Animals ; Cecum/microbiology* ; Hyperoxia/blood* ; Microbiota ; Rats

A 51-year-old gravida 5 para 5 (5005) presented with an increasing abdominal girth and a palpable abdominal mass. She was initially diagnosed with ovarian new growth and underwent exploratory laparotomy. Intraoperatively, the uterus, Fallopian tubes, and ovaries were grossly normal and a large mass was seen attached to the cecum where the appendix should be referral to surgery service was done. Right hemicolectomy and ileostomy were performed. The histopathology report was “suggestive of a Müllerian adenosarcoma (MAS) involving the appendix and cecum.” Microscopic examination showed evidence of endometriosis with no evidence of sarcomatous overgrowth, features that are favorable prognostic factors associated with higher disease-free survival. Postoperatively, the plan of management was hormonal therapy. Extragenital MAS is rare. This case is the fourth case to be reported in the literature to arise from the colon. Although there is still no standard of treatment, accurate diagnosis is imperative for appropriate management.
Appendix ; Cecum ; Colon ; Endometriosis

OBJECTIVE: To investigate the hypothesis that hydrogen could ameliorate cecal ligation and puncture (CLP)-induced lung injury of rats by inhibiting cystathionine-gamma-lyase/hydrogen sulfide (CSE/HS) system. METHODS: A total number of 24 healthy male SD rats weighting 250～300 g were randomly divided into four groups (n=6 in each group): sham operation group(sham group), hydrogen-rich saline control group(H group), CLP group and hydrogen-rich saline treatment group(CLP+H group). The rats were treated with hydrogen-rich saline or saline 10 min before CLP or sham operation. At 8 h of sham or CLP operation, lung samples were obtained to detect the changes of the CSE/HS system using biochemical and RT-PCR methods. In order to further confirm the role of HS during hydrogen improve the lung injury of CLP rats, we also observed the effect of hydrogen-rich saline on the lung injury induced by HS donor-sodium sodium hydrosulfide (NaHS). Thirty-two healthy male SD rats (250~300 g) were randomly divided into four groups (n=8 in each group): control group, HS group, HS+H group and H group. Saline(10 mg/kg) or NaHS(HS donor, 56 μmol/kg) was injected intraperitoneally (10 mg/kg) respectively into rats in the control rats or HS group. For rats in the HS+H and H group, hydrogen-rich saline (10 mg/kg) was injected 10 min before saline or NaHS administration. Eight hours after the LPS saline or NaHS administration, lung coefficient, MDA content, and MPO activity were detected. The contents of TNF-α, IL-6 and IL-10 in lung tissue were measured, and the morphological changes of lung tissue were also observed. RESULTS: CSE/HS system up-regulating were observed in animals exposed to CLP. Hydrogen-rich saline treatment significantly inhibited CSE/HS system as indicated by significantly reduced HS production in lung, along with a decreased CSE activity and CSE mRNA expression (all P＜0.05). Importantly, the results showed that lung injury and lung tissue inflammation were observed in animals exposed to NaHS. Hydrogen-rich saline treatment significantly attenuated lung injury as indicated by significantly improved histological changes in lung, significantly reduced index of quantitative assessment (IQA), MDA content and lung coefficient (all P＜0.05). MPO activity in lung tissue was significantly reduced along with decreased productions of TNF-α and IL-6, and an increased production of IL-10 in the presence of hydrogen (all P＜0.05), demonstrating antioxidant and anti-inflammatory effect of hydrogen in NaHS-induced ALI. CONCLUSION These results indicate that hydrogen-rich saline peritoneal injection improves the lung injury induced by CLP operation. The therapeutic effects of hydrogen-rich saline may be related to suppressing the production of HS.
Animals ; Cecum ; surgery ; Cystathionine gamma-Lyase ; metabolism ; Cytokines ; metabolism ; Hydrogen ; pharmacology ; Hydrogen Sulfide ; metabolism ; Ligation ; Lung Injury ; therapy ; Male ; Punctures ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Saline Solution ; pharmacology

Inulin has been used as a prebiotic to alleviate glucose and lipid metabolism disorders in mice and humans by modulating the gut microbiota. However, the mechanism underlying the alleviation of metabolic disorders by inulin through interactions between the gut microbiota and host cells is unclear. We use ob/ob mice as a model to study the effect of inulin on the cecal microbiota by 16S rRNA gene amplicon sequencing and its interaction with host cells by transcriptomics. The inulin-supplemented diet improved glucose and lipid metabolism disorder parameters in ob/ob mice, alleviating fat accumulation and glucose intolerance. The α diversity of gut microbial community of ob/ob mice was reduced after inulin treatment, while the β diversity tended to return to the level of wild type mice. Interestingly, Prevotellaceae UCG 001 (family Prevotellaceae) was obviously enriched after inulin treatment. A comparative analysis of the gene expression profile showed that the cecal transcriptome was changed in leptin gene deficiency mice, whereas the inulin-supplemented diet partially reversed the changes in leptin gene-related signaling pathways, especially AMPK signaling pathway, where the levels of gene expression became comparable to those in wild type mice. Further analysis indicated that Prevotellaceae UCG 001 was positively correlated with the AMPK signaling pathway, which was negatively correlated with markers of glycolipid metabolism disorders. Our results suggest that the inulin-supplemented diet alleviates glucose and lipid metabolism disorders by partially restoring leptin related pathways mediated by gut microbiota.
AMP-Activated Protein Kinases ; metabolism ; Animals ; Cecum ; enzymology ; metabolism ; microbiology ; Gastrointestinal Microbiome ; drug effects ; Inulin ; therapeutic use ; Leptin ; genetics ; Male ; Metabolic Diseases ; drug therapy ; enzymology ; metabolism ; microbiology ; Mice ; Mice, Obese ; Prebiotics ; Signal Transduction ; drug effects ; Transcriptome

BACKGROUND: High-fat diet is known to be implicated in the pathogenesis of various metabolic disorders related to an inflammatory response. The aim of this study was to investigate the influence of high-fat diet for intestinal acetic acid and butyric acid concentrations which are related to inflammation-associated colon cancer risk. METHODS: Both male and female rats of 6, 31, 74 and 104-week of age were fed chow diet or high-fat diet for 8 weeks. Body weight and food intake were measured weekly during the feeding period. Intestinal acetic acid and butyric acid levels were measured by high-performance liquid chromatography from luminal contents of ileum and cecum. RESULTS: Male rats showed greater weight change than female rats in every age. Calorie-adjusted food intake was also higher in male rats compared to female rats. Male rats showed similar intake of food in every age while 31-week old female rats showed increased intake, which was decreased at 74-week and 104-week of age. The ileal acetic acid concentration was increased in male rats fed high-fat diet, while female rats fed high-fat diet showed no significant change in the ileal acetic acid level. On the other hand, butyric acid almost disappeared in high-fat diet fed rats regardless of sex. CONCLUSIONS: High-fat diet increases the intestinal acetic acid concentration while reducing the butyric acid concentration which may account for increased risk of inflammation-associated colon cancer.
Acetic Acid ; Animals ; Body Weight ; Butyric Acid ; Cecum ; Chromatography, Liquid ; Colonic Neoplasms ; Diet ; Diet, High-Fat ; Eating ; Female ; Hand ; Humans ; Ileum ; Male ; Phenobarbital ; Rats

A 49-year-old man visited the emergency room of Korea University Ansan Hospital with hematochezia starting the day before the visit. Recently, he was on anti-platelet medication due to hypertension. The patient had no definite symptoms other than hematochezia. Digital rectal exam was positive and laboratory tests showed severe anemia. Sigmoidoscopy was initiated and almost no fecal material was observed in the intestinal tract, allowing insertion into the cecum. Active bleeding from the appendiceal opening was noted. On abdominal CT, contrast enhancement was observed at the tip of the appendix. Under suspicion of acute appendicitis, we consulted with a surgeon. The patient underwent appendectomy with partial cecal resection. Pathologic examination revealed a diagnosis of appendix bleeding due to acute suppurative appendicitis. The patient had no further bleeding after surgery and was discharged in a stable state. Careful observation by the endoscopist is necessary for accurate diagnosis of lower gastrointestinal hemorrhage. Appendiceal hemorrhage is very rarely reported, but it has various pathophysiologies. CT scan is useful when appendiceal hemorrhage is confirmed by endoscopic findings. Surgical treatment was needed in almost all cases reported worldwide. If bleeding from the appendix is confirmed, surgical treatment should be considered for both therapeutic and diagnostic purposes.
Anemia ; Appendectomy ; Appendicitis* ; Appendix ; Cecum ; Colonoscopy ; Diagnosis ; Emergency Service, Hospital ; Gastrointestinal Hemorrhage* ; Gyeonggi-do ; Hemorrhage ; Humans ; Hypertension ; Korea ; Middle Aged ; Sigmoidoscopy ; Tomography, X-Ray Computed

Endoscopic submucosal dissection (ESD) is widely used for the treatment of colorectal neoplasia in patients who are candidates for endoscopic resection. In particular, pyogenic liver abscess (PLA), although rare, can occur. To our knowledge, there are no reports of PLA cases after ESD. Therefore, we report a rare case of PLA caused by ESD. A 76-year-old man was referred from a local clinic and admitted to our hospital for colonic ESD for a large polypoid mass. During colonoscopy, a 5-cm mass was seen in the cecum. ESD was performed. Four days after the procedure, he complained of myalgia and abdominal discomfort. Computed tomography revealed a 5.4-cm PLA in the medial segments of the liver. He was treated with antibiotics, and a percutaneous drainage catheter was inserted. Here, we report a very rare complication (PLA) after ESD. In conclusion, comprehensive awareness of the development of PLA is needed in ESD cases.
Aged ; Anti-Bacterial Agents ; Catheters ; Cecum ; Colon ; Colonic Neoplasms ; Colonoscopy ; Drainage ; Endoscopy ; Humans ; Liver ; Liver Abscess ; Liver Abscess, Pyogenic ; Myalgia

Although the clinical definitions of sepsis and recommended treatments are regularly updated, a systematic review has not been done for preclinical models. To address this deficit, a Wiggers-Bernard Conference on preclinical sepsis modeling reviewed the 260 most highly cited papers between 2003 and 2012 using sepsis models to create a series of recommendations. This Part II report provides recommendations for the types of infections and documentation of organ injury in preclinical sepsis models. Concerning the types of infections, the review showed that the cecal ligation and puncture model was used for 44% of the studies while 40% injected endotoxin. Recommendation #8 (numbered sequentially from Part I): endotoxin injection should not be considered as a model of sepsis; live bacteria or fungal strains derived from clinical isolates are more appropriate. Recommendation #9: microorganisms should replicate those typically found in human sepsis. Sepsis-3 states that sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection, but the review of the papers showed limited attempts to document organ dysfunction. Recommendation #10: organ dysfunction definitions should be used in preclinical models. Recommendation #11: not all activities in an organ/system need to be abnormal to verify organ dysfunction. Recommendation #12: organ dysfunction should be measured in an objective manner using reproducible scoring systems. Recommendation #13: not all experiments must measure all parameters of organ dysfunction, but investigators should attempt to fully capture as much information as possible. These recommendations are proposed as "best practices" for animal models of sepsis.
Animals ; Cecum ; Disease Models, Animal ; Endotoxins ; Humans ; Models, Animal ; Multiple Organ Failure ; Sepsis

OBJECTIVE: To evaluate the cardiac function of cecal ligation and puncture (CLP) induced sepsis rats with high-resolution ultrasound. METHODS: According to the method of random number table, 48 adult male Sprague-Dawley (SD) rats were randomly divided into normal control group and sepsis 6, 12, 24, 30, 48 hours groups, with 8 rats in each group. The sepsis model was produced by CLP, and the rats in the normal control group were only anesthetized and resuscitated. The general situation after modeling in each group was observed, and the left ventricular function was assessed by high-resolution echocardiography at all the time points. The abdominal aorta blood of rats was collected, and the serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and MB isoenzyme of creatine kinase (CK-MB) were determined by enzyme-linked immunosorbent assay (ELISA). The myocardial tissue was harvested, and the pathological changes in myocardial tissue were observed by hematoxylin-eosin (HE) staining. RESULTS: The rats challenged to CLP displayed symptoms of sepsis, such as depression, ruffled fur, decreased diet and activity, and the symptoms became more obvious with the extension of time. High-resolution echocardiography could clearly show the structure of left ventricle in each group and obtain satisfactory M-mode echocardiography of left ventricle. The heart rate (HR) of rats in all sepsis groups was elevated with the increase in model time as measured by high-resolution ultrasound, and it was significantly higher than that in the normal control group at 12, 24, 30 hours (bpm: 359.66±23.33, 361.35±12.85, 392.67±11.33 vs. 306.24±29.79, all P < 0.05). Stroke volume (SV) and cardiac output (CO) in sepsis rats were decreased with the increase in model time, while left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were increased first and then decreased, and SV and LVEF in sepsis 48 hours group were significantly lower than those in the normal control group [SV (μL): 78.43±17.52 vs. 122.61±15.88, LVEF: 0.763±0.018 vs. 0.902±0.011, both P < 0.05]. Left ventricular weight (LVW) in all sepsis groups was increased to different degrees as compared with that in the normal control group, as well as the left ventricular anterior and posterior wall thickness increased in diastole and systole. Compared with the normal control group, the left ventricular posterior wall thickness was increased significantly at the end of diastolic and systolic period in the sepsis 12 hours group, and the left ventricular anterior wall thickness was also increased significantly at the end of diastolic period in the sepsis 48 hours group. The serum levels of TNF-α, IL-1β and CK-MB in sepsis rats were increased first and then decreased with the extension of model making time. The above parameters in the sepsis 48 hours group were still significantly higher than those in the normal control group [TNF-α (ng/L): 61.59±3.99 vs. 16.87±4.89, IL-1β (ng/L): 255.03±13.23 vs. 119.59±10.43, CK-MB (μg/L): 1.27±0.15 vs. 0.52±0.15, all P < 0.05]. HE staining showed that the myocardial striations of the rats in the normal control group were clear and complete, with normal morphology and orderly arrangement of cardiac cells. However in the sepsis groups, myocardial cells were swollen, ruptured and necrotic, and inflammatory cells were infiltrated, with myocardial fibers ruptured and necrosis dissolved, and the above pathological manifestations gradually increased with the extension of the model making time. CONCLUSIONS High-resolution ultrasound can evaluate the cardiac function of CLP induced sepsis rat model more comprehensive, and the consequence of evaluation index is consistent with the expression level of myocardial enzyme and histopathologic manifestations.
Animals ; Cecum ; Heart/physiopathology* ; Heart Function Tests ; Ligation ; Male ; Punctures ; Rats ; Rats, Sprague-Dawley ; Sepsis ; Tumor Necrosis Factor-alpha ; Ultrasonography

BACKGROUND/AIMS: Sessile serrated adenomas (SSAs) are known to be precursors of colorectal cancer (CRC). The proper interval of follow-up colonoscopy for SSAs is still being debated. We sought to determine the proper interval of colonoscopy surveillance in patients diagnosed with SSAs in South Korea. METHODS: We retrospectively reviewed the medical records of patients diagnosed with SSAs who received 1 or more follow-up colonoscopies. The information reviewed included patient baseline characteristics, SSA characteristics, and colonoscopy information. RESULTS: From January 2007 to December 2011, 152 SSAs and 8 synchronous adenocarcinomas were identified in 138 patients. The mean age of the patients was 62.2 years and 60.1% patients were men. SSAs were located in the right colon (i.e., from the cecum to the hepatic flexure) in 68.4% patients. At the first follow-up, 27 SSAs were identified in 138 patients (right colon, 66.7%). At the second follow-up, 6 SSAs were identified in 65 patients (right colon, 66.7%). At the 3rd and 4th follow-up, 21 and 11 patients underwent colonoscopy, respectively, and no SSAs were detected. The total mean follow-up duration was 33.9 months. The mean size of SSAs was 8.1±5.0 mm. SSAs were most commonly found in the right colon (126/185, 68.1%). During annual follow-up colonoscopy surveillance, no cancer was detected. CONCLUSIONS: Annual colonoscopy surveillance is not necessary for identifying new CRCs in all patients diagnosed with SSAs. In addition, the right colon should be examined more carefully because SSAs occur more frequently in the right colon during initial and follow-up colonoscopies.
Adenocarcinoma ; Adenoma ; Cecum ; Colon ; Colonoscopy ; Colorectal Neoplasms ; Follow-Up Studies ; Humans ; Korea ; Male ; Medical Records ; Retrospective Studies