differed significantly between HC and ECK piglets and in the colon, a similar trend was also observed. In the ECK piglets, jejunal goblet cells exhibited decrease in neutral mucins. This change in mucin profile in response to bacterial colonization suggests a potential role as a protective mechanism against pathogenic invasion of the intestinal mucosa during of gut mucosa development in piglets.

Rectosigmoid sparing en bloc pelvic resection for fixed ovarian tumors: Surgical technique and perioperative and oncologic outcomes.

PurposePatients with advanced ovarian cancer often undergo en bloc rectosigmoid resection with total hysterectomy to completely debulk the pelvis. We describe a unique rectosigmoid sparing en bloc pelvic resection technique for fixed ovarian tumors infiltrating the colon wall.MethodsFrom July 2020 to June 2021, 20 patients with advanced epithelial ovarian cancer (EOC) underwent rectosigmoid sparing en bloc pelvic resection successfully at our institution. We summarized our surgical technique and the peri-operative and oncological outcomes.ResultsTwenty cases with bowel infiltration achieved en bloc pelvic resection with rectosigmoid tumorectomy in a centripetal fashion. Only two patients required mucosal repair. None of the patients experienced any complications associated with en bloc resection. No pelvic recurrence occurred within the median follow-up time of 12 months.ConclusionRectosigmoid sparing en bloc pelvic resection may be feasible for select patients with fixed ovarian tumors infiltrating the colon wall.

Combined SUVmax and localized colonic wall thickening parameters to identify high-risk lesions from incidental focal colorectal 18F-FDG uptake foci.

ObjectiveTo evaluate the detection ability of 18F-FDG PET/CT for identifying high-risk lesions (high-risk adenomas and adenocarcinoma) from incidental focal colorectal 18F-FDG uptake foci combining maximum standard uptake value (SUVmax) and localized colonic wall thickening (CWT). The secondary objective was to investigate the factors of missed detection of high-risk adenomas by 18F-FDG PET/CT.Patients and methodsA total of 6394 patients who underwent 18F-FDG PET/CT in our hospital from August 2019 to December 2021 were retrospectively analysed, and 145 patients with incidental focal colorectal 18F-FDG uptake foci were identified. The optimal cut-off value of SUVmax for 18F-FDG PET/CT diagnosis of high-risk lesions was determined by receiver operating characteristic (ROC) curves. SUVmax and localized CWT were combined to identify high-risk lesions from incidental focal colorectal 18F-FDG uptake foci. The characteristics of incidental adenomas detected and high-risk adenomas missed by 18F-FDG PET/CT were compared.ResultsOf the 6394 patients, 145 patients were found to have incidental focal colorectal FDG uptake foci (2.3%), and 44 patients underwent colonoscopy and pathological examination at the same time. In fact, 45 lesions, including 12 low-risk lesions and 33 high-risk lesions (22 high-risk adenomas, 11 adenocarcinoma), were found by colonoscopy. The area under the ROC curve of SUVmax for low-risk lesions and high-risk lesions was 0.737, and the optimal cut-off value was 6.45 (with a sensitivity of 87.9% and specificity of 58.3%). When SUVmax ≥6.45, the combination of localized CWT parameters has little influence on the sensitivity and specificity of detection; when SUVmax <6.45, the combination of localized CWT parameters can improve the specificity of detection of high-risk lesions, but the sensitivity has little change. In addition, the size of high-risk adenomas discovered incidentally by 18F-FDG PET/CT was larger than that of high-risk adenomas missed, but there was no significant difference in lesion location, pathological type or intraepithelial neoplasia between the two groups.ConclusionsThe combination of SUVmax and localized CWT parameters of 18F-FDG PET/CT helped identify high-risk lesions from incidental focal colorectal 18F-FDG uptake foci, especially for lesions with SUVmax <6.45. Lesion size may be the only factor in 18F-FDG PET/CT missing high-risk adenomas.

Unusual Large Nodules in the Colon

Question: A 73-year-old-woman with nontuberculous mycobacterial pulmonary disease who was receiving antibiotic treatment presented with a 2-day history of progressive abdominal pain. Physical examination revealed mild tenderness in the right upper quadrant, without guarding or rebound. Laboratory tests were unremarkable except the C-reactive protein level was 2.9 mg/dL. Computed tomography of the abdomen showed grape-like clusters of air pockets within the colonic wall. Colonoscopy revealed multiple, variably sized, submucosal nodules in the ascending and transverse colon, with some protruding and almost entirely obstructing the colonic lumen (Figure A and B; Video 1). Narrow-band imaging magnified endoscopy revealed a normal surface pattern with dilated blood vessels and spots without irregularities (Figure C; Video 1).

Minute Colon Perforation by a Nonabsorbable Suture Knot after Uterine Myomectomy

We report a rare case of suture material-related colon perforation. A 60-year-old woman visited clinics because of the nonspecific abdominal discomfort for several months. There were no specific medical history except previous laparoscopic myomectomy 15 years ago. Colonoscopy and abdomen-pelvis computed tomography revealed an unknown foreign body penetrating the sigmoid colon wall adjacent to the uterus. We performed laparoscopic exploration with foreign body removal and primary colon wall repair. The foreign body was identified as a non-absorbable suture material suggestive of used in previous myomectomy. With recent trends for minimally invasive procedures in the field of pelvic organ surgery, surgeons, especially those without sufficient training have to pay attention to selecting the proper surgical suture materials. (Ewha Med J 2022;45(3):e7)

Imaging of Mischievous Intra-abdominal Fat Presenting with Abdominal Pain: A Pictorial Review.

AimTo briefly discuss the imaging features of different types of intra-abdominal fat necrosis.BackgroundTrauma and ischemic insult may result in intra-abdominal fat necrosis. Fat necrosis may present with acute abdomen, clinically simulating with other etiologies, such as acute diverticulitis and acute appendicitis.Main bodyImaging plays a crucial role in making the exact diagnosis and differentiating it from other pathologies that may require surgical intervention. Computed tomography (CT) is the most commonly used imaging modality. A small fat attenuation lesion with a hyperattenuating rim in contact with the ventral surface of the sigmoid colon indicates epiploic appendagitis while a larger fat-attenuation lesion on the right side of the abdomen in between the colon and anterior abdominal wall indicates omental infarction. Fat stranding at the root of the mesentery with fat ring sign represents inflammatory mesenteric panniculitis while retractile or sclerosing mesenteritis appears as a fibrotic spiculated mass with or without calcification, mimicking mesenteric carcinoid. In patients with acute pancreatitis, the amount of inflamed fat correlates with clinical severity and outcome.ConclusionsFamiliarity with the imaging features of different types of intraabdominal fat necrosis helps in establishing an accurate diagnosis, thus avoiding unnecessary intervention.How to cite this articlePatel RK, Mittal S, Singh S. Imaging of Mischievous Intra-abdominal Fat Presenting with Abdominal Pain: A Pictorial Review. Euroasian J Hepato-Gastroenterol 2022;12(1):45–49.

Visualization of Inflammation in Experimental Colitis by Magnetic Resonance Imaging Using Very Small Superparamagnetic Iron Oxide Particles.

Inflammatory bowel diseases (IBD) comprise mainly ulcerative colitis (UC) and Crohn´s disease (CD). Both forms present with a chronic inflammation of the (gastro) intestinal tract, which induces excessive changes in the composition of the associated extracellular matrix (ECM). In UC, the inflammation is limited to the colon, whereas it can occur throughout the entire gastrointestinal tract in CD. Tools for early diagnosis of IBD are still very limited and highly invasive and measures for standardized evaluation of structural changes are scarce. To investigate an efficient non-invasive way of diagnosing intestinal inflammation and early changes of the ECM, very small superparamagnetic iron oxide nanoparticles (VSOPs) in magnetic resonance imaging (MRI) were applied in two mouse models of experimental colitis: the dextran sulfate sodium (DSS)-induced colitis and the transfer model of colitis. For further validation of ECM changes and inflammation, tissue sections were analyzed by immunohistochemistry. For in depth ex-vivo investigation of VSOPs localization within the tissue, Europium-doped VSOPs served to visualize the contrast agent by imaging mass cytometry (IMC). VSOPs accumulation in the inflamed colon wall of DSS-induced colitis mice was visualized in T2* weighted MRI scans. Components of the ECM, especially the hyaluronic acid content, were found to influence VSOPs binding. Using IMC, co-localization of VSOPs with macrophages and endothelial cells in colon tissue was shown. In contrast to the DSS model, colonic inflammation could not be visualized with VSOP-enhanced MRI in transfer colitis. VSOPs present a potential contrast agent for contrast-enhanced MRI to detect intestinal inflammation in mice at an early stage and in a less invasive manner depending on hyaluronic acid content.

Histological structure and evaluation of cellular layers of Large intestine in Guinea pig (Cavia porcellus)

The Aim of this study is to determine the histological structure in the wall layers of large intestine of guinea pig. The cecum and colon was characterized by a delicate lining that is moisturized by mucus and also by a gel that is a by-product of bacterial fermentation. This study was performed on the cecum and ascending and descending colon in five health animals. The cecum and colon wall was composed of four tunicae (mucosa, submucosa, muscularis and serosa, the tunica mucosa consist of epithelium, lamina propria and muscularis mucosa. The colon lumen lined by simple columnar epithelium with prominent goblet cells. The epithelial surface of the colon is covered by the openings of tubular intestinal glands which penetrate deep into the thick mucosa. The glands consist of absorptive cells that absorb water and salt, goblet cells were secrete the mucus, and scattered Paneth cells. Crypts of Lie beckon (intestinal glands) are a simple tubular glands is observe in most mammals, which extending from the muscularis mucosa through the thickness of the lamina propria and they open into the intestinal lumen. Muscularis mucosa, consisted of very thin two layers of inner circular and outer longitudinal smooth muscles, the greater thickness of the muscularis mucosa was in the adult type and the submucosa was consists of dense a irregular connective tissue. The muscular layer is consists of internal circular and external longitudinal layers of smooth muscles, which mean their thickness is decreased toward the last parts. Thus, the serous coat is a thin layer of loose connective tissue, the thickness was decreases toward the last parts.

Morphological and morphometric characteristics of the subcompensated dolichocolon

Chronic constipation is one of the most urgent problems in modern coloproctology and is observed in 14–16% of the population of developed countries. The causes of chronic constipation vary widely from functional to organic. The latter include various variants of dolichocolon, which occur in 16% of cases.The aim of the study was is to give a morphological and quantitative characteristic of subcompensated dolichocolon based on the morphogenesis of changes, compared with histologically normal colon.Material and methods. Colon tissue samples from 15 people were used, which were divided into two groups. The first, control group consisted of 5 sectional cases of a morphologically normal colon wall. The second group was represented by the surgical material of 10 patients with subcompensated dolichocolon. Observation groups were representative by sex and age.Results. In patients with subcompensated dolichocolon, compared with the control group, the thickness of the mucosa in the colon wall is statistically significantly (p=0.034) reduced by 1.06 times, which indicates atrophy; the thickness of the submucosal layer increases by 1.55 times due to edema with foci of sclerosis (p=0.0001); the thickness of the muscle layer increases by 1.16 times (p=0,0003), because of working hypertrophy and compensatory hyperplasia of smooth muscle cells; at the same time, the number of nerve cells in Auerbach's plexuses decreases by 1.59 times (p=0,0001), which will lead to atrophy of the muscle layer and decrease its evacuator-motor function; the average area of lymphoid follicles increases by 1.35 times (p=0,003) and the percentage of secondary follicles decreases 8 times (p=0,0001), which is a consequence of congestion of intestinal contents and activation of the intestinal lymphoid apparatus.Conclusion. Morphological signs of atrophy and sclerosis changes of the cellular elements of the colon neuromuscular apparatus begin to form at the subcompensated stage of dolichocolon, which requires new objective clinical and morphological indications for surgical treatment of patients in order to prevent the development of decompensation of the patients’ general condition and severe complications.

Binary classification model of machine learning detected altered gut integrity in controlled-cortical impact model of traumatic brain injury

Aim of the study: To examine the effect of controlled-cortical impact (CCI), a preclinical model of traumatic brain injury (TBI), on intestinal integrity using a binary classification model of machine learning (ML). Materials and methods: Adult, male C57BL/6 mice were subjected to CCI surgery using a stereotaxic impactor (Impact One™). The rotarod and hot-plate tests were performed to assess the neurological deficits. Results: Mice underwent CCI displayed a remarkable neurological deficit as noticed by decreased latency to fall and lesser paw withdrawal latency in rotarod and hot plate test, respectively. Animals were sacrificed 3 days post-injury (dpi). The colon sections were stained with hematoxylin and eosin (H&E) to integrate with machinery tool-based algorithms. Several stained colon images were captured to build a dataset for ML model to predict the impact of CCI vs sham procedure. The best results were obtained with VGG16 features with SVM RBF kernel and VGG16 features with stacked fully connected layers on top. We achieved a test accuracy of 84% and predicted the disrupted gut permeability and epithelium wall of colon in CCI group as compared to sham-operated mice. Conclusion: We suggest that ML may become an important tool in the development of preclinical TBI model and discovery of newer therapeutics.

Total collagen content and distribution is increased in human colon during advancing age.

BackgroundThe effect of ageing on total collagen content of human colon has been poorly investigated. The aim of this study was to determine if ageing altered total collagen content and distribution in the human colon.MethodsMacroscopically normal ascending colon was obtained at surgery from cancer patients (n = 31) without diagnosis of diverticular disease or inflammatory bowel disease. Masson’s trichrome and Picrosirius red stains were employed to identify the total collagen content and distribution within the sublayers of the colonic wall for adult (22–60 years; 6 males, 6 females) and elderly (70 – 91years; 6 males, 4 female) patients. A hydroxyproline assay evaluated the total collagen concentration for adult (30–64 years; 9 male, 6 female) and elderly (66–91 years; 8 male, 8 female) patients.Key resultsHistological studies showed that the percentage mean intensity of total collagen staining in the mucosa, submucosa and muscularis externa was, respectively, 14(1.9) %, 74(3.2) % and 12(1.5) % in the adult ascending colon. Compared with the adults, the total collagen fibres content was increased in the submucosa (mean intensity; 163.1 ± 11.1 vs. 124.5 ± 7.8; P < 0.05) and muscularis externa (42.5 ± 8.0 vs. 20.6 ± 2.8; P < 0.01) of the elderly patients. There was no change in collagen content of the mucosa. The total collagen concentration was increased in the elderly by 16%. Sex-related differences were not found, and data were combined for analysis.ConclusionsGreater total collagen content was found in the submucosa and muscularis externa of the elderly human male and female colon. These changes may contribute to a possible loss of function with ageing.

Immunohistochemical visualisation of the enteric nervous system architecture in the germ-free piglets.

The enteric nervous system (ENS), considered as separate branch of the autonomic nervous system, is located throughout the length of the gastrointestinal tract as a series of interconnected ganglionic plexuses. Recently, the ENS is getting more in the focus of gastrointestinal research. For years, the main interest and research was aimed to the enteric neurons and their functional properties in normal conditions, less attention has been paid to the germ-free animals. Germ-free (GF) piglets have clear microbiological background and are reared in sterile environment. GF piglets are regarded as clinically relevant models for studying of human diseases, as these piglets' manifest similar clinical symptoms to humans. In this study we briefly summarised the main characteristics in immunohistochemical distribution of ENS elements in the wall of jejunum and colon of germ-free piglets.

Clinical Nutrition Markers as Indicators of Colorectal Cancer (CRC) Disease Stage in a Public Hospital in New York City

ObjectivesThe interrelationships between clinical nutrition markers and colorectal cancer (CRC), including the stage at disease onset, are not well defined. We evaluate nutritional indicators as a function of CRC disease stage. We seek to estimate the nutrition markers’ relative importance in the identification of advanced disease and poor prognosis.MethodsWe utilized a retrospective cross-sectional database of CRC patients treated at two inner-city public hospitals from January 1, 2016, to June 1, 2021. The database includes demographic and routine clinical variables collected at the time of CRC diagnosis. Nutrition markers of interest included hemoglobin, albumin, and body mass index (BMI). Demographic and clinical variables of interest encompassed age, sex, race, smoking status, indication for colonoscopy (screening versus diagnostic), and continuity of care. Continuity of care was defined as having a primary care evaluation at least once within 5 years of a CRC diagnosis. Data were evaluated using one-way multivariate analysis of variance (MANOVA).ResultsAnalysis was conducted on 259 patients (Gender: M = 119, F = 138; Race: White = 15.1%, African American/Black = 43.2%, Hispanic = 30.9%, Asian = 6.9%, Other = 4%). Data were divided into five cancer stages based upon CRC disease progression, with stages 0–2 representing cancer limited to the colonic wall, and stages 3–4 where the tumor extends beyond the colonic wall. MANOVA rejected hypothesis of equality of means between different stages (P = 0.0097). Individual one-way ANOVA for testing equality of means for different clinical stages with each outcome variable (adjusted for multiplicity of testing) produced significant results for albumin (P = 0.0099) and hemoglobin (P = 0.01), but not BMI (P = 0.06). When the mean of patients in stages 0–2 was compared to those in stages 3–4 (advanced versus non-advanced disease), significant differences were observed for albumin (P = 0.024) and hemoglobin (P = 0.017).ConclusionsOur results suggest that nutritional alterations are not observed in CRC patients until the tumor has advanced beyond the colonic wall (stages 3–4); our data were derived from a largely minority population. Future investigations should seek to replicate this work with more precise definitions of malnutrition, including more specific inflammatory markers besides albumin.Funding SourcesNone.

Ischemic colitis related to antipsychotics : A rare and serious entity to know

IntroductionIschemic colitis is a rare condition. It represents 3 to 10% of lower digestive hemorrhages. It preferentially affects the subject over the age of 50 with predisposing factors. Rare cases have been reported in young subjects with the use of cocaine, combined hormones or antipsychotics.ObjectivesThis work aimed to study the potential side effects of antipsychoticsMethodsWe report a case of ischemic colitis associated with antipsychotics.ResultsA 27-year-old patient, followed for 2 years for schizophrenia treated with antipsychotics (chlorpromazine and haloperidol) and an antiparkinsonian (Biperiden), consulted in the emergency room for rectorragies progressing for 3 days. The examination revealed the installation of diffuse abdominal pain associated with early postprandial vomiting which preceded the 7-day rectal bleeding. The physical examination revealed ascites without edema of the lower extremities. The stools were normal-colored on digital rectal examination. The biological workup revealed anemia and a biological inflammatory syndrome. The abdomino-pelvic scanner showed thickening of the entire colonic wall with signs of recent bleeding. The rectosigmoidoscopy showed an ecchymotic aspect of the sigmoid with less pronounced involvement of the rectum. Pathologic examination of the colonic biopsies concluded with ischemic colitis, showing hemorrhagic suffisions with numerous fibrinous thrombi of the vessels. The course was marked by the onset of multi-organ failure with acute renal failure, a picture of disseminated intravascular coagulation (DIC) and alveolar hemorrhage. Despite the resuscitation, the patient died 2 days after admission.ConclusionsIschemic colitis is a rare side effect of antipsychotics. Although rare, this entity should be evoked and diagnosed in time.DisclosureNo significant relationships.