Medicine and Health Sciences Commons^™

Arterial Vascularization Of The Colon; A Guide To Surgical Resection, Iulian Slavu, Florin Filipoiu, Raluca Tulin, Ileana Dima, Alexandru Dogaru, Bogdan Socea, Luminita Tomescu, Theodor Badea, Anca Oprescu Macovei, Adrian Tulin

Journal of Mind and Medical Sciences

Background. Colorectal cancer is a commonly diagnosed neoplasia in men and women worldwide. This study aims to rigorously map the arterial distribution of the colon in order to assess the implications of vascular patterns in surgical resection. Methods. Cadaveric dissections were performed to explore the arterial distribution (including collateral blood flow) of the colon. The study used standard dissection tools and photographic documentation to detail the vascular architecture supporting the large intestine. Results. The dissection revealed important arterial branches and anastomoses in the area of the superior and inferior mesenteric arteries, which are able to ensure continuous local blood supply …

Sars-Cov-2 Omicron Ba.1 Variant Infection Of Human Colon Epithelial Cells, Avan Antia, David M Alvarado, Qiru Zeng, Luis A Casorla-Perez, Deanna L Davis, Naomi M Sonnek, Matthew A Ciorba, Siyuan Ding

2020-Current year OA Pubs

The Omicron variant of SARS-CoV-2, characterized by multiple subvariants including BA.1, XBB.1.5, EG.5, and JN.1, became the predominant strain in early 2022. Studies indicate that Omicron replicates less efficiently in lung tissue compared to the ancestral strain. However, the infectivity of Omicron in the gastrointestinal tract is not fully defined, despite the fact that 70% of COVID-19 patients experience digestive disease symptoms. Here, using primary human colonoids, we found that, regardless of individual variability, Omicron infects colon cells similarly or less effectively than the ancestral strain or the Delta variant. The variant induced limited type III interferon expression and showed …

Ogilvie's Syndrome: Acute Colonic Pseudoobstruction. A Review For Residents., Tyler Bayliss, Caleb Clark, Errington C. Thompson

Marshall Journal of Medicine

Ogilvie's syndrome (acute colonic pseudoobstruction) was first described in 1948. Acute colonic pseudoobstruction can occur in a variety of clinical settings, including postsurgical, obstetrics, pelvic surgery, critical care and sepsis. Clinicians need to recognize the syndrome early. Colonic distention without evidence of obstruction can be seen on plain films of the abdomen or CT scan. Successful therapies, including bowel rest, neostigmine and colonoscopic decompression, have been used. Avoiding respiratory compromise from abdominal distention and colonic perforation of the primary goals of treatment. Surgical intervention should be reserved for patients who are refractory to medical treatment or develops signs and symptoms …

Is Heart Health As Simple As Gut Microbiota?, Elizabeth Moxley

Faculty Peer-Reviewed Publications

The current mortality statistics for cardiovascular disease (CVD) in the United States (US) and on a global scale are staggering. CVD is responsible for approximately 31% of global deaths,¹ and approximately 25% of adults in the United States (US) have CVD.² The American Heart Association has identified eight primary measures for improving and maintaining cardiovascular health: Life’s Essential 8.³ However, a lesser recognized measure that has a profound effect on cardiovascular health has recently emerged,^4-5 that of the gut microbiome. The link between cardiovascular health and diet is not merely due to essential nutrients found in …

Diagnosis And Management Of Colon Cancer Patients Presenting In Advanced Stages Of Complications, Vlad Denis Constantin, Adrian Silaghi, Dragos Epistatu, Anca Silvia Dumitriu, Stana Paunica, Daniela Gabriela Bălan, Bogdan Socea

Journal of Mind and Medical Sciences

Colorectal cancer is an important health problem with a significant impact on the individual and society. Malignancy (including colorectal cancer) is usually slightly symptomatic in its initial stages. This causes cancer to be discovered in some patients accidentally (either through screening tests in predisposed individuals or during routine investigations for other diseases), while in other patients the colorectal cancer is discovered in late stages, when the symptoms are much more intense due to complications. Unfortunately, such advanced cases of the disease have high rates of morbidity and mortality even with treatment. Current treatment methods are usually complex, interdisciplinary, causing significant …

A Case Presentation Of Gout Tophus In The Ascending Colon, Alexandria Dennison, Corbin Stephens, Ahmed Saeed, Jay Helsel

Continental, MidAmerica, & Mountain Divisions GME Research Day 2023

No abstract provided.

Preventive Medicine Screening Measures, Isaac Adams

Family Medicine Clerkship Student Projects

In order to make progress towards long-term health on a community level, it is imperative to address health needs on a population basis and using a preventive strategy to prevent the development of more serious illness. With this in mind, this project aimed to create a poster providing easy to understand information to patients with regard to health screenings. Specifically, it addressed screenings for diabetes and pre diabetes, colon cancer, lung cancer, and breast cancer.

Metastatic Renal Cell Carcinoma To Pancreas And Gastrointestinal Tract: A Clinicopathological Study Of 3 Cases And Review Of Literature, Jamshid Abdul Ghafar, Nasir Ud Din, Ramin Saadaat, Zubair Ahmad

Department of Pathology and Laboratory Medicine

Background: Renal Cell Carcinoma (RCC) metastasizes in approximately 20-30% cases. The most common sites for metastases are the lungs, bones, liver, and brain. Metastases of RCC in the gastrointestinal tract (GIT) are very rare. Metastatic RCC has a poor prognosis. We herein present a case series of three patients with metastatic disease in the colon, duodenum, and pancreas following complete resection of RCC.
Methods: Hematoxylin and Eosin and immunohistochemical slides of 3 cases of RCC metastatic to GIT were reviewed. These cases were diagnosed between 2002 and 2019 at French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan, and …

Novel Mechanisms Of Neuronal And Hormonal Regulation Of Large Intestinal Electrolyte Transport, Andrew John Nickerson

Graduate Theses, Dissertations, and Problem Reports

The mammalian colon plays a vital role in maintaining overall electrolyte and fluid homeostasis in the body, and it possesses the ability to either secrete or absorb water depending upon the needs of the organism. Secretion or absorption of electrolyte ions, such as Na⁺, Cl^- and K⁺, drives the movement of water across the colonic epithelium – the inner gut lining where all transport takes place. Aberrant absorptive and/or secretory activity within the colonic epithelium is central to the pathogenesis of many gastrointestinal diseases, such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), constipation …

Global Hypermethylation Of Intestinal Epithelial Cells Is A Hallmark Feature Of Neonatal Surgical Necrotizing Enterocolitis, Misty Good, Tianjiao Chu, Patricia Shaw, Lora Mcclain, Austin Chamberlain, Carlos Castro, Jamie M Rimer, Belgacem Mihi, Qingqing Gong, Lila S Nolan, Krista Cooksey, Laura Linneman, Pranjal Agrawal, David N Finegold, David Peters

2020-Current year OA Pubs

BACKGROUND: Necrotizing enterocolitis (NEC) remains one of the overall leading causes of death in premature infants, and the pathogenesis is unpredictable and not well characterized. The aim of our study was to determine the molecular phenotype of NEC via transcriptomic and epithelial cell-specific epigenomic analysis, with a specific focus on DNA methylation.

METHODS: Using laser capture microdissection, epithelial cell-specific methylation signatures were characterized by whole-genome bisulfite sequencing of ileal and colonic samples at the time of surgery for NEC and after NEC had healed at reanastomosis (n = 40). RNA sequencing was also performed to determine the transcriptomic profile of …

Correction Of Diaphragmatic Hernia Using The Transverse Colon In A Dog, Dongwook Kim, Gonhyung Kim

The Thai Journal of Veterinary Medicine

A 3-year-old female Golden Retriever was referred with weakness, tachypnea and dyspnea. An incomplete diaphragmatic silhouette, gas-filled small intestine and pleural effusion in the thoracic cavitywere revealed in radiographs, implying a diaphragmatic hernia. After laparotomy, the abdominalstructureswere gently retrieved into the abdomen and a defect of 2×7 cm2was found. The transverse colonwas used as an autologous tissue flap for the repair of the defect. There were no complications identified for 2 years after surgery. Thus, patching with the transverse colon can be considered as an alternative for treating a defect in patients with a diaphragmatic hernia.

Immune And Microrna Responses To Infection And Indole-3-Carbinol During Colitis, Rasha Raheem Alkarkoushi, Yvonne Hui, Abbas S. Tavakoli, Udai Singh, Prakash Nagarkatti, Mitzi Nagarkatti, Ioulia Chatzistamou, Marpe Bam, Traci L. Testerman

Faculty Publications

BACKGROUND: Indole-3-carbinol (I3C) and other aryl hydrocarbon receptor agonists are known to modulate the immune system and ameliorate various inflammatory and autoimmune diseases in animal models, including colitis induced by dextran sulfate sodium (DSS). MicroRNAs (miRNAs) are also gaining traction as potential therapeutic agents or diagnostic elements. Enterohepatic (EHH) species are associated with an increased risk of inflammatory bowel disease, but little is known about how these species affect the immune system or response to treatment. AIM: To determine whether infection with an EHH species alters the response to I3C and how the immune and miRNA responses of an EHH …

Immune And Microrna Responses To Infection And Indole-3-Carbinol During Colitis, Rasha Raheem Alkarkoushi, Yvonne Hui, Abbas Tavakoli Drph, Udai Singh, Prakash Nagarkatti, Mitzi Nagarkatti, Ioulia Chatzistamou, Marpe Bam, Traci L. Testerman

Faculty Publications

BACKGROUND:

Indole-3-carbinol (I3C) and other aryl hydrocarbon receptor agonists are known to modulate the immune system and ameliorate various inflammatory and autoimmune diseases in animal models, including colitis induced by dextran sulfate sodium (DSS). MicroRNAs (miRNAs) are also gaining traction as potential therapeutic agents or diagnostic elements. Enterohepatic (EHH) species are associated with an increased risk of inflammatory bowel disease, but little is known about how these species affect the immune system or response to treatment. AIM: To determine whether infection with an EHH species alters the response to I3C and how the immune and miRNA responses of an EHH …

The Significance Of So-Called Equivocal Immunohistochemical Staining For Cytomegalovirus In Colorectal Biopsies, Manju Ambelil, David M Saulino, Atilla Ertan, Andrew W Dupont, Mamoun Younes

Journal Articles

CONTEXT.—: Recent studies examining immunohistochemical staining of colorectal biopsies for cytomegalovirus (CMV) reported that some cases showed only occasional small positive nuclei that were called equivocal for CMV.

OBJECTIVES.—: To determine the extent and clinical significance of equivocal CMV staining in colorectal biopsies.

DESIGN.—: Two-hundred twenty-one consecutive cases of colon and rectal biopsies that were stained for CMV by immunohistochemistry were retrieved from our files and reviewed. Staining results were recorded as negative, unequivocal, or equivocal. Results were correlated with clinicopathologic data, results of polymerase chain reaction studies for CMV, and treatment history.

RESULTS.—: Fifty-two cases (24% of all tested, …

Early Onset Necrotizing Enterocolitis In A Full-Term Neonate, Aditya P. Singh, Arun K. Gupta, Rajlaxmi Pardeshi, Vinay Mathur

Menoufia Medical Journal

Objective We are presenting a case of necrotizing enterocolitis (NEC) in a full term neonate. Backround NEC usually affect the preterm baby while in our case baby was full term neonate. Method A 2 days old male neonate who had diagnosis of NEC, was managed by us. Result Baby had the involvement of large bowel with sever faecal peritonitis and baby was expired due to septicemia. Conclusion NEC may occurs in full term baby with large bowel involvement. Resection of the gangrenous colon and rectoascending anastomosis with protective ileostomy was done. Baby was expired after 3 days due to septicemiasepticemia.

Toothpick Perforation Of Colon Mimicking Acute Appendicitis, Jacob Wilson D.O., Adeshola Fakulujo M.D.

Rowan-Virtua Research Day

This study presents a case report of a rare complication of foreign body ingestion and offers a literature review of management options. Pre-operative imaging and clinical history was reviewed. During diagnostic laparoscopy the diagnosis of ascending colon perforation with a foreign body was made and managed with a Laparoscopic Right Hemicolectomy. Literature was reviewed for case of toothpick ingestion requiring intervention, foreign body ingestion causing perforation, and management of foreign body perforations.

How Have Advances In Ct Dosimetry Software Impacted Estimates Of Ct Radiation Dose And Cancer Incidence? A Comparison Of Ct Dosimetry Software: Implications For Past And Future Research, Susannah Maxwell, Richard Fox, Donald Mcrobbie, Max Bulsara, Jenny Doust, Peter O'Leary, John Slavotinek, John Stubbs, Rachael Moorin

Health Sciences Papers and Journal Articles

Objective: Organ radiation dose from a CT scan, calculated by CT dosimetry software, can be combined with cancer risk data to estimate cancer incidence resulting from CT exposure. We aim to determine to what extent the use of improved anatomical representation of the adult human body “phantom” in CT dosimetry software impacts estimates of radiation dose and cancer incidence, to inform comparison of past and future research.

Methods: We collected 20 adult cases for each of three CT protocols (abdomen/pelvis, chest and head) from each of five public hospitals (random sample) (January-April inclusive 2010) and three private clinics (self-report). Organ …

A Study Of Gastrointestinal Pathophysiology, Emily Minor

Graduate Theses, Dissertations, and Problem Reports

Though the duodenum is the primary site of iron absorption, the colon also contains iron transporters and participates in iron absorption. The purpose of this study was to characterize colonic iron absorption in control patients and those with ulcerative colitis (UC), a disease that frequently results in iron deficiency. Using RT-qPCR and western blot analysis, we found that colonic expression of the apical iron importer, divalent metal transporter 1 (DMT1), is equal to duodenal expression. However, colonic expression of ferroportin 1 (FPN1), an iron exporter, is only about one-quarter that of the duodenum. Patients with active ulcerative colitis were found …

Development And Ex Vivo Characterization Of Enteric Coated Chitosan Beads For Crohn’S Disease Management, Craig Mendonca

University Scholar Projects

Drug delivery is the process of transporting a drug to its site of action. It includes controlled delivery, where the drug is released at the tissue in a regulated manner. Additionally, it includes targeted delivery, where the drug is aimed at a specific tissue or region to avoid unwanted side effects (that would occur if the drug were distributed throughout the body). A cellulose acetate phthalate coated chitosan bead was developed as a formulation for controlled and targeted release of dexamethasone to the ilium and colon. This formulation was determined to be effective in delaying dexamethasone release until the formulation …

Enteric Infection Coupled With Chronic Notch Pathway Inhibition Alters Colonic Mucus Composition Leading To Dysbiosis, Barrier Disruption And Colitis., Ishfaq Ahmed, Badal C. Roy, Rita-Marie T. Raach, Sarah M. Owens, Lijun Xia, Shrikant Anant, Venkatesh Sampath, Shahid Umar

Manuscripts, Articles, Book Chapters and Other Papers

Intestinal mucus layer disruption and gut microflora modification in conjunction with tight junction (TJ) changes can increase colonic permeability that allows bacterial dissemination and intestinal and systemic disease. We showed previously that Citrobacter rodentium (CR)-induced colonic crypt hyperplasia and/or colitis is regulated by a functional cross-talk between the Notch and Wnt/β-catenin pathways. In the current study, mucus analysis in the colons of CR-infected (108 CFUs) and Notch blocker Dibenzazepine (DBZ, i.p.; 10μmol/Kg b.w.)-treated mice revealed significant alterations in the composition of trace O-glycans and complex type and hybrid N-glycans, compared to CR-infected mice alone that preceded/accompanied alterations in 16S rDNA …

Cd4 T Cell Interaction With Intestinal Microbes Under Homeostasis And Inflammation, Jiani Chai

Arts & Sciences Electronic Theses and Dissertations

Specific gut commensal bacteria improve host health by eliciting mutualistic regulatory T (Treg) cells responses. However, the bacteria that induce effector T (Teff) cells during inflammation are unclear. Here, we addressed this by analyzing bacterial-reactive T cell receptor (TCR) transgenic cells and TCR repertoires in a murine colitis model. Unexpectedly, we found that mucosal-associated Helicobacter species triggered both Treg responses during homeostasis and Teff responses during colitis, as suggested by an increased overlap between the Teff/Treg TCR repertoires with colitis. In fact, 4/6 Treg TCRs tested recognized mucosal-associated Helicobacter species in vitro and in vivo. By contrast, the marked expansion …

Negative Regulators Of Colonic Peripheral Regulatory T Cell Development, Teresa Lei Ai

Arts & Sciences Electronic Theses and Dissertations

Peripheral Treg cells (pTreg cells) maintain immune homeostasis at mucosal interfaces, where they can develop upon activation of naïve CD4+ T cells by bacteria antigen. However, the cellular and molecular requirements that govern their differentiation in inflamed and homeostatic contexts require further elucidation. To circumvent uncertainties in existing methods of distinguishing pTreg cells from thymic Treg cells (tTreg cells), we analyzed monoclonal cell populations of CT2 and CT6 transgenic (Tg) cells that develop into pTreg cells in response to different species of endogenously presented Helicobacter antigen. In our comprehensive assessment of multiple intestinal inflammatory models, including infections and physical injury, …

A Program Evaluation Of A Colon Cancer Screening Program Using At-Home Fecal Immunochemical Tests With Certified Patient Navigators, Candace E. H. Brunk

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Colorectal cancer is the second leading cause of cancer-related death in this country, but 33% of these deaths could be prevented by screening. While colonoscopy is an effective screening tool, it is expensive, invasive, and prone to encounter considerable patient resistance. An alternative is to first screen those at-risk using at-home fecal immunochemical test (FIT) kits. This study determined factors associated with the return of these kits distributed by Kentucky CancerLink, a non-profit organization, and its affiliates to participants in a colon cancer prevention program.

Objectives: To identify factors associated with: completing a FIT kit, completing the kit with minimal …

Branched Short Chain Fatty Acid Isovaleric Acid Causes Smooth Muscle Relaxation Via Camp/Pka Pathway, Inhibits Gastrointestinal Motility, And Disrupts Peristaltic Movement, Bryan Adam Blakeney

Theses and Dissertations

Isovaleric Acid (IVA) is a 5-carbon branched chain fatty acid present in fermented foods and produced by the fermentation of leucine by colonic bacteria. IVA activates G-protein coupled receptors such as FFAR2, FFAR3, and OR51E1 known to be expressed on enteric neurons and enteroendocrine cells. We previously reported that the shorter, straight chain fatty acids acetate, propionate and butyrate, differentially affect colonic propulsion; however, the effect of branched chain fatty acids on gastrointestinal motility is unknown. We hypothesize that IVA relaxes smooth muscle in a cAMP/PKA dependent manner by direct action on smooth muscle cells. IVA will also decrease peristalsis …

Tgfβ/Smad3 Regulates Proliferation And Apoptosis Through Irs-1 Inhibition In Colon Cancer Cells., Katie L. Bailey, Ekta Agarwal, Sanjib Chowdhury, Jiangtao Luo, Michael G. Brattain, Jennifer D. Black, J. Wang

Journal Articles: Eppley Institute

In this study, we have uncovered a novel crosstalk between TGFβ and IGF-1R signaling pathways. We show for the first time that expression and activation of IRS-1, an IGF-1R adaptor protein, is decreased by TGFβ/Smad3 signaling. Loss or attenuation of TGFβ activation leads to elevated expression and phosphorylation of IRS-1 in colon cancer cells, resulting in enhanced cell proliferation, decreased apoptosis and increased tumor growth in vitro and in vivo. Downregulation of IRS-1 expression reversed Smad3 knockdown-mediated oncogenic phenotypes, indicating that TGFβ/Smad3 signaling inhibits cell proliferation and increases apoptosis at least partially through the inhibition of IRS-1 expression and activation. …

Mice With Infectious Colitis Exhibit Linear Growth Failure And Subsequent Catch-Up Growth Related To Systemic Inflammation And Igf-1, Mark D. Deboer, Vidhya Vijayakumar, Meiqing Gong, John L. Fowlkes, Rachel M. Smith, Fernando Ruiz-Perez, James P. Nataro

Barnstable Brown Diabetes Center Faculty Publications

In developing communities, intestinal infection is associated with poor weight gain and linear-growth failure. Prior translational animal models have focused on weight gain investigations into key contributors to linear growth failure have been lacking. We hypothesized that murine intestinal infection with Citrobacter-rodentium would induce linear-growth failure associated with systemic inflammation and suppressed serum levels of insulin-like growth factor-1 (IGF-1). We evaluated 4 groups of mice infected or sham-infected on day-of-life 28: uninfected-controls, wild-type C.-rodentium-infected, partially-attenuated C. rodentium-infected (with deletion of 3 serine protease genes involved in colonization), and pair-fed (given the amount of daily food consumed by the …

Approaching Refusal Of Colorectal Cancer Screening, Greg Whitcher

Family Medicine Clerkship Student Projects

This project aimed to investigate the reasons why patients refuse colonoscopy, the screening rates for colonoscopy, alternatives to colonoscopy and methods primary care physicians can use to encourage patients to have colorectal cancer screening.

Aberrant Dna Methylation: Implications In Racial Health Disparity, Xuefeng Wang, Ping Ji, Yuanhao Zhang, Joseph F. Lacomb, Xinyu Tian, Ellen Li, Jennie L. Williams

Department of Biomedical Engineering Faculty Publications

Background Incidence and mortality rates of colorectal carcinoma (CRC) are higher in African Americans (AAs) than in Caucasian Americans (CAs). Deficient micronutrient intake due to dietary restrictions in racial/ethnic populations can alter genetic and molecular profiles leading to dysregulated methylation patterns and the inheritance of somatic to germline mutations. Materials and Methods Total DNA and RNA samples of paired tumor and adjacent normal colon tissues were prepared from AA and CA CRC specimens. Reduced Representation Bisulfite Sequencing (RRBS) and RNA sequencing were employed to evaluate total genome methylation of 5’-regulatory regions and dysregulation of gene expression, respectively. Robust analysis was …

Space Environmental Factor Impacts Upon Murine Colon Microbiota And Mucosal Homeostasis, Lauren E. Ritchie, Stella S. Taddeo, Brad R. Weeks, Florence Lima, Susan A. Bloomfield, M. Andrea Azcarate-Peril, Sara R. Zwart, Scott M. Smith, Nancy D. Turner

Internal Medicine Faculty Publications

Astronaut intestinal health may be impacted by microgravity, radiation, and diet. The aim of this study was to characterize how high and low linear energy transfer (LET) radiation, microgravity, and elevated dietary iron affect colon microbiota (determined by 16S rDNA pyrosequencing) and colon function. Three independent experiments were conducted to achieve these goals: 1) fractionated low LET γ radiation (¹³⁷Cs, 3 Gy, RAD), high Fe diet (IRON) (650 mg/kg diet), and a combination of low LET γ radiation and high Fe diet (IRON+RAD) in male Sprague-Dawley rats; 2) high LET ³⁸Si particle exposure (0.050 Gy), 1/6 G …

The Metabolomic Effects Of Metformin On Colon Cancer, Jennifer W. Harris

Theses and Dissertations--Clinical and Translational Science

Metformin is an oral biguanide that is prescribed to over 120 million people worldwide for the treatment of conditions including type II diabetes mellitus, polycystic ovarian syndrome, and gestational diabetes. This hypoglycemic agent is rapidly emerging as a potential cost-effective anti-oncogenic agent. Over the past decade multiple epidemiologic studies have consistently associated metformin with decreased cancer incidence and cancer-related mortality. More recently numerous preclinical and clinical studies have demonstrated anti-cancer effects of metformin, leading to the proposal of numerous clinical trials to better understand this drug and its mechanism of action.

Previously experts believed metformin primarily targeted AMP-activated protein kinase …