Search

Background: Non-radical management is an option for good responders to neoadjuvant chemoradiotherapy in mid-to-low rectal cancer. This study aimed to analyze risk factors for lymph node metastasis in patients with ypT2 rectal cancer, exploring the possibility of non-radical management. Methods: We included patients with ypT2 rectal cancer who received neoadjuvant chemoradiotherapy followed by total mesorectal excision between January 2004 and December 2022. Clinicopathological parameters were evaluated to identify risk factors for lymph node metastasis. Results: Among the 198 patients, 158 (79.8%) had ypT2N0 and 40 (20.2%) had ypT2N+. In univariable analyses, the risk factors of lymph node metastasis were perineural invasion (48.0% vs. 16.3% without perineural invasion, P < 0.001), female sex (30.0% vs. 14.8% with male sex, P = 0.011), and clinically positive nodes after neoadjuvant chemoradiotherapy (32.6% vs. 16.4% with negative nodes, P = 0.017). These factors were confirmed as independent risk factors in multivariable analyses: perineural invasion (odds ratio [OR]: 4.50; 95% confidence interval [CI]: 1.79–11.29; P < 0.001), female sex (OR: 2.62; 95% CI: 1.24–5.52; P = 0.012) and clinical node involvement after neoadjuvant chemoradiotherapy (OR: 2.28; 95% CI: 1.03–5.05; P = 0.012). The rate of lymph node metastasis in patients with ypT2 rectal cancer without any of these three risk factors was 12.5%. Conclusions: This study revealed a high probability of lymph node metastasis in patients with ypT2 rectal cancer, even in the absence of identifiable risk factors. We confirm that lymph node metastasis should be considered in ypT2 rectal cancer. [ABSTRACT FROM AUTHOR]

Aim: Preoperative factors predictive of permanent stoma creation were investigated in a long‐term follow‐up of patients with mid or low rectal cancer. Method: We included patients who underwent radical resection for mid or low rectal cancer with available data for preoperative anal function measured by manometry and Faecal Incontinence Severity Index questionnaire between January 2005 and December 2015 in three tertiary referral hospitals. A permanent stoma was defined as a stoma present until the patient's last follow‐up visit or death. Preoperative factors that predicted permanent stoma creation were analysed. Results: Over a median follow‐up of 57.4 months (range 12–143 months), a permanent stoma was created in 144/577 (25.0%) patients, including 89 (15.4%) who underwent abdominoperineal resection, one (0.2%) who underwent Hartmann's operation without reversal, 15 (2.6%) with a diverting ileostomy at the time of initial sphincter‐preserving surgery without undergoing stoma reversal, and 39 (6.8%) who underwent permanent ileostomy formation after sphincter‐preserving surgery. Patients with permanent stoma creation had a shorter tumour distance from the anal verge (P < 0.001), larger tumour size (P = 0.020) and higher preoperative Faecal Incontinence Severity Index score (P = 0.020). On multivariable analysis, tumour distance from the anal verge predicted permanent stoma formation (relative risk 0.53 per centimetre increase; 95% confidence interval 0.46–0.60; P < 0.001) but preoperative anal function did not. Conclusion: Tumour distance from the anal verge was the only preoperative determinant of permanent stoma creation in rectal cancer patients. These data may help mid and low rectal cancer patients understand the need for permanent stoma. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the association between Twitter exposure and the number of citations for coloproctology articles. Method: Original articles from journals using Twitter between June 2015 and May 2016 were evaluated for the following characteristics: publishing journal; article subject; study design; nationality, speciality and affiliation of the author(s); and reference on Twitter. Citation data for these articles were retrieved from Google Scholar (https://scholar.google.com) in January 2018. We performed a univariate analysis using these data followed by a multivariate, logistic regression analysis to search for factors associated with a high citation level, which was defined as accrual of more than five citations. Results: Out of six coloproctology journals listed on the InCites JCR database, three (Diseases of the Colon & Rectum, Colorectal Disease and Techniques in Coloproctology) used Twitter, where 200 (49.5%) out of a total of 404 articles had been featured. Citation rates of articles that featured on Twitter were significantly higher than those that did not (11.4 ± 9.2 vs 4.1 ± 3.1, P < 0.001). In multivariate analysis, Twitter exposure (OR 8.6, P = 0.001), European Union nationality (OR 2.4, P = 0.004), Colorectal Disease journal (OR 3.3, P = 0.005) and systematic review articles (OR 3.4, P = 0.009) were associated with higher citation levels. Conclusion: Article exposure on Twitter was strongly associated with a high citation level. Medical communities should encourage journals as well as physicians to actively utilize social media to expedite the spread of new ideas and ultimately benefit medical society as a whole. [ABSTRACT FROM AUTHOR]

Background: A bidet has been proposed as a replacement for the sitz bath. Like a sitz bath, it brings water into contact with the perineum. However, the high force of water from commercially used electronic bidets may harm the anus. We developed a new electronic bidet and evaluated its effects on anal resting pressure compared with a warm sitz bath. Methods: Forty volunteers used the electronic bidet and sitz bath on separate days. The electronic bidet was newly designed with warm (38 °C) water and very low force (10 mN) with a fountain type of flow. Anal resting pressure at the high-pressure zone was measured before (control) and after the electronic bidet and sitz bath. Pressure changes after bidet or sitz bath were expressed as percentages compared with control. Water temperatures and rectal temperatures were also recorded. Results: The anal resting pressures before the electronic bidet and sitz bath were 90.2 ± 24.6 and 88.1 ± 16.8 mmHg, respectively. At 3 min after the electronic bidet and sitz bath, the anal resting pressures were 71.3 ± 23.4 and 69.6 ± 19.8 mmHg, respectively. The pressure changes compared with the control were 78.2 ± 12.9 and 78.1 ± 12.5 %, respectively, which were not significantly different. The maximal increase and minimal decrease were not significantly different. The rectal temperature was not elevated, and the water temperature decreased significantly with the sitz bath ( p < 0.001). Conclusions: Our new electronic bidet may reduce the anal resting pressure much like a warm sitz bath does. [ABSTRACT FROM AUTHOR]

Copyright of Universitas Psychologica is the property of Pontificia Universidad Javeriana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A numerical method is proposed for accurate heat conduction analysis in a coarse grid system. The key idea is adopting the filtering technique, which is well established in large eddy simulations (LES) for turbulent flow predictions, to reduce the number of grids. To implement the filtering technique to the conduction heat transfer analysis, the effective thermal conductivity between two adjacent cells is decomposed into the filtered thermal conductivity and the subgrid-scale thermal conductivity. The subgrid-scale thermal conductivity is obtained by the dynamic subgrid-scale model. Simulations for one- and two-dimensional conduction heat transfer problems are conducted to verify the usefulness of the present method by comparing results with available analytic solutions and with those obtained in a fine-grid system. [ABSTRACT FROM PUBLISHER]

A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) have been reported to play a role in the degradation of aggrecan, a major component of cartilage. This study was performed to examine the effects of alendronate on the expression of ADAMTS in developing femoral epiphyseal cartilage. Primary cultured chondrocytes from this cartilage were treated with alendronate in vitro and postnatal day 1 rats were injected subcutaneously with alendronate (1 mg/kg) every second day in vivo. The number of cultured chondrocytes and their aggrecan mRNA levels were unaffected by the alendronate treatment at 10−6 to 10−4 m concentrations. The mRNA levels of ADAMTS-1, -2 and -9 in chondrocytes were also unaffected. However, the levels of ADAMTS-5 and -4 were reduced significantly by the same treatment. The thickness of the proliferating chondrocyte layers and the aggrecan mRNA levels in the epiphysis were unaffected by the alendronate treatment in vivo. However, the hypertrophied chondrocyte layers became significantly thicker, and the size of the secondary ossification centre was reduced significantly by the same treatment ( P < 0.05). Both ADAMTS-4 and -5 mRNA expressions were also reduced significantly in vivo. The immunoreactivity against ADAMTS-4 was seen in hypertrophied chondrocytes and reduced significantly by the alendronate treatment. These results suggested that alendronate can inhibit the degradation of aggrecan in the articular cartilage by downregulating the expression of matrix enzymes such as ADAMTS-4 and -5. [ABSTRACT FROM AUTHOR]

This paper describes the prediction of flux behavior in an ultrafiltration (UF) membrane system using a Kalman neuro training (KNT) network model. The experimental data was obtained from operating a pilot plant of hollow fiber UF membrane with groundwater for 7 months. The network was trained using operating conditions such as inlet pressure, filtration duration, and feed water quality parameters including turbidity, temperature and UV254. Pre-processing of raw data allowed the normalized input data to be used in sigmoid activation functions. A neural network architecture was structured by modifying the number of hidden layers, neurons and learning iterations. The structure of KNT-neural network with 3 layers and 5 neurons allowed a good prediction of permeate flux by 0.997 of correlation coefficient during the learning phase. Also the validity of the designed model was evaluated with other experimental data not used during the training phase and nonlinear flux behavior was accurately estimated with 0.999 of correlation coefficient and a lower error of prediction in the testing phase. This good flux prediction can provide preliminary criteria in membrane design and set up the proper cleaning cycle in membrane operation. The KNT-artificial neural network is also expected to predict the variation of transmembrane pressure during filtration cycles and can be applied to automation and control of full scale treatment plants. [ABSTRACT FROM AUTHOR]

The article discusses a study which looked at the impact that free tissue transfers has as a treatment for advanced mandibular osteoradionecrosis (ORN).