The chance of lymph node involvement in T(3) and T(4) rectal cancers is 20% to 60%, a risk sufficiently high that most clinicians favor mesorectal excision rather than less aggressive approaches. Patients who have a complete clinical response of the primary lesions to neoadjuvant therapy may represent a special case. Total mesorectal excision can be accomplished without sacrifice of the anal sphincters, and continence can be preserved. Evolving understanding of patterns of tumor spread and mechanisms of anal continence have resulted in increased use of continence-preserving procedures. Removal of the anal sphincters seems to be advantageous only if the sphincters are directly involved. A few small series suggest that a segmental sphincter resection could result in good local control and continence preservation, even if the sphincters are involved. Areas of controversy currently include the role of neoadjuvant therapy for high rectal lesions, the role of lateral lymph node dissection, and methods of improving anal continence after rectal resection.

https://clincancerres.aacrjournals.org/content/clincanres/13/22/6890s.full.pdf

Multidisciplinary management of patients with advanced rectal cancer.

This work aimed to evaluate the effects of the consumption of two commercial conjugated linoleic acid (CLA) mixtures on lipid content and liver histology of healthy rats. The investigation was carried out using thirty rats divided into three groups: C (control), AE (AdvantEdge®CLA), and CO (CLA One®). The concentration of CLA was 2% of feed consumption, and the animals were supplemented daily for 42 days. The total lipid content of the liver was determined, and the histology of the organ was examined by Transmission Electronic Microscopy. The results of total liver lipid contents did not exhibit significant differences between the groups. With regard to hepatic histology, it was observed that although fat globules were visibly present in higher numbers and bigger size in the CLA groups, the organ histology was considered normal since both cytoplasm and organelles showed integrity. It was concluded that even though liver microscopic images indicated the presence of fat globules in the liver, from a statistical point of view, the supplementation for 42 days did not bring about lipid accumulation, nor did it alter hepatic histology.

/pdf/conjugated-linoleic-acid-supplementation-lipid-content-and-12ppmdrzs3.pdf

Conjugated linoleic acid supplementation: lipid content and hepatic histology in healthy Wistar rats Suplementação com ácido linoleico conjugado: conteúdo de lípides e histologia hepática de ratos Wistar saudáveis

Hereditary non-polyposis colorectal cancer (HN-PCC) is one of the most common autosomal dominant diseases in developed countries. Here, we report on a system to identify the risk of a family having HNPCC based on its history. This is important since population-wide genetic screening for HNPCC is not currently considered feasible due to its complexity and expense. If the risk of a family having HNPCC can be identified/assessed, then only the high risk fraction of the population would undergo intensive screening. Here, we have developed a multi-layer feed-forward neural network to classify families into high-, intermediate- and low-risk categories and compared the result with the benchmark logistic regression model

A Comparison of Multi-Layer Neural Network and Logistic Regression in Hereditary Non-Polyposis Colorectal Cancer Risk Assessment

Treatment for NASH: the value of histology.

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Treatment for NASH: the value of histology.