Aging-like Spontaneous Epigenetic Silencing Facilitates Wnt Activation,Stemness, and BrafV600E-Induced Tumorigenesis

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Influences of the colonic microbiome on the mucous gel layer in ulcerative colitis

The colonic mucus gel layer (MGL) is a critical component of the innate immune system acting as a physical barrier to microbes, luminal insults, and toxins. Mucins are the major component of the MGL. Selected microbes have the potential to interact with, bind to, and metabolize mucins. The tolerance of the host to the presence of these microbes is critical to maintaining MGL homeostasis. In disease states such as ulcerative colitis (UC), both the mucosa associated microbes and the constituent MGL mucins have been shown to be altered. Evidence is accumulating that implicates the potential for mucin degrading bacteria to negatively impact the MGL and its stasis. These effects appear more pronounced in UC.   This review is focused on the host-microbiome interactions within the setting of the MGL. Special focus is given to the mucolytic potential of microbes and their interactions in the setting of the colitic colon.     

In Vivo Viscoelastic Response (VisR) Ultrasound for Characterizing Mechanical Anisotropy in Lower-Limb Skeletal Muscles of Boys with and without Duchenne Muscular Dystrophy

Our group has previously found that in silico, mechanical anisotropy may be interrogated by exciting transversely isotropic materials with geometrically asymmetric acoustic radiation force excitations and then monitoring the associated induced displacements in the region of excitation. We now translate acoustic radiation force-based anisotropy assessment to human muscle in vivo and investigate its clinical relevance to monitoring muscle degeneration in Duchenne muscular dystrophy (DMD). Clinical anisotropy assessments were performed using Viscoelastic Response ultrasound, with a degree of anisotropy reflected by the ratios of Viscoelastic Response relative elasticity (RE) or relative viscosity (RV) measured with the asymmetric radiation force oriented parallel versus perpendicular to muscle fiber alignment. In vivo results from rectus femoris and gastrocnemius muscles of boys aged ～7.9–10.4 y indicate that RE and RV anisotropy ratios in rectus femoris muscles of boys with DMD were significantly higher than those of healthy control boys (RE: DMD?=?1.51 ± 0.87, control?=?0.99 ± 0.69, p?=?0.04, Wilcoxon rank sum test; RV: DMD?=?1.04 ± 0.71, control?=?0.74 ± 0.22, p?=?0.02). In the gastrocnemius muscle, only the RV anisotropy ratio was significantly higher in dystrophic than control patients (DMD?=?1.23 ± 0.35, control?=?0.88 ± 0.31, p?=?0.04). In the dystrophic rectus femoris muscle, the RE anisotropy ratio was inversely correlated (slope?=?–0.03/lbf, r?=?–0.43, p?=?0.07, Pearson correlation) with quantitative muscle testing functional output measures but was not correlated with quantitative muscle testing in the dystrophic gastrocnemius. These results suggest that Viscoelastic Response RE and RV measures reflect differences in mechanical anisotropy associated with functional impairment with dystrophic degeneration that are relevant to monitoring DMD clinically.     

PDCA教学模式在完全中间入路腹腔镜右半结肠CME术中的应用价值

目的探讨PDCA教学模式在完全中间入路腹腔镜右半结肠CME术中的应用价值。方法以2017年1月1日—8月1日时间段随机选取23例于我院行完全中间入路腹腔镜右半结肠癌CME术的患者,依据建档顺序作为对照组,以及2018年1月1日—8月1日时间段随机选取23例我科在施行PDCA教学模式后行相同术式,相同入路,依据建档顺序作为研究组。通过比较实施PDCA学习模式前后,两组手术的手术时间、术中出血量、淋巴结清扫情况、术后恢复时间及住院时间等疗效指标。结果应用PDCA教学模式后,淋巴结清扫更彻底、手术时间缩短、术中出血量减少(P<0.05)。而肠功能恢复时间和术后住院时间上差异无统计学意义(P>0.05)。结论应用PDCA教学模式后,在进行完全中间入路腹腔镜下右半结肠CME手术过程中,熟练度及手术质量有提高,效果显著。     

Colon Cancer Tumor Location Defined by Gene Expression May Disagree With Anatomic Tumor Location

BackgroundCancers of the right colon have been shown to differ from left-side colon cancers in prognosis, response to epithelial growth factor receptor inhibitors, microsatellite instability and BRAF mutation status, and other molecular characteristics. Clinical application of these differences will benefit from a deeper understanding of how tumor location defines and is defined by gene expression.Materials and MethodsThis study was carried out using Affymetrix microarray datasets (Cohort A: training set, n = 352; validation set, n = 519) and samples from The Cancer Genome Atlas Colon Adenocarcinoma database (Cohort B: n = 408), in which tumor location was reported. Gene expression patterns characteristic of tumor side were identified in a manner unbiased by statistical classification method.ResultsIn the Cohort A validation set, the anatomic locations of 75% of tumors agree with the locations predicted by gene expression (so-called genomic location), whereas 8% of tumors had genomic locations discordant with their anatomic locations, and 17% of tumors had ambiguous genomic locations. Genomic location was a better predictor of microsatellite instability, CpG island methylator phenotype status, and BRAF mutation status than anatomic location. Tumors with ambiguous genomic location were significantly (P = 1.3 × 10⁻⁷) more likely to have the mesenchymal consensus molecular subtype (40%) than those with a specific genomic location (18%). A genomic signature to predict genomic location was defined.ConclusionTumor location is increasingly considered in deciding treatment of a colon tumor. We showed that genomic location was superior to anatomic location as a predictor of molecular characteristics, suggesting that it may be a more accurate predictor of response.     

A dermoid cyst fistulating with the transverse colon

We present a rare case of fistulation of a dermoid cyst with the transverse colon. We illustrate how an infected dermoid cyst can be diagnosed as an appendix abscess although the management of these is quite different. The general surgeon should be aware of this as a differential diagnosis for an appendix abscess.